Digital Commons Network^™

Anatomical Atlas Of Kinase Responsiveness To Weight Gain: Adipose Depot Reprogramming In Diet-Induced Adiposity, Wang-Hsin Lee, Zachary A. Kipp, Sally N. Pauss, Genesee J. Martinez, Mei Xu, Terry D. Hinds, Jr.

Pharmacology and Nutritional Sciences Faculty Publications

Background/Objectives: Adipose tissue depots located at different anatomical sites exert differential functions in response to adiposity and glucose intolerance. These fat depots exhibit distinct metabolic signaling patterns that may influence pathological fat accumulation, thereby affecting the efficacy of anti-obesity interventions. Nonetheless, the mechanisms underpinning depot-specific signaling and pathway responsiveness remain insufficiently understood.

Methods: Kinase activity was characterized during the progression of adiposity across five adipose tissue depots in obese versus lean mice using the advanced PamGene kinome technology. Furthermore, kinase pathways in human preadipocytes and mouse 3T3-L1 preadipocytes were analyzed and compared with those in their differentiated, mature adipocytes. The …

Noninvasive Diffuse Optical Monitoring Of Cerebral Blood Flow And Oxygenation Responses To Intermittent Hypoxia In Neonatal Rats, Pegah Safavi, Mehrana Mohtasebi, Chowdhury Azimul Haque, Faezeh Akbari, Xuhui Liu, Yiqi Yuan, Li Chen, Lei Chen, Guoqiang Yu

Biomedical Engineering Faculty Publications

Significance: Intermittent hypoxia (IH) is common in preterm neonates and can cause hypoxic–ischemic brain injury. Simultaneous monitoring of cerebral blood flow (CBF) and oxygenation is essential to detect oxygen delivery-extraction mismatches and guide intervention.

Aim: We aimed to adapt and test an innovative diffuse speckle contrast flow oximetry (DSCFO) system for continuous monitoring of cerebral hemodynamics during IH in neonatal rats, a model approximating human neonates.

Approach: Two compact laser diodes and a miniature CMOS camera were integrated into a fiber-free probe for continuous monitoring of changes in relative CBF (rCBF) and oxy- and deoxy-hemoglobin concentrations (Δ[HbO₂] and …

From Barriers To Breakthroughs: Academic Advising And Resilience Among Online Social Work Students In Appalachia, Jessica Williamson

DSW Capstone Projects

This Doctor of Social Work (DSW) capstone project examines how academic advising can be leveraged as a resilience-informed intervention to support persistence among online social work students in the Appalachian region. Although online education has expanded access to higher education, Appalachian students continue to face significant structural, technological, and cultural barriers, including limited broadband access, financial instability, geographic isolation, and norms that emphasize self-reliance. These challenges contribute to lower retention and degree-completion rates, highlighting the need for intentional, context-responsive support strategies. This project integrates three scholarly products: a systematic literature review (SLR), a conceptual paper, and a practice application paper. …

Hardin Health Link: A Community-Integrated Paramedicine (Cip) Program In Hardin County, Kentucky, Samantha Jones

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

Rural and mixed rural–urban communities face persistent disparities in access to timely emergency medical services (EMS), contributing to preventable morbidity and mortality from time-sensitive conditions such as cardiovascular disease, stroke, and injury. Hardin County, Kentucky, reflects these challenges due to its geographically dispersed population, high burden of chronic disease, and variability in EMS response times. This capstone proposes Hardin Health Link, a Community-Integrated Paramedicine (CIP) program designed to expand the traditional role of EMS providers through in-home health assessments, chronic disease monitoring, post-discharge follow-up, medication reconciliation, and connection to clinical and social services.

Guided by an evidence-informed framework, the program …

Stronger Starts: Advancing Maternal And Infant Health In Breathitt County, Kentucky, Madisyn Smith

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

Maternal and infant health outcomes remain significantly poorer in rural Appalachian communities, where structural and socioeconomic barriers limit access to timely and comprehensive care. Kentucky reports elevated rates of preterm birth and infant mortality, with counties such as Breathitt County facing challenges including limited obstetric services, transportation barriers, and high poverty rates. These factors contribute to delayed prenatal care, fragmented services, and increased risk of adverse outcomes.

The Stronger Starts Initiative is an evidence-informed public health program designed to improve maternal and infant health outcomes through a coordinated, multi-level approach. The program integrates nurse-led home visiting, telehealth obstetric consultations, community-based …

Rapid Response To Recovery: Expand Integrated, Technology-Enabled Crisis Care, Madison Chandler

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

Behavioral health challenges in rural communities continue to place significant strain on healthcare systems, particularly through repeated reliance on emergency departments for crisis care. Nelson County, Kentucky, reflects this pattern, with higher reported rates of poor mental health and limited access to behavioral health providers. This paper proposes the Beacon Behavioral Health Response Program, a community-based, multidisciplinary crisis intervention model designed to improve access to timely care and strengthen continuity of support. The program combines mobile crisis response—delivered by a licensed clinical social worker and a peer support specialist—with a technology-enabled component using the Luma AI-supported mental health platform. Together, …

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

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

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …

A Program To Increase Prenatal And Postnatal Care Access In A Rural Kentucky County, Alyssa Thomas

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

Prenatal and postpartum health care access is necessary for positive pregnancy and postpartum outcomes. Many rural areas in the United States are facing maternity care deserts, where there are no obstetric services available in their county. Maternity care deserts typically have higher rates in maternal mortality, low-birth weight, and pre-term births. Fleming County, Kentucky is a small rural community with a population of about 15,000 that is a maternity care desert. To improve prenatal and postpartum care access in this county, this program will use a mobile health clinic and community health workers (CHWs). The mobile health clinic will operate …

Momentum For Healthy Births-Hardin County, Ky, Brittany R. Jackson

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

Maternal and infant health disparities in Hardin County, Kentucky, reflect persistent gaps in timely access to care, particularly among rural and underserved populations. Structural barriers, including transportation limitations and unmet social needs, contribute to delayed prenatal care initiation and low postpartum follow-up, increasing the risk of adverse outcomes. This capstone project proposes the MOMentum (Maternal Outreach and Monitoring for Mothers) Program, an integrated care model designed to strengthen access, improve care coordination, and enhance continuity across the prenatal and postpartum period.

The program combines a Community Health Worker (CHW)-led navigation model with enhanced postpartum care supported by telehealth services and …

Improving Prenatal And Postpartum Care Gaps In Breathitt County, Megan Deaton

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

Maternal and infant health remain a major public health issue across the United States, particularly in rural communities. Barriers such as shortages of obstetric providers, transportation challenges, and limited access to prenatal and postpartum care contribute to delayed care, low follow-up rates, and an increased risk of poor outcomes, including preterm birth and low birth weight. In response, the proposed Maternal and Infant Health Program aims to address gaps in care access through a home visiting model that provides in-home support, maternal health education, care coordination, and referrals to healthcare services, with a direct focus on Breathitt County. Expected outcomes …

Implementation Of A Reminder/Recall Messaging Program In Kentucky, Laura Schwarz

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

Childhood vaccination remains a critical public health priority, yet measles, mumps, and rubella (MMR) vaccination rates in several rural Kentucky counties fall below the 95% threshold required for herd immunity. Recent declines in coverage, compounded by socioeconomic disparities and barriers to healthcare access, place children at increased risk for vaccine-preventable diseases and outbreaks. This capstone project proposes the implementation of an evidence-based reminder/recall (R/R) text messaging intervention utilizing the Kentucky Immunization Registry (KYIR) to improve timely MMR vaccination among children aged 4–6 years before kindergarten entry.

The proposed program targets thirteen Kentucky counties with vaccination rates below 70% and documented …

Strengthening Rural Mental Health Crisis Response: Integrating Broadband Telehealth Care Across Counties Served By Kentucky River District Health Department, Mary K. Mcnabb

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

Rural communities in Eastern Kentucky face persistent barriers to timely and effective mental health crisis care, including provider shortages, transportation challenges, and limited broadband infrastructure. Counties served by the Kentucky River Health Department Wolfe, Lee, Owsley, Perry, Knott, Leslie, and Letcher experience disproportionately high behavioral health needs while relying on shared regional resources. The Broadband-Enabled Rural Crisis Stabilization Initiative (BERCSI) is a proposed public health program designed to strengthen rural mental health crisis response through integrated, technology-enabled care. Grounded in evidence-based practices, including tele-mental health and crisis stabilization models, BERCSI leverages broadband expansion to facilitate rapid assessment, coordinated care, and …

Using Behavioral Skills Training To Teach And Promote Generalized Self-Instruction For High School Students With Intellectual Disability, Elise J. Slavey

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

This study presents findings from a multiple probe design that evaluated the effects of Behavioral Skills Training (BST) as a method of teaching an increase in self-instruction in completing vocational tasks for individuals with intellectual disability. The research included three U.S. high school students with intellectual disability and the data were analyzed across conditions. Throughout the intervention of BST, generalization sessions were conducted alongside. All participants acquired self-instruction for the skill acquisition targets. However, only one participant was able to generalize self-instruction to novel vocational tasks. Results and suggestions for future research regarding generalization for self-instruction and procedure reliability data …

Evaluating Dosage Within A Rapid Caregiver Coaching Model, Emma L. Lovell

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

Rapid caregiver coaching models are designed to increase caregiver implementation of naturalistic language strategies while prioritizing feasibility for both families and providers. Participants of the current study were caregivers with young children (ages 1-4) with expressive language delays and autism risk or diagnosis. The current study took place in families’ homes and examined whether a predetermined number of brief coaching and feedback cycles was sufficient to produce clinically meaningful improvements in caregiver strategy use. Target behaviors for caregivers included play-based imitation and expansion, responsive language input, and structured teaching episodes designed to expand child communication. Results were variable but demonstrated …

Effects Of Tech-Based Self-Monitoring And An Interdependent Group Contingency On Group Engagement, Ariana K. Hefter

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

This study evaluated the effects of a class-wide self-monitoring (SM) intervention delivered via the I-Connect app and paired with an interdependent group contingency, on whole-group engagement in a general fourth grade classroom. Participants included 23 students during a 30-min instructional period. The researcher measured group engagement using momentary time sampling (MTS) with planned activity check (PLACHECK) with a fixed rotation schedule in 30-s intervals and recorded the percentage of students on-task per session. A withdrawal (ABAB) design was used to examine the effects across the baseline and intervention phases. Results indicated a slight increase in group engagement during the intervention …

Evaluating The Effects Of Abbreviated And Full-Length Training Formats On Implementation Of Embedded Instruction Practices, Hannah Elizabeth Keene

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

The purpose of this study was to evaluate the effects of an abbreviated training package and full-length behavioral skills training (BST) on staff implementation of embedded instruction (EI) procedures in a university-affiliated inclusive early childhood center. A nonconcurrent multiple baseline design across participants was used with four student workers in inclusive preschool classrooms. The initial intervention included a package of didactic instruction and in-vivo modeling. Full BST was planned for participants who did not reach mastery criteria following the brief training.

The primary dependent variable was participant fidelity of EI implementation, and the secondary dependent variable measured the rate of …

Zero Tolerance Or Strong Cultural Diversity: The Hard Case Of Female Genital Surgery, James M. Donovan, Christiane Canant

Law Faculty Scholarly Articles

This article applies a thesis favoring strong cultural diversity to defend a subject-centered policy regarding female genital surgeries (FGS). That idea posits that cultural variation holds an intrinsic value that should be presumptively respected when setting policy and creating law. Correlatively, cultural homogenization, especially by force, should be resisted. 

Taking as a starting point the recent celebration of the United Nation’s Day of Zero-Tolerance for Female Genital Mutilation, the paper reviews the context of FGS practices in various societies and critiques the inconsistencies of U.N. arguments to advance its goal of total elimination by 2030. Especially problematic for the U.N. …

Characteristics Of Pulmonary Vs. Extrapulmonary Tuberculosis Cases In Kentucky From 2020 To 2024, Mariam M. Alkhairat

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

Objective: Tuberculosis (TB) remains an important public health concern in the United States, especially among people experiencing social and clinical vulnerabilities. Extrapulmonary TB, which occurs outside of the lungs, can be harder to detect and diagnose than pulmonary TB. This study aimed to describe the demographic and clinical characteristics of people with active TB in Kentucky and to identify factors associated with extrapulmonary TB.

Methods: Secondary surveillance data were obtained from the Kentucky Department for Public Health (KDPH) using the National Tuberculosis Surveillance System (NTSS). The study sample included 301 confirmed active TB cases reported in Kentucky. Descriptive statistics were …

Granulomatous Cellular Signatures In Nontuberculous And Tuberculous Mycobacterial Infections, Brianna M. Doratt, Ethan G. Napier, Mahdi Eskandarian Boroujeni, Sarah Douglas, Michael H. Davies, Luiz Bermudez, Eliot Spindel, Erin F. Mccaffrey, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Mycobacterium tuberculosis (Mtb) and nontuberculous mycobacteria (NTM) are acid-fast bacilli that trigger granuloma formation, a hallmark immune response aimed at containing infection. While the biology of Mtb granulomas has been widely investigated, far less is known about granulomas caused by NTM infection, despite the increasing prevalence and clinical challenge of NTM cases worldwide. Because granulomas influence infection control, pathology, and treatment response, understanding their cellular organization and signaling is critical to improving therapeutic strategies. Therefore, we characterized granulomas formed following infection of rhesus macaques with Mycobacterium avium subsp. hominissuis (MAH) and compared them to granulomas from cynomolgus macaques infected with …

Preventing Teen Pregnancy Through Expanded Contraceptive Access In Mccreary County, Kentucky, Dacey B. Chitwood

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

This capstone project proposes a school-based Condom Availability Program to reduce teen pregnancy risk by expanding discreet contraceptive access for adolescents in McCreary County, Kentucky. Teen pregnancy remains a persistent public health concern in rural communities where stigma, privacy concerns, transportation barriers, and limited healthcare access can prevent adolescents from obtaining reproductive health resources. McCreary County faces elevated teen birth rates, socioeconomic disadvantage, and limited maternal healthcare infrastructure, making teen pregnancy prevention an important local priority. The proposed program would place free latex and non-latex condoms in student restrooms at McCreary Central High School, with QR-code-linked information connecting students to …

Community Place Attachment As A Significant Correlate Of Motivation To Change Substance Use Behavior Among Adults Who Inject Drugs In Rural U.S., Janet K. Otachi, Shawndaya S. Thrasher, Keith J. Watts, Juma S. Mwenda, Hilary L. Surratt

Social Work Faculty Publications

Introduction: While motivation is critical for substance use disorder (SUD) recovery, many individuals fail to engage in treatment. The need to belong is a fundamental human motivation, yet the role of community place attachment (CPA) as a social asset in fostering motivation to change substance use behaviors (MCSUB) among people who inject drugs (PWID) is understudied. This paper examines the effect of CPA on PWIDs’ MCSUB.

Methodology: Cross-sectional data were collected from 350 PWID recruited from syringe service programs in rural Appalachian Kentucky (2018–2021). We used hierarchical multivariable linear regression to assess the association between CPA and MCSUB, controlling for …

Evaluating Training Effectiveness And Learning Transfer In The Kentucky Transportation Cabinet Safety Academy, Amanda L. Casolare

Theses and Dissertations--Civil Engineering

Effective evaluation of safety training is crucial to ensure that learning translates into safe work practices, particularly in high-risk public sector environments. The Kentucky Transportation Cabinet (KYTC) is developing a Safety Academy to enhance hazard recognition, risk management, and safety leadership within the organization. However, the Safety Academy has not yet been implemented, and formal evaluation methods for training have not been established. This study aimed to examine evidence-based training evaluation techniques and develop recommendations for evaluating the KYTC Safety Academy prior to program implementation.

This study employed an applied pre-implementation research design grounded in a comprehensive review of safety …

Shakespeare’S Martyrs And The Poetics Of Transformation, Robert Keim

Theses and Dissertations--English

At the beginning of William Shakespeare’s career as a playwright, England’s most widely read book, after the Bible, was Acts and Monuments of These Latter and Perilous Days, commonly known as John Foxe’s Book of Martyrs. Foxe’s martyrological literature, along with the inherently theatrical nature of martyrdom itself, helped the lives and deaths of Reformation martyrs to assume a prominent place in England’s literary consciousness. Shakespeare was not immune to their influential presence, and though overt representations of martyrdom were too controversial for the popular stage, he did enrich his plays by endowing certain characters—through imagery, allusive diction, …

We Need To Care About Care: (Un)Caring Relations In Victorian Fiction, Roslyn Fleming

Theses and Dissertations--English

The professionalization and institutionalization of care in the Victorian era ushered in a growing societal concern about the pitfalls of care being “systematized and depersonalized” and treating people as burdens, problems to be solved. Given the increasing attention paid to people’s welfare and well-being during this period, the cultural shift from intimate community care to professional and institutional care, and the growing stigmatization of disabled bodyminds, the fiction produced amidst these cultural changes makes a compelling site for a study of care. Critical scholarship attending to Victorian novels’ representations of care, however, has largely concentrated on specific categorizations of care …

Benjy's Personhood In The Sound And The Fury, Addison D. Tighe

Theses and Dissertations--English

This thesis will take a look at the way Benjy Compson’s character in William Faulkner’s novel The Sound and the Fury can be used to form an anti-eugenic argument. By taking a close look at the historical context of America’s twentieth century eugenic movement, the ways in which the novel presents an argument of personhood for those with disabilities come forth despite the eugenic pressures of the time. By taking the time to closely read Benjy’s section within the novel, a mix of disability studies and feminist disability studies, and understanding the complexity of character and stream of conscious writing, …

Role Of Estrogen Receptor Alpha In Modulating The Circadian System In Female Mice, Victoria Alvord

Theses and Dissertations--Biology

Circadian rhythms are approximately 24-hour cycles of physiology and behavior. Circadian rhythms of eating, or meal timing, are linked to cardiometabolic dysfunction in humans. Mistimed eating, such as breakfast skipping and eating late at night, increases the risk of obesity, diabetes, and cardiovascular disease in humans. Likewise, disrupted eating rhythms cause obesity in mice. This dissertation investigates how estrogens regulate eating behavior rhythms and tissue clock timing in female mice. Chapter 1 reviews three key components critical to this work. The first is an overview of the field of chronobiology and the function of the circadian system. The second is …

Spatial Marginalization Of Emotional Support: Understanding Animal-Human Dynamics Of Care On College Campuses, Aleksandra Craine

Theses and Dissertations--Geography

In 2015 Kearny-Nebraska court case determined that student campus housing is considered a dwelling and is therefore covered by housing antidiscrimination laws. Since then, increasing numbers of students across U.S. campuses applied to bring an emotional support animal to live with them. Emotional Support Animals (ESAs) are defined by the U.S. Department of Housing and Urban Development as “trained or untrained animals that do work, perform tasks, provide assistance, and/or provide therapeutic emotional support for individuals with disabilities.” Persons requesting ESA accommodations usually must provide documentation from a medical provider or therapist. ESAs remain a legally and socially contested category …

Entre Irse Y Quedarse: Sociolinguistic Effects Of The H-2a Program In The U.S. And Mexico, Hayden D. Holman

Theses and Dissertations--Hispanic Studies

This dissertation examines stabilized circular migration as a distinct sociolinguistic condition through a study of Mexican participants in the U.S. H-2A temporary agricultural worker program. Whereas much migration scholarship presumes linear settlement and cumulative immersion, the H-2A program institutionalizes repeated cycles of departure and return between specific origin and destination communities. This patterned mobility produces recurrent immersion in an English-dominant environment followed by re-centering in a Spanish-dominant community, creating conditions of cyclical activation and recalibration of linguistic repertoires.

The study investigates two interrelated questions: (1) how sustained participation in stabilized circular mobility shapes participants’ spoken repertoires, contact-induced features, and language …

Visual Genealogies Of Disability In Mexican Visual Culture, Daniela Calvache Garcia

Theses and Dissertations--Hispanic Studies

Disability in Mexico is a visually constructed category, shaped by a long genealogy of representation in which images of bodily difference actively participate in defining power and the management of all bodies. The discursive forces that define disability as unproductivity reduce body-minds to the service of the economic system, affecting our relationship with death, illness, reproduction, size, youth, and beauty. Across the Mesoamerican visual space, such representations have long unsettled dominant systems of truth about bodies. This dissertation examines how conceptions of disability are produced, negotiated, and reimagined through three historical moments and cultural expressions: Pre-Hispanic Mayan imagery, Mexican colonial …

The Rhesus Macaque Model Of Mycobacterium Avium Infection Reveals That Age-Related Disease Is Due In Part To Chronic Inflammation And Lung Microbial Dysbiosis, Ethan G. Napier

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Aging is associated with dysregulated immunity and increased susceptibility to infection, a phenomenon dubbed as immunosenescence and characterized by reduced naïve T and B cell pools, altered innate immune function, and chronic low-grade inflammation. Nontuberculous mycobacterial (NTM) pulmonary disease (NTMPD) is an increasingly relevant chronic lung infection that disproportionately affects older adults (65+ years) and immunocompromised individuals. However, the host factors underlying increased disease severity in aged patients remain poorly defined. Literature suggests that effective control of NTM relies on coordinated innate and adaptive immune responses, particularly macrophage activation and Th1 cytokine signaling. Using a rhesus macaque model that closely …