Digital Commons Network^™

From Technology Transfer To Resource Management, Janice Jiggins

IGC Proceedings (1993-2023)

Six models of technological innovation are examined. The implications for the roles and functions of research and extension, and of agricultural education systems, are analysed. The models are assessed against issues of gender, natural resource management and poverty, with consideration of who pays, and who benefits. The conclusion is drawn that the Transfer of Technology model is not a generalisable model to all circumstances, clients and policy goals. Client-driven systems and participatory approaches which build partnerships among researchers, extensionists, producers and other users of grassland landscapes, can be more effective and efficient.

Community-Level Factors And Their Associations With Changing Opioid Overdose Fatality Rates In Kentucky, 2019–2021, Shawn R. Nigam, Philip M. Westgate, Svetla Slavova, Rachel Vickers-Smith, Katherine L. Thompson

Journal of Appalachian Health

Introduction: Kentucky has one of the highest opioid overdose fatality rates in the United States, which has increased significantly from 2019 to 2020. The COVID-19 pandemic has caused lasting effects on mental health and health care, which have been linked with increased opioid overdose. These effects are exacerbated in Appalachian regions, where there is a lack of sufficient access to community pharmacies and adequate health care.

Purpose: In this study, we characterize changes in opioid overdose fatality rates in Kentucky from 2019 to 2021, with a specific focus on changes in Appalachian vs non-Appalachian counties. We aim to identify associations …

Reserving Pastures In Communal Grasslands By Agropastoralists Of Tanzania, M L. Kusekwa, A J. Mwilawa, J.K K. Msechu

IGC Proceedings (1993-2023)

Studies were conducted in “Maasai” and “Gogo” tribal communities to gain understanding of traditional management of reserved pastures. Survey techniques were used and forage production and chemical composition were estimated. Household heads were invariably old men who had no formal education. Household size averaged 14 and 11, in Maasai and Gogo tribes respectively. Most reserved pastures were privately owned. Over 90% of pastoralists preferred individual ownership of reserved grazing. Herbage production was 2510 kg DM/ha in Maasai and 3680 kg DM/ha in Gogo locations. Pastures and low protein content (5.1-6.5% CP). Constraints to reserve grazing strategies were land and water …

Development Of A Sms Rollout Plan And Evaluation, Gabriel Dadi, Hala Nassereddine, Farshid Taherpour, Salena Pham

Kentucky Transportation Center Research Report

Many state transportation agencies have introduced safety management systems (SMSs) to improve employee safety and health programs. These systems let employees quickly access safety and health policies, procedures, training, responsibilities, resources, and incident reporting tools, often electronically. Instituting a SMS is a critical step in adopting a proactive, data-driven approach to organizational safety. The Kentucky Transportation Cabinet Secretary’s Office of Safety (SOS) worked with Kentucky Transportation Center (KTC) to acquire, adapt, and rollout the Boosting Occupational Outcomes in Transportation Safety (BOOTS) system, a new SMS. Researchers assisted KYTC by conducting pre-rollout focus groups, helping to bring the system online, providing …

Social/Emotional Health, Mental Health And Quality Of Life Among Adults With Comorbid Diabetes And Hypertension: A Population-Based Cross-Sectional Study, Ranjita Misra, Sara Nayeem

Journal of Appalachian Health

Introduction: West Virginia has a disproportionately large population of rural adults with diabetes and hypertension, two common chronic, comorbid conditions that represent a national economic, social, and public health burden. Anxiety, depression, and severe mental illness are associated with poor motivation to engage in coping/self-care behaviors and related increased morbidity/mortality.

Purpose: This study examines the relationship between self-reported mental health, selected social and emotional health factors, health-related quality of life (HRQoL), and clinical outcomes among adults with comorbid diabetes and hypertension.

Methods: This cross-sectional study consisted of 75 participants who participated in a diabetes and hypertension self-management program (DHSMP) in …

Treatment At An Academic Medical Center Eliminates Survival Disparities For Appalachian Kentuckians With Pancreatic Ductal Adenocarcinoma, Emily Cassim, Hannah Mcdonald, Megan Harper, Quan Chen, Miranda Lin, Reema Patel, Michael Cavnar, Prakash Pandalai, Bin Huang, Pamela C. Hull, Joseph Kim, Erin Burke

Journal of Appalachian Health

Introduction: Rates of cancer mortality in Appalachian Kentucky is among the highest in the nation. It is unknown whether geographic location of treatment for pancreatic ductal adenocarcinoma (PDAC), one of the deadliest cancers worldwide, influences survival in Appalachian Kentuckians.

Purpose: This study compares outcomes among Appalachian Kentuckians with PDAC who received treatment at an academic medical center (AMC) or community facility (CF).

Methods: Using the Kentucky Cancer Registry, patients diagnosed with PDAC between 2003 and 2018 were identified. Patients were categorized according to treatment location (AMC v. CF) and county of residence (Appalachian v. non-Appalachian). Kaplan-Meier curves were constructed to …

Maternal Age And Inadequate Prenatal Care In West Virginia: A Project Watch Study, Madelin Gardner, Amna Umer, Brian Hendricks, Toni Marie Rudisill, Candice Lefeber, Collin John, Christa Lilly

Journal of Appalachian Health

Introduction: Adequate prenatal care (PNC) is essential to the overall health of mother and infant. Teen age and advanced maternal age (AMA) are known risk factors for poor birth outcomes. However, less is known about whether these age groups are associated with inadequate PNC.

Purpose: This study sought to determine the potential association between maternal age (in groups, aged 20–24, 25–29, 30–34, 35–39, and >40) and inadequate PNC (visits).

Methods: West Virginia (WV) Project WATCH population-level data (May 2018–March 2022) were used for this study. Multiple logistic regressions were performed on inadequate PNC (less than 10 visits) with maternal age …

Conscientious Objection: Understanding When And Why Primary Care Physicians Object To Providing Health Care To Transgender And Gender-Diverse Patients In An Appalachian Medical Center, Mili S. Patel, Kelley A. Jones, Laura Davisson, Elizabeth Miller, Nicole Kahn, Pamela J. Murray, Kacie M. Kidd

Journal of Appalachian Health

Introduction: Transgender and gender-diverse (TGD) individuals face barriers to accessing primary and gender-affirming care, especially in rural regions where a national shortage of medical providers with skills in caring for TGD people is further magnified. This care may also be impacted by individual providers’ strongly held personal or faith beliefs and associated conscientious objection to care.

Purpose: This study assesses the prevalence of conscientious objection to providing care and gender-affirming hormone (GAH) therapy to TGD individuals among physicians in an Appalachian academic medical center.

Methods: An anonymous, online, cross-sectional survey of physicians was distributed to resident and faculty physicians in …

Ensuring Equitable Application Of Interventions To Vulnerable Subpopulations In The Kentucky Consortium For Accountable Health Communities (Kc-Ahc), Jing Li, Jessica M. Clouser, Akosua Adu, Aiko Weverka, Nikita Vundi, Terry D. Stratton, Mark V. Williams

Journal of Appalachian Health

Introduction: The Centers for Medicare and Medicaid Services (CMS) has funded the Accountable Health Communities (AHC) model to test whether systematically identifying and addressing the health-related social needs (HRSNs) of individuals would impact healthcare utilization and total cost of care for Medicare and Medicaid beneficiaries. Toward this effort, AHCs implement screening, referral, and community navigation services in their local areas. There are 28 CMS-funded AHCs nationwide, including the Kentucky Consortium for Accountable Health Communities (KC-AHC).

Purpsoe: This study aims to assess the equity of KC-AHC model activities in three vulnerable sub-populations: dual enrollees, disabled individuals, and women.

Methods: Twenty-eight primary …

Check With The Intended Audience First! Content Validation As A Method For Inclusive Research For Primary Care Engagement In Rural Appalachia, Sydeena E. Isaacs, Jennifer Schroeder Tyson, Ashley Parks, Danielle Adams

Journal of Appalachian Health

Introduction: To date, referral practices based on social determinants of health (SDOH) among primary care providers (PCPs) and clinic staff in rural regions, including Appalachian North Carolina (NC), are not well understood.

Purpose: This study aims to develop and content validate a primary care engagement (PCE) survey to assess (1) engagement and burnout; (2) referral practices; and (3) self-efficacy and confidence in making referrals based on SDOH among PCPs and clinic staff in Appalachian NC.

Methods: Using the Social-Ecological Model as a theoretical framework, researchers developed a 37-item PCE survey. Content validation was completed by a panel of experts recruited …

Decistifying Trans And Gender Diverse Inclusion In Library Work: A Literature Review, Stephen G. Krueger, Keahi Adolpho

Library Faculty and Staff Publications

This comprehensive review illuminates the current state of scholarly literature on trans and gender diverse inclusion in libraries, with the intention to provide a foundation and identify gaps for further research. Covering 50 works published between 2002 and 2023 in the areas of general inclusion, public libraries, academic libraries, experiences of library workers, archives, information behavior, and cataloging, we found that, with the exception of works on archives and cataloging, little scholarly literature goes beyond introductory talking points on basic information about trans and gender diverse people. We conclude with a call for much more in-depth research on this essential …

Adjustments To Social Work Practice During The Covid-19 Adjustments To Social Work Practice During The Covid-19 Pandemic In North Carolina: Effects On Burnout And Commitment Pandemic In North Carolina: Effects On Burnout And Commitment, Aaron Brown, Jayme E. Walters, Aubrey E. Jones, Lara Cates

Social Work Faculty Publications

Since the onset of the COVID-19 pandemic, the demand for social workers in the U.S. and abroad has increased. There is demand for more social workers in North Carolina due to ongoing and increasing mental health, substance use disorder, and child welfare needs. COVID-19 has taken a toll on the personal and professional lives of social workers, and research is needed to understand the pandemic’s effects on burnout and commitment among social workers. The present study sought to understand how the COVID-19 pandemic affected the personal and professional lives of social workers practicing in North Carolina and to determine how …

A Transdisciplinary Approach To Landscape Transformation Towards Perennial, Diverse, Circular Systems: Why And How, V. Picasso, C. Williams

IGC Proceedings (1993-2023)

Prevailing agricultural systems in the U.S. are dominated by intensification through annual crop monocultures and high amounts of external inputs. Increased yields per unit of land have resulted but many undesirable environmental, ecological, and socioeconomic outcomes have co-occurred. Lack of resilience within intensified agricultural systems is a factor in these outcomes. Redesign of agricultural systems and changes in federal policy are needed to better support resilience in agriculture. Redesign for greater resilience must encourage adoption of agricultural systems that are diverse, perennial, circular, and include forages. We developed a transdisciplinary framework within a project orientation with a focus on crops …

Creating An Educational Experience That Fosters Diversity And Inclusion, M. M. Kohmann

IGC Proceedings (1993-2023)

Demographic, intellectual, and individual diversity have been linked to increase in innovation, problem-solving, critical thinking, and economic gains. However, there are multiple challenges associated with recruiting, retaining, and advancing underrepresented groups in Science, Technology, Engineering, and Mathematics (STEM). Studies have indicated negative implicit bias against women and minorities in terms of their perceived competence, worthiness to be hired, and payment irrespective to their qualification. Additionally, lack of mentoring and access to personal capital often hinder students’ academic advancement in STEM. However, there have been multiple intentional, recent efforts to increase and foster diversity in sciences. Some of the most effective …

Barriers/Drivers Of Diverse Perennial Systems: Policy Recommendations, M. L. Krome, A. S. Finan, J. Obudzinski, N. Serrano

IGC Proceedings (1993-2023)

Despite growing documentation of perennial- and grass-based systems’ importance in addressing many ecological, infrastructural, farmer profitability, and climate concerns, these systems do not predominate on most United States farm and ranch lands. To better understand what impedes their wider adoption, we undertook four focus groups of diverse current and potential farmers using perennial systems. We were especially interested in how these farmers access, or don’t, insurance, credit, and federal programs, identifying patterns among farmers embracing more sustainable practices. Our virtual focus groups comprised 16 farmers in ten states, transecting climate zones and representing both rural and urban production systems and …

Feeds And Forages Intervention Strategies For Improved Livestock Nutrition And Productivity In The Northwest Highlands Of Vietnam, M. Atieno, T. B. N. Trần, V. T. Bùi, T. T. Mai, A. Duncan, S. Douxchamps, M. Peters

IGC Proceedings (1993-2023)

Livestock production in Vietnam is critical for livelihoods particularly for ethnic minorities in the Northwest Highlands (NWH). Improved livestock management and productivity can be achieved through better feed management and increased cultivation of improved forages, to meet animal nutrition demand. This study aimed at assessing feed intervention strategies to address context-specific feed-related challenges, mainly winter feed shortage in Mai Son district, Son La province, Vietnam. Feed interventions included promotion of improved forages (grasses and legumes) and capacity building on animal nutrition techniques including feed preservation, feed mix and feeding regimes for cattle and pigs. Willing farmers selected from a list …

Biophysical, Grazing-Season Management, And Animal Traits Effects On Individual Animal Performance Of Cow-Calf Systems: Insights From A Long-Term Experiment In The Us Western Great Plains, G. Irisarri, P. A. Cipriotti, L. Castro Sardiña, M. Mortenson, J. D. Derner

IGC Proceedings (1993-2023)

Beef grazing systems require information on management, biophysical, and individual animal influences on performance metrics. However, long-term controlled experiments are lacking to comprehensively ascertain these individual and likely interacting influences. We used a legacy data set from the USDA Agricultural Research Service where individual weight gains were determined from on and off weights of Hereford cows and calves grazing native northern mixed-grass prairie, during the June through September season, from 1975-2001 near Cheyenne, Wyoming, USA. The herd size varied from a minimum of 10 to a maximum of 48 pairs across years. Management (on and off grazing dates and stocking …

Implementation Of An Evidence-Based Bundle To Educate Nurses In The Care Of Adult Post-Transplant Diabetes Mellitus Patients, Christine Slaughter

DNP Projects

Background: After solid organ transplantation, between 10-40% of patients develop post-transplant diabetes mellitus (PTDM) due to the immunosuppression regimen, infection, stress response and pain. Hyperglycemia events are common and managing glycemic targets is critical to decrease the likelihood of graft failure and mortality.

Purpose: To determine the impact of an evidenced-based bundle education strategy on the perceived confidence/knowledge of nurses and on their documentation compliance in the care of adult solid organ post-transplant diabetes mellitus patients.

Methods: A single group, pretest-posttest design was implemented to evaluate the effectiveness of the electronic educational program on the nurses perceived confidence/knowledge regarding glycemic …

The Effect Of An Intervention To Improve Screening For Opioid Use In Patients With Post Traumatic Stress Disorder, Tammy Swartz

DNP Projects

Background: Rates of post-traumatic stress disorder (PTSD) were reported to be higher during COVID-19 than during any other epidemic in history. Patients diagnosed with PTSD are at an increased risk of experiencing opioid use disorder (OUD). Early detection, prevention, and treatment are essential to prevent OUD.

Purpose: The purpose of this project was to determine if education aimed at increasing nurses’ knowledge increased patient screenings for OUD.

Methodology: A baseline chart audit was performed to determine the number of patients seen in the emergency department with PTSD who also were evaluated for OUD. Two hundred and forty emergency department registered …

The Effect Of A Community Resiliency Model Education On Resilience, Psychological Empowerment, And Well-Being In Behavioral Health Nurses, Lorrie Smith-Esterle

DNP Projects

Background: Resilience, well-being, and psychological empowerment are associated with improvement in job satisfaction and nurse retention rates. The Community Resiliency Model (CRM) can promote emotional regulation, well-being, and create an internal state of balance in response to work-related stressors. Educating nurses on how to use CRM enables the recognition of changes in thoughts, emotions, sensations, and internal or external stimuli, which can promote resilience, well-being, and psychological empowerment.

Purpose: The purpose of this project was to evaluate evaluate the effect of a resiliency education using the Community Resiliency Model (CRM) on resilience, psychological empowerment, and well-being of behavioral health nurses. …

Improving Structural Empowerment Through The Co-Creation Of A Professional Governance Program Of Nurse Managers And Front-Line Nurses, Michelle Van Outer

DNP Projects

Abstract

Background: Professional governance is a model in healthcare systems where nurses are involved by participating in decisions that lead their practice. Participation in professional governance has been shown to improve nursing practice, employee satisfaction, nursing autonomy, and patient outcomes.

Purpose: The purpose of this study is to evaluate nurses’ perceptions of empowerment when front-line nurses are involved with their nurse managers in the design and structure of an inpatient state psychiatric hospital’s professional governance program.

Conceptual Framework: Kanter’s theory of empowerment will guide this project. As individuals feel more empowered, the success of the organization increases. Kanter suggests that …

The Impact A Nurse Recruiter Has On Nursing Staff Shortages And Nurse Manager Satisfaction In An Acute Psychiatric Facility, Johna Arnett

DNP Projects

Abstract

Background: Nursing staff shortages have persisted for the last few decades. Strategies to resolve this enduring challenge continue to drive the creative efforts to attract and retain new staff. These shortages not only affect patient care but can also impact the satisfaction of nurse managers. Little information is available on the effects of a nurse recruiter role on nursing staff shortages as well as nurse manager satisfaction.

Purpose: The purpose of this project is to assess how implementing a designated nurse recruiter impacts nursing staff shortages and nurse manager satisfaction in an acute psychiatric facility. This project examines two …

Reducing Nursing Documentation Burden: Evaluation Of An Electronic Health Record Optimization Plan, Jessica Collins

DNP Projects

Background: UK HealthCare transitioned to a new enterprise electronic health record (EHR) system, offered by Epic Systems Corporation, in June 2021. Approximately 2,000 inpatient nurses use the EpicCare Inpatient Module in the 1,086 licensed bed facilities. Compared to other academic medical centers, UK HealthCare nurses take more time documenting in this EHR inpatient module’s Basic Assessment Flowsheet (documentation burden) and have a longer delay between assessment and documentation (timeliness) potentially contributing to nursing dissatisfaction with using this new EHR.

Purpose: The purpose of this project was to evaluate the effectiveness of a phase of the Epic Nurse Well-Being Project, a …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

The Effects Of An Educational Intervention On Nursing Knowledge Of Post-Operative Care Of Patients After Minimally Invasive Esophagectomy Surgery, Kelli Curry

DNP Projects

Abstract

Background: Minimally invasive esophagectomy surgery is commonly performed by thoracic surgeons on patients with esophageal cancer. The post-operative care of these patients is meticulous and follows a protocol developed by the thoracic surgeons at the University of Kentucky. At UK Chandler Medical Center, concerns have been raised regarding nurses’ lack of education of the protocol, and therefore decreased implementation. Increasing nursing knowledge pertaining to this protocol by performing educational in-services periodically and standardizing and implementing formal education as part of nursing orientation will decrease the knowledge gap and improve patient outcomes and increase utilization of the post-operative protocol.

Purpose: …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Implementation Of An Education Intervention Aimed At Intensive Care Unit Providers To Improve Knowledge Of And Screening For Cognitive Impairment Related To Post-Intensive Care Syndrome, Terry Harrod

DNP Projects

Abstract

Background: Post intensive care syndrome is a condition that can lead to a range of physical,

cognitive, and psychiatric issues and is frequently undiagnosed. Educating Nurse Practitioners,

Physician Assistants, and Physician Fellows who work in the ICU about post intensive care

syndrome and a cognitive screening tool like the MoCA can significantly enhance their

understanding and ability to diagnose a component of this syndrome.

Purpose: The purpose of this project was to evaluate the effect of an educational intervention

regarding post intensive care syndrome among ICU nurse practitioners, physician assistants, and

physician fellows treating patients within the ICU.

Methodology: …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …