Digital Commons Network^™

Patient And Therapist Perceptions Of Respiratory Functioning Due To Spinal Cord Injury: Implications For Music Therapists, A'Marie Dotson

Theses and Dissertations--Music

Decreased respiratory functioning is a common symptom of spinal cord injury (SCI) and can impact individuals’ personal, professional, and social lives. In spite of this, researchers have not explored the use of music in the lives of individuals with SCIs or music’s role in their healthcare professionals’ treatment plans to improve respiratory functioning. The purpose of this qualitative study was to better understand how decreased respiratory functioning affects individuals with SCIs and healthcare professionals through a multiple case study design. Participants were two individuals with SCIs and three healthcare professionals (physical therapist, recreational therapist, and music therapist) who worked with …

Should Conductors Listen To Recordings When They Learn Scores?, Jan Pellant

Theses and Dissertations--Music

We can observe the conductor’s work at his performances and rehearsals. However, we cannot see the process of score preparation from the time they get the score to the downbeat of the first rehearsal because the conductor does this work alone. This dissertation discusses the debate among conductors past and present about whether, when, and how to use recordings as part of the score preparation. It considers the advantages and disadvantages of using recordings in the score preparation process. I conducted several types of research on the use of recordings by living conductors. I interviewed conductors using Skype and phone …

Leveraging Cultural Assets Of Culturally And Linguistically Diverse Individuals In Music Therapy: A Qualitative Phenomenological Study, Emma Grace King

Theses and Dissertations--Music

The purpose of this thesis was to explore how music therapists can engage in cultural humility and leverage cultural assets of those who are culturally and linguistically diverse (CLD). The primary research question involved in this study was: “In what ways can music therapists leverage cultural assets of CLD individuals in practice?” Sub-questions were: “What awareness, knowledge, and skills do music therapists need to grow in culturally sensitive practice?” “How can music therapists whose first language is English effectively serve linguistically diverse individuals?” “What steps might music therapists take to effectively serve culturally diverse individuals?” and “How might cultural and …

Fantasies Of Race And Place: White Nationalist And Alt-Right Undercurrents In Fantasy Roleplaying Games, Mark Hines

Theses and Dissertations--English

Representations of fantasy settings in roleplaying games often draw upon understandings of the medieval and early Renaissance world. This dynamic often extends to racial politics in such worlds. For the contemporary roleplaying game, this often means that game mechanics are built around race, species, or gender. Often, players interpret such mechanics as a means of bioessentializing race or practicing stereotypes rooted in Eurocentric morality and values.

This thesis examines the underlying rhetoric and implicit stakes by which race in fantasy worlds overlaps with the rhetoric and proposed stakes of White Nationalist and Alt-right actors. As fantasy roleplaying games, and especially …

An Agronomic-Economic Approach To Connect Manure Nutrients Back To Grain-Producing Regions, Joshua M. Duke, Joshua M. Mcgrath

Plant and Soil Sciences Faculty Publications

Stakeholders for nutrient-impaired watersheds have long discussed the causes and consequences of nutrient surpluses associated with intensive livestock production. Nonetheless, nutrient surpluses relative to crop requirement, particularly with phosphorus (P), persist and continue to contribute to water quality impairment. Nutrient life-cycle analysis shows that mineral P, from soil minerals or mined fertilizer P, flows to livestock regions from grain-producing regions. Although creating a return flow of these nutrients to grain fields seems like an easy solution, significant economic obstacles exist to creating a connected manureshed over large geographic distances. To limit the impact of manure use on local surface water, …

Social And Biological Determinants Of Pregnancy-Related Mortality And Morbidity In A Rural, Underserved Population, Anna Hansen

Theses and Dissertations--Sociology

Cases of severe maternal morbidity (SMM) and pregnancy-related mortality (PRM) are increasing in the US. Research concerning SMM and PRM has neglected women in Central Appalachia; a largely rural, health-disparate population. The aims of this study are two-fold: (1) Examine patient-level and place-based predictors of SMM/PRM via hierarchical logistic regression modeling, and (2) Elucidate Appalachian healthcare patients’ and providers’ experiences with SMM/PRM, perceptions of contributing factors, and insights on points of intervention.

This study uses a mixed methods approach guided by the WHO’s conceptual framework for action on social determinants of health to identify determinants of SMM and PRM among …

An Integrated Computational Pipeline To Construct Patient-Specific Cancer Models, Daniel Plaugher

Theses and Dissertations--Mathematics

Precision oncology largely involves tumor genomics to guide therapy protocols. Yet, it is well known that many commonly mutated genes cannot be easily targeted. Even when genes can be targeted, resistance to therapy is quite common. A rising field with promising results is that of mathematical biology, where in silico models are often used for the discovery of general principles and novel hypotheses that can guide the development of new treatments. A major goal is that eventually in silico models will accurately predict clinically relevant endpoints and find optimal control interventions to stop (or reverse) disease progression. Thus, it is …

What Is The Sound Of Holiness? The Regulation Of Sound And Silence In Early Medieval Monastic Communities, 600-900, Melissa Kapitan

Theses and Dissertations--History

This dissertation explores how the regulation of sound and silence in the early medieval monastery formed a distinct soundscape imbued with personal, communal, and theological resonances. More narrowly, this investigation focuses on the Frankish empire of the ninth century, which saw a series of monastic reforms led by the Carolingian royal family and ecclesiastical figures and consolidated in imperial legislation and treatises on the monastic life.

These ninth-century reforms witnessed not only the promotion of a single rule and custom to guide monastic life, but also a great flowering of liturgical texts, including the earliest treatises on musical theory. These …

Understanding The Effects Of Embryonic Hyperglycemia On Retinal Development And Maintenance, Kayla Titialii-Torres

Theses and Dissertations--Biology

Hundreds of millions of people are affected by diabetes worldwide. Whether they are diagnosed with prediabetes or Type I or II diabetes, there are a variety of mechanisms in the pathogenesis of diabetes. Diabetes is a disease which consists of recurring states of hyperglycemia that can be difficult to manage due to either lack of insulin production or improper utilization of insulin. While these mechanisms of action differ, complications induced by diabetes occur in both poorly regulated Type I and II. Common complications of diabetes include nerve damage, kidney damage, and eye damage. Eye damage specifically is called diabetic retinopathy …

Assessing Ear Pinna Repair In The Mrl/Mpj Mouse Strain, Fatemeh Safaee

Theses and Dissertations--Biology

The outcome of tissue repair varies across species. Vertebrates such as salamanders have the ability to not only heal scar-free but also completely regenerate lost appendages. In contrast, most mammals heal their wounds with fibrotic scarring. Understanding the key drivers of these divergent injury responses remains a major unanswered question in animal biology. Previous work with the Murphy’s Roth Large (MRL/MpJ) inbred mouse strain suggested they have the ability to rapidly close small (2mm) ear holes. While this ability was originally published as an example of regeneration, subsequent work by other groups suggested that it might represent something more akin …

Defining Patient Cohorts For Guiding Clinical Trials And Treatment In Lafora Disease: A Model For The Rare Disease Community, Katherine Janae Donohue

Theses and Dissertations--Molecular and Cellular Biochemistry

In the US, approximately 8000 rare diseases have been identified. Combined, rare diseases impact more than 30 million people in the U.S. alone, with 75% of those being children. However, research, funding, and therapeutic development for the rare disease community remains challenging because of the incredible diversity – not only between diseases, but often even within a single disease.

LD is an ultra-rare childhood dementia and epilepsy caused by mutations in one of two driver genes: EPM2A, which encodes for the glycogen phosphatase laforin, and EPM2B/NHLRC1, which encodes the E3 ubiquitin ligase malin. Children with LD …

Child Welfare: Workforce Retention, Competence, And The Connection To Social Work Education, Brittany Stanley

DSW Capstone Projects

While there are many avenues to discuss and explore, the key area of interest for the Capstone Project is that of retention of a competent frontline workforce. Each state has their own set of guidelines for hiring frontline workers which allows for variety in the educational backgrounds of the investigative and ongoing workers. This can become problematic when the educational background may not be the most suited for the work and challenges faced by child welfare workers.

During the development of the Capstone Project, one could not help but wonder that if workers were adequately prepared for the demands of …

Models And Optimal Controls For Smart Homes And Their Integration Into The Electric Power Grid, Huangjie Gong

Theses and Dissertations--Electrical and Computer Engineering

Smart homes can operate as a distributed energy resource (DER), when equipped with controllable high-efficiency appliances, solar photovoltaic (PV) generators, electric vehicles (EV) and energy storage systems (ESS). The high penetration of such buildings changes the typical electric power load profile, which without appropriate controls, may become a “duck curve” when the surplus PV generation is high, or a “dragon curve” when the EV charging load is high. A smart home may contribute to an optimal solution of such problems through the energy storage capacity, provided by its by battery energy storage system (BESS), heating, ventilation, and air conditioning (HVAC) …

Energy-Efficient And Secure Hardware Using Adiabatic Logic And Non-Volatile Mtj Devices, Zachary Kahleifeh

Theses and Dissertations--Electrical and Computer Engineering

Internet of Things (IoT) is a collection of devices that exchange data through a network to implement complex applications. IoT devices increase the quality of life of their user base which has a wide variety such as the medical field, consumer electronics, and the manufacturing sector. However, IoT devices have several challenges that need to be overcome namely, security and energy consumption. The threat vector that IoT devices face is growing and includes the following threats, the leakage of information through a side-channel attack known as the Correlation Power Analysis (CPA), authentication, piracy, etc. A side-channel attack is an attack …

Three Dimensional Photonics Structures: Design And Applications, Mansoor Sultan

Theses and Dissertations--Electrical and Computer Engineering

Photonics is an emerging technology for light control, emission, and detection. Photonic devices control photons the same way electronic circuits control electrons in active or passive mode depending on the energy requirement of the device. This dissertation will discuss the design, fabrication, testing of photonic structures with applications including imaging and renewable energy. First, we developed a novel lithography method for fluoropolymer resist based on variable pressure electron beam lithography (VP-EBL). VP-EBL proves to be an efficient method for patterning a widely used, but challenging to process, fluoropolymer, Teflon AF. However, rather than solely mitigating charging, the ambient gas is …

Synthesizing Dysarthric Speech Using Multi-Speaker Tts For Dsyarthric Speech Recognition, Mohammad Soleymanpour

Theses and Dissertations--Electrical and Computer Engineering

Dysarthria is a motor speech disorder often characterized by reduced speech intelligibility through slow, uncoordinated control of speech production muscles. Automatic Speech recognition (ASR) systems may help dysarthric talkers communicate more effectively. However, robust dysarthria-specific ASR requires a significant amount of training speech is required, which is not readily available for dysarthric talkers.

In this dissertation, we investigate dysarthric speech augmentation and synthesis methods. To better understand differences in prosodic and acoustic characteristics of dysarthric spontaneous speech at varying severity levels, a comparative study between typical and dysarthric speech was conducted. These characteristics are important components for dysarthric speech modeling, …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Exploring Palliative Care Education Needs And Desires Of Advanced Practice Providers In The Critical Care Setting, Jill Marie Clemmons

DNP Projects

Background: Critical care providers in the ICU setting are discovering that their patients are living longer with more comorbid conditions. They are confronted with palliative care situations almost daily. Recently palliative care has been thrust into the forefront of critical care and is a resource critical care nurse practitioners and physicians’ assistants need to be able to utilize. A gap in the literature has been found in the overall education of critical care providers regarding palliative care.

Purpose: The purpose of this study was to determine what palliative care training trauma/cardiac/neurological, and pulmonary critical care providers had previously received …

Effects Of Tailored Colorectal Cancer Patient Education On Colorectal Cancer Screening Rates In An Urban Kentucky Clinic, Brittany Pittman Hardcorn

DNP Projects

Background: Colorectal cancer (CRC) is one of the leading causes of death among Americans and Kentuckians. Most colorectal cancers are slow-growing, making regular colorectal cancer screening increasingly important to decrease morbidity and mortality. Although of this importance, there is low screening rates. Thus, the need to explore all colorectal screening options.

Purpose: The purpose of this project was to increase the number of patients screened for colorectal cancer by providing education on colorectal cancer and screening options in a primary care setting.

Methods: The design of the study was a 2 group quasi-experimental practice improvement project using a post-test educational …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Effectiveness Of Substance Use Disorder Education On Knowledge And Attitudes Among Entry-Level Obstetric Nurses, Kathryn Hughes

DNP Projects

Background: Substance use disorder (SUD) among pregnant women is a significant public health concern in the United States, particularly in Kentucky. Nursing curriculum has not kept pace with the escalating public health crisis regarding SUD. Graduating nurses joining the obstetric field are often not prepared to meet the unique care needs of this vulnerable population.

Purpose: The purpose of this DNP project was to pilot an educational intervention embedded with content regarding SUD with entry-level obstetric nurses that were enrolled in the nurse residency program at UK HealthCare.

Methods: This project used a quasi-experimental pretest – posttest design. Participants completed …

Evaluation Of Dyad Effectiveness In A Psychiatric Healthcare Facility, Elizabeth Smith

DNP Projects

Background: Inadequate communication can lead to poor quality of care and patient outcomes. Physician-nurse dyad partnerships have been shown to increase effective communication but there is a lack of data to show the impact these dyads have on dyad members’ perceptions about patient safety, work engagement and quality patient outcome measures.

Purpose: This purpose of this project was to determine if a physician-nurse dyad structure in an inpatient psychiatric hospital would lead to improved participant perception about patient safety, work engagement, and patient quality outcomes.

Methods: A quasi-experimental pretest-posttest design was used. Participant perceptions related to patient safety, work engagement, …

The Effect Of An Educational Intervention On Clinical Rn Knowledge And Attitudes Toward Shared Governance Program At Eastern State Hospital, Tanna Mckinney

DNP Projects

Background: Shared governance programs are a popular way to improve Registered Nurse (RN) engagement and retention. These programs are notoriously difficult to garner and maintain participation. However, successful shared governance can improve patient outcomes, patient satisfaction and RN engagement.

Conceptual Framework: The theory of planned behavior was used as the conceptual framework for this study. This theory posits that attitudes, subjective norms, perceived behavioral control and intentions towards a behavior can predict behavioral achievement.

Methodology: Eighty clinical registered nurses were invited to voluntarily complete a survey to determine current attitudes about shared governance and intent to participate in shared governance …

Implementation Of Education And Use Of A Screening Tool To Assess Palliative Care Needs In The Critical Care Setting, Megan Stoeckinger

DNP Projects

Purpose: The purpose of this study was to measure palliative care knowledge, attitudes, perceived empowerment, and familiarity of the Supportive Palliative Care Indicators Tool (SPICT) among critical care nurses and advanced practice providers (APPs) before and after viewing a web-based educational video on an adult medicine intensive care unit (MICU).

Methods: This study was a one group pre- and post- implementation assessment using a web-based educational video and electronic surveys. The population included critical care nurses and advanced practice providers (APPs). This study spanned the timeframe between January 2022 and March 2022.

Results: Paired t-tests comparing pre-intervention …

Evaluation Of A Beverage Educational Intervention For Latino Parents Of Infants And Children Ages Nine Months To Five Years, Natalie Chelf

DNP Projects

Background: The Latino population has the highest rate of childhood obesity in the United States. Sugar-sweetened beverage (SSB) consumption has a positive correlation with increased rates of childhood obesity. Current research shows a deficit in culturally sensitive methods to reduce SSB consumption in the pediatric Latino population.

Purpose: The purpose of this project is to empower parents of Latino infants and young children with the knowledge to reduce or eliminate the consumption of SSBs in their child’s diet.

Methods: The project was a one group pre-test post-test quasi-experimental study design occurring in one pediatric outpatient clinic. The Information-Motivation-Behavioral Skills (IMB) …

Evaluation Of A Process Change On Mammography Screening Rates In A Family And Community Medicine Clinic, Christina Rademaker

DNP Projects

Abstract

Background and Significance: Breast cancer is the 2^nd leading cause of cancer death among women worldwide. Mammography is a screening approach used in the detection of breast cancer and proven to help reduce mortality. Only 72.8% of eligible American women have been screened for breast cancer within the past 2 years. One urban family and community medicine clinic (FCM) fell below the national average with a rate of 60.9%; as a result, they implemented an evidence-based strategy to improve mammography rates within the clinic.

Purpose: The purpose of this study was to evaluate the implementation of a telephone …

Improving Smoking History Screening And Documentation To Increase Lung Cancer Screenings In Primary Care Clinics, Destinee R. Rein

DNP Projects

BACKGROUND: In the United States, lung cancer has the highest mortality rate of all other cancers among men and women. Kentucky is ranked 50th among all states, leading the nation in new lung cancer cases each year. Lung cancer screening using Low dose Computed Tomography (LDCT) can reduce lung cancer-related morbidity and mortality. Lack of smoking history documentation to identify eligible patients is a major contributing factor to low national screening rates. Obtaining complete smoking history remains the most important technique in identifying candidates for lung cancer screening.

PURPOSE: The purpose of this quality improvement project was to evaluate …

The Impact Of Icu Telemedicine On Patient Outcomes In The Surgical Critical Care Setting: An Observational Study, Megan Steely

DNP Projects

Abstract

Background: In April 2020, the University of Kentucky (UK) implemented a division entitled the Enhanced Care through Advanced Technology Intensive Care Unit (eCAT ICU) to provide tele-critical care (TCC) services in all critical care areas at UK Healthcare. The eCAT ICU at UK HealthCare was the first TCC delivery system of its kind in the state of Kentucky. Use of TCC has been associated with improved patient outcomes and decreased costs.

Purpose: The purpose of this study was to analyze targeted outcomes in the surgical critical care population pre- and post-implementation of TCC at UK HealthCare. Specifically, the aims …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Screening For Severe Mental Illness In A Correctional Setting Using The Brief Jail Mental Health Screening Tool, Stephanie Kohl

DNP Projects

Abstract

BACKGROUND: Prisoners who are detained in jails and detention centers have higher rates of Severe Mental Illness (SMI) compared to the general population. However, SMI is often unidentified in this population, largely due to lack of assessment using effective SMI screening tools and lack of knowledge among prison staff about the prevalence of SMI and the importance of identification in the correctional setting. Prisoners with SMI often act out violently against others and themselves. Current standard practice for SMI screening varies significantly across jails. Many jails use standard medical questionnaires which help obtain a brief medical history but often …