Digital Commons Network^™

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

Childhood Nutrition And Lifestyle In Owensboro, Kentucky, Mckenzie J. Mattingly

DNP Projects

According to the CDC, childhood obesity is now one of the leading health problems in the United States. Thirty-five percent of adults in the United States are obese. Kentucky is the 12th most obese state for adults. and the 7th most obese state for children. The State of Obesity: Better Policies for a Healthier America, states that Kentucky’s adult obesity rate is currently 31.6 percent. This is up from 21.7 percent in 2000 and 12.7 percent in 1990. Primary care providers must work to help prevent these numbers from continuing to climb. Since our population of children who are overweight …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Examining The Relationship Between Type And Extent Of After-School Care Use And High Bmi In Children Ages 5-17, Morgan E.B. Chojnacki

DNP Projects

Objectives: The purpose of this study was to examine the relationship between body mass index (BMI) and after-school care use in school age children and adolescents in Kentucky. The specific aims of this study were to examine differences in BMI groups (high versus normal/low) by: a) type and b) extent of after-school care use.

Methods: Parents of children age 5-17 years were administered a 21-item survey which assessed the amount of time their children spent in specific types of after-school care. BMI of the child/adolescent participants were obtained at the time of the survey. High BMI was defined …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

The Influence Of Production Practices, Tillage, And Endophytic Bacteria On Bell Pepper Productivity And Physiology Under Different Irrigation Regimes, Zheng Wang

Theses and Dissertations--Plant and Soil Sciences

To evaluate the strip tillage in organic bell pepper (Capsicum annuum L.) production as an integrated system for sustainable vegetable cropping two-years of field trials were conducted in 2011 and 2012. The field trials were conducted to determine the viability of strip tillage in conventional and organic bell pepper production systems by comparing plant growth, water status, and fruit yield to plastic mulch grown plants application under different irrigation regimes. The two-year field data demonstrated that organic pepper with strip tillage application was a viable combination that produced comparable yield to conventional plastic mulch system and utilized water more …

Soil Management And Nitrogen Dynamics In Burley Tobacco Rotations, Congming Zou

Theses and Dissertations--Plant and Soil Sciences

Agronomic practices, including tillage, crop rotation and N fertilization, have been developed to efficiently manage soil N dynamics and crop N nutrition. These practices can affect soil organic carbon (SOC) and soil total nitrogen (STN) sequestration, and consequently influence soil nitrogen mineralization (SNM) and crop N nutrition. However, little research has been systematically and simultaneously conducted to examine the effect of agronomic management on (1) SOC and STN stocks; (2) SNM; and (3) crop N nutrition. Burley tobacco (Nicotiana tobacum L.) is a N demanding crop and subject to inefficiency in N fertilization. Moreover, conservation tillage and rotation have been …

Urea Formulations On The Productivity Of Bermudagrass And Bermudagrass-White Clover Pastures, Caitlin Timberlake

Theses and Dissertations--Plant and Soil Sciences

Bermudagrass (Cynodon dactylon L.) is a perennial warm-season grass that is very responsive to nitrogen (N) fertilization. Excessive N applications have negative environmental consequences and make maintaining mixed swards difficult. This study determined the effects of enhanced efficiency (EE) N fertilizers and fertilizer rate on bermudagrass yields, nutritive values, and white clover persistence. Nitrogen sources included urea, urea formulated with Agrotain^® (U+A), urea with Agrotain^® and dicyandiamide (SuperU), a polymer-coated urea (ESN), ESN+urea (75% ESN, 25% urea), and methylene urea (MU). In the urea formulation trial, SuperU and U+A maximized forage yields at lower N rates. The …

Determining The Effects Of Cd151 And Β1 On Tumor Cell Adhesion And Migration, Rachel R. Essex

Theses and Dissertations--Chemical and Materials Engineering

Previous studies have shown that the upregulation of CD151 and β₁ is associated with poor prognosis in many cancers such as breast cancer. Studies have provided evidence that these proteins are associated with the adhesion and migration of tumor cells. In this study, a microfluidic flow chamber was utilized to determine how CD151 and β₁ affected the firm and initial adhesion of metastatic breast cancer cells to a planar endothelial monolayer under shear stress. This system mimicked the adhesion of metastatic breast cancer cells to the endothelial cells of the circulatory system. CD151 and β₁ increased the …

The Effects Of Alcohol And Hypoxia Exposure In The Developing Brain, Megan L. Carter

Theses and Dissertations--Psychology

Exposure to alcohol (ethanol (ETOH)) during fetal development results in a variety of cognitive/behavioral deficits. The effects of fetal ETOH exposure vary across individuals and numerous studies have shown that ETOH’s interaction with other variables can affect outcome in offspring. These studies investigated the effects of developmental ETOH and hypoxia. It was hypothesized that a history of ETOH during development alters the response to a subsequent hypoxic challenge, such as that which may occur during parturition; this results in central nervous system (CNS) damage and behavioral deficits.

The first study determined if developmental ETOH and hypoxia exposure produced behavioral deficits …

Public Health System Partnerships And The Scope Of Maternal And Child Services: A Longitudinal Study, Sharla Smith, Glen Mays, Tommy Mac Bird, Michael A. Preston

Frontiers in Public Health Services and Systems Research

Local health departments (LHDs) struggle to serve their communities in the face of ongoing fiscal constraints. Fiscal constraints have led to the elimination and reduction of maternal and child health services (MCH). LHDs have used various strategies to minimize the negative impact fiscal constraints of elimination or reduction of services provided to their communities. Many LHDs have used strategies such as developing partnerships. While these strategies are assumed to increase the delivery of services and improve outcomes, there is limited research on the type of partnerships needed to service delivery. Our interest was identifying the type of partnerships associated with …

Left Ventricular Assist Device As Destination Therapy, Maya Guglin, Leslie W. Miller

The VAD Journal

Mechanical circulatory support is the most rapidly evolving strategy in heart failure management. The growing number of patients who need better results than medical therapy can offer, the limited pool of donors for cardiac transplantation, and several technological breakthroughs have all made the option of implanting a left ventricular assist device (LVAD) as destination therapy more important.

In this review, we outline the indications and decision making process of considering a patient for a destination therapy LVAD, as well as outcomes, complications, and issues related to management of patients on currently approved devices. The future direction of the field will …

Bovine Colostrum Supplementation Optimises Earnings, Performance And Recovery In Racing Thoroughbreds, C. K. Fenger, Thomas Tobin, P. J. Casey, Edward A. Roualdes, J. L. Langemeier, D. M. Haines

Maxwell H. Gluck Equine Research Center Faculty Publications

Bovine colostrum (BC) is the first milk produced by cows after calving and contains numerous beneficial substances for the immunity and development of the newborn calf. Because of the growth and immune factors in BC, it has become an attractive supplement for use by athletes to support immunity and health during athletic performance. In order to evaluate the effects of oral BC supplementation on equine athletes, this study evaluated the earnings, performance, recovery and incidence of upper respiratory infections (URTI) in racing horses. The study design was a randomized cross-over racing performance study. 21 horses in race training were randomly …

Mitochondria Dysfunction In Lung Cancer-Induced Muscle Wasting In C2c12 Myotubes, Julie B. Mclean, Jennifer S. Moylan, Francisco H. Andrade

Physiology Faculty Publications

Aims: Cancer cachexia is a syndrome which results in severe loss of muscle mass and marked fatigue. Conditioned media from cachexia-inducing cancer cells triggers metabolic dysfunction in skeletal muscle, including decreased mitochondrial respiration, which may contribute to fatigue. We hypothesized that Lewis lung carcinoma conditioned medium (LCM) would impair the mitochondrial electron transport chain (ETC) and increase production of reactive oxygen species, ultimately leading to decreased mitochondrial respiration. We incubated C2C12 myotubes with LCM for 30 min, 2, 4, 24 or 48 h. We measured protein content by western blot; oxidant production by 2′,7′-dichlorofluorescin diacetate (DCF), 4-amino-5-methylamino-2′,7′-difluorofluorescein diacetate (DAF), and …

Cd151-Α3Β1 Integrin Complexes Suppress Ovarian Tumor Growth By Repressing Slug-Mediated Emt And Canonical Wnt Signaling, Lauren A. Baldwin, John T. Hoff, Jason Lefringhouse, Michael Zhang, Changhe Jia, Zeyi Liu, Sonia Erfani, Hongyan Jin, Mei Xu, Qing-Bai She, John R. Van Nagell Jr., Chi Wang, Li Chen, Rina Plattner, David M. Kaetzel, Jia Luo, Michael Lu, Dava West, Chunming Liu, Fred R. Ueland, Ronny Drapkin, Binhua P. Zhou, Xiuwei H. Yang

Pharmacology and Nutritional Sciences Faculty Publications

Human ovarian cancer is diagnosed in the late, metastatic stages but the underlying mechanisms remain poorly understood. We report a surprising functional link between CD151-α3β1 integrin complexes and the malignancy of serous-type ovarian cancer. Analyses of clinical specimens indicate that CD151 expression is significantly reduced or diminished in 90% of metastatic lesions, while it remains detectable in 58% of primary tumors. These observations suggest a putative tumor-suppressing role of CD151 in ovarian cancer. Indeed, our analyses show that knocking down CD151 or α3 integrin enhances tumor cell proliferation, growth and ascites production in nude mice. These changes are accompanied by …

Mono- And Digalactosyldiacylglycerol Lipids Function Nonredundantly To Regulate Systemic Acquired Resistance In Plants, Qing-Ming Gao, Keshun Yu, Ye Xia, M. B. Shine, Caixia Wang, Duroy Navarre, Aardra Kachroo, Pradeep Kachroo

Plant Pathology Faculty Publications

The plant galactolipids monogalactosyldiacylglycerol (MGDG) and digalactosyldiacylglycerol (DGDG) have been linked to the anti-inflammatory and cancer benefits of a green leafy vegetable diet in humans due to their ability to regulate the levels of free radicals like nitric oxide (NO). Here, we show that DGDG contributes to plant NO as well as salicylic acid biosynthesis and is required for the induction of systemic acquired resistance (SAR). In contrast, MGDG regulates the biosynthesis of the SAR signals azelaic acid (AzA) and glycerol-3-phosphate (G3P) that function downstream of NO. Interestingly, DGDG is also required for AzA-induced SAR, but MGDG is not. Notably, …

The Economics Of Implementing Population Health Strategies: Progress In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …

Proper Handling And Transportation Of Eggs For Sale At Kentucky Farmers’ Markets, Anthony J. Pescatore, Jacquie Jacob

Agriculture and Natural Resources Publications

Regardless of the number of eggs produced, and whether the eggs are for home use or sale, careful egg handling is very important. The United States Food and Drug Administration (FDA) lists eggs as a potentially hazardous food, therefore careful handling is important. In Kentucky, if you sell more than 60 dozen eggs a week you need to purchase a retail license. The same holds true if you want to sell your eggs to a retail store to be re-sold or to a distributor that will sell them for you. If you produce fewer than 60 dozen eggs a week …

Sheep Breeding: Heritability, Ebvs, Epds And The Nsip, Debra K. Aaron

Agriculture and Natural Resources Publications

Genetic improvement in a flock depends on the producer’s ability to select breeding sheep that are genetically superior for traits of economic importance. This is complicated by the fact that an animal’s own performance is not always a true indicator of its genetic potential as a parent.

Uk Ag Equine Programs 2015 Calendar: A 12-Month Planning Calendar For The Care And Use Of Your Horses, Jason Phillips, Glenn Mackie, Don Sorrell, Nicholas L. Carter, Paula A. Jerrell, Brian Newman, Daniel Wilson, Christopher Jeffcoat, Karen Douglas, Katheryn L. Cerny, Fernanda Camargo, Robert Coleman, Essie Rodgers, Jim Smith

Agriculture and Natural Resources Publications

The information in this calendar is provided to aid owners in planning for the care and use of their horses. When necessary, information is discussed in the month prior to application to allow horse owners adequate time to plan for activities such as weed control, soil testing, and vaccinations.

Contact your local veterinarian for health-related issues and your county extension agent for further information. Phone numbers are listed at the end of the calendar.

An Introduction To Sheep, Debra K. Aaron, Donald G. Ely

Agriculture and Natural Resources Publications

The information in this fact sheet was developed to provide a quick reference to the most frequently asked questions about sheep and sheep production.

Basic Sheep Genetics, Debra K. Aaron

Agriculture and Natural Resources Publications

Genetics is the science of heredity. It seeks to explain differences and similarities exhibited by related individuals. The application of genetics to livestock improvement is known as animal breeding. The objective of this fact sheet is to provide a refresher course on basic genetics and to show how knowledge of genetics can be used to improve sheep production.

Keeping And Using Flock Performance Records, Debra K. Aaron

Agriculture and Natural Resources Publications

Performance records serve as the cornerstone of any good livestock management program. Unfortunately, the task of collecting, maintaining and using performance records is the one area of livestock production in general that gets the least attention. This fact sheet provides ten reasons why all sheep producers need to keep performance records on their flocks. Then, some ways of maintaining and using those records are discussed.

So You Want To Produce Your Own Eggs?, Jacquie Jacob, Anthony J. Pescatore

Agriculture and Natural Resources Publications

Backyard chicken flocks are becoming popular throughout the country in urban, suburban and rural communities. Preparation is essential for a successful backyard flock.

Connecting Undergraduate Science Education With The Needs Of Today's Graduates, Viviane Callier, Richard H. Singiser, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Undergraduate science programs are not providing graduates with the knowledgebase and skills they need to be successful on today’s job market. Curricular changes relevant to today’s marketplace and more opportunities for internships and work experience during students’ secondary education would facilitate a smoother transition to the working world and help employers find graduates that possess both the hard and soft skills needed in the workplace. In this article, we discuss these issues and offer solutions that would generate more marketplace-ready undergraduates.

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Health Management and Policy Presentations

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .

A Pilot Study On The Use Of Lecture Tools To Enhance The Teaching Of Pharmacokinetics And Pharmacodynamics, Hollie I. Swanson, Michael T. Piascik

Pharmacology and Nutritional Sciences Faculty Publications

Pharmacokinetics and pharmacodynamics are essential topics contained within the medical curriculum and are highly amenable to active-learning approaches. In this pilot study, we incorporated Lecture Tools, a cloud-based audience response system, into a lecture-based graduate course. Lecture Tools was used by both the instructors and the students during peer presentations. Advantages noted by the instructors include the versatility of the questions that can be presented and the ease with which student assessment can be conducted. Student surveys revealed that, overall, the use of Lecture Tools enhanced student attentiveness and engagement and facilitated student participation in questions and answers. Some disadvantages …

Evidence-Informed Guidelines For Pediatric Pandemic Planning And Response, Ginny Sprang, James J. Clark, Miriam Silman, Phyllis W. Leigh, Candice M. Jackson, A. Scott Lajoie

Center on Trauma and Children Reports

From the executive summary:

Pandemic events are unpredictable and inevitable. When they occur, the impact is both all-encompassing and asymmetrical; each pandemic targets specific, vulnerable populations, but ultimately impacts individuals, families and communities throughout the world. Regardless of origin or circumstances, the next pandemic will certainly count infants, children, and adolescents among its most vulnerable targets. As evidenced by the 2009 H1N1 influenza pandemic, children may be at higher risk than populations more typically seen as susceptible to pandemic illness (the elderly, those with weakened immune systems, etc.). Children also can function as disease vectors, spreading the virus through their …

Reading A Feed Tag, Jacquie Jacob, Anthony J. Pescatore

Agriculture and Natural Resources Publications

Feed stores carry a variety of feed types. How do you chose which to buy? You need to read the feed tag. A lot of information is on a feed tag that can help you make your selection.

Mineral And Protein Blocks And Tubs For Beef Cattle, Jeff Lehmkuhler, Roy Burris, Donna M. Amaral-Phillips

Agriculture and Natural Resources Publications

Nutritional supplement blocks and tubs are convenient for beef producers, require no investment in feeding troughs and require a limited area for storing. One of the most attractive features is that they lower the labor needed to supplement livestock. Many producers use these products to provide supplemental nutrients to cattle consuming low-quality forages or as a mechanism to promote a more consistent intake of minerals. These products are also attractive to producers who have off-farm employment as they eliminate the need for daily feeding. Yet, they often come at a greater cost per unit of nutrient than more conventional feedstuffs. …