Digital Commons Network^™

Emergency Nurses' Knowledge Of Pediatric Complaints, Kari J. Blackburn

DNP Projects

Each year there are more than 25 million pediatric emergency department (ED) visits, with 37-60% of the complaints being non-urgent (Brosseau, Hoffman, Nattinger, Flores, Zhang and Gorelick, 2007). Injury is the number one reason children present to the ED and is strongly associated with a complaint of pain (AHRQ, 2013). While pain is a high volume reason for visiting the ED, there are other presentation causes that may pose a high risk to pediatric patients. Nausea and vomiting is not typically viewed as a high risk complaint, yet there are some high risk etiologies resulting in nausea and vomiting that …

Assessing Prevalence Of Known Risk Factors In A Regional Central Kentucky Medical Center Heart Failure Population As An Approach To Assessment Of Needs For Development Of A Program To Provide Targeted Services To Reduce 30 Day Readmissions, Christeen Ivy Broaddus

DNP Projects

Abstract

Objectives:

1. Determine demographic, physiologic, and laboratory characteristics at time of admission of the heart failure (HF) population in a regional acute care facility in Central Kentucky through review of patient electronic medical records.
2. Determine which HF population characteristics are significantly associated with readmissions to the hospital.
3. Provide identification of the statistically significant common characteristics of the HF population to this facility so that they may work towards development of an electronic risk for readmission predictive instrument.

Design: Retrospective chart review.

Setting: Regional acute care facility in Central Kentucky.

Participants: All patients (n = 175) with a diagnosis or history …

Final Dnp Capstone Report: Improving Adolescent Hpv Vaccination Rates, Jessica L. Murray

DNP Projects

Background: Human papillomavirus (HPV) vaccines have been shown to be effective against HPV types that are linked to cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers. Despite Advisory Committee on Immunization Practices (ACIP) recommendations that all 11-12 year old males and females in the U.S. should be vaccinated with the three-dose HPV vaccine series, vaccination rates remain low. In 2012, only 34.9% of adolescent females and 6.8% of adolescent males completed the series. Efforts to increase vaccination rates are needed, and healthcare providers have been shown to be an important part of the solution.

Purpose: This investigation was conducted to …

Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani

DNP Projects

Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.

Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.

Results: All surveyed providers were aware and …

Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser

DNP Projects

CAPSTONE INTRODUCTION

Childhood overweight/obesity is a critical public health problem with devastating consequences. Many factors have combined to create the epidemic, and primary care providers can play an important role in addressing the problem by identifying overweight/obese children and encouraging them to engage in healthy behaviors. However, providers face a number of competing priorities making it difficult for them to provide these services effectively without outside support.

Obesity has reached an epidemic proportion in the nation’s youth. The Data Resource Center for Child and Adolescent Health (2011) found that 35.7% of children age 10 – 17 in Kentucky are overweight …

Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman

DNP Projects

This capstone report presents three manuscripts which focus on tobacco use interventions in the primary care setting. The first manuscript presents a critical analysis of the Public Health Service guideline on Treating Tobacco Use and Dependence. The second manuscript presents a literature review pertaining to interventions that increase primary care provider compliance with guideline recommendations. The literature obtained from these first two manuscripts led to a descriptive study, which examined the documentation and implementation of specific guideline recommendations in a primary care clinic. The third and final manuscript details this study, and presents some practical implications for improving documentation …

Evidence-Based Blood Conservation Education For Icu Nurses: A Pre And Post-Test Evaluation Of Nursing Knowledge, Stefanie M. Bull

DNP Projects

Purpose: The purpose of this evidence-based education project was (i) to evaluate baseline nursing knowledge of anemia, blood conservation and transfusion medicine, (ii) to identify current blood conservation practice and the nurse’s prior exposure to blood conservation education (iii) to determine the potential impact of evidence-based education on nursing knowledge, and (iv) to determine the impact of education on the nurse’s attitudes towards future implementation of blood conservation practices based on the nurse’s self report.

Setting: The project was implemented in the Cardiovascular and Thoracic ICU (CVICU) at an 875-bed level-1 Trauma and Multi-Organ Transplant Center located in central Kentucky. …

Tobacco Treatment In College Students, Teresa H. Huber

DNP Projects

This study was conducted in a southeastern University to determine tobacco use status in a population of university students, student intention to quit, treatment options, use of student health service, and student’s degree of support of a tobacco-free policy. A major implication for practice is the need for college health providers to screen all students utilizing the USPHS Guidelines, as even light smokers may be vulnerable to nicotine addiction. However, the study found that a high proportion of the smokers were nondaily smokers who do not consider themselves as smokers and the vast majority of those were undergraduates. Thus, college …

Assessing Provider Knowledge And Attitude Towards Animal-Assisted Therapy As A Complementary Treatment For Children, Shannon Leigh Million

DNP Projects

Objective: The purpose of this project was to determine knowledge and attitudes of pediatric primary care providers working in a university outpatient clinic settings towards the use of animal-assisted therapy as a complementary treatment for children. This report also includes an integrative review of animal-assisted therapy in pediatric populations and a clinical practice guideline analysis regarding the use of equine facilitated learning with high risk children and adolescents in residential psychiatric treatment.

Methods: A survey tool was administered to the Department of Pediatrics at UK Healthcare.

Results: There were 41 respondents to the survey, 36 of which …

Trauma Resuscitation Team Program Evaluation, Lisa J. Fryman

DNP Projects

To evaluate the effectiveness of a newly implemented charge nurse-led trauma resuscitation team approach in the Trauma Intensive Care Unit (TICU). The approach was developed to improve patient throughput efficiency at a Level 1 Trauma Center. Measures of effectiveness include patient throughput efficiency, patient clinical outcomes, and financial impact. The implementation of the charge nurse-led trauma resuscitation team showed an improvement in efficiency of patient throughput without adversely affecting patient outcomes, and opening up critical resources for the next patient that arrives.

Screening For Sepsis: A Key Strategy For Early Identification And Management Of Septic Patients, Amy P. Fisher

DNP Projects

Background: Sepsis, defined as a systemic inflammatory response to infection, is a life-threatening medical condition that rapidly progresses from severe sepsis (characterized by signs of organ dysfunction) to septic shock with fluid-refractory hypotension. Adherence to the Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock have been associated with improved delivery of care and reduced mortality. Delays in recognition of sepsis has been identified as a barrier to achieving early goal-directed therapy targets.

Purpose: To determine if a sepsis screening protocol could facilitate earlier identification of patients with sepsis

Methods: A retrospective medical record review was …

The Association Of Primary Care Physician Supply To The Prevalence Of Diabetes, Obesity, Smoking, And Hypertension In Georgia, Dennis L. White

MUSC Theses and Dissertations

The primary focus of this study was to compare primary care physician supply throughout Georgia to the prevalence of diabetes, obesity, smoking, and hypertension county by county, identifying potential issues related to primary care physician supply. This research identified the distribution of the primary care physician workforce across Georgia; county by county, and in urban and rural areas, and across public health districts. Then, the research identifies whether the current supply of Georgia primary care physicians is sufficient to meet the growing need for population healthcare. Studying the area of primary care physician supply in correlation to the prevalence of …

Further Characterization Of A Secreted Lipase From The Human Pathogen Leishmania Donovani By Determining The Effect Of Various Metal Ions On Its Enzymatic Activity., Lana Hoertz

Pell Scholars and Senior Theses

Leishmania donovani, a protozoan parasite, is the causative agent of the often fatal disease visceral leishmaniasis. The current treatments available are minimal and toxic to the patient. It has been shown that these organisms exhibit lipolytic activity during their growth in vitro. Lipases are enzymes that are known to aid in the development and virulence of several pathogenic organisms such as Candida albicans and Staphylococcus warneri. Little information is known, however, about the role of lipases in Leishmania species. We hypothesize that lipase may play a part in Leishmania's ability to survive within the human host as well as its …

The Problem Of Deterring Extraterritorial White-Collar Crime, Andrew B. Spalding

Law Faculty Publications

Recent reports of egregious labor practices in China and Bangladesh have called public attention to the potential harms of foreign direct investment (FDI) in developing countries. The best, or at least most obvious, tool for reducing destructive overseas business practices would seem to be the extraterritorial application of white-collar criminal law. The "holy grail" of contemporary criminal law is deterrence, and the deterrence literature is largely shaped by the paradigm of law and economics. Prominent within that literature is Polinsky and Shavell's "enforcement authority," which seeks to maximize social utility through the efficient deterrence of crime.a Guided by the principles …

Tall Fescue Ergovaline Concentration Based On Sample Handling And Storage Method, Krista La Moen Lea

Theses and Dissertations--Plant and Soil Sciences

Ergovaline is produced by the endophyte Neotyphodium coenophialum (Morgan-Jones and Gams) in tall fescue (Schedonorus arundinacea (Schreb.) Dumort. = Festuca arundinacea Schreb.) and is blamed for a multitude of costly livestock disorders. Testing of pastures is common in both research and on farm situations. Since ergovaline is known to be unstable and affected by many variables, the objective of this study was to determine the effect of sample handling and storage on the stability of this compound. Homogeneous milled tall fescue sub-samples were analyzed for ergovaline concentration using HPLC after a range of sample handling procedures or storage. Ergovaline …

Fusarium Head Blight Resistance And Agronomic Performance In Soft Red Winter Wheat Populations, Daniela Sarti Dvorjak

Theses and Dissertations--Plant and Soil Sciences

Fusarium head blight (FHB), caused by Fusarium graminearum Schwabe [telomorph: Gibberella zeae Schwein.(Petch)], is recognized as one of the most destructive diseases of wheat (Triticum aestivum L. and T. durum L.) and barley (Hordeum vulgare L.) worldwide. Breeding for FHB resistance must be accompanied by selection for desirable agronomic traits. Donor parents with two FHB resistance quantitative trait loci (QTL) Fhb1 (chromosome 3BS) and QFhs.nau-2DL (chromosome 2DL) were crossed to four adapted SRW wheat lines to generate backcross and forward cross progeny. F₂ individuals were genotyped and assigned to 4 different groups according to presence/ absence of …

Plant Growth Regulators And Herbicides For Management Of Poa Annua: Impact Of Biotypes And Behavior Of Flurprimidol In Turfgrass Species, Alexandra Perseveranda Williams

Theses and Dissertations--Plant and Soil Sciences

In 2011, Poa annua L. (Poa) biotypes were collected from greens of two golf courses in Lexington, Kentucky: 1.) The Lexington Country Club (LCC) and 2.) The University Club (UC). The samples were collected based on exhibiting one of two appearances while on the same green: 1.) dark green, with few to no flower heads (dark biotype) or 2.) light green, with numerous flower heads (light biotype). Two PGRs, paclobutrazol and flurprimidol, and two herbicides, bispyribac-sodium and amicarbazone, were applied to the plants both in the field and the greenhouse. Quality ratings were recorded weekly in both the …

C And N Cycling Dynamics And Microbial Community Composition In High Tunnel Production Systems, Kavita Lakshmi Mizin

Theses and Dissertations--Plant and Soil Sciences

Across the United States, high tunnels are used as a means of season extension and control over climatic variability in fruit and vegetable production. However, high tunnel systems are an intensive form of agricultural production which may compromise soil and crop quality over time. This study examined the effects of the varying environmental conditions, created in two types of tunnel system, movable and stationary, on the flow of nitrogen from amendment to plant and impact on crop and soil quality parameters. The way nutrients cycled through these systems was different and the nutrient treatments had no consistent effects on soil …

Evaluating The Effect Maturity On The Intake And Digestibility Of Switchgrass Hay Consumed By Beef Steers, David H. Davis

Theses and Dissertations--Plant and Soil Sciences

There has been increased interest in utilizing switchgrass (Panicum virgatum) as biomass. There are several challenges to developing this industry, and these have led to the potential use of switchgrass as hay for feeding beef cattle in Kentucky. The effect of increasing maturity on crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF) and nutritive values of switchgrass hay has been well documented, but few in vivo intake and digestibility trials have been conducted to assess this effect on animal performance when feeding beef cattle. Two in vivo intake and digestibility trials were conducted in 2011 …

The Influence Of Tall Fescue Cultivar And Endophyte Status On Root Exudate Chemistry And Rhizosphere Processes, Jingqi Guo

Theses and Dissertations--Plant and Soil Sciences

Tall fescue (Lolium arundinaceum (Schreb.) Darbysh.) is a cool-season perennial grass used in pastures throughout the Southeastern United States. The grass can harbor a fungal endophyte (Epichloë coenophiala) thought to provide the plant with enhanced resistance to biotic and abiotic stress. However, the alkaloids produced by the common variety of the endophyte cause severe animal health issues resulting in a considerable amount of research focused on eliminating the toxic class of alkaloids while retaining the positive abiotic and biotic stress tolerance attributes of the other alkaloids. In doing so, very little attention has been paid to the …

Bacteria In Bioethanol Fermentations, Qing Li

Theses and Dissertations--Plant and Soil Sciences

To gain a better understanding of contaminating bacteria in bioethanol industry, we profiled the bacterial community structure in corn-based bioethanol fermentations and evaluated its correlation to environmental variables. Twenty-three batches of corn-mash sample were collected from six bioethanol facilities. The V4 region of the collective bacterial 16S rRNA genes was analyzed by Illumina Miseq sequencing to investigate the bacterial community structure. Non-metric multidimensional scaling (NMDS) ordination plots were constructed to visualize bacterial community structure groupings among different samples, as well as the effects of multiple environmental variables on community structure variation. Our results suggest that bacterial community structure is facility-specific, …

Evaluation Of Correlation Between Within-Barn Curing Environment And Tsna Accumulation In Dark Air-Cured Tobacco, Mitchell Dale Richmond

Theses and Dissertations--Plant and Soil Sciences

Significant variability in cured leaf tobacco-specific nitrosamine (TSNA) content is commonly observed when sampling within dark air-curing barns. This variability may be due to inconsistency in the curing environment within different areas of the barn. A study was initiated in 2012 through support from a CORESTA Study Grant to evaluate if leaf TSNA content is related to microenvironmental conditions in the barn. Seed screened for low conversion of nicotine to nornicotine (sc) and high converter (HC) selections of TR Madole dark tobacco were cured in barns near Princeton and Lexington, Kentucky in 2012 and 2013. Temperature and relative humidity were …

Mandatory Ultrasound Statutes And The First Amendment, Shifting The Constitutional Perspective, Cheri D. Smith

Cardozo Journal of Equal Rights & Social Justice

The jurisprudence of abortion law is replete with instances in which the concerns of the woman seeking the procedure have taken a back seat. The newest battleground in abortion regulation involves mandatory ultrasound statutes touted as informed consent regulations. The analysis of courts confronting these statutes has turned on whether the mandatory disclosures violate the physician's First Amendment right to be free from compelled speech. The particular breed of statute at issue in this paper requires a physician not only to perform an ultrasound, but also to make the images visible to the woman, to make audible the heartbeat, and …

Rebalancing Pay-For-Delay: Why No-Authorized Generic Agreements Should Be Subject To Higher Antitrust Scrutiny, David C. Kurlander

Cardozo Arts & Entertainment Law Journal

No abstract provided.

The "Dot" Times They Are A-Changin': How New Generic Top Level Domains (Gtlds) Will Change Consumer Perception About The Internet, Eric J. Shimanoff

Cardozo Arts & Entertainment Law Journal

No abstract provided.

Effect Of Laser-Cut Slow-Flow Nipples On Preterm Feeding Performance, Katlyn Elizabeth Mcgrattan

MUSC Theses and Dissertations

Background: Dysphagia of prematurity is a highly prevalent condition that carries negative developmental, social, and financial implications. Although the modification of bottle nipple properties is a widely used treatment for dysphagia of prematurity, there have been a paucity of investigations examining the effect of this intervention on refined measures of feeding performance. Methods: Healthy preterm infants were evaluated for measures of milk ingestion and respiratory performance during oral intake on a laser-cut slow-flow and standard-flow nipple. Time to achieve hospital discharge milestones was recorded. Results: Few differences were observed in feeding performance between slow-flow and standard-flow nipples. Characteristics of respiration …

Cosee Ocean Inquiry Group Report: Opportunities For Creating Lifelong Ocean Science Literacy, Paul Boyle, Vince Breslin, Lisa Craig Brisson, John Fraser, Alan J. Friedman, Katie Gardner, Sarah Schoedinger, Jerry Schubel, Steve Uzzo, Steven Yalowitz

School for the Environment General Publications

This Inquiry Group Report for the Centers for Ocean Sciences Education Excellence Ocean Communities in Education And Social Networks (COSEE OCEAN) provides a fresh look at how broader ocean science literacy can be developed, especially through less-recognized channels such as opportunistic learning, the private and “third” sectors, and the enormously varied activities under the heading of informal science education. The 10 authors of this report (see Contributors section) have been working together for two years to find and review a range of issues and resources for current and potential ocean science literacy providers, both professional and volunteer.

Several chapters provide …

Physician As Teacher: Promoting Health And Wellness Among Elementary School Students, Jill E. Stefaniak, Victoria C. Lucia

STEMPS Faculty Publications

BACKGROUND: Every day, physicians engage in teaching during their patient encounters. It may be that medical students who are introduced to the principles of teaching and learning are more likely to become good communicators and learners. Service-learning may be an effective way for medical students to practice skills in teaching and communication in a real-world setting, while also filling a need within the community. The purpose of this study was to identify common themes within medical students' reflections on what they learned through participating in a teaching exercise with local elementary school children.

METHODS: As a required component of a …

Does The Sequence Of Instruction Matter During Simulation?, Jill E. Stefaniak, Carman L. Turkelson

STEMPS Faculty Publications

Introduction: Instructional strategies must be balanced when subjecting students to full-immersion simulation so as not to discourage learning and increase cognitive overload. The purpose of this study was to determine if participating in a simulation exercise before lecture yielded better performance outcomes among novice learners.

Methods: Twenty-nine participants were divided into 2 groups as follows: group 1 participated in simulation exercises followed by a didactic lecture and group 2 participated in the same learning activities presented in the opposite order. Participants were administered a multiple-choice cognitive assessment upon completion of a workshop.

Results: Learners who participated in the simulated exercises …

Effect Of Abiotic Factors On Initiation Of Red Flour Beetle (Coleoptera: Tenebrionidae) Flight, Joel Perez-Mendoza, James F. Campbell, James E. Throne

United States Department of Agriculture-Agricultural Research Service / University of Nebraska-Lincoln: Faculty Publications

Traps baited with pheromones are used to monitor the red flour beetle, Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae), populations in flour mills to aid in making pest management decisions, but the factors that influence T. castaneum movement are not fully understood. We investigated the impact of photoperiod, light intensity, temperature, and relative humidity on flight initiation. The percentage of adults initiating flight reached a maximum at 30-35°C, and then fell to zero at 22.5 and 45°C. Only 2% of beetles flew in complete darkness, and the number of beetles initiating flight increased to 41% under 18 h of light and then …