Digital Commons Network^™

International Physical Therapists Consensus On Clinical Descriptors For Diagnosing Rotator Cuff Related Shoulder Pain: A Delphi Study., Néstor Requejo-Salinas, Jeremy Lewis, Lori A Michener, Roy La Touche, Rubén Fernández-Matías, Juan Tercero-Lucas, Paula Rezende Camargo, Marcus Bateman, Filip Struyf, Jean-Sébastien Roy, Anju Jaggi, Timothy Uhl, Leanne Bisset, Craig A Wassinger, Robert Donatelli, Melina Nevoeiro Haik, Enrique Lluch-Girbés

Physical Therapy Faculty Publications

BACKGROUND: There is a lack of standardized criteria for diagnosing rotator cuff related shoulder pain (RCRSP).

OBJECTIVE: To identify the most relevant clinical descriptors for diagnosing RCRSP.

METHODS: A Delphi study was conducted through use of an international physical therapists expert panel. A 3-round Delphi survey involving an international panel of physical therapists experts with extensive clinical, teaching, and research experience was conducted. A search query was performed in Web of Science, along with a manual search, to find the experts. The first round was composed of items obtained from a previous pilot Delphi study along with new items proposed …

Efficacy Of Power Training To Improve Physical Function In Individuals Diagnosed With Frailty And Chronic Disease: A Meta-Analysis, Alexander B. Sklivas, Lauren E. Robinson, Timothy L. Uhl, Esther E. Dupont-Versteegden, Kirby P. Mayer

Physical Therapy Faculty Publications

Muscle power training with emphasis on high-velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail …

Bending The Elbow During Shoulder Flexion Facilitates Greater Scapular Upward Rotation And A More Favorable Scapular Muscle Activation Pattern, Alon Rabin, Brakha R. Tabi, Timothy L. Uhl, Zvi Kozol

Physical Therapy Faculty Publications

Context: Decreased scapular upward rotation (UR) and diminished activation of the serratus anterior (SA) and lower trapezius (LT) are often observed among patients with subacromial impingement syndrome. Maintaining the elbow fully flexed during shoulder flexion may limit glenohumeral motion due to passive insufficiency of the triceps brachii and therefore facilitate greater scapular UR and increased scapular muscle activation. Objectives: To compare scapular UR, SA, upper trapezius (UT), middle trapezius, and LT activation levels between shoulder flexion with the elbow extended (Flexion-EE) to shoulder flexion with the elbow fully flexed (Flexion-EF). This study hypothesized that Flexion-EF would result in …

Effect Of Communication And Time Spent With Children On The Parenting Difficulties Of Single Parents In Korea, Ki Jeong Park

MPA/MPP/MPFM Capstone Projects

This research aims to analyze the effect of the time spent with children and the degree of communication with children on the difficulties of parenting children by single parents in Korea. As for the single parents' parenting difficulties, economic hardships have been widely discussed. However, not many studies examined other psychosocial factors between single parents and children, such as the problem of communication between parents and children and the lack of time spent with parents and children, despite their importance in parenting children. This study claims that the focus of public policies, governmental support, and non-profit organizations' roles to resolve …

Covid-19 And Advanced Course Enrollment: Kentucky High Schools, Jessica Thomas

MPA/MPP/MPFM Capstone Projects

In Kentucky governments, districts, and schools made decisions about school closures and mode of learning that would impact community health as well as student achievement. Within those schools, students themselves were also making decisions that could impact their futures academically. In spring 2020, students were choosing their courses for the following year. Vast uncertainty about what the 2020/2021 school year would look like had the potential to impact those decisions. Disruptions to spring 2020 classes could also impact whether a student felt they had learned the prerequisite skills needed to pursue advanced coursework. This study found that advanced course enrollment …

Effect Of Trust And The Covid-19 Pandemic On Nonprofit Collaboration With Food Insecurity Services In Kentucky, Aaron Brewer

MPA/MPP/MPFM Capstone Projects

Food insecurity in Kentucky is at a crisis point. As a result of the COVID-19 pandemic and recent natural disasters, it has only gotten worse. Nonprofit organizations that focus on food insecurity are fighting to fill the gap between federal and state programs but still struggle to find enough resources as demand grows. In order to help achieve their strategic missions, organizations often engage in collaboration with one another. The COVID-19 pandemic fundamentally changed the landscape of many services and businesses across the world and certainly in Kentucky. Food insecurity organizations were faced with new challenges because of the health …

What Impact Does The Nursing Shortages Have On The Financial Health Of The Kentucky Healthcare System?, Michelle Cooper

MPA/MPP/MPFM Capstone Projects

This study investigates how the nursing shortage affects the financial health of healthcare systems. Further, it examines the economic impact that healthcare systems face due to the nursing shortage and what they are doing to cope during this time to meet their nursing staff needs. The study focuses on hospitals in Kentucky and compares Kentucky to other states in the United States. This research aims to determine how the nursing shortage financially impacts Kentucky hospitals. The main question that this research paper will address is what impact do the nursing shortages have on the financial health of the healthcare system? …

Evaluating Pharmacy Student Opinions Of The Kentucky Professionals Recovery Network, Abby Kosharek

MPA/MPP/MPFM Capstone Projects

Healthcare professionals have similar rates of substance use disorders as the general population. Healthcare professionals are in a unique position because their substance use disorder affects them and may affect their patients. Substance use disorders among healthcare professionals can result in lawsuits and loss of licensure. Kentucky Professionals Recovery Network (KYPRN) provides healthcare professionals with substance use disorders services and programs to help them recover from their disorder. Unfortunately, the University of Kentucky College of Pharmacy no longer provides education on the Kentucky Professionals Recovery Network in its formal curriculum. Instead, students are expected to gain this knowledge via experiential …

Evaluating The Shift From Income Taxes To Sales And Use Taxes In Kentucky, Benton Kirby

MPA/MPP/MPFM Capstone Projects

House Bill 8 is set up to lower the state's individual income tax from 5% down to 0%. The bill is set up when revenue and rainy-day funds reach a certain level. The state's individual income tax will decrease each year the requirements are met. In addition, the bill has several services that will be subject to the state sales tax to raise tax revenues to offset the revenue loss that decreasing the state income tax would impact the state. However, the Kentucky Legislature Research Committee estimates that the fiscal impact of a net loss of $1.15 billion of tax …

Economic Development Plans: Creating Remote Worker Incentive Programs, Sadie Barton

MPA/MPP/MPFM Capstone Projects

The decrease in population growth is impacting states and localities across the United States and is anticipated to continue in the future. To address this issue, some areas have created remote worker incentive programs to attract new residents as part of their economic development plans. Although few programs existed before 2020, the Covid-19 pandemic created an opportunity for employees to work remotely more than any other time in history. This resulted in a significant increase in remote worker incentive programs being created. These programs are designed to attract new residents to their area which in turn will have economic impacts …

Medicaid Expansion: The Choice Afforded To States By The Affordable Care Act, Robert M. Hatfield

MPA/MPP/MPFM Capstone Projects

The issue I studied is the decision states have been afforded to expand Medicaid with the Affordable Care Act (ACA). I was curious to determine the health and economic impact on states that have and have not chosen to expand Medicaid. Specifically, I targeted Kentucky (expansion state) and Tennessee (non-expansion state). Tennessee and Kentucky are similar populations, have similar political inclinations, and are both very rural states. At its core, Medicaid expansion is an opportunity to improve health for lower-income and disabled Americans. However, there are economic implications associated with Medicaid expansion as well. The goal of this research is …

Prevalence Of Alcohol-Interactive Medications And Conditions With Concurrent Alcohol Use In Older Adults, Jackson Hull

MPA/MPP/MPFM Capstone Projects

Many prescription medications can either directly or indirectly interact with alcohol and many chronic conditions may be worsened by alcohol use. Medications, such as antihypertensives, anticoagulants, and gastrointestinal agents, can be dangerous when taken with alcohol and can lead to loss of consciousness, falls, serious bleeding and other issues. Chronic conditions, such as gastroesophageal reflux disease, hypertension and cirrhosis can directly be worsened with alcohol consumption. These potential complications are pertinent to all ages, but there is greater concern of these interactions in older adults, defined as adults over 65 years old. Using survey data from older adults in Lexington, …

Forced Treatment Orders With Long-Acting Injectable Antipsychotics: Are They Forcing Implicit Biases?, Hunter Matthews

MPA/MPP/MPFM Capstone Projects

Involuntary treatment is a lengthy legal process through which an individual that is deemed to be a danger to themselves or to others is forced to receive psychiatric treatment against their will. Often, involuntary treatment utilizes a medication called a long-acting injectable antipsychotic (LAI). With the rise of implicit bias awareness as of late, there has been new research showing that Black patients receive LAIs at disproportionate rates compared to White patients. There has not been research, however, to show the impact of diversity, equity, and inclusion (DEI) training of healthcare providers on the utilization rate of LAIs among the …

Analysis Of Regulatory Options To Reduce Ethylene Oxide Emissions In Southern Louisiana, Claire Oyler

MPA/MPP/MPFM Capstone Projects

Toxic chemicals are dangerous when exposed directly to humans but are often vital for the production of goods and services. Ethylene Oxide is a carcinogenic gas used as a commercial sterilizer and emitted during the manufacturing process of common household goods. The term fence-line communities describes the residents living adjacent to facilities emitting toxic chemicals into the air. Several predominately minority, low-income fence-line communities in Southern Louisiana are exposed to higher than average levels of Ethylene Oxide from nearby manufacturing facilities. This raises environmental justice and overall public health concerns in the area. The Environmental Protection Agency (EPA) is charged …

University Of Kentucky Sustainability Strategic Plan, Sophie Beavin

MPA/MPP/MPFM Capstone Projects

Global climate change is impacting ecosystems, communities, and economies and will continue to do so into the future. To address these issues, sustainable practices and policies are needed on the local and global scale. At the University of Kentucky, sustainability implies that actions are ecologically sound, socially just, and economically viable. Harmonizing these three aspects is critical when developing and implementing sustainability goals on campus. The Office of Sustainability is responsible for coordinating and implementing sustainability policies, actions, and programs for the University of Kentucky. In 2017, they released the first Sustainability Strategic Plan that set goals through 2022. The …

Building An Academic Partnership Through A Strategic Plan: University Of Kentucky Auxiliary Services, Sally Martin

MPA/MPP/MPFM Capstone Projects

The Auxiliary Services department at the University of Kentucky (UK) is a far-reaching department on campus that contains everything from housing to dining to events. If there is an office or activity on campus that provides a service to a student, staff or faculty member, it is most likely within Auxiliary Service’s jurisdiction. Some of the departments and/or offices that fall under this umbrella include all residence halls, dining locations, the Gatton Student Center, University Events Management, and the UK Bookstore. Auxiliary Services also manages the partnerships with external companies that provide services to the campus like housing (Greystar), dining …

Financial Condition Analysis: Louisville Orchestra, Louisville Ballet And Speed Art Museum, Andrew Pashoian

MPA/MPP/MPFM Capstone Projects

Many factors can affect the financial status of a nonprofit entity, but at the core level, financial condition is the ability for an organization (for-profit or not-for-profit) to meet current and future financial commitments. Moreover, further insight into this definition is more complex in nature according to some academics. Maher, Ebdon, and Bartle (2020) mention definitions for financial condition that focus on time. For example, short-term financial health typically focuses on the ability to meet obligations in a 30 to 60-day period with cash on hand. Long term financial condition includes the capacity for an organization to meet annual obligations …

The Occurrence Of Cross Border Riverboat Casino Gambling Between Illinois And Indiana, Andrew N. Jenkins

MPA/MPP/MPFM Capstone Projects

Casino and sports gambling implementation has been a hotly debated topic in recent years as several states have passed legislation allowing it. Most states have had some form of gambling in their state for years even if it is the lottery; however, riverboat gambling is legal in six states. These casinos offering table and electronic gaming are legal as long are they remain moored on the shoreline. For example, table games take the form of poker or blackjack and electronic gaming takes the form of slots. While the introduction of casino gaming produces large annual tax payments, players do not …

Examining Ky Hb8 For 2022: What Can We Learn From Other States’ Experiences?, Patrick Welsh

MPA/MPP/MPFM Capstone Projects

Currently, Kentucky levies an individual income tax on all income earned by Kentucky residents at a rate of 5%. A bill approved in 2022 by the Kentucky legislature, KY HB8 for 2022 will phase down the individual income tax rate from 5% to 0% and expand the sales tax to 39 additional classes of services. Incremental decreases in the individual income tax rate depend on meeting General Fund receipts thresholds established in the bill after an initial reduction of one percentage point. Kentucky will join the ranks of 9 other states that do not impose an individual income tax including …

Irs Form 990 And Opportunity For Improvement, Sarah Bocklen

MPA/MPP/MPFM Capstone Projects

In the contemporary world, IRS Form 990 returns are increasingly being used to source data about the nonprofit sector, which have critical in enhancing the community's social welfare. However, there has been a considerable debate concerning the adequacy, reliability, and quality of the data contained in the document. This study incorporated a total of 150 nonprofit entities from the US to investigate the adequacy, reliability, and quality of Form 990 returns. I used both quantitative and qualitative research methods to evaluate the consistency in the selected data. Selected entries were used for analysis and compared with those of audited financial …

Effects Of Emergency Medical Service Funding Policies In Kentucky, Amber Moreland

MPA/MPP/MPFM Capstone Projects

Emergency medical services is a complicated component in local Kentucky governments. Emergency Medical Services (EMS) operated and managed by local government have various funding mechanisms and each have different methods of reporting. This paper reviews the various ways EMS is funded in Kentucky along with the impact these different funding strategies have on quality and delivery of emergency medical services.

Statewide Educational Achievement Goals: How Has Kentucky’S 60x30 Goal Affected Postsecondary Credential Completion?, Cameron Childress

MPA/MPP/MPFM Capstone Projects

During the past decade, several states have adopted statewide educational attainment goals. Kentucky’s 60x30 goal seeks to credential 60% of the adult population in the state by 2030, bringing Kentucky closer to the national average. Using a difference-in-differences empirical strategy I compare Kentucky to a control group of states from 2010-2019 in order to understand statewide gains in varying levels of postsecondary achievement, and in what subsamples of the population the largest gains have been made. The results indicate that Kentucky has been successful in increasing educational attainment compared to states who have not adopted an educational attainment goal, and …

An Analysis Of Tennessee’S New Medicaid Waiver: Tenncare Iii, Mary Moore

MPA/MPP/MPFM Capstone Projects

Medicaid is a federal-state partnership to provide health coverage benefits to certain vulnerable groups. Each state is responsible for administering its own Medicaid program in accordance with certain federal rules which include mandatory benefits for covered groups, namely, low-income children and their parents and aged, blind, and disabled individuals. There are additional groups which may be covered by Medicaid at the discretion of the state. As a partnership, the federal government covers a certain percentage of Medicaid expenditures in each state. This agreed upon rate is the federal medical assistance percentage or FMAP. Tennessee’s FMAP is set at 66.1% for …

Inter-State Variability Of Pharmacist Recovery Network Policies And Practice, Lindsey Porter

MPA/MPP/MPFM Capstone Projects

Recovery Networks (PRNs) are state organizations, typically associated with a licensing Board of Pharmacy to aid in recovery and monitoring of pharmacists with substance use disorders with the intention of providing an avenue for pharmacy professionals with infractions to return to practice. However, there is significant variation in the structure, funding, and leadership of these organizations leading to high variability in how they serve that purpose and their efficacy in doing so in a rehabilitative fashion. The purpose of this project was to assess, in twenty-five strategically chosen US states, PRN structure, function, and perceptions of Directors regarding allowance of …

The Lived Supervision Experiences Of Disabled Music Therapists, Emma Martin

Theses and Dissertations--Music

Within and outside of the music therapy field, there has been a recent push for more conversations and literature on social justice. However, disability has been largely left out of this dialogue. Disabled individuals have unique worldviews, and their voices as individuals and practitioners should be an integral part of social justice within music therapy. This study examined disabled music therapists' supervision experiences. All music therapists receive supervision during their education and clinical training, and many go on to supervise. Supervision therefore presents an opportunity to advance the profession by striving to understand disabled music therapists’ perspectives. The purpose of …

The Psalmodia Project, Saulo Moura

Theses and Dissertations--Music

The Psalmodia Project is a set of twelve compositions based on the text of preselected psalms from the Bible. The book of Psalms, part of the wisdom literature section of the Biblical Canon, is a kaleidoscope of human emotions with a total of 150 poems describing ancient Hebrew stories of faith full of plot nuances easily represented by musical expression. The compositions cover a large variety of musical genres, from Latin jazz to classical music, from small to large ensembles, with an instrumentation that employs sounds from all five different instrumental families: keyboards, strings, percussion (pitched and non-pitched), woodwinds, and …

Choosing Alternative Repertoire: Pedagogical Considerations For Robert Fuchs's Cello Sonata No. 2, Op. 83, Jerram Isaac John

Theses and Dissertations--Music

This document serves to promote Robert Fuchs's Cello Sonata No. 2, Op. 83, as a study piece for the cello, piano, and collaborative duo, showing the pedagogical benefits of this Romantic sonata. This project will begin with a biography of Fuchs and background of the work, followed by an analysis that establishes the piece in the Romantic tonal tradition. The next section will discuss the pedagogical benefits of the cello part, the technical accessibility in the piano part, and the collaborative opportunities encountered in the piece, comparing it with other Romantic sonatas in the standard repertoire. Additionally, I will be …

Survey Of Herbicide Resistance And Seed Fate Of Italian Ryegrass (Lolium Perenne Ssp. Multiflorum) In Kentucky, Amber Lynn Herman

Theses and Dissertations--Plant and Soil Sciences

Herbicide resistance is not a new problem for farmers in Kentucky, although the identification of herbicide resistant weed species continues to increase. Italian ryegrass (Lolium perenne ssp. multiflorum) is a problematic weed in Kentucky’s soft red winter wheat that has historically been documented as herbicide resistant in isolated locations. A greenhouse herbicide screen was conducted to further understand the level of glyphosate, pinoxaden, and pinoxaden plus fenoxaprop resistance in Kentucky Italian ryegrass populations. The preliminary screen and dose responses indicate there is one Italian ryegrass population resistant to glyphosate and two populations resistant to pinoxaden along with pinoxaden …

Optimizing Nitrogen Management In Winter Wheat Production Systems For Improved Bread Baking Quality, Ammar Sadiq Mahdi Al Zubade

Theses and Dissertations--Plant and Soil Sciences

In Kentucky, there is growing interest among farmers to produce high protein and strong gluten wheat that is suitable for bread baking to meet the demand of local artisanal bakers. Soft red winter wheat (SRW) is the most commonly wheat grown in the state and throughout the Southeastern US. Flours produced from SRW are relatively low in grain nitrogen (N) due to the region’s moderate winters and warm humid conditions during grain filling. As such, SRW is used in baking products where lower protein flours are preferred, such as cookies, cakes, pastries and crackers. Unlike SRW, hard red winter wheat …

Manipulating Species Diversity: Environmental Impacts In Row Crop, Livestock, And Grassland Agroecosystems, Alayna A. Jacobs

Theses and Dissertations--Plant and Soil Sciences

The diversity of living species in an agroecosystem affects both natural resources and agricultural production efficiency. The rise of managed plant monocultures has allowed agricultural yields to increase over time. However, simplifying agroecosystems affects the capacity of the system to sustainably provide clean air, water, and productive soils essential for continued food and fiber production. This dissertation manipulates species diversity in row crop and forage agroecosystems prevalent in the Eastern United States and tracks the associated environmental and agricultural production consequences.

In row crop agroecosystems, increasing plant diversity with winter cover crops has been suggested as a strategy to increase …