Medicine and Health Sciences Commons^™

Three Patients Needing High Doses Of Valproic Acid To Get Therapeutic Concentrations, James Jackson, Betsy Mccollum, Judy Ognibene, Francisco J. Diaz, Jose De Leon

Psychiatry Faculty Publications

Valproic acid (VPA) can autoinduce its own metabolism. Cases requiring VPA doses >4000 mg/day to obtain therapeutic plasma concentrations, such as these 3 cases, have never been published. Case 1 received VPA for seizures and schizophrenia and had >50 VPA concentrations in 4 years. A high dose of 5,250 mg/day of VPA concentrate was prescribed for years but this dose led to an intoxication when switched to the enterocoated divalproex sodium formulation, requiring a normal dose of 2000 mg/day. VPA metabolic capacity was significantly higher (t = -9.6; df = 6.3, p < 0.001) during the VPA concentrate therapy, possibly due to autoinduction in that formulation. Case 2 had VPA for schizoaffective psychosis with 10 VPA concentrations during an 8-week admission. To maintain a VPA level ≥50 μg/mL, VPA doses increased from 1500 …

Coffee: A Selected Overview Of Beneficial Or Harmful Effects On The Cardiovascular System?, Thomas F. Whayne Jr.

Internal Medicine Faculty Publications

With a history that began in 800 A.D., coffee is the most popular drink known and as a result, the issues regarding its physiologic effects deserve attention. Maintaining alertness is a well-known benefit and in addition, the cardiovascular (CV) effects of the active compounds, which include polyphenols and caffeine, must be considered. Genetics are relevant and where slow caffeine metabolism is inherent, the risk of nonfatal myocardial (MI) has been shown to be increased. Overall risk for coronary heart disease (CHD) is not supported and unless there is excessive intake, congestive heart failure (CHF) is not adversely affected; in moderation, …

Designing For Dissemination: Lessons In Message Design From "1-2-3 Pap", Elisia L. Cohen, Katharine J. Head, Margaret J. Mcgladrey, Anna G. Hoover, Robin C. Vanderpool, Colleen Bridger, Angela Carman, Richard A. Crosby, Elaine Darling, Mary Tucker-Mclaughlin, Nancy Winterbauer

Communication Faculty Publications

Despite a large number of evidence-based health communication interventions tested in private, public, and community health settings, there is a dearth of research on successful secondary dissemination of these interventions to other audiences. This article presents the case study of "1-2-3 Pap," a health communication intervention to improve human papillomavirus (HPV) vaccination uptake and Pap testing outcomes in Eastern Kentucky, and explores strategies used to disseminate this intervention to other populations in Kentucky, North Carolina, and West Virginia. Through this dissemination project, we identified several health communication intervention design considerations that facilitated our successful dissemination to these other audiences; these …

Factors Facilitating Constructive Coping With Stress, Kamilla Bargiel-Matusiewicz, Hatim A. Omar

Pediatrics Faculty Publications

This review focuses on coping with stress, with particular emphasis on mechanisms facilitating constructive coping with stress. An important area of contemporary research is the attempt to identify factors that make it possible to stay mentally healthy or preventing the weakening of the cognitive and social functioning. The currently prevailing approach to stress is the relational approach. According to this approach, the criterion for the occurrence of stress is the cognitive assessment of the situation made by an individual. This review presents the most recent proposals concerning the analysis of specific methods of coping with stress, in particular from the …

Revisiting Menstrual Bleeding Patterns In Adolescents Using Etonogestrel (Eng) Implant, Anna Iddings, Hatim A. Omar

Pediatrics Faculty Publications

Etonogestrel (ENG) implant is an effective method of contraception. The implant is designed to provide contraceptive efficacy for three years with a relatively quick return of fertility upon its removal. Dysfunctional uterine bleeding (DUB) is a common side effect of long acting progestins and is often the reason patients state for removal or discontinuation. A retrospective chart analysis was completed on 292 patients who chose to be on the ENG implant. Age of patients ranged from 10-29 years of age with the average age at implant being 17 years +/- 3 years. Patients retained implant for 1-68 months with the …

Cyberbullying In Adolescents: The Prevalence Of Mental Disorders And Suicidal Behavior, Elizabeth L. Mirsky, Hatim A. Omar

Pediatrics Faculty Publications

This paper defines the phenomena of cyberbullying in relation to traditional bullying, along with its negative consequences on adolescents in modern society. The reasons for the highly destructive effects of cyberbullying are given along with information about psychological instability resulting from the occurrence of cyberbullying. The correlation of cyberbullying with suicidal thoughts and behaviors is also discussed. Finally, some prevention techniques are listed in an attempt to lower the prevalence of cyberbullying.

Syphilis: The Forgotten Sexually Transmitted Disease. A Brief Case Report, Amy Burnett, Hatim A. Omar

Pediatrics Faculty Publications

Syphilis has declined significantly over the last 30 years. Due to that success, many physicians no longer have the skills to recognize its symptoms. We present a case of syphilis as a demonstration of this fact.

Hiv And Minority Youth, Mandakini Sadhir, Hatim A. Omar

Pediatrics Faculty Publications

Human Immunodeficiency virus (HIV) infection is a major public health problem with the burden of disease increasing in adolescents and young adults particularly among black males and males who have sex with males (MSM).

Paper I: Stress In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

Part Ii - Stress And Stress Management Strategies In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

The Importance Of Comprehensive Sexuality Education In Adolescents, Sarah Lebrun, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Female Athlete Triad Review, Hannah Harrison, Hatim A. Omar

Pediatrics Faculty Publications

This article defines the female athlete triad and discusses long-term consequences for adolescents and women symptoms related to the triad. The pillars of the female athlete triad consist of menstruation disruption, decreased bone mineral density, and disordered eating (energy availability). We will discuss the problems that can arise from each of the three pillars of the female athlete triad and the relationships among them. There are different treatments for the triad based on the needs of the individual and new treatments are being researched. Finally, the need for more informed coaches, parents, and medical professionals is discussed.

Effective Youth Suicide Prevention: Evidence From Kentucky, Dessi Slavova, Hatim A. Omar

Pediatrics Faculty Publications

In 2013, Suicide was the second leading cause of death among U.S. young adolescents (15-19 years of age), accounting for 18.4% of all deaths in this age group. According to a nationally representative study on the lifetime prevalence of adolescent suicidal behaviors, 12.1% of U.S. adolescents experience suicidal ideation, 4.0% develop a plan, and 4.1% attempt suicide. The same study estimated that approximately 60% of young people with a suicide plan will attempt suicide, and most of the adolescents who subsequently make an attempt do so within the first year after the onset of ideation.

These findings support the importance …

Children With Asthma: What About The Quality Of Life Of Their Parents?, Anna Trzcieniecka-Green, Kamilla Bargiel-Matusiewicz, Agnieszka Wilczyńska, Hatim A. Omar

Pediatrics Faculty Publications

An increased frequency of asthma in children has been lately observed. The course of asthma depends not only on treatment. but also on the actions taken by the parents of a sick child. Design: A non-experimental cross-sectional design. Methods: In this study the Pediatric Asthma Quality of Life Questionnaire (PACQLQ) and Satisfaction with Life Scale (SWLS) were administered to 60 parents of children with :asthma. Two groups of parents were compared. The first group consisted of parents of children who had been diagnosed with asthma less than three months before the beginning of the study. The second group consisted of …

Starting Off, Hatim A. Omar

Pediatrics Faculty Publications

This book is really a reflection of the past 15 years of work with teens and suicide prevention in the state of Kentucky. The work to establish the "Stop Youth Suicide Campaign (SYS)" has resulted in contact with many young adults and we have found that the most important thing for all of them, was finding a caring person they trust and can talk to. Because of the constant need, the SYS went from a goal of one year awareness campaign to a major community resource, to work with the state and local governments and state legislators to add as …

Disability And Suicide, Divya Nagraj, Hatim A. Omar

Pediatrics Faculty Publications

We provide a systematic review of suicide among adolescents with physical disabilities, intellectual disability and learning disability. A search was performed of English articles published prior to December 2014 in the PubMed database for studies examining suicide, suicidal behavior and suicidal ideation among adolescents with and without varied disabilities. Nine studies were retrieved, of which two studies examined adolescent populations with physical disabilities, three looked at suicide in adolescents with intellectual disability and four studies examined adolescents with learning disabilities. There were consistent results to prove that these adolescents with special needs had an increased tendency to commit suicide and …

Self-Cutting And Suicide In Adolescents, Donald E. Greydanus, Hatim A. Omar

Pediatrics Faculty Publications

Deliberate self-harm (DSH) is a common and typically secret phenomenon in adolescents, especially females that involves two main features—self-derogation and negative emotionality. Causes of non-suicidal self-injury include attempts to get help from professionals, express disgust or self-anger, resist suicidal thoughts, and correct episodes of dissociation. DSH is associated with eating disorders and alcohol abuse, as well as other illict drug abuse. Fortunately, most self-cutters are not at high risk for eventual suicide; however, all those with DSH histories should be carefully assessed for suicide as well as offered comprehensive management. Programs for prevention of suicide should be implemented for adolescents …

Law And Ethics Of Experiments On Social Media Users, James Grimmelmann

Cornell Law Faculty Publications

If you were on Facebook in January 2012, there is a chance that it tried to make you sad. If you were on OkCupid, there is a chance that it tried to match you up with someone incompatible. These were social psychology experiments: Facebook and OkCupid systematically manipulated people's environments to test their reactions. Academics doing similar experiments in a university setting would typically need to obtain informed consent from participants and approval from an Institutional Review Board (IRB). But Facebook and OkCupid, and the academics working with Facebook, had neither. This, I believe, is a problem.

These experiments offer …

Nutrition Knowledge, Choices, Attitudes, Bmi, And Height And Weight Perception Among Mississippi Firefighters, Abby Evans

Electronic Theses and Dissertations

The purpose of this study was to determine the nutrition knowledge, nutrition choices, nutrition attitudes, height and weight perception, and current body mass indices (BMI) of recruits at the Mississippi Fire Academy in Jackson, Mississippi and professional firefighters with the Oxford Fire Department in Oxford, Mississippi. All participants were asked directly by in-person visits to complete a voluntary questionnaire to assess their dietary knowledge, choices, and attitudes, body mass indices, and height and weight perception. Recruits varied in age from 18–65 plus years. It was predicted that firefighters would have on average a high BMI, indicating a large prevalence of …

Evaluation Of Novel Ligands For Opioid Receptors, Amer Hussien Tarawneh

Electronic Theses and Dissertations

No abstract provided.

Design, Synthesis And Cannabinoid Receptor Activity Of Benzofuran Ligands, Eric William Bow

Electronic Theses and Dissertations

The endocannabinoid system is a complex homeostatic signaling system controlled through the actions of two g-protein coupled receptors, cannabinoid receptor 1 (cb1) and cannabinoid receptor 2 (cb2). Significant neuronal expression and distribution of cb1 throughout the brain establishes its function as a major synaptic signaling receptor, and in regards to the actions of cannabis sativa, it is the primary mediator of the psychotropic effects of marijuana. Conversely, cb2 expression is confined to microglial cells in the brain and predominantly peripheral immune cells. The expression of cb2 provides a pharmacological basis for the well-documented immunomodulatory effects of cannabis, providing a potential …

Development Of The Medication Non-Adherence Scale (Mnas) And The Medication Non-Persistence Scale (Mnps), Amod Sudhir Athavale

Electronic Theses and Dissertations

No abstract provided.

Developing Executive Functions Through Mindfulness Training In School-Aged Children, Ashley Black Adams

PCOM Psychology Dissertations

Well-developed executive functions are necessary for successful classroom functioning. Students with executive function deficits can fall behind academically as well as socially and emotionally, relative to their same-aged peers. Effective interventions for developing executive functions within the school environment are essential for addressing this issue. This study examines changes in students’ executive functions as a result of their participation in a mindfulness training intervention. Participants included four ten-year old elementary school boys who took part in a ten-week mindfulness training intervention. The data were generated through pre and post assessments with an executive function teacher rating scale and a Goal-Attainment …

The Anxiolytic Effects Of Self-Selected Music Among Primary Care Patients, Jennifer West-Gavin

PCOM Psychology Dissertations

The primary care setting is commonly referred to as the first line of medical treatment sought for health related services. Anxiety is one of the most frequently encountered mental health issues in primary care. The purpose of this study was to examine the level of state anxiety experienced among primary care patients, attending for routine and nonroutine appointments; its further purpose was to examine if self-selected relaxing music accounts for the greatest reductions in state anxiety among primary care patients, as compared with investigator-selected (classical) music, audio commercials, or no music. Patients included a primarily underserved primary care population between …

The Relationship Between Adhd And Trait Facets Of The Five-Factor Model, Todd William Bennett

PCOM Psychology Dissertations

Facets of the Five-Factor Model (FFM) were examined in order to understand its interaction with Attention Deficit Hyperactivity Disorder (ADHD)-symptoms. By utilizing archival data, in a correlational design, adults between the ages of 18-66 were tested for the presence of ADHD, which was then compared with data gathered from the NEO-PI-R. Comorbid psychiatric conditions often associated with ADHD were accounted for in the design. Results partially supported the hypotheses, specifically, that altruism was inversely related to Impulsivity, as predicted. However, other findings largely did not support a relationship between other specific NEO-PI-R facets and ADHD. Other significant relationships that were …

Impacts Of Objective And Subjective Social Inclusion On The Quality Of Life Of Individuals With Schizophrenia Spectrum Disorders And Major Depressive Disorder, Katie A. Johanning-Gray

PCOM Psychology Dissertations

Increased social inclusion and enhanced quality of life for individuals with severe mental illnesses (SMIs) are goals of the recovery movement. The present study examined the differences in reported subjective social inclusion (SubSI) and objective social inclusion (ObjSI) between individuals diagnosed with schizophrenia spectrum disorders (SSDs) and those diagnosed with Major Depressive Disorder (MDD). Furthermore, the amount of variance in quality of life (QOL) which can be predicted by type of diagnosis, SSDs or MDD, symptom severity, and SubSI and ObjSi was determined. An archival data set was used. Participants were 337 individuals whose primary diagnosis was an SSD or …

Siblings Of Children With Long Qt Syndrome: Relationships And Coping, Courtney Mccuen-Wurst Ms, Lcsw

PCOM Psychology Dissertations

Long QT syndrome (LQTS) is a congenital heart disorder, usually diagnosed in childhood, that may lead to cardiac arrest, seizures, syncope, and sudden death. The birth of a child with LQTS, as well as the social, physical, and psychological functioning of the affected child, can have a significant impact on the family. The family stress associated with having a child with any disability or chronic illness is likely to affect the lives of siblings. The lack of research on the effects of having a sibling with long QT syndrome on individuals who do not have LQTS provided the rationale for …

Breast Cancer Screening For African American Women, Jennifer Ross

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

INTRO Breast cancer is the most common type of malignancy among women in the United States (U.S.) and the second leading killer. Despite the availability of effective breast screening tools, a disparity has formed. Specifically, white women over the age of 40 experienced a higher incidence rate of breast cancer, while African American women experience higher related mortality rate. The purpose of this study was to examine SES and ethnicity/race factors that may influence breast cancer screening rates, and specifically explore how those factors may differ between African American and white women.

METHODS Women between the ages of 50-74 who …

Impact Of Kentucky Vaccination Exemption Laws On Pertussis Incidence, Katherine Blain

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Purpose: According to CDC statistics, prior to pertussis vaccine development in the 1940’s, about 200,000 children contracted pertussis annually. Today, although this number has decreased drastically, pertussis cases began trending upward again in the 1980’s. There are several proposed contributory factors, including vaccination exemption. In Kentucky, there are both medical and religious exemptions to mandatory school vaccines. The purpose of this study was to examine possible correlations between reported school vaccination exemptions and pertussis incidence in Kentucky counties between the years 2004-2012.

Methods: This study retrospectively analyzed data from 120 Kentucky counties between 2004-2012. The Commonwealth of Kentucky School Annual …

The Comorbidity And Temporal Relationship Between Anxiety Disorders, Eating Disorders, And Personality Disorders, Mitchell C. Duross

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background - Population-level data on the prevalence of comorbidity between anxiety-, eating-, and personality disorders remain relatively unexplored. Additionally, the potential existence of a temporal relationship among these three classes of mental disorder is also of interest.

Methods - Lifetime prevalence of, and temporal relationships among, anxiety-, eating-, and personality disorders were assessed using Part II WHO Composite International Diagnostic Interview data from the National Comorbidity Survey- Replication, a nationally representative household survey (n=5692).

Results - Lifetime prevalence estimates for any anxiety-, eating-, and personality disorder were 59.8%, 2.8%, and 13.5%, respectively, among those diagnosed with at least one core …