Medicine and Health Sciences Commons^™

Implementing The National Diabetes Prevention Program In Mason County, Kentucky, Cassandra Yelton

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

The National Diabetes Prevention Program (DPP) is sponsored by the Centers for Disease Control and Prevention (CDC). The program’s goal is to reduce the incidence of diabetes through dietary modification and physical activity. On one hand, the DPP is currently offered by various organizations through the country. On the other hand, the DPP is mostly unavailable in rural areas, especially the Diabetes Belt. The Diabetes Belt is in the eastern Appalachian region of the United States. People who live in this area of the country are more likely to develop diabetes than those who do not. Mason County, Kentucky has …

Wayne County Board Of Education Adaptation Of Love Notes Curriculum For Adolescent Pregnancy Prevention, Allison Shea Merritt

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

West Virginia has the 8^th highest rate of adolescent pregnancy in the United States and the rate in Wayne County is significantly higher. Adolescent pregnancies cause negative health outcomes for both the baby and the mother. Adolescent mothers are at an increased risk of anemia, preeclampsia, and preterm labor and babies born to adolescent mothers are more likely to have a low birth weight and to have cognitive impairment. To address this burden, the school board has decided to use the ADAPT-ITT framework on the evidence-based Love Notes adolescent pregnancy prevention curriculum to adapt it to be more culturally …

Community Of Hope: A Comprehensive Suicide Prevention Intervention At Mit, Kyra Patel

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

Suicide is the second leading cause of death for most age groups in the United States. The current rate of suicide among college students is 7.5 per 100,000 with the rate remaining fairly steady over the past 30 years. While the rate is lower on college campuses, compared to the general population ages 18-24, the issue is still much larger on a college campus due to suicide bereavement or the number of people affected and to what degree they were impacted. As of 2015, MIT (Massachusetts Institute of Technology) had the highest suicide of all reporting colleges. The primary objective …

Increasing Colorectal Cancer Screening In Kentucky’S Buffalo Trace Area Development District With A Mailed Fit Program, Carrie Anne Burt

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

This program involves a partnership among eight primary care clinics in the Buffalo Trace Area Development District (BTADD) of Kentucky and proposes implementing a mailed Fecal Immunochemical Test (FIT), or FIT Pack, program to increase colorectal cancer screening (CRCS) rates in this region. Mailing FIT tests to eligible patients is an evidence-­‐based program that has been shown to increase CRCS among patients included in studies. The program will occur at the clinic level. Clinics will mail FITs and information leaflets to patients based on patient eligibility criteria identified in clinic electronic health records. The program’s short-­‐term goals are to increase …

Microclinic International Social Network Behavioral Health Intervention In Mongolia, Kalli A. Beasley

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

Diabetes is a chronic communicable disease that is projected by 2030 to be the seventh leading cause of death worldwide. In Mongolia diabetes and cardiovascular disease are the number one reason for disability-adjusted life years and trends of diabetes is starting to be observed in the poorer populations. Diabetes in countries like Mongolia are extremely costly to treat using insulin, costing $200 USD per month while the average annual income sits only at $1,466.85 USD. Mongolia has a total population of 2,959,000 and half of its population resides in the capital city of Ulaanbaatar. 60% of residents in capital live …

The Use Of A Video-Based Intervention To Motivate Gay And Bisexual Men On Prep To Use Condoms, Ethan Cardwell

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

Based on need and available resources, gay and bisexual men who have sex with men (GBMSM) in the Castro neighborhood of San Francisco, California represent the target population for this intervention. Through funding by the Center for Disease Control the Strut Clinic in collaboration with the University of California Berkley is proposing a video-based intervention with the following SMART objectives.

Objective 1: Efficiently develop and integrate a video-based intervention in the Strut Clinic within the first six months of the funding cycle.

Objective 2: Sustain an increase of consistent condom use to 30% of participants and up to a 10% …

Reducing Stigma Associated With Mental Illness And Mental Health Treatment Services In Racial And Ethnic Minority College Students, Joseph Christodoulou

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

Depression and Suicide

Mental health is a determining factor in how individuals function throughout their daily lives, encompassing an individual’s physical, emotional, and social well-being (U.S. Department of Health and Human Services, 2013). Mental illnesses such as depression, hinder daily functioning and lead to a range of negative outcomes. These include increased risk of mortality from suicide, chronic diseases such as heart disease, other conditions/behaviors such as anxiety and substance use disorders, and high economic burden (Centers for Disease Control and Prevention, 2016b). Depression is a major contributor to disability and burden of disease in the U.S., contributing to 3.7% …

Prospective Policy Analysis Of The Kentucky Health Demonstration Waiver, Keahna Akins

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

In January 2018, the Centers for Medicare & Medicaid Services approved Kentucky’s Section 1115 Medicaid demonstration waiver, which gave the state approval to require work/community engagement as a condition of Medicaid eligibility, charge premiums of up to 4% household income, and add an incentive account for dental and vison services. The waiver projected nearly 100,000 fewer enrollees and $2.4 billion less in spending over the five-year demonstration period. Two days short of the waiver July 1st implementation date a federal judge ruled the waiver invalid. This finding held that the Health and Human Services Secretary’s judgement was arbitrary and capricious. …

The Effect Of Rescheduling Of Hydrocodone On Prescription Writing Among University Of Kentucky Dentists, Robert Taylor

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

Opioid abuse has become a public health crisis over the last two decades. Hydrocodone is the most frequently prescribed opioid to patients whose deaths are related to prescription drug abuse. On October 6, 2014, Federal law changed hydrocodone, an opioid-based analgesic, from Schedule III to Schedule II. This limits the number of ways it can be prescribed, including eliminating refills. This study examined hydrocodone and oxycodone prescriptions written across all dental clinics associated with the University of Kentucky College of Dentistry and analyzed three different dental disciplines that perform procedures that require pain management. Prescription data was obtained through axiUm, …

Impact Of The School Health Innovations Grant Act On Healthcare Access, Outcomes, And Cost In The District Of Columbia, Robert West

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

This paper provided a prospective policy analysis of the Washington, D.C. School Health Innovations Grant Act. This act establishes a grant program to facilitate the formation of school-based telehealth centers to provide mental health services to District school children. The purpose of this act is to improve access to mental health services for children, especially children in disadvantaged populations, such as those low-income, predominantly African American neighborhoods in eastern Washington, D.C., where a high burden of need is compounded by a shortage of health professionals.

This analysis was guided by the Bardach framework of policy analysis. The various factors affecting …

Influence Of Depression On Treatment And Survival: A Population-Based Study In Patients With Breast Cancer In Kentucky, Feitong Lei

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

This capstone project describes the results of a consultative experience in biostatistics.

Estimating The Effects Of Z-Drugs On The Risk Of Cognitive Impairment, Xuan Zhang

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

Background: Dementia and sleep disorders are two significant health problems in older adults. Studies suggest that sleep disorders and their treatment might associate with the risk of dementia. Z-drugs are one of the most widely used prescription hypnosedatives in the United States (US) for insomnia in addition to benzodiazepines (BZDs). Studies have shown that BZDs are associated with dementia among senior users. Study Aim: The purpose of this study is to evaluate the association between Z-drug initiation and cognitive impairment among the elderly in the US. Study Design and Data Source: We conducted a retrospective cohort study with a new …

Bronchiolitis In The Bluegrass: Epidemiology, Disease Burden And Resource Utilization At Kentucky Children’S Hospital, Ashwin Krishna

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

Background: Every year Kentucky Children’s Hospital (KCH) admits infants and toddlers with respiratory disease due to viral bronchiolitis. This disease is characterized by viral-induced inflammation and edema of the lower airways. The resulting disease is characterized by increasing mucus production, acute bronchospasm, necrosis of the respiratory epithelium and functional obstructive lung disease. Patients usually present with symptoms consistent with an upper respiratory tract infection, but can progress to marked respiratory distress and ultimately respiratory failure, as well as poor oral intake and dehydration. While Respiratory Syncytial Virus (RSV) is the pathogen classically described cause of viral bronchiolitis, other viruses have …

Modeling The Impact Of 13rs-Hb358: Hpv Vaccination For School Entry In A High-Prevalence State, Stacy Lee Ware

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

Prophylactic cancer vaccination presents novel opportunities to improve the health and well-being of populations. Since the approval of a cervical cancer vaccine against human papillomavirus (HPV) in 2006, only three states have passed legislation adding it to their school-entry schedules of required vaccinations. Despite ample evidence of its safety and efficacy, the vaccine remains controversial, and national vaccination rates among both girls and boys remain low. Risk for HPV-related cancers varies by population, and Appalachian Kentucky has among the highest HPV-related morbidity and mortality in the nation. Annual attempts to pass HPV vaccine legislation in Kentucky have so far failed …

Commercial Driver License Examinees’ Misreport On Their Federal Motor Carrier Safety Administration Certification Evaluation, Adam Pascoe

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

Commercial Driver’s License (CDL) examinees report their medical history during their Federal Motors Carriers Safety Administration (FMCSA) medical certification exams ≤2 years. When the examinees report diagnoses which may impact the control and operation of commercial motor vehicles (CMV), they face scrutiny with decreased medical certification or may be Adam PascoePascoe Page 2 7/18/2018 considered unfit to control and operate a CMV. Medical examiners may have access to the examinees’ electric medical records (EMRs) to generate a deeper appreciation, independent from the examinees’ self-report, of their risk for sudden and/or gradual incapacitation. We do not know how often diagnoses are …

Latino Worker Reported Respiratory Symptoms And Stall Bedding On Thoroughbred Horse Farms, Lacy Jinks

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

Objective: The purpose of this study is to assess the association between self-reported respiratory symptoms in Latino workers and bedding type used in stalls on thoroughbred horse farms.

Methods: Self-reported community-based questionnaire data from 225 Latino horse farm workers in the southeastern US collected from October 2013-April 2014 were used to investigate associations between upper and lower respiratory symptom prevalence and the type of bedding used in stalls (straw, sawdust, or straw plus wood shavings or sawdust). Analysis was performed by chi-square to compare frequencies of symptoms and demographic and exposure risk factors. Logistic regression was used to adjust …

Using The International Classification Of Functioning, Disability, And Health To Predict Participation In Adults With Parkinson’S Disease: The Role Of Positive Psychological Capital, Brad Wayne Mcdaniels

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Participation is generally considered the ultimate rehabilitation outcome and, for individuals with progressive illnesses, elucidating the factors that impact participation is critical. Parkinson’s disease (PD) is a chronic degenerative, neurological condition affecting nearly 1 million people in the United States, making PD the second most prevalent neurodegenerative disorder. PD has a profound negative effect on functioning and activity, but limited literature exists assessing the relationship between PD and community participation. The purpose of this study was to use the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) as a framework for explaining how PD affects participation. …

Mechanical Behavior Of Posterior All‐Ceramic Hybrid‐Abutment‐ Crowns Versus Hybrid‐Abutments With Separate Crowns—A Laboratory Study, Ahmed Sabet

Dentistry

Objective: The purpose of this laboratory study was to evaluate the fatigue resist‐ ance, fracture resistance and mode of failure of posterior hybrid‐abutment‐crown vs. hybrid‐abutment with separate crown, both bonded to short titanium bases. Materials and Methods: Thirty‐two titanium implants were embedded perpendicu‐ larly in auto‐polymerizing resin. Implant‐supported restorations simulating a maxil‐ lary first premolar were designed and milled using a CAD/CAM system and divided into 2 groups according to material (n = 16): zirconia (Z) and lithium disilicate (L). Each group was subdivided into two subgroups according to design (n = 8): hybrid‐abut‐ ment‐crown (ZS, LS) and hybrid‐abutment with …

Scaling Out Evidence-Based Interventions Outside The U.S. Mainland: Social Justice Or Trojan Horse?, Melanie M. Domenech-Rodriguez, Ana A. L. Baumann, Alejandro L. Vázquez, Nancy G. Amador-Buenabad, Natalie Franceschi Rivera, Nydia Ortiz-Pons, J. Rubén Parra-Cardona

Psychology Faculty Publications

Global health disparities continue to widen as professional standards for effectiveness of mental health services provision become more precise and difficult to achieve across varied economic and social contexts. Within the U.S., health disparities are evident in Latinx populations. Globally, the health disparities are also evident in Latin America as compared to the U.S. and other economically affluent nations. The diversification of psychology in content and persons has led to a unique opportunity to build bridges that can help reduce disparities in- and outside of the U.S. mainland. Collaborations can be of great use in addressing health disparities internationally but …

Association Between Acculturation And Body Weight Status Among Migrant Children In Guangzhou, China: A Cross-Sectional Study, Xiaoling Huang, Wen Chen, Yanwei Lin, Qi Zhang, Li Ling

Community & Environmental Health Faculty Publications

Objective To assess the association between acculturation and body weight status among internal migrant children in China. Design, setting and participants A cross-sectional study was conducted among 1154 pairs of migrant children aged 11–17 years and their primary caregivers in Guangzhou, China, from April to May 2016. Measures Migrant children’s body weight status was measured by body mass index. Acculturation was measured by a questionnaire, developed and validated by the research team. The questionnaire had three dimensions with five factors, namely language, social interaction, custom, dressing and diet. Social anxiety was measured by Social Anxiety Scale for Children. Food intake …

Making A Global Impact One Vaccine At A Time, Janice E. Hawkins, Deborah C. Gray

Ellmer School of Nursing Faculty Publications

(First paragraph) Did you know that, worldwide, almost one third of deaths among children under age 5 can be prevented by vaccines? It's stunning to think that one child dies every 20 seconds from an immunization-preventable disease. That equates to 12 lives that could be saved in the time it takes to read this brief article!

Size-Dependent Inhibitory Effects Of Antibiotic Drug Nanocarriers Against Pseudomonas Aeruginosa, Feng Ding, Preeyaporn Songkiatisak, Pavan Kumar Cherukuri, Tao Huang, Xiao-Hong Nancy Xu

Chemistry & Biochemistry Faculty Publications

Multidrug membrane transporters (efflux pumps) are responsible for multidrug resistance (MDR) and the low efficacy of therapeutic drugs. Noble metal nanoparticles (NPs) possess a high surface-area-to-volume ratio and size-dependent plasmonic optical properties, enabling them to serve both as imaging probes to study sized-dependent MDR and as potential drug carriers to circumvent MDR and enhance therapeutic efficacy. To this end, in this study, we synthesized three different sizes of silver nanoparticles (Ag NPs), 2.4 ± 0.7, 13.0 ± 3.1, and 92.6 ± 4.4 nm, functionalized their surface with a monolayer of 11-amino-1-undecanethiol (AUT), and covalently conjugated them with antibiotics (ofloxacin, Oflx) …

Novel Survivin Inhibitor For Suppressing Pancreatic Cancer Cells Growth Via Downregulating Sp1 And Sp3 Transciption Factors, Myrna Hurtado, Umesh T. Sankpal, Aboubacar Kaba, Shahela Mahammad, Jaya Chhabra, Deondra T. Brown, Raj K. Gurung, Alvin A. Holder, Jamboor K. Vishwanatha, Riyaz Basha

Chemistry & Biochemistry Faculty Publications

Background/Aims: Targeting survivin, an anti-apoptotic protein and mitotic regulator, is considered as an effective therapeutic option for pancreatic cancer (PaCa). Tolfenamic acid (TA) showed anti-cancer activity in pre-clinical studies. A recent discovery demonstrated a copper(II) complex of TA (Cu-TA) can result in higher activity. In this study, the ability of Cu-TA to inhibit survivin and its transcription factors, Specificity protein (Sp) 1 and 3 in PaCa cell lines and tumor growth in mouse xenograft model were evaluated.

Methods: Cell growth inhibition was measured in MIA PaCa-2 and Panc1 cells for 2 days using CellTiter-Glo kit. Sp1, Sp3 and survivin expression …

A Purification And In Vitro Activity Assay For A (P)Ppgpp Synthetase From Clostridium Difficile, Astha Pokhrel, Asia Poudel, Erin B. Purcell

Chemistry & Biochemistry Faculty Publications

Kinase and pyrophosphokinase enzymes transfer the gamma phosphate or the beta-gamma pyrophosphate moiety from nucleotide triphosphate precursors to substrates to create phosphorylated products. The use of γ-³²-P labeled NTP precursors allows simultaneous monitoring of substrate utilization and product formation by radiography. Thin layer chromatography (TLC) on cellulose plates allows rapid separation and sensitive quantification of substrate and product. We present a method for utilizing the thin-layer chromatography to assay the pyrophosphokinase activity of a purified (p)ppGpp synthetase. This method has previously been used to characterize the activity of cyclic nucleotide and dinucleotide synthetases and is broadly suitable for …

Needlestick Injury Prevention Training Among Health Care Workers In The Caribbean, Muge Akpinar-Elci, Satesh Bisaisee, Praveen Durgampudi, Roger Radix, Julietta Rodriquez-Guzman, Myngoc Thuy Nguyen, Omur Cinar Elci

Center for Global Health Publications

The rate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections among health care workers that is caused by sharps injuries is higher in the Caribbean and Latin America than in other regions of the world. To respond to and reduce occupational exposures to bloodborne pathogens while also strengthening capacities in the Caribbean, needlestick injury prevention training programs for health care workers were implemented, beginning in 2011. The programs included lectures, workshops, policy reviews, evaluations of safety devices, and workplace assessment. During the training, baseline data from health care workers on their personal history …

Well-Being And Mental Health Impact Of Household Flooding In Guyana, The Caribbean, Muge Akpinar-Elci, Shanomae Rose, Michele Kekeh

Center for Global Health Publications

Guyana has annually experienced excessive rainfall and flooding since 2005. This study investigated the general well-being and mental health problems among occupants of households affected by the December 2008 flooding in Guyana. A cross-sectional study design was used to administer validated questionnaires, which included sections on demographics, environmental exposure, general health, and personal behavior. The response rate to the survey was 70% (130/185). The findings indicate an increased self-reported poor health for study participants who smelled moldy odors inside of their home (OR: 4.1, 95% CI: 2.0‐12.0) and for individuals who had mold or mildew inside of their homes (OR: …

A Comparison Of Outcome Measures For Speech Motor Learning In Acquired Apraxia Of Speech Using Motor Learning Guided Treatment, Rachel K. Johnson, Aileen Lott, Jessica Prebor

Communication Disorders & Special Education Faculty Publications

Purpose: The purpose of this study was to investigate potential benefits of using a qualitative and quantitative outcome measure of articulation accuracy and suprasegmental characteristics in isolation for speech motor learning in acquired apraxia of speech (AOS).

Methods: Baseline, retention, and maintenance measures from an oral reading task of 2 speakers with chronic AOS and aphasia were rated using an 11-point multidimensional rating scale accounting for articulation and immediacy and a hybrid scale measuring number of correctly produced words, presence of distortions in correctly produced words, and immediacy of the production. Participants received motor learning guided treatment two days …

Effects And Moderators Of Psychosocial Interventions On Quality Of Life, And Emotional And Social Function In Patients With Cancer: An Individual Patient Data Meta‐Analysis Of 22 Rcts, J. Kalter, I. M. Verdonck-De Leeuw, M. G. Sweegers, N. K. Aaronson, P. B. Jacobsen, Robert U. Newton, K. S. Courneya, J. F. Aitken, J. Armes, C. Arving, L. J. Boersma, A. M.J. Braamse, Y. Brandberg, S. K. Chambers, J. Dekker, K. Ell, R. J. Ferguson, M. F. M. Gielissen, B. Glimelius, M. M. Goedendorp, K. D. Graves, S. P. Heiney, R. Horne, M. S. Hunter, B. Johansson, M. L. Kimman, H. Knoop, K. Meneses, L. L. Northouse, H. S. Oldenburg, J. B. Prins, J. Savard, M. Van Beurden, S. W. Van Den Berg, J. Brug, Laurien M. Buffart

Research outputs 2014 to 2021

Objective

This individual patient data (IPD) meta‐analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention‐related characteristics.

Methods

Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed‐effect model analyses were used to study intervention effects on the post‐intervention values of QoL, EF, and SF (z‐scores), adjusting for baseline values, age, and cancer type. We studied …

Resting Hormone Alterations And Injuries: Block Vs. Dup Weight-Training Among D-1 Track And Field Athletes, Keith B. Painter, Guy Gregory Haff, N. Travis Triplett, Charles Stuart, Guy Hornsby, Mike W. Ramsey, Caleb D. Bazyler, Michael H. Stone

Research outputs 2014 to 2021

Daily undulating periodization (DUP), using daily alterations in repetitions, has been advocated as a superior method of resistance training, while traditional forms of programming for periodization (Block) have been questioned. Nineteen Division I track and field athletes were assigned to either a 10-week Block or DUP training group. Year and event were controlled. Over the course of the study, there were four testing sessions, which were used to evaluate a variety of strength characteristics, including maximum isometric strength, rate of force development, and one repetition maximum (1RM). Although, performance trends favored the Block group for strength and rate of force …

Examining Injury Data Reporting Practices Among Wildland Firefighters, Erin M. Boggs

Graduate Student Theses, Dissertations, & Professional Papers

Wildland Firefighter (WLFF) Crews lack an injury surveillance program to collect information on non-traumatic and traumatic injuries. Tactical athletes including: police, military and structural firefighters all have a variety of collection systems in place for injury data collection. The lack of injury data prevents WLFF crews from identifying high-risk environments, implementing injury prevention programs, and improving the overall quality of care on the job. Over the last several decades the recent rise in wildfire occurrences and wildfire suppression costs creates a need for healthy and strong individuals in the field. The cost of firefighter salaries and medical care can be …