Medicine and Health Sciences Commons^™

Religious Liberty Challenges To Health Care In The Age Of Covid-19 – Supreme Court Arguments In Little Sisters Of The Poor V. Pennsylvania, Law, Rights, And Religion Project

Center for Gender & Sexuality Law

On Wednesday, May 6, 2020 the Supreme Court will be hearing arguments (telephonically) in the most recent challenge to the Affordable Care Act’s requirement that employee health plans include contraception coverage, Little Sisters of the Poor v. Pennsylvania. The case raises the important question of whether religious liberty rights can be used to limit access to health care at a time when the nation – and the world – is experiencing one of the worst global pandemics in human history. For this reason, the issues in this case take on special significance.

Methamphetamine: A Potential Risk Factor For Neurodegenerative Conditions, Katelyn Sarlette

Physician Assistant Scholarly Project Papers

Methamphetamine (METH) is a highly addictive substance that persists to be a major drug of abuse within the United States, particularly the Midwest regions. While some of the major health ramifications are well documented, its neurological impact is not fully understood. Neurodegenerative conditions like multiple sclerosis (MS), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS) continue to increase in frequency, particularly in the Midwest, yet there is no identifiable cause. The purpose of the study was to determine if METH use can contribute to the development of neurological conditions such as MS, PD, and ALS. A literature review was conducted …

Whole Word Vs Phoneme Error Scoring For Audiological Word Recognition Testing, Jennifer C. Arnoult

Honors Theses

The purpose of this study was to investigate a possible alternative method of scoring for word recognition testing. The current whole word scoring method is inefficient and often inconsistent with a client’s pure tone average scores, and previous research has suggested that phoneme error scoring may be a more effective and accurate scoring method. This project analyzed the audiogram and word recognition test scores of seventeen adult clients. The test used was the standard twenty-five-word list NU-6 test. The researchers analyzed the results from whole word scoring and phoneme error scoring of the same tests and compared the results to …

Perspectives Relating To Multicultural Training With Speech-Language Pathologists, Evy Jewell Hayes

Honors Theses

The goal of this project is to assess whether Speech-Language Pathologists (SLPs) feel adequately prepared and comfortable interacting with multicultural clients. To assess if an SLP feels prepared to interact with, to assess, to teach, or to treat a multicultural client, a 25-question survey was developed. The survey included questions pertaining to the SLPs’ experiences with other cultures, both professional and personal, if the SLP speaks more than one language, and if the SLP has received any formal training on how to interact with multicultural clients. The survey was sent out via email to 814 licensed SLPs practicing in pre-school, …

An Experimental Test Of The Effects Of Sleep Deprivation On Approach Behavior, Rebecca L. Campbell

Graduate Theses and Dissertations

Emotion regulation and sleep have been identified as mechanisms that may be involved in the development and maintenance of many mental health disorders. However, there has been little research into the relation between sleep and emotion regulation. To address this gap in knowledge, a novel study was conducted. We hypothesized that sleep deprived individuals would demonstrate less approach behavior toward a negatively valenced stimulus, as well as increased self-reported avoidance, compared to a control group. To test this, a randomized controlled experiment using a behavioral measure of approach and a self-report measure of avoidance was conducted. Fifty-two healthy individuals ages …

Perceptions Of Help-Seeking Likelihood For Depression: Examining The Relative Predictive Value Of Ethnicity And Barriers To Care, Linda Esperanza Guzman

Graduate Theses and Dissertations

Latinx and non-Latinx White adults 18 years of age and older experience depression at proportional rates. However, Latinxs seek specialized care for depression at lower rates than non-Latinx Whites, suggesting these groups experience barriers in accessing care differently. This study sought to test the theoretical steps of help-seeking as informed by the Gaining Access and Treatment Equity model (GATE model; Bridges, 2018). According to the GATE model, successful help-seeking means navigating a series of barriers: sequentially, these are perceived need, attitudinal barriers, and structural barriers. Participants (N = 987) were either Latinx (n = 437) or non-Latinx White (n = …

Examination Of Language Skills In Children Who Attend Head Start Programs, Madilyn Littlefield

Graduate Theses and Dissertations

Socioeconomic status and poverty can greatly affect child development and have lasting impacts throughout life. Children who are raised in a low socioeconomic status homes may experience limited parent sensitivity, limited parental engagement, and limited access to stimulating materials. These factors may also limit opportunities to experience rich language and literacy experiences which can negatively impact development of emergent literacy skills and later educational growth. To reduce the effects of poverty on school readiness, income-based childcare programs allow families access to affordable early school readiness opportunities that are developmentally appropriate. Head Start programs are designed to facilitate child development, provide …

Development Of The Caregiver-Child Auditory Skills Tracking (Cast) Scale: A Pilot Study On Caregiver Implementation Via International Telepractice, Elizabeth Ocampo-Roman

Graduate Theses and Dissertations

Parent engagement is a key component during early language development for all children, but particularly for a child with hearing loss. Through the application of technology-based models of service delivery such as telehealth, researchers have found an increase in parent-child engagement during auditory-verbal therapy (AVT) sessions due to the physical absence of the provider and parents becoming the primary language facilitators. However, current measures of parent-child interactions do not have a coding system to monitor facilitation of auditory skills. This present study will discuss the development of the Caregiver-Child Auditory Skills Tracking (CAST) Scale to track progress of caregiver implementation …

Barriers To Integrated Primary Care And Specialty Mental Health Services: Perspectives From Latinx And Non-Latinx White Primary Care Patients, Elizabeth A. Anastasia

Graduate Theses and Dissertations

High need, low access, and rising health care costs reveal the inadequacies of the current mental health system in the U.S. Racial/ethnic minorities, including Latinxs, face substantial disparities in accessing mental health treatment compared with non-Latinx Whites. Integrated primary care (IPC) offers an alternate model for meeting mental health needs by providing care in a way that is accessible to the general population. Though it has been suggested that IPC may reduce health disparities by decreasing barriers to mental health treatment, empirical data relevant to this question are limited. A series of three studies were conducted using a mixed methodology …

Associations Of Sex, Gender, And Gender Role Beliefs With Mental Health Attitudes, Ariel Erazo

Graduate Theses and Dissertations

Mental health stigma is a strong deterrent for individual with mental illness utilizing mental healthcare. Individuals living with a mental illness experience shame and marginalization due to stigma. Stigma is perpetuated through stereotypes created and used by people in the majority. Studies have been done to assess individual’s attitudes toward mental healthcare seeking in regards to gender, age, race, and profession. This study aimed to look at traditional gender role beliefs, sex, and gender expression as predictors of individual’s mental health attitudes and individual’s views of mental health norms. Using a cross-sectional survey, 392 participants completed scales that included the …

Evaluation Of Anthelmintic Therapies In A Fall Calving Beef Cowherd, Laine Zammit

Graduate Theses and Dissertations

Internal parasitism inevitability prompts economic loss in beef cattle production by decreasing growth performance and reproductive traits. Today, the most widely used class of anthelmintic used to treat parasitism, is the macrocyclic lactone. Many studies have conflicting results on the efficacy of macrocyclic lactones (ML) efficacy against internal parasitism. The objective of this study was to evaluate the effectiveness of moxidectin and eprinomectin, two of the MLs, on cow performance. Multiparous fall calving, crossbred beef cows (n = 106) were allocated randomly to 1 of 3 anthelmintic treatments: 1) Negative control (CON), in which cows did not receive an anthelmintic, …

Landscapes Of Danger: A Geospatial Analysis Of Perceived And Realistic Risk In Bryce Canyon National Park, Tia Francis

Graduate Theses and Dissertations

The quantification of risk has inspired a wide breath of literature from the physical sciences, social sciences, and interdisciplinary disciplines like geography. Many attempts to estimate risk via natural hazards either focus on quantifying realistic risk or perceived risk of lay persons, with very little overlap between these paradigms. Due to this, a considerable knowledge gap exists within perceived risk and natural hazards research. This study aims to provide a comprehensive, risk estimation and assessment strategy through a multi-hazard risk assessment of Bryce Canyon National Park (BRCA). This case study analyzed knowledge of risk among visitors with perception surveys and …

Calling Out The Trolls: Responses To Witnessing Use Of The “Troll” Label As A Defense In An Online Group Context, Dene E. M. Wamsley

Graduate Theses and Dissertations

Although the term “troll” has existed since the 1980s, its meaning has shifted in recent years as social media use has increased. People provide contrasting and imprecise definitions for what constitutes “trolling,” and often apply the term subjectively to describe online discussants who are uncivil, who are deviant, and who and present counter-attitudinal opinions. Exposure to deviance, counter-attitudinal information, and incivility often leads to unwanted psychological effects. In theory, labeling an uncivil, counter-attitudinal deviant as a “troll” proposes that their intention is to disrupt the conversation and upset other discussants, which provides a reason for why incivility is used, and …

The Determination Of Phosphorylation Of Nato3 By Pka, Miranda M. Regenold

Masters Theses

One of the leading regulators of neuronal cell differentiation in the CNS is the family of basic helix–loop–helix (bHLH) transcription factors. One of these proteins, Nato3, is associated with the formation of dopaminergic neurons. Transcription factors can be regulated by kinase activity, and in order to detect the associated change of phosphorylation of Nato3, we have generated Nato3 with specific epitope tags that allow for the detection and isolation of the Nato3 protein. Through subcloning techniques and a successful transformation of the Nato3 gene with the sequences of the 3X-Flag epitope and the Myc epitope into the pcDNA3.0 vector, we …

Evidence-Based Policy And Procedure Review System, Meredith A. Stokes

Doctoral Projects

Policies and procedures guide practice and the care of patients in every field of healthcare. Incorporating best practice evidence into clinical practice is a critical step towards providing safer patient care and improved patient outcomes. The challenge has been finding a way to incorporate best practice evidence into policies and procedures. Accordingly, an evidence-based project to answer the following clinical practice question was proposed: What is an evidence-based strategy for reviewing, updating, and disseminating policies and procedures for office staff at a cancer treatment organization? Through the use of Donabedian’s Model for Quality Improvement, student created tools, and an evidence-based …

Surgical Innovations For Gerd: Comparing Outcomes Of Magnetic Sphincter Augmentation And Nissen Fundoplication, Steffani Nicole Johnston Mack

Physician Assistant Scholarly Project Papers

Gastroesophageal reflux disease (GERD) is a common chronic upper gastrointestinal disease with both objective and subjective components. It is defined as a reflux of gastric contents into the esophagus, which causes symptoms such as heartburn, regurgitation, and dysphagia. Severity of the disease is dependent on both severity of the symptoms and severity of the mucosal damage done by the reflux. While many cases of GERD can be managed with oral medication, persistent and refractory cases require surgical intervention. The purpose of this literature review is to compare the efficacy of GERD’s gold standard surgical technique, the Nissen fundoplication, with a …

Stroke As The Initial Presentation Of Takayasu's Arteritis: A Case Report, Paran Davari, Paige Sutton, Kimberly S. Jones

Neurology Faculty Publications

In this study, we report the case of a pediatric neurology stroke patient who was ultimately diagnosed with Takayasu's Arteritis. Our case describes a 14-year-old Hispanic female with no significant past medical history who presented to an outside hospital for acute onset of confusion and right sided weakness. She was given tissue plasminogen activator (TPA) at the outside hospital and transferred as a stroke alert. Initial The NIH stroke scale (NIHSS) was 12 with primarily right sided symptoms. Physical exam was also significant for asymmetric pulses and blood pressures. Imaging was significant for multifocal stenosis. She was ultimately diagnosed with …

The Β3-Adrenergic Receptor Agonist Mirabegron Improves Glucose Homeostasis In Obese Humans, Brian S. Finlin, Hasiyet Memetimin, Beibei Zhu, Amy L. Confides, Hemendra J. Vekaria, Riham H. El Khouli, Zachary R. Johnson, Philip M. Westgate, Jianzhong Chen, Andrew J. Morris, Patrick G. Sullivan, Esther E. Dupont-Versteegden, Philip A. Kern

Internal Medicine Faculty Publications

BACKGROUND. Beige adipose tissue is associated with improved glucose homeostasis in mice. Adipose tissue contains β3-adrenergic receptors (β3-ARs), and this study was intended to determine whether the treatment of obese, insulin-resistant humans with the β3-AR agonist mirabegron, which stimulates beige adipose formation in subcutaneous white adipose tissue (SC WAT), would induce other beneficial changes in fat and muscle and improve metabolic homeostasis.

METHODS. Before and after β3-AR agonist treatment, oral glucose tolerance tests and euglycemic clamps were performed, and histochemical analysis and gene expression profiling were performed on fat and muscle biopsies. PET-CT scans quantified brown adipose tissue volume and …

Myeloid-Specific Deficiency Of Pregnane X Receptor Decreases Atherosclerosis In Ldl Receptor-Deficient Mice, Yipeng Sui, Zhaojie Meng, Se-Hyung Park, Wei-Wei Lu, Christopher Livelo, Qi Chen, Tong Zhou, Changcheng Zhou

Pharmacology and Nutritional Sciences Faculty Publications

Abstract The pregnane X receptor (PXR) is a nuclear receptor that can be activated by numerous drugs and xenobiotic chemicals. PXR thereby functions as a xenobiotic sensor to coordinately regulate host responses to xenobiotics by transcriptionally regulating many genes involved in xenobiotic metabolism. We have previously reported that PXR has pro-atherogenic effects in animal models, but how PXR contributes to atherosclerosis development in different tissues or cell types remains elusive. In this study, we generated an LDL receptor-deficient mouse model with myeloid-specific PXR deficiency (PXR^ΔMyeLDLR^−/−) to elucidate the role of macrophage PXR signaling in atherogenesis. The …

Autism Spectrum Disorder: Investigating Predictive Adaptive Behavior Skill Deficits In Young Children., Emma L. Feige

Electronic Theses and Dissertations

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder that consists of difficulties with social communication and language, as well as the presence of restricted and repetitive behaviors. These deficits tend to present in early childhood and usually lead to impairments in functioning across various settings. Moreover, these deficits have been shown to negatively impact adaptive behavior and functioning. Thus, early diagnosis and intervention is vital for future success within this population. The purpose of this study was to further examine the subscales that comprise the adaptive behavior section of the Bayley-III to determine which of the ten subscales are …

Functionalizing Nanoparticles With Cafa Protein To Target Bar Peptide For Oral Delivery Applications., Hetal Desai

Electronic Theses and Dissertations

Background: Porphyromonas gingivalis adherence to Streptococcus gordonii may be important for P. gingivalis colonization in the oral cavity. Nanoparticles encapsulating synthetic peptide BAR (BAR-NPs) inhibit P. gingivalis adherence more potently than free BAR. However, BAR-NPs would exhibit low retention in an open flow environment. Hypothesis: Targeting BAR-NPs to the streptococcal surface using CafA protein will enhance their efficacy. Methods: CafA-modified NPs encapsulating BAR were synthesized using double emulsion approach. Surface binding and retention, and release kinetics of BAR from CafA-modified NPs was assessed. Functional inhibition assays were performed using dual a species biofilm. Results: CafA-modified NPs demonstrated specificity of adhesion, …

Hearing Loss: Investigating The Comfort, Confidence, Knowledge, And Preparedness Of Kentucky School-Based Speech-Language Pathologists., Amanda Matsumoto

Electronic Theses and Dissertations

Due to advances in technology, the number of users with hearing devices have increased. These users are often mainstreamed into classrooms with typical hearing peers. However, even with these devices, speech and language impairments may still persist. This study was conducted to analyze school-based speech-language pathologists’ (SLP) comfort, confidence, knowledge, and preparedness in treating students with hearing loss in Kentucky schools. 48 SLPs practicing in all levels of school including elementary, middle, and high, completed an anonymous online survey through the Qualtrics^® platform. Responses were received from SLPs representing 11 out of the 15 regions throughout Kentucky. Spearman’s rank …

Tobacco Enhances Bacterial-Induced Periodontal Bone Loss In Mice., Mina Iskander

Electronic Theses and Dissertations

Background: Tobacco smoking is the leading environmental risk factor for periodontal diseases. Delineation of the mechanisms underlying tobacco-induced or exacerbated periodontitis is hampered by the lack of an appropriate and reliable animal model. Hypothesis: We hypothesized that Porphyromonas-gingivalis-infected, cigarette smoke-exposed mice would represent reproducible models of acute (ligature model) and chronic (oral gavage model) tobacco-enhanced periodontitis that reflect multiple aspects of the disease noted in human smokers. Methods: In a chronic oral gavage disease model, Balb/c mice (6-8 weeks, 4 groups of n = 6 per group) were exposed to smoke produced by a Teague-10 smoking machine from 1R6F research …

School-Based Speech-Language Pathologist's Perceptions Of Sensory Food Aversions In Children, Ellen Monroe

Electronic Theses and Dissertations

Sensory Food Aversions occur frequently in children who are likely to appear on Speech-Language Pathologist’s (SLP’s) caseloads. The lack of research regarding intervention for Sensory Food Aversions in schools and the assertion of a gap in school-based services for children with feeding disorders was a significant indicator for the need of the study. A quantitative, descriptive, exploratory research design was selected using a self-developed questionnaire in order to exploreschool-based SLP’s perceptions of their knowledge and skills related to Sensory Food Aversions, as well as determine resources available for working with this population. Findings from the study suggest a need for …

Preheating-Temperature Affects Nanoleakage And Degree Of Conversion Of Dual-Cured Adhesive/Resin-Composite, Sara Adel Botros, Farid Sabry El-Askary, Zainab Diaa Soliman, Dalia Ibrahim El-Korashy

Dentistry

No abstract provided.

Volatile Organic Compound Exposure And Cardiometabolic Syndrome Risk In A Nationally Representative Cohort., Stacey Lane Konkle

Electronic Theses and Dissertations

BACKGROUND: The relative importance of environmental exposures such as volatile organic compounds (VOCs) is one of the paramount public health priorities of our time, yet is presently unstudied. VOCs are ubiquitous in the environment and have been associated with numerous adverse health effects, including a number of cardiovascular and metabolic effects that are components of Cardiometabolic Syndrome (CMS). OBJECTIVES: To examine the relationship between CMS and individual-level exposures to VOCs, measured as urinary metabolites of VOCs (UM-VOCs), in a nationally representative sample. METHODS: Associations between urinary biomarkers of exposure to 19 parent VOCs and CMS were assessed using the National …

Oral Health-Related Quality Of Life In Us Adults With Type 2 Diabetes., Giang Truong Vu

Electronic Theses and Dissertations

This dissertation focused on the relationship between type 2 diabetes (T2DM) and oral health-related quality of life (OHRQoL) and the factors associated with this relationship in the US. The objectives of the dissertation research were a three-part process: (1) to understand the relationships of T2DM with poor OHRQoL, clarify risk and preventive factors that affect this association, and identify research gaps in the literature, (2) to analyze risk factors associated with poor OHRQoL in US adults with T2DM using a nationally representative random probability cluster sample, and (3) to apply structural equation modeling (SEM) to a simplified Andersen’s Behavioral Model …

Transient Display Of Chimeric Proteins On Biological Surfaces As An Effective Strategy For Modulations Of Innate And Adaptive Immune Responses., Pradeep Shrestha

Electronic Theses and Dissertations

The major premise of this dissertation was to transiently display novel immunological ligands on biological membranes as a localized means of modulating innate and adaptive immune responses with applications to bone marrow and pancreatic islet transplantation. In Chapter two, we engineered donor allogeneic bone marrow cells to transiently display a novel form of FasL, SA-FasL, to efficiently purge out alloreactive donor T cells to prevent acute GVHD. In Chapter three, we engineered pancreatic islets with a novel form of CD47, SA-CD47, to modulate instant blood mediated inflammatory reaction (IBMIR) to prevent immediate islet graft loss following intraportal transplantation. GVHD is …

Sulforaphane Protects Against Ethanol-Induced Apoptosis And Teratogenesis Through Epigenetic Modulation Of Anti-Apoptotic Genes., Yihong Li

Electronic Theses and Dissertations

Background. Ethanol-induced excessive apoptosis in neural crest cells (NCCs), a multipotent progenitor cell population, is one of the major mechanisms underlying the pathogenesis of Fetal Alcohol Spectrum Disorders (FASD). However, the molecular mechanisms underlying FASD that results from maternal alcohol exposure during pregnancy are poorly understood. The overall goals of this study are to examine the mechanisms by which ethanol induces apoptosis and malformations in vitro and in vivo, and to develop a nutritional-based approach by using SFN and SFN-rich BSE to prevent FASD through epigenetic modulation. Results. This study demonstrates that ethanol exposure resulted in a significant increase …

Preventable Hospitalization Among Type 2 Diabetes Patients In Kentucky Before And After Medicaid Expansion 2010-2017., Turky Jamil Arbaein

Electronic Theses and Dissertations

Objectives: 1) Analyze county level variation in T2DM-PH rates in Kentucky before ACA (2010-2013) and after the ACA (2014-2017). 2) Analyze the relationship between county level socioeconomic factors (income per capita, percentage of uninsured people, percent of urban population, primary care and general preventive offices, population aged 65 and above, median age, household income, percentage in poverty, and unemployment rate ) and county level T2DM-PH rates before (2010-2013) and after (2014-2017) ACA implementation in Kentucky. Method: This research was conducted in two phases: Phase one of this study estimated the county-level PH variation among T2DM patients across eight years (2010-2017), …