Digital Commons Network^™

Exploring The Impact Of An Appalachian Higher Education Institution Had On Fostering Solidarity, Capacity, And Agency Of Female Appalachian Students Seeking To Positively Influence The Quality Of Life For Themselves And Appalachian Communities, Analiese Mitchell

Theses and Dissertations--Community & Leadership Development

Appalachian women navigating higher education encounter multifaceted challenges, often confronting marginalization and a lack of representation within academic spaces. This study investigates the experiences of female Appalachian students at Mountain University in Kentucky, aiming to shed light on their journey and the university's impact on their lives and communities. Drawing on qualitative data from interviews, the research explores themes of solidarity, capacity, agency, and Quality of Life. Findings reveal a robust sense of solidarity among Appalachian peers and faculty, fostering a supportive environment conducive to personal and academic growth. Participants express opportunities to engage with their communities positively, contributing to …

Valorization Of Bourbon Distilling Waste Using Thermal Conversion Processes For Nutrient-Rich Food Products, Tosin Olayemi Olanrewaju

Theses and Dissertations--Biosystems and Agricultural Engineering

The Commonwealth of Kentucky accounts for over 95% of global bourbon production. A primary byproduct of bourbon production is stillage, which has a very high moisture content (91–94%) and high biochemical oxygen demand, making it challenging to manage. The recent expansion of the bourbon industry has heightened environmental concerns regarding the best methods to handle this byproduct. Dewatering and drying of stillage produce distillers' spent grains (DSG-B), which are rich in dietary fiber and protein and could serve as an excellent source of functional fiber in human nutrition.

This study examined the approach for dewatering, drying, inclusion of DSG-B as …

Improving Healthcare Provider Knowledge And Confidence With Treating The Lgbtq Population Through A Web-Based Education Module, Logan Price

DNP Projects

Background: There is a need for improved healthcare staff and provider knowledge and confidence when treating the LGBTQ population, as many healthcare providers are insufficiently prepared to treat LGBTQ patients (Rowe et al., 2017). This population is at greater risk for mental illness, substance use, and physical illness than the general population due to societal factors such as minority stress and stigma (Cochran et al., 2004; Cochran & Mays 2007; Cochran et al., 2003; Meyer, 2003). Purpose: The purpose of this project is to educate healthcare staff and providers about the LGBTQ population to improve their knowledge and confidence when …

Point Of Care Ultrasound (Pocus) For Advanced Practice Providers (Apps), Crystal S. Rogers

DNP Projects

Background: Advanced practice providers (APPs) routinely lack the skillset to perform Point of Care Ultrasound (POCUS) because currently, there is not a standardized curriculum within scholarly programs (Santos et al., 2018) and/or inadequate hospital training to perform these competencies (Huang et al., 2021). The absence of a standard curriculum has limited the ability of APPs to practice with full scope, provide care that is comparable to physician partners in the acute care setting, and deliver highest quality of patient care. Implementing standard education to train APPs for POCUS addresses this identified gap.

Purpose: The purpose of this project was to …

Pharmacy Involvement In Increased Access To Opioid Treatment Programs, Catherine O'Rourke

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

The opioid epidemic still affects many Americans today. Despite approved medication treatments for opioid use disorder (OUD), a majority of the population with OUD have not received treatment. Since pharmacists are the most accessible health care professional and had an important role providing care during the COVID-19 pandemic, there has been a push to expand pharmacists’ scope of practice. The primary purpose of this investigation was to identify the benefits and barriers to community pharmacist-led treatment of OUD. The secondary purpose was to determine whether pharmacist participation in opioid treatment programs (OTPs) or office based opioid treatment (OBOT) would be …

A Case Study In Program Evaluation, Lydia Williams

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

The three core functions of public health are assessment, policy development, and assurance, and program evaluation falls under the latter category. A program is incomplete without an in-depth understanding of how well it works and what steps can be taken to make sure there is continuous progress and improvement.

In this case study, I developed an evaluation plan for the Lexington-Fayette County Health Department’s (LFCHD) infectious disease outbreak education program. The need for such a program was realized after a MRSA outbreak among a Kentucky high school football team. This case study employed the Center for Disease Control and Prevention …

Trust In Local Health Departments: A Cross-Sector Analysis Of Urban And Rural Communities, Kelsie Kwok

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

Cross-sector collaboration is being looked to as best-practice for addressing complex issues. Given that trust is an important aspect of a well-functioning network, partners may have varying perceptions of trust regarding their counterparts. The primary objective is to examine partnerships and trust scores among six Kentucky communities (three urban, three rural) and their efforts to address unmet social needs. The secondary objective is to discuss differences among urban and rural communities regarding local health departments and the role of trust. A social network analysis (SNA) was conducted using the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) …

Patterns Into Pathways For Improving Safety Culture: Refined Latent Class Analysis Informs Tailored Decision Support For South Carolina Dss Safety Culture Improvements, Michaela Voit

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

The rising prevalence of exposures to adverse childhood experiences (ACEs) demands a coordinated public health response, as a significant body of research details the cumulative impact of ACEs on chronic morbidities contributing to reduced life expectancy. Child welfare workers (CWW) are embedded in this public health effort, tasked with preventing and mitigating the impacts of ACEs through family and prevention services. The National Partnership for Child Safety (NPCS) may improve the wellbeing of CWWs and the effectiveness of Child Welfare (CW) services by improving the quality of safety culture within CW organizations. To inform NPCS quality improvement efforts, our project …

Combined Motivational Interviewing And Ecological Momentary Intervention To Reduce Hazardous Alcohol Use Among Sexual Minority Cisgender Men And Transgender Individuals, Carolyn Lauckner, Bryce Puesta Takenaka, Fidelis Sesenu, Jaime S. Brown, Sally J. Kirklewski, Erin Nicholson, Kimberly Haney, Reuben Adatorwovor, Donte T. Boyd, Keisa Fallin-Bennett, Arjee Javellana Restar, Trace Kershaw

Biostatistics Faculty Publications

Background: Sexual minority cisgender men and transgender (SMMT) individuals, particularly emerging adults (aged 18-34 years), often report hazardous drinking. Given that alcohol use increases the likelihood of HIV risk behaviors, and HIV disproportionately affects SMMT individuals, there is a need to test interventions that reduce hazardous alcohol use and subsequent HIV risk behaviors among this population. Ecological momentary interventions (EMIs), which use mobile phones to deliver risk reduction messages based on current location and behaviors, can help to address triggers that lead to drinking in real time. Objective: This study will test an EMI that uses motivational interviewing (MI), smartphone …

Using Randomization Tests To Address Disruptions In Clinical Trials, Diane Uschner, Oleksandr Sverdlov, Kerstine Carter, Jonathan Chipman, Olga Kuznetsova, Jone Renteria, Adam Lane, Chris Barker, Nancy Geller, Michael Proschan, Martin Posch, Sergey Tarima, Frank Bretz, William F. Rosenberger

Biostatistics Faculty Publications

Recent examples for unplanned external events are the global COVID-19 pandemic, the war in Ukraine, or most recently Hurricane Ian in Puerto Rico. Disruptions due to unplanned external events can lead to violation of assumptions in clinical trials. In certain situations, randomization tests can provide nonparametric inference that is robust to violation of the assumptions usually made in clinical trials. The ICH E9 (R1) Addendum on estimands and sensitivity analyses provides a guideline for aligning the trial objectives with strategies to address disruptions in clinical trials. In this article, we embed randomization tests within the estimand framework to allow for …

Stigma And Efficacy Beliefs Regarding Opioid Use Disorder Treatment And Naloxone In Communities Participating In The Healing Communities Study Intervention, Nicky Lewis, Barry Eggleston, Redonna K. Chandler, Dawn Goddard-Eckrich, Jamie E. Luster, Dacia Beard, Emma Rodgers, Rouba A. Chahine, Philip M. Westgate, Shoshana N. Benjamin, Janae Holloway, Thomas Clarke, R. Craig Lefebvre, Michael D. Stein, Donald W. Helme, Jennifer Reynolds, Sharon L. Walsh, Darcy Freedman, Nabila El-Bassel, Kara Stephens, Anita Silwal, Michelle R. Lofwall, Janet E. Childerhose, Hilary L. Surratt, Brooke N. Crockett, Amy L. Farmer, James L. David, Laura Fanucchi, Judy Harness, Ben Wilburn, Kelli Bursey, Kristin Mattson, Sarah Mann, Rebecca D. Jackson, Aimee Shadwick, Katherine Calver, Deborah Chassler, Jennifer Kimball, Nancy Regan, Jeffrey H. Samet, Rachel Sword-Cruz, Michael D. Slater

Biostatistics Faculty Publications

Background The HEALing Communities Study (HCS) included health campaigns as part of a community-engaged intervention to reduce opioid-related overdose deaths in 67 highly impacted communities across Kentucky, Massachusetts, New York, and Ohio. Five campaigns were developed with community input to provide information on opioid use disorder (OUD) and overdose prevention, reduce stigma, and build demand for evidence-based practices (EBPs). An evaluation examined the recognition of campaign messages about naloxone and whether stigma and efficacy beliefs regarding OUD treatment and naloxone changed in HCS intervention communities.

Methods Data were collected through surveys offered on Facebook/Instagram to members of communities participating in …

Developing Best Practices For Successful University Fundraising Events, Ravyn Ladenburger

MPA/MPP/MPFM Capstone Projects

This research study addresses the crucial role of fundraising in sustaining universities in the United States, particularly public institutions facing funding challenges. For this paper, fundraising refers to the seeking of financial support from individuals to support initiatives at a nonprofit entity, such as a public university. It identifies a gap in research and professionalization within higher education philanthropy, emphasizing the need for standardized training and empirical research. The focus is on studying the effectiveness of fundraising events, especially in public universities like the University of Kentucky, amidst declining government support and rising operational costs. The research problem to be …

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 …

Financial Monitoring And Oversight Of Public Higher Education Institutions By States A Descriptive Case Study Analysis, Ryan Kaffenberger

MPA/MPP/MPFM Capstone Projects

Higher education in America is at an inflection point with numerous challenges threatening the traditional business model relied on by institutions across the country. These forces include, but are not limited to: 1) A decrease in the number of high school graduates due to historical declines in birth rates (Grawe, 2018; Western Interstate Commission for Higher Education, 2020) 2) Sustained disinvestment by many states in their higher education institutions which has effectively shifted the cost of education to students and families (Kunkle & Laderman, 2023) 3) Increasing skepticism among Americans of the value of higher education, particularly given its rising …

Defining And Evaluating Quality In Early Childhood Education, Abigail Jacob, Anna Nayyir, Vaughn Nebbitt, Nate Terrell

MPA/MPP/MPFM Capstone Projects

Quality early childhood education is essential to ensure that children grow into well-adjusted, healthy, and happy adults. Early childhood is considered a child’s first five years before kindergarten, and nearly 90% of brain development occurs in these five short years (Brain Development, n.d.). According to the Kentucky Governor’s Office of Early Childhood, preschool attendance decreases the likelihood that the child will drop out of high school, be held back a grade, or be placed in special education (Importance of Early, n.d.). Not only does early childhood education benefit the child, but it can also positively influence society. Early childhood education …

Analysis Of Implementation Of Student Homeless Programs Per County School District In The State Of Georgia, Hannah Watson

MPA/MPP/MPFM Capstone Projects

This report investigates the implementation of federal and state policies concerning homeless students within school districts across Georgia. This analysis focuses on understanding how these policies are translated into practical strategies to meet the unique needs of homeless students, encompassing identification, enrollment, and provision of essential support services that result in proof of academic success. Through a combination of policy assessment techniques of current county school district procedures and services offered to students experiencing homelessness and a descriptive assessment of the contents of the current policies through the lens of public administration theories; we will develop a series of key …

Mapping The Double-Tongue: Incorporating Body Mapping Into The Double-Tonguing Learning Process, Camilla Yoder

Theses and Dissertations--Music

As the articulation technique of double-tonguing is becoming more necessary and desirable for oboists to learn, this document explores the benefits of incorporating Body Mapping methods and kinesthetic awareness exercises into the double-tonguing learning process. These methods of body exploration are applied only to the areas of the body deemed highly relevant to accomplishing double-tonguing: the atlanto-occipital joint, the temporo-mandibular joint, the throat, the tongue, and the roof of the mouth. To explore the effectiveness of this approach, an Institutional Review Board approved research study was conducted, in which eight oboists learned double-tonguing with a preliminary iteration of this method. …

Mediating Authenticity: An Ethnographic Portrait Of Experience At U.S. Popular Music Festivals, Elizabeth Navarra Varnado

Theses and Dissertations--Music

This ethnographic study of U.S. popular music festivals subverts the impression of festivals as strictly ‘presentational’ live music events by utilizing a nuanced approach that is grounded in ethnographic fieldwork, historical analysis, and participant interviews.

Interlocutors, drawn from the author’s personal network of festival attendees, musicians, and promoters, reflect on “particularly positive festival moments,” the social and emotional benefits of festivals, and the corporeality of festival aesthetics. Discourse and published media play a vital role in festival participants’ perception of the festival field and their place within it; therefore, this study draws inspiration from the tripartite focus of iconic festival …

A Case Study On Variations In Network Structure And Cross- Sector Alignment In Two Local Systems Serving Pregnant And Parenting Women In Recovery, Liza M. Creel, Yana Feygin, Madeline Shipley, Deborah Winders Davis, Tiffany Cole Hall, Chaly Downs, Stephanie Hoskins, Natalie Pasquenza, Scott D. Duncan

Biostatistics Faculty Publications

Objective: To describe network structure and alignment across organizations in healthcare, public health, and social services sectors that serve pregnant and parenting women with substance use disorder (SUD) in an urban and a rural community.

Data Sources and Study Settings: Two community networks, one urban and one rural with each including a residential substance use treatment program, in Kentucky during 2021.

Study Design: Social network analysis measured system collaboration and cross-sector alignment between healthcare, public health, and social services organizations, applying the Framework for Aligning Sectors. To understand the alignment and structure of each network, we measured network density overall …

Slope Unit Maker (Sumak): An Efficient And Parameter-Free Algorithm For Delineating Slope Units To Improve Landslide Modeling, Jacob B. Woodard, Benjamin B. Mirus, Nathan J. Wood, Kate E. Allstadt, Benjamin A. Leshchinsky, Matthew M. Crawford

Faculty, Staff, and Affiliated Publications--KGS

Slope units are terrain partitions bounded by drainage and divide lines. In landslide modeling, including susceptibility modeling and event-specific modeling of landslide occurrence, slope units provide several advantages over gridded units, such as better capturing terrain geometry, improved incorporation of geospatial landslide-occurrence data in different formats (e.g., point and polygon), and better accommodating the varying data accuracy and precision in landslide inventories. However, the use of slope units in regional (> 100 km²) landslide studies remains limited due, in part, to the large computational costs and/or poor reproducibility with current delineation methods. We introduce a computationally efficient algorithm …

Rural And Urban Clinician Views On Covid- 19’S Impact On Substance Use Treatment For Individuals On Community Supervision In Kentucky, Carrie B. Oser, Maria Rockett, Sebastian Otero, Evan Joseph Batty, Marisa Booty, Rachel Gressick, Michele Staton, Hannah K. Knudsen

Sociology Faculty Publications

Background The COVID-19 pandemic produced system-level changes within the criminal legal system and community-based substance use disorder (SUD) treatment system with impacts on recovery efforts. This study examines rural and urban clinicians’ perspectives of COVID-19 on SUD treatment delivery for people on community supervision.

Methods Virtual qualitative interviews were conducted between April and October 2020 with 25 community supervision clinicians employed by Kentucky’s Department of Corrections (DOC), who conduct assessments and facilitate community-based treatment linkages for individuals on probation or parole. Transcripts were analyzed in NVivo using directed content analysis methods.

Results Clinicians were predominantly white (92%) and female (88%) …

Precision Application Of Water To Equine Racing Surfaces, Sydney Rae Cannon

Theses and Dissertations--Biosystems and Agricultural Engineering

As the horseracing industry has come under more scrutiny as of late, horse and rider safety has become a priority. The best was to keep a rider safe is to keep them on their horse, and the best way to do that is to keep the horse upright. This all comes down to consistency both between tracks and across a single track. The most important method of managing track consistency is through moisture content. This study examined how track design can impact moisture application, how moisture content can impact the surface material, and what design elements can be implemented to …

Caught In The Crosshairs Of Educational Reform: How Teacher Labor Markets Respond To Polarized Education Policies, Danielle Duffy Chipman

Theses and Dissertations--Public Policy and Administration

Since the passage of No Child Left Behind (NCLB) teachers have been caught in the crosshairs of political debates about education policy (Davis, 2014; EPE Research Center, 2013a; Steiner & Woo, 2021; Woo et al., 2022; Zubrzycki, 2016). As political polarization between parties increased in the 2000s, debates about education policy became more acrimonious impacting teachers’ work lives (Heltzel & Laurin, 2020; Iyengar, 2021; Layman et al., 2006). The topic of these debates ranges from curriculum changes such as Common Core and Critical Race Theory (CTR), school shootings and safety, battles over school choice and voucher programs, teacher activism about …

Extracting Social Network Model Parameters From Social Science Literature, Isaac Batts

Theses and Dissertations--Computer Science

When looking at computer modeling of social situations, much of the social science literature does not include ready-to-use statistics or parameters to be included in a social model. I explore studies related to speaking about racism (and other forms of bias), and interventions designed to diminish the occurrence of biased behavior, and use those readings to synthesize plausible parameters for a social computer model.

Detecting And Recovering From Player Preference Shifts In A Player Modeled Experience Management Environment, Anton Vinogradov

Theses and Dissertations--Computer Science

An important challenge in game design is understanding and maintaining player engagement. This is particularly crucial in both entertainment and educational games, where the player's commitment to the game directly impacts their experience and learning outcomes. However, quantifying engagement proves challenging due to the diverse interests of players. This dilemma is addressed through adaptive game design techniques where the game world is personalized to suit player preferences. In computer games, this personalization is facilitated through Experience Management and Player Modeling, where an intelligent agent gathers information on the player, including their preferences and actions, and takes actions to modify the …

Transient Interactions Modulate The Affinity Of Nf-Κb Transcription Factors For Dna, Tianjie Li, Shandy Shahabi, Tapan Biswas, Oleg V. Tsodikov, Wenfei Pan, De-Bin Huang, Vivien Ya-Fan Wang, Yi Wang, Gourisankar Ghosh

Biology Faculty Publications

The dimeric nuclear factor kappa B (NF- κB) transcription factors (TFs) regulate gene expression by binding to a variety of κB DNA elements with conserved G:C-rich flanking sequences enclosing a degenerate central region. Toward defining mechanistic principles of affinity regulated by degeneracy, we observed an unusual dependence of the affinity of RelA on the identity of the central base pair, which appears to be noncontacted in the complex crystal structures. The affinity of κB sites with A or T at the central position is ~10- fold higher than with G or C. The crystal structures of neither the complexes nor …

The Integrated Behavioral Model Of Mental Health Help Seeking (Ibm-Hs): A Health Services Utilization Theory Of Planned Behavior For Accessing Care, Joseph H. Hammer, David L. Vogel, Patrick R. Grzanka, Nayeon Kim, Brian T. Keum, Claire Adams, Sarah A. Wilson

Chemical and Materials Engineering Faculty Publications

This article introduces the integrated behavioral model of mental health help seeking (IBM-HS), a theoretical model for understanding the constructs (e.g., systemic, predisposing, and enabling factors; mental health literacy; illness perceptions; perceived need; stigma; shame; perceived benefits, motivation) that influence people’s decision making around seeking professional mental health care and their ultimate access to formal treatment. The IBM-HS is a help-seeking-specific adaptation of the empirically supported integrated behavioral model and integrative model, which are themselves evolutions of the theory of planned behavior and theory of reasoned action. The IBM-HS posits that help-seeking determinants (e.g., structural forces; cultural influences; past help-seeking …

N(Alpha)-Acetyltransferase 40-Mediated Histone Acetylation Plays An Important Role In Ecdysone Regulation Of Metamorphosis In The Red Flour Beetle, Tribolium Castaneum, Sharath Chandra Gaddelapati, Smitha George, Anilkumar Moola, Karthi Sengodan, Subba Reddy Palli

Entomology Faculty Publications

Histone acetylation, a crucial epigenetic modification, is governed by histone acetyltransferases (HATs), that regulate many biological processes. Functions of HATs in insects are not well understood. We identified 27 HATs and determined their functions using RNA interference (RNAi) in the model insect, Tribolium castaneum. Among HATs studied, N-alpha-acetyltransferase 40 (NAA40) knockdown caused a severe phenotype of arrested larval development. The steroid hormone, ecdysone induced NAA40 expression through its receptor, EcR (ecdysone receptor). Interestingly, ecdysone-induced NAA40 regulates EcR expression. NAA40 acetylates histone H4 protein, associated with the promoters of ecdysone response genes: EcR, E74, E75, and HR3, and causes an increase …

University Of Kentucky Healthcare Community Engagement Program Strategic Plan, Madison Fyffe

MPA/MPP/MPFM Capstone Projects

Strategic planning is an essential tool in providing direction to an organization through analysis of its current state and ideal future, and development of strategic goals. The University of Kentucky HealthCare’s community engagement program is a robust program within the department of Brand Strategy, tasked with serving all 120 Kentucky counties and over 150 local, state, and national organizations through health education, event sponsorship, and promotional resources. In its current state, a strategic plan to guide and track performance does not exist. This capstone aims to develop a strategic plan through the assessment of strategic planning theory, stakeholder analysis, and …

Employer Incentivized Cancer Screenings In Kentucky: A Case Study, Addison Dumes, Sophia Freeman, Megan Latiff

MPA/MPP/MPFM Capstone Projects

Kentucky has some of the highest mortality rates for colon, breast, cervical and lung cancer in the United States, according to the Center of Disease Control. Our Client, The Foundation for a Healthy Kentucky, is seeking to lower these rates by increasing employer driven cancer screenings. Previous studies show many states have been successful in implementing programs to motivate employees to participate in preventative screenings. Through individual interviews with Kentucky employers, this study aims to answer what factors affect the best practices and perceived barriers amongst employers with health and wellness programs to increase the rate of preventative breast, cervical, …