Medicine and Health Sciences Commons^™

The Effects Of Cultural Competency Training On Providers Knowledge, Skills And Attitudes Towards The Latino Population, Jennifer L. Peppiatt

DNP Projects

Background: Providers in the United States (U.S.) healthcare system need to understand the cultural values, beliefs, and traditions of the growing Latino population. As a result, academic institutions are incorporating cultural competency training in their curricula. However, a noticeable knowledge gap exists for those currently practicing in the healthcare arena, impacting patient and provider satisfaction and healthcare outcomes.

Purpose: The purpose of the study was to obtain a baseline assessment of the cultural competence of a select group of Advanced Practice Providers (APPs) caring for the Latino population at the University of Kentucky and provide a targeted educational intervention, followed …

Countering Moral Distress In Ecmo Nurses With Case-Review Debriefings, Sherry D. Griggs

DNP Projects

Abstract

Background: Moral Distress occurs when nurses know the ethically correct action to take, but they are restrained from taking it. It is especially prevalent in nurses caring for critically ill patients, such as those on extra-corporeal membrane oxygenation (ECMO). Effectively addressing moral distress is crucial to the growth and health of the nursing profession, which is the cornerstone of quality and safety in healthcare.

Purpose: The purpose of this project was to evaluate the effectiveness of case-review debriefings on moral distress of ECMO nurses.

Conceptual Framework: Analysis of Moral Distress Process was utilized. This framework addresses moral distress …

Increasing Adherence To Protocolized Diuresis For De-Resuscitation Of Icu Patients By Increasing Nursing Knowledge And Confidence, Jenna Haupert

DNP Projects

Background: Fluid overload in patients requiring intensive care leads to increased costs for hospitals and patients, increased length of intensive care unit (ICU) and total hospital stay, ventilator days, acute kidney injuries, and mortality rates. Multiple studies have indicated that aggressive de-resuscitation with diuretics can decrease length of stay, ventilator days, organ injury, and mortality rates. A nurse-driven diuresis protocol utilizing intravenous (IV) push furosemide was introduced to the University of Kentucky Medicine ICU, but patients are still commonly still over-resuscitated with no plan to diurese until organ damage has occurred. By educating bedside nurses, improving their knowledge and confidence …

Nurses' Knowledge Of Delirium In The Icu, Sara Hancock

DNP Projects

Abstract

Background: Delirium costs the healthcare system $38 to $152 billion dollars annually. Nurses have a unique opportunity as healthcare providers to assess for and identify delirium, but often fail to recognize delirium.

Purpose: The purpose of this DNP project was to determine the effect of implementing an educational intervention regarding delirium risk factors, symptoms, prevention strategies, and treatments, on the knowledge of nurses working in an intensive care unit.

Methods: This DNP project used a quasi-experimental pre-test post-test design. Participants completed a pre-test (Appendix A), an educational intervention (Appendix C & D), and a post-test (Appendix B). Pre-test …

Examining The Impact Of Patient De-Escalation Techniques Training On Nurses' Feeling Of Safety, Raymond O. Young

DNP Projects

Abstract

Purpose: To evaluate the effects of patient behavioral verbal de-escalation techniques training on bedside nurses’ feeling of safety in the presence of an aggressive patient, and nurses’ confidence level in their ability to successfully de-escalate aggressive patient behavior prior to the patient becoming violent. Objectives of this study were to demonstrate increased feelings of safety and security in the workplace among nurses receiving patient de-escalation training once the training was completed; to improve the overall perception of mental health status of nurses; to improve the job satisfaction and likelihood to stay in their current position; and to assess the …

Effect Of Anticipatory Guidance On Parental Knowledge And Anxiety Prior To Discharge Of Infant From The Neonatal Intensive Care Unit To Home, Stephanie Kelty

DNP Projects

Background: Lack of adequate parental education and discharge readiness from the Neonatal Intensive Care Unit (NICU) increases the risk for poor infant outcomes, hospital readmissions, postpartum depression, parental anxiety, and post-traumatic stress disorder. One component of parental readiness at discharge is receiving anticipatory guidance from a trusted healthcare provider prior to discharge.

Purpose/Objectives: This study aimed to evaluate the effectiveness of provider-led anticipatory guidance to enhance parents’ knowledge regarding high-risk infant behaviors and decrease anxiety related to caring for their high-risk infant after NICU discharge. Additionally, this study aimed to assess parental opinions about the value of anticipatory guidance sessions. …

Evaluation Of Middle School Teachers Knowledge, Attitudes, And Barriers Pertaining To Adapted Youth Mental Health First Aid For Middle School Students, Lauren Hurley

DNP Projects

Background: An estimated 17.1 million youth have experienced a mental health disorder, more than the number of children with cancer, diabetes, and AIDS combined (National Council for Behavioral Health, 2016). Unfortunately, of those children with a diagnosable condition, only a third receive mental health treatment (National Council for Behavioral Health, 2016). If a child or adolescent’s mental health disorder is left untreated, then unresolved issues may continue to affect them as adults, creating physical and mental health impairments, that could potentially have a negative impact on their futures. Youth Mental Health First Aid (YMHFA) is an evidenced-based training program that …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

Increasing Confidence Of Nurses In Giving And Receiving Constructive Performance Feedback, Savanna Carroll

DNP Projects

Background: Nursing peer review is a process of reviewing standard nursing practice in an organization and comparing a nurse’s own practice to that standard. Nursing peer review contributes to the professional practice environment by assuring standard practice and competence, maintaining a culture of accountability, and maintaining psychological safety.

Purpose: The purpose of this project was to design and implement an educational intervention and simulation activity to prepare nurses to have constructive conversations with peers regarding work performance. Evaluation of the intervention would yield increased confidence and competence of nursing staff in giving constructive performance peer feedback.

Conceptual Framework: Bandura’s Social …

Policy Change To Reduce Active Duty Suicide Rates, Michelle Rae Loper

DSW Capstone Projects

There continues to be a dramatic increase in the rates of suicide within the Active-Duty military population. There have been a number of efforts to curb the rates without any prolonged success. Several actions and studies have been conducted on risk factors, prevention efforts, and treatment interventions in an attempt to reduce the rates. This capstone comprises a sequence of academic papers: a systematic literature review, a conceptualization paper, and a practical application paper. This project aims to identify the essential policy components necessary moving forward within the Department of Defense to address this critical issue. The research question leading …

Herstory: Women’S Professional Career Experiences In Sport Psychology, Rena M. G. Curvey

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

The purpose of this study was to explore women’s professional career experiences in sport psychology. Using qualitative methodology, seventeen female sport psychology practitioners participated in intensive semi-structured interviews from May 2021 to July 2021. This study resulted in two distinct manuscripts. First, guided by constructivist grounded theory methodology, embedded in a feminist standpoint framework, this study developed a grounded theory to help explain what sources attract and retain women in sport psychology. The developed theory includes the following main categories: sources of career attraction, training and professional development, and sources of career retention, and ten subcategories. This theory contributes to …

Overcoming Resistance To Sg-Aris In Castration-Resistant Prostate Cancer, Chaohao Li

Theses and Dissertations--Toxicology and Cancer Biology

Prostate cancer (PCa) ranks as the most diagnosed type of cancer and the second leading cause of death in men. Androgen receptor (AR) signaling plays a pivotal function in promoting the survival and progression of PCa. Therefore, medication for PCa mainly focuses on the inhibition of AR pathway, which is termed androgen deprivation therapy (ADT). However, the disease eventually progresses and develops to a lethal stage called castration-resistant prostate cancer (CRPC) that is characterized by resistance to canonical ADT. To deal with this situation, several second-generation AR inhibitors (SG-ARIs) have been created that have better efficacy against AR, including Enzalutamide …

Birthing While Black: Anti-Oppressive Social Work Practices For Improved Maternal Health Outcomes, Sara Hall

DSW Capstone Projects

Black women die at a disproportionate rate than white women in the United States due to maternal mortality. Black women are three times more likely to die because of a maternal complication than any other demographic. Although the United States has a highly developed healthcare system, it also has the worst maternal mortality rate out of developed nations. The focus of this research is social work practices that can be implemented to improve Black maternal health outcomes.

The systematic literature review focuses on gaps in social work literature related to maternal mortality and health equity, solutions for social workers to …

Mechanism Of Antibiotic Permeability Through The Gram-Negative Bacterial Envelope, Olaniyi Alegun

Theses and Dissertations--Chemistry

The outer membrane of Gram-negative bacteria (GN) makes them distinct among superbugs that are associated with the development of antibiotic resistance. The outer membrane, and inner membrane, separated by the periplasm, form a double-membrane barrier to the entry of antibiotics into the cell. Several studies have been conducted to examine the role of outer membrane modifications such as porins, lipopolysaccharides, and efflux pumps on antibiotic resistance. However, there is a paucity of knowledge on how antibiotics behave in the periplasm, to gain access into their target region. My thesis focuses on understanding the mechanism of antibiotic permeability through the cellular …

Antibiotic Permeation In Gram-Negative Bacteria And Contribution Of Inflammasome Activation And Pyroptosis In Pathogenesis Of Salmonella Systemic Infection, Ankit Pandeya

Theses and Dissertations--Chemistry

Antibiotic resistance is one of the major global issues in the field of public health and medicine. Good antibiotic candidates need to be selectively toxic, inhibit cellular target, and effectively penetrate and accumulate in bacterial cells. The last factor is a formidable barrier in the development of antimicrobials effective in Gram-negative bacteria, due to the presence of two layers of cell envelope. The first half of my thesis focuses on understanding the permeation of small molecules through this formidable cell envelope, distribution inside the cell of Gram-negative bacteria, and design of novel methods to make small molecules effectively cross the …

Nicotine And Cotinine: Microbial Modulators Of The Immune Response, Jourdan Lakes

Theses and Dissertations--Chemistry

The consumption of tobacco products is a known contributor to a variety of health conditions and disease pathologies including cardiovascular and lung diseases. In addition to these well-known pathological effects of tobacco use, it has been established recently that tobacco consumption as well as nicotine consumption alone results in distinct, dysbiotic perturbations to the enteric microflora of the gastrointestinal tract. Previous research into the intestinal microbiome has demonstrated that these microbes are active contributors to the maintenance of a homeostatic and tolerogenic environment within the host. In fact, the presence of our enteric microflora is necessary for the proper development …

Succinylated Polyethylenimine Gene Delivery Agents For Enhanced Transfection Efficacy, Md. Nasir Uddin

Theses and Dissertations--Chemistry

Gene therapy aims to treat patients by altering or controlling gene expression. Today, most clinical approaches are viral-based due to their inherent gene delivery activity. However, there is still a significant interest in nonviral alternatives for gene delivery, particularly synthetic lipids and polymers, that do not suffer the immunogenicity, high cost, or mutagenesis concerns of viral vectors. Polymeric vectors are of particular interest due to the ability to further tune the polymer properties through the incorporation of additional functional units such as targeting ligands or shielding domains. Polyethylenimine (PEI), a highly cationic polymer, is often considered a benchmark for polymer-based …

Developments In Gold(Iii) Scaffolds For Protein Bioconjugation And Enhanced Anticancer Activity, Sailajah Gukathasan

Theses and Dissertations--Chemistry

Site-selective modifications of target proteins using specially designed small molecules is a powerful tool that has been extensively utilized in biomedicine. Small molecules can modify proteins either covalently or non-covalently depending on their structures and intrinsic chemical reactivity. Covalent chemical modification presents a more stable and often irreversible interaction with target proteins; unlike non-covalent binders, which form weak, reversible interactions with protein. Therefore, covalent modifiers represent an effective class of therapeutics due to their stability and irreversibility once bound to target proteins of interest. I hypothesized that tuning biocompatible, high-valent gold(III) complexes toward nucleophile-induced reductive elimination will lead to covalent …

The Role Of Organizational Leaders In Employee Self-Care: A Change Management Approach, Olivia Dawn Honaker

DSW Capstone Projects

Although literature demonstrates that helping professionals have had high levels of stress and burnout for decades, the COVID-19 pandemic has only exacerbated the issue. The already burdened healthcare workers, now facing increased workloads, long hours, and high-level exposure to trauma, have created an urgency to address this significant risk to helping professionals. The current capstone will bring awareness to organizational leaders regarding the importance of employee self-care and the benefits of implementing employee self-care programs. First, a systematic literature review will examine self-care in helping professions and explore how organizational leaders operationalize employee self-care programs. In addition, the capstone aims …

Healthcare Equity For Transgender Individuals, Mollie Staggs

DSW Capstone Projects

In the field of social justice and integrity, Social Work has dedicated itself to improving the welfare of the world, in which we all participate and interact. There are countless issues in our society that warrant professional attention for the fundamental purpose of positively impacting the livelihood of subcategories of people. For this particular Capstone Project, the focus is on transgender individuals’ systemic healthcare barriers that cisgender people within the United States do not similarly experience. The purpose is to unveil these disparities to then pose progressive alterations within the healthcare system to make the navigation and accessibility better for …

Bolstering The Effectiveness Of Exposure-Response Prevention In The Treatment Of Obsessive-Compulsive Disorder: Using Self-Compassion As An Adjunctive Intervention, Whitney E. Dyer

DSW Capstone Projects

Individuals suffering with Obsessive-Compulsive Disorder (OCD) face many challenges receiving proper diagnostics and evidence-based treatment. Furthermore, Exposure-Response Prevention (ERP), the empirically supported gold standard approach for targeting OCD, presents its own challenges. Examining the influences of ERP treatment reluctance is paramount to bolstering the effectiveness of outcomes and safeguarding participant adherence and ultimate success. This Capstone highlights the overlooking of addressing shame within traditional ERP protocol and posits a practice application model that supports the adjunctive use of self-compassion, a potent antidote for shame, within the use of ERP. As treatment hesitation is an inhibitor to relief for OCD sufferers, …

Neuroleadership A New Burnout Prevention Strategy, Zakery David Sloan

DSW Capstone Projects

This capstone project examines the current state of burnout, prevention strategies, prevalence, and introduces neuroleadership as a new leadership theory to advance burnout prevention among the public human service population. Neuroleadership presents a new conceptualization of leadership practice and burnout prevention method by utilizing neuro-informed leadership practices. This new neuro-informed leadership strategy is explored throughout the three major products of this capstone project including a systematic literature review, conceptual paper, and practice application paper.

The first product completed was a systematic literature review. This literature review included a total of 13 articles which were used to answer the research question, …

Postpartum Depression: Mitigating Treatment Barriers For Women In Appalachia, Tabitha Simpson

DSW Capstone Projects

This capstone focuses on maternal mental needs, specifically postpartum care and postpartum depression. Each article in this capstone centers on postpartum depression, treatment barriers, introducing standard care of practice for women in rural communities, and identifying gaps leading to further research in postpartum education. Countless articles were read and utilized in conducting the systematic literature review to begin this process.

The first article in the capstone, the Systematic literature review, details the signs and symptoms of postpartum depression and how it differs from a major depressive disorder. A thorough review of the literature was conducted, identifying the central concern of …

A Pilot Randomized Controlled Trial Of Smoking Cessation Induction Treatment For Rural, Underserved Cancer Survivors Across The Continuum Of Motivation To Quit, William Bowling

Theses and Dissertations--Psychology

The United States’ smoking prevalence has decreased substantially, but this public health improvement is unevenly distributed across the population. A promising individual-level approach to cancer control equity is to develop more acceptable and efficacious interventions that are widely disseminated to rural and other disadvantaged cancer survivors. Smoking cessation induction focuses not on long-term abstinence, but on engaging people in the process of making quit attempts and may be ideal for hard-to-reach populations. The aim of this pilot randomized controlled trial was to evaluate the feasibility and acceptability of a smoking cessation induction intervention designed for rural cancer survivors. The treatment …

Single-Cell Analysis Of Aneurysmal Aortic Tissue In Patients With Marfan Syndrome Reveals Dysfunctional Tgf-Β Signaling, Ashley Dawson, Yanming Li, Yang Li, Pingping Ren, Hernan G. Vasquez, Chen Zhang, Kimberly R. Rebello, Waleed Ageedi, Alon R. Azares, Aladdein Burchett Mattar, Mary Burchett Sheppard, Hong S. Lu, Joseph S. Coselli, Lisa A. Cassis, Alan Daugherty, Ying H. Shen, Scott A. Lemaire

Saha Cardiovascular Research Center Faculty Publications

The molecular and cellular processes leading to aortic aneurysm development in Marfan syndrome (MFS) remain poorly understood. In this study, we examined the changes of aortic cell populations and gene expression in MFS by performing single-cell RNA sequencing (scRNA seq) on ascending aortic aneurysm tissues from patients with MFS (n = 3) and age-matched non-aneurysmal control tissues from cardiac donors and recipients (n = 4). The expression of key molecules was confirmed by immunostaining. We detected diverse populations of smooth muscle cells (SMCs), fibroblasts, and endothelial cells (ECs) in the aortic wall. Aortic tissues from MFS showed alterations …

Inhibition Of Bruton Tyrosine Kinase Reduces Neuroimmune Cascade And Promotes Recovery After Spinal Cord Injury, Chen Guang Yu, Vimala Bondada, Hina Iqbal, Kate L. Moore, John C. Gensel, Subbarao Bondada, James W. Geddes

Physiology Faculty Publications

Microglia/astrocyte and B cell neuroimmune responses are major contributors to the neurological deficits after traumatic spinal cord injury (SCI). Bruton tyrosine kinase (BTK) activation mechanistically links these neuroimmune mechanisms. Our objective is to use Ibrutinib, an FDA-approved BTK inhibitor, to inhibit the neuroimmune cascade thereby improving locomotor recovery after SCI. Rat models of contusive SCI, Western blot, immunofluorescence staining imaging, flow cytometry analysis, histological staining, and behavioral assessment were used to evaluate BTK activity, neuroimmune cascades, and functional outcomes. Both BTK expression and phosphorylation were increased at the lesion site at 2, 7, 14, and 28 days after SCI. Ibrutinib …

Direct Nose To The Brain Nanomedicine Delivery Presents A Formidable Challenge, Robert A. Yokel

Pharmaceutical Sciences Faculty Publications

This advanced review describes the anatomical and physiological barriers and mechanisms impacting nanomedicine translocation from the nasal cavity directly to the brain. There are significant physiological and anatomical differences in the nasal cavity, olfactory area, and airflow reaching the olfactory epithelium between humans and experimentally studied species that should be considered when extrapolating experimental results to humans. Mucus, transporters, and tight junction proteins present barriers to material translocation across the olfactory epithelium. Uptake of nanoparticles through the olfactory mucosa and translocation to the brain can be intracellular via cranial nerves (intraneuronal) or other cells of the olfactory epithelium, or extracellular …

The Use Of A Book Club To Promote Biomedical Trainee Professional Development, Jenni Ho, Stacy E. Smith, Erin J. Oakley, Nathan L. Vanderford

Toxicology and Cancer Biology Faculty Publications

Professional development for biomedical doctoral and postdoctoral trainees is vital, especially due to the increase in individuals pursuing non-faculty career paths. We created a professional development-focused discussion group between trainees and faculty/staff by utilizing a book club format in which monthly small group meetings occurred over an 8-month period. A pre- and post-survey consisting of Likert and free-response questions was completed by participants. Results demonstrated that after the book club, trainees: 1) were more knowledgeable about a variety of career paths; 2) had improved awareness of their interests in relation to their career; 3) were more knowledgeable of their transferrable …

Through The Lens: Youth Experiences With Cancer In Rural Appalachian Kentucky Using Photovoice, Katie Gaines, Courtney Martin, Chris Prichard, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Rural Appalachian Kentucky experiences disproportionately high cancer incidence and mortality rates. This cancer burden is due to social determinants of health and cultural factors prominent in the region. The firsthand experiences of community members—especially young people—can highlight these factors and identify areas for improvement. The purpose of this study was to encourage Appalachian Kentucky youth to consider determinants of cancer and visualize the effects that cancer has on their families or communities by asking them to take photographs of cancer-related objects around them. Content analysis was performed on 238 photographs submitted by 25 students, and photographs were organized into themes, …

Efficacy Of An Enhanced Implementation Strategy To Increase Parent Engagement With A Health Promotion Program In Childcare, Courtney T. Luecking, Cody D. Neshteruk, Stephanie Mazzucca, Dianne S. Ward

Dietetics and Human Nutrition Faculty Publications

Previous efforts to involve parents in implementation of childcare-based health promotion interventions have yielded limited success, suggesting a need for different implementation strategies. This study evaluated the efficacy of an enhanced implementation strategy to increase parent engagement with Healthy Me, Healthy We. This quasi-experimental study included childcare centers from the second of two waves of a cluster-randomized trial. The standard approach (giving parents intervention materials, prompting participation at home, inviting participation with classroom events) was delivered in 2016–2017 (29 centers, 116 providers, and 199 parents). The enhanced approach (standard plus seeking feedback, identifying and addressing barriers to parent participation) …