Digital Commons Network^™

The Role Of Sociality And Disturbance In Shaping Elk (Cervus Canadensis) Population Structure, Brittany L. Slabach

Theses and Dissertations--Biology

Investigating how and why individuals interact is an important component to understanding species ecology. The type and patterning of relationships (social structure) provides pertinent insight into how ecological factors such as spatial heterogeneity of resources and predation influence associations between individuals. Many taxa exhibit temporally fluid association patterns, where individuals associate with a variety of others at different rates. Ungulate species exhibit prime examples of highly fluid grouping patterns and individuals form both temporary and long-term associations. The effects of human disturbance on ungulate behavior are well documented and these changes are further exacerbated during the hunting season. Species such …

Assessment Of The Need For Provider Education On Screening For Depression In Patients With Select Dermatologic Problems, Sarah B. Zerhusen

DNP Projects

PURPOSE: The purpose of this project is to evaluate the knowledge, attitudes, perceptions, skills, and self-efficacy of dermatology providers’ assessment of depression in patients with chronic skin disease to determine the need for continuing education programs.

METHODS: This is a single practice, multi site, quantitative correlational design study to assess provider use, comfort, and proficiency of screening and discussion of depression in patients suffering from plaque psoriasis and atopic dermatitis. Data was collected through the use of a questionnaire dispensed in January of 2018. The sample consisted of 23 dermatology providers in a dermatology practice with clinics in Louisville, Lebanon, …

Impact Of Education On Provider Knowledge And Screening Practices Related To Childhood Obesity, Natalie B. Fulk

DNP Projects

PURPOSE: The purpose of this study was to evaluate the effect of a provider education program on BMI screening practices and provider knowledge related to childhood obesity by implementing an educational intervention to advanced practice providers in a primary care clinic setting.

METHODS: A pretest/posttest design was used to examine changes in provider knowledge about BMI screening practices in children and adolescents, and lifestyle recommendations after a brief educational intervention was provided. A retrospective chart review was used to assess the screening and management practices for an elevated BMI percentile and provider documentation of lifestyle recommendations.

RESULTS: A total of …

An Evaluation Of The Effects Of A Diabetes Self-Management Education Program On The Hba1c In Patients With Type 2 Diabetes, Katherine Schoo

DNP Projects

Introduction

Diabetes has become an epidemic in the United States. More than 30.3 29 million Americans are living with the disease, while an additional 84.1 million Americans are living with prediabetes (Centers for Disease Control and Prevention [CDC], 2018). Standards set forth by the American Diabetes Association (ADA) describe comprehensive and individualized self-management education and treatment as part of their guidelines for the management of diabetes (ADA, 2018). The “Active Steps for Diabetes” program is an example of a diabetes self-management education (DSME) program that supports national recommendations made by the ADA.

Methods

This study was a retrospective descriptive pre- …

Using Rapid Cycle Improvement To Improve Weight Management In Family Medicine, Kelly Mccormick

DNP Projects

PURPOSE: The purpose of this quality improvement project was to improve rates of nutrition screening and weight management in a Family and Community Medicine Clinic.

METHODS: This study was among several quality improvement projects being conducted at a Family and Community Medicine Clinic aimed at improving patient outcomes and quality measures for reimbursement beginning in 2019. Rapid cycle quality improvement was used to identify problems, implement changes, and evaluate workflow at the clinic in order to improve rates of compliance in BMI screening and documentation of weight management plans. Three PDSA cycles were completed. Activities included observation, staff education, visual …

A Retrospective Comparative Analysis On The Effectiveness Of Pharmacologic Weight Loss, Emily Dunn

DNP Projects

PURPOSE:Obesity costs the U.S. roughly $147 billion in health care spending annually. There has been a call for healthcare providers to initiate all possible weight loss interventions. One treatment strategy not used to its fullest potential is that of prescribing antiobesity medications. The purpose of this project was to examine and evaluate the effectiveness of three common weight loss medications used in the treatment of obesity, including discussion and recommendations.

METHODS: This project was a single-center retrospective study comparing three different groups of patients seen at a rural weight loss clinic. The sample consisted of 84 patients seen between September …

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …

Appraisal Of Depression Among Individuals With T2dm Not On Insulin Therapy, Beverly Woods

DNP Projects

Abstract

BACKGROUND: Type 2 diabetes (T2DM) is a complicated disease process that affects more than 15 percent of adults in the state of Kentucky, with a national average of 9.4%. Individuals with diabetes are at increased risk for micro and macro neurovascular complications. Depression is a common co-morbidity and potentially affects their ability to manager this complex disease.

PURPOSE: The purpose of this study was to examine the prevalence of depression in a group of patients with T2DM, not on insulin therapy. Further, relationships between depression and blood glucose monitoring, Hgb A1c, other co-morbidities, number of medications taken, and demographics …

Tne Effect Of In Our Own Voice On Stigma In Bsn Students, Stephanie Steele

DNP Projects

Stigma regarding mental illness is common throughout the world, and can lead to social isolation, low self-esteem, loss of income and employment, deterioration of life quality, impeded access to medical care, and a shorter lifespan for people diagnosed with a mental illness (Cleary, Deacon, Jackson, Andrew, & Chan, 2012; Corrigan et al., 2013). The purpose of this DNP project was to provide an evidence-based intervention called In Our Own Voice (IOOV) to first semester sophomore nursing students and assess its impact on their perceptions of mental illness stigma. Alterations in stigma were assessed through the Attribution Questionnaire-27 administered to students …

Dyslipidemia Screening In Children Between The Ages Of 9 And 11 Years: An Evidence-Based Approach, Meredith Toms

DNP Projects

PURPOSE: The purpose of this study is to examine the outcome of healthcare provider education on the incidence of dyslipidemia screening in a pediatric primary care clinic.

METHODS: The design of this study was a descriptive pre and post design to evaluate if dyslipidemia screening rates, knowledge, and self-efficacy of healthcare providers changed following an education series at a general pediatric clinic in Lexington, KY. The rates of dyslipidemia screening were calculated prior to providing provider education as well as afterwards to see whether there was an improvement in screening rates. Provider’s knowledge and confidence before the education series was …

An Examination Of Primary Care Providers’ Assessment And Plan Of Care For Children And Adolescents Who Are Overweight Or Obese, Kevin Pinto

DNP Projects

Background: Childhood and adolescent obesity rates have more than tripled since the 1970s. Currently in the United States, one in five children is obese (6-19 years of age). It is important to identify children and adolescents who are overweight or obese because early intervention may help to reduce the long-term implications of obesity. The purpose of this project was to examine how often pediatric primary care providers diagnosed overweight or obesity and created a plan of care for children 6-17 years of age who were overweight or obese. Facilitators and barriers to diagnosing and creating a plan of care were …

Can Increasing Grass-Fungal Endophyte Symbiotic Diversity Enhance Grassland Ecosystem Functioning?, Mahtaab Bagherzadeh

Theses and Dissertations--Plant and Soil Sciences

The relationship between biodiversity and ecosystem functioning is important in maintaining agroecosystem sustainability. Plant-microbe symbioses, such as exists between the grass tall fescue (Schedonorus arundinaceum) and the asexual fungal endophyte Epichloë coenophiala, can be utilized to enhance agroecosystem functions, such as herbivore resistance. “Novel” E. coenophiala strains that vary in the production of mammal- and insect-toxic compounds have been identified, inserted into tall fescue cultivars, and are planted in pastures globally. Novel fungal endophyte-tall fescue associations may have divergent ecosystem function effects. This study assessed effects of different fescue-endophyte symbiotic combinations on pasture ecosystem function, including aboveground …

Engineering Zinc Oxide Nanoparticles To Be Used As Nanofertilizers, Zeinah Elhaj Baddar

Theses and Dissertations--Plant and Soil Sciences

Zinc deficient soils, or soils with low Zn bioavailability, are widespread, which exacerbates Zn deficiency in human as crops grown on these soils have low Zn content. Often crop yields are also compromised. Fertilizers based on soluble Zn salts often have limited efficacy in such soils. In this research, we evaluate the performance of polymer coated and bare ZnO nanoparticles (NPs) in an attempt to overcome limitations of soluble Zn salts in alkaline soils. We first synthesized 20-30 nm bare ZnO NPs with different surface chemistries to impart colloidal stability to the particles. Bare ZnO were treated in phosphate solution …

Design And Analysis Of Curcumin Conjugated Poly(Beta-Amino Ester) Networks For Controlled Release In Oxidative Stress Environments, Carolyn T. Jordan

Theses and Dissertations--Chemical and Materials Engineering

Oxidative stress, the imbalance of free radical generation with antioxidant defenses, leads to cellular inflammation, apoptosis and cell death. This compromised environment results in debilitating diseases, such as oral mucositis (OM), atherosclerosis, and ischemia/reperfusion injury. Antioxidant therapeutics has been a proposed strategy to ameliorate these imbalances and maintain homeostatic environments. However, the success of these approaches, specifically curcumin, has been limited due to characteristics such as hydrophobicity and high reactivity when released as bolus doses to contest to oxidative stress induced diseases. The development of a controlled release system to aid in protection of the antioxidant capacity of curcumin, as …

Gender, Sexuality, And Categories Of Risk: Physician Views Of Cervical Cancer In Bangalore, India, Emily G. Capilouto

Theses and Dissertations--Anthropology

India has one of the highest rates of cervical cancer morbidity and mortality globally. Despite this, there are no national or state-wide screening efforts for cervical cancer and its prevention in India. In an effort to understand the magnitude of cervical cancer in Bangalore, India, this research draws upon data collected in hospital contexts over a month-long period to explore the ways in which physician attitudes contribute to understandings of cervical cancer and its prevention in the growing urban context of Bangalore.

Variation Of Native American Ceramics In The Big Bend Region Of The Lower Ocmulgee River Valley, Georgia, Ad 1540 To Ad 1715, Rachel Paige Hensler

Theses and Dissertations--Anthropology

Studies of European colonialism in the Western Hemisphere have shifted focus from areas of direct European/Native American contact, to investigate Native American groups outside of direct European contact. During Spanish colonization of the Southeastern United States (AD 1520 to AD 1715), the Big Bend region of the Ocmulgee River Valley, in Georgia, located about 160 kilometers from Spanish occupied coast, was inhabited by a Native American polity from the Late Prehistoric into the Mission period. This location is ideal for studying indirect contact.

Changes in ceramic production can be used to identify changes in Native American interaction through time. Attributes …

“We’Re Being Left To Blight”: Green Urban Development And Racialized Space In Kansas City, Chhaya Kolavalli

Theses and Dissertations--Anthropology

In this dissertation, I explore ‘green’ urban development and urban agriculture projects from the perspective of residents of an African American majority neighborhood in Kansas City—who reside in an area referred to as a ‘blighted food desert’ by local policy makers. In Kansas City, extensive city government support exists for urban agricultural projects, which are touted not just as a solution to poverty associated issues such food insecurity and obesity, but also as a remedy for ‘blight,’ violence and crime, and vacant urban land. Specific narratives of Kansas City’s past are used to prop up and legitimate these future visions …

Late Pleistocene Adaptations In The Midsouth: The Paleoindian Occupation Of The Carson-Conn-Short Site And The Lower Tennessee River Valley, James Scott Jones

Theses and Dissertations--Anthropology

The Midsouth has long been known to be a locus of Paleoindian (13,200-10,000 yrs B.P.) populations. Paleoindian populations have generally been characterized as highly mobile hunter-gatherers with egalitarian social structure. Utilizing the theoretical lens of diversification and intensification of resource use, the Late Pleistocene adaptations of the region’s populations are examined from both a large scale or coarse grain perspective as well as more fine grain data from the site level. Previous models of Paleoindian adaptations are defined and tested in this study to determine the applicability of these models with new data. Coarse grain data are derived from lithic …

A Highly Stable Blood Meal Alternative For Rearing Aedes And Anopheles Mosquitoes, Ted Baughman, Chelsea Peterson, Corrie Ortega, Sarah R. Preston, Christopher Paton, Jessica Williams, Amy Guy, Gavin Omodei, Brian Johnson, Helen Williams, Scott L. O'Neill, Scott A. Ritchie, Stephen L. Dobson, Damian Madan

Entomology Faculty Publications

We investigated alternatives to whole blood for blood feeding of mosquitoes with a focus on improved stability and compatibility with mass rearing programs. In contrast to whole blood, an artificial blood diet of ATP-supplemented plasma was effective in maintaining mosquito populations and was compatible with storage for extended periods refrigerated, frozen, and as a lyophilized powder. The plasma ATP diet supported rearing of both Anopheles and Aedes mosquitoes. It was also effective in rearing Wolbachia-infected Aedes mosquitoes, suggesting compatibility with vector control efforts.

Cdc Grand Rounds: National Amyotrophic Lateral Sclerosis (Als) Registry Impact, Challenges, And Future Directions, Paul Mehta, D. Kevin Horton, Edward J. Kasarskis, Ed Tessaro, M. Shira Eisenberg, Susan Laird, John Iskander

Neurology Faculty Publications

Amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease, is a rapidly progressive fatal neurologic disease. Currently, there is no cure for ALS and the available treatments only extend life by an average of a few months. The majority of ALS patients die within 2–5 years of diagnosis, though survival time varies depending on disease progression (1,2). For approximately 10% of patients, ALS is familial, meaning it and has a genetic component; the remaining 90% have sporadic ALS, where etiology is unknown, but might be linked to environmental factors such as chemical exposures (e.g., heavy …

Acute Resistance Exercise Induces Sestrin2 Phosphorylation And P62 Dephosphorylation In Human Skeletal Muscle, Nina Zeng, Randall F. D'Souza, Vandre C. Figueiredo, James F. Markworth, Llion A. Roberts, Jonathan M. Peake, Cameron J. Mitchell, David Cameron-Smith

Center for Muscle Biology Faculty Publications

Sestrins (1, 2, 3) are a family of stress-inducible proteins capable of attenuating oxidative stress, regulating metabolism, and stimulating autophagy. Sequestosome1 (p62) is also a stress-inducible multifunctional protein acting as a signaling hub for oxidative stress and selective autophagy. It is unclear whether Sestrin and p62^Ser403 are regulated acutely or chronically by resistance exercise (RE) or training (RT) in human skeletal muscle. Therefore, the acute and chronic effects of RE on Sestrin and p62 in human skeletal muscle were examined through two studies. In Study 1, nine active men (22.1 ± 2.2 years) performed a bout of single-leg strength …

Inhibition Of Growth And Ammonia Production Of Ruminal Hyper Ammonia-Producing Bacteria By Chinook Or Galena Hops After Long-Term Storage, Michael D. Flythe, Brittany E. Harlow, Glen E. Aiken, Gloria L. Gellin, Isabelle A. Kagan, Jesse Pappas

Animal and Food Sciences Faculty Publications

Surplus hops (Humulus lupulus L.) that are not needed by the brewing industry could be used as a feed supplement for cattle and other ruminants. Previous research indicates that antimicrobial hops plant secondary metabolites (i.e., α- and β-acids) inhibit methane and ammonia production and promote the growth of ruminant animals. The goal was to determine that hop pellets produced for brewing still possessed the requisite antimicrobial activity after 5-year storage. HPLC (high performance liquid chromatography) analysis indicated that the α- and β-acid concentrations in two varieties of hops were relatively stable after 5 years of storage under N_{2 …}

Metabolic Dysregulation And Cancer Mortality In A National Cohort Of Blacks And Whites, Tomi Akinyemiju, Justin Xavier Moore, Suzanne Judd, Susan Lakoski, Michael Goodman, Monika M. Safford, Maria Pisu

Epidemiology and Environmental Health Faculty Publications

Background: We examined the association between metabolic dysregulation and cancer mortality in a prospective cohort of Black and White adults.

Methods: A total of 25,038 Black and White adults were included in the analysis. Metabolic dysregulation was defined in two ways: 1) using the joint harmonized criteria for metabolic syndrome (MetS) and 2) based on factor analysis of 15 variables characterizing metabolic dysregulation. We estimated hazards ratios (HRs) and 95% confidence intervals (CIs) for the association of MetS and metabolic dysregulation with cancer mortality during follow-up using Cox proportional hazards models.

Results: About 46% of Black and 39% of White …

Accuracy Of Recall Of Musculoskeletal Injuries In Elite Military Personnel: A Cross-Sectional Study, Mita Lovalekar, John P. Abt, Timothy C. Sell, Scott M. Lephart, Erin Pletcher, Kim Beals

Physical Therapy Faculty Publications

Background Self-reported data are often used in research studies among military populations.

Objective The accuracy of self-reported musculoskeletal injury data among elite military personnel was assessed for issues with recall.

Design Cross-sectional study.

Setting Applied research laboratory at a military installation.

Participants A total of 101 subjects participated (age 28.5±5.6 years). Study participants were active duty military personnel, with no conditions that precluded them from full duty.

Primary and secondary outcome measures Self-reported and medical record reviewed injuries that occurred during a 1-year period were matched by anatomic location, injury side (for extremity injuries), and injury year and type. The …

Synthesis And Characterization Of Thermoresponsive Hydrogels Based On N-Isopropylacrylamide Crosslinked With 4,4′-Dihydroxybiphenyl Diacrylate, Shuo Tang, Martha Floy, Rohit Bhandari, Manjula Sunkara, Andrew J. Morris, Thomas D. Dziubla, J. Zach Hilt

Chemical and Materials Engineering Faculty Publications

A novel crosslinker [4,4′-dihydroxybiphenyl diacrylate (44BDA)] was developed, and a series of temperature-responsive hydrogels were synthesized through free radical polymerization of N-isopropylacrylamide (NIPAAm) with 44BDA. The temperature-responsive behavior of the resulting gels was characterized by swelling studies, and the lower critical solution temperature (LCST) of the hydrogels was characterized through differential scanning calorimetry. Increased content of 44BDA led to a decreased swelling ratio and shifted the LCST to lower temperatures. These novel hydrogels also displayed resiliency through multiple swelling–deswelling cycles, and their temperature responsiveness was reversible. The successful synthesis of NIPAAm-based hydrogels crosslinked with 44BDA has led to a …

Type 1 Diabetes Alters Lipid Handling And Metabolism In Human Fibroblasts And Peripheral Blood Mononuclear Cells, Albert R. Jones Iv, Emily L. Coleman, Nicholas R. Husni, Jude T. Deeney, Forum Raval, Devin Steenkamp, Hans Dooms, Barbara S. Nikolajczyk, Barbara E. Corkey

Clinical and Translational Science Faculty Publications

Triggers of the autoimmune response that leads to type 1 diabetes (T1D) remain poorly understood. A possibility is that parallel changes in both T cells and target cells provoke autoimmune attack. We previously documented greater Ca²⁺ transients in fibroblasts from T1D subjects than non-T1D after exposure to fatty acids (FA) and tumor necrosis factor α (TNFα). These data indicate that metabolic and signal transduction defects present in T1D can be elicited ex vivo in isolated cells. Changes that precede T1D, including inflammation, may activate atypical responses in people that are genetically predisposed to T1D. To identify such cellular differences …

Strengths And Limitations Of Nitrogen Rate Recommendations For Corn And Opportunities For Improvement, Thomas F. Morris, T. Scott Murrell, Douglas B. Beegle, James J. Camberato, Richard B. Ferguson, John H. Grove, Quirine Ketterings, Peter M. Kyveryga, Carrie A.M. Laboski, Joshua M. Mcgrath, John J. Meisinger, Jeff Melkonian, Bianca N. Moebius-Clune, Emerson D. Nafziger, Deanna Osmond, John E. Sawyer, Peter C. Scharf, Walter Smith, John T. Spargo, Harold M. Van Es, Haishun Yang

Plant and Soil Sciences Faculty Publications

Nitrogen fi xation by the Haber–Bosch process has more than doubled the amount of fi xed N on Earth, significantly influencing the global N cycle. Much of this fi xed N is made into N fertilizer that is used to produce nearly half of the world’s food. Too much of the N fertilizer pollutes air and water when it is lost from agroecosystems through volatilization, denitrification, leaching, and runoff. Most of the N fertilizer used in the United States is applied to corn (Zea mays L.), and the profitability and environmental footprint of corn production is directly tied to N …

Influence Of Dietary Salt Knowledge, Perceptions, And Beliefs On Consumption Choices After Stroke In Uganda, Martin N. Kaddumukasa, Elly Katabira, Martha Sajatovic, Svetlana Pundik, Mark Kaddumukasa, Larry B. Goldstein

Neurology Faculty Publications

Background

Previous research on Uganda's poststroke population revealed that their level of dietary salt knowledge did not lead to healthier consumption choices.

Purpose

Identify barriers and motivators for healthy dietary behaviors and evaluate the understanding of widely accepted salt regulation mechanisms among poststroke patients in Uganda.

Methods

Convergent parallel mixed methods triangulation design comprised a cross-sectional survey (n = 81) and 8 focus group discussions with 7-10 poststroke participants in each group. We assessed participant characteristics and obtained insights into their salt consumption attitudes, perceptions, and knowledge. Qualitative responses were analyzed using an inductive approach with thematic analytic procedures. Relationships …

Hydroxyurea Differentially Modulates Activator And Repressors Of Γ-Globin Gene In Erythroblasts Of Responsive And Non-Responsive Patients With Sickle Cell Disease In Correlation With Index Of Hydroxyurea Responsiveness, Xingguo Zhu, Tianxiang Hu, Meng Hsuan Ho, Yongchao Wang, Miao Yu, Niren Patel, Wenhu Pi, Jeong-Hyeon Choi, Hongyan Xu, Vadivel Ganapathy, Ferdane Kutlar, Abdullah Kutlar, Dorothy Tuan

Pharmacology and Nutritional Sciences Faculty Publications

Hydroxyurea (HU), the first of two drugs approved by the US Food and Drug Administration for treating patients with sickle cell disease (SCD), produces anti-sickling effect by re-activating fetal γ-globin gene to enhance production of fetal hemoglobin. However, approximately 30% of the patients do not respond to HU therapy. The molecular basis of non-responsiveness to HU is not clearly understood. To address this question, we examined HU-induced changes in the RNA and protein levels of transcription factors NF-Y, GATA-1, -2, BCL11A, TR4, MYB and NF-E4 that assemble the γ-globin promoter complex and regulate transcription of γ-globin gene. In erythroblasts cultured …

Alcohol And Cancer Stem Cells, Mei Xu, Jia Luo

Pharmacology and Nutritional Sciences Faculty Publications

Heavy alcohol consumption has been associated with increased risk of several cancers, including cancer of the colon, rectum, female breast, oral cavity, pharynx, larynx, liver, and esophagus. It appears that alcohol exposure not only promotes carcinogenesis but also enhances the progression and aggressiveness of existing cancers. The molecular mechanisms underlying alcohol tumor promotion, however, remain unclear. Cancer stem cells (CSC), a subpopulation of cancer cells with self-renewal and differentiation capacity, play an important role in tumor initiation, progression, metastasis, recurrence, and therapy resistance. The recent research evidence suggests that alcohol increases the CSC population in cancers, which may underlie alcohol-induced …