Introducing An Eating Disorder Protocol In The Pediatric Primary Care Setting, Brandi Bozarth

DNP Projects

Background: The incidence of eating disorders has been on the rise, often beginning in adolescence and continuing well into adulthood. Consequences of untreated disrupted eating patterns can affect multiple body systems and are responsible for thousands of deaths annually. Despite these facts, research and data regarding eating disorders in adolescent patients are severely deficient. There is also a lack of standardization regarding assessing eating disorders in the pediatric primary care setting, as there are no specific guidelines or screening processes recommended by the American Academy of Pediatrics for the detection of eating disorders.

Purpose: The purpose of this project is …

Evaluating The Implementation Of Social Determinants Of Health Screening In An Interdisciplinary Clinic, Taylor M. Adams

DNP Projects

Background: Social Determinants of Health (SDOH), including food, housing, interpersonal violence, and transportation are non-medical problems that can influence health outcomes (World Health Organization, 2020). Low-income minorities and public-payer groups are at considerable higher risk for social needs. Collaboration within the community can improve health outcomes (Sulley et al., 2021). A literature review revealed limited evidence of screening in dental clinic settings. Failure to identify and address SDOH needs in this population can lead to poorer health outcomes.

Purpose: The purpose of this quality improvement project was to implement and evaluate social determinants of health screening and evaluate the …

Evaluating The Outcomes Of An Educational Intervention For Providers And Two-Week Home Blood Pressure Monitoring In Adults, Michelle Ann Schuler

DNP Projects

Abstract

Background: Approximately 1.28 billion adults worldwide have hypertension (HTN), which greatly increases the risk of morbidity and premature death. Home blood pressure monitoring (HBPM) has been shown to increase efficacy of treatment decisions, but is underused in primary care. About 46% of adults are unaware that they have hypertension and only about 21% of those who have been diagnosed have it controlled.

Purpose: The purpose of this project is to evaluate a previous practice improvement project and improve the HBPM process for sustainability.

Methods This HBPM study utilized a retrospective study design combined with a practice improvement project …

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 …

Primary Nurse Framework: All-Registered Nurse Staffing Model In A Twelve Bed Critical Care Unit, Jeanette E. Sanders

DNP Projects

Background: Registered Nurses (RNs) comprise one of the largest professions in healthcare, and they play a critical role in delivering patient-centered care. The nursing shortage exacerbates inadequate nurse staffing levels, leading to increased workloads, higher patient-to-nurse ratios, and a high-stress work environment.

Purpose: This project aimed to evaluate the implementation of a primary-nurse-led care delivery model with an all-RN staffing design and its effects on nurse-sensitive patient outcomes, patient length of stay, nurse-sensitive related outcomes, and associated financial implications in the Intensive Care Unit (ICU) setting. Nursing knowledge and opinions about the all-RN staffing model were also assessed.

Methods: Staffing …

Evaluating The Effect Of A Mindfulness App On Pediatric Nurses Caring For Adolescent Patients Diagnosed With Disordered Eating, Kaitlyn Green

DNP Projects

Abstract

Background. The health and wellbeing of nurses are affected by the demands of their workplace and the people that they care for. In turn, nurses’ wellbeing affects their work and patient outcomes. There are opportunities to address certain workplace structures, systems, and policies that create stressors and lead to burnout, fatigue, and poor mental and physical health. For nurses to continue to provide quality care in environments that have increasing demands, they must first feel healthy, well, and supported themselves. Healthcare leaders have a role in ensuring the wellbeing of their nursing staff. Compassion fatigue is a large focus …

The Impact Of Code Lavender On Compassion Fatigue And Burnout Of Pediatric Bedside Staff, Sara L. Castle

DNP Projects

Background: Compassion fatigue is a significant problem in healthcare that can impact staff retention, job satisfaction, and patient outcomes. Code Lavender combats compassion fatigue by serving as a crisis intervention tool using evidence-based relaxation techniques, paired with increased support from Leadership.

Purpose: The purpose of this project was to evaluate the impact of Code Lavender on reported levels of compassion fatigue and burnout amongst pediatric bedside staff working on a 12-bed progressive care unit at a Children’s Hospital in a large Academic Medical Center.

Method: This study employed a pilot evaluation design, consisting of pre- and post-surveys utilizing questions from …

Evaluation Of A Brief Mindfulness-Based Intervention Of Work-Related Stress, Job Satisfaction, Retention, And Quality Care: A Quality Improvement (Qi) Project, Laura M. Bragg

DNP Projects

Burnout among advanced practice providers (APPs) remains a significant concern nationally and within the University of Kentucky Healthcare system, with post-COVID evidence showing persistently elevated stress and emotional exhaustion. This quality improvement (QI) project implemented and evaluated a brief, app-based mindfulness intervention using the Headspace “Learn the Basics of Meditation” program for work-related stress, job satisfaction, mindfulness, and retention intentions among APPs. A one-group pre-post design was implemented, with 45 APPs completing the pre-intervention survey and four completing both the pre- and post-intervention surveys. Although no statistically significant improvements were observed, nonsignificant decreases in emotional exhaustion, fatigue, and turnover intention …

Evaluating Preoperative Care Providers' Perceptions Of The Autism Support Checklist For Surgical Patients With Autism Spectrum Disorder, Amanda Hancock

DNP Projects

Abstract

Background: Individuals with autism spectrum disorder (ASD) are more likely to report barriers to healthcare access than individuals with other disabilities and non-autistic persons. Many barriers to healthcare for those on the spectrum have been identified and include: negative interactions with healthcare staff, communication barriers with healthcare providers, lack of providers knowledgeable of ASD, sensory concerns, and difficulty navigating the healthcare system. The Autism Support Checklist (ASC) is a tool designed to outline communication methods, sensory concerns, soothing items/actions, triggers, special interests, safety concerns, and other information pertinent to an autistic patient. The tool is designed to convey the …

Zoysiagrass Tolerance To Selective Herbicides For The Removal Of Bermudagrass And The Distribution Of The Annual Bluegrass Weevil (Listronotus Maculicollis) In Kentucky, Kenneth D. Clayton

Theses and Dissertations--Plant and Soil Sciences

Bermudagrass (Cynodon dactylon) may be a problematic weed within zoysiagrass (Zoysia spp.) swards across its entire range. The objective of this study was to determine the efficacy of the herbicide safener metcamifen + trifloxysulfuron-sodium, in conjunction with fluazifop-P-butyl, at removing bermudagrass from zoysiagrass and how varying levels of treatment affected bermudagrass control and zoysiagrass tolerance. Field studies tested rates of metcamifen + trifloxysulfuron-sodium applied with fluazifop-P-butyl compared to treatments of fluazifop alone and fenoxaprop with triclopyr. All treatments controlled bermudagrass, and treatments with the herbicide safener remained under the 20% injury threshold for zoysiagrass for ≤ to 15 days compared …

Advancing Root Trait Measurements For A Deeper Understanding Of Soil Biogeochemistry, Brian Rinehart

Theses and Dissertations--Plant and Soil Sciences

Climate change is disrupting (agro)ecosystems, with the potential for significant losses in crop productivity and ecosystem resilience due to changes in water and biogeochemical cycling. These disruptions can also release more carbon dioxide into the atmosphere through the degradation of soil organic matter. Plant roots have emerged as a potential tool for mitigating these effects, given their roles in plant function and in driving soil biogeochemistry. While this interest is growing, our ability to implement root trait selection is limited due to constraints on characterizing roots and limited clarity on the effects of traits on plant and ecosystem function. My …

Giving Props To Soil Property Predictive Models: Utilizing Mir To Predict Soil Health Properties, Diala M. Abboud

Theses and Dissertations--Plant and Soil Sciences

Soil health is critical to sustaining life on Earth, influencing plant growth, agricultural productivity, water quality, and overall ecosystem sustainability. In response to climate change and intensifying land use, the need to improve our understanding of soil health has become increasingly urgent. The application of mid-infrared (MIR) spectroscopy coupled with statistical modeling has emerged as a promising, cost-effective approach to predict soil health parameters, offering a quicker alternative to traditional wet chemistry analyses. MIR methods have been successfully applied to predict various soil health properties, such as bulk density (BD), cation exchange capacity (CEC), base saturation (BS), electrical conductivity (EC), …

The Effects Of Technology-Based Self-Monitoring Intervention To Increase On-Task Behaviors For Adolescents With Intellectual And Developmental Disabilities, Deris Cox Jr

Theses and Dissertations--Educational, School, and Counseling Psychology

This study aims to assess the effects of technology-based self-monitoring interventions and to promote independent functioning skills for adolescents with intellectual and developmental disabilities (IDD). It also seeks to replicate the findings of Rosenbloom et al. (2019). IDD typically appears in adolescents before the age of 18 and affects an individual’s ability to learn, reason, and manage daily tasks. Behavior analysis is a common approach used to teach individuals with developmental disabilities new skills, decrease challenging behaviors, and enhance quality of life.

Characterization Of The Solid-State Bonding For Simulated Charge And Seam Welds In The Porthole Die Extrusion Process, Randall L. Bowers

Theses and Dissertations--Chemical and Materials Engineering

The isothermal (ISO-T) compression configuration is ideal for utilizing as a material input of flow stress at temperature and strain rate in models of the porthole die extrusion process due to the isothermal nature of the test. Micro-tensile testing was conducted to validate the solid-state welding integrity of the ISO-T samples at various temperatures and strain rates. Results of the mechanical testing were correlated with fractography and microstructural evaluations of the welds to confirm bonding behavior. Both clean interface conditions and oxidation and lubrication layers were evaluated to simulate the difference of seam and charge welds in the process. Results …

Computational Modeling Of The Heat Treatment Of White Oak Bound For Spirit Maturation, Kate E. Mclarney-Popham

Theses and Dissertations--Chemical and Materials Engineering

Maturation of distilled spirits in white oak barrels is a long standing practice known to have great impact on spirit character. Much of this impact can be controlled by the thermal modification of the barrel, since thermal degradation of the wood determines what wood compounds are available to interact with the spirit during maturation. In this work, a computational model for the thermal degradation of wood was developed and, with flavor compound data from literature, was used to investigate the effect of heat treatment on lignin-derived flavor compounds. The computational model in this work accounted for three solid species, three …

The Optimization And Manufacturing Scale-Up Of Polymeric Membranes Using Eco-Friendly Solvents, David Lu

Theses and Dissertations--Chemical and Materials Engineering

Polymeric membranes have become a prominent technology applied in water filtration due to the lower cost, energy input, and simpler manufacturing process relative to other separation technologies. However, the environmental impact of polymeric membrane fabrication remains a hindrance due to the use of hazardous solvents derived from fossil fuels (e.g., DMAc, NMP, DMF) that pose a risk to the environment and human health. Whereas recent studies have demonstrated the proof-of-concept of polymeric membrane derived from eco-friendly solvents, the next steps of optimizing and upscaling the production of these membranes remains understudied and a gap between lab-scale studies and the path …

Combinatorial Thin Film Approach To Accelerate Materials Discovery: Development Of Nanoporous And Bulk Multi-Principal Element Alloys, Tibra Das Gupta

Theses and Dissertations--Chemical and Materials Engineering

Multi-principal element alloys (MPEAs) have garnered significant attention in materials science due to their potential for exhibiting a combination of desirable properties stemming from their unique configurational entropy. While early research focused on equiatomic compositions, recent studies have indicated that non-equiatomic MPEAs may offer superior mechanical performance. However, the identification of optimal non-equiatomic compositions remains challenging due to the vast compositional space and the reliance on time-consuming and computationally expensive methods. This dissertation presents a combinatorial thin film approach as a rapid and efficient strategy for discovering two types of materials: nanoporous and bulk MPEAs.

The first study explores the …

Impact Of Catastrophic Brain Injury Guidelines On Organ Donation Rates, Kristen D. Nordham, Danielle Tatum, Abdallah S. Attia, Mayur B. Patel, Anil Paramesh, Juan C. Duchesne, Jeffry Nahmias, Amelia W. Maiga, Allan B. Peetz, Pascal O. Udekwu, Anquonette Stiles, Chloe Shell, Joshua D. Stodghill, Taneen Maghsoudi, Erin Iacullo, Bryant Mclafferty, Erin Coonan, Ryan M. Boudreau, Steven A. Zimmerman, Berje Shammassian, Tanya Egodage, Isabella Aramento, Patrick Morris, Jacob Metheny, Michael S. Farrell, Matthew D. Painter, Owen T. Mccabe, Philomene Spadafore

Surgery Faculty Publications

BACKGROUND One third of organ donors suffer catastrophic brain injury (CBI). There are no standard guidelines for the management of traumatic CBI prior to brain death, and not all trauma centers have institutional CBI guidelines. In addition, there is high variability in management between institutions with guidelines. Catastrophic brain injury guidelines vary and may include various combinations of hormone therapy, vasopressors, fluid resuscitation, and other practices. We hypothesized that centers with CBI guidelines have higher organ donation rates than those without. METHODS This prospective, observational EAST-sponsored multicenter trial included adult (18+ years old) traumatic-mechanism CBI patients at 33 level I …

Long-Term Air Pollution Exposure And The Risk Of Primary Graft Dysfunction After Lung Transplantation, Tatsuki Koyama, Zhiguo Zhao, John R. Balmes, Carolyn S. Calfee, Michael A. Matthay, John P. Reilly, Mary K. Porteous, Joshua M. Diamond, Jason D. Christie, Edward Cantu, Lorraine B. Ware

Surgery Faculty Publications

Background: Primary graft dysfunction (PGD) contributes substantially to both short- and long-term mortality after lung transplantation, but the mechanisms that lead to PGD are not well understood. Exposure to ambient air pollutants is associated with adverse events during waitlisting for lung transplantation and chronic lung allograft dysfunction, but its association with PGD has not been studied. We hypothesized that long-term exposure of the lung donor and recipient to high levels of ambient air pollutants would increase the risk of PGD in lung transplant recipients. Methods: Using data from 1428 lung transplant recipients and their donors enrolled in the Lung Transplant …

The Physiology Of Exercise, Rosie Lanphere

Open Educational Resources

The Physiology of Exercise (3rd Edition) is an essential resource for upper-level undergraduates studying exercise science. Written by Rosie Lanphere, PhD, CSCS, this text provides a clear and comprehensive exploration of how the human body responds and adapts to physical activity.

Covering metabolism, energy expenditure, and the integrated roles of the nervous, cardiovascular, endocrine, muscular, and respiratory systems, this edition reflects the latest research and practical applications in the field.

Designed with students in mind, each chapter includes learning objectives, key terms, and scholarly questions to reinforce understanding. Whether preparing for a career in exercise science or professional certification, this …

Secondhand Tobacco Smoke Exposure And Sleep Disturbance In School-Aged Children In Appalachian Ohio, Ketrell Mcwhorter, Christine Kim, Timothy J. Hilbert, Danielle E. Mcbride, Anthony A. Mangino, Patrick J. Parsons, Kurunthachalam Kannan, Erin N. Haynes

Epidemiology and Environmental Health Faculty Publications

Introduction: Secondhand tobacco smoke (SHS) exposure remains a major public health concern for children and has been implicated in sleep disturbances through biological and behavioral mechanisms. Different methods of measuring SHS exposure have yielded inconsistent results. This study examined the relationship between SHS exposure and sleep among rural Appalachian 7–9-year-olds, utilizing three SHS measurements: natural log-transformed (ln) serum cotinine concentrations, dichotomized serum cotinine levels (≥0.05 vs. <0.05 ng/ml), and parent/caregiver report of ≥1 smoker in the home. We hypothesized SHS-exposed children would have a significantly higher prevalence of sleep disturbance—e.g., short sleep, frequent snoring, night awakenings—compared to unexposed, regardless of measurement method. Methods: We used data from the Marietta Community Actively Researching Exposure Study, a cohort of 404 children in Marietta and Cambridge, Ohio. Sleep disturbances were parent/caregiver-reported. Linear models were used for continuous outcomes to estimate beta coefficients; log-binomial models with generalized estimating equations (exchangeable correlation) were applied for dichotomized outcomes to estimate prevalence ratios (PR), each with 95% confidence intervals (CI). Results: Twenty-six percent of children had a parent/caregiver report of ≥1 sleep disturbance. There was a 35% increased prevalence of short sleep [PR = 1.35 (95%CI:1.02–1.80), p =.04] with each unit increase of ln serum cotinine levels, adjusting for age, sex, parent education, BMI percentile, and history of breathing difficulties in the past two years. Increasing ln serum cotinine levels were associated with a significant 5.5-min decrease in average sleep duration in age-adjusted models. Conclusions: Higher SHS exposure was associated with poorer sleep outcomes, with serum cotinine emerging as the only measure linked to short sleep, underscoring the importance of smoke-free environments, particularly in rural communities, and objective exposure assessment.

Incarceration Reimagined: A Diversionary Option For Serious Felony Offenders, Jane Mitchell

Kentucky Law Journal

No abstract provided.

Effects Of Heat Stress On The Accuracy Of An Ear-Tag Accelerometer For Monitoring Rumination And Eating Behavior In Dairy-Beef Cross Cattle Using An Automated Gold Standard, Jennifer R. Weinert-Nelson, Jessica Werner, Alayna A. Jacobs, Les Anderson, Carey A. Williams, Brittany E. Davis

Animal and Food Sciences Faculty Publications

Accelerometer-based technologies can be used for precision monitoring of feeding behaviors, but limited information is available regarding the effect of varying environmental conditions on sensor performance. The objective of this study was to determine if a commercially available ear-tag sensor (CM; CowManager SensOor, Agis Automatisering BV) could accurately quantify eating and rumination time under heat stress conditions. Data obtained from CM sensors was compared with data collected using an automated gold standard (RW; Rumiwatch System; Itin+Hoch). Automated measurements were obtained from 2 experiments in which cattle were exposed to heat stress conditions. In the principal study (experiment 1), 3,428 h …

A Comparison Of Fecal Output Determined By Total Fecal Collection Or Titanium Dioxide In Horses, Ashley L. Fowler, Morgan B. Pyles, Susan H. Hayes, Andrea D. Crum, Laurie M. Lawrence

Animal and Food Sciences Faculty Publications

Total fecal collection studies to determine digestibility of nutrients are costly and laborious. The use of externally dosed indigestible markers, such as titanium dioxide (TiO₂), to estimate digestibility using spot samples could be advantageous, but studies validating their use in horses are inadequate. Two experiments were conducted to determine if TiO₂ in fecal spot samples effectively estimated fecal output in horses. In Exp. 1, four mature horses were fed a forage-based diet (85:15 forage: concentrate) split into two equal meals with 1.75±0.03g TiO₂/kg DM (10g TiO₂) per day top-dressed on their daily ration. …

Determining The Effects Of Light, Oxygen Diffusion, And 4-Hydroxy-2-Nonenal On Redox Stability Of Beef And Pork Oxymyoglobins, Rishav Kumar, Surendranath P. Suman, Runnan Li, Morgan M. Pfeiffer, Gretchen G. Mafi, Ranjith Ramanathan

Animal and Food Sciences Faculty Publications

Retail light conditions influence consumers’ perception of meat color. Previous studies have shown that lipid and myoglobin oxidation are interrelated. 4-Hydroxy-2-nonenal (HNE)-induced beef and pork oxymyoglobin (OxyMb) oxidation is influenced by pH, temperature, and atmospheric oxygen partial pressure. However, limited knowledge is available on the effects of HNE on myoglobin redox stability under light/dark and aerobic/anaerobic (either allow or not allow atmospheric oxygen in contact with myoglobin solution) systems. Therefore, the objective was to examine the effects of light and dark storage conditions (experiment 1) as well as to compare aerobic and anaerobic systems (experiment 2) on HNEinduced beef and …

Factors Of Willingness To Pay For Equine Veterinary Services, Olivia Gibson, Shuoli Zhao, C. Jill Stowe

Animal and Food Sciences Faculty Publications

This study estimates correlates of willingness-to-pay (WTP) for routine, elective, and urgent equine veterinary services in the United States. Through a nationwide online survey of US horse owners aged 18 and older, a payment card approach was utilized to elicit WTP for annual vaccinations, a lameness exam, and emergency colic surgery. Based on the results from an interval regression model, we found that financial capacity, income level, and the number of horses owned were significant predictors of WTP across all three service types. These findings have implications for equine veterinary practice management and client communication regarding treatment costs.

Resilience After Prenatal Substance Exposure: Exploring The Role Of Cumulative And Specific Protective Factors In Predicting Toddlerhood Temperament Profiles, Anjeli Elkins

Theses and Dissertations--Psychology

Objective

Prenatal exposure to common substances, including nicotine, marijuana, cocaine, methamphetamine, opiates, and alcohol, has been linked to a wide range of psychiatric disorders and neurodevelopmental impairments. Identifying protective factors that may improve temperament profiles in toddlers who have experienced prenatal substance exposure may protect against these adverse outcomes and is crucial for developing targeted early interventions.

Methods

Participants (n=92; Mage = 28.7 years; 47.0% White) were biological mothers of toddlers (Mage = 22.6 months) with prenatal substance exposure. Mothers responded to an online survey that gathered information on substance use during pregnancy, proposed perinatal protective factors, and child temperament. …

Responses To Tobacco Use Screening And Tobacco Cessation Assistance Offers Among Rural And Ubran Cancer Survivors At An Nci-Designated Comprehensive Cancer, Abigayle Feather

Theses and Dissertations--Psychology

Smoking after cancer diagnosis is associated with poor outcomes while smoking cessation can improve quality of life and promote survival. Although there are calls for equitable tobacco treatment delivery in cancer and other healthcare settings, disparities in tobacco-related disease burden persist. In the context of an outpatient cancer center’s population-based tobacco treatment program, this study examines the association between cancer survivors’ rural and Appalachian residence and 1) current tobacco use status, 2) decision to decline cessation assistance, and 3) reason for declining assistance. A cross-sectional, retrospective analysis was conducted using electronic health record data from 16,839 adults (64.04% female, 88.49% …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Global Sleep Quality, Emotion Regulation Difficulties, And Ptsd Symptom Severity In Trauma-Exposed College Women, Grace M. Seymour

Theses and Dissertations--Psychology

Sleep problems are common among college women and may contribute to PTSD symptoms. Those with emotion regulation difficulties may have increased difficulty managing distress worsened by poor sleep, though it is unclear which specific facets of emotion regulation are most relevant. This study examined interactions between sleep quality and facets of emotion regulation difficulties on PTSD symptoms among college women (N = 1,037) using self-report measures: the Pittsburgh Sleep Quality Index (PSQI), PTSD Checklist for DSM-5 (PCL-5), and Difficulties in Emotion Regulation Scale (DERS-18). Two significant interactions emerged. Sleep disturbance interacted with difficulties engaging in goal-directed behavior (b …