Digital Commons Network^™

Hallucinogen Use Among Parents Of Children In The United States: Associations With Mental Health And Substance Use, Maggie K. Richardson

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

Hallucinogen use has reemerged in the United States amid expanding clinical research and shifting social and policy contexts. However, population-based evidence remains limited regarding hallucinogen use among adults living with children and its relationship with mental health impairment severity in caregiving environments. Therefore, this study’s objective was to examine associations between past-year hallucinogen use and past-year mental health impairment among U.S. adults, and to test whether associations differ by parental status and number of children in the household. A secondary aim examined correlates of co-occurring substance use among those reporting hallucinogen use.

Data were drawn from the 2023 National Survey …

Bridging The Intention–Behavior Gap In Mental Health Help-Seeking, Wenqi Weng

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

Objective: To examine whether modifiable factors shape the extent to which help-seeking intention is translated into formal mental health service initiation among distressed adults. Method: Participants were U.S. adults (N = 777; M age = 47.21 years, SD = 16.70; 73.23% women; 77.74% White) who reported at least moderate psychological distress and were not currently receiving formal mental health treatment. At baseline, participants completed measures of help-seeking intention, focal moderators (action planning, psychological distress, and mental health steward self-identity), coping planning, cues to action, and emotion regulation as exploratory candidate moderators. At three-month follow-up, participants reported whether …

Electromyography Of The Coracobrachialis—Construct Validity And Implications For Rehabilitation Of Anterior Shoulder Dislocation, Alon Rabin, Timothy L. Uhl, Ido Druckmann, Zvi Kozol, Yossi Ruah, Dani Rotman, Dan Stein

Physical Therapy Faculty Publications

Background: The coracobrachialis (CB) is an important anterior shoulder stabilizer, yet no study has previously reported its electromyography (EMG). The purpose of this study was to validate a novel technique for surface EMG (sEMG) of the CB.   Methods: Thirty-two (21 females) healthy individuals participated in this cross-sectional study. A surface landmark for recording the CB was identified within the medial aspect of the proximal arm using real-time ultrasound imaging and cadaver dissection. The EMG from this landmark as well as from the biceps brachii (BB) were simultaneously recorded during shoulder horizontal adduction (SHAd) (a CB-dominant test), and during elbow flexion …

Developing A Multidisciplinary Pediatric Cancer Predisposition Service At A Mid-Sized Children’S Hospital, Amanda M. Harrington, John August D'Orazio

Markey Cancer Center Faculty Publications

Roughly one in ten children and young adults diagnosed with cancer has an underlying genetic variant that may explain his/her malignancy. It is critical to identify patients with cancer predisposition syndromes (CPSs) to provide personalized cancer treatment, surveillance, counseling, psychosocial support, and in some cases, risk-reducing interventions to maximize long-term outcomes. Over the past five years, we developed a comprehensive pediatric CPS program at our institution. We engaged our institutional adult cancer center for clinical cancer genetic counseling services and needed research shared resource facilities. We also initiated a clinical study called “Project Inherited Cancer Risk” (PICR) to identify pediatric …

Bureaucratic Responsiveness In Times Of Crisis, Anna Gunderson, Maggie Macdonald

Political Science Faculty Publications

In 2020, American cities experienced mass protest after fatal police violence against Black Americans. Did police address these protests differently after the murder of George Floyd or the protests in their communities? Did that response vary depending on the racial or ideological makeup of their constituents? We link policing protests and Facebook posts from about 4,000 American police departments to investigate differences in agency responses to protest. Departments posted more about protest after Floyd's death, especially in those communities that also had a policing protest. Republican cities were less likely to post about protests, but racial demographics are not associated …

The Impact Of A Kentucky Nutrition Education Program Social Marketing Campaign On Resident Health, Trinity Elizabeth Foster

Theses and Dissertations--Agricultural Economics

Poor diet quality and physical inactivity are common health issues in the United States. To remedy these issues among low-income households, the United States Department of Agriculture created the Supplemental Nutrition Assistance Program Education Program (SNAP-Ed), which promoted healthy eating and physically active lifestyles through multiple avenues. The social marketing approach of SNAP-Ed uses marketing strategies to relay information to the public. In Kentucky, a statewide billboard campaign was launched in 2018 encouraging residents to focus on nutrition and physical activity. This study investigates the impact of that campaign on health outcomes in counties throughout the state. Using billboard location …

Resilience Shields And Grit Intensifies Subjective Cognitive Decline In Middle‐To‐Older Aged Black Americans, Sunkanmi Folorunsho, Maria Clark, Obinna Odo, Yolanda L. Jackson, Candidus C. Nwakasi, Darlingtina K. Esiaka

Behavioral Science Faculty Publications

Background: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap.

Methods: The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to …

Evidence Of Heterogeneity In The Opioid Withdrawal Syndrome: Spontaneous And Precipitated Withdrawal, Suky Martinez, Jermaine D. Jones, Kelly E. Dunn, Andrew Huhn, Joshua A. Lile, Thomas P. Shellenberg, Laura Brandt

Behavioral Science Faculty Publications

Aims: This study characterized the heterogeneity of opioid withdrawal by comparing naturally occurring withdrawal during opioid abstinence (spontaneous withdrawal) with abrupt, pharmacologically induced naloxone-precipitated withdrawal in adults with Opioid Use Disorder (OUD).   Methods: A secondary analysis was conducted on de-identified data from 86 adults meeting DSM-5 criteria for moderate-to-severe OUD. Participants either presented in spontaneous withdrawal (n = 28) or underwent naloxone challenge to precipitate withdrawal (n = 58). Withdrawal symptoms were rated using the Wang procedure. Principal Component Analysis (PCA) of binary symptom data was performed to identify dominant patterns of symptom co-occurrence. Separate PCAs were then …

Fiber-Reinforced Composites For Vaginal Tissue Engineering Applications, Samyuktha S. Kolluru, Abir Hamdaoui, Annabella M. Mascot, Siobhan S. Sutcliffe, Jerry L. Lowder, Michelle L. Oyen, Samantha G. Zambuto

Mechanical Engineering Faculty Publications

The vagina is a fibromuscular tube-shaped organ that plays critical roles in menstruation, pregnancy, and female sexual health. Vaginal tissue constituents, including cells and extracellular matrix components, contribute to tissue structure, function, and prevention of injury and pathology. However, much microstructural function remains unknown, including how the fiber-cell and cell–cell interactions influence macromechanical properties. A deeper understanding of these interactions will provide critical information needed to reduce and prevent vaginal pathologies. Our objective for this work is to design a novel tissue-mimicking biomaterial for vaginal tissue engineering, and characterize its biological and mechanical performance in the vaginal microenvironment. We successfully …

Feasibility, Acceptability, And Preliminary Efficacy Of A Pilot Study To Integrate Buprenorphine Into A Harm-Reduction Drop-In-Center In Kampala, Uganda, Julia Dickson-Gomez, Sergey Tarima, Wamala Twaibu, Dan Katende, Latifah Kyeswa, Laura Glasman, Arthur Kiconco, Sarah Krechel, Bryan Johnston, Moses Ogwal, Brian Byamah Mutamba, Peter Mudiope, Stella Alamo, Rhoda Wanyenze, Geofrey Musinguzi

Biostatistics Faculty Publications

Illicit drug use has been increasing rapidly in Sub-Saharan Africa in the past decade. However, until recently HIV prevention has largely ignored people who inject drugs and medications to treat opioid use disorder (MOUD) were largely absent. This paper reports results of a pilot intervention that integrated buprenorphine into a harm-reduction drop-in-center for people with opioid use disorder (OUD) in Kampala, Uganda. We collected implementation outcomes and changes in self-reported drug use after buprenorphine initiation. We conducted qualitative interviews with a subset of 14 participants who had initiated buprenorphine. Sixty-two participants were screened for OUD, of whom 57 were eligible …

Artificial Intelligence In Biomedical Team Science: Perceptions, Practices, And Training Needs, Emily Slade, Kelsey N. Karnik, Caitline Phan, Megan E. Hall, Yana Feygin, Kristen J. Mcquerry

Biostatistics Faculty Publications

Introduction: Artificial intelligence (AI) is increasingly used in biomedical research, yet limited empirical work has described how researchers use AI tools on collaborative research teams and how they view their role within team-based research. This study examines researchers’ experience with and attitudes toward AI use in collaborative research environments.

Methods: A cross-sectional survey was administered to 178 investigators engaged in collaborative research at the University of Kentucky. Questions assessed AI use across research and communication tasks, team-related decision-making practices, perceived benefits and concerns, and preferences for training and frameworks.

Results: Thirty-nine participants responded (22%). AI use was heterogeneous: 26% had …

Dual Orexin Receptor Antagonism With Lemborexant Enhances Microglial Clearance Of Β-Amyloid In Mice, Ashish Sharma, Emiko Segawa, Xiaoying Chen, Sohui Park, Shoutang Wang, Riley E. Irmen, Nicholas J. Constantino, Chanung Wang, Michael F. Kanan, Marco Colonna, Shannon L. Macauley, Jocelyn Y. Cheng, Ken Hatanaka, Margaret Moline, Erik S. Musiek

Sanders-Brown Center on Aging Faculty Publications

Background: Sleep disturbances elevate brain amyloid-beta (Aβ) levels and represent a modifiable risk factor for Alzheimer’s disease (AD). The orexin/hypocretin system regulates sleep–wake behavior and has emerged as a therapeutic target in AD; however, the effects of FDA-approved dual orexin receptor antagonists (DORAs) on amyloid pathology remain unclear. We compared lemborexant, an FDA-approved DORA, to doxepin, an antihistaminergic sleep medication, on amyloid pathology and microglial responses in PSAPP mice.

Methods: PSAPP mice received lemborexant (10 or 30 mg/kg/day), doxepin (35 mg/kg/day), or vehicle for 6 weeks beginning prior to plaque onset or 4 weeks after established pathology. Sleep was assessed …

Effect Of Canagliflozin Pretreatment On The Efficacy Of Insulin Therapy To Rescue Type 1 Diabetes-Related Bone Fragility In Male Mice, Jeffry S. Nyman, R. Clay Bunn, Sasidhar Uppuganti, Elizabeth M. Hennen, Plaban Mishra, Philip D. Ray, Anthony Garcia Mendez, Evangelia Kalaitzoglou, John L. Fowlkes

Barnstable Brown Diabetes Center Faculty Publications

Humans with type 1 diabetes (T1D) have a higher-than-expected fracture risk, and bone is weak in mouse models of T1D. Since hyperglycemia is thought to deleteriously affect tissue-level sensitivity of insulin action, we hypothesized that glucose-lowering by canagliflozin (Cana) improves the ability of insulin treatment to rescue the T1D-related decrease in bone strength. To test this hypothesis, male DBA/2 mice with and without streptozotocin (STZ)-induced hyperglycemia at 8 weeks of age were fed a diet with and without Cana (50 ppm) at 10 weeks of age and then the T1D mice, regardless of placebo diet or Cana diet, were treated …

Emergency Department-Initiated Standard Versus High-Dose Buprenorphine Induction (Envision): A Randomised Clinical Trial Protocol, Kathryn Hawk, Andrew Herring, Marek Chawarski, Erik S. Anderson, Michael Baumann, Alyrene Dorey, August F. Holtyn, Christopher Jones, Shara Martel, Patricia Owens, Kaitlin Kmiecik, Tania D. Strout, Peter Taillac, Michelle R. Lofwall, Sharon L. Walsh, Gail D’Onofrio

Center on Drug and Alcohol Research Faculty Publications

Introduction: The initiation of buprenorphine for patients with opioid use disorder (OUD) in the emergency department (ED) has been associated with improved outcomes including reduced ED visits and increased treatment engagement. Though both standard-dose (8 mg buprenorphine equivalent) and high-dose (24 mg buprenorphine equivalent) strategies to initiate buprenorphine have been used in the ED, no prospective trials comparing outcomes among patients receiving these treatments have been reported.

Methods and analysis: This multisite randomised clinical trial is a multisite double-blind, double-dummy, randomised clinical trial enrolling 360 emergency department patients with moderate-to-severe OUD. Enrolled patients will be randomised to one of two …

Experiential Spillover In Public Views Of Police And Courts, Emma Henderson, Matthew Mettler, Jeffery J. Mondak, Mark Peffley

Political Science Faculty Publications

Personal experiences with public officials influence how those officials are perceived. We question whether these experiential effects extend to other officials. If people draw on what they know to make inferences about unfamiliar evaluative targets, then interactions with one actor may shape evaluations of other independent actors. Focusing on police and courts, analyses of data from two surveys reveal that personal interactions with public officials produce spillover effects on appraisals of officials in different sectors. The findings indicate that experiential spillover constitutes an underappreciated force in public opinion, one that operates outside the control of the actors being evaluated.

Facebook As A Strategy To Deliver A Peer Navigation Intervention For Recently Incarcerated Women With Opioid Use Disorder: A Mixed Methods Descriptive Profile, Martha Tillson, Jaxin Annett, Marguerite A. Webster, Amanda Fallin-Bennett, Mandi Webster, Amber Clemons, Cynthia Robinson, Kevin Crabtree, Casey Baker-Romans, Michele Staton

Center on Drug and Alcohol Research Faculty Publications

Recovery support and treatment linkages are critical during transitions from incarceration to community but can be challenging to deliver to hard-to-reach populations. This paper will examine Facebook contacts between peer navigators (PNs) and women with opioid use disorder (OUD) following jail release to explore women’s use of PN services, including purpose and content of Facebook messages. As part of a larger clinical trial under the Justice Community Opioid Innovation Network (JCOIN), PNs provided OUD treatment navigation and recovery support for 12 weeks following women’s release from jail, using remote options such as Facebook. Facebook Messenger transcripts between PNs and participants …

Evolution Of A Client‐Level Dataset: 20 Years Of National Child Traumatic Stress Network Data Collection, C. A. Purbeck, A. N. Cooke, L. J. Liang, C. Smith, J. Staten, J. Epstein, H. B. Hodgdon, Jessica Eslinger, A. Wells, J. Goodrich, T. H. Bethel, K. Willett, Y. C. Fu, J. A. Fairbank, E. C. Briggs

Center on Trauma and Children Faculty Publications

Objectives: For 20 years, the National Child Traumatic Stress Network's (NCTSN) data collection efforts have been a central mechanism for Clinical Quality Improvement (ClQI). The NCTSN is a federally funded initiative in the United States composed of programs dedicated to raising the standard of care and increasing access to services for children and families who have experienced traumatic events.

Methods: These efforts span three initiatives: the Core Data Set (CDS), the Clinical Improvement through Measurement Initiative (CIMI) Measurement Based Care (MBC), and CIMI Data Sharing (CIMI-DS) that collected and analyzed client-level data to improve care for children and families served …

Response Efficacy And Discrete Emotions In Message Design: Testing Emotional Pathways To Help-Seeking Intentions And Engagement, Marian Jaitto-Jeffrey

Theses and Dissertations--Communication

Research on fear appeals shows that threat-framed messages promote adaptive outcomes when accompanied by efficacy information. According to the extended parallel process model (EPPM), danger-control responses, including message acceptance, positive attitudes toward recommended behaviors, and help-seeking intentions, are most likely to occur when efficacy appraisals, particularly perceptions of response efficacy, are sufficient to meet perceived threat. When efficacy appraisals fall short of perceived threat, fear-control responses, such as message derogation, denial, or resistance to seeking help, are most likely to emerge. Beyond reducing defensive processing, response efficacy cues may also evoke positive emotions such as hope. Whereas fear is often …

Music-Based Storytelling For Older Adult Well-Being: An Adapted Multiple Case Study, Zachary Michael Palma

Theses and Dissertations--Music

Autobiographical storytelling can be a meaningful way for older adults to reflect on life experience and support social and emotional well-being. Music has been widely documented as a cue for autobiographical memory. Although the benefits of storytelling and music as a memory cue have been independently examined, limited research has explored its combination with older adults. The purpose of this study was to explore music-based autobiographical storytelling in the lives of older adults. There were three research questions: (1) How do older adults describe their experiences with music-based storytelling? (2) How do they describe the social experience with music-based storytelling? …

Contemporary Commercial Music: A Scoping Review With Implications For Music Therapy Practice, John A. Lawwill

Theses and Dissertations--Music

Contemporary Commercial Music (CCM) is an increasingly popular group of non-classical musical styles. Music therapists need to know how to sing a wide variety of CCM genres authentically, yet little information exists on effectively teaching vocal CCM techniques to music therapists. The purpose of this study was to conduct a scoping review on CCM singing instruction and to synthesize implications for music therapists. I used EBSCOhost and ProQuest to search for reports in English published after 2002 containing the terms “Contemporary Commercial Music” or “CCM,” and variations of the term “sing.” I identified 26 reports that met inclusion criteria, including …

Belting In Musical Theatre: Vocal Pathologies, Injuries, And Pedagogical Implications, Kaylee Piatt

Theses and Dissertations--Music

Belting has become one of the most defining and contested vocal styles in contemporary musical theatre. Valued for its dramatic immediacy, speech-like intensity, and ability to cut through amplified orchestration, belting is frequently associated with heightened injury risk and pedagogical controversy. This thesis examines the relationship between belting, vocal pathology, and pedagogy through an interdisciplinary lens that integrates voice science, clinical literature, and professional performance practice. Rather than framing belting as an inherently harmful or stylistically aberrant technique, this study conceptualizes belting as a functional vocal coordination shaped by physiological mechanisms, cumulative vocal load, and occupational demands.

Drawing on existing …

Reimagining The Reduction: A Pianist’S Guide To The Piano Reductions Of Korngold’S Violin Concerto And Vaughan Williams’S Tuba Concerto, Zhongyue Zhang

Theses and Dissertations--Music

Piano reductions are an essential medium through which collaborative pianists work with orchestral concertos. However, many existing reductions, particularly of 20th century works, hinder effective performance in terms of orchestral fidelity and feasibility of execution. The problem is twofold: reductions may contain technically cumbersome passages with diminishing musical returns; they may also omit or misrepresent important orchestral effects and textures. For these problematic situations, this work presents pianistic revisions that aim to preserve essential orchestral sound characteristics. Using the first movements of Erich Wolfgang Korngold’s Violin Concerto and Ralph Vaughan Williams’s Tuba Concerto as examples, this work demonstrates a systematic …

A Conductor's Guide To All-State Orchestra: An Overview Of Repertoire And Best Practices, Nicoletta Moss

Theses and Dissertations--Music

For over one-hundred years, all-state orchestras have served as the premier gatherings of high school musicians across the United States. These short-term events offer intensive ensemble experiences that bring together students from diverse musical and social backgrounds. While conductors play a central role in shaping these experiences, research is limited examining the areas of repertoire programming, pedagogical practices, and other logistical considerations associated with all-state orchestra leadership. In this dissertation, I address these gaps and develop a comprehensive resource for current and future all-state conductors. The present study employs a two-study design: 1) a content analysis of repertoire performed between …

Burnout And Mindful Self-Care Practices Among Bipoc Women Music Therapists: A Cross-Sectional Survey, Melissa V. Peters

Theses and Dissertations--Music

Music therapy as a profession has long acknowledged burnout as a significant occupational concern, yet the experiences of marginalized therapists remain understudied. In particular, little research has explored how burnout and self-care manifest for those who identify as Black, Indigenous, or People of Color (BIPOC) women in a field historically dominated by white women. Most of the existing literature on this topic is focused on the majority identity of music therapists, white women. The purpose of this thesis was to examine the reported levels of burnout among BIPOC women music therapists as well as their reported frequency of engagement in …

Engineering Plga Nanoparticle Size To Modulate Immune Responses After Spinal Cord Injury, Daniel J. Kolpek

University of Kentucky Doctoral Dissertations

Spinal cord injury is a severe and debilitating condition that often results in lifelong complications, including paralysis. Many of these chronic outcomes are driven by a sustained inflammatory response at the injury site, which limits tissue regeneration and functional recovery. As a result, therapeutic strategies that modulate this immune response have gained significant interest. Polymer based nanoparticle therapies have emerged as a promising approach due to their ability to interact with and influence immune cell behavior. Importantly, the physicochemical properties of nanoparticles can be precisely tuned to optimize these effects. Among these properties, size has been shown to influence key …

The Political Economy Of Pfas Treatment And Water Regionalization In Harrison County, Kentucky, Jackson S. Patru, Rajan Sampat

MPA/MPP/MPFM Capstone Projects

The discovery of per- and polyfluoroalkyl substances (PFAS) in the water supply of Harrison County, Kentucky has prompted an urgent reevaluation of local treatment infrastructure. This situation has exposed a complex political economy between the City of Cynthiana, which owns and operates the municipal water plant, and the Harrison County Water Association (HCWA), which represents the majority of the ratepayers supplied by the plant. Using a qualitative research design grounded in inductive thematic analysis, semi-structured interviews were conducted with leadership from both Cynthiana and HCWA, as well as operators at the treatment plant, to evaluate two proposed solutions: a $14 …

Kentucky Space Futures: Defining The Driving And Limiting Factors Of Growth In The State Aerospace Industry, Ashley M. Grospitch, Isabella A. Sibold

MPA/MPP/MPFM Capstone Projects

Kentucky’s aerospace industry has quietly become one of the state’s most significant economic drivers, generating almost $19 billion in exports in 2024 and ranking third nationally in aerospace exports in 2023 (Mattingly, 2025; Babbage & Hartsough, 2024). Despite this, Kentucky remains largely invisible as an aerospace state, both to Kentuckians and national audiences. This work was conducted on behalf of our client, Kentucky Space Futures, to identify the factors shaping the growth of Kentucky’s aerospace industry, including its driving and limiting factors, and provide actionable guidance for policymakers and industry leaders.

Using a qualitative research design, this study triangulated findings …

Narrowing The K-12 Excellence Gap In Kentucky Schools: Lessons On High Achievement From High Achievers, Jimmy M. W. Bartlett, Johnathan K. Hurley

MPA/MPP/MPFM Capstone Projects

Disparities in high-level academic achievement – known as excellence gaps – remain a persistent equity challenge in K–12 education, particularly in access to advanced mathematics learning. This study examines school-level practices associated with narrower excellence gaps in Kentucky public schools. Principals of schools demonstrating higher-than-expected advanced achievement and relatively small gaps by gender and economic status were invited to semi-structured interviews. The interviews cover seven schools, spanning grade levels and other characteristics. Guided by the Excellence Gap Intervention Model, a hybrid inductive–deductive thematic analysis reveals that narrower excellence gaps are not driven by isolated programs or policy mandates, but by …

Comparing Economic Development And Blight Remediation Tax Increment Financing: Design, Governance, And Measurable Outcomes, Leigh Compton

MPA/MPP/MPFM Capstone Projects

Tax Increment Financing (TIF) is a widely used local government tool for redevelopment and economic growth, yet its expanding application has raised questions regarding its design, governance, and measurable outcomes. This study compares two primary uses of TIF: blight remediation and economic development. While remediation-focused TIF is intended to address identifiable market failures in distressed areas, economic development TIF is typically used to attract or accelerate private investment in more competitive environments.

Using a structured comparative analysis of selected Kentucky TIF districts, this research evaluates how differences in statutory justification, financing mechanisms, governance structures, and performance measures align with each …

Kentucky Is Working: An Examination Of Higher-Than-Expected Labor Force Participation Rates In Kentucky, Grace E. Coleman, Gabriel M. Kalla, Joseph S. Matthews

MPA/MPP/MPFM Capstone Projects

This client-based capstone examines the drivers of higher-than-expected labor force participation rates across five counties in Kentucky, i.e., Kenton, Pendleton, Owen, Taylor, and Monroe counties. Our client, the Kentucky Chamber of Commerce, requested a qualitative analysis of semi-structured interviews with local stakeholders to identify and contextualize factors contributing to the five counties’ overperformance. Our findings suggest that factors such as collaboration and partnership; education and career pathway initiatives; and community champions all play important roles in supporting strong labor force participation. These insights can be used by other counties seeking to strengthen their local workforce.