Digital Commons Network^™

A Case Report On A Women’S Residential Substance Use Program In A Rural And Urban Setting, Deborah Winders Davis, Yana Feygin, Madeline Shipley, Tiffany Cole Hall, Chaly Downs, Stephanie Hoskins, Natalie Pasquenza, Scott D. Duncan, Liza M. Creel

Biostatistics Faculty Publications

Purpose To describe program characteristics and outcomes of a residential substance use recovery program serving pregnant and parenting women in a rural and urban location.

Description This assessment of administrative records from April 1, 2020 through March 31, 2022, included women in a rural (n = 140) and urban (n = 321) county in Kentucky.

Assessment This retrospective case study used descriptive and non-parametric analyses to assess the population and examine differences between locations, race, and ethnicity for women served. Logistic regression tested predictors of goal achievement by community. Of 461 women served, 65 (14.1%) delivered a baby while in …

Health Care For People Who Are Incarcerated: Teaching Third-Year Medical Students About Rights, Challenges, And Avenues Of Advocacy, Anna-Maria South, Kelsey N. Karnik, Sara Hieneman, Anthony A. Mangino, Michelle R. Lofwall

Biostatistics Faculty Publications

Introduction: Incarcerated patients are a vulnerable patient population with unique barriers to health care that physicians in every specialty encounter. Current medical school curricula lack universal education on health care for incarcerated people.

Methods: We developed an interactive workshop to provide third-year medical students at the University of Kentucky with information about delivering care outside of dedicated carceral settings to individuals who are incarcerated. The workshop included education on the demographic characteristics and medical conditions present in these populations along with understanding incarcerated persons’ rights to health care and how to interact with them and the associated jail/prison workforce often …

Rapid Jail-Based Implementation Of Overdose Education And Naloxone Distribution In Response To The Covid-19 Pandemic, Carrie B. Oser, Margaret J. Mcgladrey, Marisa Booty, Hilary L. Surratt, Hannah K. Knudsen, Patricia R. Freeman, Danelle Stevens-Watkins, Monica F. Roberts, Michele Staton, April M. Young, Emma Draper, Sharon L. Walsh

Center on Drug and Alcohol Research Faculty Publications

Background People incarcerated in jails are highly impacted by the opioid epidemic, and overdose education and naloxone distribution (OEND) is an effective strategy to reduce opioid overdose deaths. This study examines barriers and facilitators of fast-track OEND implementation within the jails in the Wave 1 Kentucky counties of the HEALing Communities Study during the COVID-19 pandemic.

Methods Meeting minutes with jail stakeholders were qualitatively coded using the Practical, Robust Implementation and Sustainability Model (PRISM) as the coding framework. The analysis highlighted the top barriers and facilitators to fast-track OEND implementation within the PRISM framework.

Results Space and staffing shortages related …

Dimitris Kafyris: The Legacy And Pedagogy Of A Trailblazing Greek Trumpeter, Stephen M. Wadsack

Theses and Dissertations--Music

Dimitris Kafyris (Δημήτρης Κάφυρης, 1932–2020) is regarded as one of the most talented trumpeters of the twentieth century, within his native homeland of Greece. From the early 1950s into the mid-1980s, Kafyris performed with the Athens State Orchestra (Greece’s premier orchestral ensemble), the Greek Radio Symphony, and the National Opera. During this period, Kafyris also maintained a teaching position at the Hellenikon Conservatory (Ελληνικόν Ωδείον) in Athens. Following what many would already consider to be a robust career, Kafyris returned home to the Greek island of Corfu, where he assumed the roles of Bandmaster and Director of the Corfu Philharmonic …

Exploring How Music Therapy Can Support Transition-Aged Young Adults With Intellectual And Developmental Disabilities: An Adapted Multiple Case Study, Hayley Davis

Theses and Dissertations--Music

Young adults with Intellectual and Developmental Disabilities (IDD) face barriers and challenges after their transition from high school to their post-high school lives. While in high school, a student with IDD receives support and services through the Individuals with Disabilities Education Act, but once a student with IDD graduates high school, they no longer have access to the services that they were once receiving. While this phenomenon (often referred to as the “disability cliff”) has been examined, there is a lack of research surrounding the perspectives and lived experiences of young adults with IDD. Furthermore, there is very limited research …

Humor Matters: An Adapted Multiple Case Study Exploring Music Therapists’ Perspectives Of Humor With Older Adults, Caleb M. Posey

Theses and Dissertations--Music

Humor is a ubiquitous human experience and a skill retained in older adulthood. It is also an integral but elusive therapeutic tool with numerous benefits and risks to well-being. Therapeutic humor – the application of humor to client well-being – is an emerging area of study. However, scant music therapy literature on humor is available. The purpose of this qualitative thesis was to explore the use and function of humor in music therapy with older adults from the perspectives of experienced music therapists. There were three research questions: (1) how do music therapists describe their use of humor with older …

Understanding The Effects Of Hormone Treatments On The Transgender Singer: A Pedagogical Study And Voice Studio Guide, Erin M. Hannon

Theses and Dissertations--Music

Transitioning from one gender to another can be an arduous and emotionally charged experience, accompanied by many physical and mental transformations. The journey of self-discovery and vocal explorations is both unique and deeply personal. Modifications that emerge in an individual's vocal characteristics have a profound influence on their capacity to communicate and express themselves.

Transgender vocal students and professional singers must navigate the delicate balance between their vocal and gender identities while considering the possible risks of Gender Affirming Hormone Therapy. Though these therapies may significantly alter one's appearance and overall well-being, they are also capable of causing notable declines …

Formative Musical Experiences Of Older Adult Sexual Minority Women From Rural Areas: An Adapted Case Study, Sabrina Hartsfield

Theses and Dissertations--Music

People often have strong emotional connections between music and memories, which can affect a person’s identity and self-concept. The deep meaning that individuals find within music that is important to them helps music therapists to make connections to clients and to work with clients to understand their experiences through the lens of music. The purpose of this project was to examine in depth the musical experiences of sexual minority women aged 65 and older from rural areas, and to see how musical experiences may have impacted their identity. In this adapted case study, I conducted in-depth one-on-one interviews and constructed …

How Spirituals Influenced Both Resistance To Nazis And Civil Rights Protests, Chandi Plummer

Theses and Dissertations--Music

How have American Negro Spirituals inspired later generations of oppressed and marginalized people? Which songs of suffering and hope were particularly poignant in providing courage and inspiration? Questions such as these sparked my research journey, reaching a crescendo during a lecture recital on November 10, 2023, and now culminating in a dissertation.

Spirituals inspired Albert Franklin Fisher and Dietrich Bonhoeffer in New York City in 1930 during the Harlem Renaissance and traveled (via phonograph and music books) with Bonhoeffer to Nazi Germany during World War II. In America, spirituals influenced Myles and Zilphia Horton, Rosa Parks, and Martin Luther King, …

Expert Perceptions Of Needs Of Pregnant Individuals With Substance Use Disorder In Kentucky: A Qualitative Multiple Case Study, Emma Foret Latham

Theses and Dissertations--Music

Substance misuse is a pandemic with far reaching effects on those personally affected, their families, and their communities. Kentucky has one of the highest rates of substance use disorder (SUD) in the country, and most research has focused on how to help men in recovery. There is very little research regarding how to support pregnant individuals with SUD. The purpose of this qualitative thesis was to identify the perceived needs of pregnant individuals with SUD, define characteristics of effective care, and learn how music therapists can support this population in substance use rehabilitation settings from the perspectives of experienced professionals. …

Developing Best Practices For Successful University Fundraising Events, Ravyn Ladenburger

MPA/MPP/MPFM Capstone Projects

This research study addresses the crucial role of fundraising in sustaining universities in the United States, particularly public institutions facing funding challenges. For this paper, fundraising refers to the seeking of financial support from individuals to support initiatives at a nonprofit entity, such as a public university. It identifies a gap in research and professionalization within higher education philanthropy, emphasizing the need for standardized training and empirical research. The focus is on studying the effectiveness of fundraising events, especially in public universities like the University of Kentucky, amidst declining government support and rising operational costs. The research problem to be …

How Do Hospital Characteristics Affect Veteran Patients’ Satisfaction In South Korea?, Miran Jo

MPA/MPP/MPFM Capstone Projects

This study examined the impact of the characteristics of commissioned hospitals on the satisfaction of veterans by using the satisfaction survey data of Korean veterans. As a result of a regression analysis using departments, beds, and specialists as independent variables and satisfaction scores as dependent variables, it was found that there was a positive correlation between the number of specialists and satisfaction in general hospitals. However, in clinics and tertiary hospitals, the number of beds was found to have a negative effect on satisfaction. Additionally, the presence or absence of a Veterans Affairs hospital did not have a significant effect …

Financial Monitoring And Oversight Of Public Higher Education Institutions By States A Descriptive Case Study Analysis, Ryan Kaffenberger

MPA/MPP/MPFM Capstone Projects

Higher education in America is at an inflection point with numerous challenges threatening the traditional business model relied on by institutions across the country. These forces include, but are not limited to: 1) A decrease in the number of high school graduates due to historical declines in birth rates (Grawe, 2018; Western Interstate Commission for Higher Education, 2020) 2) Sustained disinvestment by many states in their higher education institutions which has effectively shifted the cost of education to students and families (Kunkle & Laderman, 2023) 3) Increasing skepticism among Americans of the value of higher education, particularly given its rising …

Defining And Evaluating Quality In Early Childhood Education, Abigail Jacob, Anna Nayyir, Vaughn Nebbitt, Nate Terrell

MPA/MPP/MPFM Capstone Projects

Quality early childhood education is essential to ensure that children grow into well-adjusted, healthy, and happy adults. Early childhood is considered a child’s first five years before kindergarten, and nearly 90% of brain development occurs in these five short years (Brain Development, n.d.). According to the Kentucky Governor’s Office of Early Childhood, preschool attendance decreases the likelihood that the child will drop out of high school, be held back a grade, or be placed in special education (Importance of Early, n.d.). Not only does early childhood education benefit the child, but it can also positively influence society. Early childhood education …

Lfcug's Utilization Of 2022 Opioid Settlement Funds For Recovery Housing, Emily Wiley, Ken Britton Jr, Madelaine Coy

MPA/MPP/MPFM Capstone Projects

Following national settlements to combat the opioid epidemic, Kentucky and its local governments received a collective $842 million to invest in prevention and treatment. To employ these dollars most effectively, Lexington-Fayette Urban County Government (LFUCG) aims to become “recovery ready” as a part of Kentucky’s Recovery Ready Communities (RRC) certification program. This mixed methods comparative case study determined the following high-priority variables that align with RRC certification requirements: recovery housing infrastructure, certification disclosure, and medications for opioid use disorder (MOUD) services. To provide additional insight into Fayette County’s recovery housing landscape, we analyzed the following supplemental variables: vulnerable populations served, …

A Review Of The Individuals With Disabilities Education Act In Kentucky Schools System, Spencer Collins

MPA/MPP/MPFM Capstone Projects

The federal government's role in education has been center stage for the past decade. Policy actors on the right call for a complete deconstruction of the federal Department of Education (ED). In today's partisan fighting over government funding, the topic of education services is critical. With further investigations into education services provided by federal funding, one vulnerable population that needs to be safeguarded is those students with disabilities. Protecting those students with disabilities and ensuring equal access to education and resources provided for non-disabled students should be one of the highest priorities of policy actors within the education sphere today. …

Relationship Between Weir Openings And Green Tide Variation In Korean Rivers, Uisuk Jung

MPA/MPP/MPFM Capstone Projects

On the four major rivers in South Korea (Han River, Nakdong River, Geum River, and Yeongsan River), 16 weirs were installed in 2011 to secure water resources. However, there is controversy that the weirs allow the summer Green Tide (hereafter referred to as GT) to thrive, so the South Korean government has been opening them since 2017 to evaluate their effectiveness. The opening of the weirs was mainly done at three weirs on the Geum River, where there are few constraints, and some on the Yeongsan and Nakdong rivers, depending on the degree of constraints, while the Han River was …

Sports Betting In Kentucky: An Analysis Of Kentucky’S Sports Wagering Legislation Through Local And Regional State Budgetary Revenue Trends, Brett Gillispie

MPA/MPP/MPFM Capstone Projects

Kentucky’s legislation legalizing sports wagering in the Commonwealth and delineating its taxation, HB551 of the 2023 Regular Session of the General Assembly, has been implemented and posted numbers in its early months that suggested it will exceed revenue projections for the Commonwealth. Researchers have raised concerns, particularly in studying West Virginia, which implemented similar legislation in 2019, that sports betting may be cannibalizing existing gambling revenue for states that implement it. However, this was not conclusive. While evidence from West Virginia suggests that sports betting may be cannibalizing existing revenue, evidence from Kentucky and the individual and broader regional trends …

The Impact Of Actuarial Valuation Reporting On State Pension Funds, Samantha Montgomery

MPA/MPP/MPFM Capstone Projects

The U.S. is currently experiencing a public pension funding crisis that has become the topic of news outlets around the country and political talking points for legislators. It is estimated at the end of fiscal year 2023 that the average funded ratio for a public pension program is 78.1%, which equates to total unfunded pension liabilities for state retirement systems being approximately $1.4 trillion (Pension Plan Funded Ratio Rankings 2023, 2024). Pension systems across the U.S. are managed by boards and pension agencies that are charged with fiduciary responsibility to manage the pension funds in a manner that focuses on …

Evaluating The Impact Of Patient Acuity On Nursing Productivity: A Case Study At Uk Healthcare Chandler Hospital, Kara Klein

MPA/MPP/MPFM Capstone Projects

This study examines the relationship between patient acuity and nursing productivity at UK HealthCare (UKHC) Chandler Hospital from June 2022 to April 2024. Patient acuity, characterized by the complexity and intensity of nursing care required by patients (Juvé-Udina et al., 2020), is crucial in determining staffing needs and operational efficiency. The primary objective of this research is to investigate how variations in patient acuity levels impact Full-Time Equivalents (FTE), a key metric for assessing nursing productivity. The study utilized hospital data and applied descriptive statistics, correlation analyses, and regression models to assess the impact of patient acuity on FTE. The …

Enhancing Equity And Economic Growth: A Strategic Review Of Procurement Practices In Prince George’S County, Andrew Stover

MPA/MPP/MPFM Capstone Projects

Procurement represents a substantial portion of public spending in state and local governments, and thus is an essential element of responsible public financial management. This paper explores the procurement process on the local government level and provides research into best practices that are conducive to equity and economic development. It takes a look specifically at Prince George’s County, Maryland and analyzes its procurement function in relation to these best practices. An analysis of the County finds that despite its strides in implementing equitable procurement policies, significant gaps remain in the engagement of disadvantaged classes of businesses. To tackle these challenges, …

Role Of Program Activity Data In Allocation Decision-Making For The Community Development Block Grant Program, Carolyn Anne Ferguson

MPA/MPP/MPFM Capstone Projects

The forthcoming study aims to further the conversation on the importance of data for effective, efficient use of public funding by conducting a quantitative, correlational case study of the Community Development Block Grant (“CDBG”) activity obligation approvals for grant allocations administered by the U.S. Department of Housing and Urban Development (“HUD”), Office of Community Planning and Development (“CPD”). The increasing use of data, including but not limited to program outcomes, accomplishments, capacity, sustainability, compliance, efficacy, efficiency, and activity provision, to inform decision-making associated with appropriations, allocations, and awards results in a mounting need to focus on various means of data …

The Next Frontier In Plan Fee Litigation: Health Plan Fees, Kathryn L. Moore

Law Faculty Books and Chapters

On September 11, 2006, Jerry Schlichter, a personal injury lawyer from Saint Louis, Missouri, filed some of the first lawsuits claiming that excessive fees in 401(k) plans violated ERISA’s fiduciary standards. Since then, hundreds of suits have been filed challenging retirement plan fees, and the Supreme Court has rendered two decisions in cases claiming that excessive 401(k) plan fees violated ERISA’s fiduciary standards. Since the Supreme Court issued the second decision in 2022, retirement plan excessive fee litigation may have begun to slow. There may, however, be a new frontier in plan fee litigation: health care plan fees.

This article …

Different Cohort, Disparate Results: Selection Bias Is A Key Factor In Autopsy Cohorts, Kathryn Gauthreaux, Walter A. Kukull, Karin B. Nelson, Charles Mock, Yen-Chi Chen, Kwun C. G. Chan, David W. Fardo, Yuriko Katsumata, Erin L. Abner, Peter T. Nelson

Neurology Faculty Publications

INTRODUCTION: Research-oriented autopsy cohorts provide critical insights into dementia pathobiology. However, different studies sometimes report disparate findings, partially because each study has its own recruitment biases. We hypothesized that a straightforward metric, related to the percentage of research volunteers cognitively normal at recruitment, would predict other inter-cohort differences.

METHODS: The National Alzheimer’s Coordinating Center (NACC) provided data on N = 7178 autopsied participants from 28 individual research centers. Research cohorts were grouped based on the proportion of participants with normal cognition at initial clinical visit.

RESULTS: Cohorts with more participants who were cognitively normal at recruitment contained more individuals who …

Essays On Corporate Debt Structure, Kyuyoung Oh

Theses and Dissertations--Finance and Quantitative Methods

The dissertation consists of three chapters exploring three different facets of corporate debt structure choice. In the first chapter, “Risk Management and the Choice between Secured and Unsecured Debt: Evidence from Natural Experiment,” I study whether and how corporate hedging affects firms’ choice between secured and unsecured debt. Exploiting the introduction of steel futures as a natural experiment, I provide causal evidence that risk management enables firms to switch from secured to unsecured debt without sacrificing debt capacity. Cross-sectional evidence supports the interpretation that risk management drives the results. The effects are stronger for firms that are more likely to …

De Aquí, Y De Allá: Education, Culture, And Identity Development Of Transnational Latinas, Elizabeth Harris-Medina

Theses and Dissertations--Educational Policy Studies and Evaluation

De Aquí, y De Allá: Education, Culture, and Identity Development of Transnational Latinas This ethnographic case study examines the experiences of three transnational Latina women, descendants of families from Degollado, Jalisco, Mexico, exploring how their migration history and educational backgrounds influence their life trajectories. Focusing on these three women, the study aims to better understand their challenges and inform the development of resources to support their success in the U.S. education system. Using ethnographic interviews and Ecological Systems Theory, the research highlights how places and social systems shape views and life paths, offering insights into how best to support these …

Student Loan Debt: Exploring The Economic Influences On Federal Student Loan Default For Students That Attended Public, Two-Year Institutions, Brian Perry

Theses and Dissertations--Educational Policy Studies and Evaluation

Over the past 30 years, a shift occurred in higher education that saw more of the burden for paying for postsecondary education placed on students. Combined with rising tuition and fees, this has led students to take on increasing amounts of student debt. Despite the historic rise in student loans, surprisingly little attention has focused on those students who default on their student loans. Additionally, the academic literature on student loans has predominately focused on traditional students at four-year institutions, despite the fact that nearly half of all undergraduates attend public two-year institutions. Finally, those studies that include economic factors …

The Impact Of Dual Credit Participation On Graduation & Excess Hours, Erin Mulligan-Nguyen

Theses and Dissertations--Educational Policy Studies and Evaluation

The interest and participation in dual credit programs and courses has grown over the past several decades, especially within Texas; however, there is a lack of research that shows how the participation in dual credit programs and courses has impacted leading and lagging student success metrics once they enroll at a post-secondary institution.

The purpose of this study was to examine the impact dual credit participation had on six-year graduation rates and exceeding excess hours at a public four-year regional university in South Texas. The researcher used a non-experimental quantitative study with ex-post facto student data. The study examined leading …

Black Girl Wisdom: A Black Feminist Analysis Of Success Strategies Of Professional African American Women At Predominately White Higher Education Institutions, Teasia Jordan

Theses and Dissertations--Educational Policy Studies and Evaluation

This phenomenological study examines the success strategies employed by professional African American women (AAW) at predominately white higher education institutions (PWIs). Grounded in Black Feminist Thought (BFT), the “Outsider Within” framework (Collins, 1986), and the concept of “failed citizenship” (Banks, 2017), it explores how AAW navigate and redefine success within environments shaped by exclusionary white patriarchal norms. Through interviews with ten co-laborers, two themes emerged: liberation from unsupportive environments and negotiation strategies to define success.

Findings reveal that AAW’s success strategies center on identity, self-awareness, and rejecting institutional oppression. Co-laborers articulated their liberation by naming the environment as oppressed, fostering …

A Cytosine Analogue 5-Azacitidine Improves The Accumulation Of Licochalcone A In Licorice Glycyrrhiza Inflata., Xiaoling Ma, Ningxin Jiang, Jingxian Fu, Yuping Li, Lijun Zhou, Ling Yuan, Ying Wang, Yongqing Li

Plant and Soil Sciences Faculty Publications

Licochalcone A (LCA) is a characteristic compound of Glycyrrhiza inflata with anti-inflammatory, antioxidant and antitumor activities. However, G. inflata produces LCA in low quantities that does not meet the market demand. In this study, we found that DNA methylation inhibitor 5-azacitidine (5-azaC) successfully improved the LCA contents in G. inflata seedlings. Transcriptome analysis revealed a series of differentially expressed genes (DEGs), including transcription factors such as MYB, ERF, WRKY, and some structural genes related to flavonoid biosynthesis. However, whole genome bisulfite sequencing (BS-seq) results showed little effect of the 5-azaC treatment on the alteration of DNA methylation on these genes, …