Medicine and Health Sciences Commons^™

A Case Study In Program Evaluation, Sydney Wilcoxson

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

Evaluation is a critical component of a successful evidence-based health promotion program or intervention. In public health, evaluations ensure that interventions are achieving their intended objectives, provide feedback on program strengths and weaknesses, and serve as a mechanism of accountability and transparency to stakeholders so that they know their invested resources are being utilized in the most efficient manner. Without evaluation, it would be much more difficult to understand how well the intervention is working, and communication between stakeholders would be significantly affected.

A recently confirmed Methicillin-resistant staphylococcus aureus (MRSA) outbreak on a Fayette County Public Schools (FCPS) high school …

The Relationship Between Self-Reported Depressive Symptoms At 3 Timepoints And Infant Sleep Practices At 6-Month Follow-Up In A Population Of Mothers In Santo Domingo, Ecuador, Kassidy Lane

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

Abstract

Background

Previous studies have linked maternal depression with poor infant sleep (e.g., waking up at night and infants having trouble settling to sleep). This study examined the relationship between maternal depressive symptoms at three time points and safe infant sleep at 6-month follow-up.

Methods

Data was collected from a randomized clinical trial including 100 women recruited from a health center in Santo Domingo, Ecuador during their third trimester of pregnancy. Log-binomial regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of safe infant sleeping at 6 months among mothers who reported depressive symptoms at 3 …

Interprofessional Collaboration In A Lung Cancer Screening Learning Collaborative, Angela Fu

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

The primary purpose of this paper is to identify partners and levels of engagement through investigating participants of the Kentucky Lung Cancer Screening Learning Collaborative: Achieving Equity, which was led by the Kentucky Lung Cancer Education Awareness Detection Survivorship (KY LEADS^TM) Prevention and Early Detection team now known as the Quality Implementation of Lung Cancer Screening (QUILS^TM) group in collaboration with the Healthy Kentucky Initiative supported by UK HealthCare. A secondary objective was to identify and categorize organizational and system policies related to lung cancer and screenings. The six-session series focused on equity in lung cancer …

The Relationship Between Social Vulnerability And Cardiovascular Disease Outcomes In Kentucky, Karcyn Brummett

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

Background: Cardiovascular disease (CVD) is a leading cause of death in the United States, and some regions, such as the Appalachian region, have relatively higher burdens of CVD deaths. CVD has been shown to be influenced by various social factors, with some leading to an increased risk of disease.

Objective: The objectives of this study were to determine the potential correlation between social vulnerability and cardiovascular disease outcomes in Kentucky and how this varies in the Appalachian versus non-Appalachian regions of the state.

Methods: Heart disease death rates and county social vulnerability index (SVI) values in Kentucky were evaluated to …

Adolescent Vaccination Rates And Pharmacists' Ability To Prescribe And Administer, Paul Jake Faulkner

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

Vaccines are arguably the most significant advancement in healthcare in the prevention of diseases. The CDC has created a series of recommendations to help guide providers and patients toward a healthier future with vaccines. These recommendations were adopted by the Health People Goals 2020 and 2030 to increase each state's rates of completing specific vaccination series by defined age thresholds. This capstone aims to assess if there is a correlation between vaccination rates and pharmacists; specifically to see if states that give less restrictions about vaccinating would have higher rates. It is also important to see if states with more …

Cardiovascular Disease Among Commercially Insured Adults With Type 1 Diabetes In The Us , 2016-2019, Orighomisan F. Agboghoroma

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

Objectives: The objective of this study is to examine the overall as well as age- and sex-specific burden of cardiovascular disease (CVD) among adults with type 1 diabetes (T1D) in the US using nationwide commercial claims data from 2016-2019.

Research Design and Methods We used nationwide commercial claims data (1/1/2016-12/31/2019) from Merative™MarketScan to identify adults ≥20 years with T1D (ascertained using ICD-10 codes). CVD was ascertained using ICD-10 diagnostic codes for myocardial infarction, atrial fibrillation, ischemic heart disease, heart failure, peripheral arterial disease, and stroke. The annual prevalence and age-specific prevalence of CVD were calculated. Age-adjusted prevalence of CVD …

Changes In Primary Care Availability In Appalachia, Whitney Beckett

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

The Affordable Care Act (ACA) was a groundbreaking moment in the United States healthcare system. It affected many different aspects of the system, including access to primary care professionals. Primary care professionals provide a key role in American’s health, especially when it comes to preventative care. With one-third of Americans experiencing barriers to such access, a solution is desperately needed to increase said access. These barriers are especially profound in low-income, underserved areas such as the Appalachian regions of Georgia, Kentucky, Tennessee, and West Virginia. The ACA attempted to increase access via Medicaid expansion; however, not all States expanded their …

Empirical Insights Into Survivorship Care: A Cross-Sectional Study Of Coc Accredited Hospitals In Kentucky, Amanda M. Beckett

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

ABSTRACT

Background:

Cancer survivorship care programs play a vital role in supporting cancer survivors and improving their quality of life. Understanding the landscape of survivorship and the potential barriers is key to optimizing care delivery.

Methods:

The primary purpose of this cross-sectional study was to explore existing cancer survivorship care programs offered by Commission on Cancer (CoC) accredited hospitals in Kentucky. Data from the Markey Cancer Affiliate Network (MCCAN) from 2022 through 2023 was analyzed. Variables included hospital characteristics such as rural code, types of survivorship services offered, and reported barriers to these services.

Results:

Analysis of n=19 CoC facilities …

Novel Cannabinoid Use Among Young Adults In Lexington, Kentucky, Victoria A. Hamilton

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

Purpose: The purpose of this study was to implement a survey to estimate the prevalence of novel cannabinoid use among young adults in Lexington, Kentucky, and to examine modes of use and motivations for novel cannabinoid use. The primary hypothesis of this study was that many respondents would indicate medical reasons for using novel cannabinoids.

Methods: A cross-sectional primary data analysis of 101 young adults in Lexington, Kentucky to determine prevalence of lifetime novel cannabinoid use, past 30-day novel cannabinoid use, mode of use, motivation for use, and related demographic characteristics. Univariate and bivariate analysis were produced using the PROC …

Mccovid Campaign – A Social Media Implementation To Decrease Vaccine Hesitancy In Rural Counties, Harper Ford

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

This capstone will explore the challenges of vaccine hesitancy, a continuously rising problem in the public health field. The focus is primarily on rural millennials in McCracken County, Kentucky. The study identifies key factors contributing to vaccine hesitancy including misinformation, trust issues, and the rapid development of the covid-19 vaccine. To address the above concerns the study proposes a targeted social media campaign using the health belief model to increase COVID-19 vaccine uptake through Facebook ads targeting millennials. The campaigns utilize the leverage of local insights and real-time data to enhance engagement and reduce hesitancy, focusing on adapting strategies based …

Environmental Justice In West Louisville, Ky, Ashley Wright

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

It is evident that West Louisville and Rubbertown are experiencing environmental exposures and related health impacts. It is important for environmental justice (EJ) areas like West Louisville and Rubbertown to gain increased awareness, due to EJ areas commonly being overlooked and forgotten about because of unjust treatment and lack of involvement. Furthermore, all of the data used for this project was publicly accessible. Community residents and the general public can access these data sources to identify which facilities are emitting toxins, as well as specific hazardous substances that are being released, the location of hazardous sites, cleanup status, and more. …

Improving Black Maternal Outcomes In Christian County, Ky: A Social Marketing Approach To Perinatal Provider Change, Ariel A. Arthur

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

Compared to other states in the country, Kentucky has historically poor population health outcomes. While the statewide maternal mortality rate is 16.1 per 100,000 live births, this statistic belies the stark racial disparities that exist. In 2018, the pregnancy-related death rate for Black women was 40.2 per 100,000 live births compared to 13.1 for White women. This pattern is persistent even after controlling for socioeconomic status, prenatal care, and other protective factors. Research shows that institutional and interpersonal racism when receiving obstetric care contributes to poor childbirth and postpartum outcomes for Black women. Additionally, geography and rural status may compound …

Implementation Of A Postpartum Depression Program In A Rural Kentucky County, Abby Cecil

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

This paper aims to describe the process of implementing a Postpartum Depression (PPD) prevention program in low-income women residing in rural communities. The paper describes the process of recruiting women in this population, where and how the program will be integrated into an existing clinic, and how the program will be sustained. PPD is a significant global public health problem that can be prevented and treated. The ROSE program (Reach Out, Stay Strong, Essentials for new mothers) is a series of classes that provide informational and social support to prevent PPD. This evidence-based program has been previously successful in reducing …

Increasing Hpv Vaccination In Two Appalachian Counties, Autumn Rice

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

In response to the Funding Opportunity Announcement (FOA), the evidence-based Making Effective HPV Vaccine Recommendations training program will be implemented in the Southeast Kentucky AHEC region over the course of three years. The implementation of the Making Effective HPV Vaccine Recommendations program has three specific aims:

Aim 1: Effectively implement and deliver the Making Effective HPV Vaccine Recommendations program to immunization providers in the Southeast Kentucky AHEC region

Aim 2: Increase provider self-efficacy for making strong recommendations for HPV routinely

Aim 3: Increase the number of recommendations for the HPV vaccine among adolescents of Bell and Harlan Counties in Kentucky …

Patient Access To Glp-1 Ra’S: A Medicare Part D Policy Analysis, Celine Hummer

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

This policy analysis examines the evolving landscape of GLP-1 receptor agonists (GLP-1 RAs) and their implications for Medicare Part D coverage. Initially developed for managing type 2 diabetes, GLP-1 RAs have rapidly gained popularity due to their efficacy in treating obesity and reducing cardiovascular events, leading to broader therapeutic applications. However, access to these medications under Medicare Part D is limited by high costs and coverage restrictions, particularly when used for obesity without diabetes. This analysis evaluates current Medicare Part D policies, including specialty drug tier placement, formulary restrictions, and the potential impact of recent legislative initiatives such as the …

The Nature And Validity Of Implicit Bias Training For Health Care Providers And Trainees: A Systematic Review, Nao Hagiwara, Conor Duffy, John Cyrus, Nadia Harika, Ginger S. Watson, Tiffany L. Green

VMASC Publications

The number of health care educational institutions/organizations adopting implicit bias training is growing. Our systematic review of 77 studies (published 1 January 2003 through 21 September 2022) investigated how implicit bias training in health care is designed/delivered and whether gaps in knowledge translation compromised the reliability and validity of the training. The primary training target was race/ethnicity (49.3%); trainings commonly lack specificity on addressing implicit prejudice or stereotyping (67.5%). They involved a combination of hands-on and didactic approaches, lasting an average of 343.15 min, often delivered in a single day (53.2%). Trainings also exhibit translational gaps, diverging from current literature …

Designing A Blockchain-Empowered Telehealth Artifact For Decentralized Identity Management And Trustworthy Communication: Interdisciplinary Approach, Xueping Liang, Nabid Alam, Tahmina Sultana, Eranga Bandara, Sachin Shetty

VMASC Publications

Background: Telehealth played a critical role during the COVID-19 pandemic and continues to function as an essential component of health care. Existing platforms cannot ensure privacy and prevent cyberattacks.

Objective: The main objectives of this study are to understand existing cybersecurity issues in identity management and trustworthy communication processes in telehealth platforms and to design a software architecture integrated with blockchain to improve security and trustworthiness with acceptable performance.

Methods: We improved personal information security in existing telehealth platforms by adopting an innovative interdisciplinary approach combining design science, social science, and computer science in the health care domain, with prototype …

Effectiveness Of Full Pulpotomy Compared With Root Canal Treatment In Managing Teeth With Signs And Symptoms Indicative Of Irreversible Pulpitis: A Protocol For Prospective Meta-Analysis Of Individual Participant Data Of Linked Randomised Clinical Trials (Prove), Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Background: Full pulpotomy has been proposed as an alternative to root canal treatment in teeth with signs and symptoms indicative of irreversible pulpitis (IRP), but the evidence is limited, relying on underpowered studies with a high risk of bias. The aim of this study is to conduct a prospective meta-analysis (PMA) of individual participant data of a series of individual randomised trials to provide robust evidence on the clinical and cost-effectiveness of pulpotomy compared with root canal treatment. Methods: Individual participant data will be obtained from a series of randomised trials designed and conducted by a consortium of multi-national investigators …

Anatomical Analysis Of Inferior Alveolar Nerve Relation To Mandibular Posterior Teeth Using Cone Beam Computed Tomography: A Retrospective Radiographic Analysis Study, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Introduction: Cone beam computed tomography (CBCT) is reliable in the assessment of structures related to teeth. The assessment of the inferior alveolar neurovascular (IAN) bundle location using CBCT is considered one of its prime uses in different mandibular surgeries. Methodology: Retrospective CBCT data of patients presented to the institute were assessed to measure relations of IAN. Measurements were taken to assess the bone thickness adjacent to IAN, the superior-inferior dimension between the canal and the teeth, and the dimension between the canal and the inferior border of the mandible. Results: Out of the 170 patients the root apices nearest to …

Impact Of Angle Of File Access And Location Of Canal Curvature On The Dynamic Cyclic Fatigue Of Nickel Titanium Rotary Instruments, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Objective: To evaluate the impact of different file access angles and root canal curvature’s location on the fatigue failure of One Curve (OC) and E3 Azure (EZ) NiTi files using a dynamic model at simulated body temperature. Methods: Eighty new instruments with similar tip sizes and taper (#25/0.06) from two NiTi rotary systems, One Curve and E3 Azure, were tested at simulated body temperatures (37°C) using a custom-made dynamic cyclic fatigue device. Instruments were divided into four subgroups according to the location of root canal curvature (a coronal curve 5 mm from the root canal orifice and an apical curve …

Physicochemical Properties Of Ah Plus Bioceramic Sealer, Bio-C Sealer, And Adseal Root Canal Sealer, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Background: The aim of this study was to evaluate the physicochemical properties of two newly introduced premixed calcium silicate-based root canal sealers (AH Plus Bioceramic Sealer and Bio-C Sealer) compared to a resin-based root canal sealer (ADseal root canal sealer). Methods: Solubility, pH analysis, calcium ion release, and film thickness of each sealer were evaluated following ISO guidelines. The data were examined using the two-way ANOVA test. Furthermore, X-ray diffraction (XRD) examination was performed to investigate the crystalline phase of each type of sealer. X-ray fluorescence (XRF) analysis was done for the chemical elemental analysis of each sealer. Results: The …

Two-Year Clinical Performance Of Indirect Restorations Fabricated From Cad/Cam Nano Hybrid Composite Versus Lithium Disilicate In Mutilated Vital Teeth. A Randomized Controlled Trial, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Trial design: This is a randomized, controlled, superiority, double-blinded, parallel-group, two-arms trial with an allocation ratio of 1:1. The aim of this trial was to compare the two-year clinical performance of partial indirect restorations fabricated from CAD/CAM nano-hybrid composite and ceramic lithium disilicate blocks using the modified USPHS criteria. Methods: In two parallel groups (n = 50 restorations), fifty participants having mutilated vital teeth with a minimum of two remaining walls were randomly enrolled in this trial and received indirect restorations of either nano-hybrid composite resin blocks (Brilliant, Coltene, Switzerland) or Lithium Disilicate (IPS Emax CAD). The restorations were assessed …

Comparison Of Different Dental Restorative Materials On Orthodontic Brackets Performance In Class V Lesions. (In Vitro Study), Shadwa Kabil, Mohamed Mostafa Zayed, Shaimaa Rhoym

Dentistry

No abstract provided.

Adaptation Of Conventional Versus Digitally Fabricated Auricular Prosthesis: A Randomized Clinical Trial, Sara Fikry, Fatma Mohei El Mogei Dr, Mohamed El Khashab Prof, Amal Rekabi Prof

Dentistry

Aim: This study aimed to compare digitally fabricated auricular prostheses to conventional prostheses, regarding adaptation to defect site in patients with auricular defects.

Subjects and methods: Fifteen patients were recruited for auricular prosthetic reconstruction. Endosseous implants were placed, then patients were assigned into two groups. In control group, ear models were processed on stone cast obtained from conventional impression. In intervention group, computed tomography and optical scanning were combined to obtain a virtual model with digital analogues over which ear models were designed and printed. Ear models of both groups were seated, and adaptation was measured on the patient using …

Comorbidities And Final Outcome Of Post Covid-19 Associated Oral Mucormycosis Patients: A Cross-Sectional Study, Dalia Ghalwash, Asmaa Abou-Bakr, Ayman El-Gawish

Dentistry

Background

Mucormycosis is an invasive and possibly fatal fungal infection that frequently affects the mouth. Co-infection in post COVID-19 patients is an emerging concern, owing to their complex nature and higher mortality. Therefore, this study aimed to report the underlying risk factors, clinical characteristics, presentation, and final outcome of COVID-19 associated oral mucormycosis cases.

Results

This study included 51 patients with oral mucormycosis 28 (55%) males and 23 (45%) females. Twenty-three patients (45%) presented with deep necrotic ulcer, 16 patients (31%) presented with superficial ulcer, and 12 patients (23%) of them presented with fistula. The overall survival rate was 51% …

Evaluation Of Different Approaches For Management Of Separated Endodontic Instruments. (In-Vitro Study), Engy M. Kataia Professor, Hala Fayek Ass. Professor, Osama Ahmed El-Karamany

Dentistry

Objective: to evaluate different approaches (ultrasonic troughing, and trephine bur

with extractors) to manage separated endodontic instruments.

Methods and Materials: A block of wax containing mandibular molars were

scanned to get preoperative CBCT to select a total number of 32 mandibular molars

that were later divided into two groups (n=16) according to file retrieval procedure:

Group (A) (control group): the broken segment was retrieved by ET-25 ultrasonic

tips, Group (B): the broken segment was retrieved by micro-extractor (Zumax

retrieval kit). Traditional endodontic access cavity was created, orifice opener was

used to make coronal third enlargement up to 4mm of …

Indirect Composite Color Stability And Surface Roughness After Finishing, Mohamed Fouad Haridy, Sarah Adel Botros, Nermeen Hamada Hassan

Dentistry

No abstract provided.

Two -Year Clinical Performance Of Indirect Restorations Fabricated From Cad/Cam Nanohybrid Composite Versus Lithium Disilicate In Mutilated Vital Teeth. A Randomized Controlled Trial, Mohamed Fouad Haridy, Shehabeldin Saber, Haneen Ahmed El Moselhy, Olfat Hassanien, Maha Elbaz

Dentistry

No abstract provided.

Fracture Resistance Of Mod Cavities In Maxillary Premolar Teeth Restored With Different Restorative Protocols: An In-Vitro Study, Hend Sayed Ahmed, Rania Elsaady Badawy, Ahmed Fawzy Aboelezz

Dentistry

No abstract provided.

Microtensile Bond Strength Of Two Bioactive Restorative Materials To Sound Dentin (In-Vitro Study), Hend Sayed Ahmed, Hassan Abuolazm, Mostafa Nomair

Dentistry

No abstract provided.