A Triage Process To Decrease Door To Ekg Times For Adult Patients With Suspected Cardiac Abnormalities In The Emergency Department, Khay Douangdara

DNP Projects

Objective: The emergency department (ED) triage process for adult patients presenting with suspected cardiac abnormalities should be reliable; however, delays in identifying significant cardiac rhythms can negatively impact patient outcomes. The American Heart Association (AHA) and the American College of Cardiology (ACC) recommend that patients presenting to the ED with cardiac-related concerns undergo an electrocardiogram (EKG) within 10 minutes of arrival. This project aimed to educate ED nurses and implement changes in the triage process to reduce door-to-EKG times for adult patients with suspected cardiac abnormalities.

Methods: This quasi-experimental study utilized a pre- and post-intervention design to evaluate the effectiveness …

Implementation And Evaluation Of Diet And Physical Activity Screening Tools For Adults With Type 2 Diabetes Mellitus In Primary Care, Ashley O. Dalton

DNP Projects

Background: Only half of individuals with type 2 diabetes mellitus (T2DM) have a hemoglobin A1C (HbA1c) of less than 7%, indicating poor glycemic control and contributing to a global diabetes epidemic. Diabetes is considered a diet-sensitive disease and an individual’s diabetes-related nutrition knowledge is one of the most challenging aspects of the treatment plan. Empirical evidence supports that a combination of dietary and physical activity interventions is more effective than nutrition education alone. Performing a dietary evaluation is fundamental to establishing nutrition goals. The use of the Starting the Conversation (STC) tool, which assesses an individual’s dietary practices, and Physical …

Improving The Diabetic Foot Screening Process And Foot Care Patient Education In A Primary Care Setting, Keelie Tillett

DNP Projects

Background: Foot ulcerations are a common diabetes-associated complication that can lead to significant morbidity, mortality, and financial burden for patients and health care systems. Health care providers (HCPs) play an important role in providing diabetic foot care. Despite national guidelines recommending HCPs perform an annual foot exam in all individuals with diabetes to recognize at-risk feet, research shows that many patients with type 2 diabetes (T2DM) do not receive routine diabetic foot exams (DFE) in the primary care setting.

Purpose: To evaluate the effect of provider education, a standardized DFE template, an electronic health record (EHR) alert, and online educational …

Screening For The Unseen: Depression Detection Through Phq-9 And Provider Education In Pain Management, Veronica Shaw

DNP Projects

Background: Depression leads to significant economic and health burdens, causing 200 million lost workdays and costing employers $17 to $44 billion annually (CDC, 2022). It accounts for 4.3% of the global disease burden and is a leading cause of disability worldwide (WHO, 2021). Chronic pain, affecting 20.9% of United States adults, often exacerbates depression, creating a vicious cycle of physical and emotional suffering (Rikard et al., 2023). Despite the availability of effective treatments, depression is frequently missed in primary care settings, with 50% of cases undiagnosed (Hawkes, 2019). Addressing both depression and chronic pain through improved screening and holistic care …

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 …

Utilization Of Organ Inventories In The Primary Care Setting: Two Questions To Increase Usage, Siobhan A. Lister

DNP Projects

Background: The Transgender and Gender Diverse (TGD) population experiences significant health disparities in accessing preventative care when compared to their cisgender counterparts. These disparities often occur with organ-specific screenings and lead to poorer health outcomes, due to patients having organs that do not match their sex assigned at birth. The evidence recommends a two-question method of gender identification to identify those patients whose gender does not match their sex assigned at birth. Using the 2-question method can help identify patients who need an organ inventory completed, which will lead to appropriate preventative health screenings being done.

Purpose: The purpose was …

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 …

Fusarium Head Blight Resistance Genes Impact Agronomic Performance, Flavor, Milling, And Baking Traits In Soft Red Winter Wheat, Joyce Morris

Theses and Dissertations--Plant and Soil Sciences

Fusarium Head Blight (FHB) is an economically devastating disease of wheat (Triticum aestivum L.) causing low yields and poor quality. FHB, caused by Fusarium graminearum, disrupts the grain filling phase and results in bleached spikes and shriveled seeds. Deoxynivalenol (DON) is a mycotoxin produced by the fungal pathogen when it infects the plant; DON is harmful when consumed by humans and causes feed rejection in livestock. Using FHB resistant varieties and timely applications of fungicides is the optimum strategy for management of this disease. However, there has been little research focusing on the impact of FHB resistance genes …

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 …

Influence Of Industrial Hemp On Soil Health Parameters In A Kentucky Cropping System, Jack T. Eaker

Theses and Dissertations--Plant and Soil Sciences

Industrial hemp (fiber, floral, and grain: Cannabis sativa L.) legalization has prompted research into its incorporation into agronomic rotations and impacts on agroecosystem services such as nutrient dynamics. This study quantified the effects of integrating grain and fiber hemp on soil health, hypothesizing hemp would positively impact soil health due to its taproot, reported C benefits, and nutrient requirements. Conducted in Kentucky at two locations, a completely randomized block design included six crop rotation treatments, with soil cores collected at initiation (2020) and post three growing seasons (2023). Soil parameters analyzed included particulate organic matter, short-term CO2 mineralization, water-extractable organic …

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), …

Revolutionizing Grapevine Breeding Programs: A Mobile Genome Editing System For Perennial Crops, Bridget Bolt

Theses and Dissertations--Plant and Soil Sciences

Grapevine (Vitis vinifera) faces unprecedented challenges from climate change, with up to 90% of current growing regions potentially becoming unsuitable for production within decades. Traditional breeding approaches require 25-30 years for variety development, creating a time constraint incompatible with the pace of environmental change. This research establishes the approach for a novel mobile RNA-based gene editing platform that addresses longstanding bottlenecks in grapevine improvement while preserving cultivar identity and reducing breeding timelines.

This research developed a three-component system for transgene-free gene editing in grapevine. First, a mobile CRISPR/Cas9 system was established using Agrobacterium rhizogenes transformation and the cut-and-dip …

Exploring The Role Of Living Roots In Soil Organic Matter Dynamics, Sharmin Akther

Theses and Dissertations--Plant and Soil Sciences

Roots play a central role in soil organic matter (SOM) formation, yet the contributions of living roots compared with root- and shoot-derived litter remain incompletely understood across systems and management contexts. This thesis combines a global meta-analysis with a two-year field experiment to evaluate how continuous living root activity shapes soil organic carbon (SOC) dynamics. The meta-analysis synthesized 21 studies (57 observations) comparing cropping systems with enhanced living root continuity to systems with fallow periods or annual-only rotations. Perennial and continuous cropping systems increased annual C inputs and SOC stocks relative to controls, but their SOC sequestration efficiency declined because …

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.

Spanish-Speaking Interpreters’ Perspectives: How Latinx Immigrant Caregivers Navigate The Special Education Process, Lizeth B. Tomas Flores

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

The study examined the experiences of Spanish-speaking interpreters working with Latinx immigrant caregivers during the special education process, their perspectives on how caregivers and the IEP professional committee members participate in the process, aiming to gain a better understanding of how Latinx immigrant families navigate the special education process. Interpreters play a crucial role in the special education process for families from culturally and linguistically diverse backgrounds, as they facilitate the transmission of information between caregivers and special education teams. Interviews were conducted with six special education interpreters in a southwestern suburban school district in the United States. A qualitative …

“Hard To Rememeber, Then Hard To Forget:” A Qualitative Exploration Into The Attitudes And Lived Experiences Of Black People With Black Names, Destin L. Mizelle

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

Naming practices within the Black American community are vibrant and deeply rooted in cultural traditions and shared values. Much like other ethnic groups, these names tell stories, reflect heritage, and connect individuals to their community, making each choice meaningful and significant. However, due to the systemic effects of anti-Blackness, Black Americans often have a complex relationship with their names. While previous research has primarily utilized quantitative methodologies focusing on the negative associations and consequences of having a Black name, this study aims to amplify the voices of Black people who possess Black names. Using reflexive thematic analysis, this qualitative study …

An Examination Of The Effects Of School-Based Experiences On High-Achieving Black Female High School Students Using Photovoice 2.0, Kameron R. White Mcdaniel

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

This study used a youth-led participatory action research inquiry and Photovoice 2.0 methodology to investigate the school-based experiences of seven high-achieving black female students across two public high schools. The objectives of the project were to explore how high-achieving Black high school girls perceived their academic identity within their school setting, and to determine any school and/or classroom contextual factors that affected these participants' school-based learning experiences and outcomes. The demographic makeup of each school was also evaluated through qualitative analysis to consider if it served as a moderating variable in participants’ reported school-based experiences. It is through gained insight …

The Impact Of Whiteness Among Black College Students' Racial Identity, La'quida Reneé Smith

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

Although the impact of racism is well-documented in both conceptual and empirical research on the experiences of Black college students, some scholars have pointed out that many of the negative, race-based experiences these students face on college campuses extend beyond overt acts of racism (e.g., individual racism, institutional racism; Gusa, 2010; Hargons et al., 2022; Ingram & Wallace, 2019; Le et al., 2020; Smith et al., 2011; Tyler et al., 2022). Whiteness has been identified as an overt factor shaping the lived experiences of Black individuals (Leonardo, 2009; Matias, 2016; Tyler et al., 2022) and is, therefore, believed to impact …

Chemoproteomic Profiling Of A Carbon-Stabilized Gold(Iii) Macrocycle Reveals Cellular Engagement With Hmox2, Sailajah Gukathasan, Chibuzor Ngozi Olelewe, Libby Ratliff, Jong H. Kim, Alyson M. Ackerman, J. Robert Mccorkle, Sean Parkin, Gunnar F. Kwakye, Jill M. Kolesar, Samuel G. Awuah

Chemistry Faculty Publications

In this work, we discovered a novel organometallic gold(III) macrocycle, Au-Mac1, that demonstrates anticancer potency in a panel of triple-negative breast cancer cells (TNBC), and based on this complex, a biotinylated-Au-Mac1 probe was designed for target identification via chemoproteomics, which uncovered the engagement of HMOX2 of the heme-energy metabolism pathway. Using orthogonal chemical biology and molecular biology approaches, including immunoblotting, flow cytometry, and cellular thermal shift assays, it was confirmed that Au-Mac1 engages HMOX2 in cells. Downstream effects of Au-Mac1 on the depletion of mitochondrial membrane proteins and bioenergetics point to the potential role of HMOX2 in cancer. Importantly, Au-Mac1 …

Electrochemical Observation And Ph Dependence Of All Three Expected Redox Couples In An Extremophilic Bifurcating Electron Transfer Flavoprotein With Fused Subunits, Debarati Das, Wassim El Housseini, Monica Brachi, Shelley D. Minteer, Anne-Frances Miller

Chemistry Faculty Publications

Bifurcating enzymes employ energy from a favorable electron transfer to drive unfavorable transfer of a second electron, thereby generating a more reactive product. They are therefore highly desirable in catalytic systems, for example, to drive challenging reactions such as nitrogen fixation. While most bifurcating enzymes contain air-sensitive metal centers, bifurcating electron transfer flavoproteins (bETFs) employ flavins. However, they have not been successfully deployed on electrodes. Herein, we demonstrate immobilization and expected thermodynamic reactivity of a bETF from a hyperthermophilic archaeon, Sulfolobus acidocaldarius (SaETF). SaETF differs from previously biochemically characterized bETFs in being a single protein, representing a …

Functional Utility Of Gold Complexes With Phosphorus Donor Ligands In Biological Systems, Adedamola S. Arojojoye, Samuel G. Awuah

Chemistry Faculty Publications

Metallo-phosphines are ubiquitous in organometallic chemistry with widespread applications as catalysts in various chemical transformations, precursors for organic electronics, and chemotherapeutic agents or chemical probes. Here, we provide a comprehensive review of the exploration of the current biological applications of Au complexes bearing phosphine donor ligands. The goal is to deepen our understanding of the synthetic utility and reactivity of Au-phosphine complexes to provide insights that could lead to the design of new molecules and enhance the cross-application or repurposing of these complexes.

Caspase-11 And Nlrp3 Exacerbate Systemic Klebsiella Infection Through Reducing Mitochondrial Ros Production, Yuqi Zhou, Zhuodong Chai, Ankit Pandeya, Ling Yang, Yan Zhang, Guoying Zhang, Congqing Wu, Zhenyu Li, Yinan Wei

Chemistry Faculty Publications

Introduction: Klebsiella pneumoniae is a Gram-negative bacterium and the third most commonly isolated microorganism in blood cultures from septic patients. Despite extensive research, the mechanisms underlying K. pneumoniae-induced sepsis and its pathogenesis remain unclear. Acute respiratory failure is a leading cause of mortality in systemic K. pneumoniae infections, highlighting the need to better understand the host immune response and bacterial clearance mechanisms. Method: To investigate the impact of K. pneumoniae infection on organ function and immune response, we utilized a systemic infection model through intraperitoneal injection in mice. Bacterial loads in key organs were quantified, and lung injury was assessed. …