Digital Commons Network^™

A Case Study In Program Evaluation: Evaluation Of A Program To Increase Physical Activity, Megan M. Harper

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

Public health revolves around 3 core functions: assessment, policy development, and assurance.¹ For public health initiatives to have long-term success, we must determine if the intended effects of those programs are met in the beginning stages of program development and implementation; thus, program evaluation relates to the core function of assessment. The Centers for Disease Control and Prevention (CDC) developed a framework to facilitate this process and enable subsequent informed decisions on how to improve public health programs, which relates to policy development.² The CDC framework is comprised of 6 interconnected steps and 4 groups of standards; together, …

Understanding The Impact Of Pharmacist Prescriptive Authority On Hiv Pre-Exposure Prophylaxis At The State Level, Cameron G. King

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

HIV transmission, with relative risk reductions of up to 99%. However, real world data have revealed that even with large increases in PrEP use, new HIV diagnoses may only slightly decline. This disparity suggests that access to PrEP may be suboptimal, especially among high-risk subgroups, who are often hard to maintain on the continuum of HIV care. Pharmacists, because of their accessibility, trusted role in their communities, and growing scope of practice, could serve as an intervention point to improve access to PrEP.

A previously validated algorithm using National Drug Codes (NDCs) and the International Classification of Disease, 10^{th …}

How Sleep Disorders And Sleep Duration Impact Memory, Alexandria J. Sims

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

INTRODUCTION: Sleep duration and sleep disorders can cause changes in memory function as populations age. Previous studies have shown that disordered sleep is associated with increased risk of cognitive dysfunction and long and short sleep durations can cause memory impairment. This study studies aims to find if there is an association between sleep disorders and sleep duration and the impacts on memory.

METHODS: In this study, 3,478 participants aged 60 year and older from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 dataset were included in adjusted and unadjusted models, comparing the sleep disorders and sleep duration exposures to …

Environmental And Behavioral Determinants Of Congenital Defects: An Ecologic Study In Kentucky, Amelia G. Floyd

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

Congenital defects are a significant contributor to infant morbidity and mortality. The multifactorial etiology of such defects presents complex challenges for public health. This ecologic study investigates the association between environmental and behavioral exposures and congenital defects rates at the county level in Kentucky from 2010 to 2019. The Kentucky Department for Public Health, Office of Vital Statistics, provided all relevant defect data. County-level exposure data was collected from multiple sources.

Descriptive and geospatial analyses revealed substantial geographic variability, with notable high defect rates in northeastern Kentucky. Negative binomial regression models identified behavioral and socioeconomic factors to be the strongest …

Assessing The Impact Of A Physical Activity Program In Bourbon County Using The Cdc Evaluation Framework, Abigail Lay

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

Physical inactivity is a significant public health concern, contributing to increased risks of chronic diseases such as obesity, cardiovascular disease, and diabetes (Centers for Disease Control and Prevention [CDC], 2022). To address this issue, communities across the United States have implemented physical activity programs to promote healthier lifestyles, including Bourbon County. This project evaluates the impact of a physical activity program in Bourbon County, KY, using the CDC Framework for Program Evaluation to assess its effectiveness, sustainability, and areas for improvement (CDC, 1999).

The primary objective of this evaluation is to determine whether the program has successfully increased participants' physical …

Changes In Local Public Health System Characteristics Before And After The Implementation Of Ohio’S Public Health Accreditation Board Policy For Local Public Health Departments., Christine Lynn Vazquez

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

The Public Health Accreditation Board is a nationally recognized nonprofit organization that manages a series of programs including the national public health accreditation program. Public health accreditation is awarded to health departments that achieve a set of nationally recognized goals and standards for departments to adopt. The state of Ohio initiated policy requiring that Local Health Departments to achieve accreditation by 2018. In result, Ohio has the largest number of accredited local health departments. This study looked at the local health departments in Ohio responses to the National Longitudinal Survey of Public Health Systems to understand if services provided improved …

Evaluating Hiv Testing Strategies And Screening In The University Of Kentucky’S Target 4 Project, Emily E. Wagoner

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

The University of Kentucky’s Target 4 project aims to expand HIV testing and provide accessible, confidential services throughout Kentucky, focusing on individuals at highest risk for HIV and Hepatitis C. In December 2023, the Target 4 project implemented a new, expanded HIV screening form, increasing the number of questions from seven to eighteen. This study analyzes the impact of the new screening form on risk factor identification and HIV positivity rates in Region 9, a 16-county area in central Kentucky, from September 2021 to November 2023. Data from 11,187 encounters before the implementation of the new screening form and 2,585 …

You’Re On Fire: Social Skills Training To Increase Sportsmanship For Teenagers With Disabilities, Madeline K. Wainwright

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

This study presents findings from a multiple probe design that evaluated the effects of social skills training as a method of teaching an increase of good sportsmanship, more particularly compliments of gameplay, for individuals with intellectual disabilities. The research included three U.S. high school students with intellectual disabilities and the data was analyzed across conditions. Following mastery criterion, generalization sessions across contexts were conducted. All participants acquired complimenting behavior through social skills training. However, none of the participants were able to generalize the skill to different contexts. Results and directions for future research regarding generalization in replication and use of …

Parental Stress, Self-Compassion, And Meaning In Life Among Mothers Of Children With Autism Spectrum Disorder, Hyun-Ju Ju

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

Mothers of children with autism spectrum disorder (ASD) often experience higher levels of parenting stress than mothers of typically developing children or children with other developmental disabilities, which can undermine their psychological well-being. Additionally, parental stress among mothers of children with ASD is influenced by various demographic factors. This study primarily identified the relationship between parental stress and demographic factors. It also examined the correlations among parental stress, self-compassion, and meaning in life of mothers raising children with ASD within a positive psychology context. Finally, this study investigated whether self-compassion mediates the relationship between parenting stress and two distinct dimensions …

How Do Couples Of Autistic Children Perceive Their Quality Of Life? A Case Study Featuring Sequential Mixed Methodology, Amanda Duncan Dr.

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

Families who have autistic children report significantly lower quality of life indicators than neurotypical families and those with other developmental disabilities (Bitsika & Sharpley, 2004; Brown et al., 2006; Charnsil & Bathia, 2010; De Sousa, 2010; Merkaj et al., 2013). However, the reports fluctuate between family members as mothers report more mental health challenges than fathers, including stress, anxiety, and depression (Dabrowska & Pstiula, 2010; Hodapp et al., 2003; Merkaj et al., 2013). Yet, these findings are based on the limited research that has been done on fathers and couples (Cheuk & Lashewicz, 2015; Osborne & Reed, 2008; Papageorgiou & …

Assessing The Content Validity And Usability Of An Implementation Fidelity Checklist For The Assessment, Evaluation, And Programming System, 3rd Edition (Aeps-3), Cameron A. Tyrrell

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

The included studies examined the content validity and useability of an implementation fidelity checklist for the Assessment, Evaluation, and Programming System (AEPS) for Infants and Young Children 3^rd Edition (AEPS-3). Study 1 assessed a revised version of an implementation fidelity checklist for item clarity and criterion clarity. After further revisions, Study 2 asked administrators of early childhood educational programs to implement the fidelity checklist in a classroom environment and assess the clarity of items, criterion, and feasibility of scoring different items. In addition, administrators included the length of time it took the implement the checklist and the strengths and …

Exercise As An Antecedent Intervention, Alexis M. Estephan

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

Special education classroom teachers often experience students demonstrating challenging behaviors causing themselves and their peers to fall off task. This study examined the effect of antecedent exercise on on-task behaviors. This exercise included modeling a dance video to assess increasing levels of duration of on-task behaviors.

Effectiveness Of Class-Wide Function Related Intervention Teams On The On-Task Behavior Of Middle School Students With Disabilities In A Resource Settings, Sharon Manikya

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

The current study examined the effectiveness of Class-Wide Function-related Intervention Teams (CW-FIT) in promoting on-task behavior and improving classroom functioning. The study was conducted with five students, and a single-subject withdrawal experimental design was used to evaluate the impact of CW-FIT on students’ behavior. Results demonstrated a functional relation between the intervention and increased on-task behavior. Overall, findings indicated that CW-FIT had a positive effect on student behavior and classroom functioning, suggesting that the intervention is an effective strategy for enhancing engagement and promoting a productive learning environment. Implications for future research include examining CW-FIT with larger groups of students, …

Special Educator Persistence: Unveiling Teacher Perceptions, Janet Nutt

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

There is a continually growing shortage of special education teachers (SET). The shortage is so dire that the U.S. Bureau of Labor Statistics (2024) anticipates that as many as 35,900 new SET will be needed each year for the next decade. One of the leading factors contributing to the shortage of special educators is attrition, or any loss of teachers from their positions (Darling-Hammond, 2003; Ingersoll, 2001). Teacher persistence, therefore, is a critical concern in addressing the teacher shortage. The purpose of this mixed-methods research study is to examine the association between previously identified factors of attrition and SET decisions …

Effects Of Dietary Energy Source And Stress On Equine Intestinal Permeability And Inflammation, Amanda R. Bauman

Theses and Dissertations--Animal and Food Sciences

Dietary concentrate is often provided to exercising horses to meet energy requirements. However, both high-starch and high-fat diets may be associated with alterations in intestinal barrier function. To investigate this, 32 mature horses were fed one of four isocaloric dietary concentrate treatments (n = 8 per treatment): 1) a concentrate with cracked corn providing 4 g starch⋅kg BW^-1⋅d^-1 and 0.2 g fat⋅kg BW^-1⋅d^-1 (CC), 2) a concentrate with puffed corn providing 4 g starch⋅kg BW^-1⋅d^-1 and 0.2 g fat⋅kg BW^-1⋅d^-1 (PC), 3) a concentrate with puffed corn and …

Metabolic And Barrier Function In Response To Β-Caryophyllene In Intestinal Epithelial Cells, Hannah Scroggins

Theses and Dissertations--Animal and Food Sciences

Butyrate, a short-chain fatty acid, regulates cellular metabolism and energy status in intestinal epithelial cells. β-caryophyllene (BCP) is a plant-derived compound that may provide advantageous effects on intestinal barrier function and nutrient utilization. The goal of this thesis was to investigate the effects of BCP on butyrate utilization and metabolism in intestinal epithelial cells. Throughout this thesis, Caco-2 cells in hanging inserts in multi-well plates were used as a model for the intestinal barrier. One study was conducted to investigate the effect of BCP on butyrate utilization and barrier function in intestinal epithelial cells. A second study aimed to elucidate …

Comparison Of Sheep And Cattle Rumen Microbiological And Physiological Responses To An Abrupt Transition From A High-Forage To A High-Concentrate Diet, Katherine Purvis

Theses and Dissertations--Animal and Food Sciences

Sheep and cattle are often used interchangeably due to having the same gastrointestinal anatomy; however literature directly comparing the two species is minimal. Previous in vitro studies have pointed towards potential species differences in rumen carbohydrate utilization and acidosis susceptibility. The objective of this study was to evaluate in vivo microbiological and physiological responses of wethers and steers when abruptly transitioned from a high-forage to a high-concentrate diet. We hypothesized there are differences between species in response to abrupt dietary transition with respect to intake, rumen microbiology, and the rumen environment. Individually housed, rumen cannulated purebred Polypay wethers (n = …

Cancer Screening In Appalachia, Kimberly M. Kelly, Sabina O. Nduaguba, Randi Shedlosky, Electra D. Paskett, Nancy Schoenberg, Nicole Yantes

Anthropology Faculty Publications

Background: The Appalachian region in the USA has some of the highest rates of cancer and cancer mortality in the country, due in part to suboptimal screening. Routine screening for cervical and colorectal cancer can decrease cancer morbidity and mortality. The current study sought to assess the feasibility and preliminary impact of an intervention guided by the Common-sense Model of Self-regulation to improve cervical and colorectal cancer attitudes and screening intentions. Method: Participants were approached in safety net clinics in Appalachian communities. Individuals completed surveys before and after an intervention that was designed to address lay understandings about the risks …

Early Changes In Inflammation-Related Proteins In The Cerebrospinal Fluid And Plasma Of Patients With Aneurysmal Subarachnoid Hemorrhage, David J. Braun, Kevin W. Hatton, Justin F. Fraser, Robert M. Flight, Hunter N. B. Moseley, Caleb S. Bailey, Josh M. Morganti, Bingqing Zhang, Ishara S. Ariyapala, Tae K. Kim, Linda J. Van Eldik

Sanders-Brown Center on Aging Faculty Publications

Background

Aneurysmal subarachnoid hemorrhage (aSAH) is a relatively uncommon but high mortality form of stroke that can result in long-lasting disability. A better understanding of key neuroinflammatory changes during the early phase (< 72 h) may provide potential avenues of treatment.

Methods

In an attempt to understand these early changes, we recruited 7 aSAH patients for profiling of longitudinal plasma and cerebrospinal fluid (CSF) proteins at up to 72 h post injury. We additionally compared this to control plasma obtained previously from healthy elderly volunteers. Using the Alamar Biosciences NULISAseq platform, we obtained a comprehensive picture of early peripheral and central inflammatory changes after injury.

Results

This study …

Nicorandil Treatment Improves Survival And Spatial Learning In Aged Granulin Knockout Mice, Dana M. Niedowicz, Wang-Xia Wang, Paresh Prajapati, Yu Zhong, Shuling X. Fister, Colin B. Rogers, Pradoldej Sompol, David K. Powell, Indumati Patel, Christopher M. Norris, Kathryn E. Saatman, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

Mutations in the human granulin (GRN) gene are associated with multiple diseases, including dementia disorders such as frontotemporal dementia (FTD) and limbic-predominant age-related TDP-43 encephalopathy (LATE). We studied a Grn knockout (Grn-KO) mouse model in order to evaluate a potential therapeutic strategy for these diseases using nicorandil, a commercially available agonist for the ABCC9/Abcc9-encoded regulatory subunit of the “K⁺ATP” channel that is well-tolerated in humans. Aged (13 months) Grn-KO and wild-type (WT) mice were treated as controls or with nicorandil (15 mg/kg/day) in drinking water for 7 months, then tested for neurobehavioral …

Gait Variability As A Marker Of White Matter Integrity In Individuals With Down Syndrome, Elizabeth M. Leach, David K. Powell, Amanda C. Glueck, Elizabeth Head, Moaz W. Ibrahim, Amelia J. Anderson-Mooney, Kathryn L. Van Pelt, Jordan P. Harp, Frederick A. Schmitt, Ahmed A. Bahrani

Sanders-Brown Center on Aging Faculty Publications

Introduction: Individuals with Down syndrome (DS) face a significant risk of neurodegeneration, and gait variability may serve as a clinical biomarker of neurological health. This longitudinal parent substudy aimed to explore relationships between gait, white matter (WM) integrity, and cognitive function in DS.

Methods: The associations were investigated between magnetic resonance imaging diffusion tensor imaging (DTI), cognition, and self-paced gait data from 22 DS participants (mean age ± SD 37 ± 7.5 years).

Results: DTI measures, such as lower fractional anisotropy (FA) and higher mean diffusivity, were correlated with greater step time variability but not normalized velocities. Lower cognitive scores …

Disrupted Calcium Dynamics In Reactive Astrocytes Occur With End Feet–Arteriole Decoupling In An Amyloid Mouse Model Of Alzheimer’S Disease, Blaine Weiss, John C. Gant, Ruei-Lung Lin, Jenna L. Gollihue, Colin B. Rogers, Susan D. Kraner, Edmund B. Rucker, Yuriko Katsumata, Yang Jiang, Peter T. Nelson, Donna M. Wilcock, Pradoldej Sompol, Olivier Thibault, Christopher M. Norris

Sanders-Brown Center on Aging Faculty Publications

While cerebrovascular dysfunction and reactive astrocytosis are extensively characterized hallmarks of Alzheimer's disease (AD) and related dementias, the dynamic relationship between reactive astrocytes and cerebral vessels remains poorly understood. Here, we used jGCaMP8f and two-photon microscopy to investigate calcium signaling in multiple astrocyte subcompartments, concurrent with changes in cerebral arteriole activity, in fully awake 7- to 8-month-old male and female 5xFAD mice, a model for AD-like pathology, and wild-type (WT) littermates. In the absence of movement, spontaneous calcium transients in barrel cortex occurred more frequently in astrocyte somata, processes, and perivascular regions of 5xFAD mice. However, evoked arteriole dilations (in …

Gilead: Municipal Liability For Punitive Damages Under The Fair Housing Act, Robert G. Schwemm

Law Faculty Scholarly Articles

The 1968 Fair Housing Act (“FHA”) has always been understood to apply to local governments, which have proved to be among the most frequent and significant violators of this law, especially in their opposition to housing of particular value to racial minorities and persons with disabilities. Yet not until the Second Circuit’s decision last year in Gilead Community Services, Inc. v. Town of Cromwell did an appellate court approve an FHA-based punitive-damage award against a municipality. Before Gilead, district courts had generally blocked such awards, applying § 1983’s immunities to protect local governments and their officials from the FHA’s …

How Grand Jury Secrecy And Bias Protects And Perpetuates Police-Suspect Impunity, Ilana M. Friedman

Law Faculty Scholarly Articles

This Article proceeds in four parts. Part I introduces the theoretical frameworks for various questions involving police-suspect grand juries, including the structure and function of contemporary grand juries, the law surrounding examinations into an officer’s use of force, modern prosecutorial influences, findings from social psychologists on the impacts of diversity on jury decision-making practices, and how police-suspect grand juries implicate unique political pressures.

Part II presents a description of original methods of data collection. To investigate this setting, forty-seven in-depth, semi-structured interviews with twenty-one respondents in five field sites around the country was conducted. Respondents included civilians and legal

professionals …

Confronting The Duty To Capitalize In Veil-Piercing, Douglas C. Michael

Law Faculty Scholarly Articles

In corporate law, the doctrine of “piercing the corporate veil” allows courts to hold shareholders personally liable for corporate obligations. The doctrine—which now also applies to entities other than corporations—has been widely criticized as imprecise and unworkable. I respond to that criticism in the area of veil-piercing law which remains most intractable—the case of the tort victim who remains unsatisfied after exhausting corporate assets. Although most commentators have eschewed talk of any duty owed by the business owner to vest the business with sufficient assets, I argue that courts and legislatures should recognize—confront—such a duty. I look to negligence law …

Deceptive Exploitation: Deepfakes, The Rights Of Publicity And Privacy, And Trademark Law, Michael D. Murray

Law Faculty Scholarly Articles

This article addresses the application of right of publicity, right of privacy, and trademark law to the problem of deepfakes. It will explore the routine and not so routine ways that personality and persona attributes are exploited in traditional privacy contexts and publicity contexts. It will also examine the use of First Amendment defenses in legal actions traditionally associated with the exploitation of celebrities, sports figures, and other persons under state law theories of name-image-likeness exploitation, as well as and federal trademark law theories of false endorsement and false designation of origin.

Part I provides an introduction and background to …

History, Tradition, And Voter Registration, Joshua A. Douglas

Law Faculty Scholarly Articles

History and tradition are dominating the Supreme Court, which has invoked history and tradition to curtail some rights, such as abortion, while using it to elevate other rights, such as the right to bear arms. Might history and tradition also cause the Court to strike down new restrictions on the right to vote, even if doing so would cut against the current Court’s narrow protection of voting rights? Disputes over voter registration restrictions will pose that very question. Many states have recently implemented onerous rules on voter registration, especially targeting third-party voter registration organizations. Congress is also debating the SAVE …

Gender Disparity In Social Security, Kathryn L. Moore

Law Faculty Scholarly Articles

Facially neutral, the U.S. Social Security system structurally discriminates against women because it prefers those who successfully fulfill the traditional male breadwinner role rather than the traditional female caregiving role. Overall, women receive lower worker benefits, are much more likely to claim spouse and surviving spouse benefits, and are more dependent on Social Security for their retirement benefits than are men.

This Article assesses Social Security’s disparate treatment of women and how Social Security might be reformed to enhance benefits for women. It begins by providing a broad overview of Social Security benefits. It then discusses how women and couples …

The Migration Of Abolition Theory, Matthew Boaz

Law Faculty Scholarly Articles

This Article considers whether and how theories of abolition developed by criminal law scholars are transferrable to the realm of immigration enforcement. A key question is how abolitionist principles might be employed in support of critiques of the United States’ immigration regulatory regime in the same way that these principles have been deployed in denouncing racialized policing and an injurious, industrialized prison system.

This Article makes two contributions: First, it identifies and illuminates a methodology adopted by critical and decarceral criminal law scholars: (i) denouncing the harms of a structural system, (ii) identifying the normative justification(s) for this system, and …

Knee Health Is A Major Determinant Of Mobility Across The Healthspan, Brandon M. Peoples, Kenneth Harrison, Michael A. Samaan, Christopher B. Mobley, David T. Redden, Jaimie A. Roper

Kinesiology and Health Promotion Faculty Publications

Knee health constitutes a pivotal determinant of locomotor function and overall mobility throughout the healthspan. Impairments in knee function lead to a series of biomechanical and physiological alterations that pose substantial public health challenges and economic burdens worldwide. This review synthesizes evidence that delineates the complex and multifaceted relationship between knee health and mobility, emphasizing the interplay across various domains in adult populations. Knee health is conceptualized as a dynamic, interconnected system whereby structural integrity, neuromuscular mechanisms, biomechanical adaptations, and functional mobility are intricately interrelated through cascades of mechanistic processes operating across different temporal stages. A comprehensive understanding of these …