Digital Commons Network^™

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

Sociology Faculty Publications

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

Antibiotic Alternatives And Next-Generation Therapeutics For Salmonella Control: A One Health Approach To Combating Antimicrobial Resistance, Mohamed Saleh, Ashutosh Verma, Khaled A. Shaaban, Yosra A. Helmy

Veterinary Science Faculty Publications

The growing prevalence of antimicrobial resistance has significantly compromised the efficacy of conventional antibiotic-based interventions in controlling Salmonella infections across human and veterinary settings. This growing challenge necessitates a strategic rethinking of pathogen control, prompting the integration of next-generation therapeutics capable of disrupting Salmonella pathogenesis through novel, antibiotic-sparing mechanisms. In this context, a diverse array of emerging alternatives, including bacteriophages, antimicrobial peptides, probiotics, prebiotics, short-chain fatty acids, nanoparticles, and host-directed immunomodulators, have gained prominence as a promising frontier in non-antibiotic therapeutics. These modalities offer targeted approaches to inhibit Salmonella colonization, virulence expression, and persistence, while minimizing collateral damage to the …

A Large Electroencephalogram Database Of Freewill Reaching And Grasping Tasks For Brain Machine Interfaces, Bhoj Raj Thapa, John Boggess, Jihye Bae

Electrical and Computer Engineering Faculty Publications

Brain machine interfaces (BMIs) offer great potential to improve the quality of life for individuals with neurological disorders or severe motor impairments. Among various neural recording modalities, electroencephalogram (EEG) is particularly favorable for BMIs due to its noninvasive nature, portability, and high temporal resolution. Existing EEG datasets for BMIs are often limited to experimental settings that fail to address subjects’ freewill in decision making. We present a large EEG dataset, containing a total of 6808 trials, recorded from 23 healthy young adults (eight females and 15 males with an age range from 18 to 24 years) while performing reaching and …

Community-Engaged Approach To Improve Food Access And Consumption Of Fruits And Vegetables In A Rural Appalachian Community, Courtney Luecking, Makenzie Barr, Dawn Brewer, Kathryn M. Cardarelli

Dietetics and Human Nutrition Faculty Publications

Background/Objectives: Community–academic partnerships offer unique opportunities to leverage expertise and resources to modify structural factors that address community priorities. However, few in-depth examples of successful partnerships in rural communities to improve food security are available. This manuscript describes the process of building a partnership to reduce food insecurity in a rural Kentucky community.

Methods: The research team worked with Cooperative Extension to form a community advisory board (CAB) representative of diverse sectors of the community who had interest in food security, agriculture, and/or nutrition. The CAB convened regularly, in-person or virtually, to review community assessment information and identify, select, and …

Black Love, Media Portrayals, And Social Identity, Nigel M. Taylor

Theses and Dissertations--Communication

This dissertation explores how media stereotypes about Black relationships influence Black individuals' perceptions, shaping their understanding and expectations of love. Using social identity theory as a foundation, a mixed-methods approach integrates both qualitative and quantitative methods to examine the impact of media portrayals on self-concept and relationship expectations. The quantitative findings investigate connections between media exposure, self-esteem, and partner preferences, revealing how media shapes ideas about ideal relationships and internalized racial dynamics. The qualitative analysis identifies seven themes that define Black Love and seven themes that depict media stereotypes of Black relationships. The study shows that while media often reinforce …

Cybersecurity Training As Risk Communication: A Theory-Informed Model Of Employee Learning And Behavior Change, Daniel Chaney

Theses and Dissertations--Communication

Cybersecurity threats like phishing remain a persistent and costly challenge for organizations. Despite widespread corporate cybersecurity training (CCT) programs, many fail to produce lasting behavior change. This dissertation introduces the Training Knowledge Flow (TKF) Model to assess why such efforts often fall short. Grounded in communication theory, risk messaging, and adult learning principles, the TKF Model conceptualizes cybersecurity training as a staged process of learning, application, and behavioral adaptation. The model includes three phases: (1) Employee as Learner, focusing on message clarity and cognitive engagement; (2) Employee as Practitioner, assessing workplace transfer and training relevance; and (3) Employee …

Addressing The "Hidden Crisis" In Doctoral Education: Identifying The (De)Motivating Effects Of Memorable Messages From A Self-Determination Theory Perspective, Alexis A. Murphy

Theses and Dissertations--Communication

Although PhD students are academically capable, they paradoxically produce alarmingly high attrition rates. For several years, retention rates in PhD programs have averaged between 40% and 70% (Ames et al., 2018; Bowen & Rudenstine, 1992; Cochran et al., 2014; Gardner & GoPaul, 2012; Lovitts, 2001; Rockinson-Szapkiw & Spaulding, 2012). Scholars have presented several potential reasons that PhD students discontinue their studies, none of which include academic ability (Lovitts, 2001; Tucker, 1964; Sverdlick et al., 2018). Framed by self-determination theory (SDT), this study explores the social and communicative components of the doctoral education system by the psychological impact of memorable messages …

"The Lgbtq Community, That's My New Church": An Examination Of Lgbtq+ Former Church Members' Experiences Of Religious Exit, Samantha N. Pfeiffer

Theses and Dissertations--Communication

This study examines the experiences of LGBTQ+ individuals who previously attended Independent Fundamentalist Baptist (IFB) churches, considering their experiences of being in the church, leaving the church, and rebuilding outside of the church. It also examines sermons from IFB churches that addressed topics related to the LGBTQ+ community to examine the teachings these individuals received while in the church. My examination of this topic was based in scholarly literature addressing the rhetoric of church sermons, the process and experience of religious disaffiliation, and Weick’s (1995) theory of organizational sensemaking. I used multiple qualitative methods in this study, including qualitative content …

Crystal Structures And Low-Affinity Complex Formation Of Halogenase Ctcp And Fad Reductase Ctcq From The Chlortetracycline Biosynthetic Pathway, Caixia Hou, Sylvie Garneau-Tsodikova, Oleg V. Tsodikov

Pharmaceutical Sciences Faculty Publications

Enzymatic halogenation in natural products has been intensely investigated due to its potential utility as a tool to improve pharmacological and pharmaceutical properties of drug leads. Chlortetracycline (CTC), the first tetracycline (TC) antibiotic discovered nearly eight decades ago, contains a chlorine group. This chlorine is installed enzymatically by the flavin adenine dinucleotide (FAD)-dependent halogenase CtcP. CtcP and the FAD reductase CtcQ, which is also encoded in the CTC biosynthetic gene cluster, function as a two-component system. Structural information on CtcP and CtcQ has been lacking. In this study, we determined crystal structures of CtcP from Kitasatospora aureofaciens in a complex …

Borreliosis And Doxycycline Treatment Disrupt Gut Microbiota And Immune Responses In Nonhuman Primates, Ethan G. Napier, Isaac R. Cinco, Sheridan B. Wagner, Ethan V. Stuart, Qi Qiao, Joshua Taylor, Brian Stevenson, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Borrelia burgdorferi (Bb) is the spirochete that causes Lyme disease (LD). Transmission to humans occurs via bites of infected Ixodes spp. ticks. Doxycycline is often used to treat LD patients, which is sometimes delayed due to current diagnostic challenges. Recently, several lines of evidence show dysbiosis of the gut microbiome in LD patients, which may be a host factor contributing to pathogenesis and symp tomology but is still an understudied area in the field. To address this knowledge gap, we longitudinally compared the immune response and gut microbial composi tion of Japanese macaques after intradermal infection with Bb strain 297 …

Aluminum In Beverages And Foods: A Comprehensive Compilation Of Regulations; Concentrations In Raw, Prepared, And Stored Beverages And Foods; And Intake, Robert Yokel

Pharmaceutical Sciences Faculty Publications

The history and controversy concerning aluminum use in beverage and food preparation and storage are reviewed. This review on aluminum in drinking water, foods, and beverages updates and exceeds prior reviews. Country and international organization regulations that permit incorporation of aluminum containing food additives, their use limit, and purposes are presented. The aluminum concentration in beverages and foods consumed worldwide was gleaned from approximately 2100 sources available to the author. The approximately 17700 values are compiled in 175 tables by beverage or food category that include the analytical method used, sample source, and reference. The tables are posted on the …

A Cocaine Hydrolase Engineered From Human Butyrylcholinesterase As A Medical Countermeasure For Aldicarb Poisoning, Johnathan E. Lesaint, Nellore Bhanu Chandar, Annet Kyomuhangi, Huimei Wei, Fang Zheng, Chang-Guo Zhan

Pharmaceutical Sciences Faculty Publications

Aldicarb is known to be the most toxic carbamate pesticide and could be used easily by terrorists to cause a mass casualty incident. It is highly desired to discover a medical countermeasure for aldicarb poisoning. Based on structural insights from molecular modeling and in vitro experimental validation, CocH3-Fc(M3), a potent cocaine hydrolase engineered from human butyrylcholinesterase (BChE), has a ~4-fold improved binding affinity with aldicarb compared to wild-type human acetylcholinesterase (AChE) and BChE and a 9-28-fold improved bimolecular rate constant for the carbamylation with aldicarb compared to AChE. CocH3-Fc(M3) also has significant catalytic activity for aldicarb hydrolysis and, hence, is …

Development Of A Ghrelin Deacylase To Attenuate Drug Reward And Associated Effects Of Methamphetamine, Madeline J. Stewart, Huimei Wei, Nellore Bhanu Chandar, Fang Zheng, Chang-Guo Zhan

Pharmaceutical Sciences Faculty Publications

All addictive substances directly or indirectly interact with the dopamine reward system to alter the brain’s dopamine receptor activities. It is essential for a truly effective addiction medication to attenuate substance reward and normalize the brain’s physiological functions. Conventional pharmacological intervention approaches to the treatment of substance addiction usually aim to develop and deliver a potential therapeutic agent to the brain to directly block or decrease actions of the substance or its therapeutic target in the brain. However, it is a grand challenge to attenuate the substance reward without affecting the normal physiological functions of brain receptors or transporters. Here, …

Effects Of Biased Analogues Of The Kappa Opioid Receptor Agonist, U50,488, In Preclinical Models Of Pain And Side Effects, Ross Van De Wetering, Loan Y. Vu, Lindsay D. Kornberger, Dan Luo, Brittany Scouller, Sheein Hong, Kelly F. Paton, Thomas E. Prisinzano, Bronwyn M. Kivell

Pharmaceutical Sciences Faculty Publications

Kappa opioid receptor (KOR) agonists have well-established antinociceptive effects. However, many KOR agonists have negative side effects, which limit their therapeutic potential. Some researchers have suggested that the development of biased agonists that preferentially stimulate KOR G-protein pathways over β-arrestin pathways may yield drugs with fewer adverse side effects. This was investigated in the current study. We describe the synthesis and characterization of three U50,488 analogues, 1, 2, and 3. We evaluated the acute and chronic antinociceptive effects of these compounds in mice using the warm-water tail flick assay and in a paclitaxel-induced neuropathic pain model. Side …

Effects Of Fentanyl-Adulterated Methamphetamine On Circulating Ghrelin In Rats, Huimei Wei, Elise C. Maul, Shawn Park, Kaniz Fatema, Daniel J. Peter, Chang-Guo Zhan, Fang Zheng

Pharmaceutical Sciences Faculty Publications

The appetite hormone ghrelin influences biological processes that are responsible for substance use disorder, which is related to alcohol and most abused drugs including cocaine, methamphetamine, nicotine, etc. In general, upregulation of the ghrelin system enhances drug cravings and substance use. Studies reported in the literature consistently demonstrated that the ghrelin system is associated with stimulants. However, research on opioids in combination with methamphetamine has not been reported. In this study, we examined the relationship of circulating ghrelin with the polydrug use of fentanyl and methamphetamine in male Sprague-Dawley rats, demonstrating for the first time that concurrent use of fentanyl …

Effects Of Fentanyl-Laced Cocaine On Circulating Ghrelin, Insulin, And Glucose Levels In Rats, Huimei Wei, Elise C. Maul, Annet Kyomuhangi, Shawn Park, Maddilynn L. Mutchler, Chang-Guo Zhan, Fang Zheng

Pharmaceutical Sciences Faculty Publications

Opioid mixed with cocaine has been increasingly implicated in overdose deaths, including both intentional co-use of opioid and cocaine and fentanyl-adulterated drug supply. As ghrelin plays an important role in drug reward and can also influence insulin, this study aimed to assess responses of the circulating ghrelin, insulin, and glucose levels to the combined use of fentanyl and cocaine (a polydrug) in rats by performing combined animal behavioral experiments and biochemical analysis. The experimental data consistently revealed that the fentanyl and cocaine co-use can significantly elevate both the acyl-ghrelin and desacyl-ghrelin levels and significantly decrease the insulin level without significant …

Fluorescence-Guided Resection Of Gl261 Red-Fluc And Trp-Mcherry-Fluc Mouse Glioblastoma Tumors, Louis T. Rodgers, Bryan J. Maloney, Anika M. S. Hartz, Björn Bauer

Pharmaceutical Sciences Faculty Publications

Background: Most preclinical studies on glioblastoma (GBM) fail to provide translational utility in the clinic. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) improves tumor resection, disease prognosis, and, thus, patient outcomes. Given the critical role of surgery in managing recurrent GBM, it is essential to incorporate surgical elements into preclinical models to accurately reflect clinical scenarios and enhance translational success. However, existing protocols for 5-ALA-guided resection in preclinical models are limited and often lack clinical relevance.

Methods: To address this gap, we developed a novel protocol for the 5-ALA-guided resection in two mouse GBM models: TRP-mCherry-FLuc and GL261 Red-FLuc.

Results: The …

Development Of Zafirlukast Analogues For Improved Antithrombotic Activity Through Thiol Isomerase Inhibition, Justine A. Keovilay, Kaitlind C. Howard, Kirk A. Taylor, Sabeeya Khan, Sienna E. Wurl, Melanie K. Szahaj, Tanya Sage, Nishad Thamban Chandrika, Caixia Hou, Oleg V. Tsodikov, Jonathan M. Gibbins, Sylvie Garneau-Tsodikova, Daniel R. Kennedy

Pharmaceutical Sciences Faculty Publications

Background:   Thiol isomerases play essential and nonredundant roles in platelet activation, aggregation, and thrombus formation. Thiol isomerase inhibitors have the potential to overcome the 2 major drawbacks of current antithrombotic therapies, as they target both arterial and venous thrombosis without enhancing bleeding risks. Recently, a Food and Drug Administration–approved drug, zafirlukast (ZAF), was shown to be a promising pan-thiol isomerase inhibitor. The objective of this study is to develop analogues of ZAF with optimized thiol isomerase inhibition and antithrombotic activity.   Methods:   Thirty-five ZAF analogues were tested in an insulin turbidometric assay for thiol isomerase inhibition. Analogues were tested for platelet …

Functional And Structural Studies On The Esperamicin Thioesterase And Progress Toward Understanding Enediyne Core Biosynthesis, Erome D. Hankore, Mitchell D. Miller, Abigael J. Kosgei, Weijun Xu, Kemin Tan, Michael Endres, Minakshi Bhardwaj, Grazyna Joachimiak, Andrzej Joachimiak, George N. Phillips Jr., Jon S. Thorson, Steven G. Van Lanen

Pharmaceutical Sciences Faculty Publications

Enediynes are among the most potent antitumor and antibacterial natural products. Studies on their biosynthetic pathways have identified a shared, linear polyene precursor generated from an iterative type I polyketide synthase (PKSE) as the source of the enediyne warhead. A key step is the release of this polyene from the PKSE by a discrete thioesterase (TE). Here, we used X-ray crystallography, site-directed mutagenesis, and heterologous coexpression of PKSEs and TEs to elucidate how enediyne TEs mediate the production of the polyene. We solved the structure of wild-type EspE7 from esperamicin producer Actinomodura verrucosospora. The substrate binding pocket was also …

Association Between Lifetime Interpersonal Violence And Post– Covid-19 Condition Among Women In Kentucky, 2020-2022, Ayşe Güler, Heather M. Bush, Katie Schill, Nurlan Kussainov, Ann L. Coker

Biostatistics Faculty Publications

Objective: The COVID-19 pandemic increased the risk of interpersonal violence. We investigated the association between lifetime interpersonal violence experience and risk of post–COVID-19 condition (the persistence of symptoms of COVID-19 and severity of health problems associated with COVID-19 that last a few weeks, months, or years) among women with lifetime interpersonal violence experience.   Methods: Women participants aged ≥18 years in Kentucky’s Wellness, Health & You—COVID-19 study completed online quantitative surveys about the impacts of the pandemic, developing COVID-19, and symptoms of post–COVID-19 condition. We conducted cross-sectional analyses estimating rate ratios of developing COVID-19 and symptoms of post–COVID-19 condition during the …

Development And Clinical Validation Of The Sensor-E Exoskeleton For Objective Hand Function Assessment In Stroke Rehabilitation, Madison Bates

Theses and Dissertations--Biomedical Engineering

Hand function is often impaired following neurological trauma or in conditions such as stroke, limiting independence and the ability to perform activities of daily living (ADLs). Current clinical assessments rely heavily on subjective rating scales that lack the resolution to detect subtle changes in motor performance, which can limit access to rehabilitation. Recent advances in wearable technologies highlight the potential for hand-worn devices to provide objective, real-time measures of hand function. However, most systems focus solely on kinematics and rarely capture both movement and exerted force. Moreover, integration into rehabilitation frameworks and brain-computer interface (BCI) protocols remains limited. To address …

Image Processing And Machine Learning Using Lidar And 360 Camera In Underground Mines, Ana Fabiola Patricia Tejada Peralta

Theses and Dissertations--Mining Engineering

Underground mining environments present several safety challenges due to low visibility, poor lighting, and the absence of GPS coverage. These factors hinder situational awareness and delay hazard detection, particularly during post-disaster conditions. This research introduces an integrated framework that combines image processing and machine learning techniques applied to 360-degree camera and LiDAR data to enable automated object detection and remote monitoring in underground mines.

The study was divided into two main stages: 2D object detection and 3D object detection. The 2D component employed images captured with a Ricoh Theta Z1 360° camera and utilized YOLO-based deep learning models for object …

Development Of A Stable Isotope Method To Measure Protein Fractional Synthesis Rate In Equine Skeletal Muscle, Antoinette E. Foliart

Theses and Dissertations--Animal and Food Sciences

Muscle mass is regulated by the balance between muscle protein synthesis and degradation. Previous research in horses has shown that the signaling pathway that regulates protein synthesis is upregulated with increasing protein intake; however, whether this corresponds to an increase in muscle protein synthesis rates had not been previously explored. The objective of this study was to develop an isotopic method to measure muscle protein fractional synthesis rate (FSR) in horses following graded protein intake. Eight mature Thoroughbred horses were studied using a randomized cross-over design. Horses consumed meals containing 0 (No), 0.125 (Low), 0.25 (Med), or 0.5 (High) g …

Where Does The Money Go? Three Essays On Intergovernmental Transfers, Spending, And Poverty In Indonesia, Jacobus Cd Rijoly

Theses and Dissertations--Public Policy and Administration

Indonesia allocates substantial intergovernmental transfers to local governments; nonetheless, the decrease in poverty remains limited. This dissertation posits that the binding constraint is institutional, specifically the regulations and incentives that dictate the extent to which funds are allocated from the government to designated programs. Institutional pass-through refers to the fraction of a transfer that is allocated to a program expenditure. The three essays integrate estimation, budget composition evidence, and a formal model to explain both modest average effects and heterogeneity across regions and programs.

The first essay evaluates the impact of transfers on provincial poverty from 2001 to 2022 by …

Essays On Public And Nonprofit Financial Management In Times Of Crisis, Junoh Jeon

Theses and Dissertations--Public Policy and Administration

This dissertation comprises three essays that examine critical aspects of public and nonprofit financial management, focusing on interorganizational relationships, local government influence, and financial reserve management in times of crisis.

The first essay examines how interorganizational relationships, specifically nonprofit organizations’ board interlocks, relate to their financial distress, depending on the temporal and spatial contexts. Organization-level fixed-effects regression analysis with Kentucky nonprofits from 2018 to 2022 shows that nonprofits with board interlocks in urban areas were less likely to experience financial distress during the COVID-19 pandemic. I suggest that board interlock acts as an adaptive buffering tool that helps manage resource …

Daily Anxiety And Dual Use Of Cigarettes And Vaping Products: Disparities By Sex, Race, And Ethnicity In U.S. Adults, Maggie K. Richardson, Delvon T. Mattingly, Osayande Agbonlahor, Alison C. Mcleish, Joy L. Hart, Kandi L. Walker

Educational, School, and Counseling Psychology Faculty Publications

Objective:

Despite a decline in cigarette use, the dual use of cigarettes and electronic vaping products (EVPs) is a concerning pattern of nicotine consumption in the United States. Anxiety, a risk factor for tobacco use, may contribute to dual-use patterns; however, the association between daily anxiety symptoms and dual use of cigarettes and EVPs is not known. This study investigated associations between daily anxiety symptoms and dual cigarette and EVP use overall and by sex, race, and ethnicity.

Method:

Data are from the 2020–2022 National Health Interview Survey (n = 83,544). Multinomial logistic regression models, adjusted for sociodemographic factors, …

Sonic Photovoice And Critical Literacy: Listening To And Sounding What Is Me, What Is Not Me, And What Is Between, Alexander Chadwell

Theses and Dissertations--Curriculum and Instruction

This study examined sonic photovoice, a sound-based arts research method, as a tool for developing critical literacy in middle and high school students. Participants found and recorded sounds related to three categories, “what is me,” “what is not me,” and “what is between,” composed a sound collage using the sounds, and reflected on the experience. Framed by 4EA cognition, participatory sensemaking, and relational and everyday aesthetics, the study explored how listening and sounding shaped students’ conceptions of self and reality. Data from recordings, journals, and interviews suggest that the sonic engagement can foster relational, emergent understandings of self and …

Examining The Relationship Between Cognitive Auditory Processing And Sex Hormones, Trey A. Cline

Theses and Dissertations--Gerontology

Estrogen and progesterone have demonstrated modulatory effects on central auditory nervous system (CANS) function. Post-menopausal females often present to audiology clinics with complaints of difficulty hearing in background noise. However, these individuals often have normal peripheral hearing sensitivity on standard audiometry. Previous studies using the auditory brainstem response (ABR) in post-menopausal females demonstrated longer response latencies compared to their premenopausal counterparts, suggesting that sound does not transmit through the CANS as efficiently. However, to date, the available literature focused on sex hormones and the CANS relies mainly on objective measures, predominantly the ABR. The ABR reflects physiologic function through the …

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

Epidemiology and Environmental Health Faculty Publications

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

Evaluating Impact Of Stress First Aid Programs In A Primary Care Setting, Ryan Marler

DNP Projects

Background: Prolonged stress in healthcare workers (HCWs) can lead to burnout and absenteeism. High stress also negatively impacts work productivity and healthcare quality. The Stress First Aid (SFA) program aims to improve recovery from stress among HCWs. Chronic stress is evident in primary care clinics, where absenteeism and burnout symptoms have increased.

Purpose: This project aimed to evaluate the SFA program's effectiveness in reducing burnout and absenteeism and improving healthcare workers (HCW) knowledge of stress and available resources at University of Kentucky Healthcare (UKHC).

Methods: A quasi-experimental quality improvement project included pre- and post-education surveys, an SFA education session, and …