Medicine and Health Sciences Commons^™

Quality Improvement In The Department Of Family And Community Medicine At The University Of Kentucky, Manisha Vasishta

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

The purpose of this capstone project is to analyze the quality improvement data that was collected in order to increase the pediatric population at the University of Kentucky Department of Family and Community Medicine clinic at Turfland. There were three different patient populations that were surveyed: reproductive aged women between 18 and 40, parents of the pediatric population that the clinic saw between July 2014 and June 2015, and pregnant women between July 2014 and June 2015. The results show that continuity of care and not being able to see the provider of choice were some of the weaknesses that …

Behavioral Modification Program To Control Obesity Among School Children In Knott County, Kentucky, Samjhana Shakya

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

Childhood obesity is one of the major public health concerns in the United States (US). Obese children have a greater likelihood of developing cardiovascular disease risk factors such as high blood pressure and cholesterol, and impaired blood glucose[7].The prevalence of obesity among children 2 to 5 years of age in Kentucky was 15.7% (US average 8.4%) and 17.6% (US average 17%) among adolescents in Kentucky being higher than the national averages [8,3].

A major goal of the Behavioral Modification Program is to promote healthy behaviors among elementary school children to control obesity by modifying eating, physical activity and screen time …

The Impact Of An Ambulatory Clinical Intervention On Viral Load Suppression And Retention In Care For Newly Diagnosed Hiv Persons, Latasha R. Jones

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

Ambulatory clinical healthcare settings that serve patients infected with the human immunodeficiency virus (HIV) are critical in improving access to quality HIV care and treatment, in part due to their ability to streamline patient care along the HIV care continuum. Barriers to HIV care are significant among newly diagnosed HIV patients and in order to engage and retain these individuals in care and treatment, specific interventions must be in place to link these individuals to care. In this study, the difference in differences method was used for data analysis to measure the impact of an ambulatory clinics intervention on their …

Access For Adolescents: Multisystemic Therapy In The Juvenile Justice System, Meagan Pilar

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

In this application for funding, DC YouthLink, a non-profit organization that connects adolescents in the juvenile justice system to community resources, proposes to implement an evidence-based mental health intervention into the juvenile justice system in Washington D.C. The Director of DC YouthLink will serve as the Principal Investigator for this pilot program; she, along with five trained staff members, will be responsible for implementing multisystemic therapy (MST), an intensive form of therapy designed specifically for at-risk youth and their families. We propose to intervene at three main stages of the juvenile justice system— intake, correctional placement/probation supervision, and reentry. The …

Enough Smoke: Implementation Of An Evidence-Based Smoking Cessation Program In Owsley County, Kentucky, Meghan Fay Johnson

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

In 1964, the first United States (U.S.) Surgeon General’s Report explicitly stating the dangers of smoking, including an increased risk of lung cancer, was released. Fifty years later, the U.S. continues to carry the significant health and economic burdens for failing to heed this public health warning. Owsley County, Kentucky, located in the heart of the Appalachian is one of the most impoverished and medically underserved counties in the U.S., ranking last in almost every category of overall health outcomes in the state. The county is also entirely rural, with no major cities within an 80-mile radius. In every health …

Focas Appalachia: A Cervical Cancer Prevention Program For The Women Of The Kentucky River Area Development District, Chrisanthi M. Masero

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

In response to the National Institute of Health’s (NIH) funding announcement, the Kentucky River District Health Department (KRDHD) proposes to implement an evidence-based cervical cancer prevention program in the Kentucky River Area Development District (KRADD) in southeastern Appalachian Kentucky. The proposed evidence-based program was part of the National Cancer Institute’s (NCI) “Public Health Approaches to Breast and Cervical Cancer” research initiative and is one of nine cervical cancer Research Tested Intervention Programs (RTIPs) on the NCI’s RTIP database. The Forsyth County Cancer Screening Project (FoCaS) was designed to improve the beliefs, attitudes, and behaviors regarding breast and cervical cancer screening …

Effect Of Dietary Supplementation With Different Levels Of Inulin-Typefructans On Renal Expression Of Aquaporin 2 Of Growing Piglets, Katarzyna Michalek, Marta Grabowska, Mariusz Skowronski, Adam Lepczynski, Agnieszka Herosimczyk, Maria Laszczynska

Turkish Journal of Veterinary & Animal Sciences

The purpose of this study was to identify and investigate the expression of aquaporin 2 (AQP2) in the renal tubules of growing piglets fed with different levels of inulin-type fructans. The experiment was performed on five groups of PIC x Penarlan P76 crossbred piglets fed with the following diets: standard diet (control group) and standard diet supplemented with 1% (group I), 2% (group II), and 3% (group III) of water extract of chicory root inulin-type fructans. The animals from the group IV were fed with standard diet supplemented with 4% dried chicory roots. To analyze immunolocalization and expression of AQP2 …

An Explorer In A Cardboard Land: Emotion, Memory, And The Embodied Experience Of Doing Jigsaw Puzzles, Angela Cora Garcia

Natural & Applied Sciences Faculty Publications

The purpose of this paper is to demonstrate how playing a game or engaging in a leisure activity provides the participant with an experience which integrates physical, mental, and emotional elements. I use an autoethnographic approach to study the process of completing jigsaw puzzles. The main focal point of the paper is the connection between engagement in a physical activity (completing a puzzle) and how the mind works and where it goes during the performance of that activity. The goal of the paper is to illustrate the connections between action and thought, and to show how one of the benefits, …

Assessing Differences Between Early And Later Adopters Of Accountable Care Organizations Using Taxonomic Analysis, Frances M. Wu, Stephen M. Shortell, Valerie A. Lewis, Carrie H. Colla, Elliott S. Fisher

Dartmouth Scholarship

Objective. To compare early and later adopters of the accountable care organization (ACO) model, using the taxonomy of larger, integrated system; smaller, physician-led; and hybrid ACOs. Data sources. The National Survey of ACOs, Waves 1 and 2.

Studydesign. Clusteranalysisusingthetwo-stepclusteringapproach,validatedusing discriminant analysis. Wave 2 data analyzed separately to assess differences from Wave 1 and then data pooled across waves. Findings. Compared to early ACOs, later adopter ACOs included a greater breadth of provider group types and a greater proportion self-reported as integrated delivery systems. When data from the two time periods were combined, a three-cluster solution similar to the original cluster …

Sexual And Reproductive Health Knowledge, Attitudes, And Practices Among Early Adolescents And Young Adults In Uganda: Findings From A Link Up Exploratory Study, Population Council

HIV and AIDS

The Population Council collaborated with Makerere University’s Child Health and Development Centre to conduct a study of males and females ages 10–24 to help inform future programs and policies affecting these young people. This study was conducted as part of the Link Up project, a global consortium led by the International HIV/AIDS Alliance that aims to improve the sexual and reproductive health and rights (SRHR) of young vulnerable people. Results indicate that adolescents and young adults have broad gaps in their knowledge about HIV and SRHR; early adolescents fared significantly worse in these areas than their older counterparts, suggesting that …

Analysis Of Sports Injuries Among High School Athletes In 18 West Central Florida Schools, Karen D. Liller, Siew Wong-Jacobson, Barbara Morris, Yingwei Yang

Florida Public Health Review

Through this study we report the 2014-15 injuries of high school athletes in 18 west central Florida schools utilizing the Reporting Information Online (RIO) data system. Certified athletic trainers (ATCs) were hired and trained by researchers from the University of South Florida to collect and report injury findings from high school athletes. Descriptive statistics, injury rates, and rate ratios were calculated. Overall, 726 injuries were reported by the ATCs. Football was the leading sport for number of injuries and injuries per athlete-exposures for practices and competitions. Boys had significantly greater injury rates compared to girls overall and in competitions and …

Creation Of Novel Inducible Cell Line To Study Alveolar Rhabdomyosarcoma, Kaoru Takasaki

Yale Medicine Thesis Digital Library

CREATION OF NOVEL INDUCIBLE CELL LINE TO STUDY ALVEOLAR RHABDOMYOSARCOMA. Kaoru Takasaki, Ranjini K. Sundaram, Ranjit S. Bindra. Departments of Therapeutic Radiology and of Pathology, Yale University, School of Medicine, New Haven, CT.

Rhabdomyosarcoma (RMS) is a group of relatively rare mesenchymal malignancies classically associated with skeletal muscle and most frequently seen in the pediatric population. While chemotherapy, radiation, and surgical resection can confer long-term event-free survival rates of up to 85-95%, the prognosis for alveolar rhabdomyosarcoma (ARMS), particularly those positive for either the t(2;13) PAX3-FOXO1 or t(1;13) PAX7- FOXO1 translocation, is significantly worse. As such, the development of therapies …

Prevalence And Associated Factors Of Low Back Pain Among Motorcycle Taxi Drivers In Sriracha, Nahatai Jongprasitkul, Komwudh Konchalard, Kunakorn Sinthoppong

Chulalongkorn Medical Journal

Background : Low back pain (LBP) is a common disorder associated with muscle and the skeleton structure. It is also generally found in all age groups and professions. LBP also affects the financial loss in society and activity of daily living. Motorcycle taxi drivers (MTD) are mainly focused in the study because it is one of the most common careers which tends to grow rapidly in the future. There is no study in this topic before. Objective : To determine the prevalence and associated factors of low back pain among the motorcycle taxi drivers in Sriracha District, Chonburi, Thailand. Setting …

Modified Bilateral Sagittal Split Osteotomy For Correction Of Severe Anterior Open Bite: Technical Note And Case Report, Prasarn Tangarturonrasme, Laddawun Sununliganon

Chulalongkorn Medical Journal

Bilateral sagittal split osteotomy (BSSO) is a common procedure used for the correction of mandibular anomalies. This procedure has been through various modifications that aims to increase skeletal stability and reduce possible complications. So far, the limitation of BSSO technique remains a concern in certain circumstances, such as skeletal relapse after closing of anterior open bite, especially in severe cases. Also, there is a risk of facial paralysis following a large amount of mandibular setback in a severe mandibular prognathism. Therefore, concomitant surgery such as segmented osteotomy and/or maxillary osteotomy may be used for correction of the deformity in order …

Development Of A Bedside Shift Report Policy And Guidelines To Assist Nurses With Patient Care, Cynthia Snedecor

Walden Dissertations and Doctoral Studies

In 2013, the Hospital Consumer Assessment of Healthcare Providers System (HCAHPS), a national, independent metric of patient satisfaction, revealed room for improvement at a teaching hospital in the southeastern section of the United States. This project reports the development and validation of a Bedside Shift Report (BSR) policy, practice guidelines, and associated documentation. Several initiatives, models, and theories informed thinking about this project. The work of Kurt Lewin and the Institute for Healthcare Improvement- Robert Wood Johnson Foundation's joint initiative, Transforming Care at the Bedside, both guided the project in terms of the process of institutional change. SBAR (Situation Background …

Longitudinal Examination Of Perceived Stress And Depression Symptomology In Division I Student-Athletes, Bobby Daigle

Electronic Theses and Dissertations

CONTEXT: Concussions are all too prevalent in amongst athletes. Concussions make up almost 5 percent of all collegiate athletic injuries. Concussions have been linked with many long lasting effects including depression and increased stress or anxiety.

OBJECTIVE: To longitudinally examine post-concussion depression and stress levels in National Collegiate Athletic Association Division 1 athletes.

DESIGN: Descriptive longitudinal study.

SETTING: National Collegiate Athletic Association Division I collegiate athletics.

PARTICIPANTS: Concussed and uninjured Division I collegiate athletes, ages 18-22, competing in football, women’s soccer, baseball, softball, and women’s track.

INTERVENTION(S): Participants completed the CES-D at baseline, 1 week, 1 month, and 3 months …

Identity Theory And Women’S Choice Of Medical Specialty, Kelli A. Rolfsmeyer

Electronic Theses and Dissertations

The purpose of this study was to answer the research question: Does a self theory of social action account for female physicians’ perceptions of past choice of specialty? Perceptions of self changed as she prepared herself to become a physician. During her medical training, a medical student gains a better sense of who she is as a person who will become a doctor. The ability to act back on one’s self, called selfreflexivity, is the mechanism involved in the transitions of a physician’s biographical self. The data for this study was collected through interviews centered on questions chosen from the …

Optimization And Application Of Metabolomic Assays For Analyzing Diet-Induced And Gut Microbiota-Derived Short-Chain Fatty Acids In Mice And Humans, Robert M. Juenemann

Electronic Theses and Dissertations

Introduction: In recent decades, the obesity epidemic worldwide has prompted the need for research targeting disease prevention, treatment, and maintenance. Dietary interventions are one of the primary methods to instill positive nutrition habits into one’s lifestyle. Thus, resistant starch type 4 (RS4), a prebiotic dietary fiber, has been proposed to induce beneficial immunometabolic health outcomes. Currently there is a lack of knowledge on the health outcomes of RS4 in adults with metabolic syndrome (MetS). Goal: The goal of this research was to optimize a metabolomic assay to quantify fecal short chain fatty acids (SCFAs), a byproduct of microbial fermentation …

An Advertisement Analysis Of Alcohol Products In Popular Women’S Magazines, M Dottington Fullwood, Jennifer Mongiovi, Grace Hillyer, Corey H. Basch, Danna Ethan, Rodney Hammond

Publications and Research

No abstract provided.

Impact Of Home- And Hospital-Based Exercise In Cardiac Rehabilitation On Hopelessness In Patients With Coronary Heart Disease, Susan L. Dunn, L. Maureen Dunn, Nicole P. Rieth, Grace B. Olamijulo, Lien L. Swieringa, Theresa P. Holden, Jacob A. Clark, Holli A. Devon, Nathan L. Tintle

Faculty Work Comprehensive List

Hopelessness is associated with increased adverse events and decreased survival in patients with coronary heart disease (CHD). The purpose of this research was to examine the effect of regular home- and hospital-based cardiac rehabilitation (CR) exercise on hopelessness levels in patients with CHD, hypothesizing that increased exercise in either setting would lead to decreased state hopelessness.

The Correlation Between Strength Levels Measured Through Dynamic Strength Exercises And The Incidence And Severity Of Injury Among Collegiate Athletes, Alex Jardine

Electronic Theses and Dissertations

Injury to athletes in sport occurs as a result of extrinsic and intrinsic risk factors. Mounting evidence points toward decreased strength as a predictor of injury in athletes. By comparing strength levels in functional movement patterns to injury, the strength and conditioning professional will be able to design effective training programs to reduce the incidence of injury in sport better. The purpose of this study was to determine the correlation between strength measured through dynamic strength exercises (power clean, the squat, and the bench press) among collegiate athletes and the incidence and severity of injury. We hypothesized that greater incidence …

Differences In Running Mechanics Between Overweight/Obese And Healthy Weight Children, Kristen Roles

Electronic Theses and Dissertations

Background/Purpose: Physical activity is commonly prescribed to reduce childhood obesity. However, due to differences in mechanics during low-impact activities, such as walking, obese children may be more prone to negative physical complications during high-impact activities, such as running. Therefore, this study analyzed the mechanical differences in running mechanics between healthy weight (HW) and overweight/obese (OV/OB) children. We hypothesized that when compared to HW children, OV/OB children would display higher vertical loading, greater joint moments and greater joint angular impulses during running. We also expect decreased sagittal plane range of motion and increased frontal plane range of motion of the hip, …

Icook 4-H: 0 To 24-Month Accelerometer-Derived Physical Activity And Sedentary Time In Youth, Emily Hofer

Electronic Theses and Dissertations

To assess accelerometer-derived physical activity and sedentary time from 0 to 24- months in youth in the iCook 4-H program. The iCook 4-H Program was a 5-state, randomized, control-treatment, family-based childhood obesity prevention intervention promoting cooking, eating and playing together. Youth, 9-10 years old, and their main adult meal preparer, participated in the 12-week program followed by monthly newsletters and bi-yearly booster sessions until 24-months. Physical activity and sedentary time were determined for youth who wore an Actigraph GT3X+ accelerometer for 7 days at 0, 4, 12, and 24-months and met defined accelerometer compliance standards. Mean daily minutes of sedentary …

Relationship Between Self-Care Agency, Self-Care Practices, And Body Mass Index Among Nursing Professionals, Takara Schomberg

Electronic Theses and Dissertations

Purpose: The purpose of this study is to investigate the relationship between self-care agency (SCA), self-care practices (SCP), and Body Mass Index (BMI) among Registered Nurses (RNs) living in an urban South Dakota county. These specific constructs and their relationships have not been researched among nursing professionals. Methods: This study used a non-experimental, predictive correlational approach based on Orem’s Self-Care Deficit Theory to quantify the relationship between self-care agency and self-care practices and subsequently body mass index (BMI) among nursing professionals. A tracked but anonymous online survey was sent by email via QuestionPro to 210 nursing professionals selected using systematic …

The Nurse As A Family Caregiver: Their Experience, Their Story, Julie A. Hansen

Electronic Theses and Dissertations

The purpose of this qualitative narrative research study was to explore and bring more attention to the Registered Nurse in the role of informal caregiver to family members. These caregivers are responsible for the care of parents, spouses, and children. The stories shared in this study are not isolated experiences as more and more nurses are placed in the caregiver role outside of their formal professional role. The number of caregiver roles are expected to increase with the increasing numbers of baby boomers and improved life expectancy.

Body Satisfaction And Ability To Identify Weight Status Of Preschool-Aged Children By Their Caregivers, Andrea Brown

Electronic Theses and Dissertations

Rates of childhood obesity have been rising consistently across the nation and internationally. As a result, interventionists have been working to develop ways to combat this and have focused on interventions involving caregivers. Previous research indicates caregivers experience challenges in identifying obesity among their own children, which leads to barriers in addressing and reducing rates of obesity as caregivers remain unaware of any problems. The current study explored caregivers’ ability to correctly assign their child to the appropriate weight category and whether their ability was impacted by caregivers’ own weight status. Further, it also explored caregivers’ level of body satisfaction …

Effects Of Ischemic Preconditioning On Exercise Economy, Gungeet Kaur

Electronic Theses and Dissertations

Ischemic preconditioning (IPC) is the application of small bouts of ischemia followed by reperfusion. IPC has shown to enhance exercise performance in varied sports like 5K running, cycling and swimming. However, effect of ischemic preconditioning on running economy have not be investigated so far. We proposed that bilateral ischemic preconditioning will improve running economy in young healthy people. Methods: The study was a randomized single- blinded crossover study. Nineteen men and women were included in the study. Each participant underwent a sham and IPC trial using high pressure cuff (EC20 rapid cuff inflator, DE Hokanson, Inc.) followed by running economy …

Influence Of Cardiovascular Risk Factors On Remote Ischemic Preconditioning, Tiffany Trachte

Electronic Theses and Dissertations

A powerful therapy against microvascular endothelial ischemia-reperfusion injury is remote ischemic preconditioning (rIPC), which triggers tissue protection by exposing a limb to small cycles of vascular occlusion. Animal models indicate that CVD risk factors reduce the protective benefits of ischemic conditioning. However, there are no human studies investigating how a burden of risk factors interferes with rIPC to prevent endothelial injury. The purpose of the present study was to determine the influence of risk factor burden on the capacity of rIPC to prevent endothelial reperfusion injury in humans. Twenty-two (age: 45±14 yr., BMI: 31±8 kg/m2) sedentary adults (12 lower burden: …

Pilot Study Of The Effects Of Heart Rate Variability Biofeedback On Perceived Stress, Perceived Coping Ability, And Resilience In Accelerated Baccalaureate Nursing Students, Andrea J. Harmelink

Electronic Theses and Dissertations

Objective. The purpose of this quasi-experimental randomized controlled two-group pilot study was to test the effectiveness of a Heart Rate Variability Biofeedback (HRVB) intervention on accelerated baccalaureate nursing (ABN) students’ perceived stress, perceived coping ability, and resilience over four weeks during an academic term of ABN coursework. This study was guided by Lazarus and Folkman’s Transactional Theory of Stress and Coping, with a focus on primary appraisal.
Background. ABN students report higher perceived stress and anxiety compared with nursing students in traditional four-year nursing programs due to the compressed and fast-paced format of the ABN curriculum. Qualitative data points to …

Food/Drug Interactions: Assessing Student Knowledge Before And After Viewing An Interactive Educational Website, Cole Smith

Undergraduate Honors Thesis Collection

Background: Knowledge of food and drug interactions is important and may greatly impact compliance and success of drug therapy. Patients are required to be educated about food and drug interactions at the point of care by the Joint Commission on Accreditation of Healthcare Organizations’ standards; and, in both the institutional and community settings, quality of patient care is improved if the patient understands the importance of food and drug interactions. Methods: This study was conducted online via a web-based survey using Survey Monkey. Students in their second year of pre-pharmacy classes were asked to complete a pre-survey, review a website …