Medicine and Health Sciences Commons^™

Examining Anxious Attachment And Its Effects On Sexual Behaviors In Adulthood, Justin Graham

Theses and Dissertations--Family Sciences

The current study aimed to investigate the relationship between anxious attachment and adult sexual behaviors. The study utilized pairfam, a nationally representative German sample, as a secondary data set for its quantitative analysis. Participants responded to two anxious attachment scales and questions regarding sexual desire, sexual confidence, and age at first sexual experiences. Analyzing data from 5561 individuals, averaging 29.27 years old, a path analysis was conducted to assess variable effects. Findings indicate that higher anxious attachment correlates with reduced sexual confidence and earlier onset of sexual intercourse. Future studies should investigate additional attachment scales and include a more diverse …

Examining The Feasibility Of Implementing Farm To School Programs In Rural Kentucky Schools: Barriers And Successes Of Initiating Programming As Identified Through Teacher’S Observations, Christina Wilson

Theses and Dissertations--Nutrition and Food Systems

Farm to School (FTS) programs provide experiential learning opportunities to children that have the potential to shape eating patterns and, in turn, improve health and learning outcomes. Participation in FTS programs in Kentucky is growing. However, programming varies widely across schools, and few have an edible school garden. This study examined the feasibility of establishing an edible school garden while incorporating FTS programming by evaluating teachers' observations and experiences. Six rural Kentucky schools were selected to receive a $5,000 grant to initiate an edible school garden and incorporate FTS programming. A Qualtrics survey measured six categories regarding implementation. The results …

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …

Influencers Of Fidelity In Implementation Of Go Napsacc At Selected Early Childhood Education Centers In Kentucky, Adeyimika Desmennu

Theses and Dissertations--Nutrition and Food Systems

Several lifestyle interventions have been explored to ameliorate obesity and most associated non-communicable diseases in children attending early childhood education settings (ECE). Go Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) program has been implemented nationally to improve dietary intake and physical activities among children in ECE settings. However, a large proportion of ECE centers do not complete the five-step process that leads to change. This project, thus, aims to identify contextual factors that facilitate and/or impede the fidelity in implementation of Go NAPSACC.

This thesis is a comparative case study using secondary data to compare, and contrast reported …

Current And New Perspectives On Equine Protozoal Myeloencephalitis Therapeutics, Izabela De Assis Rocha

Theses and Dissertations--Veterinary Science

Equine protozoal myeloencephalitis (EPM) is an important neurologic disease of horses in the Americas. It is caused by the apicomplexan parasite Sarcocystis neurona and less commonly by the related parasite Neospora hughesi. Current antiprotozoal treatment relies on the use of either folate inhibitors (sulfadiazine/pyrimethamine) or triazine drugs (diclazuril/ponazuril), with a success rate of 60-70% regardless of the drug of choice. Successful treatment is defined as the improvement of at least one ataxia grade following the modified Mayhew scale, which often is not enough for the horse to return to the previous level of performance. The goals of this dissertation …

Evaluating The Caring Cards Program And Its Effect On Mental Health Indicators Among A Self-Defined Agricultural Group In Rural Kentucky, Katrina Clontz

Theses and Dissertations--Community & Leadership Development

Suicide is currently the 11^th leading cause of death in the Unites States (American Foundation for Suicide Prevention, 2024), and is especially high among the farming and agricultural population (Kennedy et al., 2021; Klingelschmidt et al., 2022; Monteith et al., 2020). Additionally, mental health access and outcomes are worse among this population, partially due to the inaccessibility of care in rural areas (Taylor, 2019). Communication among caring individuals is thought to be an effective suicide prevention strategy (Long, 2023; Ross & Bassilos, 2019). The Caring Cards program was developed as a way to facilitate mental health communications among a …

Exploring The Usefulness Of Pre-Visit Materials For Children With Autism At A Public Museum, Jennifer K. Fortuna, Elaine Chamberlain, Libby Filice, Madeline Kurt, Taylor Porter, Shannon Twichell, Stephanie Ogren

Translational Science in Occupation

Abstract

Children with autism spectrum disorder (ASD) participate in community-based settings at lower rates than typically developing children. Museums provide a structured, predictable, and supportive place for children with ASD to learn. Visiting a museum may create unique challenges for children with ASD and their families. Sensory processing disorder (SPD) is a common barrier to participation that makes it difficult to process information coming in through the senses. For children who are easily overstimulated, crowds, noise, and long lines can be a source of anxiety and stress. Providing pre-visit materials such as social stories, accessibility maps, and communication books can …

Routines And Attitudes Of Smartphone And Tablet Use For Social Connection Among Rural Older Adults, Amanda U. Davis, Chelsea Conrad, Maya Dupree, Deja Myers, Monica Le

Translational Science in Occupation

Background: Loneliness is associated with negative health outcomes for older adults. Social connection may occur using information and communication technologies (ICTs), such as smartphones and tablets and interventions to increase ICT use have shown positive results. Purpose: This study aims to investigate the routines and attitudes of smartphone and tablet use for social connection and secondarily, determine if there is an association between the routines and attitudes and connection. Methods: Participants completed a survey with questions that included demographics, 3-item UCLA Loneliness Scale, Brief Sense of Community Scale, and open-ended questions. Results: Participants (N=21, median age of 76-80) report …

The Role Of An Occupational Therapy Practitioner In Professional Advocacy: A Scoping Review, Sarah Mckinnon, Natalie Petrone, Amanda Tarbet

Translational Science in Occupation

Background: Participation in professional advocacy amongst occupational therapy practitioners (OTPs) is necessary for strengthening the profession. Although advocacy remains essential for practice, specific activities of OTPs in professional advocacy remain inconsistent and unclear.

Purpose: To examine the activities occupational therapy practitioners are engaging in related to professional advocacy. To identify key strategies and future opportunities to strengthen OT practitioner participation in professional advocacy.

Methods: We systematically searched 4 databases and 1 search engine for relevant articles- MEDLINE via PubMed, The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebscohost, ERIC via Ebscohost, APA PsycInfo …

Lack Of Protocol Standardization For Vestibular Evoked Myogenic Potentials, Kendall J. Werhane

Graduate Theses/Dissertations

Vestibular Evoked Myogenic Potentials (VEMPs) are used in the field of Audiology to allow us to evaluate otolith and vestibular nerve function, which provides us with information that prior testing could not exclusively identify. While the collection of data from VEMPs is useful for many audiologic and vestibular diagnoses, achieving accurate recordings can be challenging due to the complex nature of testing. The article below will take a deep dive into different VEMP devices and the protocol they used to record VEMPs on their participants. The purpose of developing state-of-the-art (SOTA) equipment for VEMP testing is to ensure that the …

The Kinetic Modulation Of Α - Synuclein Fibrillation And Toxicity By 4-Phenylbutyric Acid, Kristos Awuah Baffour

Graduate Theses/Dissertations

ABSTRACT

The Protein misfolding and aggregation of alpha-synuclein (α-syn) into neurotoxic amyloids underlies the pathogenesis of neurodegenerative diseases such as Parkinson's disease (PD). 4-Phenylbutyrate (PBA), an FDA drug approved for treating urea cycle disorders, has garnered significant attention as a potential chemical chaperone for targeting alpha-synuclein (α-syn) aggregation. Using in vitro assays, we demonstrated that PBA treatment alters the pattern of α-syn aggregation, as evidenced by reduced formation of oligomeric species and its increased susceptibility to proteolytic cleavage under the influence of PBA. Proteinase K assay, surface plasmon resonance, and Nile red studies indicate that PBA interacts with the extensive …

Development Of Functional Plasmonic Nanoceria For The Ultrasensitive Detection Of Ebola Glycoprotein, Carissa A. Sutton

Graduate Theses/Dissertations

Infectious diseases have been increasing in both severity and prevalence, leading to increasing economic burdens and health concerns. Ebola hemorrhagic fever is an infectious disease that is both highly communicable and highly fatal. Current detection methods for the virus have high specificity and sensitivity but have long and/or complicated procedures that do not allow for early virus detection in highly affected areas. Compared to the lengthy procedure of reverse transcription-polymerase chain reaction (RT-PCR), real-time RT-PCR is more time-efficient; however, specificity and sensitivity are reduced. Since early detection of the virus is the only way to increase survival rates, sensitive detection …

The Efficacy Of Zuranolone Versus Placebo In Postpartum Depression And Major Depressive Disorder: A Systematic Review And Meta-Analysis, Mackenzie Winslow, Emily White, Suzanne J. Rose, Elijah Salzar, Eric C. Nemec

Physician Associate Studies Faculty Publications

Background Zuranolone, an oral version of allopregnanolone and neurosteroid, is a novel drug for the treatment of major depressive disorder (MDD) and postpartum depression (PPD).

Aim The purpose of this systematic review and meta-analysis was to assess the efficacy of zuranolone in the treatment of MDD and PPD.

Method A systematic search was conducted using EBSCOhost to simultaneously search Academic Search Premier, APA PsycArticles, APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL Ultimate, and MEDLINE with Full Text. Two independent reviewers screened the articles and completed a full-text review using Covidence. The quality of …

Vacuum-Induced Tamponade For Managing Postpartum Hemorrhage: A Systematic Review, Laura M. Card, Alexandra V. Klinkowski, Elijah Salzar, Eric C. Nemec, Suzanne J. Rose

Physician Associate Studies Faculty Publications

Objective: Postpartum hemorrhage is a leading cause of maternal mortality and morbidity around the globe. The novel low-suction vacuum hemorrhage device (VHD) provides an alternative treatment option for cases of postpartum hemorrhage when first-line uterotonic agents fail. This systematic review aims to review current data evaluating the overall efficacy and safety of VHDs in treating postpartum hemorrhage.

Methods: We searched CINAHL Ultimate, Academic Search Premier, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE with Full Text, and PubMed and reference lists of retrieved studies for eligible studies that included outcomes of effectiveness, efficacy, or safety. Two …

Effect Of Personalized Spinal Profile On Its Biomechanical Response In An Emg-Assisted Optimization Musculoskeletal Model Of The Trunk, C. Larivière, A.H. Eskandari, H. M., F. Ghezelbash, D. Gagnon, A. Shirazi-Adl

Études primaires

Recent developments in musculoskeletal (MS) modeling have been geared towards model customization. Personalization of the spine profile could affect estimates of spinal loading and stability, particularly in the upright standing posture where large inter-subject variations in the lumbar lordosis have been reported. This study investigates the biomechanical consequences of changes in the spinal profile. In 31 participants (healthy and with back pain), (1) the spine external profile was measured, (2) submaximal contractions were recorded in a dynamometer to calibrate the EMG-driven MS model and finally (3) static lifting in the upright standing challenging spine stability while altering load position and …

Availability, Use, And Impact Of Workplace Mental Health Supports During The Covid-19 Pandemic In A Canadian Cohort Of Healthcare Workers, Shannon Ruzycki, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, France Labreche, Tanis Zadunayski, Nicola Cherry

Études primaires

We investigated the availability and use of workplace mental health (MH) supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers (HCW) and measured anxiety and depression by the Hospital Anxiety and Depression Scale (HADS) completed at four contacts 2020–2022. Reports were available for 4400 HCW working with patients. Half the HCWs had a clinically significant HADS score at one or more contacts Access to MH supports increased during the pandemic, with 94% reporting access to some workplace support by 2022: 47% had made use of at least one support. 25% of those with high HADS scores used …

Hitting The Right Spot: How Inclusion Of Pleasure In Sexual Education Can Lead To Safer Sex Practices, Jessica Guerrette, Tara Hassani Goodarzi, Joanne Chopak-Foss, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

Advocacy: Public Health In Its Truest Form, Tobi Oloyede, Wandoo Abwa, Katie M. Mercer

Eagles Talking About the Public’s Health

No abstract provided.

Firearms, Intimate Partner Violence, And Maternal Mortality: A Call For Action And Reform, Alisha Riggins, Jessica Guerrette, Nazish Masud, Tobi Oloyede, Sarah Sejoro, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Point Of Care Ultrasound (Pocus) For Advanced Practice Providers (Apps), Crystal S. Rogers

DNP Projects

Background: Advanced practice providers (APPs) routinely lack the skillset to perform Point of Care Ultrasound (POCUS) because currently, there is not a standardized curriculum within scholarly programs (Santos et al., 2018) and/or inadequate hospital training to perform these competencies (Huang et al., 2021). The absence of a standard curriculum has limited the ability of APPs to practice with full scope, provide care that is comparable to physician partners in the acute care setting, and deliver highest quality of patient care. Implementing standard education to train APPs for POCUS addresses this identified gap.

Purpose: The purpose of this project was to …

Investigating The Correlation Between Social Determinants Of Health And Drug Selling Among People Who Use Drugs In Rural Appalachia, Kentucky, Grace A. Debo

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

Abstract

Aims: To identify demographic, socioeconomic, health and access to resources, and drug use correlates associated with drug selling among adult, people who use drugs (PWUD) in rural Appalachia.

Methods: This cross-sectional study analyzed survey data from the ongoing KyOSK and SNAP projects. The surveys included information on participant characteristics (demographic, socioeconomic), and health and drug use behaviors. Our analysis was restricted to only those who answered the question regarding drug selling (n=738). Both univariate and multivariate logistic regression models were employed to identify correlates of drug selling.

Results: Among 738 participants, 20.6% reported selling or attempting to sell drugs …

Pharmacy Involvement In Increased Access To Opioid Treatment Programs, Catherine O'Rourke

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

The opioid epidemic still affects many Americans today. Despite approved medication treatments for opioid use disorder (OUD), a majority of the population with OUD have not received treatment. Since pharmacists are the most accessible health care professional and had an important role providing care during the COVID-19 pandemic, there has been a push to expand pharmacists’ scope of practice. The primary purpose of this investigation was to identify the benefits and barriers to community pharmacist-led treatment of OUD. The secondary purpose was to determine whether pharmacist participation in opioid treatment programs (OTPs) or office based opioid treatment (OBOT) would be …

The Effects Of Stigma Within The Prep Care Cascade Among People Who Inject Drugs In Rural Kentucky, Abby Burton

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

Background: Injection drug use has increased HIV burden in low-prevalence communities, specifically within rural Kentucky. Pre-exposure prophylaxis (PrEP) has been successful in terms of HIV prevention, yet uptake remains low among people who inject drugs (PWID). PWID living in rural areas face unique challenges to receiving PrEP care, including significant barriers of substance use- and HIV-related stigma. Recent studies have only started to explore the overlapping effects of these two stigmas. Considering the barriers each stigma independently poses to PrEP care, it is important to investigate their role in tandem for any compounding effects. This paper is a secondary analysis …

A Case Study In Program Evaluation, Lydia Williams

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

The three core functions of public health are assessment, policy development, and assurance, and program evaluation falls under the latter category. A program is incomplete without an in-depth understanding of how well it works and what steps can be taken to make sure there is continuous progress and improvement.

In this case study, I developed an evaluation plan for the Lexington-Fayette County Health Department’s (LFCHD) infectious disease outbreak education program. The need for such a program was realized after a MRSA outbreak among a Kentucky high school football team. This case study employed the Center for Disease Control and Prevention …

Trust In Local Health Departments: A Cross-Sector Analysis Of Urban And Rural Communities, Kelsie Kwok

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

Cross-sector collaboration is being looked to as best-practice for addressing complex issues. Given that trust is an important aspect of a well-functioning network, partners may have varying perceptions of trust regarding their counterparts. The primary objective is to examine partnerships and trust scores among six Kentucky communities (three urban, three rural) and their efforts to address unmet social needs. The secondary objective is to discuss differences among urban and rural communities regarding local health departments and the role of trust. A social network analysis (SNA) was conducted using the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) …

Patterns Into Pathways For Improving Safety Culture: Refined Latent Class Analysis Informs Tailored Decision Support For South Carolina Dss Safety Culture Improvements, Michaela Voit

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

The rising prevalence of exposures to adverse childhood experiences (ACEs) demands a coordinated public health response, as a significant body of research details the cumulative impact of ACEs on chronic morbidities contributing to reduced life expectancy. Child welfare workers (CWW) are embedded in this public health effort, tasked with preventing and mitigating the impacts of ACEs through family and prevention services. The National Partnership for Child Safety (NPCS) may improve the wellbeing of CWWs and the effectiveness of Child Welfare (CW) services by improving the quality of safety culture within CW organizations. To inform NPCS quality improvement efforts, our project …

Health-Related Social Needs Before And After Critical Illness Among Medicare Beneficiaries, Tamar A. Kaminski

Yale Medicine Thesis Digital Library

Health-Related Social Needs (HRSNs), such as financial strain, food insecurity, social isolation, and transportation disadvantage, are unmet social needs associated with poor health outcomes and increased healthcare utilization. In qualitative work, survivors of the intensive care unit (ICU) report financial strain; however, little is known about food insecurity, social isolation, and transportation disadvantage after critical illness. The objectives of this study were twofold: (1) to ascertain changes in three HRSNs—food insecurity, social isolation, and transportation disadvantage—from the year before critical illness to the year following discharge among older adult survivors of critical illness, and (2) to evaluate demographic, pre-admission, and …

Evaluating The Length Of Clinical Rotations In Medical Laboratory Science Education, Kendal Beazer

Dissertations and Theses

Medical laboratory scientists and technicians play a crucial role in healthcare by utilizing advanced methods to aid in the diagnosis, monitoring, and prevention of a wide range of diseases. Certifying as an MLS or MLT professional is detailed and specific, requiring years of laboratory training that is crucial to accurately perform testing that impacts patient care. Shortages of qualified medical laboratorians have persisted for decades, causing laboratory administrators to hire individuals who lack basic laboratory training. Laboratory education programs are not keeping up with the staffing demands, in part due to the lack of clinical rotation placements needed for MLS …

A Cost-Effectiveness Analysis Of Oropharyngeal Cancer Post-Treatment Surveillance Practices, Rema Shah

Yale Medicine Thesis Digital Library

Post-treatment surveillance imaging for oropharyngeal squamous cell carcinoma (OPSCC) is guided by the National Comprehensive Cancer Network (NCCN) and often is routinely performed beyond the suggested guidelines. With the advent of biomarker-based disease surveillance, there may be an alternative option that can reduce the cost-burden of post-treatment imaging for OPSCC. This study investigates the comparative cost-effectiveness of a hypothetical miRNA biomarker test for specifically HPV-negative (HPV-) OPSCC post-treatment surveillance and also investigates whether the extra imaging practices that are often employed for both HPV+ and HPV- OPSCC are truly cost-effective in order to inform evidence-based decision making after OPSCC treatment. …