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Investigating Pre-Health Students’ Science Identity And The Factors That Influence Them To Change Programs Or Tracks., Taylor Humphreys

College of Arts & Sciences Senior Honors Theses

Retention is a particularly pressing issue for undergraduate students, specifically those in pre-health programs or tracks. This can be affected by a students’ science identity, which is referred to as viewing oneself as a “science person.” This study focused on investigating science identity and influencing factors that can cause program or track change of pre-health students. Previous studies have investigated these factors regarding pre-health students applying to medical school, but this study opened the investigation to a variety of pre-health students and focused on characterizing students’ experiences prior to their health professional school applications. The analysis of peer-led focus group …

Organizational Change In Saudi Healthcare Settings: Evaluating Organizational And Individual Readiness For Change, And The Mediating Role Of Readiness For Change Between Management Support And Commitment To Change., Sultan Alsaif

Electronic Theses and Dissertations

BACKGROUND: To respond to the constantly changing environment and developments of healthcare, leaders of healthcare organizations have been trying to introduce and implement transformations that allow their organizations to be able to operate effectively and efficiently to meet the shifts in healthcare demand and to deal with new patterns of health issues, comply with the new policies, and to enhance their present in the market. Thus, it is important for managers to determine the level of readiness for implementing organizational changes from to perspectives. These perspectives include organizational readiness for change and individual readiness for change. METHOD: This first manuscript …

Environmental Exposures And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

In recent years, research into air pollution has shown that exposure to certain components in air pollution, primarily PM2.5 can accelerate biological aging and thereby lead to increased susceptibility to multiple diseases. We hypothesize that prolonged exposure to air pollutants can result in premature aging leading to extensive tissue dysfunction and susceptibility to diseases. To examine this, we exposed mice to PM2.5 for 9, 15, and 21 days, then measured the telomere lengths, cellular senescence, and histone methylation patterns of multiple cell types. We found consistently increased telomere attrition, cellular senescence and advanced age-consistent histone methylation patterns in groups exposed …

From Awareness To Action: Understanding And Addressing Health Disparities, Aamira Shah

The Cardinal Edge

In the United States, marginalized groups consistently face barriers to healthcare services necessary for maintaining quality of life and achieving positive health outcomes. Health disparities can be defined as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been disadvantaged by their social or economic status, geographic location, or environment” (CDC, 2008). With input from insightful interviews, this article seeks to investigate specific challenges faced by marginalized groups in the healthcare setting and provide potential solutions to reduce health disparities.

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Remote Blood Pressure Monitoring Program: Program Evaluation., Brittany Walker

Doctor of Nursing Practice Papers

The prevalence of hypertension is high at the local, state, and national levels. In 2021, 39% of Kentucky adults were diagnosed with high blood pressure (CDC, 2021). Primary care providers are utilizing remote blood pressure monitoring (RBPM) to assist with the management of hypertension. Literature reveals that remote BP monitoring alone, without the use of other interventions such as counseling and education, may not effectively control blood pressure (Uhlig K, et al, 2013). This project evaluated the RBPM program utilized at a federally qualified health center in Louisville, KY. Patient engagement within the RBPM program includes BP measurement, communication with …

Swallow, Breathing And Survival: Sex-Specific Effects Of Opioids., Michael Frazure

Electronic Theses and Dissertations

This dissertation presents a series of studies examining mechanisms of deglutition and respiration, and how these vital processes are impacted by opioids. The experiments in Chapter Two investigated the role of the upper esophagus in airway protection through systematic activation of pharyngeal and esophageal mechanoreceptors in a cat electromyography model. Chapter Three compared effects of opioid administration on breathing and swallowing between male and female rats, and found that females are more susceptible to opioid-induced depression of breathing and swallow than males. Findings from Chapters Two and Three led to the development of a translational model of opioid-induced dysphagia using …

Utilizing Mhealth To Increase Follow-Up In Latinx Adults With Hyperlipidemia., Jessica Raymond Richards

Doctor of Nursing Practice Papers

Background: Management of hyperlipidemia (HLD) is crucial to the prevention and management of cardiovascular disease cardiovascular disease (CVD), a leading cause of death in the United States (US) and Latinx adults (Centers for Disease Control and Prevention (CDC), 2019). The main difficulty affecting monitoring of lipid levels in patients diagnosed with HLD is lack of adherence to follow-up appointments.

Purpose: The purpose of this Quality Improvement (QI) project is to evaluate the impact of culturally competent translated short message service (SMS) texts to increase adherence follow-up on a Latinx population served at the Kentucky Racing Services Health Center (KRSHC).

Intervention: …

Improving Postoperative Breast Augmentation Patient Education Delivery., Madison Callery

Doctor of Nursing Practice Papers

Background: Effective patient education promotes successful postoperative outcomes. Nurses in an outpatient surgery center lacked consistent patient education practices and materials.

Purpose: The purpose of the project was to implement an evidence-based multimodal educational strategy for patients who undergo breast implant surgeries.

Methods: At an outpatient plastic surgery center, pre- and post-intervention phone calls were tracked; post-intervention education, documentation, and patient satisfaction data were recorded. Nurses were educated on the new materials, delivery procedures, and electronic health record (EHR) documentation. All patients undergoing breast implant surgery received multimodal education at each postoperative appointment. Outcomes included (1) the number of patient …

Evaluating The Effectiveness Of A Standardized Mobile Vaccination Clinic Training Program For Team Leaders In Reducing Vaccination Administration Errors., Valenchia Brown

Doctor of Nursing Practice Papers

In response to the urgent need for mobile COVID-19 vaccination clinics, the Kentucky Nurses Association (KNA) developed a standardized training program aimed at equipping nurse leaders with the necessary tools and resources for safe and efficient vaccine administration, free of vaccination errors, during mobile vaccination clinics. The purpose of this study was to assess the process effectiveness of the training program as perceived by team leaders and evaluate the number and types of vaccination errors during these clinics. The CDC’s Logic Model served as the framework for this project. The interventions included team leaders undergoing standardized training outlined in the …

Tapped Twice: A Case Of A Rapidly Re-Accumulating Hepatic Hydrothorax In A Patient With Spontaneous Bacterial Empyema, Amir Khalil, Suma Alzouhayli, Silvia Novakova, Saad Shams, Ahmad Baiyasi, Maria Khalil, Mohammed Uddin, Aryan Shiari, Kareem Bazzy

The University of Louisville Journal of Respiratory Infections

Hepatic hydrothorax (HH) is a complication of decompensated liver cirrhosis that only occurs in about 5–6% of cirrhosis patients, defined as a pleural fluid in the setting of known liver disease, with the absence of any other cardiopulmonary etiology. Infected HH is a rare complication, designated as spontaneous bacterial empyema (SBEM), found in only 13–16% of patients with HH. This case follows a patient with SBEM who developed a recurrent pleural effusion minutes after thoracentesis. Our patient is a 56-year-old female with a history of alcoholic cirrhosis with pleuritic pain found to have right-sided pleural effusion with decompensation. She had …

The Association Of Long Working Hours And The Use Of Prescription Sedatives Among U.S. Workers., Emmanuel Ezekekwu

Electronic Theses and Dissertations

BACKGROUND: Meeting the needs of a round-the-clock and globalized society has led to an increase in long working hours. This trend has been accompanied by a corresponding rise in sleep disorders and subsequent use of sedating medications. Overtime hours have been associated with adverse health outcomes such as cardiovascular diseases, symptoms of psychological distress, and health behaviors, including risky intake of alcohol and smoking. Hence, the main objectives of this three-paper dissertation were to examine the multi-faceted relationship between working hours, the use of prescription sleep aids, the onset of psychological distress, and the use of health care services. METHODS: …

Peer-Supervision Of Nursing Professionals: A Shield Against Burnout, Kyle Gamache, Sarah Gamache, Joseph Robillard

Journal of Wellness

Introduction: Burnout is a major risk in healthcare professions and is a significant contributor to the current nursing shortage. Strategies to combat burnout of healthcare professionals are in desperate need. The purpose of this project is to introduce the clinical peer supervision model as a method to alleviate burnout in nursing professionals.

Approach: Eight nurses from in-patient settings participated in a peer-supervision support group, modeled after existing European nursing and mental health provider-support protocols. To assess the effect of this intervention, qualitative data analysis was conducted on the transcripts of session and the results described. All participants reported statistically high …

Wellness Review 2022, Part 1, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: This article represents the first of a two-part assessment of 2022 literature addressing wellness in healthcare professionals published from January 1, 2022 to June 30, 2022.

Methods: Three editors conducted a similar keyword search in Pubmed, also adding manually curated articles. Focusing chiefly on clinical trials and other prospective research, we settled on a final 25 significant papers focusing on wellness in medical professionals to include in this review.

Literature Review: Recent literature into HCW wellness continues to describe burnout factors and COVID-19 impact, but includes more resilience-targeting interventions and systematic reviews of trials seeking bolstering of well-being. Subsections …

Coexistence Of Cutaneous Squamous Cell Carcinoma And Basal Cell Carcinoma In A Renal Transplant Recipient: A Case Report., Diana Voloshyna, Tanveer Ahamad Shaik, Sunita Shrestha, Ajmat Ansari, Faraz Saleem, Muhammad Abu Zar Ghaffari

Faculty Scholarship

In solid organ transplant patients, non-melanoma skin cancer remains a leading cause of mortality. The most common skin malignancies in solid organ transplant patients are squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). In organ transplant patients, SCC is 100 times more prevalent, and BCC is 10 times more prevalent than in the general population. Many risk factors for developing such malignancies are equivalent to those in the general population. However, in the transplant population, such cancers occur at an earlier age, act more aggressively, and often appear at multiple locations. Thus, assiduousness on the patient's part and healthcare …

Reducing Weekly Screen Time Use In College Students., Anna Louise Davidson

Doctor of Nursing Practice Papers

Background: Screen time overuse is a serious problem currently affecting college students. Studies have shown that too much screen time use can contribute to symptoms of depression and anxiety as well as stress, insomnia, and sedentary behavior contributing to obesity and cardiometabolic issues. Though much research has been devoted to assessing and reducing screen time use in children and adolescents, there are fewer published studies on interventions specific to college students. Therefore, the interventions for adolescents (ages 13 to 17) were reviewed and synthesized, as college students are close in age and brain development to late adolescent stage.

Setting: The …

Aggregatibacter Actinomycetemcomitans Exploits And Modulates The Immune Response By Human Neutrophils For Survival In The Anaerobic Environment., Hazel Ozuna

Electronic Theses and Dissertations

Aggregatibacter actinomycetemcomitans (Aa) is a Gram-negative facultative anaerobe and an opportunistic oral pathogen, strongly associated with localized periodontitis and other inflammatory diseases. Periodontitis is a chronic inflammation of the periodontium resulting from the inflammatory response of the host towards the dysbiotic microbial community present at the gingival crevice. The host immune response creates a hostile environment for microorganisms; therefore, it is important for Aa to be able to regulate the necessary genes to survive and thrive in such an environment. Aaexpresses several virulence factors such as a cytolethal distending toxin (Cdt), lipopolysaccharide (LPS) and leukotoxin A (LtxA), …

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

Microbial Influence On Alzheimer's Disease, Ashley N. Hamby

The Cardinal Edge

No abstract provided.

Concurrent Reporting Of Adverse Childhood Experiences Among Perspectives Of Adolescents And Caregivers., Katie J. Berghuis

Electronic Theses and Dissertations

The consequences of Adverse Childhood Experience (ACE) events in youth have predominantly been studied through retrospective studies that assess adults’ first 18 years of life or caregiver report of ACEs in youth. Reliance on only caregiver report to discern ACEs is a limitation amongst prior studies as research has found that caregivers tend to underestimate ACEs among their children, and there is even a greater discrepancy of reporting between caregivers and youth 12 years and older. Therefore, this study investigated concurrent reporting of self-report ACE scores in adolescents – defined in this study as 12 to 20 years old – …

Development Of 3d-Bioprinted Scaffolds For Oral Probiotic Application., Jhanvi Patel

Electronic Theses and Dissertations

Background: Porphyromonas gingivalis adheres to and invades gingival epithelial cells, resulting in decreased cell viability. Previous studies have indicated that probiotics are effective against dental pathogens; however, few approaches provide sustained-delivery of active agents in the oral cavity. Hypothesis: Probiotics will limit P. gingivalis effects on Telomerase Immortalized Gingival Keratinocyte (TIGK) cells and 3D-printed scaffolds will prolong probiotic release. Methods: Lactobacillus acidophilus, Lactobacillus reuteri, and Bifidobacterium bifidum were assessed with adhesion and antibiotic protection assays to limit P. gingivalis effects on TIGKs. Scaffolds were printed with a select probiotic and evaluated for release kinetics. Results: Free L.a., …

Expediting Dental Treatment For Patients With Diabetes Mellitus In A University-Based Dental Clinic., Michelle Baxter

Doctor of Nursing Practice Papers

Oral health and diabetes are connected in a reciprocal relationship linked through the pathological mechanisms of bacteremia, inflammation, and the immune response. Dental patients experience a delay in receiving treatment at a university-based dental clinic secondary to obtaining required medical consultation from the patients’ private providers for complex medical conditions. This project was implemented to minimize barriers in access to care, reduce the risk for oral health and systemic diabetes complications, and optimize the health outcomes for diabetic patients seeking comprehensive dental treatment. The intervention group included 32 patients with diabetes who participated in hemoglobin A1c (HbA1c) testing during their …

Student Loans And Health-Related Financial Hardship, Sophia T. Anong, Robin Henager

Journal of Student Financial Aid

Research has shown that student loan borrowers in repayment exhibit physical and mental health problems. These can be exacerbated by and contribute to health-related financial hardship. We use the 2015 U.S. National Financial Capability Study to examine the likelihood of having past due medical bills and of avoiding health care services by not purchasing prescribed medication, skipping tests or follow-up with a doctor or not seeking care for a medical problem. Borrowers on income-driven repayment plans and those who made late payments are found to be more likely to have unpaid medical bills and to have avoided required medical attention. …

Perceived Stress And Self-Care In Graduate Students Amidst The Covid-19 Pandemic, Devona M. Stalnaker-Shofner, Cathy Lounsbury, Sadie Collagan, Sean Keck, Ryan Roberts

Journal of Wellness

Introduction: This study examines the perceived stress and self-care behaviors of graduate students as impacted by the COVID-19 pandemic. Students who participated had varying degree concentrations, with the majority of participants having a Clinical Mental Health Counseling, Couples and Family Therapy, Dance Movement Therapy, or Clinical Psychology focus. This study is particularly relevant to health care workers, especially those whose focus is mental health. Markedly elevated prevalence of reported adverse mental and behavioral health conditions associated with the COVID-19 pandemic highlight the broad impact of the pandemic and the need to prevent and treat these conditions. This study sought …

Particulate Matter Exposure And Community-Acquired Pneumonia Mortality Among Hospitalized Adults With Pneumococcal Pneumonia: Incidence Study (Happi) Participants., Jack Anthony Pfeiffer

Electronic Theses and Dissertations

The role of air pollution as an agent of elevated morbidity and mortality has come under increasingly intense scrutiny in recent years. As the body of literature grows, so too does our understanding of how extensive the harm of such pollutants can be. Particulate matter (PM) particularly harmful due to its small size, ability to travel great distance while airborne, and capacity to infiltrate numerous bodily systems, often to the detriment of those exposed. Besides being associated with increased mortality risk in more heavily exposed populations, PM exposure has also been associated with complications in the respiratory, cardiovascular, and nervous …

Streptococcus Anginosus Lung Infection And Empyema: A Case Report And Review Of The Literature, Nishita Tripathi, Kuldeep Ghosh, Anupama Raghuram

The University of Louisville Journal of Respiratory Infections

Streptococcus milleri group (SMG) also referred to as the Streptococcus anginosus group. These are Gram-positive, variable hemolysis, catalase negative, microaerophilic, non-motile facultative anaerobes which have been known to cause abscesses in humans. We report a case of empyema caused by Streptococcus anginosus in a patient with an unresolved pneumonia for over a month. In early October 2018, the patient presented to an emergency room with the complaints of shortness of air, productive cough, chills, subjective fever and weight loss for 4 weeks. A chest X-ray revealed a left lower lobe pneumonia. He was treated with 250 mg of azithromycin for …

The Health Of Haitian Schoolchildren: Longitudinal Effect Of Annual Visits On Growth, Jamarie Geller, Mary Starrs, Andrew Bartholomew, Sara Kaliszak, Jeri Kessenich

Journal of Refugee & Global Health

Objectives: Haiti has one of the highest rates of childhood undernutrition in the world, devastating overall health. This study focuses on the growth of children offered longitudinal healthcare by Kids Health for Haiti, using BMI to indicate developmental and nutritional status. Objectives include collecting baseline prevalence data, examining the longitudinal impact of longitudinal interventions, and discussing future investigation and programming areas.

Methods: A retrospective longitudinal observational chart review on 245 students over a six-year period analyzing height, weight, and BMI. All data was collected as part of routine health provision and underwent statistical analysis using a single-subject design.

Results:46.3%, …

Predicting Dental Student's Performance On National Board Dental Examination (Nbde) Part I: Exploring Demographic Factors, Dental Admission Test (Dat) Factors, Pre-Program Academic Factors, And Dental Program Academic Performance., Wei-Shao Lin

Electronic Theses and Dissertations

Dental students need to successfully challenge a national licensure examination to be able to practice dentistry. Dental educators currently have difficulty in identifying candidates who are at risk of failing this examination. This non-experimental quantitative study examined existing dental student data from the 2017, 2018, and 2019 graduating classes, using a retrospective and correlational approach to identify possible markers for at risk students. Demographic factors, dental admission test (DAT) factors, pre-program academic factors, dental program academic performance, and National Board Dental Examination (NBDE) Part I performance. A series of independent t-tests and One-Way analysis of variances (ANOVAs) were used to …

Letters That Will Not Be Read, Kaila Pomeranz

Journal of Wellness

No abstract provided.