Phase 1 Open-Label Study Of Asp9801, An Oncolytic Virus, In Patients With Advanced Or Metastatic Solid Tumors, John L. Villano, Jason J. Luke, Ricklie Julian, Christos Fountzilas, Manish R. Patel, Michael J. Chisamore, Pranob Bhattacharya, Shigeru Takeshita, Serguei Soukharev, Shunsuke Yamada, Leshi Zhang, Kristopher P. Wentzel

Neurology Faculty Publications

Purpose ASP9801, an oncolytic virus encoding interleukin-7 and interleukin-12, was assessed for safety, tolerability, pharmacokinetics, and antitumor activity in patients with advanced solid tumors in a Phase 1 study. Methods The study comprised Part 1 ASP9801 monotherapy dose escalation and Part 2 dose expansion with ASP9801 monotherapy or plus pembrolizumab. Each part was divided into Groups A (ASP9801 injection into cutaneous/subcutaneous lesions) and B (ASP9801 injection into visceral lesions). Primary objectives were safety and maximum tolerated dose and/or recommended Phase 2 dose expansion (RP2D); secondary objectives included antitumor activity and pharmacokinetics. Results In dose escalation, 17 and 10 patients in …

Assessing Interdisciplinary Learning And Knowledge: A State-Of-The-Art Review And Heuristic, Kacey Beddoes, Kristi Bartlett

Product Design Faculty Publications

Background – The need for interdisciplinary training is increasingly important, but assessing the effects of interdisciplinary education initiatives remains challenging. One of the leading difficulties is identifying and selecting the best instrument or technique for a given purpose.

Purpose -- To help researchers and educators identify available options and determine the best options for their purposes, we conducted a literature review and created a heuristic table of available techniques. Our review addresses the questions: 1) What domain-general techniques and instruments exist for assessing interdisciplinary learning or knowledge? 2) What research scenarios, populations, and questions are each technique or instrument most …

Innovative Strategies For Incorporating Clinical Experiences Into An Rn To Bsn Program, Angie Hensley, Jessica Rice, Brooke Kuns-Adkins

Nursing Faculty Publications

Curricula for Registered Nurse to Baccalaureate (RN to BSN) programs need to enhance nurse’s scope of practice, critical reasoning, and analytical skills. The purpose of this paper is to demonstrate how one RN to BSN program innovatively integrated clinical experiences into the curriculum.  Students enrolled in the RN to BSN program were required to complete 40 hours of an on-site practice experience that integrated classroom learning with direct clinical experiences incorporated into the Capstone course.

Body Mass Index Has No Impact On Complications And Mortality For Patients With Stage Iv Pancreatic Ductal Adenocarcinoma, Ren Bryant, Hannah Darnell, Megan Hall, Kelsey N. Karnik, Kristen J. Mcquerry, Ruben R. Plentz

Biostatistics Faculty Publications

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of United States (USA) cancer death. Overweight and obesity developing into a growing global medical and socio-economic problem, affecting approximately 42% of adults in the USA population. The aim of our analysis was to evaluate the influence of overweight and obesity on complications and clinical outcome in patients with stage IV PDAC.

Methods: We retrospectively reviewed electronic health records of patients diagnosed with stage IV PDAC (n=162) who followed with the University of Kentucky from January 2017–October 2024. Comparisons were based on the body mass index (BMI): low BMI …

Impact Of Covid-19 Positive Status On Outcome For Individuals With Stroke Treated In Acute Inpatient Rehabilitation, Amy Ziems, Christopher J. Mclouth, Nicholas Elwert, Elissa Charbonneau, Joseph Stillo, Susan Mcdowell

Neurology Faculty Publications

Background: Stroke, whether or not accompanied by concurrent COVID-19 infection, has been associated with varying acute care outcomes, with patients who are COVID-19 positive typically faring worse. This study aims to explore the functional outcomes of patients with stroke —with and without simultaneous COVID-19 infection—who survived their acute care stay and progressed to acute inpatient rehabilitation (IRF). Objectives: To identify differences in sociodemographic factors, medical complexity, and rehabilitation outcomes from an IRF stay between patients with stroke with concurrent COVID-19 and those without. Design: A retrospective, observational cohort study using electronic medical records (EMR) data. Setting: EMR data from 138 …

Coalition Building And Citizen Science For Radon Risk Reduction, Stacy Stanifer, Kathy Rademacher, Whitney Sedio, Naomi Cheek, David Gross, Caitlyn Curtis, Amanda Thaxton-Wiggins, Mary Kay Rayens, Ellen J. Hahn

Nursing Faculty Publications

We evaluated the implementation of local coalitions led in partnership with citizen scientists, community-based organizations, and public libraries in four rural communities to lower exposure to radon in the home. The objectives were to (1) describe the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) of four radon coalitions, and (2) compare RE-AIM factors among citizen scientists who participated in the coalitions and those who did not. A larger community-engaged research project embedded coalition building using a citizen science approach. Three of the four coalitions focused on health and wellness more broadly (18–34 members); one focused solely on radon (10 members). Coalition membership and activities varied …

Leveraging Community Health Worker’S Deep Community Knowledge To Address Food And Nutrition Security In Appalachia, Alexis Kimbro Scott, Melissa D. Olfert, Dawn Brewer, Makenzie Barr, Julie Plasencia

Journal of Appalachian Health

Introduction: Community health workers (CHWs) are trusted professionals in communities because of the deep understanding and cultural insights learned from their lived experiences. In Appalachia, CHWs are embedded in the community, giving them a unique understanding of how social determinants, like food and nutrition security, impact health outcomes.

Purpose: This study aimed to examine the professional characteristics and knowledge of CHWs while identifying culturally sensitive practices around food insecurity.

Methods: This cross-sectional, mixed-methods study used an online survey and in-depth phone interviews with CHWs in the Appalachian Region to examine their professional characteristics and knowledge on food security in their …

Candida Auris Screening, Positivity Trends, And Patient Characteristics At The University Of Kentucky Between 2021 And 2024, Faith Fursman, Natalie Fitzsimmons, Da Nelle Overton, Court Desmond, Kimberly Blanton, Kevin W. Hatton, Rachel Howard, David Olafsson, Sean Mctigue, Nicholas Van Sickels, Derek Forster, Takaaki Kobayashi

Surgery Faculty Publications

We evaluated a targeted Candida auris screening program, which revealed a 0.96% positivity rate. The proportion of community-onset cases increased from 8% to 54% following implementation. No significant differences in demographic or clinical characteristics were observed between patients with colonization and those with infection.

Partial Oral Versus Intravenous Antibiotic Therapy For Endocarditis With Management By A Multidisciplinary Team, Sami El-Dalati, Bennett Collis, Takaaki Kobayashi, Evan Hall, Talal Alnabelsi, Chloe Cao, Meredith Johnson, John Gurley, Luke Strnad, Corey Adams, Victoria Weaver, Hassan Reda, Michael Sekela, Tessa London, Kara Kennedy, Armaghan E.Rehman Mansoor, David Olafsson, Grant Laugherty, Alyssa Tremblay, Angella Linder, Deborah Gill, Nicholas J. Van Sickels, Alexander Pomakov, William Harris, Bobbi Jo Stoner

Surgery Faculty Publications

Background. Despite trial data supporting oral stepdown therapy for infective endocarditis (IE), its use remains limited, especially in North America. We evaluated outcomes of patients with IE managed by a multidisciplinary team and treated with either intravenous (IV) or partial oral antibiotics. Methods. This was a single-center retrospective study of patients with definite IE identified from an institutional registry between 7 September 2021 and 1 March 2025. Clinical and outcomes data were analyzed using multivariable logistic regression. Results. Of 236 patients, 143 received IV therapy alone and 93 were transitioned to partial oral therapy. Baseline characteristics were similar, though valve …

The Impact Of A Geriatric Trauma Unit On Patient Outcomes, Shannon E. Johnson

DNP Projects

Abstract

Background: Traumatic injuries in the geriatric (> 65) patient population can have devastating effects. Only a small percentage of these patients return to independent ambulation and living. As the population continues to age and life expectancy continues to increase, the incidence of traumatic injuries in geriatric patients will continue to increase. Geriatric friendly hospital wards in several disciplines have been shown to reduce length of stay and improve patient outcomes. However, there has been no research surrounding geriatric trauma wards specifically.

Purpose: The purpose of this quality improvement project was to evaluate the impact of admitting geriatric trauma patients …

Improving End-Of-Life Care: A Nursing Education Initiative, Spring C. Kingsley

DNP Projects

Background: This study addresses the gap in education and training for medical intensive care unit (MICU) nurses regarding the care of hospice patients. The traditional medical model of healthcare prioritizes illness treatment, often leading to inadequate end-of-life support and increased hospitalization during patients' final days. The rise of in-hospital hospice programs, or scatter-bed hospice models, highlights the need for nurses to enhance their skills in providing end-of-life compassionate care. The MICU at the University of Kentucky’s Chandler Hospital serves as a focal point for this initiative, given its role in caring for critically ill patients who require hospice attention.

Purpose: …

“What We Say Matters”: Reducing Drug Use Stigmatization By Healthcare Professionals Through A Narrative-Based Awareness Campaign, Adam M. Traugott

DNP Projects

Background: Stigma towards substance use has been identified as a contributor to poor care and health outcomes amongst people who use drugs (PWUD), a vulnerable population. Healthcare worker stigma negatively affects the outcomes of individual patients and may have greater public health implications. Methods of addressing drug-use stigma have previously been implemented in a variety of clinical settings. Presenting the lived experience of PWUD to healthcare workers via emotionally compelling narratives has been found to be an effective means of stigma reduction.

Purpose: This study utilized two psychometrically validated tools to measure (1) the baseline prevalence of drug use stigma …

Frailty Indices In Patients Undergoing Functional Neurosurgical Procedures: A Systematic Review, Carmelo Venero Jr., Joanna M. Roy, Nirbha Ghurye, Akshay Warrier, Muhammad Usman Khalid, Niels Pacheco-Barrios, Farhan A. Mirza, Christian A. Bowers

Neurosurgery Faculty Publications

Introduction: Functional neurosurgery covers a wide array of neurological disorders with an equally vast array of treatment modalities, including neuromodulation, decompressive, and ablative therapies for disparate pathologies such as pain, neuromodulation, disconnection, and refractory epilepsy. One of the most common functional treatments is deep brain stimulation for movement disorders and select psychiatric diseases. Functional neurosurgery treats patients with reduced quality of life from pathological neuronal pathways. Optimal patient selection by preoperatively identifying high-risk patients is critical for avoiding as many operative complications as possible, in addition to managing complications better once they occur. Frailty indices have demonstrated superior discrimination in …

Hardcore And Metal Music In Music Therapy: A Functional Guide For Music Therapists And Music Therapy Students, Caroline Nc Wood

Theses and Dissertations--Music

Hardcore and metal music have long been misrepresented, stigmatized, and dismissed in music academia, and overlooked in music therapy literature and education. However, these genres hold significant emotional, cultural, and therapeutic value for many listeners, offering unique opportunities for connection, expression, catharsis, and healing. This thesis presents a practical, introductory guide to help music therapists and music therapy students gain an understanding of why, when, and how to effectively and authentically incorporate hardcore and metal music into clinical practice. The project explores the historical development of these genres; sociocultural associations and considerations, including stigmatization, sensationalism, and the juxtaposing sociopolitical dynamics …

Breaking Ground On Self-Efficacy: A Qualitative Exploration Of Intimate Partner Violence Survivors’ Experiences With Therapeutic Horticulture, Rachel Marie Reeves

Theses and Dissertations--Sociology

This dissertation explores how participation in a Therapeutic Horticulture program may support the self-efficacy of survivors of Intimate Partner Violence. Through a thematic analysis of interviews with 45 women living at a domestic violence shelter in Lexington, Kentucky, this study investigates whether and how gardening activities contributed to participants’ belief in their abilities to shape outcomes in their lives.

Findings are organized around Bandura’s four sources of self-efficacy: enactive mastery experiences, vicarious experience, verbal persuasion, and physiological/affective states. These insights contribute to feminist criminology and trauma-informed care literature by illuminating the transformative potential of nature-assisted healing programs.

A Nurse-Driven Protocol To Increase Music Therapy Referrals To Manage Patient Pain And Anxiety In The Medicine Intensive Care Unit, Ashley Fox

DNP Projects

Background: Critically ill patients often suffer from pain and anxiety. Music therapy is a safe and effective treatment option. However, most nurses never receive education or training on it, resulting in a lack of awareness of its value and its actual usage in care.

Purpose: The purpose of this project was to increase the number of music therapy referrals to manage pain and anxiety in eligible medicine intensive care unit (MICU) patients via a music therapy protocol that increased nurses’ knowledge, attitudes, and skills related to the use of music as an alternative treatment option for pain and anxiety in …

Facilitating Caregiver Involvement In Reducing Delirium Among Critically Ill Children In The Pediatric Intensive Care Unit, Emma R. Bilberry

DNP Projects

Background: The pediatric intensive care unit (PICU) is a dynamic, fast-paced, and high-acuity unit where children are prone to the development of pediatric delirium (PD). PD is a condition of neurologic dysfunction increasing risk of morbidity and mortality among patients. Literature on PD is rapidly expanding, providing an opportunity for increased research on how to manage PD. Caregivers know their children, are often readily available at the bedside, and invested in being included in care. Additionally, literature shows that caregiver presence at the bedside is one non- pharmacological intervention that can aid in reducing PD. The development and implementation of …

Nsd3::Nutm1 Fusion Sarcoma Mimicking Malignant Peripheral Nerve Sheath Tumor With Prolonged Survival, Jing Di, Ali M. Alhaidary, Chi Wang, Jinge Liu, Sainan Wei, Joseph Valentino, Therese J. Bocklage

Markey Cancer Center Faculty Publications

Nuclear Protein in Testis (NUT)-rearranged tumors comprise predominantly NUT car- cinoma but also include certain lymphomas, leukemias, skin appendage tumors, and sarcomas. Although histologically diverse, all are genetically identified by oncogenic rearrangement in the NUTM1 gene. Many fusion partners occur, and NSD3 is NUT carcinoma’s third most common partner. Herein, we present a case of a 26-year-old man with an NSD3::NUTM1 fusion sarcoma. The patient presented at the age of 13 months with a scalp nodule. Over the next 24 years, he experienced five local recurrences and ultimately expired of a rapidly progressive recurrence. His treatment included surgical resections, radiation, …

Association Between Opioid-Benzodiazepine Trajectories And Injurious Fall Risk Among Us Medicare Beneficiaries., Grace Hsin-Min Wang, Juan M. Hincapie-Castillo, Walid F. Gellad, Bobby L. Jones, Ronald I. Shorr, Seonkyeong Yang, Debbie L. Wilson, Jeannie K. Lee, Gary M. Reisfield, Chian K. Kwoh, Chris Delcher, Khoa A. Nguyen, Christopher A. Harle, Zachary A. Marcum, Wei-Hsuan Lo-Ciganic

Pharmacy Practice and Science Faculty Publications

Background/Objectives: Concurrent opioid (OPI) and benzodiazepine (BZD) use may exacerbate injurious fall risk (e.g., falls and fractures) compared to no use or use alone. Yet, patients may need concurrent OPI-BZD use for co-occurring conditions (e.g., pain and anxiety). Therefore, we examined the association between longitudinal OPI-BZD dosing patterns and subsequent injurious fall risk. Methods: We conducted a retrospective cohort study including non-cancer fee-for-service Medicare beneficiaries initiating OPI and/or BZD in 2016-2018. We identified OPI-BZD use patterns during the 3 months following OPI and/or BZD initiation (i.e., trajectory period) using group-based multi-trajectory models. We estimated the time to first injurious falls …

Processes For Identifying Caregivers And Screening For Caregiver And Patient Distress In Community Oncology: Results From Wf-1803cd., Chandylen L. Nightingale, Anna C. Snavely, Laurie E. Mclouth, Emily V. Dressler, Erin E. Kent, Christian S. Adonizio, Suzanne C. Danhauer, Rachel Cannady, Judith O. Hopkins, Heather Kehn, Kathryn E. Weaver, Katherine R. Sterba

Behavioral Science Faculty Publications

BACKGROUND: Despite their vital roles, informal caregivers of adult cancer patients are commonly overlooked in cancer care. This study describes processes for identifying cancer caregivers and processes for distress screening and management among caregivers and patients in the understudied community oncology setting.

METHODS: Supportive care leaders from the National Cancer Institute Community Oncology Research Program practices completed online survey questions regarding caregiver identification, caregiver and patient distress screening, and distress management strategies. We described practice group characteristics and prevalence of study outcomes. Multivariable logistic regression explored associations between practice group characteristics and caregiver identification in the electronic health record (EHR). …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Managing Hazardous Waste Pharmaceuticals In Healthcare: A Perplexing Prescription, Garrison Rosser

Kentucky Journal of Equine, Agriculture, & Natural Resources Law

No abstract provided.

The Distribution Of Cp-Cre Cases From 2013-2020 In The Commonwealth Of Kentucky, Hannah Hiscox

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Multidrug-resistant organisms (MDROs), particularly Carbapenem-Resistant Enterobacterales (CRE), pose a significant threat to public health due to their resistance to multiple antibiotics, including carbapenems. CRE infections, especially those producing carbapenemases (CP-CRE), are associated with high morbidity and mortality rates, making them a growing concern in healthcare settings. Despite the prevalence of CRE infections in the United States, limited data exist on the incidence and distribution of CP-CRE infections in specific regions, such as the Appalachian counties of Kentucky.

This study aimed to investigate the cumulative incidence and distribution of CP-CRE cases in Appalachian and non-Appalachian counties of Kentucky, as well as …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Understanding Intention And Behavior Of Practicing Yoga Through The Lens Of Theory Of Planned Behavior Specifically In Rural Communities; A Qualitative Study, Shelley Meyer

Theses and Dissertations--Kinesiology and Health Promotion

While there are known health benefits for participating in yoga, little has been studied on the intention and behavior for why individuals practice yoga especially through a theoretical lens and intense qualitative thematic analysis. Targeting the rural community considers other extenuating circumstances experienced by rural residents that can impact yoga participation in rural areas. Interviews were used to gain insight into a holistic viewpoint with the rich data bringing clarity to an individual’s thought process (of intention) to incorporate yoga (behavior) in their daily life. Utilizing the Theory of Planned Behavior as the theoretical framework for developing interview questions allowed …

Humor Matters: An Adapted Multiple Case Study Exploring Music Therapists’ Perspectives Of Humor With Older Adults, Caleb M. Posey

Theses and Dissertations--Music

Humor is a ubiquitous human experience and a skill retained in older adulthood. It is also an integral but elusive therapeutic tool with numerous benefits and risks to well-being. Therapeutic humor – the application of humor to client well-being – is an emerging area of study. However, scant music therapy literature on humor is available. The purpose of this qualitative thesis was to explore the use and function of humor in music therapy with older adults from the perspectives of experienced music therapists. There were three research questions: (1) how do music therapists describe their use of humor with older …

Formative Musical Experiences Of Older Adult Sexual Minority Women From Rural Areas: An Adapted Case Study, Sabrina Hartsfield

Theses and Dissertations--Music

People often have strong emotional connections between music and memories, which can affect a person’s identity and self-concept. The deep meaning that individuals find within music that is important to them helps music therapists to make connections to clients and to work with clients to understand their experiences through the lens of music. The purpose of this project was to examine in depth the musical experiences of sexual minority women aged 65 and older from rural areas, and to see how musical experiences may have impacted their identity. In this adapted case study, I conducted in-depth one-on-one interviews and constructed …

Expert Perceptions Of Needs Of Pregnant Individuals With Substance Use Disorder In Kentucky: A Qualitative Multiple Case Study, Emma Foret Latham

Theses and Dissertations--Music

Substance misuse is a pandemic with far reaching effects on those personally affected, their families, and their communities. Kentucky has one of the highest rates of substance use disorder (SUD) in the country, and most research has focused on how to help men in recovery. There is very little research regarding how to support pregnant individuals with SUD. The purpose of this qualitative thesis was to identify the perceived needs of pregnant individuals with SUD, define characteristics of effective care, and learn how music therapists can support this population in substance use rehabilitation settings from the perspectives of experienced professionals. …

A Community-Engaged, Mixed-Methods Approach To Prioritizing Needs In A Statewide Assessment Of Community Cancer Needs, Jessica R. Thompson, Todd Burus, Caree R. Mcafee, Christine Stroebel, Madeline Brown, Keeghan Francis, Melinda Rogers, Jennifer Redmond Knight, Elaine Russell, Connie L. Sorrell, Elizabeth A. Westbrook, Pamela C. Hull

Markey Cancer Center Faculty Publications

Introduction Kentucky has the highest all-site cancer incidence and death rate in the US. In 2021, the University of Kentucky Markey Cancer Center convened a steering committee to conduct a statewide community cancer needs assessment (CNA). The goal of the final CNA phase was to gather community input on prioritizing Kentucky’s cancer-related needs and ways to address them. Methods In 2021, we recruited 162 people to participate in online concept mapping, a participatory mixed method, to explore connections and identify priority areas. Fifty-one community members and 111 organizational partners participated in survey-based activities to prioritize 80 items representing key CNA …

Mediators Of The Association Between Cognitive Function And Self-Care Behaviors In Patients Hospitalized With An Exacerbation Of Heart Failure, Jia-Rong Wu, Chin-Yen Lin, Abigail Latimer, Muna Hassan Hammash, Debra K. Moser

UK CARES Faculty Publications

Background: Patients with heart failure (HF) must engage in self-care, yet their self-care is often poor. Cognitive function commonly is impaired in HF and is associated with poor self-care. Heart failure knowledge and self-care confidence also are needed to preform self-care. Few investigators have examined mediators of the association of cognitive function with self-care.

Objectives: The aim of this study was to determine whether HF knowledge and self-care confidence mediated the association of cognitive function with self-care maintenance and management among patients with HF.

Methods: This was a cross-sectional observational study of 164 patients with HF. Cognitive function was assessed …