Digital Commons Network^™

An Examination Of Three Transitional Events In The Substance Misuse Trajectories Of Women With Criminal Legal System Involvement, Martha Tillson

Theses and Dissertations--Sociology

Research has consistently demonstrated that criminal legal system (CLS)-involved women are distinct from men in initiation and course of drug use, with important differences on biological, environmental, and sociocultural levels. Thus, the unique pathways and transitions into and out of drug use for women with CLS involvement are critical to consider from a research perspective, but also from a need to develop and support evidence-based, women-centered services in correctional contexts. This dissertation project uses a three-paper format to investigate three aims: (1) to understand CLS-involved women’s initiations to injection drug use and their experiences providing injection initiation assistance (IIA) to …

The Role Of Shoc2 In Embryonic Development, Rebecca G. Norcross

Theses and Dissertations--Molecular and Cellular Biochemistry

The canonical ERK1/2 signaling cascade regulates cellular functions critical in vertebrate embryonic development such as proliferation, apoptosis, differentiation, and migration. Thus, its signals are controlled by a variety of mechanisms. Scaffold proteins are considered central to the mechanisms regulating the transmission of the ERK1/2 signals. Yet, their functions in development nor the molecular mechanisms by which they exert their control are not well understood.

This study focuses on the essential regulator of ERK1/2 signals during development – the scaffold protein Shoc2. Loss of Shoc2 leads to early embryonic lethality in mice and zebrafish. Germline mutations in the shoc2 gene result …

Structural Basis For Reversible Glucan Phosphorylation By Glucan Dikinases And Glucan Phosphatases, Tiantian Chen

Theses and Dissertations--Molecular and Cellular Biochemistry

Plants store glucose in the form of starch, an insoluble macromolecule that is synthesized and degraded diurnally. Glucan phosphatases play a critical role in starch breakdown, working with glucan dikinases in a cyclic phosphorylation and dephosphorylation. Herein, we present a novel glucan phosphatase Like SEX Four3 (LSF3) from Physcomitrella patens. Structural and enzymatic studies demonstrate that LSF3 is a dimeric glucan phosphatase that displays robust specific glucan phosphatase activity. Dimerization is shown to be essential for LSF3 stability and function. Structure-guided bioinformatic analysis shows that LSF3 is found in early land plants and green algae.

Building upon our understanding of …

An Integrated Computational Pipeline To Construct Patient-Specific Cancer Models, Daniel Plaugher

Theses and Dissertations--Mathematics

Precision oncology largely involves tumor genomics to guide therapy protocols. Yet, it is well known that many commonly mutated genes cannot be easily targeted. Even when genes can be targeted, resistance to therapy is quite common. A rising field with promising results is that of mathematical biology, where in silico models are often used for the discovery of general principles and novel hypotheses that can guide the development of new treatments. A major goal is that eventually in silico models will accurately predict clinically relevant endpoints and find optimal control interventions to stop (or reverse) disease progression. Thus, it is …

What Is The Sound Of Holiness? The Regulation Of Sound And Silence In Early Medieval Monastic Communities, 600-900, Melissa Kapitan

Theses and Dissertations--History

This dissertation explores how the regulation of sound and silence in the early medieval monastery formed a distinct soundscape imbued with personal, communal, and theological resonances. More narrowly, this investigation focuses on the Frankish empire of the ninth century, which saw a series of monastic reforms led by the Carolingian royal family and ecclesiastical figures and consolidated in imperial legislation and treatises on the monastic life.

These ninth-century reforms witnessed not only the promotion of a single rule and custom to guide monastic life, but also a great flowering of liturgical texts, including the earliest treatises on musical theory. These …

Deletion Of Period Genes Exacerbates Diet-Induced Obesity In Female, But Not Male, Mice, Elizabeth Kantra

Theses and Dissertations--Biology

Sex differences in obesity in mice are mediated by differential responses of circadian rhythms to high-fat feeding in males and females. Other studies also showed circadian Period genes regulate diet-induced obesity in mice. In this study, we investigated the role of the Period genes in regulating sex differences in obesity. Male and female C57BL/6J wild type, Per1/2 KO, and Per1/2/3 KO mice were housed in 12L:12D and fed high-fat diet for 12 weeks. We found a striking sex difference in obesity such that disabling the Period genes exacerbated adiposity in female, but not male, mice. Increased adiposity in female Period …

Understanding The Effects Of Embryonic Hyperglycemia On Retinal Development And Maintenance, Kayla Titialii-Torres

Theses and Dissertations--Biology

Hundreds of millions of people are affected by diabetes worldwide. Whether they are diagnosed with prediabetes or Type I or II diabetes, there are a variety of mechanisms in the pathogenesis of diabetes. Diabetes is a disease which consists of recurring states of hyperglycemia that can be difficult to manage due to either lack of insulin production or improper utilization of insulin. While these mechanisms of action differ, complications induced by diabetes occur in both poorly regulated Type I and II. Common complications of diabetes include nerve damage, kidney damage, and eye damage. Eye damage specifically is called diabetic retinopathy …

Identifying Epidermal Enriched Genes Required For Planarian Regeneration- Sp. Schmidtea Mediterranea, Pallob Barai

Theses and Dissertations--Biology

The outer epithelial layer covering an organism, commonly known as the epidermis, is crucial for maintaining homeostasis and for the wound healing processes after injury. The planarian epidermis allows flatworms to heal their wounds and virtually restore any missing tissues. Immediately after amputation, planarians contract their muscle and stretch their epidermis to heal the wound area. However, how the planarian epidermis coordinates with other tissues and mechanisms after the initial wound healing processes begins is not understood in detail. I hypothesized that epidermal cell stretching upon wound healing induces transcriptional changes that are required for effective regeneration. To test this …

Assessing Ear Pinna Repair In The Mrl/Mpj Mouse Strain, Fatemeh Safaee

Theses and Dissertations--Biology

The outcome of tissue repair varies across species. Vertebrates such as salamanders have the ability to not only heal scar-free but also completely regenerate lost appendages. In contrast, most mammals heal their wounds with fibrotic scarring. Understanding the key drivers of these divergent injury responses remains a major unanswered question in animal biology. Previous work with the Murphy’s Roth Large (MRL/MpJ) inbred mouse strain suggested they have the ability to rapidly close small (2mm) ear holes. While this ability was originally published as an example of regeneration, subsequent work by other groups suggested that it might represent something more akin …

The Role Of Protein Tyrosine Phosphatase Receptor Type F In Intestinal Homeostasis And Colorectal Cancer, Ashley T. Skaggs

Theses and Dissertations--Molecular and Cellular Biochemistry

Protein phosphorylation defines one of the most important regulatory mechanisms in cell signaling. PTPRF, protein tyrosine phosphatase receptor type F, belongs to the class I R2A subfamily of protein tyrosine phosphatases (PTP). The overall objective of this dissertation is to investigate the molecular mechanisms by which PTPRF regulates normal and cancer stem cells by controlling Wnt signaling.

Dysregulation of Wnt signaling promotes the initiation and progression of colorectal cancer (CRC). We first determined the functional important of PTPRF in regulating Wnt signaling in CRC. Combining cell culture, 3D tumor organoid and xenograft models, results from our study establish PTPRF as …

A Multidisciplinary Characterization Of The Enzymology And Biology Of Reversible Glucan Phosphorylation In Toxoplasma Gondii , Robert Murphy

Theses and Dissertations--Molecular and Cellular Biochemistry

Toxoplasma gondii is an opportunistic, protozoan parasite of all warm-blooded animals, infecting roughly one-third of humans worldwide. Humans acquire infections by consuming T. gondii tissue cysts in undercooked meat or from oocysts shed in cat feces. Encysted parasites convert into rapidly growing tachyzoites that disseminate throughout the body, defining the acute phase of infection. Under host immune pressure, tachyzoites convert into bradyzoites that populate tissue cysts found in CNS or muscle tissue and persist for the lifetime of the host, defining the chronic phase of infection. Tissue cysts are responsible for transmission via carnivory, but also possess the ability to …

Defining Patient Cohorts For Guiding Clinical Trials And Treatment In Lafora Disease: A Model For The Rare Disease Community, Katherine Janae Donohue

Theses and Dissertations--Molecular and Cellular Biochemistry

In the US, approximately 8000 rare diseases have been identified. Combined, rare diseases impact more than 30 million people in the U.S. alone, with 75% of those being children. However, research, funding, and therapeutic development for the rare disease community remains challenging because of the incredible diversity – not only between diseases, but often even within a single disease.

LD is an ultra-rare childhood dementia and epilepsy caused by mutations in one of two driver genes: EPM2A, which encodes for the glycogen phosphatase laforin, and EPM2B/NHLRC1, which encodes the E3 ubiquitin ligase malin. Children with LD …

Examining Psychological And Knowledge Barriers To Colorectal Cancer Screening In Rural Appalachian Kentucky, Caroline Jenkins, Matthew Rutledge, Lauren Hudson, Nathan L. Vanderford, Nancy Schoenberg

Markey Cancer Center Faculty Publications

While recent rates of colorectal cancer (CRC) screening have improved in Appalachian Kentucky due to public health efforts, they remain lower compared to both KY as a whole, and the USA. Suboptimal screening rates represent a missed opportunity to engage in early detection and prevention. The purpose of this study is to determine the impact that lack of knowledge has on psychological barriers (e.g., fear and embarrassment) to CRC screening as well as the potential effect of a psychosocial intervention to reduce these barriers. Participants were recruited through faith-based organizations and other community sites. After randomizing participants to either an …

The Wheel Of Oppression: Rolling Towards Substance Use In Central Appalachia, Sydney Cox

DSW Capstone Projects

For nearly 100 years, Central Appalachia has been characterized by some of the highest poverty rates in the nation. Not coincidentally, the region has also been characterized by some of the highest rates of substance use. Despite decades of funding and support, Central Appalachia continues to foster a symbiotic relationship between poverty and substance use. The purpose of this project was to explore the missing link that ties the two poor determinants of health together and to provide a name to a phenomenon otherwise omitted from social work and policy making practice within Central Appalachia.

The first product of this …

Child Welfare: Workforce Retention, Competence, And The Connection To Social Work Education, Brittany Stanley

DSW Capstone Projects

While there are many avenues to discuss and explore, the key area of interest for the Capstone Project is that of retention of a competent frontline workforce. Each state has their own set of guidelines for hiring frontline workers which allows for variety in the educational backgrounds of the investigative and ongoing workers. This can become problematic when the educational background may not be the most suited for the work and challenges faced by child welfare workers.

During the development of the Capstone Project, one could not help but wonder that if workers were adequately prepared for the demands of …

Explainable Data-Driven Motor Condition Monitoring And Fault Disgnosis, Yuming Wang

Theses and Dissertations--Electrical and Computer Engineering

Industrial motors are widely used in various fields such as power generation, mining, and manufacturing. Motor faults and time-consuming maintenance process will lead to serious economic losses in this context. To monitor motor faults and detect motor conditions, different types of sensors that can test vibration and current signals are mounted on motors. However, the main challenge was how to use information gained by sensors to analyze or diagnose motor conditions.

Machine learning is a popular technology in recent years, and it's very suitable for crunching and analyzing data. As an important subset of machine learning, deep learning is suitable …

Models And Optimal Controls For Smart Homes And Their Integration Into The Electric Power Grid, Huangjie Gong

Theses and Dissertations--Electrical and Computer Engineering

Smart homes can operate as a distributed energy resource (DER), when equipped with controllable high-efficiency appliances, solar photovoltaic (PV) generators, electric vehicles (EV) and energy storage systems (ESS). The high penetration of such buildings changes the typical electric power load profile, which without appropriate controls, may become a “duck curve” when the surplus PV generation is high, or a “dragon curve” when the EV charging load is high. A smart home may contribute to an optimal solution of such problems through the energy storage capacity, provided by its by battery energy storage system (BESS), heating, ventilation, and air conditioning (HVAC) …

Caring For Ourselves Before We Care For Others: A Mindfulness-Based Intervention For Acute Care Nursing Staff, Kent Brouwer

DNP Projects

Background: Acute care nursing staff have recently faced increasing rates of anxiety, stress, emotional exhaustion, and burnout. Nursing burnout is directly linked to patient outcomes, nurse retention, and the resilience of our nurses. Therefore, it is in the best interest of hospital organizations to focus efforts on the well-being of the nursing workforce. A recent innovative technology to prevent burnout teaches mindfulness through the utilization of smartphone applications. There is limited evidence regarding the implementation and impact of brief mindfulness interventions on intra-professional acute care providers.

Methods: A pretest-posttest design with a midpoint evaluation was utilized in this pilot study. …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

The Effect Of An Educational Intervention On Attitudes Toward Behavioral Health Patients Among Medical Floor Nurses: A Pilot Study, Caroline C. Bowman

DNP Projects

Background: Stigma towards behavioral health patients by healthcare workers can create barriers to quality care for patients. Addressing these negative attitudes towards behavioral health patients can improve health outcomes and reduce healthcare costs. Current evidence-based practice for tackling stigmatizing attitudes include interventions to improve mental health education among healthcare providers to promote improved patient outcomes.

Purpose: The goal of this project was to enhance medical floor nurses' attitudes toward behavioral health patients by delivering a web-based educational intervention on recognition and management of behavioral health disorders. The aims of the project were to: 1.) Assess nurses' stigma toward behavioral health …

Exploring Palliative Care Education Needs And Desires Of Advanced Practice Providers In The Critical Care Setting, Jill Marie Clemmons

DNP Projects

Background: Critical care providers in the ICU setting are discovering that their patients are living longer with more comorbid conditions. They are confronted with palliative care situations almost daily. Recently palliative care has been thrust into the forefront of critical care and is a resource critical care nurse practitioners and physicians’ assistants need to be able to utilize. A gap in the literature has been found in the overall education of critical care providers regarding palliative care.

Purpose: The purpose of this study was to determine what palliative care training trauma/cardiac/neurological, and pulmonary critical care providers had previously received …

Effects Of Tailored Colorectal Cancer Patient Education On Colorectal Cancer Screening Rates In An Urban Kentucky Clinic, Brittany Pittman Hardcorn

DNP Projects

Background: Colorectal cancer (CRC) is one of the leading causes of death among Americans and Kentuckians. Most colorectal cancers are slow-growing, making regular colorectal cancer screening increasingly important to decrease morbidity and mortality. Although of this importance, there is low screening rates. Thus, the need to explore all colorectal screening options.

Purpose: The purpose of this project was to increase the number of patients screened for colorectal cancer by providing education on colorectal cancer and screening options in a primary care setting.

Methods: The design of the study was a 2 group quasi-experimental practice improvement project using a post-test educational …

Effectiveness Of A Web-Based Smoking Cessation Training Program For Health Care Professionals Within An Acute Psychiatric Facility, Allie Carmichael

DNP Projects

Background: Tobacco use is the leading preventable cause of death and disease in the United States, with the prevalence remaining especially high among people with mental illness. Mental health providers often lack training in smoking cessation and feel uncomfortable addressing the issue with this patient population. Studies show that educational training offered to providers can lead to increased knowledge that improves the provider’s confidence and attitude about delivering smoking cessation treatment to patients. Mental health professionals must receive training on smoking cessation treatment modalities so they can effectively provide holistic care needed for recovery for patients with mental illness.

Purpose …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Effectiveness Of Substance Use Disorder Education On Knowledge And Attitudes Among Entry-Level Obstetric Nurses, Kathryn Hughes

DNP Projects

Background: Substance use disorder (SUD) among pregnant women is a significant public health concern in the United States, particularly in Kentucky. Nursing curriculum has not kept pace with the escalating public health crisis regarding SUD. Graduating nurses joining the obstetric field are often not prepared to meet the unique care needs of this vulnerable population.

Purpose: The purpose of this DNP project was to pilot an educational intervention embedded with content regarding SUD with entry-level obstetric nurses that were enrolled in the nurse residency program at UK HealthCare.

Methods: This project used a quasi-experimental pretest – posttest design. Participants completed …

Evaluation Of Dyad Effectiveness In A Psychiatric Healthcare Facility, Elizabeth Smith

DNP Projects

Background: Inadequate communication can lead to poor quality of care and patient outcomes. Physician-nurse dyad partnerships have been shown to increase effective communication but there is a lack of data to show the impact these dyads have on dyad members’ perceptions about patient safety, work engagement and quality patient outcome measures.

Purpose: This purpose of this project was to determine if a physician-nurse dyad structure in an inpatient psychiatric hospital would lead to improved participant perception about patient safety, work engagement, and patient quality outcomes.

Methods: A quasi-experimental pretest-posttest design was used. Participant perceptions related to patient safety, work engagement, …

The Effect Of An Educational Intervention On Clinical Rn Knowledge And Attitudes Toward Shared Governance Program At Eastern State Hospital, Tanna Mckinney

DNP Projects

Background: Shared governance programs are a popular way to improve Registered Nurse (RN) engagement and retention. These programs are notoriously difficult to garner and maintain participation. However, successful shared governance can improve patient outcomes, patient satisfaction and RN engagement.

Conceptual Framework: The theory of planned behavior was used as the conceptual framework for this study. This theory posits that attitudes, subjective norms, perceived behavioral control and intentions towards a behavior can predict behavioral achievement.

Methodology: Eighty clinical registered nurses were invited to voluntarily complete a survey to determine current attitudes about shared governance and intent to participate in shared governance …

Implementation Of Education And Use Of A Screening Tool To Assess Palliative Care Needs In The Critical Care Setting, Megan Stoeckinger

DNP Projects

Purpose: The purpose of this study was to measure palliative care knowledge, attitudes, perceived empowerment, and familiarity of the Supportive Palliative Care Indicators Tool (SPICT) among critical care nurses and advanced practice providers (APPs) before and after viewing a web-based educational video on an adult medicine intensive care unit (MICU).

Methods: This study was a one group pre- and post- implementation assessment using a web-based educational video and electronic surveys. The population included critical care nurses and advanced practice providers (APPs). This study spanned the timeframe between January 2022 and March 2022.

Results: Paired t-tests comparing pre-intervention …

Evaluation Of A Beverage Educational Intervention For Latino Parents Of Infants And Children Ages Nine Months To Five Years, Natalie Chelf

DNP Projects

Background: The Latino population has the highest rate of childhood obesity in the United States. Sugar-sweetened beverage (SSB) consumption has a positive correlation with increased rates of childhood obesity. Current research shows a deficit in culturally sensitive methods to reduce SSB consumption in the pediatric Latino population.

Purpose: The purpose of this project is to empower parents of Latino infants and young children with the knowledge to reduce or eliminate the consumption of SSBs in their child’s diet.

Methods: The project was a one group pre-test post-test quasi-experimental study design occurring in one pediatric outpatient clinic. The Information-Motivation-Behavioral Skills (IMB) …

Evaluation Of A Process Change On Mammography Screening Rates In A Family And Community Medicine Clinic, Christina Rademaker

DNP Projects

Abstract

Background and Significance: Breast cancer is the 2^nd leading cause of cancer death among women worldwide. Mammography is a screening approach used in the detection of breast cancer and proven to help reduce mortality. Only 72.8% of eligible American women have been screened for breast cancer within the past 2 years. One urban family and community medicine clinic (FCM) fell below the national average with a rate of 60.9%; as a result, they implemented an evidence-based strategy to improve mammography rates within the clinic.

Purpose: The purpose of this study was to evaluate the implementation of a telephone …