Digital Commons Network^™

“You Said Burnout? Whew, Chile!” A Multigenerational Collaborative Autoethnography On The Complexities Of Burnout And Care Among Black Women Researching Substance Use, Natalie Malone, Kaylee A. Palomino, Valerie P.A. Verty, Mona K.M. Goggins, Jasmine K. Jester, Brittany Miller-Roenigk, Paris Wheeler, Jardin Dogan-Dixon, Mekaila Keeling, Kendall A. Mccleod, India Mccray, Zoe A. Sigola, Jovonna D. Atkinson, Candice N. Hargons, Danelle Stevens-Watkins

Educational, School, and Counseling Psychology Faculty Publications

Background: Researchers and participants who are members of minoritized populations experience negative psychosocial and wellness outcomes like burnout. Burnout may manifest uniquely for Black women in academia conducting research with Black women participants navigating similar sociocultural contexts. Objectives: This article qualitatively interprets our experiences as 15 Black women scholar-practitioners at a midwestern university conducting community-engaged research. We discuss our experiences of care and burnout while working to reduce opioid use disparities among Black women community members as we simultaneously navigate multilevel challenges in academia. Design: We employ collaborative autoethnography, an autobiographical writing method, using a Black feminist framework and intersectionality …

Reproductive Isolation And Gene Flow Across Space, Time And Genomes In Neodiprion Lecontei And N. Pinetum, Ashleigh Nicole Glover

Theses and Dissertations--Biology

To explain biodiversity, evolutionary biologists must understand how independent lineages arise via the evolution of reproductive isolation during the speciation process. Hybridizing taxa provide an excellent opportunity to investigate the evolution of reproductive isolating barriers and genomic divergence, thereby enhancing our understanding of speciation. However, hybridization between diverging taxa can vary across geographic space, the genome, and time. Thus, understanding the factors that promote or inhibit hybridization can provide insight into the biotic, environmental, and genetic causes of divergence and gene flow. Importantly, the mechanisms responsible for generating variation in hybridization dynamics and the consequences of such hybridization remains unknown …

Abnormal Regulation Of Mitochondrial Sphingolipids During Aging And Alzheimer’S Disease, Simone M. Crivelli, Zainuddin Quadri, Ahmed Elsherbini, Hemendra J. Vekaria, Patrick G. Sullivan, Wenbo Zhi, Pilar Martinez-Martinez, Stefka D. Spassieva, Erhard Bieberich

Markey Cancer Center Faculty Publications

During pathogenesis of Alzheimer’s disease (AD), mitochondria suffer alterations that lead to low energy production and reactive oxygen species formation. However, the mechanism of impaired mitochondria homeostasis in AD is not fully understood. We hypothesized that abnormal sphingolipid metabolism in mitochondria could be one of the contributing factors to mitochondrial dysfunction. Synaptic and non-synaptic mitochondria were isolated from 5xFAD and wild type (WT) mice at 3 and 7 months using Ficoll gradient ultracentrifugation, and their function was analyzed using Seahorse assay. Additionally, mitochondria were ana- lyzed using mass spectrometry for proteomics and sphingolipidomics analyses. Sphingolipid levels were also determined in …

Nudcl2 Is Required For Cytokinesis By Stabilizing Rcc2 With Hsp90 At The Midbody, Xiaoyang Xu, Yuliang Huang, Feng Yang, Xiaoxia Sun, Rijin Lin, Jiaxing Feng, Mingyang Yang, Jiaqi Shao, Xiaoqi Liu, Tianhua Zhou, Shanshan Xie, Yuehong Yang

Markey Cancer Center Faculty Publications

Cytokinesis is required for faithful division of cytoplasmic components and duplicated nuclei into two daughter cells. Midbody, a protein-dense organelle that forms at the intercellular bridge, is indispensable for success- ful cytokinesis. However, the regulatory mechanism of cytokinesis at the midbody still remains elusive. Here, we unveil a critical role for NudC-like protein 2 (NudCL2), a co-chaperone of heat shock protein 90 (Hsp90), in cytokinesis regulation by stabilizing regulator of chromosome condensation 2 (RCC2) at the midbody in mam- malian cells. NudCL2 localizes at the midbody, and its downregulation results in cytokinesis failure, multinu- cleation, and midbody disorganization. Using iTRAQ-based …

Pai-1 As A Critical Factor In The Resolution Of Sepsis And Acute Kidney Injury In Old Age, Maria E. C. Bruno, Sujata Mukherjee, Jamie L. Sturgill, Virgilius Cornea, Peng Yeh, Gregory S. Hawk, Hiroshi Saito, Marlene E. Starr

Markey Cancer Center Faculty Publications

Elevated plasma levels of plasminogen activator inhibitor type 1 (PAI-1) are documented in patients with sepsis and levels positively correlate with disease severity and mortality. Our prior work demonstrated that PAI-1 in plasma is positively associated with acute kidney injury (AKI) in septic patients and mice. The objective of this study was to determine if PAI-1 is causally related to AKI and worse sepsis outcomes using a clinically-relevant and age-appropriate murine model of sepsis. Sepsis was induced by cecal slurry (CS)-injection to wild-type (WT, C57BL/6) and PAI-1 knockout (KO) mice at young (5–9 months) and old (18–22 months) age. Survival …

Human Papillomavirus Circulating Tumor Dna Assays As A Mechanism For Head And Neck Cancer Equity In Rural Regions Of The United States, Melina Windon, Catherine Haring

Markey Cancer Center Faculty Publications

The rates of human papillomavirus-positive oropharyngeal cancer (HPV-OPC) are rising worldwide and in the United States, particularly in rural regions including Appalachia. Rural areas face unique health challenges resulting in higher cancer incidence and mortality rates, and this includes HPV-OPC. The recent advent of highly sensitive liquid biopsies for the non-invasive detection of HPV-OPC recurrence (circulating tumor HPV DNA, HPV ctDNA) has been swiftly adopted as part of surveillance paradigms. Though knowledge gaps persist regarding its use and clinical trials are ongoing, the ease of collection and cost-effectiveness of HPV ctDNA make it more accessible for HPV-OPC survivors than usual …

Measuring Modern And Historic Maize Root Phenotypes And Their Impact On Soil Organic Carbon, Travis A. Banet

Theses and Dissertations--Plant and Soil Sciences

Supporting a growing human population under the duress of a changing global climate is arguably the greatest challenge faced by today’s world. Over the last century, agricultural development has primarily focused on improving grain yields to increase production of food, fuel, and fiber. However, recent work has emphasized that agroecosystem management can potentially help mitigate the climate crisis by storing atmospheric carbon in the soil as soil organic carbon (SOC). Furthermore, a growing body of research has focused on the critical role that roots play in building SOC. Maize crops occupy a substantial portion of the world’s cropland. As yields …

Investigation Of Delta-Focused Ictal Electrical Source Imaging In Refractory Focal Epilepsy, Jared A. Rybarczyk

Theses and Dissertations--Electrical and Computer Engineering

Refractory focal epilepsy is characterized by the presence of seizures that cannot be controlled via anti-seizure medications. For patients suffering from this form of epilepsy, accurate identification of the seizure onset zone is a crucial step for many modalities of treatment. Electrical source imaging (ESI) allows for estimation of the seizure onset zone from electroencephalography. EEG feature extraction is an important step that can impact the final accuracy of source estimates. This work provides a review of 23 ictal ESI studies and proposes a delta-focused ictal ESI methodology. Our proposed delta-focused ictal ESI is implemented across 33 refractory focal epilepsy …

Multi-Physics Modeling Of Immersion Cooled Electric Power Apparatuses, Reza Ilka

Theses and Dissertations--Electrical and Computer Engineering

Electric power conversion apparatuses such as electromagnetic transformers and power electronic converters play a backbone role in the global power and energy industries, such as power transmission and distribution, electrified transportation vehicle systems, industry automation, and the like. To investigate the performance (efficiency, reliability, etc.) of such critical power conversion apparatuses, high-fidelity multi-physics modeling becomes critical which involves dedicated coupling among multiple physical domains, including electrical, magnetic, thermal, mechanical, and material engineering. Nevertheless, the majority of the existing models for these power conversion apparatuses focus only on one or two physical domains, and the modeling fidelity needs to be further …

A Novel Processor Architecture Implementing The Stacked Error Diffusion Algorithm And Its Zynq-Based Realization, Qishi Hu

Theses and Dissertations--Electrical and Computer Engineering

Digital halftoning reproduces continuous-tone images using patterns of black and white dots, while multitoning extends this concept by incorporating inks with intermediate intensities. These techniques are extensively utilized in the printing industry to accommodate the limited range of inks available in printers. Stacked error diffusion is a high-quality multitoning algorithm that adheres to the blue-noise dithering standard. This thesis research studies the potential parallelism inherent in the algorithm and introduces the design of a novel processor architecture optimized for efficient execution. The architecture is realized on an FPGA development board featuring a Zynq SoC. Additionally, the hardware prototype can also …

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 Impact Of An Educational Training To Front-Line Nurses And Providers To Reduce Seclusion And Restraint: Assessing Knowledge, Practices, And Attitudes, Kevin Bryant

DNP Projects

Background: The use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. Although it is typically agreed that such measures should be used as a last resort in patient care, the majority of nurses feel that seclusion and restraint are necessary interventions in managing adverse behaviors of mental illness. There is a lack of data examining front-line nurses’ and providers’ knowledge, practices, and attitudes toward the use of seclusion and restraint following the use of a targeted educational training.

Purpose: This project aimed to evaluate the impact of a web-based educational intervention on the knowledge, …

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 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 …

An Educational Intervention On Provider Knowledge Of Hypertension Guidelines And Home Blood Pressure Monitoring, Alison Claire Oesterritter

DNP Projects

Background: While hypertension is the leading preventable risk factor for cardiovascular disease, disease control remains suboptimal. In the U.S., 47% of adults have hypertension, but only 25% are controlled. Despite having quality evidence-based guidelines, many recommendations are not implemented due to clinical inertia, or the tendency to not change therapy when targets aren’t met. Research has shown that this can be overcome with educational programs. Purpose: To provide training on hypertension guidelines and home blood pressure monitoring (HBPM) to overcome clinical inertia and improve patient outcomes related to hypertension. Methods: The project was a quasi-experimental, pre- and post- …

Improving Knowledge, Confidence, And Competency Among Icu Nurses Concerning The Benefits Of Using The Uk Ventilator Separation Protocol, Brittany Monroe

DNP Projects

Background: The trauma intensive care unit (ICU) at University of Kentucky (UK) Healthcare uses a ventilator separation protocol which provides specific guidelines on the successful weaning of patients from mechanical ventilation. However, many of the nurses are not aware of this protocol as formal education is not included in their orientation or training. This lack of knowledge can lead to risks such as increased patient morbidity, mortality, ICU length of stay, and healthcare-related costs. Research shows that using structured mechanical ventilator weaning tools in the ICU can shorten the duration of mechanical ventilation, which in turn, lowers these associated risks. …

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: …

The Effect Of An Educational Intervention On Early Mobility Compliance In Oncology Nurses, Jonathan A. Hacker

DNP Projects

Background: Geriatric adult patients admitted into acute care hospital settings are at risk of functional decline in their capacity for activities of daily living and independent ambulation. Many of these patients fail to achieve pre-hospitalization levels of function and continue to decline, requiring additional support and care after discharge. Current literature supports early mobilization and ambulation during hospitalization. However, ambulation and patient mobilization has been shown to be the most missed item of nursing care. There is a gap in literature and patient outcome data regarding the impact of early mobilization on medical-surgical patient populations.

Purpose: The purpose of this …

Provider And Staff Education Surrounding Universal Hcv Screening And Linkage To Care In An Ambulatory Care Setting, Lauren Clifford

DNP Projects

Abstract

Background: In the United States, it is estimated that there are more than 2 million cases of Hepatitis C (HCV), with over 66,000 new cases since 2020 However, an estimated 75% of those with HCV go undiagnosed and less than 35% receive treatment within a year of diagnosis. In 2018, UK Healthcare (UKHC) implemented a universal HCV screening method using a Best Practice Advisory (BPA) for anyone 18 and older who presented to the Emergency Department and had labs ordered. Patients who screened positive were then referred to outpatient clinics for HCV treatment. Approximately ten percent of positive patients …

Improving Education On Routine Echocardiograms In Reducing Right Sided Heart Failure When Managing Vv- Ecmo Patients, Ashley Williams

DNP Projects

Background: Patients who are placed on veno- venous extracorporeal membrane oxygenation (VV- ECMO) are at high risk for developing right sided heart failure. An echocardiogram is essential for diagnostics and recovery in ECMO patients and should be a standard of care when managing this patient population. More research is needed to understand the effect of reducing right sided heart failure using routine echocardiograms. Purpose: The purpose of this study is to evaluate if there is a significant difference in outcomes of VV- ECMO patients who received routine echocardiograms compared to those who did not, and appropriately manage once RV dysfunction …

Enhancing Communication Between Nurses And First Call Providers Using A Secure Chat Algorithm, Karen Hilt

DNP Projects

BACKGROUND: Healthcare requires quality multidisciplinary communication for patient care. Secure Chat is a feature within the Epic electronic health record to facilitate communication without violating Health Insurance Portability and Accountability Act (HIPPA). An algorithm to streamline communication utilizing this feature is needed to improve patient care.

PURPOSE: The purpose of this study was to determine, develop, implement, and evaluate a communication protocol between nurses and first call providers. The overall goal was to improve the knowledge, attitudes, efficacy, and address barriers with communication of nursing staff and providers through efficient messaging embedded within Epic, electronic health record

CONCEPTUAL MODEL: …

Electroconvulsive Therapy: Improving Psychiatric Rn Knowledge And Attitudes Using An Educational Module, Garrett Payne

DNP Projects

Abstract

Background: Electroconvulsive Therapy (ECT) is a robust, versatile treatment option for many psychiatric disorders and diseases, but systemic low levels of knowledge and negative attitudes exist towards the procedure among healthcare workers, specifically among psychiatric RNs. The negative attitudes surrounding ECT are most attributable to a misunderstanding of its uses, efficacy, procedures, and safety. Psychiatric RNs hold more negative beliefs and misconceptions about ECT than any other group of healthcare workers who directly care for patients receiving the treatment. Psychiatric RNs also demonstrate poor understanding of ECT treatment procedures and outcomes. Current evidence-based practice shows that providing psychiatric RNs …

An Educational Intervention To Improve Neonatal Icu Nurses’ Breastfeeding Support Knowledge, Self-Efficacy, And Breastfeeding Rates At Discharge, Sarah Money

DNP Projects

Background: The benefits of breastfeeding for both mother and baby are known. It is recommended that all infants be exclusively breastfed until six months (Meek & Noble, 2022; North et al., 2021). Despite this, breastfeeding rates remain low, especially in medically fragile infants requiring care in the neonatal intensive care unit (NICU) (Rollins et al., 2016). Receipt of evidence-based breastfeeding support by healthcare providers has been shown to improve breastfeeding success; however, many healthcare providers report not being comfortable or knowledgeable enough to offer support consistently (Mulcahy et al., 2022; Rollins et al., 2016).

Purpose: This study aims …

Surveys, Field Studies, And Laboratory Incubation Experiments To Improve Alfalfa Production In The Mid-South, William Fleming

Theses and Dissertations--Plant and Soil Sciences

The objective of the alfalfa survey was to determine the role of soil fertility in the alfalfa yield plateau. Soil samples at depths of 10, 15, and 30 cm and tissue samples were collected from 114 alfalfa stands across Kentucky and surrounding states. Results indicate that soil fertility is likely contributing but not driving the alfalfa yield plateau. The main objective of the polyhalite incubation study is to determine if POLY4 was soluble enough to support potassium (K) and sulfur (S) for plant growth. The design of the study included four fertilizer treatments, three soil types, and four incubation times. …

Identifying Physiological, Morphological, And Genetic Drivers Of Key Intermediary Phenotypic Traits Associated With Stalk Lodging Resistance Within Genetically Diverse Maize Germplasm And Sorghum, Norbert Bokros

Theses and Dissertations--Plant and Soil Sciences

Maize stalk lodging reduces grain yields due to the permanent breakage or deformation of stalk tissue before grain harvest. To reveal new insights into the complex problem of maize stalk lodging, this dissertation will examine three primary objectives. First, the direct, diurnal influence of turgor pressure will be shown to have only marginal effects on stalk bending strength, a key trait associated with stalk lodging resistance. Up to a dozen individual stalks, grown to physiological maturity within the same field, were tested using a DARLING testing device. In parallel, stalk turgor status as measured by leaf water potential and turgor …

The Effect Of Spring And Winter Killed Cover Crops On Soil Physical Properties And Soil Organic Carbon, Danielle Doering

Theses and Dissertations--Plant and Soil Sciences

Maintaining soil organic carbon (SOC) and healthy soil physical structure in agroecosystems is crucial to sustainable production. To assess medium term impacts of cover crops on soil health in the top 90 cm, we conducted a field experiment in central Kentucky with varying levels of winter cover: spring and winter kill cover crops, weedy and bare winter fallows. After eight years of cover crop use, some soil physical properties improved: 35% greater mean weight aggregate diameter at 0-30 cm with spring kill covers and 5.2% more C held within large aggregates for both cover crop treatments compared to winter fallow. …

Functionalized Microfiltration Membranes For Aerosol Capture To Chloro-Organic Degradation, Rollie George Mills

Theses and Dissertations--Chemical and Materials Engineering

The environmental remediation of water and air sources is a challenging field, due to widespread contamination, pollutant variety, and efficiency of existing treatment options. Remediation of certain pollutants, such as per- and polyfluorinated chemicals (PFAS), polychlorinated biphenyls (PCBs), volatile organic compounds (VOCs), and viral aerosols, has shown promise via adsorptive, degradative, or filtration-based processes, each with their respective advantages and limitations. Membrane technology is one option that has exhibited considerable pollutant removal from environmental sources via reverse osmosis (RO) filtration, but is limited by low permeabilities and lack of pollutant detoxification. With the support of NIEHS and NSF, the functionalization …

Sustained Release Systems For Endometrial Cancer, Claire E. Rowlands

Theses and Dissertations--Chemical and Materials Engineering

Endometrial cancer (EC) is the sixth most common cancer in women worldwide and is the most common cancer of female reproductive organs. From 2007-2016 there has been a global rise in incidence of EC of 1.3 %. Typically, EC is treated with surgery, but at later stages surgery is less effective requiring chemotherapy and/or radiation therapy. These treatment options are less effective than surgery and there are very few FDA approved chemotherapies for EC. The minuscule number of effective treatment options as well as an increase in incidence shows the need for creating improved treatments for EC. There has been …

Experimental Characterization And Quantification Of Deformation Behavior In A Porous Carbon Fiber Network, Robert N Quammen

Theses and Dissertations--Chemical and Materials Engineering

Due to their wide range of attractive functional properties (such as low thermal conductivity and low density) porous materials are utilized in a variety of applications. In order to characterize these properties and others, the intrinsically heterogeneous microstructures of these materials need to be taken into account. These microstructures result in interactions across multiple length scales spanning several orders of magnitude. This makes the creation of robust computational models and straight-forward predictions of mechanical properties difficult for porous materials. With this in mind, this dissertation aims to provide experimental mechanical and deformation information spanning the length scales of interest for …