Medicine and Health Sciences Commons^™

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Increasing Awareness Of Implicit Bias And Systemic Racism Among Clinical Staff Caring For Non-Hispanic Black Maternal Patients, Melissa Courtney

DNP Projects

Background: Kentucky is ranked 17^th in the nation for the highest maternal mortality rate in the U.S. with a rate of 22.9 per 100,000, and 78 percent of those maternal deaths were considered preventable. The Non-Hispanic Black maternal death rate in the U.S. and Kentucky is 2.9 times higher than that of the Non-Hispanic White maternal counterparts (Kentucky Department of Public Health Division of Maternal and Child Health (KDPHDMCH), 2022). The fundamental cause of maternal health inequities is structural racism, which leads to poor treatment and experiences in the healthcare system (Chinn et al., 2020). Structural racism and implicit …

Dean's Update, January 2024, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Increasing Annual Depression Screening For Adults In A Primary Care Setting, Sandy Zachery, Sheryl Winn, Flor Culpa-Bondal

Graduate Research Showcase

Increasing Annual Depression Screening for Adults in a Primary Care Setting

Background:

Depression is a mental illness that's common worldwide, which can cause an individual to function poorly in society and can progress to suicide. Because of several barriers, patients in a primary care environment are not being seen or treated for depression. Even though the U.S. Preventive Services Task Force (USPSTF) recommends that all adults in primary care receive annual depression screening that delivers effective treatment with the correct diagnosis and accurate follow-up, patients are still not being screened for depression.

Purpose:.

This project aims to improve …

Occupational Therapy Interventions Supporting Women's Transition Into Motherhood: A Systematized Review​, Hadley Milks, Jocelyn Anderson, Madison Krueger, Bridgette Quinn, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Importance: The transition to motherhood is difficult for many women due to multidimensional changes including psychological and emotional shifts, evolving social relationships, and bodily fluctuations (Hwang et al., 2022; Marinucci, 2023).

Objective: To synthesize information about interventions within the occupational therapy scope of practice to improve the transition to motherhood.

Data sources: A medical librarian performed searches in PubMed, CINAHL, PsychINFO from 2014-2024.

Design: The inclusion criteria included pregnant women or women with a baby for up to 1 year of age, OT interventions, quantitative studies, and systematic reviews written in English.

Findings: There were 13 articles ranging from scoping …

Pupillometry As A Viable Augmentative And Alternative Communication Pathway: A Machine Learning Application, Kouadio Marc-Antoine Niamba

Dissertations and Theses

Every year, clinicians diagnose 5000 new Amyotrophic Lateral Sclerosis (ALS) cases in the United States (Mehta et al., 2018). ALS is a degenerative neuromuscular disease that prevents neurons from sending impulses to the muscles, thus resulting in paralysis and death. People with ALS (PALS) not only experience limited mobility but also lose their ability to communicate. Although the disease currently remains incurable, efforts to improve the patients’ communication are increasingly leading toward Augmentative and Alternative Communication (AAC) systems (Beukelman and Mirenda, 2013). AAC systems are assistive technologies that propose to counteract the defects resulting from ALS through non-verbal communication channels. …

Associations Between Physical Activity Levels And Physical And Mental Health In Military Veterans., Troy Hubert

Theses and Dissertations--Psychology

Research suggests that higher rates of health conditions are associated with lower levels of physical activity, but this association is not well characterized in U.S. Military Veterans. The current study utilized a sample of U.S. military veterans (n = 3,989) from the 2019-2020 National Health and Resiliency in Veterans Study (NHRVS). Physical activity levels (insufficient, moderate, and active), physical and mental health were evaluated with a variety of self-report questionnaires. After controlling for covariates, veterans with any disability, asthma, chronic pain, diabetes, high cholesterol, and stroke were significantly less likely to report sufficient physical activity compared to insufficient physical …

Developing And Implementing A Sexually Transmitted Disease Screening Program To Decrease Chlamydia Cases On A College Campus, Amanda C. Harris

All Capstone Projects

Introduction: Sexually active college students were experiencing a high incidence, spread, and reinfection of the sexually transmitted Disease (STD) chlamydia on a university campus.
Purpose: To determine if implementing of a quality improvement program on campus utilizing a holistic approach would help decrease chlamydia cases. This program focused on fast-track STD screening, increasing knowledge about STDs, and addressing mental health issues.
Methods & Study Design: This was a descriptive/quasi-experimental design. Participants utilized the fast-track STD screening and completed surveys. Descriptive statistics and frequency tables were used to summarize survey responses for 1) the pre-and post-sexually transmitted disease (STD) education survey, …

Implementing Social Determinants Of Health Data Collection In A Large Urban Pediatric Hospital Setting, Stormee Williams, Kristina Hill, Barry Owen, Forest Melton

Research

No abstract provided.

Student Academic Success System, Brandi Castle

Doctor of Nursing Practice Projects

This project aimed to enhance academic success and retention rates in a practical nursing program through the implementation of a Student Academic Success System (SASS), utilizing evidence-based teaching strategies. A quality improvement design using both the Iowa Model of Evidence-Based Practice and the Plan, Do, Study, Act (PDSA) framework was guided by Kolb’s Model. Nurse faculty saw a need for increased student retention among practical nursing students; the student then proposed a plan, translated evidence, created a pre- and post-survey, and carried out SASS with the use of trained nurse faculty coaches. The goal of the project was to reduce …

Occupational Therapy’S Role In Facilitation And Compliance With Clean Intermittent Self-Catheterization (Cisc), Abigail P. Hernandez

Occupational Therapy Doctorate Capstone Projects

Background: The Occupational Therapy Practice Framework (OTPF) (4th ed.) states that toileting and toilet hygiene includes management of continence needs, including catheters and the necessary equipment to maintain bladder control (American Occupational Therapy Association, 2020b). However, the overall perspectives of occupational therapy’s role are poorly understood.

Purpose: The study's purpose was to collect data about occupational therapy (OT) practitioners' practice trends in client management of clean intermittent self-catheterization (CISC), including perceived competency, education and training, and frequency and extent of involvement in supporting clients with CISC needs.

Theoretical Framework: The study is also supported by the American Occupational Therapy Association …

The Effectiveness And Feasibility Of Telehealth Occupational Performance Coaching With Young Adults With Intellectual Disabilities: A Case Study, Mara Sampson

Occupational Therapy Doctorate Capstone Projects

Background: College students with intellectual disabilities (ID) experience occupational performance barriers, impeding participation. Limited evidence-based techniques are available to therapists working with this population. Telehealth Occupational Performance Coaching (OPC) has been found to be an effective treatment technique for improving occupational performance and self-determination for populations outside of college students with ID.

Purpose: The purpose of this experimental case study was to test whether participation in a telehealth OPC program for college students with ID increases occupational performance, occupational satisfaction, and self-determination.

Theoretical Framework: Self-Determination Theory and the Canadian Model of Occupational Performance and Engagement (CMOP-E) provide for the theoretical …

Impact Of Iadl Interventions On Discharge Readiness: Musculoskeletal Conditions In Inpatient Rehabilitation, Kasi B. Gannon

Occupational Therapy Doctorate Capstone Projects

Background: Musculoskeletal conditions are the highest contributing cause of the need for rehabilitation globally, and are common conditions treated by occupational therapy in inpatient rehabilitation. Basic activities of daily living (BADLs) are the main focus of rehabilitation in these settings, which may leave clients unprepared to complete important higher level instrumental activities of daily living (IADLs) at home.

Purpose: The purpose of this study was to determine the impact that instrumental activities of daily living (IADL) intervention and training has on individuals’ perceived discharge readiness and quality indicator scoring for those admitted to an inpatient rehabilitation facility with a musculoskeletal …

"Shut Down And Closed Off": A Routine Activity Approach To Investigating The Relationship Between Covid-19 School Closures And Child Sexual Abuse Report Characteristics In Georgia, Spencer E. Riner

College of Graduate Studies: Theses & Dissertations

The COVID-19 pandemic of 2020 created a public health crisis that led to an unprecedented number of school closures. A major concern raised by child advocates, law enforcement, and social service providers was the possible increase in undetected child abuse and maltreatment. Undergirding this concern was the belief that this mitigation effort might place child abuse victims and offenders within proximity for extended periods of time. While this was a significant concern, it has rarely been analyzed empirically. To address this gap in the literature, this thesis investigates how school closures impacted the characteristics of child sexual abuse (CSA) reports …

When Divergent Worlds Collide: Dr. Santiago Ramón Y Cajal’S Influence On The Surrealism Movement, William J. Hardman Iii, Md

MA Theses

Dr. Santiago Ramón y Cajal’s drawings were created for the sole purpose of illustrating his newly discovered and earth-shattering revelations in the field of neuroscience culminating with his magnum opus: the “Neuron theory” and the “Theory of Dynamic Polarization.” For these discoveries and many others, he shared the 1906 Nobel Prize in medicine and physiology with his rival Dr. Camilo Golgi, an Italian pathologist. At no time did he envision that his drawings would capture the interest of artists as it did with members of the Surrealism Movement. This thesis will explore and present for the first time supporting evidence …

A Tai Chi And Qigong Mind-Body Program For Low Back Pain: A Virtually Delivered Randomized Control Trial, Yang Yang, Sydne Mccluskey, Mohamad Bydon, Jaspal Ricky Singh, Robert D. Sheeler, Karim Rizwan Nathani, Ana C. Krieger, Neel D. Mehta, Joshua Weaver, Libin Jia, Sharo Decelle, Robert C. Schlagal, Jay Ayar, Sahar Abduljawad, Steven D. Stovitz, Ravindra Ganesh, Jay Verkuilen, Kenneth A. Knapp, Lin Yang, Roger Härtl

Publications and Research

Background: Mind-body treatments have the potential to manage pain, yet their effectiveness when delivered online for the treatment of low back pain (LBP) is unknown. We sought to evaluate whether a virtually delivered mind-body program integrating tai chi, qigong, and meditation (VDTQM) is effective for treating LBP.

Methods: This randomized controlled trial compared VDTQM (n=175) to waitlist control (n=175). Eligible participants were at least 18 years old, had LBP for at least 6 weeks, were not pregnant, had not previously taken tai chi classes, and had not undergone spine surgery within 6 months. The treatment group received a 12-week VDTQM …

Fight-Pd: A Feasibility Study Of Periodized Boxing Training For Parkinson Disease, David J. Blacker, Raimondo Fazio, Claire Tucak, Phillip Beranek, Connor Pollard, Tegan Shelley, Sanathraj Rajandran, Georgina Holbeche, Mitchell Turner, Travis Cruickshank

Research outputs 2022 to 2026

Background: Boxing training has become a popular form of exercise for people with Parkinson disease (PD). There is a dearth of high-quality feasibility, safety, and efficacy data on boxing training for PD. Feasibility of Instituting Graduated High-intensity Training (FIGHT-PD) aimed to examine these features in a periodized boxing training program featuring high-intensity physical and cognitive demands. Objective: To conduct a feasibility study, aiming to address deficiencies in the current knowledge base and to provide data for future studies. Design: Single-arm, open-label feasibility. Setting: University department and medical research institute. Participants: Ten people with early stage PD without contraindications to intense …

Frailty Knowledge, Training And Barriers To Frailty Management: A National Cross-Sectional Survey Of Health Professionals In Australia, Leila S. Hanjani, Sarah Fox, Ruth E. Hubbard, Emily Gordon, Natasha Reid, Sarah N. Hilmer, Rosemary Saunders, Danijela Gnjidic, Adrienne Young

Research outputs 2022 to 2026

Objective(s): To understand Australian health professionals' perceptions of their knowledge and previous training about frailty, as well as barriers to frailty assessment and management in their practice. Methods: A cross-sectional online survey was developed and distributed to health professionals (medical, nursing and allied health) engaged in clinical practice in Australia through convenience and snowball sampling techniques from March to May 2022. The survey consisted of five sections: frailty training and knowledge; confidence in recognising and managing adults with frailty; the importance and relevance of frailty; barriers to assessing and managing frailty in practice; and interest in further frailty training. Responses …

Maximal Number Of Repetitions At Percentages Of The One Repetition Maximum: A Meta-Regression And Moderator Analysis Of Sex, Age, Training Status, And Exercise, James L. Nuzzo, Matheus D. Pinto, Kazunori Nosaka, James Steele

Research outputs 2022 to 2026

The maximal number of repetitions that can be completed at various percentages of the one repetition maximum (1RM) [REPS ~ %1RM relationship] is foundational knowledge in resistance exercise programming. The current REPS ~ %1RM relationship is based on few studies and has not incorporated uncertainty into estimations or accounted for between-individuals variation. Therefore, we conducted a meta-regression to estimate the mean and between-individuals standard deviation of the number of repetitions that can be completed at various percentages of 1RM. We also explored if the REPS ~ %1RM relationship is moderated by sex, age, training status, and/or exercise. A total of …

New Treatment Modality For Metastatic Cancer By Targeting The Endothelin Type A Receptor (Etar), Elbara Fathelrahman Abdelmoula

Theses

Ambrisentan, an FDA-approved selective antagonist of the Endothelin Type A Receptor (ETAR) for pulmonary arterial hypertension, has shown potential in limiting cancer growth and metastasis. While effective treatment options for melanoma remain elusive, this study investigates the effects of Ambrisentan on invasive, metastatic B16F10 melanoma using a syngeneic mouse model, aiming to assess Ambrisentan’s impact on tumor growth, metastasis, and overall host survival in B16F10 melanoma, along with gaining mechanistic insights into ETAR antagonism. C57Bl/6 mice were divided into two groups, receiving either dH2O or Ambrisentan orally. Treatments commenced prior to tumor implantation and continued post-implantation. Luciferase-expressing B16F10 cells facilitated …

Envisaging A Thriving Future: The Integration Of Positive Psychology Into Brief Psychotherapy And Family Therapy Practice, Richard Lakeman

Research outputs 2022 to 2026

This paper delves into the pragmatic integration of positive psychology, particularly Seligman's PERMA model, and brief psychotherapy to foster a vision of a thriving future for clients. Despite the entrenched tribalism within psychotherapy that often resists the incorporation of new techniques, a deliberate and flexible approach to integration, rooted in congruence with theoretical frameworks, can overcome these barriers. Positive psychology dovetails neatly with the goals of family therapy by highlighting strengths and resilience. The PERMA model—encompassing Positive emotions, Engagement, Relationships, Meaning and Accomplishment—captures the essence of a flourishing life. While primarily applied in non-clinical settings, its potential to enhance wellbeing …

Error In Jump Height Estimation Using The Flight Time Method: Simulation Of The Effect Of Ankle Position Between Takeoff And Landing, Carlos Gonçalves, Roberto Baptista, James Tufano, Anthony J. Blazevich, Amilton Vieira

Research outputs 2022 to 2026

During vertical jump evaluations in which jump height is estimated from flight time (FT), the jumper must maintain the same body posture between vertical takeoff and landing. As maintaining identical posture is rare during takeoff and landing between different jump attempts and in different individuals, we simulated the effect of changes in ankle position from takeoff to landing in vertical jumping to determine the range of errors that might occur in real-life scenarios. Our simulations account for changes in center of mass position during takeoff and landing, changes in ankle position, different subject statures (1.44–1.98 m), and poor to above-average …

Examining The Effects Of Dynamic And Isometric Resistance Training On Knee Joint Kinetics During Unplanned Sidesteps In Elite Female Athletes, Daniel Kadlec, Matthew J. Jordan, Jacqueline Alderson, Sophia Nimphius

Research outputs 2022 to 2026

Kadlec, D, Jordan, MJ, Alderson, J, and Nimphius, S. Examining the effects of dynamic and isometric resistance training on knee joint kinetics during unplanned sidesteps in elite female athletes. J Strength Cond Res XX(X): 000-000, 2024 - The purpose of this study was to examine the effects of a 4-week block of isometric (isometricRT) and dynamic resistance training (dynamicRT) on kinetic variables associated with anterior cruciate ligament (ACL) injury risk during unplanned sidesteps in elite female athletes. Twenty-one elite female athletes competing for a women's international rugby union team were recruited with 15 (n = 15; age: 23.4 ± 4.7 …

Exploration Of Alzheimer's Disease-Related Gene Expression Following High-Intensity And Moderate-Intensity Exercise Interventions, Kieran J. Marston, Jaisalmer De Frutos-Lucas, Tenielle Porter, Lidija Milicic, Michael Vacher, Kelsey R. Sewell, Jeremiah J. Peiffer, Simon M. Laws, Belinda M. Brown

Research outputs 2022 to 2026

Objectives: There are currently 29 genome regions that demonstrate associations with Alzheimer's disease (AD) risk. Regular physical exercise can promote systemic change in gene expression and may modify the risk of cognitive decline and AD. This study is a secondary analysis of a randomised controlled trial and examines the effect of a six-month exercise intervention versus control on AD-related gene expression. Design: Single-site parallel pilot randomised controlled trial. Methods: 91 cognitively unimpaired older adults were enrolled in the Intense Physical Activity and Cognition (IPAC) study. Participants were randomised into one of three groups: high-intensity exercise, moderate-intensity exercise, or inactive control …

Lessons Learned: Drive-Through Covid-19 Clinic Testing During An Adaptive Epidemic Response And A Point-Of-Care Test Assessment Of A Computer-Read Rapid Lateral Flow Immunoassay With Fluorescence-Based Detection, Leah Rankine-Wilson, Teresa Oncken, Irshan Basrewan, Courtney Jeffery, Todd M. Pryce, Rebecca Wake, Aus A.L. Molan, T. F. Paton, Tim J.J. Inglis

Research outputs 2022 to 2026

Background. The COVID-19 pandemic demonstrated a need for robust SARS-CoV-2 test evaluation infrastructure to underpin biosecurity and protect the population during a pandemic health emergency. Gap statement. The first generation of rapid antigen tests was less accurate than molecular methods due to their inherent sensitivity and specificity shortfalls, compounded by the consequences of self-testing. This created a need for more accurate point-of-care SARS-CoV-2 detection methods. Aim. Here we present the lessons-learned during the COVID-19 emergency response in Western Australia including the detailed set-up, evaluation and operation of rapid antigen test in a state-run drive-through sample collection service during the COVID-19 …

Measuring Attitude Change In Nursing Students After Completion Of A First Nations Peoples’ Health Unit: Embedding A Validated Tool In Learning And Assessment Practices, Kylie Mccullough, Angela Genoni, Melanie Murray, Darren Garvey, Linda Coventry

Research outputs 2022 to 2026

The health inequities experienced by Aboriginal and Torres Strait Islander peoples, rooted in the historical and ongoing negative impacts of colonisation and disrupted traditional lifestyles, sees higher rates of illness and hospitalisations, increased morbidity and higher premature death rates than other Australians. Nurses represent the majority of Australia’s health workforce and nursing students must have knowledge to provide culturally safe care to Australia’s Aboriginal and Torres Strait Islander peoples. An Aboriginal and Torres Strait Islander Peoples’ Health and Wellbeing unit was developed and introduced into an undergraduate nursing curriculum. This project aimed to determine the effectiveness of the unit content …

Out-Of-Hospital Birth Training, Experience And Confidence Of Australian Rural Volunteer Ambulance Officers, Michella G. Hill, Belinda Flanagan, Sara Hansen, Luke Hopper, Brennen Mills

Research outputs 2022 to 2026

Introduction: Unplanned out-of-hospital births represent less outs have a high risk of life-threatening complications, which are than 1% of ambulance requests for assistance. However, these call- particularly complex in rural or remote settings with limited accessibility to specialist care support. Many community hospitals Four themes emerged from analysis: (1) Lack of education and no longer provide obstetrics care, so birth parents must travel to exposure to birth resulted in low confidence. Most participants larger regional or metropolitan hospitals for assistance. Increased reported significant anxiety attending obstetric call-outs, and travel time may increase the risk of unplanned out-of-hospital explained under-utilisation of …

Prevalence Of Disordered Eating And Its Relationship With Rapid Weight Loss Amongst Male And Female Combat Sport Competitors: A Prospective Study, Colin S. Doherty, Lauren V. Fortington, Oliver R. Barley

Research outputs 2022 to 2026

Objectives:

To compare prevalence and change scores of disordered eating (DE) in combat sport athletes by sex and explore the potential relationship between rapid weight loss (RWL) and DE scores.

Design:

Prospective study based on 24 events (September 2022–2023).

Methods:

A body mass (BM) questionnaire was completed at ~ 1 day post-competition providing pre-competition BM data for − 7 days, − 24 h, and weigh-in. The Athletic Disordered Eating (ADE) online questionnaire was completed at ~ 7 and ~ 28 days post-competition, providing overall DE and four subscale scores (food and energy control, bingeing, body control, and body discontent).

Results: …

Self-Efficacy And Home Dialysis: An Integrative Review, Nicola A. D'Souza, Ma'en Zaid Abu-Qamar, Lisa Whitehead

Research outputs 2022 to 2026

Background: Enhancing patient confidence in their ability (self-efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self-efficacy in patients managing home dialysis. Objectives: To identify self-reported levels of self-efficacy, the measurements used to assess self-efficacy and the effectiveness of interventions to enhance self-efficacy in patients undergoing home dialysis. Design: An integrative review approach was employed using Whittemore and Knafl's methodology. Methods: A comprehensive search was conducted to identify literature on self-efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and …