Medicine and Health Sciences Commons^™

Building Confidence In Critical Thinking Through Faculty Implementation Of Simulation, Melissa Morris

Doctor of Nursing Practice Projects

Simulation provides nursing students with experiences that are as effective as clinical experiences in a non-threatening environment. Clinical experiences such as obstetrics, pediatrics, and mental health have been observation only at the project site. With observation-only clinicals, students do not have opportunities to master skills specific to nursing, which bridge theory to practice. The purpose of this Quality Improvement (QI) project focuses on educating nursing faculty who may not be simulation experts to learn the skills to build and implement simulations that align with the International Nursing Association Clinical and Simulation Learning (INACSL) simulation standards. The Primary Investigator (PI) utilized …

Enhancing Faculty Confidence And Candidate Selection: Evaluation Of A Standardized Holistic Interview Rubric In Nursing Program Admission, Jennifer M. Bray

Doctor of Nursing Practice Projects

Nursing programs continue to struggle with high attrition rates, which impact student success, program outcomes, and the development of a competent nursing workforce. National data show that associate degree nursing programs report attrition rates as high as 50% in the first year, highlighting the urgency for more effective admission strategies. The problem addressed in this quality improvement project was the use of traditional academic metrics, such as grade point average (GPA) and standardized test scores, as primary admission criteria, which often overlook essential non-cognitive attributes linked to student persistence and success. The purpose of the project was to improve faculty …

The Impact Of Staff Education On Menopausal Care, Oluwatoyosi Olumide

Doctor of Nursing Practice Projects

Natural menopause typically occurs around the age of 51. During this transition, many women experience a variety of vasomotor symptoms, with hot flashes and night sweats being the most common. As women age, diminishing levels of estrogen, progesterone, and testosterone can lead to various health complications. Without proper assessment, diagnosis, and treatment, many may suffer in silence. This quality improvement project sought to evaluate the impact of staff education on menopausal care. The symptom checklist, or the Menopause Rating Scale (MRS), is a standardized, evidence-based tool for assessing menopause symptoms and serves as an essential component of the admission process …

The Effect Of Intraoperative Facet Joint Denervation In The Prophylaxis Of Back Pain After Spinal Fixation: A Randomized Prospective Controlled Single-Blind Study, Mohamed Ali Abbas, Ahmed Zaghlol, Ayman M Ismail, Hamdy Nabwi, Mohamed Ismail, Ahmed Sameh Nada, Mona Mokhtar, Ahmed Shaker Elakhras

Mansoura Medical Journal

Background: Failed back surgery syndrome (FBSS) remains a significant challenge after fixation procedures of the spine. The present research assessed the efficacy of intraoperative facet joint denervation in preventing postoperative back pain in individuals undergoing spinal fixation. Methods: A randomized retrospective controlled single-blind study was carried out on 70 patients requiring spinal fixation assigned to two equal groups: Group A: intraoperative facet joint denervation was performed, while Group B was a control group. Pain levels were evaluated utilizing the visual analog scale (VAS) for 7 days following surgery. Follow-up visits occurred at 2 weeks, 1, 3, and 6 months. The …

Lost In Transition: The Need For Research On Immersive Clinical Experiences In Athletic Training Education, Julie M. Cavallario, Stephanie M. Singe

Rehabilitation Sciences Faculty Publications

Context

Immersive clinical experiences (ICEs) were integrated into athletic training education to enhance student learning. However, their structure and effect remain poorly understood.

Objective

To highlight the lack of research on ICEs and the need for data-driven improvements in athletic training education.

Background

Since the transition to graduate-level education, ICEs have been required to provide students with uninterrupted exposure to professional practice. Despite this requirement, little evidence exists regarding their effectiveness or best implementation practices.

Synthesis

Authors of recent studies have revealed inconsistencies in implementation, limited placement diversity, and inadequate preceptor training. Despite widespread adoption, little evidence supports how ICEs …

Exploring The Barriers To The Implementation Of Acute Care Nurse Practitioner Roles, Madeline Wd Mcnulty

2025 Fall Honors Capstones Projects - Archive

Acute care nurse practitioners (ACNPs) are associated with improved patient outcomes and are among the fastest-growing professions in healthcare. However, this growth is accompanied by barriers to the ACNP role. Despite this expansion, limited research has examined these barriers or identified strategies to reduce them in acute care settings. Therefore, this study aimed to identify the obstacles to ACNP practice and to describe approaches to overcoming them. A qualitative descriptive design was employed. Twenty-one pioneering ACNPs participated in semi-structured interviews. Data were analyzed using the “Sort and Sift, Think and Shift” method. We identified nine themes in the study: four …

Environmental Health Priorities In Rural Public Health Departments: Perspectives From Health Agency Directors, Michelle Rastegar

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rural communities are staffed by environmental health practitioners with less formal public health training and fewer years of public health experience. The literature on environmental health program implementation in rural communities is incomplete and specifically misses the perspectives of those charged with developing and fielding such programs. The purpose of this paper is to gather and report the insights of three rural local public health department leaders regarding the challenges, opportunities and stakeholders for implementing environmental health programs. Using purposive sampling of faculty community partners, three rural Kentucky local health department directors were recruited to participate in the study. After …

Promoting Physical Activity (Pa) Among Latinas In Fayette County, Ky, Vanessa Diaz Mph

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the United States, the prevalence of overweight and obesity continues to rise at a disproportionate rate that is greatly affecting Latinas. This paper outlines the implementation of an adapted version of Fe en Acción, a faith-based evidence-based physical activity (PA) intervention that was initially implemented in San Diego, CA. The program targets Latinas in Fayette County, KY through culturally tailored, faith-based PA classes held at local Catholic churches. By using promotoras– health promoters– the program works to increase self-efficacy and social support while promoting sustainable behavior change. Key adaptations include a reduction in class frequency (four times a week), …

Pathways To Green River District Health Department, Gracelyn P. Bush

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In an effort to decrease Neonatal Abstinence Syndrome (NAS) in the Green River District of Western Kentucky, this grant proposes the expansion of the evidence-based University of Kentucky PATHways program to the Green River District Health Department (GRDHD). To protect the health of both women and children, this program will specifically target pregnant women with substance use disorder (SUD). This program will deliver a group-based prenatal and postpartum curriculum with the integration of Peer Recovery Support Specialists, specifically modeled on Social Cognitive Theory and the adoption of whole-person care. The proposed program spans a three-year time frame, beginning with program …

A Case Study In Program Evaluation: Evaluation Of A Community Program To Increase Rates Of Physical Activity, Emma Hughes

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Bourbon County faces rates of obesity and levels of physical inactivity that are at, or worse, than the Kentucky state average. The Bourbon County Health Department (BCHD) has prioritized addressing these issues and received funding from a private foundation to do so. Collaboration with the University of Kentucky and additional funding from UK Healthcare (UKHC) will support these efforts to improve the rates of regular physical activity, raise awareness of the negative health impacts of inactivity, and increase access to safe places to exercise. The BCHD developed a 6-month program that involves several interventions aimed at increasing the percent of …

Understanding The Intersection Between Alaska Native And Military Cultural Identities: Using Arts-Based Narrative Inquiry With Mixed Methods, Leslie M. Robertson

Art Therapy | Doctoral Dissertations

American Indian and Alaska Native (AI/AN) peoples have contributed significant efforts towards involvement in the military and have served in the Armed Forces at five times the national average. AI/AN peoples have served with distinction in every major conflict for over 200 years. There has been a pervasive and historical lack of recognition for their service and a lack of awareness of the intersection between Indigenous and military cultures (Ault, 2020; Bennett, 2009; Department of Veterans Affairs, 2020; Harris & Hirsch, 2020; Holm, 2010; Krouse, 2007; Marston, 1972; Nalewicki, 2021; NICOA, 2019; Viola, 2008; Wooda et al., 2021).

This study …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …

Investigating Sex-Specific Role Of The Kynurenine Pathway In Opioid Withdrawal, Blake Brady

Psychology Theses - Archive

The opioid epidemic has led to a surge in opioid use disorder (OUD) and overdose deaths, making opioid withdrawal a critical area of study. Opioid withdrawal is characterized by both somatic and affective symptoms, including anxiety-like behaviors and physical withdrawal signs, yet the underlying neurobiological mechanisms remain insufficiently understood. The kynurenine pathway (KP), a primary metabolic route for tryptophan (TRP), is increasingly implicated in neuroinflammatory responses and neuropsychiatric disorders, yet its involvement in opioid use and withdrawal remains poorly studied, with even less known about potential sex-specific differences. Historically, the predominant use of male subjects in preclinical research has compounded …

The Influence Of Social Support On The Stress Levels Of Pre-Nursing Students, Michelle Chinwendu Nicole Izuwah

2025 Fall Honors Capstones Projects - Archive

Introduction/Background: The nursing shortage in the United States continues to pose a significant challenge due to the widening gap between the supply of and demand for qualified nurses. The COVID-19 pandemic demonstrated the importance and vitality of nurses to society. Thus, it is important to support students throughout their nursing journey, even from the earliest stages. Pre-nursing students are college students who have not yet begun taking upper-division classes and are enrolled in nursing programs, and face a unique set of struggles due to the pressure of prerequisite classes, as well as fears of not being accepted into the nursing …

Burnout Among Nurses In The United States, Faheem Ohri

Social Work Dissertations - Archive

Burnout is an exhausted state of the body, mind, and emotions, characterized by feelings of “depersonalization and reduced personal accomplishment” resulting from prolonged and continuous occupational stress. Burnout among nurses in the United States (U.S.) is a growing concern with significant implications for healthcare professionals and patient outcomes. Nurse burnout compromises patient safety and workforce stability, but pre-pandemic national correlates remain understudied. This dissertation examined employment settings and demographic correlates of burnout among U.S. nurses using the National Sample Survey of Registered Nurses (NSSRN) secondary datasets. Compared inpatient burnout odds pre-/post-pandemic using national twin surveys. Jackknife complex survey logistic regression …

Excitation And Polarization Of Isolated Neurons By High-Frequency Sine Waves For Temporal Interference Stimulation, Iurii Semenov, Vitalii Kim, Giedre Silkuniene, Andrei G. Pakhomov

Bioelectrics Publications

The capacity of temporal interference (TI) stimulation to target deep brain regions without affecting nearby surface electrodes remains uncertain. Using artifact-free optical recording, we compare excitation patterns and thresholds in hippocampal neurons stimulated by “pure” and amplitude-modulated sine waves, representing TI waveforms near electrodes and at the target, respectively. We show that pure 2- and 20-kHz sine waves induce repetitive firing at rates that increase up to 60–90 Hz with stronger electric fields. Beyond this limit, action potentials merge into sustained depolarization, resulting in an excitation block. Modulating the sine waves at 20 Hz aligns firing with amplitude “beats” and …

Accuracy And Repeatability Of Autorefraction In Young Adults: A Comparison Of Cycloplegic And Non-Cycloplegic Methods, Megan Doyle, Veronica O'Dwyer O'Dwyer, Michael Moore, Síofra Harrington

Articles

Clinical Relevance: Cycloplegic refraction remains crucial in young adults, where accommodative activity can obscure accurate refractive status. Autorefractor repeatabil­ity is essential for precise optical correction and refractive error categorisation in clinical and research settings.

Background: Cycloplegic autorefraction is recommended for individuals up to 20 years to prevent hyperopia underestimation and myopia overestimation. This study evaluated differences between non-cycloplegic and cycloplegic spherical equivalent refraction following cyclopentolate hydrochloride (cycloplegic agent) administration in young adults. This study also explored whether this difference varied by refractive status (hyperopia (≥1.00D), emmetropia ( >−0.50, < 1.00D), myopia (≤-0.50D)) or pre- instillation of proxymetacaine hydrochloride and whether cycloplegia improved autorefractor repeatability.

Methods: Participants were 182 young adults (17–30 years) (mean (standard deviation): 21.66 …

The Influence Of Adhesive Curing Mode (Light Vs. Dual) On The Microtensile Bond Strength Of Cad/Cam Composite Blocks To Human Dentin : (In-Vitro Study), Mohamed Fouad Haridy, Shadwa Hatem Kabil, Amr Hesham

Dentistry

No abstract provided.

Perioperative Surgical Site Infection Reduction Bundle In Colorectal Patients, Flatasha A. Roland

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Surgical site infections (SSIs) are a common and preventable complication after colorectal procedures, significantly impacting patient morbidity and increasing healthcare costs. This quality improvement (QI) project aimed to lower SSIs in adult colorectal surgery patients by implementing a perioperative SSI reduction bundle at a large acute care facility in North Texas. The intervention targeted three modifiable risk factors: perioperative hypothermia, hyperglycemia, and incorrect antibiotic timing. Despite established protocols, institutional data revealed subpar compliance with active warming (46%), blood glucose control (52%), and antibiotic stewardship (75%), all of which fell below national benchmarks. A gap analysis and literature review guided the …

Regionality In Heart Failure Self-Care Behaviors Using The Medical Expenditure Panel Survey, Gretchen K. Wendt

Nursing Dissertations - Archive

Heart failure (HF) risks increase as patients age, with most of the HF patients having at least one chronic condition and 40% having two or more. Further confounding the HF morbidity and chronic medical conditions are psychiatric conditions like depression and anxiety. For most Americans with HF, managing the diagnosis and chronic conditions can be overwhelming. To formalize the definitions of HF disease management, the concepts of self-care from the situation-specific theory of HF self-care (SST-HFSC) were applied.

The medical complexity of HF self-care during the pandemic was shown to vary based on the US region where the individual resided. …

Physical And Perceived Effects Of The Menstrual Cycle On Female Athletes, Talia E. Casarella, Alyssa M. Quiteles, Emily E. Liddick, Madelyn R. Swarthout, Rebecca J. Turner

Student Research Poster Presentations 2025

Purpose: The purpose of this study was to understand the physical and perceived effects of the menstrual cycle on female athletes’ performance during training and competition.

Hypothesis: The researchers hypothesized that there would be a significant difference in performance based on the phase of the menstrual cycle.

Methods: This study used EBSCO Academic Search Complete and Science Direct, focusing on peer-reviewed articles from the last 10 years. Search terms included: (exercise or physical fitness or physical activity) AND (menstrual cycle or period or menstruation or menses or follicular phase or luteal phase) AND (female athletes or women athletes or athletic …

Radiation Dose In Computed Tomography, Jonathan Paniagua

Student Research Poster Presentations 2025

This poster provides detail of the radiation doses patients are exposed to in computed tomography (CT). CT helps give radiologists a more detailed image of patients. With CT first coming in the United States in the 1970s the usage has increased every decade. Presently over 100 million CT examinations are done annually. With increased usage some patients are being overexposed by scanners. A study done in the late 2000s found patients received up to eight times the radiation needed. Incidents such as this caused the need for imaging campaigns to be launched by the American Society of Radiologic Technologists to …

Time Of Urine Sampling May Influence The Association Between Urine Specific Gravity And Body Composition, Patrick B. Wilson, Brian K. Ferguson, Ian P. Winter

Exercise Science Faculty Publications

Urine specific gravity (USG) is frequently utilized in sports practice and research to assess hydration status. Prior research suggests that individuals with large amounts of fat-free mass (FFM) and muscle have elevated USG, but little is known about whether the time of collection (first-morning vs. spot sampling) and various nutritional factors influence these relationships. This cross-sectional, observational study assessed fasted first-morning (n = 55) and non-fasted spot USG (n = 51) samples in adults and evaluated relationships of USG with body composition and nutrition intake. The InBody 770 was used to estimate FFM, skeletal muscle mass (SMM), and total body …

Predicting Biologic Nonadherence In Inflammatory Bowel Disease Using Machine Learning Models, Christian Rhudy

Theses and Dissertations--Clinical and Translational Science

Inflammatory bowel disease is a chronic relapsing-remitting disease of the intestinal tract affecting approximately 0.5% of the population in the US. Moderate to severe inflammatory bowel disease is managed with biologic therapies to induce and maintain remission, however nonadherence to biologics occurs in and estimated 16.9% and 45% of patients. Nonadherence to biologics can increase the risk of disease flares, emergent healthcare utilization, and surgical intervention. While numerous factors have been associated with biologic nonadherence, there are limited resources for prospectively assessing patient-specific risk of biologic nonadherence. Accordingly, objective of this work is to develop machine learning methods of predicting …

Association Of State Cannabis Legalization With Cannabis Use Disorder And Cannabis Poisoning, Jayani Jayawardhana, Jialin Hou, Patricia Freeman, Jeffery C. Talbert

Health Management and Policy Faculty Publications

IMPORTANCE Whether state implementation of medical and recreational cannabis laws is associated with increased cannabis use disorder (CUD) and/or cannabis poisoning among adults is not evident.

OBJECTIVE To examine state-level medical and recreational cannabis laws’ associations with CUD and cannabis poisoning, overall and by sex and age subgroups.

DESIGN, SETTING, AND PARTICIPANTS In this longitudinal cohort study, state-level CUD and cannabis poisoning diagnoses from January 2011 to December 2021 were examined across all 50 US states and the District of Columbia before and after the implementation of medical and recreational cannabis laws (MCLs and RCLs, respectively) using a staggered adoption …

Demographic Variation In Continuous Glucose Monitoring Utilisation Among Patients With Type 1 Diabetes From A Us Regional Academic Medical Centre: A Retrospective Cohort Study, 2018–2021, Omer Atac, Kory R. Heier, Daniela Moga, John L. Fowlkes, Min-Woong Sohn, Aaron J. Kruse-Diehr, Teresa M. Waters, Mary E. Lacy

Health Management and Policy Faculty Publications

Objective: While continuous glucose monitoring (CGM) utilisation has been increasing among patients with type 1 diabetes (T1D), few studies have examined patterns of use across age, race/ethnicity and insurance status together. In this study, we examine CGM utilisation among patients with T1D from a regional academic medical centre across all insurance types.

Design and Setting: This is a retrospective cohort study including both paediatric and adult patients with T1D who visited a regional academic medical centre between 1 January 2018 and 31 December 2021.

Methods: Patients were followed from the date of their first T1D encounter during the study period …

Plasma S100Β Is A Predictor For Pathology And Cognitive Decline In Alzheimer’S Disease, Geetika Nehra, Bryan J. Maloney, Rebecca Smith, Wijitra Chumboatong, Erin L. Abner, Peter T. Nelson, Björn Bauer, Anika M. S. Hartz

UK CARES Faculty Publications

Background Blood–brain barrier dysfunction is one characteristic of Alzheimer’s disease (AD) and is recognized as both a cause and consequence of the pathological cascade leading to cognitive decline. The goal of this study was to assess markers for barrier dysfunction in postmortem tissue samples from research participants who were either cognitively normal individuals (CNI) or diagnosed with AD at the time of autopsy and determine to what extent these markers are associated with AD neuropathologic changes (ADNC) and cognitive impairment.

Methods We used postmortem brain tissue and plasma samples from 19 participants: 9 CNI and 10 AD dementia patients who …

Artesunate Enhances The Efficacy Of Enzalutamide In Advanced Prostate Cancer, Xinyi Wang, Jinghui Liu, Fengyi Mao, Yifan Kong, Qiongsi Zhang, Chaohao Li, Daheng He, Chi Wang, Yanquan Zhang, Ruixin Wang, Sally R. Ellingson, Qiou Wei, Zhiguo Li, Xiaoqi Liu

Toxicology and Cancer Biology Faculty Publications

Prostate cancer (PCa) is one of the leading causes of death among men worldwide. Treatments targeting the androgen receptor pathway remain the standard therapy for PCa patients. Enzalutamide (ENZ), a second-generation androgen receptor inhibitor, was developed to treat castration-resistant prostate cancer. However, while patients initially respond to ENZ, drug resistance typically develops within a few months. Artesunate (ART), a semisynthetic derivative of the Artemisinin plant, is approved for antimalaria treatment. In this study, we conducted an FDA-approved drug screening and identified ART as a potential candidate for overcoming ENZ resistance in PCa. Mechanistically, ART induces the degradation of c-Myc, enhancing …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Metformin In Overcoming Enzalutamide Resistance In Castration-Resistant Prostate Cancer, Kendall Simpson, Derek B. Allison, Daheng He, Jinpeng Liu, Chi Wang, Xiaoqi Liu

Markey Cancer Center Faculty Publications

Androgen deprivation is the standard treatment for patients with prostate cancer. However, the disease eventually progresses as castration-resistant prostate cancer (CRPC). Enzalutamide, an androgen receptor inhibitor, is a typical drug for treating CRPC and with continuous reliance on the drug, can lead to enzalutamide resistance. This highlights the necessity for developing novel therapeutic targets to combat the gain of resistance. Metformin has been recently investigated for its potential antitumorigenic effects in many cancer types. In this study, we used enzalutamide and metformin in combination to explore the possible rescued efficacy of enzalutamide in the treatment of enzalutamide-resistant CRPC. We first …