Digital Commons Network^™

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …

Assessment Of Depression Screening In Women’S Primary Care Clinic, Susanna Gorton

DNP Projects

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary …

Retrospective Analysis Of Body Mass Index Screening And Obesity Counseling In A Primary Care Setting: Comparative Analysis Of Demographic Variables And Co-Morbidities, Christina Fisher Higdon

DNP Projects

Study Purpose: To assess obesity screening and counseling in patients at annual wellness exams in an urban primary care clinic. Specific aims of the study: determine percentage of patients with documented body mass index (BMI), ICD-9/ICD-10 diagnosis of overweight or obesity, documentation of education or a follow-up plan for weight management, follow-up visit for weight loss and documentation by provider, and comparative analysis of co-morbidities and demographic variables during well-exam visits.

Target Population and Measures: Adults over the age of 18 in an urban primary care clinic with a BMI greater than 25 kilograms (kg)/meters squared (m2). BMI screening and …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …

Preventing Delirium Through The Implementation Of The Abcde Bundle And Pad Guideline Into Everyday Care In A Community Hospital Intensive Care Unit: Opportunities For Practice Improvement, Mary Zody

DNP Projects

This DNP project focuses on the reduction of delirium through improvement of nursing knowledge of delirium and implementation of evidence based bundle ( Awake, Breathing, Coordination, Early Mobility, and Pain, Agitation, Delirium) into a twelve bed intensive care unit located in a 150 bed community hospital. Specifically, this project will review the literature supporting the evidence based bundle and report on a comprehensive gap analysis which was done to determine areas for practice improvement to reduce delirium and improve patient outcomes. The gap analysis included a comparison of current practice to the evidence, a review of administrative policies/ statements of …

An Evaluation Of Providers' Interventions And Patients' Adherence In Diabetes Management, Hoang Ngo

DNP Projects

Background: Diabetes is one of the leading causes of death and disability in the United States including Kentucky. Despite advances in medicine, the current management of type 2 diabetes mellitus (T2DM) remains challenging. Poor self-management coupled with the increasing complexity of the disease can lead to poor glycemic control.

Purpose: The purpose of this project was to examine current practices related to insulin-using patients’ treatment adherence and management of T2DM. In addition, providers’ perceptions on the management of T2DM were also assessed.

Methods: A retrospective chart review and semi-structured interviews were conducted. Patients (N = 84) with T2DM, over the …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …

The Effects Of Manufactured Nanomaterial Transformations On Bioavailability, Toxicity And Transcriptomic Responses Of Caenorhabditis Elegans, Daniel L. Starnes

Theses and Dissertations--Plant and Soil Sciences

In recent decades, there has been a rapid expansion in the use of manufactured nanoparticles (MNPs). Experimental evidence and material flow models predict that MNPs enter wastewater treatment plants and partition to sewage sludge and majority of that sludge is land applied as biosolids. During wastewater treatment and after land application, MNPs undergo biogeochemical transformations (aging). The primary transformation process for silver MNPs (Ag-MNPs) is sulfidation, while zinc oxide MNPs (ZnO-MNPs) most likely undergo phosphatation and sulfidation. Our overall goal was to assess bioavailability and toxicogenomic impacts of both pristine, defined as-synthesized, and aged Ag- and ZnO-MNPs, as well as …

In Vivo-Expressed Proteins Of Virulent Leptospira Interrogans Serovar Autumnalis N2 Elicit Strong Igm Responses Of Value In Conclusive Diagnosis, Veerapandian Raja, Santhanam Shanmughapriya, Murugesan Kanagavel, Sergey Artiushin, Sridhar Velineni, John F. Timoney, Kalimuthusamy Natarajaseenivasan

Maxwell H. Gluck Equine Research Center Faculty Publications

Leptospirosis is a serious zoonosis that is underdiagnosed because of limited access to laboratory facilities in Southeast Asia, Central and South America, and Oceania. Timely diagnosis of locally distributed serovars of high virulence is crucial for successful care and outbreak management. Using pooled patient sera, an expression gene library of a virulent Leptospira interrogans serovar Autumnalis strain N2 isolated in South India was screened. The identified genes were characterized, and the purified recombinant proteins were used as antigens in IgM enzyme-linked immunosorbent assay (ELISA) either singly or in combination. Sera (n = 118) from cases of acute leptospirosis along …

Adaptability In A Bhutanese Refugee Community: Navigating Integration And The Impacts On Nutritional Health After U.S. Resettlement, Chris Grosh

Theses and Dissertations--Anthropology

Increasing rates of overweight, obesity, and related metabolic diseases documented among refugee communities across the United States necessitate greater attention to how processes of integration impact refugee health. These nutritional health trends (e.g., increasing rates of obesity) suggest potential disconnects between refugees' past environments and their conditions after re-settlement, which may contribute to adverse changes in energy balance (diet and exercise). While Bhutanese refugees were among the largest refugee groups entering the US during the five years leading up to this research, very few studies have examined how they have responded to integration and the impact of this transition on …

Rapamycin Rescues Vascular, Metabolic And Learning Deficits In Apolipoprotein E4 Transgenic Mice With Pre-Symptomatic Alzheimer’S Disease, Ai-Ling Lin, Jordan B. Jahrling, Wei Zhang, Nicholas Derosa, Vikas Bakshi, Peter Romero, Veronica Galvan, Arlan Richardson

Sanders-Brown Center on Aging Faculty Publications

Apolipoprotein E ɛ4 allele is a common susceptibility gene for late-onset Alzheimer's disease. Brain vascular and metabolic deficits can occur in cognitively normal apolipoprotein E ɛ4 carriers decades before the onset of Alzheimer's disease. The goal of this study was to determine whether early intervention using rapamycin could restore neurovascular and neurometabolic functions, and thus impede pathological progression of Alzheimer's disease-like symptoms in pre-symptomatic Apolipoprotein E ɛ4 transgenic mice. Using in vivo, multimodal neuroimaging, we found that apolipoprotein E ɛ4 mice treated with rapamycin had restored cerebral blood flow, blood–brain barrier integrity and glucose metabolism, compared …

Summer-Long Grazing Of High Vs. Low Endophyte (Neotyphodium Coenophialum)-Infected Tall Fescue By Growing Beef Steers Results In Distinct Temporal Blood Analyte Response Patterns, With Poor Correlation To Serum Prolactin Levels, Joshua J. Jackson, Merlin D. Lindemann, James A. Boling, James C. Matthews

Animal and Food Sciences Faculty Publications

Previously, we reported the effects of fescue toxicosis on developing Angus-cross steer growth, carcass, hepatic mRNA, and protein expression profiles of selected serum proteins, and blood clinical and chemical profiles, after summer-long grazing (85 days) of high endophyte (HE)- vs. low endophyte (LE)-infected fescue pastures. We now report the temporal development of acute, intermediate, and chronic responses of biochemical and clinical blood analytes determined at specified time intervals (period 1, day 0–36; period 2, day 37–58; and period 3, day 59–85). Throughout the trial, the alkaloid concentrations of the HE forage was consistently 19–25 times greater (P ≤ 0.002) …

Renal Replacement Therapy In Patients With Left Ventricular Assist Device: What Do The Cardiologists Need To Know?, Hesham R. Omar

The VAD Journal

Renal failure after left ventricular assist device (LVAD) implantation occurs either due to worsening chronic kidney disease which is common in end-stage heart failure, or due to acute kidney injury in the peri-implantation period, and is associated with high morbidity and short-term mortality. The increased utilization of LVAD in refractory heart failure either as a bridge to transplantation or destination therapy will eventually create a population of patients with LVADs who are dialysis-dependent. There are multiple challenges encountered during dialysis of patients with LVADs including the unfamiliarity of nephrologists with the LVAD technology, difficulty in hemodynamic monitoring with continuous flow …

Selection Of Reference Genes For Rt-Qpcr Analysis In A Predatory Biological Control Agent, Coleomegilla Maculata (Coleoptera: Coccinellidae), Chunxiao Yang, Huipeng Pan, Jeffrey Edward Noland, Deyong Zhang, Zhanhong Zhang, Yong Liu, Xuguo Zhou

Entomology Faculty Publications

Reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) is a reliable technique for quantifying gene expression across various biological processes, of which requires a set of suited reference genes to normalize the expression data. Coleomegilla maculata (Coleoptera: Coccinellidae), is one of the most extensively used biological control agents in the field to manage arthropod pest species. In this study, expression profiles of 16 housekeeping genes selected from C. maculata were cloned and investigated. The performance of these candidates as endogenous controls under specific experimental conditions was evaluated by dedicated algorithms, including geNorm, Normfinder, BestKeeper, and ΔCt method. In addition, …

Chronic Ethanol Exposure Enhances The Aggressiveness Of Breast Cancer: The Role Of P38Γ, Mei Xu, Siying Wang, Zhenhua Ren, Jacqueline A. Frank, Xiuwei H. Yang, Zhuo Zhang, Zun-Ji Ke, Xianglin Shi, Jia Luo

Pharmacology and Nutritional Sciences Faculty Publications

Both epidemiological and experimental studies suggest that ethanol may enhance aggressiveness of breast cancer. We have previously demonstrated that short term exposure to ethanol (12–48 hours) increased migration/invasion in breast cancer cells overexpressing ErbB2, but not in breast cancer cells with low expression of ErbB2, such as MCF7, BT20 and T47D breast cancer cells. In this study, we showed that chronic ethanol exposure transformed breast cancer cells that were not responsive to short term ethanol treatment to a more aggressive phenotype. Chronic ethanol exposure (10 days - 2 months) at 100 (22 mM) or 200 mg/dl (44 mM) caused the …

Impact Of Sleep And Circadian Disruption On Energy Balance And Diabetes: A Summary Of Workshop Discussions, Deanna M. Arble, Joseph Bass, Cecilia Diniz Behn, Matthew P. Butler, Etienne Challet, Charles Czeisler, Christopher M. Depner, Joel Elmquist, Paul Franken, Michael A. Grandner, Erin C. Hanlon, Alex C. Keene, Michael J. Joyner, Ilia Karatsoreos, Philip A. Kern, Samuel Klein, Christopher J. Morris, Allan I. Pack, Satchidananda Panda, Louis J. Ptacek, Naresh M. Punjabi, Paolo Sassone-Corsi, Frank A. Scheer, Richa Saxena, Elizabeth R. Seaquest, Matthew S. Thimgan, Eve Van Cauter, Kenneth P. Wright

Clinical and Translational Science Faculty Publications

A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in this area and a number of specific opportunities. Studies in this area would be facilitated by active collaboration between investigators in sleep/circadian research and investigators in metabolism/diabetes. There is a need to translate the elegant findings from basic research into improving the metabolic health of the American public. There is also a need for investigators studying the impact …

Methylseleninic Acid Promotes Antitumour Effects Via Nuclear Foxo3a Translocation Through Akt Inhibition, Míriam Tarrado-Castellarnau, Roldán Cortés, Miriam Zanuy, Josep Tarragó-Celada, Ibrahim H. Polat, Richard Hill, Teresa W-M Fan, Wolfgang Link, Marta Cascante

Toxicology and Cancer Biology Faculty Publications

Selenium supplement has been shown in clinical trials to reduce the risk of different cancers including lung carcinoma. Previous studies reported that the antiproliferative and pro-apoptotic activities of methylseleninic acid (MSA) in cancer cells could be mediated by inhibition of the PI3K pathway. A better understanding of the downstream cellular targets of MSA will provide information on its mechanism of action and will help to optimize its use in combination therapies with PI3K inhibitors. For this study, the effects of MSA on viability, cell cycle, metabolism, apoptosis, protein and mRNA expression, and reactive oxygen species production were analysed in A549 …

Endoplasmic Reticulum Stress And Ethanol Neurotoxicity, Fanmuyi Yang, Jia Luo

Pharmacology and Nutritional Sciences Faculty Publications

Ethanol abuse affects virtually all organ systems and the central nervous system (CNS) is particularly vulnerable to excessive ethanol exposure. Ethanol exposure causes profound damages to both the adult and developing brain. Prenatal ethanol exposure induces fetal alcohol spectrum disorders (FASD) which is associated with mental retardation and other behavioral deficits. A number of potential mechanisms have been proposed for ethanol-induced brain damage; these include the promotion of neuroinflammation, interference with signaling by neurotrophic factors, induction of oxidative stress, modulation of retinoid acid signaling, and thiamine deficiency. The endoplasmic reticulum (ER) regulates posttranslational protein processing and transport. The accumulation of …

Individual Responses For Muscle Activation, Repetitions, And Volume During Three Sets To Failure Of High- (80% 1rm) Versus Low-Load (30% 1rm) Forearm Flexion Resistance Exercise, Nathaniel D. M. Jenkins, Terry J. Housh, Samuel L. Buckner, Haley C. Bergstrom, Kristen C. Cochrane, Cory M. Smith, Ethan C. Hill, Richard J. Schmidt, Joel T. Cramer

Kinesiology and Health Promotion Faculty Publications

This study compared electromyographic (EMG) amplitude, the number of repetitions completed, and exercise volume during three sets to failure of high- (80% 1RM) versus low-load (30% 1RM) forearm flexion resistance exercise on a subject-by-subject basis. Fifteen men were familiarized, completed forearm flexion 1RM testing. Forty-eight to 72 h later, the subjects completed three sets to failure of dumbbell forearm flexion resistance exercise with 80% (n = 8) or 30% (n = 7) 1RM. EMG amplitude was calculated for every repetition, and the number of repetitions performed and exercise volume were recorded. During sets 1, 2, and 3, one …

Alteration Of Tobacco Alkaloid Content Through Modification Of Specific Cytochrome P450 Genes, Ralph E. Dewey, Balazs Siminszky, Steven W. Bowen, Lily Gavilano

Plant and Soil Sciences Faculty Patents

Compositions and methods for reducing the level of nomicotine and N'-nitrosonornicotine (NNN) in Nicotiana plants and plant parts thereof are provided. The compositions comprise isolated polynucleotides and polypeptides for cytochrome P450s that are involved in the metabolic conversion of nicotine to nornicotine in these plants. Expression cassettes, vectors, plants, and plant parts thereof comprising inhibitory sequences that target expression or function of the disclosed cytochrome P450 polypeptides are also provided. Methods for the use of these novel sequences to inhibit expression or function of cytochrome P450 polypeptides involved in this metabolic conversion are also provided. The methods find use in …

Early Shifts Of Brain Metabolism By Caloric Restriction Preserve White Matter Integrity And Long-Term Memory In Aging Mice, Janet Guo, Vikas Bakshi, Ai-Ling Lin

Sanders-Brown Center on Aging Faculty Publications

Preservation of brain integrity with age is highly associated with lifespan determination. Caloric restriction (CR) has been shown to increase longevity and healthspan in various species; however, its effects on preserving living brain functions in aging remain largely unexplored. In the study, we used multimodal, non-invasive neuroimaging (PET/MRI/MRS) to determine in vivo brain glucose metabolism, energy metabolites, and white matter structural integrity in young and old mice fed with either control or 40% CR diet. In addition, we determined the animals’ memory and learning ability with behavioral assessments. Blood glucose, blood ketone bodies, and body weight were also measured. We …

Mice Deficient In Endothelial Α5 Integrin Are Profoundly Resistant To Experimental Ischemic Stroke, Jill Roberts, Leon De Hoog, Gregory J. Bix

Sanders-Brown Center on Aging Faculty Publications

Stroke is a disease in dire need of better therapies. We have previously shown that a fragment of the extracellular matrix proteoglycan, perlecan, has beneficial effects following cerebral ischemia via the α5β1 integrin receptor. We now report that endothelial cell selective α5 integrin deficient mice (α5 KO) are profoundly resistant to ischemic infarct after transient middle cerebral artery occlusion. Specifically, α5 KOs had little to no infarct 2–3 days post-stroke, whereas controls had an increase in mean infarct volume over the same time period as expected. Functional outcome is also improved in the α5 KOs compared with controls. Importantly, no …

Antioncogenic And Oncogenic Properties Of Nrf2 In Arsenic-Induced Carcinogenesis, Young-Ok Son, Poyil Pratheeshkumar, Ram Vinod Roy, Andrew Hitron, Lei Wang, Sasidharan Padmaja Divya, Mei Xu, Jia Luo, Gang Chen, Zhuo Zhang, Xianglin Shi

Center for Research on Environmental Disease Faculty Publications

Arsenic (As³⁺) is a carcinogen with considerable environmental and occupational relevancy. The present study shows that As³⁺-transformed human lung bronchial epithelial BEAS-2B cells (AsT cells) exhibit the property of apoptosis resistance. The level of basal reactive oxygen species (ROS) is very low in AsT cells in correlation with elevated expressions of both antioxidant enzymes and antiapoptotic proteins. Nuclear factor erythroid 2-related factor (Nrf2) and p62 are constitutively expressed. These two proteins up-regulate antioxidant enzymes and antiapoptotic proteins. The knockdown of Nrf2 or p62 by small interfering RNA (siRNA) enhanced both ROS levels and As³⁺-induced …

Biosafety Research For Non-Target Organism Risk Assessment Of Rnai-Based Ge Plants, Andrew F. Roberts, Yann Devos, Godwin N. Y. Lemgo, Xuguo Zhou

Entomology Faculty Publications

RNA interference, or RNAi, refers to a set of biological processes that make use of conserved cellular machinery to silence genes. Although there are several variations in the source and mechanism, they are all triggered by double stranded RNA (dsRNA) which is processed by a protein complex into small, single stranded RNA, referred to as small interfering RNAs (siRNA) with complementarity to sequences in genes targeted for silencing. The use of the RNAi mechanism to develop new traits in plants has fueled a discussion about the environmental safety of the technology for these applications, and this was the subject of …

Short-Term, High-Fat Diet Accelerates Disuse Atrophy And Protein Degradation In A Muscle-Specific Manner In Mice, Steven L. Roseno, Patrick R. Davis, Lance M. Bollinger, Jonathan J. S. Powell, Carol A. Witczak, Jeffrey J. Brault

Kinesiology and Health Promotion Faculty Publications

BACKGROUND: A short-term high-fat diet impairs mitochondrial function and the ability of skeletal muscle to respond to growth stimuli, but it is unknown whether such a diet alters the ability to respond to atrophy signals. The purpose of this study was to determine whether rapid weigh gain induced by a high-fat (HF) diet accelerates denervation-induced muscle atrophy.

METHODS: Adult, male mice (C57BL/6) were fed a control or HF (60 % calories as fat) diet for 3 weeks (3wHF). Sciatic nerve was sectioned unilaterally for the final 5 or 14 days of the diet. Soleus and extensor digitorum longus …

Pharmacology: The Pharmacodynamics Of Nutrients And Nutrient Interactions In Biological Functions, M. Hasan Mohajeri, Gunter P. Eckert, James R. Pauly, Christopher M. Butt

Pharmaceutical Sciences Faculty Publications

No abstract provided.

Forage News [2015-11], Department Of Plant And Soil Sciences, University Of Kentucky

Forage News

• Debby Dulworth as Keynote Speaker on Extending the Grazing Season at Heart of America Grazing Conference
• Study Shows No Damage to Soils from Grazing of Cover Crops
• Forage News Quote of the Month
• Get the Most out of Grazing Corn Stalks
• 2016 Kentucky Small Ruminant Grazing Conference schedule announced
• Muhlenberg County Producer and Ag Teacher to Represent Kentucky at AFGC
• Heart of America Grazing Conference Registration Open
• AGFC Annual Meeting Agenda Available