Medicine and Health Sciences Commons^™

Grades In Prerequisite Courses As Predictors Of Success In A Nursing Program, Elaine Zeilke Foster

Dissertations

Problem: The U.S. Bureau of Labor Statistics forecast that by 2016 more than one million new and replacement nurses will be needed to fill jobs in the health care field . In order to meet the medical needs of a changing society, schools of nursing must continue to educate and graduate significant numbers of nurses. This may be done by increasing the success rates of those who are admitted in nursing programs. Success rate is thought to be related to admission criteria used to admit students which, in turn, may reduce attrition rate, which is between 20 to 40% in …

What Nurses Say: Communication Behaviors Associated With The Competent Nursing Handoff, Anne Claiborne Ray Streeter

University of Kentucky Doctoral Dissertations

Communication competence and medical communication competence served as the theoretical framework for this research that seeks to identify specific communication behaviors associated with what nurses say constitute a communicatively competent patient handoff at the nursing change of shift. Data collected from 286 nurses responding to an online modified Medical Communication Competence Scale posted at www.allnurses.com supported the hypotheses that information exchange (information giving, seeking and verifying) and socioemotional communication behaviors are rated more highly in the best patient handoffs than in the worst ones. Research questions found that the incoming nursing role rated behaviors associated with information verifying and socioemotional …

Health System Processes, Clinician Attitudes, And Referrals To Tobacco Treatment Programs, Karma Bryan Cassidy

University of Kentucky Doctoral Dissertations

Assisting smokers to quit and stay quit is the most important intervention clinicians can undertake to improve the length and quality of life of patients who use tobacco. The chronic, relapsing nature of tobacco dependence complicates tobacco treatment. Tobacco treatment counseling programs provide on-going support to help patients avoid relapse. Assistance with a referral increases the likelihood that patients will participate in counseling, but few clinicians regularly assist with referrals to tobacco treatment programs. This dissertation examined health system processes and clinician attitudes that influence the likelihood that clinicians will refer their patients for tobacco treatment counseling.

Three papers examined …

Cardiac Rhythm During Mechanical Ventilation And Weaning From Ventilation, Muna Hassan Hammash

University of Kentucky Doctoral Dissertations

The transition from mechanical ventilation (MV) to spontaneous ventilation during weaning is associated with hemodynamic alterations and autonomic nervous system (ANS) alterations (reflected by heart rate variability [HRV]). Although cardiac dysrhythmias are an important manifestation of hemodynamic alterations, development of dysrhythmias during MV and weaning and subsequent impact on length of MV has received little attention.

The purposes of this dissertation were to 1) evaluate the relationship of heart rate variability (HRV) during weaning to the development of cardiac dysrhythmias and 2) determine the relationship of cardiac dysrhythmias to length of MV.

A convenience sample of 35 patients (66.7% men; …

Modulation Of The Alpha-7 Nicotinic Acetylcholine Receptor Following Experimental Rat Brain Injury Improves Cellular And Behavioral Outcomes, Thomas Matt Woodcock

University of Kentucky Doctoral Dissertations

Traumatic brain injury (TBI) is a leading cause of death and long-term disability worldwide, and survivors are often left with cognitive deficits and significant problems with day to day tasks. To date, therapeutic pharmacological treatments of TBI remain elusive despite numerous clinical trials. An improved understanding of the molecular and cellular response to injury may help guide future treatment strategies. One promising marker for brain injury is the translocator protein (TSPO), which is normally expressed at a low level, but is highly expressed following brain damage and is associated with neuroinflammation. The isoquinoline carboxamide PK11195 binds selectively to the TSPO …

Negotiating Equitable Access To Influenza Vaccines: Global Health Diplomacy And The Controversies Surrounding Avian Influenza H5n1 And Pandemic Influenza H1n1, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

The Isolation Of Viruses Infecting Archaea, Kenneth M. Stedman, Kate Porter, Mike L. Dyall-Smith

Biology Faculty Publications and Presentations

A mere 50 viruses of Archaea have been reported to date; these have been investigated mostly by adapting methods used to isolate bacteriophages to the unique growth conditions of their archaeal hosts. The most numerous are viruses of thermophilic Archaea. These viruses have been discovered by screening enrichment cultures and novel isolates from environmental samples for their ability to form halos of growth inhibition, or by using electron microscopy to screen enrichment cultures for virus-like particles. Direct isolation without enrichment has not yet been successful for viruses of extreme thermophiles. On the other hand, most viruses of extreme halophiles, the …

Racial /Ethnic Differences In Susceptibility And Intention To Smoke On Smoking Behavior Among Adolescents, Kafilat Tolani Jimba

Walden Dissertations and Doctoral Studies

Every year, more than 400,000 Americans die prematurely because of tobacco use, and most users began smoking during their teen years. Adolescent tobacco use remains the nation's most preventable threat to life and health. A better understanding of the relationships between susceptibility to smoking and intention to smoke on smoking behavior by ethnicity, age, and gender is useful for program planners and health educators in designing ethnic, age, and gender specific strategies for tobacco control and prevention initiatives. The purpose of this study was to test the relationships between susceptibility to smoking and intention to smoke on smoking behavior among …

The Impact Of Stakeholder Collaboration On Effectiveness Of Health Program Implementation In Ghana, Samuel Kwami Agbanu

Walden Dissertations and Doctoral Studies

Healthcare providers increasingly recognize the importance of collaboration among stakeholders in cost-effective healthcare delivery. While collaborative relationships offer great advantages, little research has addressed their relevance in an international development aid context, particularly in sub-Saharan Africa. The region is a major recipient of international development support, yet health indicators on HIV/AIDS, malaria, tuberculosis, and child and maternal mortality indicate the health of the region is among the weakest worldwide. This sequential mixed method, descriptive study of a USAID-funded community health program in Ghana examined the nature of collaboration among six stakeholders and impact of this collaboration on effectiveness of program …

Social Capital Variables As Predictors Of Hiv Risk-Taking Behaviors Among Sub-Saharan African Immigrants In The United States, Gbadebo Ogundiran Ogungbade

Walden Dissertations and Doctoral Studies

Vulnerable populations, including immigrants, are often at risk for human immunodeficiency virus (HIV) infection because of their risk-taking behaviors. This study investigated risk-taking behavior for HIV infection among Sub-Saharan African (SSA) immigrants in United States. Using social capital as a theoretical foundation, the study aimed to address the question, is there any association between social capital assets of educational opportunity, employment, and eligibility for social assistance and HIV risk-taking behavior, defined as condom use before sex (CUBS) among SSA immigrant in the U.S? Potential participants were recruited through religious and social organizations in a southwestern US state. The survey generated …

The Effect Of Direct Contact On Public Attitudes Towards People Living With Human Immunodeficiency Virus (Hiv) And Acquired Immune Deficiency Syndrome (Aids) In Zimbabweans, Mavis Mashingaidze

Walden Dissertations and Doctoral Studies

Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. Allport's contact hypothesis was hypothesis was the theoretical frame used to assess the effect of direct contact on public attitudes towards people living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Zimbabweans with the …

To What Extent Is The Spirit Of Motivational Interviewing Present In The Experience Of Alcoholics Anonymous Members?, Mark Williams

Theses : Honours

More people tum to Alcoholics Anonymous (AA) in an attempt to recover from alcohol dependence than any other intervention. AA has historical links with confrontational approaches to alcohol treatment, and motivational interviewing (MI) was conceived by Miller in the 1980's as an alternative to these confrontational approaches. There are divided opinions on whether AA is confrontational; therefore, the primary aim of this qualitative study was to gain an insight into how the spirit of AA is experienced by its members. Ten members of AA were interviewed using a semi-structured interview schedule. Thematic analysis from a constructionist perspective was utilised in …

Experiences And Perceptions Of How Community-Based Interventions Can Promote Young Adults' Resilience To Suicide Within Rural/Regional Communities, Tracy Evans

Theses : Honours

In the literature, both statistics and studies have noted that suicide in rural/regional young adults' is an important concern. Recent research suggests, that to facilitate a primary approach to suicide prevention in young people, there is a need to promote the protective construct of resilience at a community level, highlighting strategies such as connectedness, and decreasing the stigma related to mental illness and health-seeking behaviour (Commonwealth Department of Health & Aged Care, 2005; Injury Control Council of Western Australia, 2006). However, there is a need to investigate and identify the links or mediating factors that promote individual resilience within a …

Quantification Of Circulating Melanoma Cells, Jamie Freeman

Theses : Honours

Current prognostic techniques for Cutaneous Malignant Melanoma (CMM), a highly aggressive and drug resistant skin cancer, are inadequate at managing the disease and identifying early stage patients requiring treatment. It is thought that Circulating Tumour Cells (CTCs), which circulate in patient blood after being shed from solid tumours, may be useful in enhancing prognostic techniques and it has previously been shown in other malignancies that the presence of CTCs in patient blood is associated with poor prognosis. In CMM, CTCs can be detected through RT-PCR for melanoma associated markers, although this technique does not allow CTCs to be quantified. In …

The Work Practices And Employment Patterns Of Parents Of A Child With Rett Syndrome, Jessica Coles

Theses : Honours

Objective: To review the literature examining the work practices and employment patterns of parents of a child with an intellectual disability, with a specific focus on Rett syndrome. Method: Electronic database searches of Medline, Cinahl and ISI Web of Knowledge and manual searches of reference lists were conducted. Government Reports obtained from Australian Bureau of Statistics were also examined. Quality of articles was assessed using Qualitative and Quantitative Assessment Checklists from Standard Quality Assessment Criteria for Evaluating Primary Research Papers used to assess quality of literature. Results: The work practices and employment patterns of parents of children …

Day Therapy Programs For Adolescents With Mental Health Problems: A Systematic Review, Yamini Deenadayalan, Saravana Kumar, Zuzana Machotka, Luke Perraton

Internet Journal of Allied Health Sciences and Practice

Day therapy programs are one of many interventions available for adolescents with mental health issues. Day therapy programs utilise a multi-disciplinary community-based approach to the treatment of mental health issues and allow adolescents to remain under the care of their family. To date, no review has specifically investigated the effectiveness of day therapy programs for adolescents. This review aims to investigate both the effectiveness of day therapy programs for adolescents with mental health problems and highlight the key components underpinning these programs. A systematic review of peer- reviewed literature was undertaken, using recognised processes. Eight studies were included in this …

Emergency Department Physical Therapist Service: A Pilot Study Examining Physician Perceptions, Michele T. Lebec, Steven Cernohous, Lisa Tenbarge, Colleen Gest, Kristen Severson, Sharon Howard

Internet Journal of Allied Health Sciences and Practice

Though physical therapist consultation has been described as a means of enhancing care in the Emergency Department (ED), such services are rare and often poorly understood. This pilot study utilizes qualitative methodology for the purpose of describing how one group of emergency physicians experienced with physical therapist consultation in the ED perceive these services and the challenges associated with their provision. Transcripts of interviews with 11 emergency physicians were analyzed for recurrent themes. Findings indicated that these physicians found ED physical therapist services to be of value for themselves, their patients, and the department as a whole and described specific …

Review Of: Orthotics And Prosthetics In Rehabilitation, Second Edition., Cindy Laporte

Internet Journal of Allied Health Sciences and Practice

No abstract provided.

Minimizing Injuries And Enhancing Performance In Golf Through Training Programs, Erik P. Meira, Jason Brumitt

Faculty Publications - College of Physical Therapy

Context: Golf is a popular sport, particularly in older populations. Regardless of age and skill level, golfers risk injury to the back, shoulder, wrist and hand, elbow, and knee. Because of the unique compressive, shear, rotational, and lateral bending forces created in the lumbar region during the golf swing, the primary sport-related malady experienced by amateurs and professionals is low back pain. Extrinsic and intrinsic injury risk factors have been reported in the literature. A growing body of evidence supports the prescription of strength training routines to enhance performance and reduce the risk of injury.

Evidence Acquisition: Relevant studies were …

Deep Posterior Compartment Strength And Foot Kinematics In Subjects With Stage Ii Posterior Tibial Tendon Dysfunction, Christopher Neville, Adolph S. Flemister, Jeff Houck

Faculty Publications - College of Physical Therapy

Background: Tibialis posterior muscle weakness has been documented in subjects with Stage II posterior tibial tendon dysfunction (PTTD) but the effect of weakness on foot structure remains unclear. The association between strength and flatfoot kinematics may guide treatment such as the use of strengthening programs targeting the tibialis posterior muscle.

Materials and Methods: Thirty Stage II PTTD subjects (age; 58.1 ± 10.5 years, BMI 30.6 ± 5.4) and 15 matched controls (age; 56.5 ± 7.7 years, BMI 30.6 ± 3.6) volunteered for this study. Deep Posterior Compartment strength was measured from both legs of each subject and the strength ratio …

Oasis Inter-Rater Reliability And Reimbursement: A Study Of Inter-Rater Reliability Of The Outcome And Assessment Information Set (Oasis): Its Effects On The Home Health Resource Group (Hhrg) And Reimbursement, Paul A. Shew

Faculty Publications - College of Physical Therapy

One of the outcomes of the initial Outcome and Assessment Information Set (OASIS) is to establish a level of reimbursement through the Medicare Prospective Payment System (PPS). Several inter-rater reliability (IRR) studies have noted differences in responses to individual questions within the OASIS but little is known about how variations in scoring might affect the final reimbursement projection. In a one-way repeated measures design study, the OASIS was completed on 52 patients by both an RN and a PT within a 24-hour timeframe and the projected reimbursement rates were compared. Fifty-four percent of the outcomes of the assessment pairs were …

Repetitive Eccentric Muscle Contractions Increase Torque Unsteadiness In The Human Triceps Brachii, Andrew Mezsaros, Masaki Iguchi, Shuo-Hsiu Chang, Richard K. Shields

Faculty Publications - College of Physical Therapy

Torque steadiness and low-frequency fatigue (LFF) were examined in the human triceps brachii after concentric or eccentric fatigue protocols. Healthy young males (n = 17) performed either concentric or eccentric elbow extensor contractions until the eccentric maximal voluntary torque decreased to 75% of pre-fatigue for both (concentric and eccentric) protocols. The number of concentric contractions was greater than the number of eccentric contractions needed to induce the same 25% decrease in eccentric MVC torque (52.2 ± 2.9 vs. 41.5 ± 2.1 for the concentric and eccentric protocols, respectively, p < .01). The extent of peripheral fatigue was 12% greater after the concentric compared to the eccentric protocol (twitch amplitude), whereas LFF (increase in double pulse torque/single pulse torque), was similar across protocols. Steadiness, or the ability for a subject to hold a submaximal isometric contraction, was 20% more inpaired during the Ecc protocol (p = .052). Similarly, the EMG activity required to hold the torque steady was nearly 20% greater after the eccentric compared to concentric protocol. These findings support that task dependent eccentric contractions preferentially alter CNS control during a precision based steadiness task.

Acute Musculoskeletal Sports Injury And Topical Nsaid, Amit M. Deokar, Shawn J. Smith, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this chapter is to summarize the current standards of pain management in minor sports related musculoskeletal injuries. We also address the topical form of non-steroidal anti-inflammatory drug as an effective pain management option in an out-patient setting. Design: Quantitive systematic review of randomized controlled trials. Methods: The data was obtained through literature review of articles published in the last 10 years. In addition, FDA information on non-steroidal anti-inflammatory medications was also reviewed. The patient population studied in the articles included children and adults. Conclusion: Current standards of managing pain resulting from sports injuries involve a number of …

Down Syndrome And Sexuality, Maria José Carvalho Sant'anna, Bruna Marques Bononi, André Chao Vasconcellos De Oliveira, Tadeu Silveira Renattini, Carla Franchi Pinto, Maria Lucia Passarelli, Veronica Coates, Hatim A. Omar

Pediatrics Faculty Publications

In recent years important gains and changes have been observed in the life of teenagers with Down syndrome (DS) with increased inclusion into society. This chapter will discuss adolescence and sexuality in teenagers with DS from a descriptive study of 50 patients with DS between the ages of 10 and 20 years. The mean age was 13.5 years, 50% females. 86% went to school with 62.2% in school for over six years. Of the patients that attended school, 60% went to special education school and only 10% read and wrote correctly. In evaluation of autonomy, 66% took shower, 78% performed …

Chronic Illness And Mental Health Issues, Marlene B. Huff, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

By 2015, worldwide, 1.2 billion children aged 5-14 years will have some kind of significant chronic disease. Although scientific evidence indicates that children with chronic illness have more mental health issues than their healthy peers, many controversies and gaps in the literature exist. It is imperative that an understanding of the effects of chronic illness upon the mental health status of children and adolescent be undertaken. This article uses a biopsychosocial perspective to investigate the connection between chronic illness and mental health. The intent of the article is to suggest ways that medical and mental health professionals can provide services …

Educating Adolescents About Puberty: Are We Missing Something?, Hatim A. Omar

Pediatrics Faculty Publications

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of …

Mental Health Aspects Of An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pediatrics Faculty Publications

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this chapter was to identify mental health problems in an adolescent medicine clinic population in Lexington, KY and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. 68% of the patient population was urban, while 32% was rural. In terms of gender, 40% of the patients were male and 60% were female. 80% …

Quality Of Life And Adolescents In Rural Kentucky, Hatim A. Omar, Søren Ventegodt, Joav Merrick

Pediatrics Faculty Publications

In many rural areas in Kentucky, adolescents lack the basic assets for a good quality of life, such as having caring adults, a safe place and useful activities after school. In this chapter we analyze data from middle and high school students referred to a comprehensive school based health promotion center (SBHPC). From August 2006 to February 2008, a total of 382 students (200 female, 182 male, aged 12-18 years) were referred to the SBHPC for help. Only two (0.5%) students had two parents living with them and 12 (3.1 %) had safe, organized after school activities. 19.9% of the …

The Vampire Adolescent, Megan White, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Quality Of Life And Persons With Intellectual Disability: Can We Measure Qol In This Population?, Søren Ventegodt, Hatim A. Omar, Flemming Struve, Tove K. Nielsen, Isack Kandel, Joav Merrick

Pediatrics Faculty Publications

Quality of life (QOL) has been discussed by professionals working with persons with intellectual disability (ID) for some time, but since QOL is concerned with subjective well-being, satisfaction and happiness, how is it possible to measure, when the person in question is unable to communicate? Consciousness is believed to be an internal and personal thing, but we have done the simple experiment to ask observers to rate QOL of another person, also in sub dimensions like self-assessed physical and mental health, relationship with self, self-assessed sexual ability, self-assessed social ability, and we have found that people are able to assess …