Digital Commons Network^™

Outcomes Experienced By Patients Presenting With Ventral Hernias And Morbid Obesity In A Surgical Clinic, Margaret A. Plymale

DNP Projects

Surgeons generally agree that morbid obesity is a contraindication to ventral hernia repair surgery due to risk of adverse outcomes. The purpose of this study was to describe the experience of patients with ventral hernia complicated by morbid obesity by reviewing a population of patients that were seen by a surgical service to determine the characteristics of those patients that had favorable and unfavorable outcomes. A retrospective medical record review was conducted of new patients with ventral hernias and morbid obesity (body mass index (BMI ) ≥ 40 kg/m²) seen by one surgical service over a two and …

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …

Assessment Of Depression Screening In Women’S Primary Care Clinic, Susanna Gorton

DNP Projects

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary …

Retrospective Analysis Of Body Mass Index Screening And Obesity Counseling In A Primary Care Setting: Comparative Analysis Of Demographic Variables And Co-Morbidities, Christina Fisher Higdon

DNP Projects

Study Purpose: To assess obesity screening and counseling in patients at annual wellness exams in an urban primary care clinic. Specific aims of the study: determine percentage of patients with documented body mass index (BMI), ICD-9/ICD-10 diagnosis of overweight or obesity, documentation of education or a follow-up plan for weight management, follow-up visit for weight loss and documentation by provider, and comparative analysis of co-morbidities and demographic variables during well-exam visits.

Target Population and Measures: Adults over the age of 18 in an urban primary care clinic with a BMI greater than 25 kilograms (kg)/meters squared (m2). BMI screening and …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …

Preventing Delirium Through The Implementation Of The Abcde Bundle And Pad Guideline Into Everyday Care In A Community Hospital Intensive Care Unit: Opportunities For Practice Improvement, Mary Zody

DNP Projects

This DNP project focuses on the reduction of delirium through improvement of nursing knowledge of delirium and implementation of evidence based bundle ( Awake, Breathing, Coordination, Early Mobility, and Pain, Agitation, Delirium) into a twelve bed intensive care unit located in a 150 bed community hospital. Specifically, this project will review the literature supporting the evidence based bundle and report on a comprehensive gap analysis which was done to determine areas for practice improvement to reduce delirium and improve patient outcomes. The gap analysis included a comparison of current practice to the evidence, a review of administrative policies/ statements of …

An Evaluation Of Providers' Interventions And Patients' Adherence In Diabetes Management, Hoang Ngo

DNP Projects

Background: Diabetes is one of the leading causes of death and disability in the United States including Kentucky. Despite advances in medicine, the current management of type 2 diabetes mellitus (T2DM) remains challenging. Poor self-management coupled with the increasing complexity of the disease can lead to poor glycemic control.

Purpose: The purpose of this project was to examine current practices related to insulin-using patients’ treatment adherence and management of T2DM. In addition, providers’ perceptions on the management of T2DM were also assessed.

Methods: A retrospective chart review and semi-structured interviews were conducted. Patients (N = 84) with T2DM, over the …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …

The Effects Of Manufactured Nanomaterial Transformations On Bioavailability, Toxicity And Transcriptomic Responses Of Caenorhabditis Elegans, Daniel L. Starnes

Theses and Dissertations--Plant and Soil Sciences

In recent decades, there has been a rapid expansion in the use of manufactured nanoparticles (MNPs). Experimental evidence and material flow models predict that MNPs enter wastewater treatment plants and partition to sewage sludge and majority of that sludge is land applied as biosolids. During wastewater treatment and after land application, MNPs undergo biogeochemical transformations (aging). The primary transformation process for silver MNPs (Ag-MNPs) is sulfidation, while zinc oxide MNPs (ZnO-MNPs) most likely undergo phosphatation and sulfidation. Our overall goal was to assess bioavailability and toxicogenomic impacts of both pristine, defined as-synthesized, and aged Ag- and ZnO-MNPs, as well as …

Patient Engagement: The Impact Of Electronic Patient Portal Use On Missed Appointments In Patients With Diabetes, A Retrospective Study, Keli P. Walden

MUSC Theses and Dissertations

Background: This retrospective observational chart review evaluated the use of the MyChart® patient portal as a viable tool for engaging patients. Engagement was measured as fewer missed appointments (no-shows and same-day cancellations). Objectives: To determine who uses the MyChart® patient portal in a chronically ill population of adult patients with diabetes and assess the association of portal use with missed appointments. Methods: The medical records of adult patients (18-80) with a diagnosis of Type 1 and/or Type 2 Diabetes Mellitus (DM) were reviewed (N=7,795). The efficacy of the MyChart® patient portal at reducing missed appointments was assessed by comparing patients …

Registration Of Ne Trailblazer C-1, Ne Trailblazer C0, Ne Trailblazer C2, Ne Trailblazer C3, Ne Trailblazer C4, And Ne Trailblazer C5 Switchgrass Germplasms, Kenneth P. Vogel, Robert B. Mitchell, Gautam Sarath

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

NE Trailblazer C-1 (GP-101, PI 672015), NE Trailblazer C0 (GP-100, PI 672014), NE Trailblazer C2 (GP-102, PI 672016), NE Trailblazer C3 (GP-103, PI 672017), NE Trailblazer C4 (GP-104, PI 672018), and NE Trailblazer C5 (GP-105, PI 672019) switchgrass (Panicum virgatum L.) germplasms were released by the USDA-ARS and the University of Nebraska-Lincoln on 10 Sept. 2014. These germplasms were developed by six generations of divergent breeding for in vitro dry matter digestibility (IVDMD). As a result of the multigenerations of recurrent breeding, the resulting populations differ significantly for IVDMD and for 25 other forage quality or biomass composition traits, …

Missing The “Target”: Preventing The Unjust Inclusion Of Vulnerable Children For Medical Research Studies, Ruqaiijah A. Yearby

All Faculty Scholarship

Nearly everyone has experienced a burn and the resulting pain. Now imagine that you suffer a third-degree radiation burn that injures all the layers of your skin as well as the tissue, causing you extreme pain. . The burn turns your skin white, cherry red, or black and may produce blisters that are dry, hard, and leathery-looking. The burn can also be seen on the surface of your lungs and gastrointestinal tract. If the burn is big enough you will need skin grafts and surgery to replace the skin and tissue that will never grow back, as well as treatment …

Enhanced Approaches For Identifying Amadori Products: Application To Peanut Allergens, Katina L. Johnson, Jason G. Williams, Soheila J. Maleki, Barry K. Hurlburt, Robert E. London, Geoffrey A. Mueller

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

The dry roasting of peanuts is suggested to influence allergic sensitization as a result of the formation of advanced glycation end products (AGEs) on peanut proteins. Identifying AGEs is technically challenging. The AGEs of a peanut allergen were probed with nano-scale liquid chromatography−electrospray ionization−mass spectrometry (nanoLC−ESI−MS) and tandem mass spectrometry (MS/MS) analyses. Amadori product ions matched to expected peptides and yielded fragments that included a loss of three waters and HCHO. As a result of the paucity of b and y ions in the MS/MS spectrum, standard search algorithms do not perform well. Reactions with isotopically labeled sugars confirmed that …

Standardization Of Rp-Hplc Methods For The Detection Of The Major Peanut Allergens Ara H 1, Ara H 2 And Ara H 3, Harmit Singh, Mary Jo Cantoria, Poonam Malave, Denny Saputra, Soheila Maleki

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

Crude peanut extract (CPE) was analyzed for three major allergens (Ara h 1, h 2, and h 3) using a C₁₂ and a C₁₈ column at two wavelengths (280 and 220 nm) and under different solvent conditions. HPLC profiles were compared for retention time, resolution, and peak heights. CPE samples were spiked with pure allergens to identify the peaks corresponding to allergens. The HPLC fractions of corresponding allergens were collected and freeze-dried in order to perform SDS–PAGE and immunoblotting tests. The best method was identified the one with a shorter retention time, better resolution, and greater peak height …

Rising Atmospheric Co2 Is Reducing The Protein Concentration Of A Floral Pollen Source Essential For North American Bees, Lewis H. Ziska, Jeffery S. Pettis, Joan Edwards, Jillian E. Hancock, Martha B. Tomecek, Andrew Clark, Jeffrey S. Dukes, Irakli Loladze, H. Wayne Polley

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

At present, there is substantive evidence that the nutritional content of agriculturally important food crops will decrease in response to rising levels of atmospheric carbon dioxide, C_a. However, whether C_a-induced declines in nutritional quality are also occurring for pollinator food sources is unknown. Flowering late in the season, goldenrod (Solidago spp.) pollen is a widely available autumnal food source commonly acknowledged by apiarists to be essential to native bee (e.g. Bombus spp.) and honeybee (Apis mellifera) health and winter survival. Using floral collections obtained from the Smithsonian Natural History Museum, we quantified C_{a …}

Rethinking Drinking: A Paradigm Shift For Estimating Social And Behavioral Harm, Thomas Hall

Electronic Theses and Dissertations

This study challenges old saws about negative consequences attributed to alcohol use. Previous research findings associate negative social and behavioral consequences with alcohol consumption, as if college students only do regrettable things when they are drunk. Typical research related to negative consequences and alcohol use relies on retrospective self-reporting. Investigators often frame negative consequences as outcomes of problematic drinking or, as more commonly labeled, "binge drinking." In the nomenclature of prevention, binge drinking is not a direct measure of alcohol use resulting in intoxication; it is a hypothetical tipping point, predicting an increased likelihood of the incidence of negative consequences …

A Tale Of Two Palmettos: The Foundation Of Ecosystems, Warren G. Abrahamson Ii

Faculty Journal Articles

Fruits of saw palmetto (Serenoa repens) provide crucial, high-quality resources to wildlife while providing a matrix for many southeastern US ecosystems. As a foundation species, saw palmetto plays a major role in structuring fire-maintained plant communities. Often living on nutrient-poor soil conditions, the thick leaves of saw palmetto are long lived, up to 2.8 years in shaded sand pine scrub.

Self-Compassion, Mindfulness And Wellbeing In Counselors-In-Training, Lea Fairbanks

All Master's Theses

The purpose of this study was to examine if self-compassion and mindfulness predict wellbeing in counselors-in-training. The sample was made up of counselors-in-training from CACREP accredited programs in the WACES region of the United States (N=45). Data was collected from three scales including the Self-Compassion Scale, Five Facet Mindfulness Scale and the Psychological Wellbeing Scale. To analyze the data, a simultaneous regression was used to determine if self-compassion and mindfulness significantly predicted wellbeing in counselors-in-training. The results showed that self-compassion and mindfulness was positively correlated with wellbeing and significantly predicted 64.9% of the variance in wellbeing for counselors-in-training. The results …

Mate Selection Comparisons In Heterosexual And Homosexual Individuals, Daina Lee Wierzbinski

All Master's Theses

The effects of character traits and socioeconomic status on mate selection for both heterosexual and homosexual individuals was studied. The current study recruited 347 Central Washington University students who ranked the importance of descriptive traits in a potential long-term mate, and also reported how willing they were to date a fictional potential mate in both a short-term and long-term context. Participants also described themselves in a dating profile scenario. The findings support the hypothesis that women are more interested in traits that signal resource acquisition and high socioeconomic status, and also support the hypothesis that men are more interested in …

Conflict-Affected Youth Livelihoods Programming: Bridging The Gap Between Research & Practice, Chanel M. Marin

Public Health Theses

The current thesis project consists of a programmatic mapping of existing policy and programming related to conflict-affected youth livelihoods and a Rapid Evidence Assessment (REA) of the literature to identify the evidence base for effective interventions. The programmatic mapping identified key actors in the field and existing policy and programming, revealing a need for: data regarding evidence-based interventions; demand-driven intervention strategies; cross-sectoral partnerships providing holistic programming approaches; increased outreach to vulnerable sub-populations; and increased youth participation in program design, implementation, management, and evaluation. The REA revealed a severe shortage of evidence-based practice in this area, but sheds light on the …

Health For Achievement: Greater Health Assets Associated With Better Standards-Based Assessment Scores Among Eighth Grade Students, Sarah Jane Maver

Public Health Theses

Purpose: Improving adolescent health and educational attainment remain national priorities. However, major gaps remain in coordination of these efforts. Study objectives were to: (1) document associations between health assets and academic achievement, (2) examine cumulative effects of health assets on academic achievement, and (3) identify health assets most strongly associated with academic achievement.

Methods: Participants include 8th grade students attending 12 randomly selected schools (N=517, 75% of all eligible students). Data include physical measurements, student surveys, and school records, including standards-based assessment scores in literacy and mathematics. We assessed 20 health indicators covering three related domains of health as proposed …

Factors Influencing Dietary Practices Among Liberian Refugees And Ghanaian Residents, Jennifer Mandelbaum

Public Health Theses

Buduburam Refugee Settlement was established in Ghana in 1990 by the United Nations High Commission for Refugees (UNHCR) in response to Liberia’s first civil war (1989-1997). A limited amount of research on intergenerational differences and acculturation with respect to diet in refugee populations has been published, despite refugees’ susceptibility to food insecurity and diet-related health conditions. As the worldwide refugee population continues to grow, it becomes increasingly important to develop socio-cultural frameworks to address specific health and nutrition needs of refugees. Therefore, the purpose of this qualitative study was to understand among Liberian refugees in Buduburam Refugee Settlement: 1) dietary …

Sociodemographic Differences In Human Papillomavirus Vaccine Impact: A Systematic Review, Alexandra Nichole Montano

Public Health Theses

IMPORTANCE: The majority of literature related to disparities in human papillomavirus (HPV) vaccination has been focused on sociodemographic differences in vaccine uptake. Now nearly ten years after the introduction of the vaccine, and with a better understanding of disparities in uptake, a small but growing body of evidence is beginning to examine the impacts of the vaccination campaign. Monitoring disparities in the impact of the vaccine is crucial in order to better understand the full implications of the vaccine and to properly guide future programs and recommendations.

OBJECTIVE: To systematically review the literature on the impact of the human papillomavirus …

Tying Community Engagement With Appropriate Technology At The Last Mile: A Cluster Randomized Trial To Determine The Effectiveness Of A Novel, Digital Pendant And Voice Reminder Platform On Increasing Infant Immunization Adherence Among Mothers In Rural Udaipur, India, Ruchit B. Nagar

Public Health Theses

Background: 500,000 children under the age of five die from vaccine preventable diseases in India every year. More than just improving coverage, increasing timeliness of immunizations is critical to ensuring infant health in the first year of life. Novel, culturally-appropriate, community engagement strategies are worth exploring to close the immunization gap. In this case, a digital pendant and voice call reminder (components of the Khushi Baby platform) are tested for the effectiveness in improving DTP3 adherence within two monthly camps from DTP1 administration.

Methodology: A cluster randomized trial was conducted in which 96 village health camps were randomized to three …

Exposure To Pesticides And Food Packaging Materials And Bmi In Samoan Mothers And Children, Jennifer Park

Public Health Theses

Background: Growing evidence suggests that environmental chemicals, including certain pesticides and bisphenol A (BPA), may be linked to obesity because of their ability to disrupt metabolic functions. Methods: We conducted a community-based, cross-sectional survey of 319 non-pregnant mothers, ≥18 years old, with a child aged 2-Samoa, a country with high obesity prevalence, understudied agricultural and residential pesticide use and BPA consumption from canned and packaged goods. We measured weight and height of the mother-child pair and interviewed mothers about their potential environmental exposures. Using multivariable logistic regression, we evaluated the association between pesticide and BPA exposure surrogates and weight status. …

Trust And A Respect For Persons: Public Health As A Profession Of Relationships, Michael Anthony Perrin

Public Health Theses

The purpose of this thesis is to explore the concept of empathy, or “the ability to share someone else’s feelings," in public health, examining the concept’s effect on both the ethical mandates of the profession and the validity of community-engaged research results. The ethical guidelines of the profession, as outlined by the American Public Health Association and other prominent public health researchers, were used to inform such an exploration, as was personal experience and Yale public health researcher insights. A case study of homelessness public health research was conducted. Interviews and surveys were conducted with prominent homelessness community advocates with …

Barriers To Care For Cardiovascular Risk Factor Management, Morgan Anne Pratte

Public Health Theses

Introduction: Hypertension, high cholesterol, diabetes, obesity, and smoking are established risk factors for cardiovascular disease (CVD), and the presence of several risk factors is associated with worse health outcomes. Access to healthcare has a major influence on the management and treatment of these modifiable conditions. The objective of this study is to examine barriers to care among non-elderly adults with multiple risk factors for CVD, and to furthermore identify socio-demographic disparities within this group.

Methods: Analyses utilized data from a subset of 39 U.S. states and territories that implemented the optional healthcare access module in the 2013 Behavioral Risk Factor …