Digital Commons Network^™

A Twenty-First Century Approach To Darius Milhaud's Saudades Do Brasil, Paige H. Crain

Theses and Dissertations--Music

French composer Darius Milhaud (1892-1974) lived in Rio de Janeiro, Brazil from February 1917 to November 1918. Milhaud’s experience in Rio was overwhelmingly positive, and several of his works were influenced by this period of his life, one being a suite for solo piano titled Saudades do Brasil, Op. 67. Inspired by Brazilian popular music, this piece is an example of exoticism, a trend of writing music based on cultures other than the composer’s own. Considering that exoticism historically has the potential to perpetuate harmful stereotypes or generate false information, this research delves into Saudades do Brasil, exploring …

Professional Experiences Of Disabled Music Therapists: An Adapted Multiple Case Study, August Lily Tuggle

Theses and Dissertations--Music

Literature about disability often focuses on disabled people as recipients of professional services and there is scant literature about disabled professionals. Although music therapists work primarily with disabled individuals, there is little research on or from the perspectives of disabled music therapists. A growing body of qualitative research, grey literature, and media platforms provides perspectives from the disability community regarding music therapy. Disabled individuals both within and outside the profession critique common music therapy attitudes and practices that conflict with the expressed needs of the disability community. However, much of this literature contains the perspectives of one individual or a …

Comparative Analysis Of Community Solar Energy Programs For Developing Sustainable Solar Initiatives In Lexington-Fayette County, Kentucky, Benjamin Kokkonen, Nelson Stone, Widodo Tri Saputro

MPA/MPP/MPFM Capstone Projects

The transition to renewable energy is a critical policy priority for Lexington-Fayette County, Kentucky, as the city aims to achieve net-zero greenhouse gas emissions by 2050. However, expanding solar energy presents a complex challenge: increasing renewable energy capacity while preserving the county’s prime agricultural land. This capstone examines how community solar programs in Virginia, Maryland, and New Jersey can inform the development of a sustainable and equitable solar initiative in Lexington.

Using a comparative program analysis of three state-level community solar models, the research evaluates policies on site selection, financial incentives, equity measures, regulatory enforcement, and program implementation. Findings indicate …

From Campus To Career: Enhancing Career Support Services For Graduate International Students At The University Of Kentucky, Aku Fiagbeto, Ratwah Alhazmi

MPA/MPP/MPFM Capstone Projects

During the 2023–2024 academic year, the University of Kentucky enrolled a total of 1,285 international students, with 784 (61%) being graduate students. International students play a crucial role in enriching the university’s cultural and academic landscape. While UK has achieved record enrollment and improved student success rates, including a 66% graduation rate that places it among the top 100 public institutions in the U.S., it is important to consider whether these trends apply to international students as well. Retention and graduation rates for this demographic may differ from those of domestic students, highlighting potential challenges such as visa restrictions, financial …

Integrating Deconstruction And Historic Preservation: A Best Practices Policy Comparison, Kelsey M. Baldwin

MPA/MPP/MPFM Capstone Projects

Carl Elefante, the former president of the American Institute of Architects, famously said, “The greenest building is…one that is already built” (Elefante, 2012). Elefante articulated the environmental benefits of reuse and the significant energy costs associated with demolition and new construction. In 2022, the commercial and residential building sectors produced 31% of the United States’ greenhouse gas (GHG) emissions (EPA, 2025). A large percentage of this is tied to the production of building materials.

Beyond The Gas Tax: Evaluating Oregon’S Road Usage Charge (Orego) As A Model For Sustainable Infrastructure Funding, Gilles David Kwekam

MPA/MPP/MPFM Capstone Projects

Fuel tax revenues are declining nationwide due to electric vehicle adoption, improved fuel efficiency, and long periods without rate adjustments. This erosion has created long-term instability in transportation funding, including in Oregon, where revenue no longer aligns with road use. Road usage charges (RUCs) offer a potential replacement by charging drivers per mile traveled rather than per gallon consumed. However, their success depends less on technology and more on how programs are designed and governed.

This capstone examines which design features make RUC programs effective, using Oregon’s OReGO program as the central case. A Qualitative Comparative Analysis (QCA) comparing Oregon, …

Targeted Federal Advocacy For Financial Stability: Recommendations For United Way Of The Bluegrass, Jefferson Abney, Lou Hurst

MPA/MPP/MPFM Capstone Projects

Advocacy refers to activities undertaken with the intent of influencing policy change. For nonprofit organizations, advocacy can be a critical aspect of furthering their mission. Successful advocacy requires a comprehensive, dynamic understanding of the needs and priorities of stakeholders, as well as an understanding of the political context in which the organization operates and the challenges and opportunities that context poses for its institutional goals. A policy agenda helps nonprofit organizations identify and communicate the most pertinent policy needs for consideration when making decisions around advocacy.

For this project, in response to a request from United Way of The Bluegrass …

Public University Gift Management Policies: Building A Best Practice Guide, Cristin Costello

MPA/MPP/MPFM Capstone Projects

Currently, no consistent standards exist for how institutions of higher education should manage their non-endowed gift revenue. Good stewardship of gift funds is vital to ensuring the maintenance of donor relationships to create unions that bring further financial opportunities to universities for years to come. Public institutions, as recipients of government dollars, are especially vulnerable to the negative repercussions that could come with the scandal of misappropriated gift dollars. Overall cash donations to higher education have significantly increased in the past few decades as state appropriations fall short and the need to keep tuition rates stable increases. It is more …

Boys & Girls Clubs Of Greater Cincinnati Strategic Plan, Emily Yellman

MPA/MPP/MPFM Capstone Projects

After-school organizations nationwide, such as Boys & Girls Clubs, provide youth with out-of-school opportunities for academic and social-emotional learning. Strategic plans can help after-school organizations maximize their impact. This paper outlines a strategic plan for Boys & Girls Clubs of Greater Cincinnati, specifically to increase the number of members they serve on an average daily basis. The plan addresses both Club member recruitment and retention techniques, and includes specific action items, communication, and monitoring plans.

Mind The Gap: Supporting Freshmen Voice Students Transitioning To Higher Education Through Coaching Conversations, Erica L. Gabriel

Theses and Dissertations--Music

The experiences one may encounter while matriculating through the K-12 system of education are vastly different from the world of higher education. While one feeds directly into the other, the transition can be a difficult one for young singers also navigating the developmental leap from adolescence to adulthood. This is due to several systematic and instructional differences, compounded with unique challenges encountered by freshman voice students in the first year. Gaps in support systems compiled with new and increasing financial, social, and academic demands can lead to a decline in overall student well-being and an increase in stress.

This increase …

Treating Social Media Addiction In Adolescents: A Scoping Review With Implications For Music Therapy Practice, Roman D. Swain

Theses and Dissertations--Music

With the rapid expansion of online connectivity, concerns have emerged regarding the influence of digital interactions on adolescents’ real-world relationships and mental health. Social media use can expose adolescents to harmful content and disrupt the brain’s pleasure centers, increasing the risk of developing addictive patterns of use. Such disruptions may interfere with daily functioning and contribute to negative mental health outcomes. Given the impact of music on the brain’s reward system, music therapy may offer a beneficial approach for helping adolescents develop mindfulness of social media use and strengthen offline social connections. This thesis presents a scoping review of current …

Talking About Cancer And Tobacco (Tact) Study With Lgbtq Patients And Their Care Providers, William Bowling

Theses and Dissertations--Psychology

Due to multilevel factors, including a high prevalence of tobacco use, the burden of some cancers is disproportionately higher in the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community than the general population. Evidence-based tobacco treatment delivery with high rates of tobacco cessation would be a powerful tool for secondary cancer prevention in the LGBTQ community, yet few studies have explored this issue. The current study aimed to 1) uncover both positive and negative aspects related to the lived experience and treatment of LGBTQ cancer survivors who use tobacco, 2) elucidate barriers and facilitators of tobacco treatment and cessation, and …

Racial And Rural Disparities In Financial Toxicity And Healthcare Transitions Among Adolescent And Young Adult Cancer Survivors In Kentucky, Jean S. Edward, Brent J. Shelton, Lauren Corum, Haafsah Fariduddin, Katie Brown, John A. D’Orazio, Kimberly D. Northrip

Physiology Faculty Publications

Introduction: Adolescent and young adult cancer survivors, especially racial/ethnic minorities and rural residents are particularly vulnerable to financial toxicity due to limited healthcare access, socioeconomic disparities, and cultural/language barriers. These social determinants of health compound financial hardship and contribute to poor healthcare transitions from pediatric to adult care, leading to worse outcomes and higher mortality rates. Methods: Our cross-sectional survey study examined racial (Black vs White) and geographic (rural vs urban) disparities in financial toxicity and healthcare transition outcomes among 260 adolescent and young adult cancer survivors through the Kentucky Cancer Registry. Survey data were collected on financial toxicity, healthcare …

Sex-Based Differences In The Long-Term Fate Of Hippocampal Neurons Born After A Traumatic Brain Injury, Hannah C. Downing, Ashley B. Glover, Jessica E. Gebhardt, Katherine L. Thompson, Kathryn E. Saatman

Physiology Faculty Publications

Introduction: Moderate-to-severe traumatic brain injury (TBI) results in an early loss of immature hippocampal granule cells and the activation of typically quiescent neural stem cells (NSCs) in the dentate gyrus. Activation of NSCs leads to a robust increase in proliferation and generation of neural progenitor cells (NPCs), supporting restoration of the immature neuron population of over a period of 1–2 weeks. However, it is unclear if neurons born early after injury develop normally, survive long-term and functionally integrate into the hippocampal network. Although adult hippocampal neurogenesis is regulated in a sex-dependent manner, the majority of pre-clinical TBI studies lack the …

Skeletal Muscle Stem Cell Mitochondria Are Transferred To Muscle Fibers In Response To A Hypertrophic Stimulus, Jensen Goh, Julia G. Williams, Sarah E. Ogle, Jai K. Joshi, Logan N. Scott, Benjamin Burke, Alex R. Keeble, Nicholas T. Thomas, Christopher S. Fry, Ahmed Ismaeel, John J. Mccarthy

Physiology Faculty Publications

The fusion of skeletal muscle stem cell (MuSC) to myofibers during hypertrophy has exclusively focused on the transfer of the MuSC nucleus, leaving the fate of other MuSC organelles, such as mitochondria, largely unexplored. The objective of this study was to determine whether MuSCs transfer their mitochondria upon myofiber fusion in response to a hypertrophic stimulus. To achieve this goal, we specifically labeled MuSC mitochondria with Dendra2 fluorescence by crossing the MuSC-specific CreER (Pax7^CreER/CreER) mouse with the Rosa26-Dendra2 mouse to generate the Pax7-Dendra2 mouse. To induce the fusion of MuSC to myofibers, Pax7-Dendra2 mice underwent synergist ablation surgery …

Engaging Nurses In Effective Cost Of Care Conversations To Address Cancer-Related Financial Toxicity: Results From An Exploratory Survey, Jean Edward, Amanda T. Wiggins, Louis G. Baser, Haafsah Fariduddin, Joanna F. Doran, Monica F. Bryant, John August D'Orazio, Kimberly D. Northrip

Markey Cancer Center Faculty Publications

Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage Cancer® to prepare oncology nurses to identify and assist patients/caregivers facing financial and/or legal barriers to care. Ten pediatric oncology nurses completed the training and pre/post-surveys on behaviors related to financial and legal need screening, frequency and comfort level of answering questions, knowledge, and behavior changes, along with training evaluation questions. At baseline, six nurses reported never …

Dissecting The Biophysical Mechanisms Of Oleate Hydratase Association With Membranes, William A. Lathram, Robert J. Neff, Ashley N. Zalla, James D. Brien, Vivekanandan Subramanian, Christopher D. Radka

Markey Cancer Center Faculty Publications

This study investigates the dynamics of oleate hydratase (OhyA), a bacterial flavoenzyme from Staphylococcus aureus, and its interactions with lipid membranes, focusing on the factors influencing membrane binding and oligomerization. OhyA catalyzes the hydration of unsaturated fatty acids, playing a key role in bacterial pathogenesis by neutralizing host antimicrobial fatty acids. OhyA binds the membrane bilayer to access membrane-embedded substrates for catalysis, and structural studies have revealed that OhyA forms oligomers on membrane surfaces, stabilized by both protein-protein and protein-lipid interactions. Using fluorescence correlation spectroscopy (FCS), we examined the effects of membrane curvature and lipid availability on OhyA binding to …

Advances In Magnetic Nanoparticles For Molecular Medicine, Xiaoyue Yang, Sarah E. Kubican, Zhongchao Yi, Sheng Tong

Markey Cancer Center Faculty Publications

Magnetic nanoparticles (MNPs) are highly versatile nanomaterials in nanomedicine, owing to their diverse magnetic properties, which can be tailored through variations in size, shape, composition, and exposure to inductive magnetic fields. Over four decades of research have led to the clinical approval or ongoing trials of several MNP formulations, fueling continued innovation. Beyond traditional applications in drug delivery, imaging, and cancer hyperthermia, MNPs have increasingly advanced into molecular medicine. Under external magnetic fields, MNPs can generate mechano- or thermal stimuli to modulate individual molecules or cells deep within tissue, offering precise, remote control of biological processes at cellular and molecular …

Engaging Nurses In Effective Cost Of Care Conversations To Address Cancer-Related Financial Toxicity: Results From An Exploratory Survey, Jean Edward, Abigail Wiggins, Louis G. Baser, Haafsah Fariduddin, Joanna F. Doran, Monica F. Bryant, John A. D'Orazio, Kimberly D. Northrip

Markey Cancer Center Faculty Publications

Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage Cancer® to prepare oncology nurses to identify and assist patients/caregivers facing financial and/or legal barriers to care. Ten pediatric oncology nurses completed the training and pre/post-surveys on behaviors related to financial and legal need screening, frequency and comfort level of answering questions, knowledge, and behavior changes, along with training evaluation questions. At baseline, six nurses reported never …

M1 Macrophage‑Engineered Vesicles Have Anti‑Cancer Activity In Ovarian Cancer, Connie D. Cao, J. Robert Mccorkle, Derek B. Allison, Donglin Yan, Kristen S. Hill, Lan Li, Rani Jayswal, David Schweer, Charles S. Dietrich Iii, Frederick R. Ueland, Christopher I. Richards, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Background: Ovarian cancer typically presents at an advanced stage, has a poor prognosis, and is a leading cause of cancer-related deaths in women. Extracellular vesicles (EVs) are cell membrane-derived nanoparticles that function in specific cell- to-cell communication and are under development as novel drug delivery vehicles and modulators of the tumor microenvironment. Artificial cell-derived vesicles (ACDVs) from M1 macrophages are able to repolarize macrophages from a M2 to a M1 phenotype and target tumor cells in in vitro studies.

Results: In this study, we generated engineered EVs (EEVs) by membrane disruption of M1 macrophages (MEVs) with and without cisplatin to …

Measuring The Impact Of A Catchment Area Surveillance Tool On Cancer Center Adopters, Todd Burus, Caree R. Mcafee, Natalie P. Wilhite, Pamela C. Hull

Markey Cancer Center Faculty Publications

Background: The University of Kentucky Markey Cancer Center developed the data gathering and visualization platform Cancer InFocus (CIF) as a solution for cancer center catchment area surveillance. CIF was released in June 2022 and made available for use to other institutions through a no‐cost licensing agreement. The purpose of this study was to evaluate the impact CIF has had on cancer centers since its release.

Methods: The authors adapted an existing management evaluation framework to assess the impact of CIF across three spheres—idea dissemination, product engagement, and adopter satisfaction. This assessment included an online survey administered between the dates of …

Tracking Community Outreach And Engagement Activities Among National Cancer Institute-Designated Cancer Centers, Todd Burus, Caree R. Mcafee, Pamela C. Hull, Amy E. Leader, Christopher Mcnair

Markey Cancer Center Faculty Publications

The National Cancer Institute’s (NCI) Cancer Center Support Grant mandates that NCI-designated cancer centers establish a Community Outreach and Engagement (COE) component to help direct efforts at reducing cancer burden within their catchment areas. Despite the critical role of COE offices, little is known about how they track and evaluate outreach activities and outcomes. We gathered information on current practices from representatives of 40 out of 65 COE offices using an online survey. Although nearly all responding centers (97.5%) tracked COE activities, no consensus existed on resources used, and satisfaction with current solutions was mixed (51.0% not satisfied). Respondents expressed …

African American And African-Born Black Women’S Perspectives And Experiences With A Cervical Health Education And Hpv-Self Sampling Intervention, Shania Jones, Abubakari Wuni, Adaeze Aroh, Adebola Olamide Adegboyega

Markey Cancer Center Faculty Publications

Background/Objectives: A combination of cervical cancer prevention education and the provision of HPV self-collection kits has been found to increase the uptake of HPV testing among women. However, there is limited research evaluating the perspectives and experiences of women who have participated in a cancer prevention education and received a complimentary HPV self-collection kit. We report the experiences of women who took part in Health is Wealth: a cervical health intervention and received a complimentary HPV self-sampling kit for cervical cancer screening.

Methods: This pilot qualitative study enrolled twenty-four women who participated in one-on-one semi-structured interviews to provide feedback and …

Capturing Community Perspectives In A Statewide Cancer Needs Assessment: Online Focus Group Study, Jessica R. Thompson, Keeghan Francis, Caree R. Mcafee, Madeline Brown, Todd Burus, Melinda Rogers, Connie L. Sorrell, Elizabeth A. Westbrook, Lovoria B. Williams, Jennifer Redmond Knight, Elaine Russell, Natalie P. Wilhite, Pamela C. Hull

Markey Cancer Center Faculty Publications

Background: Kentucky has the highest all-site cancer incidence and mortality rates in the United States. Conducting needs assessments in a large geographic area, such as an entire state, poses challenges in collecting qualitative data from diverse rural and urban contexts. In 2021, a steering committee was formed to drive a multimethod, statewide cancer needs assessment (CNA) to identify the future priorities for all cancer-related care in Kentucky.

Objective: We aimed to report on the online focus group component of the CNA by documenting existing community resources and perceived needs across the cancer care continuum. In addition, we aimed to explore …

Cisplatin-Loaded M1 Macrophage-Derived Vesicles Have Anti-Cancer Activity In Osteosarcoma, Namrata Anand, Joseph Robert Mccorkle, David Schweer, Lan Li, Kristen S. Hill, Melissa A. Fath, Derek B. Allison, Christopher L. Richards, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Osteosarcoma (OS) is a relatively rare bone malignancy that primarily affects children and young adults and is associated with significant morbidity and mortality. Cisplatin is a mainstay of treatment, but its efficacy is limited by off-target toxicities. Immunotherapy is not effective due to a poor antigenic tumor microenvironment. Here, we address these challenges by using manufactured M1 macrophage-derived vesicles (MVs) loaded with cisplatin. Human blood and mouse RAW 264.7 M1 macrophages were used to prepare empty (E-MVs) and cisplatin-loaded MVs (C-MVs). Human OS cell lines were used in vitro and in a tibia xenograft mouse model to evaluate the anti-cancer …

Disparities In Human Papillomavirus–Associated Cancer Incidence By Appalachian Residence, Todd Burus, Melina Windon, Yasminka A. Jakubek, Krystle A. Lang Kuhs

Markey Cancer Center Faculty Publications

Importance  Poor socioeconomic conditions and corresponding health disparities have historically characterized the Appalachian region of the US. Low uptake of the human papillomavirus (HPV) vaccine and high rates of cervical cancer have been observed in the region; however, a comprehensive assessment of HPV-associated cancer in Appalachia has not been performed.

Objective  To compare the burden of HPV-associated cancer incidence between the Appalachian and non-Appalachian regions of the US.

Design, Setting, and Participants  This cross-sectional study of HPV-associated cancer incidence rates and trends used the US Cancer Statistics Incidence Analytic Database, covering 99% of the US population and 100% of the …

Examining Geographic Disparity: Variation In Cancer Outcomes Within Appalachia, Todd Burus, Pamela C. Hull, Krystle A. Lang Kuhs, Tianyan Gao, Christine F. Brainson, B. Mark Evers

Markey Cancer Center Faculty Publications

BACKGROUND: 

The Appalachian region of the US extends from the Mississippi Delta to southern New York. Although disparities in Appalachian cancer outcomes have long been observed, recent rates and trends have not been assessed.

STUDY DESIGN: 

We calculated 5-year age-adjusted US cancer incidence and mortality rates for 2017 to 2021, stratified into Appalachian and non-Appalachian populations, as well as Appalachian subregions, using the US Cancer Statistics Incidence Analytics Database and National Center for Health Statistics mortality files. Annual rates for 2004 to 2021 were also calculated.

RESULTS: 

In 2017 to 2021, all-site cancer incidence (466.6; 95% CI 465.5 to 467.6) …

Health Care Access Domains And Treatment As Mediators Of Ovarian Cancer Racial Disparities In Survival: A Structural Equation Modeling Analysis In Seer-Medicare, Clare Meernik, Quan Chen, Lauren E. Wilson, Ashwini Joshi, Fariha Rahman, Maria Pisu, Margaret Liang, Kevin C. Ward, Margaret Gates Kuliszewski, Thomas Tucker, Andrew Berchuck, Bin Huang, Tomi Akinyemiju

Markey Cancer Center Faculty Publications

Racial differences in health care access (HCA) may contribute to disparities in ovarian cancer (OC) survival. We used structural equation models (SEMs) to examine associations between race and HCA domains (affordability, availability, accessibility) in relation to overall and OC-specific mortality. Non-Hispanic (NH)–Black and non-Black (Hispanic, NH-White) women diagnosed with OC in 2008-2015 were identified from Surveillance, Epidemiology, and End Results–Medicare. Cox proportional hazards regression was used to conduct mediation analysis for associations between race and HCA domains with overall and OC-specific mortality. SEM models adjusting for demographic and clinical covariates were used to estimate hazard ratios (HRs) and 95% CIs. …

Cancer Advocacy Empowers Appalachian Kentucky Youth, Lauren Hudson Rose, Holly Burke, Olivia Thornsbury, Kameron Jackson, Rebecca Spradlin, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky has the highest cancer incidence rate and second highest cancer mortality rate in the United States, and the Appalachian region of the state experiences a disproportionate cancer burden. Cancer-related advocacy, a movement that strives to provide support to cancer patients, families, and organizations, along with policy creation, could help address this disparity by enhancing cancer-related prevention and control efforts. The University of Kentucky Markey Cancer Center’s Appalachian Career Training in Oncology (ACTION) Program partners with the American Cancer Society Cancer Advocacy Network (ACS CAN) to involve Appalachian Kentucky high school and undergraduate students in cancer advocacy activities at the …