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Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

Increasing Efficiency Of Finishing Beef Production: Strategies To Optimize Starch Digestion, Improve Flake Quality, And Reduce Methane Emissions, Ronald J. Trotta

Theses and Dissertations--Animal and Food Sciences

To continue to meet the demands of increasing food production and environmental sustainability, new strategies are needed to enhance the efficiency of finishing cattle production. A review of the literature identified several nutritional and physiological constraints that limit the ability for cattle to digest starch and absorb glucose from the small intestine. Comparative sequencing analyses revealed a missing region of the sucrase-isomaltase protein which could affect the capacity for starch digestion in cattle. Post-flaking sampling and handling recommendations were generated based on a series of experiments to improve estimates of starch availability and flaking consistency for commercial feedlots and laboratories. …

Alzheimer’S Disease Genetics And Short-Chain Fatty Acid Treatment In Studies Of The Murine Gut Microbiome, Diana Zajac

Theses and Dissertations--Physiology

Elucidating the relationship of the gut microbiome in Alzheimer's Disease (AD) risk and pathogenesis is an area of intense interest. Since 60 to 80% of AD risk is related to genetics and APOE alleles represent the most impactful genetic risk factors for AD, their mechanism(s) of action are under intense scrutiny.

First, I conducted a study on APOE targeted replacement mice to investigate the impact of APOE alleles on the murine gut microbiome. The relative abundance of bacteria from the family Ruminococacceae and related genera increased with APOE2 status. The relative abundance of the class Erysipelotrichia increased with APOE4 status, …

Leveraging Community Health Workers’ Expertise In The Community To Address Food Insecurity In Appalachia, Alexis Kimbro Scott

Theses and Dissertations--Nutrition and Food Systems

Residents of the Appalachian region of Kentucky are disproportionately affected by poor social determinants of health that contribute to the persistence of food insecurity and diet related diseases in this region. Poverty levels persist in rural areas of the Appalachian region while they improve throughout the rest of the United States. As this further perpetuates food insecurity in rural Appalachia, it is critical to identify culturally sensitive solutions to food insecurity. Utilizing Community Health Workers (CHWs), lay members of the community who have deep understanding of the communities they live in and serve, may be the answer to this problem. …

Maximal Strength Training Increases Metabolic Energy Expenditure In Sedentary Adults Classified As Obese, Robert E. Anderson Iii

Theses and Dissertations--Nutrition and Food Systems

Background: Metabolic adaptations reduce resting and non-resting energy expenditure to account for approximately 120 kcal/day. Weight loss promotes greater skeletal muscle efficiency, reducing the energy cost of physical activity and is correlated with declines in skeletal muscle glucose oxidation. Maximal Strength Training (MST) has the potential to upregulate glucose utilization and may offset these metabolic adaptations. Objective: To determine if MST offsets markers of metabolic adaptation by increasing resting and non-resting energy expenditure in sedentary individuals classified as obese. Methods: Five (5) participants (2 females, 3 males), ages 18-35 years, with obesity (BMI 30–45 kg/m2) were enrolled in an 8-week …

“It’S Just Part Of Our Hospitality:” Examination Of Cultural Factors That May Inform Future Initiatives To Improve Health Outcomes In A Rural Appalachian Community, Lauren Cassidy Batey

Theses and Dissertations--Nutrition and Food Systems

Diet and physical activity are influenced by a person’s culture and may contribute to the presence of health disparities within a geographic region. Health disparities are evident in Appalachia where a unique cultural identity exists. Culture-based initiatives focused on improving diet quality and increasing physical activity have improved health outcomes in diverse groups, yet interventions considering geographically tied cultures, like Appalachia, are limited. This study aims to identify specific aspects of Appalachian culture that influence health outcomes to inform and increase success of health focused interventions. Five focus groups were conducted in one rural Appalachian community in summer 2021. Grounded …

The Effect On Incorporating Fresh Fruits And Vegetables Into An Emergency Food Box Program In Rural Appalachia Kentucky, Zixuan Li

Theses and Dissertations--Nutrition and Food Systems

About 1 in 8 Kentuckians experiencing food insecurity. Low-income Appalachian Kentuckians often utilize food assistance programs and community resources to obtain food and they have lack regular access to fresh food, especially fruits and vegetables. Of concern is nutrition quality and the ability to use food items. The study aimed to explore if and how low-income Appalachian Kentuckians living in a food desert utilized their standard food pantry box as well as a supplemental box of free fresh produce. The study was done through distribution of supplemental fruit and vegetable boxes along with their emergency food box seven different times …

Farmers’ Market Incentive Program As An Intervention For Improving Behavior Regarding Fruit And Vegetable Consumption In Children And Adolescents, Madison Blades

Theses and Dissertations--Nutrition and Food Systems

Background: Previous research shows that there is low consumption of fruits and vegetables in children and adolescents, specifically those residing in the state of Kentucky which is ranked the lowest of all states in fruit and vegetable (F/V) consumption. The lack of F/V in a diet of someone during their developmental ages can result in negative health outcomes in the future.

Objective: To determine if the use of a farmers’ market incentive program as a nutritional intervention affects the consumption of F/V in children and adolescents.

Methods: 261 children and adolescents, ages 3-14, from 160 families participated in a 10-week …

Nutritional Status In Critical Care Of Covid-19 Patients, Dolph Lewis Davis Iii

Theses and Dissertations--Nutrition and Food Systems

Critical care nutrition is a poorly researched, and such a sudden pandemic event requiring manipulation of nutritional status via propofol-induced sedation for mechanical ventilation is potentially impactful on patient outcomes. This paper seeks to provide context to the impact of critical care protocols on the nutritional status of obese patients suffering from COVID-19.

Estrogen Regulation Of Daily Metabolic Rhythms In Female Mice, Oluwabukola Omotola

Theses and Dissertations--Biology

Circadian rhythms are approximately 24-hour cycles of behavior, physiology, and gene expression. In mammals, these circadian rhythms are generated by clocks located in nearly every tissue in the body. The function of circadian clocks is to synchronize physiology and behavior with environmental cycles such as the light-dark cycle. After menopause, when circulating levels of estrogens are very low, women are more susceptible to obesity comorbidities such as metabolic syndrome and cardiovascular disease, suggesting that estrogens regulate these processes. Estrogens could protect females from metabolic dysfunction by regulating circadian rhythms. Consumption of diets that are high in fat contribute to obesity. …

Pilot Study: The Role Of Online Grocery Shopping In Meal Planning & Prepartion: Utilizing Text Message Based Behavioral Nudges, Brittany Nikole Cox

Theses and Dissertations--Nutrition and Food Systems

Purpose: To examine if an online grocery shopping intervention improves meal planning and preparation and subsequent dietary intake. The primary hypothesis was that online shopping can improve meal planning and meal preparation habits while also improving dietary intake.

Method: Participants were randomized to either online only (O), online plus nutritional nudges (O+I), or standard brick and mortar (BM). Those in the O+I arm received behavioral nudges three (3) times per week and were part of a Facebook group assisting them with meal planning, nutrition education, and reminders to shop online. The O arm only received reminders to shop online, and …

Family And Consumer Sciences Extension Agents Perception Of A Sustainable Eating Curriculum For Kentuckians, Lindley Barker

Theses and Dissertations--Nutrition and Food Systems

The population is rapidly increasing all over the world. As foods are produced for us to consume, the food system generates negative environmental impacts at each step. The extent of damage generated by food production depends on the amount of land, water, and energy depleted. These environmental impacts can result in reduced quantities of food produced, damages to the land and water used to grow/produce food, pollution of food, and food waste. All of which impact the amount of product produced. Thereby, shifting food-related behaviors of consumers toward sustainable eating may be a way to promote the health of people …

Factors Associated With Lifestyle Modification For Type 2 Diabetes Self-Management And Prevention, Leigh Anne Koonmen

Theses and Dissertations--Nursing

Diabetes is the seventh leading cause of death in the United States, affecting roughly 13% of U.S. adults aged 18 years or older. Type 2 diabetes accounts for 90-95% of all diabetes cases and is characterized by the progressive development of insulin resistance leading to sustained elevated blood glucose levels. Management of type 2 diabetes includes risk-reduction strategies and continuous medical care to prevent the development of complications.

Lifestyle is a major contributing factor to morbidity and mortality rates in the United States. Preventative health behaviors, such as engaging in physical activity, maintaining a healthy weight, and following a healthy …

Factors Influencing Mare Milk And Foal Gastrointestinal Health, Morgan Brewer Pyles

Theses and Dissertations--Animal and Food Sciences

Foals are born lacking a functional microbial community in their gastrointestinal tract (GIT). However, these microbes quickly colonize after birth. Factors influencing the process of microbial colonization and health of the foal’s gastrointestinal tract, such as milk yield and composition, are not well understood. Milk contains non-lactose carbohydrates termed “oligosaccharides”, which serve as prebiotics in human neonates and may serve a similar function in foals. Three animal studies were conducted to evaluate factors influencing mare milk and digestive health in the foal. In experiment 1, bacteria were enumerated and identified in foal feces and the utilization of different carbohydrates by …

Genetic Mouse Models Of Liver Disease: Potential Roles Of Zhx2 (Afr1) And Afr2 In Damage And Regeneration, Courtney P. Turpin

Theses and Dissertations--Pharmacology and Nutritional Sciences

The liver is the largest internal organ in mammals and responsible for carrying out various processes, including lipid and carbohydrate metabolism, detoxification of chemicals, and production of serum proteins. Liver damage, which can be caused by a variety of agents including viral infection, environmental toxins, alcohol and excessive dietary fats, can cause dysregulation of these critical functions, leading to worsening liver pathophysiology and impacting health. However, the liver has the remarkable ability to regenerate when damaged. Hepatocytes, which comprise a majority of liver cells, are relatively quiescent under healthy conditions. Upon injury, remaining hepatocytes can proliferate to recover from liver …

Exploring The Relationships Between Cultural Values And Diet Patterns Among Mexican And Cuban Immigrants In Kentucky, Nasreen Omran

Theses and Dissertations--Nutrition and Food Systems

The number of Latinx in the U.S. is expected to grow to about 28 percent of the population by the year 2060. As the number of Latinx increases in the U.S. it is important to understand how cultural beliefs influence dietary behaviors as Latinx are disproportionately affected by diet related disease such as diabetes mellitus, cancer, and cardiovascular disease. The aim of this secondary data analysis is to examine the relationship between family values, gender roles, and religious values on diet patterns in adult Mexican and Cuban immigrants in Kentucky utilizing the Mexican American Cultural Values Scale. The study findings …

Monocyte Abundance And White Blood Cell Expression Of Prolactin And Nf-Kb Pathway Genes In Beef Steers Are Altered By Grazing Toxic Endophyte-Infected Tall Fescue And Lipopolysaccharide Challenge, Cecilia Winfrey

Theses and Dissertations--Animal and Food Sciences

Experiment 1 tested the hypothesis that ad libitum consumption of a 1:1 blend (MIX) of sodium selenite (ISe) and SELPLEX vs solely ISe as selenium (Se) supplements (27 ppm) in a vitamin-mineral mix (V-M) by steers subjected to summer-long grazing of toxic endophyte-infected tall fescue (TE) would ameliorate the negative effects of TE by positively affecting the expression pattern of prolactin (PRL) and NF-kB pathway genes by circulating leukocytes (WBC). Experiment 2 tested the hypothesis that the MIX form of supplemental Se also would ameliorate the negative effects of in vitro blood lipopolysaccharide challenge (LPS) on WBC gene expression. The …

Nurse Driven Enteral Nutrition Protocol For Mechanically Ventilated Patients, Deena Shewekah

DNP Projects

Introduction: Delayed enteral nutrition in critically ill patients increases the risk of complications and poor outcomes. Current evidence-based guidelines recommend initiation of enteral nutrition within 24-48 hours of intensive care unit (ICU) admission. The quality improvement (QI) project aim was to examine whether enteral nutrition was initiated within 24- 48 hours of mechanical ventilation after implementation of QI intervention in order to determine practice change.

Methods: The QI protocol was introduced to the Cardiovascular ICU (CVICU) at UK Chandler Hospital (UKHC) nurses via an education session. A post-education electronic survey identified the nurse’s understanding of the protocol. To identify nursing …

Apoe As A Metabolic Regulator In Humans, Mice, And Astrocytes, Brandon C. Farmer

Theses and Dissertations--Physiology

Altered metabolic pathways appear to play central roles in the pathophysiology of late-onset Alzheimer’s disease (AD). Carrier status of the E4 allele of the APOE gene is the strongest genetic risk factor for late-onset AD, and increasing evidence suggests that E4 carriers may be at an increased risk for neurodegeneration based on inherent metabolic impairments. A new appreciation is forming for the role of APOE in cerebral metabolism, and how nutritional factors may impact this role. In chapter 1, the literature on nutritional interventions in E4 carriers aimed at mitigating disease risk is reviewed. Studies investigating the mechanism by which …

Appetite-Regulating Hormones In Energy Compensation With Exercise, Jack Moreland

Theses and Dissertations--Nutrition and Food Systems

Background: The appetite-regulating hormones may influence compensatory increases in energy intake with exercise, although this causal relationship has been difficult to prove in a longitudinal trial.

Methods: 37 participants (29 female) aged 18 to 40 years performed aerobic exercise 6 days (6d), 2 days (2d), or 0 days per week for 12-weeks. Concentrations of ghrelin, leptin, glucagon-like peptide 1 (GLP-1), and insulin were assessed before (fasting, minute 0) and after a standardized meal at minute 15, 30, 45, 60, 90, 120, 150, and 180. Linear mixed-effects models were used to model the relationships between time point (12 weeks vs. baseline) …

Arthropod Resistant Tomatoes: Screening Tools, Yield And Nutritional Quality Of Interspecific Hybrids, Mohammad Hasan Salman Ali Dawood

Theses and Dissertations--Plant and Soil Sciences

Tomato (Solanum lycopersicum) is one of the most economically important vegetable crops grown around globe but is a host for numerous pests and pathogens. In the future, tomato breeders will have to focus on increasing fruit quantity and on enhancing pest resistance. Many accessions of the wild relative of tomato, S. habrochaites display high levels of resistance towards arthropods such as spider mites. The presence of the sesquiterpene hydrocarbon, 7-epi-zingiberene, found in S. habrochaites type IV trichomes has been associated with arthropod resistance. However, the presence of other compounds in its trichome secretions may also be related …

Berrycare: A Sustainable Community-Academia Nutrition Based Collaborative Program To Promote Well-Being In Older Adults, Abbey L. Moellering

Theses and Dissertations--Nutrition and Food Systems

With medical advancement and technology, generations are living longer. The process of aging is accompanied by development of chronic disease, reduced physical function, and increased risk of mortality. Older adults do not meet dietary requirements for fruits and vegetables due to lack of access, early satiety, socioeconomic factors, etc. Without proper attainment of fruit and vegetable recommendations, older adults are placed at risk of chronic disease. Interventions exist to help bridge the gap between older adult nutrition and currently established dietary guidelines. Built environments, such as community gardens, have received attentions in the public health arena as a successful way …

Promotion Of Fruit And Vegetable Intake Through Recipe Card Distribution And Sampling At Farmers’ Markets Throughout Kentucky, Umaima Sidra Afsheen Syeda

Theses and Dissertations--Nutrition and Food Systems

The Center for Disease Control and Prevention (CDC) reports indicate that 8% and 6.3% of Kentuckians consume enough fruits and vegetables, respectively. The Plate It Up! Kentucky Proud (PIUKP) project is a recipe-development project that aims to boost produce consumption by incorporating local fruits and vegetables. The purpose of this study was to implement promotional strategies using PIUKP recipes at farmers’ markets and determine their effects on consumers’ intent of purchasing and preparing the produce. The study was conducted at nine farmers’ markets across Kentucky (n=300) in collaboration with Cooperative Extension agents/assistants.

The consumers’ impression of the sample was positively …

Tanglewood Trail Walking And Voucher Program, Kelci Marie Mchugh

Theses and Dissertations--Nutrition and Food Systems

Rural Appalachian populations have greater rates of obesity and chronic diseases attributed to lesser consumption of fruits and vegetables (F/V) and physical inactivity. Barriers to F/V consumption and physical activity include poor access and affordability. To help overcome these barriers, a community-initiated walking and farmers market F/V voucher program was implemented.

Participants were encouraged to walk (1.2 miles roundtrip) to the local farmers market to redeem a $10 voucher which could only be spent on F/V. The 16-week program (June – Sept) included 121 participants. Data was analyzed by creating two groups, low-engagers and high-engagers that differed significantly in the …

Forms Of Supplemental Selenium In Vitamin-Mineral Mixes Differentially Affect Serological And Hepatic Parameters Of Growing Beef Steers Grazing Endophyte-Infected Tall Fescue, Yang Jia

Theses and Dissertations--Animal and Food Sciences

Consumption of endophyte-infected tall fescue results in a syndrome of negatively altered physiological systems, collectively known as fescue toxicosis. Another challenge to endophyte-infected tall fescue -based beef cattle operations is that the soils often are selenium (Se) poor, necessitating the need to provide supplemental Se. To test the general hypothesis that different forms of supplemental Se would ameliorate the negative effects of fescue toxicosis, predominately-Angus steers (BW = 183 ± 34 kg) were randomly selected from herds of fall-calving cows grazing an endophyte-infected tall fescue pasture and consuming vitamin-mineral mixes that contained 35 ppm Se as sodium selenite (ISe), SELPLEX …

Improved Iron Status In Weanling Pigs Leads To Improved Growth Performance In The Subsequent Nursery Period, Tyler Chevalier

Theses and Dissertations--Animal and Food Sciences

The objectives of this thesis were: 1) to assess the iron status of piglets, 2) to thoroughly evaluate the blood profile, growth performance, and tissue mineral concentration of young pigs during the pre and postweaning periods after receiving various dosages of iron (0, 50, 100, 200, and 300 mg iron) at birth, 3) as well as evaluate the effects of an additional iron injection before weaning on hematological measures, growth performance, and tissue mineral concentration postweaning. In the initial experiment, there was a 60% incidence of iron deficiency at weaning after administration of a 150 mg iron injection at birth. …

Microalgae And Zinc Source Supplementation Of Broiler Breeder Diets Affects Broiler Breeder Skeletal Development And Reproduction With Transgenerational Impacts On Offspring Performance And Skeletal Characteristics, Marquisha A. Paul

Theses and Dissertations--Animal and Food Sciences

Leg problems and disorders are of major concern for the poultry industry and animal welfare. Previous studies suggest that it may be possible to improve skeletal characteristics through nutrition. Omega-3 fatty acids, including Docosahexaenoic acid (DHA), are essential nutrients and are known to play an important role in bone tissue development. FORPLUS™ (Alltech, Inc.) is an unextracted, whole-cell microalgae (Aurantiochytrium limacinum CCAP 4087/2) that contains 64% fat and 16% DHA. Zinc (Zn) is a trace element and essential nutrient for growth and skeletal development. Bioplex^® Zn (Alltech, Inc.) is a Zn proteinate that has been shown to be …

Evaluating The Experiences Of Fcs Cooperative Extension Agents Use Of Policy, Systems And Environmental Strategies To Reduce Obesity In Rural Counties, Jordan Lynn Bressler

Theses and Dissertations--Nutrition and Food Systems

High rates of obesity are seen across the country with rural areas disproportionately affected. Based on the socio-ecological model, policy, system, and environmental approaches targeted at the population level have the potential to create more sustainable health behavior change than individual level approaches. Historically, the Cooperative Extension Service (CES) has provided direct education related to healthy eating and active living in response to high obesity rates. Utilizing the resources and infrastructure of the CES, the Centers for Disease Control challenged CESs across the country to implement PSE strategies in counties with obesity rates greater than 40% through the CDC 1416 …

The Utilization Of Technology As An Approach To Improve Meal Planning And Dietary Intake, Alexa Lauren Kuziel

Theses and Dissertations--Nutrition and Food Systems

The prevalence of obesity is rising in the United States and one factor that contributes to it is the lack of cooking at home and planning out meals. Since text messaging is now a main avenue of communication, it could be used to motivate people to plan out their meals and cook at home instead of consuming fast food. Current research on how weekly nudges might relate to peoples’ goals about meal preparation and dietary intake is very limited. The purpose of this study was to examine if sending weekly nudges, focusing on specific dietary goals, improves meal planning and …

Dive Into The Hunger Pool: Exploring Students’ Experiences, Coping Strategies, And Suggestions Related To Elements Of Food Security At The University Of Kentucky, The Nu Sandar Oo

Theses and Dissertations--Nutrition and Food Systems

Background: College food insecurity (CFI) is a prevalent social justice and public health issue in the U.S. with the prevalence ranging between 15-59%. Though numerous quantitative studies were first conducted in the past decade, little qualitative research was conducted to assess CFI.

Objective: To explore and deeply understand the contexts of CFI at a land-grant university in Kentucky.

Methods: This qualitative study used a validated food insecurity survey tool and hour-long focus groups that were audio recorded and transcribed. Three theoretical models were combined into an adapted model and utilized for the thematic analysis.

Results: Thirty-three students participated in one …