Medicine and Health Sciences Commons^™

Efforts To Improve Colorectal Cancer Screening Rates, Yong S. Girdler

DNP Projects

This project attempts to describe the efficacy of FOBT (guaiac-based FOBT & fecal immunochemical test), explore FluFOBT program, and examine the relationship between advanced practice registered nurse knowledge level about CRC screening recommendation guideline and self-reported referral rates in efforts to improve CRC screening rates.

Are Type 2 Diabetes Patients Receiving Diabetes Self-Management Education In The Primary Care Setting?, Erica Mahone

DNP Projects

Diabetes is a growing health concern in the United States, with approximately 1.7 million new cases diagnosed yearly. A management option to help patients gain glycemic control is the participation in diabetes self-management education (DSME). DSME aims to teach patients how and why they need to perform self-care, and not solely rely on medications to manage diabetes. A literature review of 10 studies between 2007 and 2014 was conducted and found favorable health outcomes for participants of DSME. Patients who participated in DSME had improved glycemic control, achieved blood pressure and cholesterol goals, and lost weight. An analysis of the …

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

An Evaluation To The Adherence Of A Sepsis Protocol At A Central Kentucky Community Hospital, Somer K. Robinson

DNP Projects

Background: Sepsis is defined as a “systemic response to an active infectious process in the host” and “represents the systemic inflammatory response to the presence of infection” (American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, 1992, p.865). In 2008, an estimated 727,000 patients were hospitalized with a diagnosis of sepsis, an increase from 326,000 in 2000, or a 55% increase in prevalence over the eight-year period (Hall, Williams, DeFrances, & Golosinskiy, 2011). Early identification of sepsis with early and effective management strategies has been shown to improve patient outcomes and decrease mortality and prevent organ dysfunction (Levy …

2013 Jin Shin Jyutsu® Patient Response, Nathan Garrett

DNP Projects

Background: Pain and stress are symptoms experienced by many patients with cancer. Integrative therapies including energy therapies can help manage these symptoms. Jin Shin Jyutsu (JSJ) is one such energy therapy, but there is limited research regarding its utility on pain and stress for patients with cancer.

Objectives: The following study had two main objectives: 1) evaluate the self-reported perception of pain and stress before and after a first-time JSJ session, and 2) examine gender differences in perceptions of pain and stress following JSJ.

Methods: A retrospective study employing a pretest-posttest design was used to examine the perceptions of pain …

Stress In Parents Of Children With Type 1 Diabetes, Megan B. Carter

DNP Projects

Pediatric healthcare providers across the country care for many children with complex chronic diseases. Many of these children are not developmentally mature enough to manage their disease process, leaving the parent of the chronically ill child to manage their disease. The parent of the chronically ill child may experience stress related to their child’s illness, termed pediatric parenting stress, and may have difficulty dealing with this stress (Streisand, Kazak, & Tercyak, 2003). The manuscripts in this Practice Inquiry Project further investigate the relationship between pediatric parenting stress and the health of the parent and the chronically ill child. The instruments …

Evaluation Of An Educational Intervention To Improve Nurse Managers' Understanding Of And Self-Assessed Competence With Personnel Budgeting, Sue J. Mcfarlan

DNP Projects

Purpose: The purpose of this paper is to report on the process and outcomes of a DNP practice inquiry project.

Design: The design is a pretest posttest comparative evaluation.

Setting: The University of Kentucky Healthcare Chandler, Samaritan, and KY Children’s hospitals.

Subjects: A voluntary convenience sample of nurse managers was obtained (n=10)

Intervention: The intervention was a 2 hour didactic session and an individualized one-on-one educational session focused on general healthcare finance terms and more specifically on personnel budgeting and productivity metrics

Measures: The pretest and posttest consisted of 20 questions obtained from healthcare finance texts and preparatory materials for …

Adolescent Risk Behaviors, Screening, And Referral At An Adolescent Health Clinic: A Retrospective Review, Cheryl Marrs

DNP Projects

Aim: Investigate provider patterns of risk behavior screening at an adolescent health clinic and describe findings from a study that investigated patterns of risk behavior screening in an adolescent health clinic.

Background: Adolescents who engage in risky behaviors are vulnerable to problems with current and future mental health issues such as depression, substance use, or other psychiatric disorders. Identifying the risky behaviors in adolescents that are associated with the potential presence of depressive symptoms can be helpful to the provider when deciding to refer an adolescent for further mental health assessment. Provider fidelity in risk behavior screening is central to …

Pediatric Oncology Nurses’ Knowledge Of Safe Administration Of Chemotherapy/Biotherapy, Leslee A. Bertram

DNP Projects

The introduction of chemotherapy in pediatric oncology tremendously impacted the survival of children with cancer. In the past 60 years, the survival rates of children with cancer have drastically improved with 5-year survival rates of the most common types of childhood cancer nearing 90%. Use of chemotherapeutic agents is not without risk as they are administered in a variety of routes and doses. Disturbingly high error rate ranging from 4% to 18%, depending upon the administration setting (inpatient or outpatient) are reported in the literature (Watts & Parsons, 2013).

Chemotherapy errors have the potential to be lethal because of a …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

Evaluating The Effectiveness Of Crucial Conversations® Training On Nurses’ Self-Efficacy, Deeanna R. Mccallie

DNP Projects

Background: The history of nurse/physician communication is well documented. Although there is no universal definition of nurse-physician communication, an increasing body of evidence identifies this factor as an important component of organizing and delivering safe, quality care to patients. Communication has been identified as the root cause in 65% of sentinel events and noted as having significant effect on patient outcomes; contributing significantly to increasing care coordination, decreasing length of stay, and decreasing mortality rates. Purpose: To examine whether Crucial Conversations® training improves nurses’ self-efficacy scores and assess whether clinical nurse report improved ability to communicate with physicians. Methods: A …

Assessment Of Nurses’ Views And Current Practice Of Trauma-Informed Pediatric Nursing Care: Oncology, Alesandra S. Conley

DNP Projects

Purpose: The purpose of this project is to: (i) assess and evaluate the awareness, knowledge and current practice trends of pediatric oncology nurses as they relate to pediatric trauma-informed care. Methods: A prospective, cross-sectional sample of convenience was used to assess pediatric nursing staff at the Kentucky Children’s Hospital. The survey used in this study was replicated from a previous study, “Nurses’ Views and Current Practice of Trauma-Informed Pediatric Nursing Care,” authored by Kassam-Adams et al., nurses and doctors affiliated with Children's Hospital of Philadelphia, University of Pennsylvania, Penn State Hershey Children's Hospital, Nemours Child Health System, Children's Hospital of …

Childhood Nutrition And Lifestyle In Owensboro, Kentucky, Mckenzie J. Mattingly

DNP Projects

According to the CDC, childhood obesity is now one of the leading health problems in the United States. Thirty-five percent of adults in the United States are obese. Kentucky is the 12th most obese state for adults. and the 7th most obese state for children. The State of Obesity: Better Policies for a Healthier America, states that Kentucky’s adult obesity rate is currently 31.6 percent. This is up from 21.7 percent in 2000 and 12.7 percent in 1990. Primary care providers must work to help prevent these numbers from continuing to climb. Since our population of children who are overweight …

Improving Nutritional Status In The Hematologic Oncology Population, Mary A. Malone

DNP Projects

Background: Patients undergoing treatment for both solid tumor and hematologic malignancies experience numerous symptoms that greatly affect their nutritional status. Malnutrition can have a negative impact on oncology patient outcomes. There is a reduced response to treatment, reduced survival and quality of life. Early and consistent interventions have proven beneficial in the oncology population.

Most hematologic cancer patients have good nutritional health. However, as their treatments intensify, side effects compared to their solid tumor counterparts can adversely affect nutrition. Interventions, consisting of total parenteral or enteral nutrition are initiated but only after oral intake has been impeded for 2-3 days. …

Examining The Relationship Between Type And Extent Of After-School Care Use And High Bmi In Children Ages 5-17, Morgan E.B. Chojnacki

DNP Projects

Objectives: The purpose of this study was to examine the relationship between body mass index (BMI) and after-school care use in school age children and adolescents in Kentucky. The specific aims of this study were to examine differences in BMI groups (high versus normal/low) by: a) type and b) extent of after-school care use.

Methods: Parents of children age 5-17 years were administered a 21-item survey which assessed the amount of time their children spent in specific types of after-school care. BMI of the child/adolescent participants were obtained at the time of the survey. High BMI was defined …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …

Mhealth: A Utilization Review By Feature Classification For Sustained Use, Elaine Dunn

MUSC Theses and Dissertations

mHealth is a fast growing segment for healthcare. However, there has been little research into the specific elements of mHealth that can drive continued use for optimization of the potential benefits. The purpose of this case study was to use the Delone and McLean Information System Model as a framework for classification of mHealth functionality and then to review the utilization of those categories over a six month period of time. A sample of 137 pediatric diabetics was reviewed. The activation rate was high at 94.9% indicating an interest in using mHealth. There was higher utilization of system features in …

Characterization Of Co-Circulating Swine Influenza A Viruses In North America And The Identification Of A Novel H1 Genetic Clade With Antigenic Significance, Tavis K. Anderson, Brian A. Campbell, Martha I. Nelson, Nicola S. Lewis, Alicia Janas Martindale, Mary Lea Killian, Amy L. Vincent

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

Multiple genetically and antigenically distinct hemagglutinin genes of the H1 and H3 influenza A virus (IAV) subtypes co-circulate in North American swine. This diversity has evolved by repeated transmission of IAVs from humans to swine and subsequent antigenic drift in swine. To understand the evolutionary dynamics of these diverse HA lineages in North American swine, we undertook a phylogenetic analysis of 1576 H1 and 607 H3 HA gene segments, as well as 834 N1 and 1293 N2 NA gene segments, and 2126 M gene segments. These data revealed yearly co-circulation of H1N1, H1N2, and H3N2 viruses, with three HA clades …

Investigating The Effect Of Arsenic On Chromium(Vi)-Induced Genotoxicity In Human Lung Fibroblasts, Jason Stewart Ms

All Student Scholarship

Hexavalent chromium (Cr(VI)) compounds are well-established human lung carcinogens. Arsenic (As) is a well documented human carcinogen with long term exposure to AS in drinking water being linked to lung, kidney and liver cancer, among others. Co-exposure studies are now becoming more common as humans are not exposed to just one toxicant at a time. This is the first study to investigate the effects of co-exposure with arsenic and soluble or particulate Cr(Vi) compounds in human lung fibroblasts.

High-Definition Tdcs Of Noun And Verb Retrieval In Naming And Lexical Decision, Svetlana Malyutina, Dirk B. Den Ouden

Communication Sciences and Disorders Faculty Articles and Research

High-definition transcranial direct current stimulation (HD-tDCS) is a novel brain stimulation method that has high potential for use in language therapy for speakers with aphasia, due to its safety and focality. This study aimed to obtain foundational data on using HD-tDCS to modulate language processing in healthy speakers. Participants received stimulation either of left Broca’s area or of angular gyrus (20 minutes of anodal, cathodal and sham stimulation on separate days), followed by naming and lexical decision tasks with single-word verb and noun stimuli. We found that cathodal stimulation over both Broca’s area and left angular gyrus increased naming speed …

Case 213: Primary Spenic Angiosarcoma, John J. Krol, Vera V. Krol, Adrian Dawkins, Halemane S. Ganesh

Radiology Faculty Publications

A 75-year-old woman with a medical history of gastroesophageal reflux disease and type II diabetes presented to the hospital with a 3-month history of gradually worsening headaches, vague upper abdominal pain, and lower back pain. The patient denied fevers, night sweats, contact with sick individuals, occupational exposure to infection, bleeding, immunodeficiency, intravenous drug use, alcohol or tobacco abuse, history of malignancy, family history of genetic disorders, and international travel. Physical examination revealed a skin-colored mass protruding from the right side of her forehead, but there were no other notable abnormalities. Her diabetes was managed with diet, and the only prescription …

Agreement In The Army's Circumference Measurements And Dual-Energy X-Ray Absorptiometry, Katherine Mitchell

All Master's Theses

The United States military has two primary outcomes for fitness: combat readiness and physical appearance. In response to the Army Weight Control Program, height-weight tables were put forth to evaluate soldiers’ body fat percentages and screen for overweight individuals. However, few studies have examined the agreement in body composition estimates between the Army’s circumference measurements and dual-energy x-ray absorptiometry (DXA). The purpose of this study was to quantify the agreement in body fat percentage estimates between the Army’s circumference measurements and dual-energy x-ray absorptiometry in male Army Reserve Officers’ Training Corps (R.O.T.C.) cadets. Male R.O.T.C. cadets (N = 23) …

Beverage Selections And Presence Affect Healthy Eating Index Scores In Lunches Of Elementary Age Children, Whether From Home Or School, Mary K. Barbee

All Master's Theses

Objectives: Examined differences in school lunch meals (served and consumed) brought from home (LBFH) versus National School Lunch Program (NSLP) using Healthy Eating Index 2010 scores for assessment of Meal Quality by component food groups. Influence of beverage selections on HEI-2010 scores were examined for each meal origin. Methods: Digital plate waste estimations were analyzed for 509 NSLP meals and 524 LBFH from 2nd-5th-grade students in four elementary schools during the 2011-2012 academic year. Nutrient Data Software for Research (NDSR) determined food groups and nutrients for calculations. Independent t-tests compared NSLP and LBFH meal components. Two one-way ANOVA tests compared …

Community Readiness Assessment: Applications For Community Nutrition Research, Whitney E. Houser

All Master's Theses

Trends in qualitative community nutrition research demonstrate a powerful, emerging perspective in the midst of a field historically dominated by quantitative methods of inquiry. For this qualitative study, ten key respondents were purposively selected and interviewed using the Community Readiness Model (CRM) to capture community knowledge of food insecurity issues and strategies. Data were analyzed using anchored rating scales, revealing readiness at a stage three, characterized by a vague awareness of local food insecurity. The purpose of this study is to report on the strengths and challenges of the CRM experienced when utilizing the model to address food insecurity. The …

Exercise Motivations Of Older Adults, Laura J. Attaway

All Master's Theses

This study examined and compared activity levels and motives in 103 older (over 50 years of age) competitive athletes (CA) and non-competitive fitness exercisers (NCF). The findings indicate that the CA group was significantly higher in the motives of enjoyment, competition, and social recognition. Ranking of the strength of the motivation factors for each group indicated that enjoyment was the strongest motivating factor for both groups, health ranked high for both groups, and social recognition ranked lowest in both groups. Findings related to rankings were not tested for significance, so are more tentative.

Amla Enhances Autophagy And Modulates Beta Amyloid Metabolism In An In Vitro Model Of Alzheimer’S Disease, Elham Teimouri, Prashant Bharadwaj, Stephanie R. Rainey-Smith, Paul Fraser, Giuseppe Verdile, Ralph N. Martins

ECU Posters

Alzheimer’s disease (AD) is a progressive, fatal neurodegenerative disease characterized by extensive neuronal loss associated with increased accumulation of the beta amyloid (Aβ) protein. Reducing production, preventing aggregation and improving clearance of Aβare areas of active research in the development of therapeutic agents to ameliorate neurodegeneration in AD. The Indian plant amla (Emblicaofficinalis), commonly known as Indian gooseberry, has widely been utilized in traditional Ayurvedic medicine preparations in the treatment of a variety of disease conditions including cardiovascular disease and diabetes: accumulating evidence also suggests that amla may be beneficial in AD. Amla exhibits antioxidant, anti-inflammatory, and anti-apoptotic mechanisms and …

Hiv Infrastructure Study Jackson, Mississippi, Susan S. Reif, Elena Wilson, Carolyn Mcallaster, Miriam Berger

Faculty Scholarship

No abstract provided.

Adiponectin Protects Against Paraquat-Induced Lung Injury By Attenuating Oxidative/Nitrative Stress., Rong Yao, Yaxiong Zhou, Yarong He, Yaowen Jiang, Peng Liu, Lei Ye, Zhijie Zheng, Wayne Bond Lau, Yu Cao, Zhi Zeng

Department of Emergency Medicine Faculty Papers

The specific mechanisms underlying paraquat (PQ)-induced lung injury remain unknown, which limits understanding of its cytotoxic potential. Although oxidative stress has been established as an important mechanism underlying PQ toxicity, multiple antioxidants have proven ineffective in attenuating the deleterious effects of PQ. Adiponectin, which shows anti-oxidative and antinitrative effects, may have the potential to reduce PQ-mediated injury. The present study determined the protective action of globular domain adiponectin (gAd) on PQ-induced lung injury, and attempted to elucidate the underlying mechanism or mechanisms of action. BALB/c mice were administered PQ, with and without 12 or 36 h of gAd pre-treatment. The …