Digital Commons Network^™

Attitudes Towards Fentanyl Test Strips Among A Cohort Of People Who Use Drugs In Rural Kentucky, Alaina Murphy

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

Background and aims Fentanyl-related overdoses have largely contributed to the nearly 500,000 opioid overdose deaths in the United States since 1999. Fentanyl test strips (FTS) are a new technology that is designed to help prevent these overdoses. People who use drugs (PWUD) can test their drug supply for fentanyl by placing the strip in a sample of the drug. However, access to FTS varies across the country. This variance is largely due to rural PWUD not having the same access to harm reduction programs, compared to urban settings. This study uses data on PWUD in rural Kentucky to evaluate attitudes …

Local Public Health System Comprehensiveness And Opioid Overdose Mortality, 2012-2018, Stephanie Courtney

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

Background: Deaths due to opioid overdose are a significant public health burden in the United States. Studies suggest that local public health systems that perform a high number of essential activities where local health departments contribute to the delivery of the activities and promote increased partnership may positively influence population health outcomes such as overdose mortality. Studies have shown that comprehensive public health systems are associated with improved health outcomes, but this association has not been addressed in the context of opioid overdose deaths. Study Aim: The purpose of this study is to evaluate the associations between local public health …

A Plague Of Their Own: Injury Incidence Remains Elevated In The 2021 Major League Baseball Season Compared To Pre-Covid-19 Seasons, Brooks N. Platt, Breanna Sullivan, Shawn Dripchak, Timothy L. Uhl, Aaron Sciascia, William B. Kibler, Austin V. Stone

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background Significant increases in injuries were observed in the 2020 Major League Baseball (MLB) season; these were attributed to an increased acute to chronic workload due to the interrupted preseason and compressed season during the coronavirus disease of 2019 (COVID-19) pandemic. In 2021, the MLB resumed its regular schedule.

Hypothesis/Purpose The purpose of this study was to determine the injury incidence and epidemiology of the 2021 MLB season compared to the injury incidence in the 2020 season and pre-COVID-19 seasons. The hypothesis was that, with the return to normal preseason training, injury incidence in 2021 would return to pre-COVID-19 rates. …

Opioid Addiction In Rural America: The Transportation Need For Treatment Adherence, Jennifer Smith

DSW Capstone Projects

The opioid epidemic has continued to soar throughout the United States for over 20 years. While this epidemic knows no boundaries and affects all of America, rural communities have been drastically impacted by the number of persons suffering from this addiction, and the resulting staggering mortality rates. Rural populations face greater treatment barriers preventing patients from obtaining needed services as compared to other geographical locations. Patients face obstacles related to accessibility, availability, and stigmatization, placing them at higher risk for opioid misuse, abuse, and/or death. Even though this targeted population faces multiple complications in seeking treatment, transportation barriers are among …

Teaching Anti-Racism Practices To White Social Work Students And Community Members, Dennis Cornell

DSW Capstone Projects

Racism continues to plague the United States and White people hold a key element to ending racism by adopting anti-racism practices in their professional and personal lives. This capstone on the findings of a comprehensive systematic literature review, examines empirically-based anti-racism interventions and practices that social work teachers and community educators can utilize in anti-racism courses and workshops for White students and community members. The final results yielded 29 peer-reviewed, qualitative/quantitative research studies within the years of 2003-2021 that can be broken down into six anti-racism intervention categories: class/educational groups, teaching methods, Implicit Association Test (IAT) usage, pro-Black stories/perspectives, interracial …

Disparities In Uptake Of The Primary Sars-Cov-2 Vaccine Series In A Southern Indiana Vaccine Clinic, Cassidy Padgett

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

Objective: COVID-19 is a potentially severe respiratory disease caused by infection from the SARS-CoV-2 virus. COVID-19 was first discovered in 2019 and vaccines against the virus began development in early 2020. COVID-19 vaccines are effective at preventing severe illness, hospitalizations, and death from SARS-CoV-2 infection. Clark Memorial Health is a 236-bed community health system located in southern Indiana. As one of the first four hospitals in the state of Indiana to receive the Pfizer-BioNTech’s COVID-19 vaccine in December of 2020, this health system led the area in vaccine administration. Prior to the emergency use authorization (EUA) of the COVID-19 vaccines, …

Effects Of Covid Prevention And Control Policies In Kentucky Schools During The Fall 2020 Semester, Ciaran Allen-Guy

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

Schools are reopening or have already reopened while implementing precautions intended to reduce the transmission of COVID-19. However, evidence on the effects of these strategies or their benefits relative to each other in the school environment is indirect or lacking. This study investigated the effects of some of these strategies as employed by Kentucky schools in the fall 2020 semester using a linear mixed effects regression model using publicly available fall 2020 school incidence data, survey data from school staff, and Kentucky Department of Education data on school faculty and primary enrollment.

An Analysis Of Rural-Urban Differences In Health Care Access Among Women In The United States, Ellery Denny

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

The purpose of this project was to examine the relationship between women’s health care access and rural and urban America. Extensive review of existing literature was completed and showed that the United States ranked last out of 11 high-income countries in regard to access to care, administrative efficiency, equity, and health care outcomes (Schneider, 2021). Additionally, women in the United States faced heightened financial barriers to health care that men do not, and also faced unique disadvantages that resulted in reduced utilization of care (Cameron, 2010, p. 1649).

Results showed that rural women were significantly more likely to have one …

Disparities In Access To Chemotherapy Among Kentucky Stage Iv Non-Small Cell Lung Cancer Patients, Joshua Brown

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

OBJECTIVE: This population-based retrospective cohort study examines the association of sociodemographic disparities with the receipt of chemotherapy among patients with metastatic non-small cell lung cancer in the Commonwealth of Kentucky in the precision oncology and immunotherapy era.

METHODS: Kentucky Cancer Registry data from 2010 through 2017 was analyzed using univariate, bivariate, unadjusted, and adjusted multivariate regressions to assess disparities in our population (N = 9490).

RESULTS:We found no significant difference in receipt of chemotherapy between sexes (OR 0.99, P=0.90) nor races (OR 1.12, P=0.22). Patients diagnosed in an Appalachia county were significantly less likely to receive chemotherapy (OR 0.71, …

Recharge Moments, Scott Keel

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

Abstract Title: Recharge Moments

Background: Recent articles from the CDC and other healthcare agencies have demonstrated the detrimental effects that the COVID-19 pandemic is having on the physical and mental health of the healthcare workforce. Unfortunately, they were less informative in regard to those working for local public health departments. Pre-pandemic and concurrent publications on mindfulness-based interventions have demonstrated the positive and protective effects mindfulness-based interventions can have on burnout prevention and resilience promotion. To gain a better understanding of how the current pandemic might be affecting the public health workforce and to assess whether mindfulness-based interventions would be helpful …

The Impact On Recovery Capital Following High-Intensity Exercise Adjuvant Therapy In Opioid Addiction Treatment, Aaron M. Macdonald

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

OBJECTIVE: The Counseling Center (TCC), a substance abuse disorder (SUD) recovery facility located in Portsmouth, Ohio, began investigating alternative treatment methods that may improve long-term recovery rates through increased recovery capital (RC). RC takes into account numerous social and physical variables during the recovery phase of SUD and evidence shows a higher RC can lead to better recovery outcomes. TCC partnered with Portsmouth Spartan Kettlebell Club (PSKC), a nearby CrossFit (CF) affiliated gym, and created a partnership that allowed clients at TCC to participate in a guided CF program. The purpose of this study was to examine how this program, …

Policy Approaches To Address Childhood Obesity, Omoadoni Roseline Obielodan

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

Background: Childhood obesity continues to be a serious international public health concern. Unfortunately, there are limited treatment options for obesity. One notable intervention option is the University of Kentucky (UK) Pediatric high BMI clinic intervention for childhood obesity. The Clinic provides intervention for childhood obesity through healthy lifestyle habits. This intervention has been reported to be effective.

Even though there is evidence that public health policies that promote healthy behaviors would substantially reduce and prevent the alarming prevalence of childhood obesity, the state of Kentucky does not have well-established practical policies that promote healthy behaviors in children. Studies have shown …

Increasing Initiations Of Communication For Students With Moderate And Severe Disabilities Using A Prompt Hierarchy, Ryan Elizabeth Queenan

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

The purpose of this study was to increase initiations of communication for high school students with moderate and severe disabilities using a prompt hierarchy in the context of environmental arrangements. A multiple probe across participants design was used to evaluate the effectiveness of implementing a prompt hierarchy with an environmental arrangement. The results showed that when using a prompt hierarchy in the context of an environmental arrangement were effective in increasing initiations of communication for high school students with moderate and severe disabilities.

Comparing Self-Delivered To Instructor-Delivered Reinforcement During Vocational Instruction For Students With Intellectual Disability Using Video Activity Schedules, Katherine Elise White

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

In this study, an adapted alternating treatments design was used to compare the effectiveness of teaching vocational task when using self-delivered reinforcement versus instructor-delivered reinforcement while using video prompting. Participants consisted of four high school students who had been diagnosed with intellectual disabilities. Results indicated that instructor delivered reinforcement was slightly more effective at teaching a vocational task for 2 of the 4 participants. The results of the other 2 participants indicated that both forms of reinforcement delivery were similarly effective.

Toxic Public Goods, Brian L. Frye

Law Faculty Scholarly Articles

Everybody loves public goods. After all, they are a perpetual utility machine. Obviously, we want as many of them as possible. But what if the consumption of a public good actually decreases net social welfare? I refer to this kind of public good as a "toxic public good." In this essay, I discuss three kinds of potential toxic public goods: trolling, pornography, and ideology, and I reflect on how we might make the production of toxic public goods more efficient.

The Multi-Level Marketing Pandemic, Christopher G. Bradley, Hannah E. Oates

Law Faculty Scholarly Articles

Among the societal effects of the COVID-19 pandemic has been a sharp rise in the activities of multi-level marketing companies (MLMs). MLMs are business enterprises in which participants seek not only to sell products to friends, family, and social media contacts, but also to recruit them as MLM participants, with the promise of "building their own business from home."

False promises often pervade MLM sales pitches. Evidence shows that few participants see even a dollar of profit from their MLM work; the vast majority of recruits quickly abandon their MLM dreams and lose their investments. Yet the pitch has become …

Covid-19, Chronic Stress, And Adolescent Mental Health, Corina Barker

DSW Capstone Projects

The COVID-19 pandemic has had an undeniable impact on adolescent mental health. Though not considered to be high risk when it comes to physically contracting the virus itself, adolescents have shown to be significantly impacted by the indirect effects of the pandemic. Because of the unique and formative time, this is in their lives, adolescents are already vulnerable to the impact of social stressors. Risk factors associated with the COVID-19 pandemic such as social isolation, disruption in routine, uncertainty, fear, and chronic stress have all proven to have a profound negative impact on adolescent mental health and overall well-being. It …

Self-Care And Cultural Humility: Expanding The Practice Of Social Work Leaders, Donia Addison

DSW Capstone Projects

Social workers experience vicarious trauma, secondary traumatic stress, and compassion fatigue regularly. Well documented in the literature, self-care has the ability to assuage these negative consequences, as well as, positively impact retention rates, decrease burnout and increase the quality of services provided to clients. Despite a burgeoning of research on self-care and burnout over the last few decades, continued empirical research is necessary. This capstone project sought to add to the knowledge base on self-care and provide pragmatic recommendations for future research and social work practice.

This capstone project was comprised of three scholarly products and focused on fostering cultural …

The Impact Of Bias And Historical Racial Trauma On Black Girls’ Education: Using Theory To Better Understand Benefits, Angela Fisher-Williams

DSW Capstone Projects

ABSTRACT OF CAPSTONE

Implicit biases are among the most unfair discriminating microaggressive habits; Black students face within the compulsory educational system. However, college institutions are not sufficiently preparing social work students to work with this marginalized group to help manage these needs through diversity training courses. The researcher wrote a synthesis paper that synthesized two theories, the Critical Race Theory (CRT) and Post Traumatic Slave Syndrome (PTSS). This research will determine if social work students who take part in diversity training embedded in their coursework could better prepare social workers for the field. This research employed a descriptive design while …

Vicarious Trauma In The Black Community Due To Police Brutality And Aggressive Policing: How Social Work Clinicians Can Understand And Mitigate The Problem, Sharrion Brown

DSW Capstone Projects

Police brutality and aggressive policing impacts the Black community. Social media and new outlets allow visuals of police brutality and aggressive policing to be shared rapidly. This form of second-hand exposure can cause trauma. The purpose of this study is to explore the adverse mental health outcomes in the Black community due to police brutality and aggressive policing and find ways that social work clinicians can understand and mitigate the problem. This study was conducted because when Black people seek therapeutic services, they are often met with clinicians who invalidate their racial trauma and racial experiences due to second-hand exposure …

Evaluating The Use Of A Diet Screening Tool For Diabetes And Weight Management In Primary Care, Christie Mcbride

DNP Projects

Background: Type 2 diabetes mellitus is a prominent disease and leading cause of death in the nation. Many complications can develop when glucose levels are poorly controlled. When patients receive education and support in diabetes self-management, including individualized dietary interventions, it leads to improved glycemic control.

Purpose: The purpose of this quality improvement (QI) project was to evaluate the incorporation of a diet recall tool, Starting the Conversation (STC), in the standard care for diabetic patients with abnormal body mass index (BMI). The study aimed to examine: (1) patient opinion of the intervention and (2) healthcare provider satisfaction with use …

The Isolated As The Revolutionary: How “Leftover” Men In China Challenge Heteronormativity, Ruwen Chang

Theses and Dissertations--Gender and Women's Studies

In contemporary China, demographers estimate that 30 million men are single because there are simply not enough women in the Chinese population, and the 2020 Chinese census shows that there are 34.9 million more men than women. These men are called guanggun, which can be directly translated to “bare sticks/branches,” a slur that indicates a lack of marriage and sex. In this project, I demonstrate that guanggun’s singlehood marks them as the marginalized at the intersection of heteronormativity, patriarchy, globalizing capitalism, and pronatalist governmentality. In a highly heteronormative and patrilineal culture, guanggun are branded as abnormal/incomplete. However, because …

An Electrochemical, Fluidic, Chip-Based Biosensor For Biomarker Detection, Lauren Bell

Theses and Dissertations--Biomedical Engineering

Biosensors and their use in both the research and clinical field for the detection and monitoring of critical biomarkers are prevalent and constantly improving. However, continued research needs to be done to address shortcomings, such as low sensitivity, poor specificity, and poor readiness for integration into research use and patient care. The objective of this research was to create a combined fluidic, chip-based biosensor that could detect different biomarkers with high sensitivity and ease of use. For assessing the developed sensor, three separate biomarkers were tested: glucose, cholesterol, and oxygen. Both the glucose biosensor and cholesterol biosensor were combined with …

Characterizing The Internal Porous Structure Of Equine Proximal Sesamoid Bones Subjected To Race Training Using Fast Fourier Transforms, Joseph Erik Davis

Theses and Dissertations--Biomedical Engineering

The equine racing industry is one of the main proponents in Kentucky’s economic infrastructure. In this industry there has come a need to investigate the nature of the proximal sesamoid bone (PSB). Breakdowns involving the PSBs are the leading cause in racehorse deaths in the industry, with still little known about what causes this bone to fracture. This study seeks to shed insight by investigating the internal structure of the PSB. Using microCT scanning, the internal porous structure was captured. From there, noticeable differences in the pores were noticed and quantified using fast Fourier transform (FFT) analysis.

The dominant peak …

Sewer Vapor Intrusion Pathway: Simulation Of Indoor Piping Systems And Operation Of Aroma-Voc Gas Analyzer, Hong Cheng Tay

Theses and Dissertations--Civil Engineering

Vapor Intrusion (VI) is a transport phenomenon that occurs when contaminants migrate from sub-surface sources into indoor spaces. Sewer tunnels, plumbing connections, and piping infrastructures can be important contributors to an increased potential of VI in a site, which results in indoor concentrations of volatile organic compounds (VOC). In the present work, the topic of sewer VI pathways were investigated through a prototype made from various types of indoor plumbing pipe fittings. This prototype simulates indoor piping systems and determine whether air and VOC were escaping through the pipe fittings. Moreover, this study is the first effort to use a …

Investigation Of Pfas Exposure Risks In Kentucky Using Mapping Tools, Sweta Ojha

Theses and Dissertations--Civil Engineering

Per- and polyfluoroalkyl substances (PFAS), a group of environmentally-persistent compounds, are environmentally ubiquitous and challenging to remediate. Several studies show that PFAS are detected in drinking water systems when sampling is conducted, making human exposure via drinking water an important health consideration. This research: 1) develops a mapping tool for prioritizing sampling locations; 2) establishes a method for making GIS data and meta(data) in the mapping tool accessible; 3) fosters decision making by integrating knowledge brokering and the alignment interest and influence matrix (AIIM). The tool developed is this research is a geospatial and statistical PFAS hot-spot screening model that …

Green-Route Synthesis Of Halide Perovskite Materials And Their Optoelectronic Properties, Xiaobing Tang

Theses and Dissertations--Chemical and Materials Engineering

Colloidal semiconductor quantum dots (QDs), also called as nanocrystals (NCs), are a class of functional materials with extraordinary properties, which are different from their bulk counterparts and benefit from their exclusive quantum confinement (size) effect. Semiconductor exhibits the quantum confinement effect when the characteristic size of the semiconductor is comparable to or smaller than the de Broglie wavelength of the electron wave function and/or the exciton Bohr diameter of the bulk semiconductor. In recent years, metal halide perovskite NCs, as next-generation semiconductor materials for lighting and display, have aroused a wide attention due to their excellent optoelectronic properties. However, traditional …

Warriors, Mothers, And Queens: Weighty Women Of Myths And Legends, Betsy Packard

Theses and Dissertations--English

Because traditional stories, myths, and legends have a patriarchal orientation, often portraying women as negative or weak characters, post-modern literary criticism calls for a feminist response. These poems are written in the genre of feminist revisionist mythology. Through the medium of poetry, women in these stories are provided with voices outside of the previously accepted patriarchal framework and challenge the exclusionary theories of Joseph Campbell. The stories are told through a perspective informed by feminist theory.

The Reflective Age: Nostalgia At The End Of History, Zachary Griffith

Theses and Dissertations--English

This project investigates the ways in which nostalgic American media of the last decade reflects the sociopolitical conditions of the end of history. It begins with the assertion that the end of history represents a confounded, contradictory moment in which large-scale political change is relatively scarce, and belief in a progressive future has largely been abandoned, while cultural change has also accelerated at a pace never before seen––spurred on, in particular, by the constant return of dead styles and dormant IP. In other words, it seems as if nothing is changing and everything is changing simultaneously. The recent boom in …

Gorgeous Gorgeous Girls, Chioma Ezeano

Theses and Dissertations--English

Gorgeous Gorgeous Girls is a feminist collection. These are short stories that circumnavigate the peculiarities of Nigerian women. Each story takes a specific lens into the lives of the average Nigerian women, their daily survivals, their daily struggles—how these women examine life and existence. Through these variegated means, the stories ponder how societal ideologies, societal demands affect these women, especially the average Nigerian woman living beyond the poverty threshold. Each character wrestles, questions what it means, what it takes to survive struggles. They interrogate sexuality, mental health, immigration, capitalism, what it means to be a full human, people capable of …