Digital Commons Network^™

A Case Study In Program Evaluation: A Prospective Program Evaluation Of Timely Reporting And Action Of An Infectious Disease Outbreak, Destiny Cozart

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

Methicillin-resistant Staphylococcus aureus also known as MRSA is an infection of a staph bacteria. High school athletes are at risk of contracting MRSA through skin to skin contact and/or MRSA contaminated equipment. This case study uses the CDC's six-step framework for program evaluation to measure the effectiveness of the online training modules designed to increase the knowledge of staff and stakeholders about MRSA and infectious disease outbreaks. The findings from this evaluation will advise the potential change(s) implemented in training modules, ultimately to enhance competency for decision makers and prevent MRSA and infectious disease outbreak amongst high school athletic programs.

Fall 2023 Covid-19, Influenza, And Respiratory Syncytial Virus Vaccine Uptake In Kentucky, Abigail Dial

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

Fall 2023 COVID-19, Influenza, and Respiratory Syncytial Virus Vaccine Uptake in Kentucky

Background: In the fall of 2023, vaccine recommendations included updated COVID-19 and influenza vaccines, as well as a new vaccine and immunization for respiratory syncytial virus (RSV). Vaccine co-administration, the administration of more than one vaccine in one vaccination session, is safe and effective for COVID-19, influenza, and RSV vaccines and can improve vaccine uptake for all recommended vaccines (Bonanni, et al., 2023; CDC, 2023). The COVID-19 pandemic altered the landscape for locations where people receive vaccinations, and it may be beneficial to public health to have …

Industrial Hemp Production And Potential Risks In Kentucky, Hoyeon Jeong

Theses and Dissertations--Agricultural Economics

Since the Agricultural Improvement Act of 2014 and 2018 legalized Industrial Hemp (Cannabis Sativa. L), interest in grain, fiber, and floral hemp production has seen growing pains. As an emerging crop, there is a research gap in the impact of weather and agronomic conditions on hemp production including THC (Delta 9 Tetrahydrocannabinol) and pollen drift as risks in hemp cultivation. The first essay aims to measure the impact of weather and agronomic factors on hemp grain, fiber, and floral yields in Kentucky using a yield-weather model with information on field locations. The results show that heat conditions during the growing …

Navigating Success In Higher Education: Generative Ai, Financial Well-Being, And Parental Support, Tanya Gardner

Theses and Dissertations--Public Policy and Administration

Postsecondary education is viewed as a sure path to economic mobility. This dissertation contains three essays which examine correlates of postsecondary value. Postsecondary students face a variety of stressors throughout their college career which may impact their ability to be successful. They must complete their coursework and pass their classes while balancing work, social, and familial obligations. Tools such as generative AI may help students achieve their goals even in the face of personal challenges such as low financial stability or the inability to afford the high costs of college. Together these essays add to the body of literature which …

Essays On Public And Nonprofit Financial Dynamics, Yunjun Kim

Theses and Dissertations--Public Policy and Administration

This dissertation consists of three essays that explore different dimensions of financial dynamics in the public and nonprofit sectors. Each chapter examines how the fiscal behavior of neighboring jurisdictions, policy interventions, and financial practices influence fiscal decision-making and financial performance within these entities.

In the first essay, I investigate yardstick competition in local government spending in South Korea by leveraging the exogenous variation introduced by by-elections. This approach allows me to estimate the influence of neighboring jurisdictions on local expenditures. Contrary to previous empirical studies from other countries, my findings reveal no significant interdependence in spending among South Korean municipalities, …

How Black Undergraduate Students Experience Whiteness In Postsecondary Education, Karen Margaret Guettler-James

Theses and Dissertations--Educational, School, and Counseling Psychology

Critical whiteness scholars have described whiteness as a system of oppression that privileges White identities above others and perpetuates White supremacy. On the college campus, institutional, social, and historical norms reinforce the educational status quo and work together to maintain a system of whiteness that marginalizes Black students. This study investigated perceptions of whiteness held by student participants who self-identify as Black undergraduate students. Through focus group interviews, participants were asked to share their lived experiences with whiteness on the college campus. With the words of the participants, I reveal how campus standards that align with White Eurocentric norms devalue …

Fowl Play And Lame Ducks: How A Three-Headed Circuit Split Confuses Century-Old Migratory Bird Protections, Omer Arain

Kentucky Journal of Equine, Agriculture, & Natural Resources Law

No abstract provided.

Accurate Knowledge Of Roadway Horizontal And Vertical Alignment Is Essential, Bekir Bartin, Mojibulrahman Jami, Kaan Ozbay

Kentucky Transportation Center Presentations

No abstract provided.

Elucidating The Role Of Fatty Acid Synthase In Apc-Driven Colorectal Cancer, Courtney O. Kelson

Theses and Dissertations--Toxicology and Cancer Biology

Globally, colorectal cancer (CRC) is the second leading cause of cancer related deaths. Currently, there is a growing incidence rate for individuals aged 20-49 years. Genetic and environmental factors contribute to the risk of this cancer. Early detection of CRC allows for the most effective treatment option in which surgical resection of the primary tumor occurs along with adjuvant chemotherapy. This therapeutic approach contributes to 5-year survival rate of 91%. However, surgical procedures and chemotherapy struggles against metastatic and relapsed CRC resulting in 5-year survival rate of 14%. Inefficacious treatments for relapsed and metastatic diseases emphasizes the need for more …

Elucidation Of Mismatch Repair Regulation By Abl1: Advantages/Disadvantages Of Tyrosine Kinase Inhibitor Treatment, Hannah Daniels

Theses and Dissertations--Toxicology and Cancer Biology

DNA mismatch repair (MMR) is a critical repair process necessary for not only repairing mispairs incorporated into the DNA during replication, but also for inducing apoptosis in response to certain types of DNA damage. MMR is required for maintaining genomic integrity and due to the importance of this pathway, any impairment of its function can lead to increased mutation frequency, which is well known to be a driving force of cancer development, progression, and resistance. Despite extensive studies involving the proteins involved in the MMR pathway, the regulation of those proteins remains relatively unknown. Regulation of MLH1, a protein necessary …

Porcupine’S Role In The Enhancement Of Enzalutamide Efficacy In Drug Resistant Prostate Cancer, Katelyn Jones

Theses and Dissertations--Toxicology and Cancer Biology

Androgen receptor (AR) signaling continues to participate as a vital component of castration-resistant prostate cancer (CRPC). Subsequently, this has led to the development of Androgen Signaling Inhibitors (ASI), specifically Enzalutamide (ENZ), which is a direct inhibitor of AR, to clinically manage CRPC. Inevitably, ENZ treatment only provides improvement for approximately two months before advancing to an incurable form, ENZ-resistant CRPC. With PCa ranking as the second leading cause of cancer-related deaths in USA males, there is an urgency and necessity for the discovery and development of novel therapeutic approaches for CRPC. Wnt signaling has been extensively documented in its involvement …

State Governance And Less-Skilled Migrant Workers In South Korea, Weejun Park

Theses and Dissertations--Geography

This dissertation examines the migration governance of South Korea with a focus on the immigration of less-skilled migrant workers. While geographers and broader social scientists have explored this topic, previous studies have two main foci: 1) individual immigrants and their activities; and 2) migration policy development. Despite these studies’ contribution to the scholarship, there seems to be a relative lack of interest in the South Korean state as a potentially crucial actor in governing less-skilled migrant workers. To address this gap, this dissertation draws upon (political) geography, related social sciences, and interdisciplinary fields such as border studies, migration studies, and …

Navigating The Crooked Road: A Case-Study Into The Appalachian Regional Commission’S Strategy To Promote Economic Development Through Cultural Tourism, Nicholas Relich

Gaines Fellow Senior Theses

Since 1965, the federal government’s Appalachian Regional Commission (ARC) has sought to improve Appalachia’s wellbeing by funding state and local economic development projects. One recent ARC strategy is investing in projects to develop the region’s tourism sector as a means of growth, particularly “cultural tourism,” which markets Appalachia’s cultural heritage to potential visitors. This paper seeks to evaluate the effectiveness of such ARC investments based on economic theory and by performing an empirical and qualitative case-study of one such series of projects: The Crooked Road, a music heritage trail located in Southwest Virginia. Officially organized in 2004 and receiving substantial …

A Case Study In Prospective Program Evaluation, Sarai Rosemary Combs

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

Evaluation is a helpful tool in public health to provide transparency about community interventions and programs. The following is a prospective evaluation of a case study, looking at a recently designed program by the Lexington-Fayette County Health Department, as a capstone project for the Health Management and Policy concentration of the Masters in Public Health program of the College of Public Health. The health department developed a series of online training modules to increase knowledge of Methicillin-resistant staphylococcus aureus (MRSA) and other similar organism outbreaks and how to respond to these outbreaks. The program targets were Fayette County Public School …

A Case Study In Program Evaluation, Iantha Wright

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

The framework for program evaluation is a systematic way of improving and accounting for public health actions by providing practical, feasible, ethical, and accurate information. As a practical, non-prescriptive tool, it guides public health professionals through the essential steps in program evaluation. The framework uses the six steps to understand how to improve and conduct assessments effectively. Additionally, it emphasizes integrating stakeholders and using ongoing evaluation strategies to plan effective interventions, improve existing programs, and demonstrate the efficient use of resources.

A Case Study In Program Evaluation, Sierra L. Williams

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

The Lexington-Fayette County Health Department (LFCHD) developed an education program targeted toward infectious disease outbreaks. The program ensures timely reporting and action during an infectious disease outbreak within the Fayette County Public Schools (FCPS) system. I have been tasked with evaluating the program and its implementation of training modules through pre and post-surveys to determine if the program is significantly increasing the overall knowledge of program participants and make recommendations for how program aspects can be improved.

Program Evaluation Case Study, Grace Mullikin

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

Program evaluation case study utilizing Center for Disease Control and Prevention's Case Evaluation Framework.

The Effect Of Adding Perceptual-Cognitive Load To Assessments And Intervention Strategies In Healthy Adults, Ke'la H. Porter

Theses and Dissertations--Rehabilitation Sciences

In collegiate athletes, approximately one in four injuries require more than seven days before the athlete can return to full participation. Additionally, there are significant long-term consequences associated with these injuries, such as pain and osteoarthritis. Despite the role that the sensorimotor system and cognitive function play in athletic competition, the interaction between these systems in relation to sport-related injury is commonly overlooked. The sensorimotor system integrates and processes sensory, motor, and central mechanisms to produce a motor response. Further, cognition constructs, such as visual attention or processing speed, allow athletes to navigate the chaotic sporting environment. When there are …

The Role Of Social Determinants Of Health On Patient Recovery After Critical Illness, Lindsey E. Fresenko

Theses and Dissertations--Rehabilitation Sciences

Patients who survive critical illness have a prolonged recovery which impacts their quality of life and outcomes. The sudden life changes from being critically ill may create or exacerbate social factors or needs also known as social determinants of health. Patients’ SDOH are defined as the environments in which we live, work and play that impact health outcomes. Patients’ SDOH impact their life in early recovery from changes in previous roles to their need for increased financial, physical and emotional support. During this early recovery, patients are often recommended to participate in rehabilitation to improve their physical function. Although, accessing …

Association Of Plasma Neurofilament Light Chain With Microstructural White Matter Changes In Down Syndrome, Herminia Diana Rosas, Nathaniel David Mercaldo, Yasemin Hasimoglu, Melissa Petersen, Lydia R. Lewis, Florence Lai, David Powell, Asim Dhungana, Ali Demir, David Keater, Michael Yassa, Adam M. Brickman, Sid O'Bryant

Neuroscience Faculty Publications

INTRODUCTION: Both micro- and macrostructural white matter (WM) abnormalities, particularly those related to axonal degeneration, are associated with cognitive decline in adults with Down syndrome (DS) prior to a diagnosis of Alzheimer disease. Neurofilament light chain (NfL) is a support protein within myelinated axons released into blood following axonal damage. In this study we investigated cross-sectional relationships between WM microstructural changes as measured by diffusion tensor imaging (DTI) and plasma NfL concentration in adults with DS without dementia.

METHODS: Thirty cognitively stable (CS) adults with DS underwent diffusion-weighted MRI scanning and plasma NfL measurement. DTI measures of select WM tracts …

Get It In Writing: How To Make Medications For Opioid Use Disorder Available During Incarceration, Margaret J. Mcgladrey, Jordan Kelsch, Michelle R. Lofwall, Laura C. Fanucchi, Sharon L. Walsh, Carrie B. Oser

Center on Drug and Alcohol Research Faculty Publications

In a case example from the Kentucky HEALing Communities Study, extensive resources were deployed to address structural barriers and facilitate the provision of medication for opioid use disorder (OUD) in an urban county jail. However, implementation was unsuccessful, and this case example emphasizes the importance of including evidence-based medication for OUD (MOUD) treatment in the scope of work of jails’ contracted medical providers. The privatization of correctional health care services allows local governments with opioid abatement funds to incorporate requirements into medical provider contracts to screen all people entering jails for OUD and to offer MOUD at intake, throughout incarceration, …

Perceived Versus Actual Hiv Risk Among Prep Indicated Persons With Criminal Legal Involvement, Taylor Krajewski, Katherine H. Lemasters, Carrie B. Oser, Lauren Brinkley-Rubinstein

Behavioral Science Faculty Publications

Individuals involved with community supervision experience multi-level obstacles impacting health outcomes. This is a high-risk period for HIV acquisition due to potential reengagement in unprotected sex and/or unsafe injection drug practices. This study aimed to assess the congruence between actual and perceived HIV risk and the degree to which individual, social, and behavioral factors impact risk perception among individuals on community supervision. While all participants were clinically indicated for PrEP, most participants (81.5%) did not consider themselves at risk for HIV (69.5%) or were not sure of their risk (12.0%). Among those with no or unsure perceived risk, 94% engaged …

Screening Incarcerated Women For Opioid Use Disorder, Michele Staton, Martha Tillson, Mary M. Levi, Matthew Webster, Carrie B. Oser, Carl Leukefeld

Behavioral Science Faculty Publications

The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree …

A Social History Of Opioids’ Crimedical Cycle, Jerel M. Ezell, Alex Rains, Babatunde Patrick Ajayi, Kyle Miller, Erin Augustine, Dawn Goddard-Eckrich, Elizabeth N. Kinnard, Michelle R. Lofwall

Behavioral Science Faculty Publications

Historically, public and political discourse around people who nonmedically use opioids has largely been rendered via a deficits-oriented lens, presenting this population as weak, disinterested, and deviant,and thus undesirable and ill-positioned for wellness and communal integration. These narratives, and subsequent policies used to engage people who use opioids, are intermittently formed and disrupted by geopolitical changes, as public and institutional attitudes, often driven by racial and class-related considerations, shift. As part of what we term the crimedical cycle, a population’s behaviors fluctuate between periods of medicalization and criminalization. Strengths-based theory, an offshoot of ‘positive psychology’ that helps contextualize the crimedical …

Extended-Release Injection Vs Sublingual Buprenorphine For Opioid Use Disorder With Fentanyl Use, Edward V. Nunes, Sandra D. Comer, Michelle R. Lofwall, Sharon L. Walsh, Stefan Peterson, Fredrik Tiberg, Peter Hjelmstrom, Natalie R. Budilovsky-Kelley

Behavioral Science Faculty Publications

Importance: Fentanyl has exacerbated the opioid use disorder (OUD) and opioid overdose epidemic. Data on the effectiveness of medications for OUD among patients using fentanyl are limited.

Objective: To assess the effectiveness of sublingual or extended-release injection formulations of buprenorphine for the treatment of OUD among patients with and without fentanyl use.

Design, Setting, and Participants: Post hoc analysis of a 24-week, randomized, double-blind clinical trial conducted at 35 outpatient sites in the US from December 2015 to November 2016 of sublingual buprenorphine-naloxone vs extended-release subcutaneous injection buprenorphine (CAM2038) for patients with OUD subgrouped by presence vs absence of fentanyl …

Correction: Bayesian Kinetic Modeling For Tracer-Based Metabolomic Data, Xu Zhang, Ya Su, Andrew N. Lane, Arnold Stromberg, Teresa Whei-Mei Fan, Chi Wang

Statistics Faculty Publications

No abstract provided.

Detecting Cognitive Decline In High-Functioning Older Adults: The Relationship Between Subjective Cognitive Concerns, Frequency Of High Neuropsychological Test Scores, And The Frontoparietal Control Network, Justin E. Karr, Jonathan G. Hakun, Daniel B. Elbich, Cristina N. Pinheiro, Frederick A. Schmitt

Neurology Faculty Publications

Objective: Neuropsychologists have difficulty detecting cognitive decline in high-functioning older adults because greater neurological change must occur before cognitive performances are low enough to indicate decline or impairment. For high-functioning older adults, early neurological changes may correspond with subjective cognitive concerns and an absence of high scores. This study compared high- functioning older adults with and without subjective cognitive concerns, hypothesizing those with cognitive concerns would have fewer high scores on neuropsychological testing and lower frontoparietal network volume, thickness, and connectivity.

Method: Participants had high estimated premorbid functioning (e.g., estimated intelligence ≥75th percentile or college-educated) and were divided based on …

Using Digital Pathology To Analyze The Murine Cerebrovasculature, Dana M. Niedowicz, Jenna L. Gollihue, Erica M. Weekman, Panhavuth Phe, Donna M. Wilcock, Christopher M. Norris, Peter T. Nelson

Neurology Faculty Publications

Research on the cerebrovasculature may provide insights into brain health and disease. Immunohistochemical staining is one way to visualize blood vessels, and digital pathology has the potential to revolutionize the measurement of blood vessel parameters. These tools provide opportunities for translational mouse model research. However, mouse brain tissue presents a formidable set of technical challenges, including potentially high background staining and crossreactivity of endogenous IgG. Formalin-fixed paraffin-embedded (FFPE) and fixed frozen sections, both of which are widely used, may require different methods. In this study, we optimized blood vessel staining in mouse brain tissue, testing both FFPE and frozen fixed …

Ruling In The Shadows: Analysis Of The Supreme Court’S Use Of The ‘Shadow Docket’ And Its Effects, Emilee Smart

Theses and Dissertations--Political Science

The recent increased use of the shadow docket has left the public and scholars with unanswered questions about how procedures influence outcomes and behavior. Many of these shadow docket cases have been petitioned to the justices as emergencies in very important policy areas such as immigration, abortion, elections, and transgender rights. I collect a large dataset of all outcomes of the Supreme Court's shadow docket from 2010-2022. I examine the language the justices use to justify their decisions made using alternate procedures. I find unique differences in the justifying behavior of the justices as well as significant differences in the …

Evaluating A High School Mrsa Prevention Program: A Case Study, Jamie Henning

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

MRSA poses a significant health risk to athletes nationwide. This case study examines the application of an online training module to address knowledge gaps regarding Methicillin-resistant Staphylococcus aureus (MRSA) among key decision-makers for high school athletes. It reviews the development and initial evaluation of a web-based training program designed to empower decision-makers with the knowledge to prevent MRSA infection and respond to suspected cases. Program evaluation recommended expanding the training module to wrestling staff with improved evaluation methods while continuing implementation and effectiveness assessment for the football staff. Despite initial data quality limitations, the online training module evaluation offered valuable …