Digital Commons Network^™

Redistricting's Ultimate Antidote, Douglas M. Spencer

Kentucky Law Journal

No abstract provided.

Self-Districting: The Ultimate Antidote To Gerrymandering, Edward B. Foley

Kentucky Law Journal

No abstract provided.

The Phantasm Of Principle, Wilfred U. Codrington Iii

Kentucky Law Journal

No abstract provided.

Redistricting In The Political Thicket: The Ghosts Of Colegrove V. Green, Anthony J. Gaughan

Kentucky Law Journal

No abstract provided.

Introduction: There Must Be Something In The Water—Or The Bourbon—In Kentucky: Voting Rights In The Bluegrass State, Joshua A. Douglas

Kentucky Law Journal

No abstract provided.

The Neighborhoods Study, Grace C. George, Sarah A. Keller, Erin Abner, Sara Adar, Michael L. Alosco, Liana G. Apostolova, Kelly Bakulski, Lisa L. Barnes, James R. Bateman, Stuart Batterman, Thomas G. Beach, Barbara B. Bendlin, David A. Bennett, Tobey J. Betthauser, James Brewer, William Buckingham, Carmen I. Carrión, Joshua Chodosh, Suzanne Craft, Raina Croff, Anthony Fabio, Sarah Tomaszewski Farias, Eva L. Feldman, Felicia Goldstein, Stephen A. Goutman, Gina Green-Harris, Victor Henderson, Thomas K. Karikari

Epidemiology and Environmental Health Faculty Publications

INTRODUCTION: The Neighborhoods Study (TNS) is a novel investigation of adverse social exposome and brain health leveraging 22 Alzheimer's Disease Research Centers (ADRCs). TNS aims to understand if the adverse social exposures increase Alzheimer's disease and related dementias (ADRD) risk. METHODS: TNS uses innovative methods to determine lifetime addresses of living (n = ≈ 3116) and brain bank cohorts (n = ≈ 8637). Addresses are linked to time-concordant adverse social exposome using the Area Deprivation Index (ADI) and summarized over time. Brain health measures are provided by the National Alzheimer's Coordinating Center. RESULTS: We highlight a general overview and methodology …

The Reporting And Methodological Recommendations For Observational Studies Estimating The Effects Of Deprescribing Medications (Remrose-D) Ispe-Endorsed Guidance, Kaleen N. Hayes, Joshua D. Niznik, Danijela Gnjidic, Frank Moriarty, Dimitri Bennett, Marie Laure Laroche, Denis Talbot, Matthew Alcusky, Maurizio Sessa, Antoinette B. Coe, Caroline Sirois, Andrew R. Zullo, Xiaojuan Li, Sri Harsha Chalasani, Jehath Syed, Mouna Sawan, Daniela C. Moga

Epidemiology and Environmental Health Faculty Publications

Purpose: Pharmacoepidemiologic studies on deprescribing are challenging to implement, yet little guidance exists on methods to avoid bias and minimum reporting for replicability and appraisal. We developed consensus recommendations for the methods and reporting of observational studies that aim to examine the effects of deprescribing. Methods: We formed candidate recommendations based on our prior systematic review that methodologically appraised observational studies on deprescribing. We then conducted a two-round modified Delphi process with researchers working in deprescribing pharmacoepidemiology to refine, select, and reach consensus on recommendations for a checklist based on > 70% agreement of their importance. We termed this list the …

Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland

Journal of Appalachian Health

Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.

Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).

Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. …

“Literally Made Me Cry”: The Impact Of Course Material Costs On University Of Kentucky Students, Stephen Krueger

Library Reports and White Papers

The Student Course Materials Cost Survey was administered September 16 – October 6, 2024. It was open to current students at the University of Kentucky (UK). The goals were to help UK Libraries better understand how the cost of course materials affects students at UK and to provide a snapshot of student spending across the university. The questions were based on similar research done at other institutions in Virginia (Virginia Course Materials Survey, 2021) and Florida (2022 Student Textbook and Instructional Materials Survey, 2022). Other work based on those surveys includes the 2023 Illinois Course Materials Survey (CARLI, 2023) and …

Patient-Clinician Communication In The Appalachian Region: A Scoping Review, Kawther Al Ksir, Hadii M. Mamudu, Chidiebube J. Ugwu, Emily K. Flores, Tracy Fasolino, Holly Wei, Rick L. Wallace, Florence M. Weierbach

Journal of Appalachian Health

Introduction: Effective communication between patients and clinicians is a critical component of quality health care, influencing disease prevention, management, and outcomes. In regions with unique socioeconomic and geographic challenges, communication barriers can further exacerbate health disparities. Understanding the factors that facilitate or hinder patient-clinician communication is essential for developing targeted interventions that improve health care delivery.

Purpose: This review explores the existing literature on patient-clinician communication concerning cardiovascular disease (CVD) in the Appalachian Region with the aim to understand existing gaps and interventions.

Methods: PubMed and Web of Science databases were utilized to conduct a systematic search. The Population, Concept, …

Determinants Of Willingness To Share Wearable Health Data With Health Care Providers In Appalachian Populations: An Exploratory Study, Gilbert Munoz Cornejo, Joonghee Lee

Journal of Appalachian Health

Background: Wearable health devices capture metrics (e.g., physical activity, ECG, sleep) that can enhance care when shared with providers. Yet, willingness to share wearable data may differ in Appalachia, where chronic disease burdens, mistrust, and limited infrastructure pose unique challenges.

Objective: This study explored (1) which sociodemographic, health, and digital behaviors correlate with willingness to share wearable data and (2) how these insights can guide region-specific interventions in Appalachia.

Methods: We analyzed 320 Appalachian respondents from the Health Information National Trends Survey (HINTS 6). Descriptive statistics and logistic regression models examined willingness to share wearable data. Because of small cell …

Heartache In The Heartland: Unraveling The Social Roots Of Deaths Of Despair In Kentucky, Lyndsey K. Blair, Madeline M. Tomlinson, Michele Abee-Biskis, Jessica Hume, Gabri Warren

Journal of Appalachian Health

Introduction: Deaths of despair (DoD), encompassing suicides, drug overdoses, and alcohol-related liver diseases, have emerged as a critical public health crisis in the United States, with their rise particularly pronounced from 1995 to 2013 and exacerbated by the COVID-19 pandemic. Kentucky, grappling with high rates of substance use disorder, poor mental health, and economic hardship, is at the forefront of this issue, particularly in its rural and Appalachian regions.

Purpose: This study explores the social determinants contributing to DoD in Kentucky, focusing on economic and social factors that influence rising rates of suicide, drug overdose, and alcohol-related liver disease. The …

Time And Location: Physical Activity Trends In Parents And Children In A Rural Region During Covid-19, Brooke C. Towner, Robert Broce, Rebecca A. Battista

Journal of Appalachian Health

Introduction: COVID-19 restrictions altered the structure of the school and workday for families with children and led to changes in active transportation. Continued restrictions impacted access to many community locations and led to changes in physical activity (PA) behavior.

Purpose: The objectives of the study were to describe the changes in the 1) amount of PA time per day, 2) frequency of PA, and 3) sitting time. Information about how PA changed for parents and children during the COVID-19 pandemic will have potential implications for education, public health, and recreation management.

Methods: This cross-sectional study enlisted participants via an online …

Introducing Social Determinants Of Health To The Alzheimer's Disease Research Center Network, Megan Zuelsdorff, Erin L. Abner, Joyce E. Balls-Berry, Gregory A. Jicha, Serggio Lanata, Gladys E. Maestre, Monica Rosselli, Shana D. Stites, Rachel A. Whitmer, Consuelo H. Wilkins, Lisa L. Barnes

Epidemiology and Environmental Health Faculty Publications

The Alzheimer's Disease Research Centers (ADRCs) consortium represents a critical locus of research on Alzheimer's disease and related disorders (ADRD) prevention, diagnosis, and intervention. Through the National Alzheimer's Coordinating Center's (NACC) standardized protocol, the Uniform Data Set (UDS), ADRCs have collected rich, harmonizable clinical and cognitive data. However, the collection of social data has been sparse and Center specific, constraining ADRD science that addresses research priorities on social determinants of health (SDOH) and health equity. Capitalizing on the transition to a revised UDS version 4, an interdisciplinary committee representing 10 ADRCs reviewed the literature and instrumentation, ultimately creating a brief …

Genetic Identification Of Lamprey Genera And Anadromous Ecotypes In Watersheds Of The Northeastern Pacific Ocean, G. S. Silver, R. T. Lampman, N. Percival, N. Timoshevskaya, J. J. Smith, K. T. Bentley, J. Wade, S. R. Narum, J. E. Hess

Biology Faculty Publications

Nonparasitic, nonmigratory Western Brook Lamprey (WBL; Lampetra ayresii), and parasitic, anadromous Western River Lamprey (WRL; L. ayresii) are sympatric lampreys that likely represent different life history variations of a single species. Novel genetic tools are critical for differentiating WBL and WRL, whose larvae preclude morphological identification (ID) and will enable comprehensive assessment of imperiled native lampreys of the Northeastern Pacific (including WBL, WRL, and Pacific Lamprey, Entosphenus tridentatus). We developed 47 candidate single nucleotide polymorphism (SNP) markers using whole genome resequencing of WBL (N = 24) and WRL (N = 15) from Ksi Ts'oohl Ts'ap Creek (Nass River, British Columbia, …

Development Of Measures For Highway Criticality Assessment, Xu Zhang, Mei Chen

Kentucky Transportation Center Research Report

Existing network criticality assessments, often biased towards heavily used highways in populous areas by incorporating traffic and sociodemographic attributes, can lead to an underestimation of the vital role of rural infrastructure. Consequently, rural highways, particularly low-volume roads, often receive less consideration despite their critical role in network connectivity and local access to services and economic opportunities. To address this, we develop a criticality framework based on the egalitarian principle, which prioritizes equitable consideration of all network links regardless of traffic volume or population density, comprising two complementary measures. First, the normalized betweenness centrality quantifies a road's relative importance in efficiently …

Among-Population Variation In Telomere Regulatory Proteins And Their Potential Role As Hidden Drivers Of Intraspecific Variation In Life History, Sarah E. Wolf, Mary J. Woodruff, David A. Chang Van Oordt, Ethan D. Clotfelter, Daniel A. Cristol, Elizabeth P. Derryberry, Stephen M. Ferguson, Mark T. Stanback, Conor C. Taff, Maren N. Vitousek, David F. Westneat, Kimberly A. Rosvall

Biology Faculty Publications

Biologists aim to explain patterns of growth, reproduction and ageing that characterize life histories, yet we are just beginning to understand the proximate mechanisms that generate this diversity. Existing research in this area has focused on telomeres but has generally overlooked the telomere's most direct mediator, the shelterin protein complex. Shelterin proteins physically interact with the telomere to shape its shortening and repair. They also regulate metabolism and immune function, suggesting a potential role in life history variation in the wild. However, research on shelterin proteins is uncommon outside of biomolecular work. Intraspecific analyses can play an important role in …

Macroevolutionary Inference Of Complex Modes Of Chromosomal Speciation In A Cosmopolitan Plant Lineage, Carrie M. Tribble, José Ignacio Márquez-Corro, Michael R. May, Andrew L. Hipp, Marcial Escudero, Rosana Zenil-Ferguson

Biology Faculty Publications

The effects of single chromosome number change—dysploidy – mediating diversification remain poorly understood. Dysploidy modifies recombination rates, linkage, or reproductive isolation, especially for one-fifth of all eukaryote lineages with holocentric chromosomes. Dysploidy effects on diversification have not been estimated because modeling chromosome numbers linked to diversification with heterogeneity along phylogenies is quantitatively challenging. We propose a new state-dependent diversification model of chromosome evolution that links diversification rates to dysploidy rates considering heterogeneity and differentiates between anagenetic and cladogenetic changes. We apply this model to Carex (Cyperaceae), a cosmopolitan flowering plant clade with holocentric chromosomes. We recover two distinct modes of …

Investigating Suicide Risk Factors Among Appalachian West Virginian Adults, Erin D. Caswell, Angela M. Dyer, Summer D. Hartley, Caroline P. Groth, Mary Christensen, Sahiti K. Tulabandu, Bryce K. Weaver, Ruchi Bhandari

Journal of Appalachian Health

Introduction: Suicide rates in the United States have increased over the past two decades, with rural areas, particularly the Appalachian Region, facing unique challenges that elevate suicide risk. These include economic hardships, social isolation, and limited access to mental health services.

Purpose: This study addresses critical gaps in understanding lifetime suicide risk in West Virginia (WV), a predominantly rural state entirely within the Appalachian Region. By identifying the factors driving urban-rural differences in suicide risk, this research seeks to inform interventions tailored to the state's distinct needs and provide insights applicable to the broader Appalachian Region

Methods: Using 2021 Mountain …

Current Attitudes And Barriers Among Appalachian Patients Towards Orthopaedic Surgery, Dylan Smith Md, Justin B. West Ms, Wade Smith Md, Micah Macaskill Md, Jonathan Lash, Matthew W. Bullock Do, Mpt

Journal of Appalachian Health

Introduction: This study explores the challenges faced by residents of rural West Virginia in accessing orthopaedic care due to geographic and socioeconomic barriers.

Purpose: This study seeks to survey rural West Virginia residents about their attitudes and experiences regarding access to orthopaedic care in southern West Virginia.

Methods: A total of 132 electronic surveys were collected from rural West Virginia residents during an appointment with their primary care provider located at an affiliated outreach clinic. The survey was designed to investigate various factors influencing their access to orthopaedic care.

Results: Delays in seeking orthpaedic care are common in rural West …

Coffee Farmgate Price And Post-Harvest Processing In Honduras., Isaac Desouza

Theses and Dissertations--Agricultural Economics

Volatile commodity markets and changing climate expose coffee farmers to price and production risk. Proponents recommend specialty coffee as a strategy to combat price risk, because its unique attributes differentiate it from commodity coffee. Extrinsic and intrinsic attributes define specialty coffee and affect prices at many levels of the supply chain. Despite much work on extrinsic attributes, little is known about how intrinsic attributes relate to farmgate price. Post-harvest processing is itself an intrinsic trait and driver of coffee quality. In 2024 we surveyed 261 coffee farmers from La Paz, Honduras, to uncover relationships between capital, post-harvest processing, and farmgate …

Including Black Farmers, Excluding Pests: Perspectives On Participation In The Cooperative Extension Service, Briana Bazile

Theses and Dissertations--Entomology

In recent years, the U.S. Department of Agriculture has faced renewed scrutiny for documented discrimination against Black farmers, yet far less attention has focused on its century-old partner in public service delivery, the Cooperative Extension Service (CES). This gap is especially notable considering 1) federal parity mandates extant since 1972 in response to significant disparities between Black and White constituents and staff,2) public commitments to Diversity, Equity & Inclusion in 2020 and, 3) the contributions of Black leaders at the origins of CES, at Tuskegee University in the late nineteenth century. Using the Kentucky Cooperative Extension Service (KYCES) as a …

Geographic Patterns Of Human Immunodeficiency Virus (Hiv) Risk Behaviors Among Older Adults: A Strategy For Identifying Space As A Risk Exposure, Laneshia R. Conner, Reuben Adatorwovor, Sarah Jane Robbins, Rujeko O. Machinga-Asaolu, Kathryn Showalter, Carrie B. Oser

Social Work Faculty Publications

Objectives: This study examined geographical patterns of HIV risk among adults aged 60 and older.

Methods: The 2019 Behavioral Risk Factor Surveillance System (BRFSS) weighted data was used to analyze self-reported participation in HIV risk behaviors among older adults (n = 62,852). Logistic regression models were used on a dichotomous HIV risk variable to map the distribution of HIV risk behaviors across both census regions and divisions.

Results: The weighted model revealed significance across regions. Across all regions, identifying as female, identifying as Hispanic, and reporting not having depression were protective from participating in HIV risk behaviors.

Discussion: The …

Fairehr, Karen S. Galea, Finlay Brooker, Shahzad Rashid, Michael Bader, Yu Ait Bamai, Jos Bessems, Embialle Mengistie Beyene, Alison Connolly, Carla Costa, Pravina Deligannu, Radu Corneliu Duca, Kaoutar Chbihi, Kasahun Eba, Manosij Ghosh, Melissa Gonzales, Stuart Harrad, Erin N. Haynes, Nancy B. Hopf, Po Chin Huang, Kate Jones, Konstantinos M. Kasiotis, Ming Kei Chung, Jihyon Kil, Holger Koch, Jung Hwan Kwon, Elizabeth Ziying Lin, Henriqueta Louro, Kyriaki Machera

Epidemiology and Environmental Health Faculty Publications

The FAIREHR (Findable, Accessible, Interoperable, Reusable Environmental and Health Registry) platform is a state-of-the-art online registry for prospective harmonization of human biomonitoring (HBM). It was developed by the HBM working group of the Europe Regional Chapter of the International Society of Exposure Science (ISES Europe) and is supported by the HBM Global Network. FAIREHR is designed to harmonize HBM metadata and support the implementation of the FAIR (Findable, Accessible, Interoperable and Reusable) Guiding Principles throughout HBM studies or programs. The registry enables preregistration of HBM by capturing key metadata on study design, metadata management, and planned methods before participant recruitment. …

The New American Farmer – Extension Engagement With Urban Agriculture And Food Systems, Margaux S.C. Robinson, Kc V. Cunningham, Jeffery A. Young, Nicole D. Breazeale, Kenneth Jones, Julie Zimmerman

Sociology Faculty Publications

Extension's evolving role in urban food production will require intensive reflexivity and ongoing collaboration. Extension educators around the country have already made progress in engaging with both the social and horticultural sides of urban agriculture. Designed appropriately, urban food systems hold the potential for healthy food access, community and environmental resilience, and economic prosperity (Rangarajan & Riordan 2019). Moving forward, we offer recommendations for Extension staff to apply within their institutions and beyond. Specifically, we urge Extension to prioritize the following: 1) mediate the rural/urban dichotomy, 2) tackle structural and institutional power dynamics, and 3) intensify strategies for community resilience.

High-Resolution Geospatial Database: National Criteria-Air-Pollutant Concentrations In The Contiguous U.S., 2016–2020, Tianjun Lu, Sun-Young Kim, Julian D. Marshall

Epidemiology and Environmental Health Faculty Publications

Concentration estimates for ambient air pollution are used widely in fields such as environmental epidemiology, health impact assessment, urban planning, environmental equity and sustainability. This study builds on previous efforts by developing an updated high-resolution geospatial database of population-weighted annual-average concentrations for six criteria air pollutants (PM_2.5, PM₁₀, CO, NO₂, SO₂, O₃) across the contiguous U.S. during a five-year period (2016–2020). We developed Land Use Regression (LUR) models within a partial-least-squares–universal kriging framework by incorporating several land use, geospatial and satellite–based predictor variables. The LUR models were validated using conventional …

The Paradox Of Survival: Gendered Food Insecurity, Labor Inequalities, And Coping Strategies During The 2023/4 Drought In Eastern Ethiopia, Meron E. Lemma

Theses and Dissertations--Geography

In drought-prone regions of Eastern Ethiopia, recurring droughts profoundly reshape everyday life in ways that deepen existing gendered inequalities. Drawing on fieldwork conducted in Fedis district, including semi-structured interviews with women, project implementers, and government officials, as well as group discussions with community members, this study explores how women experience, navigate, and resist the gendered impacts of drought. By attending to the sociopolitical dynamics of drought and the development interventions that accompany it, I analyze how these forces restructure labor, land, food systems, and authority in ways that reproduce and exacerbate existing inequalities. Women’s coping strategies, ranging from begging and …

Commercial Attention Spaces: A Century Of Discourses, Measurements, And Models Of Attention In The Construction Of U.S. Advertising Markets, Jacob Saindon

Theses and Dissertations--Geography

A vast assemblage of networked devices populate our everyday spaces. Concomitant with the increasing ubiquity of media devices are advertisements. Indeed, many networked devices, specifically the “free-to-use” software applications, websites, or platforms displayed through them, are advertising-dependent. An assortment of firms within the commercial media industry—brands, agencies, publishers, vendors—work in concert to sustain a market for advertising. The core operation of the commercial media industry, I argue, is the production and exchange of attention as an economic object. In this study, I approach the production of attention and the framing of its markets as spatial processes. The continued growth of …

A Qualitative Study Of End-Stage Liver Disease And Liver Transplant Referral Practices Among Primary Care Providers In Nonurban America, Vashisht Madabhushi, Matthew Wright, Gabriel Orozco, Allison Murphy, Antonio R. Garcia, Natalie D. Pope, Xiaonan Mei, Alexandra Cocca, Roberto Gedaly, Meera Gupta

Surgery Faculty Publications

Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider’s (PCP’s) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY).

Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes.

Findings: …

Gut Microbiome, Neuroinflammation, And Fetal Alcohol Spectrum Disorders: Insights From Rodent Models, Abdulrahman M. Busayli, Wenhua Xu, Ghaidaa A. Raffah, Gang Chen

Pharmacology and Nutritional Sciences Faculty Publications

Fetal alcohol spectrum disorder (FASD) is a significant public health issue that affects children. It results from ethanol exposure during pregnancy, leading to considerable physical, neurodevelopmental, behavioral, and cognitive deficits. The exact mechanism is not well understood. Recently, considerable attention has been focused on the influence of gut microbiome on brain development through the gut–brain axis. Changes in the gut microbiome resulting from ethanol exposure may contribute to the pathology of FASD, potentially involving neuroinflammation. This literature review summarizes the existing research and primary animal studies on the impact of early ethanol exposure on the gut microbiome, neuroinflammation, brain development, …