Medicine and Health Sciences Commons^™

Using The Re-Aim Framework To Evaluate A Community-Based Summer Camp For Children With Obesity: A Prospective Feasibility Study, Shauna M. Burke, Sheree Shapiro, Robert J. Petrella, Jennifer D. Irwin, Michelle Jackman, Erin S. Pearson, Harry Prapavessis, Joel Kevin Shoemaker

Health Studies Publications

Background

Increasing rates of childhood overweight and obesity highlight a need for the evaluation of lifestyle interventions. The purpose of the study was to determine the Reach, Effectiveness, Adoption, Implementation and Maintenance of a novel family-focused program targeting children with obesity (i.e., the Children’s Health and Activity Modification Program [C.H.A.M.P.]) using the RE-AIM framework, an evaluation tool for community-based health interventions.

Methods

A single-centre, single cohort interventional feasibility study was conducted over the course of two years. Children with obesity and their families completed a 4-week group-based lifestyle intervention in Year 1 (n = 15; M_age = 10.6; …

The Physical Activity Levels And Sedentary Behaviors Of Latino Children In London (Ontario, Canada), Gillian E. Mandich, Shauna Burke, Anca Gaston, Patricia Tucker

Health and Rehabilitation Sciences Publications

OBJECTIVE: To assess the physical activity and sedentary behaviors of a sample of Latino children in London, Ontario, Canada.

METHODS: Seventy-four Latino children (54.1% male; mean age = 11.4) completed self-report questionnaires related to physical activity and sedentary behaviors. A subset of children (n = 64) wore Actical (Mini Mitter, Respironics) accelerometers for a maximum of four days.

RESULTS: Latino children self-reported moderate levels of physical activity (i.e., mean score of 2.8 on 5-point scale). Accelerometer data revealed that children spent an average of 50.0 min in moderate-to-vigorous physical activity (MVPA; 59.2 min on weekdays and 50.6 min on weekend …

Reliability Of Three Landmarking Methods For Dual Inclinometry Measurements Of Lumbar Flexion And Extension, Joy C. Macdermid, Vanitha Arumugam, Joshua I. Vincent, Kimberly L. Payne, Aubrey K. So

Health and Rehabilitation Sciences Publications

Background

To examine the intra and inter-rater reliability of lumbar flexion and extension measurements attained using three landmarking methods for dual inclinometry.

Methods

This was a repeated measures reliability study. Convenience sampling was used to obtain forty volunteer subjects. Two assessors measured a series of lumbar flexion and extension movements using the J-Tech™ dual inclinometer. Three different landmarking methods were used: 1) straight palpation of PSIS and L1, 2) palpation of PSIS and the site of the nearest 5 cm interval point closest to L1 and 3) location of PSIS and 15 cm cephalad. Upon landmarking, adhesive tape was used …

The Impact Of Childhood Symptoms Of Conduct Disorder On Driver Aggression In Adulthood, Christine Wickens, Evelyn R. Vingilis, Robert Mann, Patricia Erickson, Maggie Toplak, Natan Kolla, Jane Seeley, Anca Ialomiteanu, Gina Stoduto, Gabriela Ilie

Family Medicine Publications

Background: Despite limited empirical investigation, existing scientific literature suggests that individuals with a history or current diagnosis of conduct disorder (CD) may be more likely to demonstrate reckless and aggressive driving. Much of the limited research in this field examines the impact of childhood CD on driver behaviour and collision risk in young adults. Few, if any, studies assess the impact of this disorder on driver behaviour beyond age 21 years. The current research is a population-based study of the impact of CD symptoms during childhood on the risk of engaging in driver aggression during adulthood.

Methods: Data are based …

Connectionist Perspectives On Language Learning, Representation And Processing., Marc F Joanisse, James L Mcclelland

Brain and Mind Institute Researchers' Publications

The field of formal linguistics was founded on the premise that language is mentally represented as a deterministic symbolic grammar. While this approach has captured many important characteristics of the world's languages, it has also led to a tendency to focus theoretical questions on the correct formalization of grammatical rules while also de-emphasizing the role of learning and statistics in language development and processing. In this review we present a different approach to language research that has emerged from the parallel distributed processing or 'connectionist' enterprise. In the connectionist framework, mental operations are studied by simulating learning and processing within …

Istent As A Solo Procedure For Glaucoma Patients: A Systematic Review And Meta-Analysis, Monali S. Malvankar-Mehta, Yufeng Nancy Chen, Yiannis Iordanous, Wan Wendy Wang, John Costella, Cindy M. L. Hutnik

Department of Medicine Publications

BACKGROUND: Glaucoma is a leading cause of irreversible blindness. It is firmly entrenched in the traditional treatment paradigm to start with pharmacotherapy. However, pharmacotherapy is not benign and has been well documented to have a number of significant challenges. Minimally invasive glaucoma surgery (MIGS) that targets the outflow pathway with minimal to no scleral dissection has resulted in the need to reconsider the glaucoma treatment paradigm.

PURPOSE: To perform a systematic review and meta-analysis to evaluate and quantify the effect on post-operative intraocular pressure (IOP) and number of topical glaucoma medications, in patients receiving the iStent MIGS device as the …

The Flip-Side To Readmission: Focused After-Care, Amresh Srivastava

Data and Test Instruments

paper 1. Suicidality in hospitalized early psychosis patients at time of discharge The purpose of this study was to investigate the presence and nature of suicidal risk among early psychosis patients at the time of discharge from hospital. Is it only related to the involvement of a suicidal attempt at admission? Thirty such patients, who were admitted after a suicide attempt were compared with 30 patients similarly diagnosed, but admitted for clinical reasons not involving a suicide attempt. Dependent measures of psychopathology, adjustment and suicidality were used. It was found that the two groups did not differ in suicidality, which …

Non-Language Barriers To Effective Care Of The Hispanic Population, Elizabeth M. Dobbins

Undergraduate Honors Theses

This research study was designed to improve the quality of health care received by the Hispanic population in northeast Tennessee. After reviewing past research, it is evident that the Hispanic population reports a lower level of health care satisfaction and a greater number of health disparities. Although attempts to reconcile this problem have included implementing regulations and guidelines on the cultural competency of and the provision of language services by health care providers, no measurable improvement has been noted. To positively impact this pervasive problem, the focus must shift away from how health care agencies can affect health care for …

Blood Pressure Management In Patients With Spontaneous Intracerebral Hemorrhage, Paul Mammarello

Nursing Masters

The purpose of this study was to determine the efficacy of current American Stroke Association (ASA) blood pressure guidelines for non-traumatic intracerebral hemorrhage (ICH) in preventing neurological decline. In addition, it was intended to assist in determining if more strict blood pressure control correlates with better neurological outcomes.

An Evaluation Of The Attitudes, Beliefs, And Mental Health Literacy Of Young African American College Graduates, Marshae Antoinette Mcneal

Dissertations

The aim of this study was to examine the relationships between the attitudes, beliefs, and mental health literacy of young college-educated African Americans as compared to their Caucasian counterparts. Previous research indicates these two populations differ when receiving services for mental illness. The goal of this study was to see if this difference is due to their mental health literacy level, attitudes toward seeking help, as well as their attitudes and beliefs toward mental illness. A quantitative analysis was conducted using elements of the MacArthur Mental Health Module and the Attitudes toward Seeking Professional Psychological Help Scale-Short Form (ATSPPHS-SF) to …

Race And Ethnicity, Obesity, Metabolic Health, And Risk Of Cardiovascular Disease In Postmenopausal Women, Michelle D. Schmiegelow, Haley Hedlin, Rachel H. Mackey, Lisa W. Martin, Mara Z. Vitolins, Marcia L. Stefanick, Marco V. Perez, Matthew Allison, Mark A. Hlatky

Medicine Faculty Publications

Background It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups.

Methods and Results We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m²) as normal weight (body mass index 18.5 to P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with …

Radium-223 For The Treatment Of Castration-Resistant Prostate Cancer, Joelle El-Amm, Jeanny B. Aragon-Ching

Medicine Faculty Publications

The vast majority of patients with metastatic castration-resistant prostate cancer (mCRPC) develop bone metastases. Bone metastases are a source of significant morbidity and affect quality of life in these patients. Several bone-targeting agents are approved for the treatment of bone metastases in prostate cancer, including bisphosphonates, denosumab, and radiopharmaceuticals. Radium-223 is a novel first-in-class alpha-emitting radiopharmaceutical that has been approved for treatment of patients with mCRPC with bone metastases. Radium-223 delivers cytotoxic radiation to the sites of bone metastases and offers the advantage of minimal myelosuppression. The landmark Phase III ALSYMPCA trial demonstrated that, in addition to providing bone-related palliation, …

Impact Of Implementing The Geriatric Resource Nurse Model On Fall And Hospital Acquired Pressure Ulcer Rates, And Length Of Stay In Older Adults In An Acute Care Hospital, Elzbieta Kmiecik, Cathie E. Guzzetta, Mary-Michael Brown, Qiuping Pearl Zhou, Desale Sameer

GW Research Days 2015

Background.Older adults are at high risk for adverse care outcomes, such as injuries from falls, hospital acquired pressure ulcers (HAPUs), and prolonged length of stay (LOS). Available evidence suggests outcomes may improve when older adults are cared for by healthcare providers with competence in geriatrics. To improve outcomes, an acute care not-for-profit teaching hospital in Washington DC area implemented a Geriatric Resource Nurse (GRN) model that prepares registered nurses (RNs) as clinical experts on core geriatric principles on four general care wards (three medical-surgical and one cardiac).

Objectives. Toexamine the effects of GRN model implementation on fall and …

Fibroblast Growth Factor 9 Regulation By Micrornas Controls Lung Development And Links Dicer1 Loss To The Pathogenesis Of Pleuropulmonary Blastoma, Yongjun Yin, Angela M. Castro, Marrit Hoekstra, Thomas J. Yan, Ajay C. Kanakamedala, Louis P. Dehner, D. Ashley Hill, David M. Ornitz

Pathology Faculty Publications

Pleuropulmonary Blastoma (PPB) is the primary neoplastic manifestation of a pediatric cancer predisposition syndrome that is associated with several diseases including cystic nephroma, Wilms tumor, neuroblastoma, rhabdomyosarcoma, medulloblastoma, and ovarian Sertoli-Leydig cell tumor. The primary pathology of PPB, epithelial cysts with stromal hyperplasia and risk for progression to a complex primitive sarcoma, is associated with familial heterozygosity and lesion-associated epithelial loss-of-heterozygosity of DICER1. It has been hypothesized that loss of heterozygosity of DICER1 in lung epithelium is a non-cell autonomous etiology of PPB and a critical pathway that regulates lung development; however, there are no known direct targets of epithelial …

Investigation Of Sex Differences In The Expression Of Rora And Its Transcriptional Targets In The Brain As A Potential Contributor To The Sex Bias In Autism, Valerie W. Hu, Tewarit Sarachana, Rachel Sherrard, Kristen M. Kocher

Medicine Faculty Publications

Background

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by significant impairment in reciprocal social interactions and communication coupled with stereotyped, repetitive behaviors and restricted interests. Although genomic and functional studies are beginning to reveal some of the genetic complexity and underlying pathobiology of ASD, the consistently reported male bias of ASD remains an enigma. We have recently proposed that retinoic acid-related orphan receptor alpha (RORA), which is reduced in the brain and lymphoblastoid cell lines of multiple cohorts of individuals with ASD and oppositely regulated by male and female hormones, might contribute to the sex bias …

Discharge Education Curriculum For Residents Rotating On An Inpatient Pediatric Ward, Kaitlin Widmer, Priti Bhansali, Julie Noffsinger

E-Learning Modules

Adult literature has demonstrated that patient preferences and understanding of discharge instructions can impact success of discharge and even predict return ER visits. There is very little data in pediatric literature describing what information should be discussed with families when providing discharge instructions, and most pediatric residents do not receive formal education on the topic. This curriculum is designed as a brief educational intervention that can improve residents’ comfort and skills in providing discharge education to families. The materials include both how to present the curriculum and tools to assess resident knowledge, behaviors and attitudes regarding discharge education as well …

The Cost Of Caring: Compassion Fatigue In Hospice Nursing, Stephanie O'Neil

Senior Honors Projects

Compassion fatigue is a concept that is often referred to as the “cost of caring.” Hospice nurses, who regularly care for patients at the end of life, are most susceptible to this sense of helplessness, isolation, and confusion, as each day they are faced with bearing witness to the tragic loss of their patients. Compassion fatigue has detrimental effects on the health and wellbeing of nurses, and impacts on the safety and dignity preservation of patients. The purpose of this project was to explore the concept of compassion fatigue in Hospice nursing practice. Kim and Schwartz-Barcott’s Hybrid Model is a …

Pertinacity Volume 1 Issue 1, Yuri Hosokawa

Pertinacity

No abstract provided.

Caregiving Factors Affecting Breastfeeding Duration Within A Neonatal Intensive Care Unit., Sharon G. Casavant, Georgine Burke, Carrie-Ellen Briere, Jacqueline Mcgrath

University Scholar Projects

Abstract

Background: Increasingly, evidence supports oral feeding of very-low-birth-weight (VLBW) preterm infants exclusively at breast or with breastmilk. Despite known breastmilk benefits, outcomes related to exclusive breastmilk provision are poor. Identifying factors that promote breastmilk provision is critical.

Purpose: Breastfeeding practices of mothers of VLBW infants admitted to neonatal intensive care unit (NICU) were explored to identify factors associated with mode of feeding at discharge.

Method:

This retrospective study replicates previous work. Subjects were VLBW preterm infants consecutively admitted during a 24-month period. Primary outcomes included receiving any breastmilk at discharge. Infant variables included gestational age (GA), post-menstrual age (PMA) …

Executive Function And Attention-Deficit/Hyperactivity Disorder In Ugandan Children With Perinatal Hiv Exposure, Matthew Burkey, Robert Opoka

Paediatrics and Child Health, East Africa

Background: Attention-deficit/hyperactivity disorder (ADHD) is among the most commonly diagnosed mental disorders in childhood and is associated with substantial deficits in executive functioning and lost academic and occupational attainment. This study evaluates symptoms of ADHD and their association with neurocognitive deficits in a cohort of rural Ugandan children who were born to HIV-infected mothers.

Methods: We assessed ADHD symptoms and executive function (including memory and attention) in a non-clinical sample of children born to HIV-infected mothers in rural eastern Uganda. Analyses included assessments of the psychometric properties, factor structure, and convergent and discriminant validity of the ADHD measure (ADHD-Rating Scale-IV); …

Portland Bicycle Share Health Impact Assessment, Nicole A. Anderson

Muskie School Capstones and Dissertations

The findings of this project have shown the potential health impact for implementing a bike share program in Portland, including improved air quality and rates of physical activity for bike share users. The recommendations to create the most health-conscious bike share program include basic requests of the bike share vendors that will provide the program to Portland including: recommending the use of helmets, distributing bike share stations throughout the City, tracking bicycle crashes, tracking minutes of physical activity, etc. The findings and recommendations show the importance of a potential bike share program, while creating a program that is safe and …

Direct Differentiation Of Adult Ocular Progenitors Into Striatal Dopaminergic Neurons., Iqbal Ahmad, Xing Zhao, Sowmya Parameswaran, Christopher J. Destache, J F. Rodriguez-Sierra, Wallace B. Thoreson, Hiba Ahmad, John Sorrentino, Sudha Balasubramanian

Journal Articles: Ophthalmology

Parkinson's disease, characterized by motor dysfunction due to the loss of nigrostriatal dopaminergic neurons, is one of the most prevalent age-related neurodegenerative disorders. Given there is no current cure, the stem cell approach has emerged as a viable therapeutic option to replace the dopaminergic neurons that are progressively lost to the disease. The success of the approach is likely to depend upon accessible, renewable, immune compatible, and non-tumorigenic sources of neural progenitors from which stable dopaminergic neurons can be generated efficaciously. Here, we demonstrate that neural progenitors derived from limbus, a regenerative and accessible ocular tissue, represent a safe source …

Effects Of Heat Stress On Arterial Compliance In Smokers: A Pilot Study, Erin Dougherty

Health, Human Performance and Recreation Undergraduate Honors Theses

Arterial compliance (i.e., arterial elasticity) is a major contributor to the pathophysiology of cardiovascular disease (CVD) and has been recognized as an independent risk factor for CVD. Smokers have poor arterial compliance compared to non-smokers. In non-smokers, passive heat stress has been shown to acutely improve arterial compliance. It is unknown how passive heat stress affects arterial compliance in smokers. The purpose of this pilot study was to test the hypothesis that passive heat stress improves arterial compliance in smokers to a greater extent than non-smokers. This pilot study involved 2 male smokers and 2 male non-smokers, ages 18-21. Smokers …

Factors That Affect Adherence With Long-Term Controller Medications Used To Manage Asthma In Children, Brittany Bowks

HIM 1990-2015

Problem: Asthma affects one out of every ten children in the United States. It is recommended that children with persistent asthma take long-term controller (LTC) medications to achieve control. However, adherence varies, and many children do not take their LTC medication at all. The average cost for hospitalization of a child with asthma is $8,406. Asthma in children also contributes to school absenteeism and a decrease in quality of life. Objective: A literature review was performed to examine factors that affect adherence to LTC medications used to control asthma in children. Method: A literature review was performed using the CINAHL, …

The Effects Of Complementary Hippotherapy For Children With Austism Spectrum Disorder, Jamie Hicks

HIM 1990-2015

Autism Spectrum Disorder (ASD) is an intricate and complex disorder that continues to grow in its prevalence year after year. The disorder is based on decreased social communication with prevalent stereotypical behaviors and problems in sensory processing. Due to the disorder diagnosis based on a spectrum, each child is different in their severity, and thus requires individualized forms of therapies and treatments. The cause of ASD is unknown, which makes the treatment difficult to standardize. Desperate to find a regimen that benefits their child’s ability to function more successfully, more and more parents are utilizing complementary alternative medicine (CAM). The …

Impact Of Numeracy On Parental Self-Efficacy And Treatment Outcome Of Children On Complex Diets., Diana Cardina Pantalos

Electronic Theses and Dissertations

Health numeracy, a counterpart to health literacy, can be a mediator of health disparities. This study analyzed the impact of both cognitive and affective numeracy on the pathway linking health behavior to health outcomes, and the role of self-efficacy in this relationship, based on the Health Belief Model. The context was parental management of children's complex diets that require numerical calculations. Parents of children ages 12 months to 12 years with type 1 diabetes (T1D) or phenylketonuria (PKU) were recruited at clinics or community events in east-central states. Ninety-eight participants completed a standardized test of math skills, an instrument to …

The Association Of Medical Student Debt On Choice Of Primary Care Specialty And Rural Practice Location., Craig Ziegler

Electronic Theses and Dissertations

A shortage of primary care physicians (PCP) is present nationally and within Kentucky. The shortage is expected to worsen, unless a dramatic increase occurs in the generation of additional primary care clinicians. Geographical maldistributions of PCP also exist. Whereas 20% of the US population resides in rural areas, only 10% of physicians practice in these areas. This study explores factors that influence medical students’ decisions to select primary care residency training programs, and to practice in rural areas. Specifically, the levels of debt among 1391 graduates from University of Louisville School of Medicine (ULSOM) during 2001-2010 were examined in association …

The Relationship Between Financial Empowerment And Health Related Quality Of Life In Family Scholar House Participants., Chelsey Erbaugh Franz

Electronic Theses and Dissertations

The Family Scholar House program was a unique intervention designed to stop the cycle of poverty by providing college education and support to single parents. The different aspects of the Family Scholar House program addressed each of the five social determinants of health (economic stability, education, social and community context, health care, and neighborhood and built environment). Results of the studies showed that participant’s mental health and general health rating, as measured by a health-related quality of life survey, improved during the time in the Family Scholar House program. Upon graduation from the program, the mental health and the health …

Implementation Of Break Time For Employee Nursing Mothers At The University Of Louisville : A Case Study., Robin Elise Weiss, 1971-

Electronic Theses and Dissertations

This dissertation is a mixed methods look at the barriers to successful implementation of the Break Time for Nursing Mothers provisions of the Affordable Care Act (ACA) at an upper southern-midwestern university. As public health and medical officials push the desire for an increase in breastfeeding initiation and duration, many mothers must overcome barriers within the employment arena. Previous work has failed to look at how the university setting presents unique challenges with a diverse workforce, varied jobs, and differing space availability. In other settings, barriers have been identified; the goal of this dissertation was to identify what the specific …

The Influence Of Child Physical Activity Programs On Parent Physical Activity In A Rural Community., Katie F. Leslie

Electronic Theses and Dissertations

Introduction: In 2008, a coalition of community leaders and parents sought to increase access to physical activity opportunities for residents of Meade County, a rural Kentucky community. To date, the Meade Activity Center has implemented a variety of year-round programs conducted at borrowed spaces from local schools that have targeted children, utilizing the strategy to first engage children as a way to extend behavior change to other members of the community. This study assessed the influence of child participation in physical activity programs on parent physical activity, and determined potential methods of intervention to increase adult physical activity in a …