Digital Commons Network^™

Treatment At An Academic Medical Center Eliminates Survival Disparities For Appalachian Kentuckians With Pancreatic Ductal Adenocarcinoma, Emily Cassim, Hannah Mcdonald, Megan Harper, Quan Chen, Miranda Lin, Reema Patel, Michael Cavnar, Prakash Pandalai, Bin Huang, Pamela C. Hull, Joseph Kim, Erin Burke

Journal of Appalachian Health

Introduction: Rates of cancer mortality in Appalachian Kentucky is among the highest in the nation. It is unknown whether geographic location of treatment for pancreatic ductal adenocarcinoma (PDAC), one of the deadliest cancers worldwide, influences survival in Appalachian Kentuckians.

Purpose: This study compares outcomes among Appalachian Kentuckians with PDAC who received treatment at an academic medical center (AMC) or community facility (CF).

Methods: Using the Kentucky Cancer Registry, patients diagnosed with PDAC between 2003 and 2018 were identified. Patients were categorized according to treatment location (AMC v. CF) and county of residence (Appalachian v. non-Appalachian). Kaplan-Meier curves were constructed to …

Maternal Age And Inadequate Prenatal Care In West Virginia: A Project Watch Study, Madelin Gardner, Amna Umer, Brian Hendricks, Toni Marie Rudisill, Candice Lefeber, Collin John, Christa Lilly

Journal of Appalachian Health

Introduction: Adequate prenatal care (PNC) is essential to the overall health of mother and infant. Teen age and advanced maternal age (AMA) are known risk factors for poor birth outcomes. However, less is known about whether these age groups are associated with inadequate PNC.

Purpose: This study sought to determine the potential association between maternal age (in groups, aged 20–24, 25–29, 30–34, 35–39, and >40) and inadequate PNC (visits).

Methods: West Virginia (WV) Project WATCH population-level data (May 2018–March 2022) were used for this study. Multiple logistic regressions were performed on inadequate PNC (less than 10 visits) with maternal age …

Decistifying Trans And Gender Diverse Inclusion In Library Work: A Literature Review, Stephen G. Krueger, Keahi Adolpho

Library Faculty and Staff Publications

This comprehensive review illuminates the current state of scholarly literature on trans and gender diverse inclusion in libraries, with the intention to provide a foundation and identify gaps for further research. Covering 50 works published between 2002 and 2023 in the areas of general inclusion, public libraries, academic libraries, experiences of library workers, archives, information behavior, and cataloging, we found that, with the exception of works on archives and cataloging, little scholarly literature goes beyond introductory talking points on basic information about trans and gender diverse people. We conclude with a call for much more in-depth research on this essential …

Adjustments To Social Work Practice During The Covid-19 Adjustments To Social Work Practice During The Covid-19 Pandemic In North Carolina: Effects On Burnout And Commitment Pandemic In North Carolina: Effects On Burnout And Commitment, Aaron Brown, Jayme E. Walters, Aubrey E. Jones, Lara Cates

Social Work Faculty Publications

Since the onset of the COVID-19 pandemic, the demand for social workers in the U.S. and abroad has increased. There is demand for more social workers in North Carolina due to ongoing and increasing mental health, substance use disorder, and child welfare needs. COVID-19 has taken a toll on the personal and professional lives of social workers, and research is needed to understand the pandemic’s effects on burnout and commitment among social workers. The present study sought to understand how the COVID-19 pandemic affected the personal and professional lives of social workers practicing in North Carolina and to determine how …

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 …

Division Of Labor And Relationship Satisfaction: Examining The Mediating Role Of Self Esteem, Ellen Keith

Theses and Dissertations--Family Sciences

As a result of feminist movements, rejections of gender roles, and changing economic conditions, profound changes have occurred within the structure of American families. This study delves into the intricate dynamics of divisions of household labor (DoL), self-esteem, and relationship satisfaction within the context of contemporary relationships. Drawing on data from the Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam), this study tested five hypotheses, and investigates how perceptions of fairness in DoL tasks influence self-esteem and relationship satisfaction. Significant associations were found between reported share of DoL and indicated fairness of DoL, indicated fairness of DoL and relationship …

Beyond The Hands: Exploring Intersectional Identities Of Black American Sign Language Users, Tatum Turner

Theses and Dissertations--Linguistics

There is a significant gap in research related to the impact of intersectionality on linguistic identity performance among individuals negotiating multiple marginalized identities. This gap is especially significant among deaf Black and African American individuals who use the American Sign Language (ASL) variety deemed Black American Sign Language (BASL) (Hairston & Smith, 1983). This research aims to identify and discuss the use of the eight distinguishing features of BASL (McCaskill et al. 2011) as indexes of intersectional identities.

My data consists of videos sourced from YouTube, each chosen according to the following criteria: must have at least one self-identifying Black …

Impact Of The Availability And Affordability Of Childcare On The Economy, Valentina Osunmade, Cameron French

MPA/MPP/MPFM Capstone Projects

Kentucky's workforce participation rates are among the lowest in the nation, thus underscoring the urgent need to strengthen and sustain its workforce (Aull, 2023). One significant barrier for many families in the workforce is the lack of accessibility and affordability of childcare. The Child Care Assistance Program (CCAP) in Kentucky aims to alleviate this burden for low-income families. Despite the program's importance, no prior study has examined the direct impact of CCAP enrollment on workforce participation in Kentucky. This research addresses this gap by conducting a multiple regression analysis using aggregate data from the Kentucky Center for Statistics, the US …

Changes In Criminal Thinking Among Homeless Veterans Receiving Housing First Services, Deirdra Robinson

Theses and Dissertations--Social Work

Homelessness is a social problem that has plagued the United States for decades. as early as 1987, veterans were identified has making up a large proportion of people living unhoused. This dissertation is a retrospective exploratory, quantitative study exploring the relationship between criminal thinking and specific characteristics (mental health symptoms, social connectedness, perception of seriousness of legal issues, and housing) of veterans who received services from a Housing First program. Using Survival Mode Theory as a framework for organizing and understanding the context of the study, and the utility of the findings, this dissertation aimed at improving practice and theoretical …

Fathers’ Perspectives On The Role Of Spirituality In Substance Misuse Disorder Treatment And Engaging With Their Children, Kendra Michelle Eubank

Theses and Dissertations--Social Work

The father's role and the extent of involvement with his children have shifted over the past several decades. As a result, researchers have made considerable advances in understanding paternal influences on child development and families. However, one under-researched topic is how fathers' substance misuse, and the recovery process may influence father involvement and effective co-parenting, and specifically, how spirituality plays a role in that. In this qualitative study, fourteen participants participated in semi-structured interviews. The data revealed two main themes: 1) pillars of a spiritual awakening and 2) applying spirituality to healthy fatherhood engagement.

These findings led to four interpretations: …

Public Justice: Analyzing The Interactions Of Supreme Court Justices With The American Public, Abbie Wood

Theses and Dissertations--Political Science

When and how do Supreme Court justices choose to interact with the public? What motivating factors spur a justice to make a public appearance? In the fields of political science, public law, and legal studies, research has overwhelmingly studied on-the-bench behavior. Scholars have analyzed judicial voting patterns, opinion writing, oral arguments, and more. Despite the prevalence and importance of non-decision making activities as well as the growing reporting by media outlets concerning justices' public appearances, there remains a lack of attention devoted to exploring how justices behave off-the-bench. In this dissertation, I seek to develop this neglected area within judicial …

Malleability Of Abortion Attitudes, Allison Leip

Theses and Dissertations--Family Sciences

Although abortion attitudes have been thoroughly investigated and population-level attitudes have not changed much over the past half-century, polls and research inquiring about abortion attitudes tend to ask isolated questions about if, and in what circumstances, abortion should be legal. The purpose of this study was to examine the extent to which abortion attitudes both varied and changed according to several contextual factors. A multiple-segment factorial vignette was conducted with 530 respondents in the state of Kentucky. Overall, most respondents held strong attitudes on access to abortion, both before the rationale was provided and regardless of the rationale provided. However, …

Examining Anxious Attachment And Its Effects On Sexual Behaviors In Adulthood, Justin Graham

Theses and Dissertations--Family Sciences

The current study aimed to investigate the relationship between anxious attachment and adult sexual behaviors. The study utilized pairfam, a nationally representative German sample, as a secondary data set for its quantitative analysis. Participants responded to two anxious attachment scales and questions regarding sexual desire, sexual confidence, and age at first sexual experiences. Analyzing data from 5561 individuals, averaging 29.27 years old, a path analysis was conducted to assess variable effects. Findings indicate that higher anxious attachment correlates with reduced sexual confidence and earlier onset of sexual intercourse. Future studies should investigate additional attachment scales and include a more diverse …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

Identifying Public Perceptions Towards Precision Dairy Technology Use, Brad Kelly

Theses and Dissertations--Animal and Food Sciences

To remain sustainable, the dairy industry must demonstrate commitment to addressing concerns from the public, such as sustainability and animal welfare. Precision dairy technologies (PDT) are a potential solution to ameliorate this issue, but public perceptions towards PDT are currently underinvestigated. This thesis aims to describe public perceptions towards PDT. Specifically, the objectives are to 1) describe baseline perceptions of the U.S. public towards PDT, 2) determine the effects of framing information about human-animal bond, data transparency, and animal welfare on PDT perceptions, and 3) evaluate how demographic characteristics mediate these perceptions. An online survey was used to measure baseline …

The Effect Of A Community Resiliency Model Education On Resilience, Psychological Empowerment, And Well-Being In Behavioral Health Nurses, Lorrie Smith-Esterle

DNP Projects

Background: Resilience, well-being, and psychological empowerment are associated with improvement in job satisfaction and nurse retention rates. The Community Resiliency Model (CRM) can promote emotional regulation, well-being, and create an internal state of balance in response to work-related stressors. Educating nurses on how to use CRM enables the recognition of changes in thoughts, emotions, sensations, and internal or external stimuli, which can promote resilience, well-being, and psychological empowerment.

Purpose: The purpose of this project was to evaluate evaluate the effect of a resiliency education using the Community Resiliency Model (CRM) on resilience, psychological empowerment, and well-being of behavioral health nurses. …

"And I / Am The Arrow": The Narrative, Personae Construction, And Language Ideology Of Confessional Poets' Identity Performance, Madison Fuchs

Theses and Dissertations--Linguistics

This thesis argues for consideration of linguistic features in service of raising the postmodern confessionalist poet identity as an utterance and an act of loyalty to performance. The embodiment of the confessionalist identity, attributed to the features used to adhere to the confessional mode, is realized through the invention of confessional personae. These confessional personae merge the responsibilities of the speaker and the narrator to convey a pseudo-autobiographical utterance to a designated audience. In this thesis, I analyze a sequence of poems that either possess taboo subjects or utilize linguistic functions, like indexicality and audience design, that mark its mode. …

Relationship Of Criterion A Level Of Personality Functioning With Borderline Personality Disorder Over The Course Of Brief Treatment, Michelle M. Smith

Theses and Dissertations--Psychology

The Alternative Model of Personality Disorders (AMPD) housed within DSM-5 Section III posits that impairments in personality functioning, operationalized by the Level of Personality Functioning Scale (LPFS) “constitute the core of personality psychopathology” (APA, 2013, p. 762). If this is the case, there should be strong associations between LPFS and DSM personality disorders, including borderline personality disorder (BPD). BPD Compass is a comprehensive CBT-based treatment for BPD which aims to reduce BPD symptoms over the course of 18 weekly sessions. This study examined if a) LPFS would be associated with changes in BPD symptoms, b) whether LPFS has incremental validity …

Gender Differences In Preschool Conduct Disorder Symptoms Across One-Year, Madeline K. Petersen

Theses and Dissertations--Psychology

Conduct disorder is a childhood disruptive behavior disorder that exhibits striking gender differences in prevalence, comorbidities, and associated outcomes. These gender differences, particularly symptomology, remain understudied in conduct disorder despite the growing prevalence in females. This paper seeks to examine gender differences in parent rated conduct disorder symptoms in preschoolers overrecruited for disruptive behavior problems at three different timepoints across one-year. It is hypothesized that males will exhibit higher levels of physical aggression symptoms at the initial timepoint with declining rates across a one-year period compared to females, while females will exhibit lower levels of conduct problems at the first …

Differential Impacts Of Weather Anomalies On Household Energy Expenditure Shares: A Comparison Of Clustered Panel Analysis Methods, Jordan Champion

Theses and Dissertations--Agricultural Economics

Recent emphasis on environmental justice has highlighted deficiencies in our energy system that produce disparities in accessibility and affordability for the most vulnerable. Meanwhile, the realities of a gradually warming climate and the onset of a global energy crisis (IEA 2022) have coincidently contributed to spikes in both energy prices and demand. These implications threaten to further exacerbate existing disparities for income-constrained and vulnerable populations, enhancing their risk of falling into prolonged insecurity. To ensure our transition to a just, sustainable future, we must first ensure equitable access to affordable and reliable energy for everyone. Combining household-level panel and state-level …

An Investigation Of Body Image And Eating Behaviors In Former Ncaa Heptathletes, Claire Bailey

Theses and Dissertations--Kinesiology and Health Promotion

Research consistently supports associations between body image dissatisfaction and disordered eating pathologies in collegiate athletes (e.g., Reel & Voelker, 2012; Sundgot-Borgen, 1994). More specifically, female NCAA athletes report feeling torn between peak performance body composition and body fat levels fitting ideal feminine standards (Beckner & Record, 2016; Carson et al., 2020). Examining track and field, most event groups hold a lean-promoting perspective. However, heptathletes warrant further investigation due to the multifaceted and contradictory nature of events. Specifically, heptathletes encounter complex pressures training for a wide range of physical demands, which can create confusion in expected body types (Heazlewood et al., …

How Do Hospital Characteristics Affect Veteran Patients’ Satisfaction In South Korea?, Miran Jo

MPA/MPP/MPFM Capstone Projects

This study examined the impact of the characteristics of commissioned hospitals on the satisfaction of veterans by using the satisfaction survey data of Korean veterans. As a result of a regression analysis using departments, beds, and specialists as independent variables and satisfaction scores as dependent variables, it was found that there was a positive correlation between the number of specialists and satisfaction in general hospitals. However, in clinics and tertiary hospitals, the number of beds was found to have a negative effect on satisfaction. Additionally, the presence or absence of a Veterans Affairs hospital did not have a significant effect …

It Takes A Village: Impact Of Lgbtq+ Community On The Relationship Between Parenting Stress, Parent Mental Health, And Child Adjustment, Kevin Mcaweeney

Theses and Dissertations--Psychology

While LGBTQ+ parented families are largely the same as their cis-het parent counterparts, they still experience unique factors exclusive to them. One such factor is access to the LGBTQ+ community. While research has emphasized the importance of community within the family system, the role the LGBTQ+ community can play for LGBTQ+ parented families is largely unexplored. Additionally, LGBTQ+ research examining parents of adolescents is similarly lacking. Utilizing a sample of LGBTQ+ parents with adolescent children, and informed by ecological systems theory, self-determination theory, and the parenting stress model, I examine the influence parent’s sense of LGBTQ+ community has on the …

“Your Legs Don’T Look All That Good” An Analysis Of Impoliteness And Politeness In Individuals With Traumatic Brain Injuries In The Workplace, Grace Kozal

Theses and Dissertations--Communication Sciences and Disorders

Background: Social communication disorders are a common outcome from traumatic brain injury (TBI). This social communication disorder can be seen through impolite speech acts during conversation. While politeness is a social norm for workplace discourse, instances of impoliteness may have poor consequences. This research explores the use of impoliteness in persons with TBI within computer generated work-based conditions.

Methods: Language samples from the Voicemail Elicitation Task (VET) and Feedback/Advice Spoken Task (FAST) were transcribed word-for-word. Transcripts from all 62 participants were coded for impoliteness using a developed Impoliteness Codebook and were analyzed to identify significant differences in the number of …

Pixels Or People: A Comparison Of The Differenital Effects Of Animated And Human Video Models On Exercise Behaviors For Hgh School Students With Intellectual Disability, Jade Alexis Fulkerson

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Individuals with intellectual disabilities, with or without autism spectrum disorder, often require structured programming to facilitate acquisition of skills. Video modeling, an evidence-based strategy, offers a promising avenue for skill instruction. While research has demonstrated the effectiveness of human-modeled video interventions, limited research has been conducted into the efficacy of animated models. Addressing this gap, the present study employed an alternating treatments design to compare the effectiveness of human and animated models in teaching exercise behaviors to high school students with intellectual disabilities, with or without autism spectrum disorder. Results revealed variability among participants: one individual exhibited superior performance with …

High-Risk Individuals And Naloxone Use: Implications For Thn Programs In Rural Appalachian Communities, Victor Garcia, Lisa Mccann, Erick Lauber, Christian Vaccaro, Melissa Swauger, Alex Daniel Heckert

Journal of Appalachian Health

Introduction: Take-home naloxone (THN) is being made available across rural Appalachia to curb opioid overdose fatalities. Despite this initiative, some opioid users do not possess naloxone, and if they do, do not administer it to others.

Purpose: Research findings on risk factors that contribute to opioid overdose are presented. These factors, identified in a sample of 16 overdose cases, are (1) early onset age of opioid use; (2) progressive opioid use; (3) a transition from pain medication to heroin and fentanyl; (4) fears of being arrested at a naloxone intervention if first responders are contacted, and (5) limited knowledge of …

Changes In Perceptions Of First Responders After Witnessing A Drug Overdose: Individual And Contextual Variations Among People Who Use Opioids In West Virginia, Kathleen L. Egan, Kelly Gurka, Alexandria Macmadu, Herb Linn

Journal of Appalachian Health

Introduction: Success of opioid overdose interventions involving first responders is dependent on the comfort level that bystanders have with first responders and their willingness to call for assistance. Positive or negative experiences with first responders following witnessing an overdose may influence a person’s willingness to call a first responder for assistance in the future.

Purpose: The objective of this study was to examine changes in bystanders’ perceptions of first responders following witnessing an overdose attended by emergency medical services or a law enforcement official. It specifically explored perception changes among a sample of individuals residing in Appalachia who use prescription …

Self-Reported Consumption Of Bottled Water V. Tap Water In Appalachian And Non-Appalachian Kentucky, Jason W. Marion

Journal of Appalachian Health

Introduction: Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water.

Purpose: To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky.

Methods: Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. …

On Being Seen, On Being Legible, On Being: A Black, Agender Perspective On A Career In Libraries, Adrian Williams

Library Faculty and Staff Publications

This ethnographic essay explores the author’s journey in understanding, contending with, and building a career in academic libraries that is affirming to their Black and agender identity. The essay discusses the hypervisibility of the author’s race in libraries, in contrast to the invisibility of their transness, and how that contrast has affected how they navigate their work as a pre-tenure librarian.

A Better Life: Factors That Help And Hinder Entry And Retention In Mat From The Perspective Of People In Recovery, Adam D. Baus, Martha Carter, Jennifer Boyd, Erin Mcmullen, Trey Bennett, Alexandra Persily, Danielle M. Davidov, Christa Lilly

Journal of Appalachian Health

Introduction: Opioid addiction and opioid-related overdoses and deaths are serious public health problems nationally and in West Virginia, in particular. Medication-assisted treatment (MAT) is an effective yet underutilized treatment for opioid use disorder (OUD).

Purpose: Research examining factors that help individuals succeed in MAT has been conducted from provider and program perspectives, but little research has been conducted from the perspective of those in recovery.

Methods: This study, co-developed with individuals in recovery, took place in West Virginia-based MAT programs using an exploratory sequential mixed methods approach. The survey was open February through August 2021. Data were analyzed late 2021 …