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Author ORCID Identifier
0000-0002-3444-0923
Date Available
7-29-2028
Year of Publication
2026
Document Type
Doctoral Dissertation
Degree Name
Doctor of Philosophy (PhD)
College
Education
Department/School/Program
Kinesiology and Health Promotion
Faculty
Kirby Mayer
Faculty
Ashley Samson
Abstract
Background: Pediatric oncology therapies frequently induce secondary sarcopenia, which traditional metrics fail to capture. Additionally, social determinants of health (SDoH) act as potent modulators of clinical outcomes, particularly in vulnerable Appalachian regions.
Objective: This research establishes a bedside-accessible framework to monitor nutritional and functional status by quantifying SDoH risks, validating interprofessional muscle ultrasound (mUS) reliability, and characterizing longitudinal changes.
Methods: This multifaceted research utilized three distinct methodologies. First, a retrospective electronic health record review mapped spatial access to nutritional and healthcare resources. Second, a prospective observational study evaluated the interrater reliability of muscle ultrasound between a novice pediatric dietitian and an expert sonographer. Finally, a longitudinal cohort study tracked changes in mUS alongside functional measures across the first year of the cancer diagnosis.
Results: Rural Appalachian patients experienced significantly poorer food and healthcare access than urban cohorts. mUS demonstrated good-to-excellent interrater reliability across all parameters. Longitudinally, mUS and functional tests effectively characterized the trajectory of acute-phase muscle wasting and mobility declines.
Conclusion: Integrating SDoH profiling, functional testing, and accessible mUS training challenges static nutritional paradigms. This empowers frontline clinicians to proactively detect secondary sarcopenia, facilitating targeted, equity-driven interventions to preserve physiological resilience in childhood cancer survivors.
Digital Object Identifier (DOI)
https://doi.org/10.13023/etd.2026.372
Archival?
Archival
Recommended Citation
Hawes, Corey, "A Bedside-Accessible Framework for Pediatric Oncology: Validating Point-of-Care Muscle Ultrasound and Characterizing the Interplay of Secondary Sarcopenia, Physical Fitness, and Social Risk" (2026). Theses and Dissertations--Kinesiology and Health Promotion. 136.
https://uknowledge.uky.edu/khp_etds/136
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