Digital Commons Network^™

Evaluation Of Barriers For Small-Scale Fruit And Vegetable Growers In Kentucky, Amanda Schroeder Hege

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

The food system in the United States has witnessed significant challenges resulting in food security and safety concerns, environmental damage, economic distress, and a decline in our population’s health. While the last fifty years showed a drop in land and workforce dedicated to farming, industrialized farms are producing an overabundance of cheap corn that directly supplies inexpensive, unhealthy foods leading to American’s diets falling short of recommendations for good health, thus contributing to the obesity epidemic. This study utilizes an upstream approach to learn from farmers’ ability to grow good food that promotes healthy people, environments, and communities. Specifically, the …

The Relationship Between Access To Healthcare And Heart Disease Mortality In Kentucky, 2012-2014, Nima Farsi

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

Cardiovascular disease is the cause for a large portion of the mortalities in the United States. Furthermore, Kentucky has one of the highest heart disease mortality rates out of all 50 U.S. States. This study hypothesized that heart disease mortality in Kentucky counties has a positive relationship with lack of accessibility to healthcare. Furthermore, this ecological study hypothesized that because there is no available usual source of a healthcare providers and ultimately a lack of accessibility to receive diagnostic/preventative services for this population, the high rate of cardiovascular disease mortality in Kentucky is dependent on access to healthcare services.

This …

A Policy Analysis Of The Kupuna Caregivers Act: Addressing The Needs Of Working Caregivers In Hawaii, Emily S. Mccarthy

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

The primary purpose of this paper was to provide a policy analysis of the Kupuna Caregivers Act that was passed at the end of 2017 in Hawaii. This legislation provides a $70 daily voucher that working caregivers can use to hire long-term care services for their elderly loved ones. This type of assistance allows caregivers to stay in the workplace, alleviates the stress of caregiving, and assists them in securing their own financial futures. The number of people over the age of 65 will double in size over the next forty years, presenting a variety of long-term care challenges in …

Implementing The National Diabetes Prevention Program In Mason County, Kentucky, Cassandra Yelton

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

The National Diabetes Prevention Program (DPP) is sponsored by the Centers for Disease Control and Prevention (CDC). The program’s goal is to reduce the incidence of diabetes through dietary modification and physical activity. On one hand, the DPP is currently offered by various organizations through the country. On the other hand, the DPP is mostly unavailable in rural areas, especially the Diabetes Belt. The Diabetes Belt is in the eastern Appalachian region of the United States. People who live in this area of the country are more likely to develop diabetes than those who do not. Mason County, Kentucky has …

Wayne County Board Of Education Adaptation Of Love Notes Curriculum For Adolescent Pregnancy Prevention, Allison Shea Merritt

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

West Virginia has the 8^th highest rate of adolescent pregnancy in the United States and the rate in Wayne County is significantly higher. Adolescent pregnancies cause negative health outcomes for both the baby and the mother. Adolescent mothers are at an increased risk of anemia, preeclampsia, and preterm labor and babies born to adolescent mothers are more likely to have a low birth weight and to have cognitive impairment. To address this burden, the school board has decided to use the ADAPT-ITT framework on the evidence-based Love Notes adolescent pregnancy prevention curriculum to adapt it to be more culturally …

Reducing Stigma Associated With Mental Illness And Mental Health Treatment Services In Racial And Ethnic Minority College Students, Joseph Christodoulou

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

Depression and Suicide

Mental health is a determining factor in how individuals function throughout their daily lives, encompassing an individual’s physical, emotional, and social well-being (U.S. Department of Health and Human Services, 2013). Mental illnesses such as depression, hinder daily functioning and lead to a range of negative outcomes. These include increased risk of mortality from suicide, chronic diseases such as heart disease, other conditions/behaviors such as anxiety and substance use disorders, and high economic burden (Centers for Disease Control and Prevention, 2016b). Depression is a major contributor to disability and burden of disease in the U.S., contributing to 3.7% …

Prospective Policy Analysis Of The Kentucky Health Demonstration Waiver, Keahna Akins

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

In January 2018, the Centers for Medicare & Medicaid Services approved Kentucky’s Section 1115 Medicaid demonstration waiver, which gave the state approval to require work/community engagement as a condition of Medicaid eligibility, charge premiums of up to 4% household income, and add an incentive account for dental and vison services. The waiver projected nearly 100,000 fewer enrollees and $2.4 billion less in spending over the five-year demonstration period. Two days short of the waiver July 1st implementation date a federal judge ruled the waiver invalid. This finding held that the Health and Human Services Secretary’s judgement was arbitrary and capricious. …

The Effect Of Rescheduling Of Hydrocodone On Prescription Writing Among University Of Kentucky Dentists, Robert Taylor

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

Opioid abuse has become a public health crisis over the last two decades. Hydrocodone is the most frequently prescribed opioid to patients whose deaths are related to prescription drug abuse. On October 6, 2014, Federal law changed hydrocodone, an opioid-based analgesic, from Schedule III to Schedule II. This limits the number of ways it can be prescribed, including eliminating refills. This study examined hydrocodone and oxycodone prescriptions written across all dental clinics associated with the University of Kentucky College of Dentistry and analyzed three different dental disciplines that perform procedures that require pain management. Prescription data was obtained through axiUm, …

Impact Of The School Health Innovations Grant Act On Healthcare Access, Outcomes, And Cost In The District Of Columbia, Robert West

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

This paper provided a prospective policy analysis of the Washington, D.C. School Health Innovations Grant Act. This act establishes a grant program to facilitate the formation of school-based telehealth centers to provide mental health services to District school children. The purpose of this act is to improve access to mental health services for children, especially children in disadvantaged populations, such as those low-income, predominantly African American neighborhoods in eastern Washington, D.C., where a high burden of need is compounded by a shortage of health professionals.

This analysis was guided by the Bardach framework of policy analysis. The various factors affecting …

Bronchiolitis In The Bluegrass: Epidemiology, Disease Burden And Resource Utilization At Kentucky Children’S Hospital, Ashwin Krishna

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

Background: Every year Kentucky Children’s Hospital (KCH) admits infants and toddlers with respiratory disease due to viral bronchiolitis. This disease is characterized by viral-induced inflammation and edema of the lower airways. The resulting disease is characterized by increasing mucus production, acute bronchospasm, necrosis of the respiratory epithelium and functional obstructive lung disease. Patients usually present with symptoms consistent with an upper respiratory tract infection, but can progress to marked respiratory distress and ultimately respiratory failure, as well as poor oral intake and dehydration. While Respiratory Syncytial Virus (RSV) is the pathogen classically described cause of viral bronchiolitis, other viruses have …

Commercial Driver License Examinees’ Misreport On Their Federal Motor Carrier Safety Administration Certification Evaluation, Adam Pascoe

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

Commercial Driver’s License (CDL) examinees report their medical history during their Federal Motors Carriers Safety Administration (FMCSA) medical certification exams ≤2 years. When the examinees report diagnoses which may impact the control and operation of commercial motor vehicles (CMV), they face scrutiny with decreased medical certification or may be Adam PascoePascoe Page 2 7/18/2018 considered unfit to control and operate a CMV. Medical examiners may have access to the examinees’ electric medical records (EMRs) to generate a deeper appreciation, independent from the examinees’ self-report, of their risk for sudden and/or gradual incapacitation. We do not know how often diagnoses are …

Unending Mazes: Gendered Inequalities, Drug Use, And State Interventions In Rural Appalachia, Lesly-Marie Buer

Theses and Dissertations--Anthropology

Prescription opioids are associated with rising rates of overdose deaths and hepatitis C and HIV infection in the US, including in rural Central Appalachia. Yet there is a dearth of published ethnographic research examining rural opioid use. The aim of this dissertation is to document the gendered inequalities that situate women’s encounters with substance abuse treatment as well as additional state interventions targeted at women who use drugs. These results are based on ethnographic fieldwork completed from 2013 to 2016 and centered around one county seat in rural Central Appalachia. Data are ascertained through semi-structured interviews with women who have …

Things Fall Apart: The Determinants Of Military Mutinies, Jaclyn M. Johnson

Theses and Dissertations--Political Science

Military mutinies are occurring more frequently in the last two decades than ever before. Mutinies impact every region of the world. Given that they are occurring more frequently, impact every region, and often have disastrous implications, scholars must answer the foundational question: why do mutinies occur? What are the proximate domestic conditions that give rise to military mutinies? This project makes three contributions. First, I set out to formally define mutinies and collect a new dataset that will allow scholars to examine mutinies empirically. Second, I present a theoretical framework that explains when and why mutinies will occur. Finally, I …

Fintech's Double Edges, Christopher G. Bradley

Law Faculty Scholarly Articles

The pace of change in financial technologies has quickened due to the rapid advances in technology from the late 1990s through today, exemplified by the advance of handheld devices and applications and the pervasiveness of the Internet in every facet of commerce. New financial technologies--commonly identified by the portmanteau "FinTech" or "fmtech"--have already reshaped many commercial practices that affect businesses and consumers, and they are likely to change many more.

The increasing availability and sophistication of FinTech offers both promises and perils. Artificial intelligence-driven algorithms purport to improve access to credit on "objective" criteria but may sometimes reinforce longstanding discriminatory …

The Sharpest Tool In The Toolbox: Visual Legal Rhetoric, Michael D. Murray

Law Faculty Scholarly Articles

Visual briefs and other forms of visual rhetoric in legal communication may eventually become the norm in legal practice because of the enormous communicative and rhetorical power of visual media. I have discussed the uses of visual legal rhetoric and the ensuing ethical and professional considerations elsewhere. Here, I will focus on providing instruction to law students and lawyers regarding proper and effective usage of visual legal rhetoric.

Reducing Depression And Suicide Ideation Among College Students, Andrew Ritzel

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

Suicide rates have been on the rise for the past 30 years; 42,773 Americans dying every year by suicide. Suicide is the tenth leading cause of death among all ages, but the second leading cause of death among Americans ages 15-24. College students traditionally fall within this age group, and are especially at risk for suicide due to stressful life conditions. The University of Kentucky, located centrally within Kentucky in the city of Lexington, is an ideal location for a suicide prevention intervention. Students demonstrated an increased rate of depression compared to the national population (15.13% of students surveyed reported …

Evaluating The Attitudes And Practices Of Exercise Prescription Among Psychotherapists, Igor Vasilj

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

Exercise has been shown to improve mood, anxiety, stress, and promote neuroplasticity (Conn, 2010; Donaghy, 2007; Josefsson, Lindwall, & Archer, 2014; Silveria et al., 2013; Stathopoulou et al., 2006). However, limited research on the topic suggests that many psychologists and mental health providers are not incorporating exercise into psychological treatment, and many lack the confidence to do so (Burton, Pakenham, & Brown, 2010; Weir, 2011). The purpose of this study was to evaluate current exercise prescription trends among practicing psychologists and trainees, including identifying their current beliefs, attitudes, training, and the perceived barriers hindering psychotherapists from recommending and prescribing exercise. …

Multimodal Noncontact Diffuse Optical Reflectance Imaging Of Blood Flow And Fluorescence Contrasts, Daniel Irwin

Theses and Dissertations--Biomedical Engineering

In this study we design a succession of three increasingly adept diffuse optical devices towards the simultaneous 3D imaging of blood flow and fluorescence contrasts in relatively deep tissues. These metrics together can provide future insights into the relationship between blood flow distributions and fluorescent or fluorescently tagged agents. A noncontact diffuse correlation tomography (ncDCT) device was firstly developed to recover flow by mechanically scanning a lens-based apparatus across the sample. The novel flow reconstruction technique and measuring boundary curvature were advanced in tandem. The establishment of CCD camera detection with a high sampling density and flow recovery by speckle …

Assessment Of Watershed Nutrient Loads And Effectiveness Of Best Management Practices, Saeid Nazari

Theses and Dissertations--Civil Engineering

Several methods have been developed for use in estimating the water quality loads associated with urban and agricultural landuses and practices. These include the use of sophisticated computer models, typically based on using pollutant loading and runoff functions, regression equations, load export coefficients (LECs), and event mean concentrations (EMCs). This research has examined the feasibility of using a simple EMC approach with the Kentucky Nutrient Model (KYNM). The thesis includes an extensive literature review of EMCs and a synthesis of recommended values for a range of typical urban and agricultural landuses. The thesis also includes an extensive literature review of …

Preferential Pathways For Vapor Intrusion: Site Screening And Field Sampling Of Sewers To Assess Inhalation Exposure Risks, Evan James Willett

Theses and Dissertations--Civil Engineering

Hazardous waste sites and aging wastewater infrastructure are common in the United States. There are hundreds of thousands of contaminated sites and more than a million miles of sewer pipes. Populations living close to hazardous waste sites often suffer from increased risk of adverse health effects due to exposure to contaminated environmental media. Vapor intrusion is one process by which nearby populations can be exposed to volatile organic compounds (VOCs). Aging wastewater infrastructure is important for vapor intrusion site assessments because sewer pipes can serve as preferential vapor transport pathways. Near contaminated sites, pipe deterioration allows migration of contaminants into …

Numerical Modeling And Isotope Tracers To Investigate Karst Biogeochemistry And Transport Processes, Admin Husic

Theses and Dissertations--Civil Engineering

This dissertation investigated the physical and biogeochemical processes affecting the source, fate, and transport of sediment, carbon, and nitrogen within a highly-coupled fluviokarst system. Elemental and isotopic datasets were collected at surface and subsurface locations for both dissolved and particulate contaminant phases, new methodology regarding data collection was presented to the karst research community, an in-cave sediment transport model coupling physical transport with elemental and isotopic mass balances of carbon and nitrogen was formulated, pathway and process control on nitrate leaching from agricultural karst watersheds was assessed, and nitrate mobilization and fractionation were modeled using high frequency storm sampling and …

Understanding Inhibition Of A Biodesulfurization Enzyme To Improve Sulfur Removal From Petroleum, Yue Yu

Theses and Dissertations--Chemical and Materials Engineering

The biodesulfurization 4S-pathway is a promising complementary enzymatic approach to remove sulfur from recalcitrant thiophenic derivatives in petroleum products that remain from conventional hydrodesulfurization method without diminishing the calorific value of oil. The final step of this pathway involves the carbon-sulfur bond cleavage from HBPS, and the production of the final products 2-hydroxybiphenyl (HBP) and sulfite, has been recognized as the rate-limiting step, partially as a result of product inhibition. However, the mechanisms and factors responsible for product inhibition in the last step have not been fully understood. In this work, we proposed a computational investigation using molecular dynamic simulations …

Modeling And Mapping Location-Dependent Human Appearance, Zachary Bessinger

Theses and Dissertations--Computer Science

Human appearance is highly variable and depends on individual preferences, such as fashion, facial expression, and makeup. These preferences depend on many factors including a person's sense of style, what they are doing, and the weather. These factors, in turn, are dependent upon geographic location and time. In our work, we build computational models to learn the relationship between human appearance, geographic location, and time. The primary contributions are a framework for collecting and processing geotagged imagery of people, a large dataset collected by our framework, and several generative and discriminative models that use our dataset to learn the relationship …

“I Thought I Found Home”: Locating The Hidden And Symbolic Spaces Of African American Lesbian Belonging, Aretina Rochelle Hamilton

Theses and Dissertations--Geography

This dissertation investigates the place-making practices of African American lesbians in Atlanta, Georgia, from 1990 to 2010. For this project, I ask how African American lesbians claim space to examine how race, sexuality, and class shape their place-making practices. The study is situated in the city before and following the 1996 Olympic Games, which was a period of rapid social, economic, and political growth.

The primary question posed in this study is as follows: How do African American lesbians claim space in Atlanta? This dissertation posits three arguments. First, African American queer spaces are transitory, reflecting the shrinking boundaries of …

“One More Way To Sell New Orleans”: Airbnb And The Commodification Of Authenticity Through Local Emotional Labor, Ian Spangler

Theses and Dissertations--Geography

Since 2014, Airbnb has been the poster-child for an impassioned debate over how to best regulate short-term home rentals (STR’s) in New Orleans, Louisiana. As critical perspectives toward on-demand economic practice become increasingly common, it is important to understand how the impacts of STR platforms like Airbnb extend beyond the realm of what is traditionally conceptualized as the economic (i.e., pressure on housing markets). In this thesis, I explore the ways in which Airbnb recalibrates the spatial and temporal rhythms of everyday neighborhood life for people external to the formal trappings of an STR contract. Drawing in particular on theories …

Financial Inclusion In The City: Examining The Democratization Of Finance In Boston, Massachusetts, Jessa M. Loomis

Theses and Dissertations--Geography

This doctoral dissertation examines how the financialization of the economy affects the everyday lives of low and moderate-income (LMI) urban residents in the United States. Specifically, the research presented in this dissertation provides a critical examination of the democratization of finance by examining financial empowerment programs designed to promote financial inclusion for LMI residents in Boston, Massachusetts. These programs were created in the wake of the financial crisis to promote financial security by training participants to manage their debt, to monitor their credit scores, to avoid predatory lending, and to invest using mainstream financial products.

This research has two significant …

La Representación De Los Ecuatorianos En España: El Discurso Como Expresión De Poder, Racismo E Ideologías, Francesco Masala

Theses and Dissertations--Hispanic Studies

This dissertation focuses on the representation of Ecuadorians in Spain between 2000 and 2015 in literature, film and the press. After enduring a decade of economic, climatic, and political problems, more than 175,000 Ecuadorians emigrated to Spain in 2001 alone (Herrera 2005). This process marked the beginning of a major migratory movement which has caused Spain to become a premier destination. The response to such migration has been disparate, yet both Ecuadorian and Spanish artists as well as the Spanish press have shown the different perspectives related to a discriminatory ideology. This dissertation focuses on three cultural products and three …

#Hashtags: A Look At The Evaluative Roles Of Hashtags On Twitter, Leah Rose Schaede

Theses and Dissertations--Linguistics

Social media has become a large part of today’s pop culture and keeping up with what is going on not only in our social circles, but around the world. It has given many a platform to unite their causes, build fandoms, and share their commentary with the world. A tool in helping group posts together or give commentary on a thought is the hashtag. In this paper I explore the evaluative roles of hashtags in social media discourse, specifically on Twitter. I use a sample of randomly selected tweets from the Twitter API stream I collected and compiled myself. I …

Pragmatic Functionality Of Punctuation On Twitter, Elizabeth M. Wright

Theses and Dissertations--Linguistics

This work presents an analysis of punctuation use in computer-mediated communication (CMC); in particular, the present study aims to describe the pragmatic functions of nonstandard punctuation on Twitter, providing a corpus-driven overview of the distribution and frequency of nonstandard punctuation use, and an analysis of sampled tweets at the individual tweet level to estimate noise levels in the overall corpus. A survey was also conducted which aimed to identify user understanding of the affective content of nonstandard punctuation strings and to identify any possible effects of character repetition. Survey results indicate that linguistic content was the strongest indicator of affective …

Itexts: Techxtual Poetics, Authorship And Re-Wreaders In 21St-Century Spanish Literature, Joshua M. Hoekstra

Theses and Dissertations--Hispanic Studies

In 2007, Nuria Azancot published an article in the magazine El Cultural in which she identified a burgeoning group of Spanish writers that she referred to as the “Nocilla Generation.” The catalyst behind the article was a literary reunion that took place weeks before in Seville and brought together authors from all parts of Spain to talk about the status and future of writing. She described them as “transgressors” and “bloggers” who hybridized literary genres and held a revolutionary approach to the literary that was clearly marked by the Internet. Numerous articles and dissertations have since highlighted the impact that …