Digital Commons Network^™

Test Of A Workforce Development Intervention To Expand Opioid Use Disorder Treatment Pharmacotherapy Prescribers: Protocol For A Cluster Randomized Trial, Todd Molfenter, Hannah K. Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Mark Van Etten, Jee-Seon Kim, Eric Haram, Elizabeth Collier, Sanford Starr, Alexander Toy, Lynn Madden

Behavioral Science Faculty Publications

Background: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations’ efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications. Historically, the addiction treatment field has not attracted physicians, and many barriers to implementing OUD pharmacotherapy exist, ranging from lack of confidence in treating OUD patients to …

Leadership For Public Health 3.0: A Preliminary Assessment Of Competencies For Local Health Department Leaders, Emmanuel D. Jadhav, James W. Holsinger Jr., Billie W. Anderson, Nicholas Homant

Health Management and Policy Faculty Publications

Background: The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize …

Review Of Project Development Practices And Project Management Resources At State Transportation Agencies, Christopher Van Dyke, Bryan Gibson, Jeff Jasper, Doug Kreis

Kentucky Transportation Center Technical Assistance Report

At the Kentucky Transportation Cabinet’s (KYTC) Department of Highways, project development encompasses all the work activities needed to move a transportation project from concept and project initiation to construction letting. Developing projects efficiently requires the adoption of sound project management practices. And having recourse to validated project development practices is critical for helping KYTC project managers negotiate the variety of tasks and processes leading up to project implementation and delivery. For a project manager to be successful, they must possess a holistic understanding of how the complex interplay of engineering, environmental, and economic issues affect different stages and facets of …

Crowd-Sourcing The Smart City: Using Big Geosocial Media Metrics In Urban Governance, Matthew Zook

Geography Faculty Publications

Using Big Data to better understand urban questions is an exciting field with challenging methodological and theoretical problems. It is also, however, potentially troubling when Big Data (particularly derived from social media) is applied uncritically to urban governance via the ideas and practices of “smart cities”. This essay reviews both the historical depth of central ideas within smart city governance —particular the idea that enough data/information/knowledge can solve society problems—but also the ways that the most recent version differs. Namely, that the motivations and ideological underpinning behind the goal of urban betterment is largely driven by technology advocates and neoliberalism …

Clinical Performance Measures And Quality Improvement System Considerations For Dental Education, Joseph W. Parkinson, Gregory G. Zeller

Oral Health Practice Faculty Publications

Quality improvement and quality assurance programs are an integral part of providing excellence in health care delivery. The Dental Quality Alliance and the Commission on Dental Accreditation recognize this and have created standards and recommendations to advise health care providers and health care delivery systems, including dental schools, on measuring the quality of the care delivered to patients. Overall health care expenditures have increased, and the Affordable Care Act has made health care, including dentistry, available to more people in the United States. These increases in cost and in the number of patients accessing care contribute to a heightened interest …

Bridging Public Health And Clinical Practice: A Pilot Of The Cdc’S Stopping Elderly Accidents, Deaths, And Injuries (Steadi) Fall Risk Screening And Prevention Program In An Academic Medical Center Family And Community Medicine Clinic, Carolyn C. Shammas

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

Background: Fall-related morbidity and mortality in the older adult population is a pressing public health problem both nationally and in Kentucky, which has a fall rate above the national average. Implementation of the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall prevention program, offers an opportunity to effectively reduce falls, fall-related injuries and associated costs. The implementation process also serves to foster cooperative interdisciplinary and interdepartmental relationships within health care systems, and bridge public health and clinical practice.

Purpose:The capstone describes and evaluates a pilot of STEADI at the University of Kentucky’s Family and Community Medicine (UKFCM) …

Managers' Network Change And Their Promotability During A Merger, Wookje Sung

Theses and Dissertations--Management

I investigate whether cross-functional or cross-organizational networking following a large corporate merger and acquisition improves managers’ career outcomes. Previous research on networks and career success has focused on stable organizational environments, finding that large, open networks with many structural holes are most advantageous because of superior information benefits and control power, while closed networks provide redundant information that is unhelpful career-wise. However, I suggest that while dense, closed networks formed within knowledge (functional) or identity (legacy organization) boundaries might be detrimental to executives’ future promotability, closed networks are helpful if they are created across those boundaries. These ties help to …

How Organizational Turbulence Shapes The Broker Vision Advantage, Jesse Fagan

Theses and Dissertations--Management

Research on social networks has established that those who bridge the gaps between dense social groups (i.e. structural holes) are granted a “vision advantage” compared to those who are embedded in dense groups. A common explanation for the advantage is that bridging a structural hole provides the broker with access to diverse information. What is less clear is how this process performs when the organizational context is turbulent. I propose that in a turbulent organizational context, when the organization is experiencing dramatic changes, employees benefit less from building a repertoire of diverse information and instead benefit more from adopting socially …

Introduction Of A Comprehensive Modified Early Warning Scoring System In A Large Rural Hospital, Beth A. Meade

DNP Projects

PURPOSE: To develop and test a comprehensive modified early warning scoring (MEWS) system for use on two medical-surgical-telemetry units in a large rural hospital in northeastern Kentucky; to educate and train nursing staff in utilization of a new MEWS system and early identification and management of clinical deterioration; and to determine nursing satisfaction regarding education, training, and use of a new MEWS system.

BACKGROUND: Adult medical-surgical patients are at risk for clinical deterioration. Rapid response systems and MEWS systems are strategies that have been employed to assist nursing staff in early identification and management of clinical deterioration. Testing of a …

Behavioral Deficits Across Development In A Novel Mouse Model Of Fetal Ethanol Effects, Andrew B. Hawkey

Theses and Dissertations--Psychology

Fetal Alcohol Spectrum Disorders (FASD) are a spectrum of anatomical, developmental and neurobehavioral impairments resulting from ethanol (ETOH) exposure during fetal development. Efforts to develop and screen novel pharmacotherapies against fetal ETOH effects depend heavily upon rodent models to provide indicators of the safety and efficacy of such compounds, in addition to helping better understand the underlying mechanisms to develop and test these pharmacotherapies. The following experiments describe the development of a novel mouse model of FASD using behavioral batteries to assess behavioral or cognitive deficits in juvenile and adolescent offspring (Experiment 1, Experiment 2) and whether deficits with this …

Determined To Make A Difference: A Qualitative Study Of College Women Student Leaders, Heather Yattaw Wagoner

Theses and Dissertations--Educational Policy Studies and Evaluation

While research has grown related to the experiences of gender and leadership in the workplace, little research exists on the experiences of gender and leadership in collegiate student organization settings. This study explores the experiences of college women holding executive leadership roles in highly visible on-campus registered student organizations. More specifically, the study seeks understanding of how social role expectancies interfaced with the women’s perceptions and experiences as college leaders.

Data were generated with undergraduate women leaders at a large, public research institution in the southeast during the fall of 2014 using qualitative methods including individual interviews, group interviews, and …

Evaluating The Quality Of Online Courses Within The Kentucky Community And Technical College System (Kctcs), Kevin R. Dunn

Theses and Dissertations--Educational Leadership Studies

The purpose of this exploratory, multi-phased iterative study was to explore the extent to which Kentucky Community and Technical College (KCTCS) faculty utilize quality standards during the design and continuous improvement of their online courses. The study also explored how leadership supports quality online instruction. More specifically, this study sought (a) to determine to what degree KCTCS quality assurance rubrics aligned with national quality standards, (b) to what degree did faculty use quality standards to design, develop, and improve courses, (c) to what role did KCTCS leadership play in ensuring course quality, (d) to examine the quality of KCTCS online …

Enhancing The Culture Of Professional Learning In A High Performing School, Ann Elizabeth Ingram

Theses and Dissertations--Educational Leadership Studies

Essential transformations within a school culture that ensure organizational learning take place at the individual, group, and organizational levels. With the recent implementation of the Teacher Professional Growth and Effectiveness System, Kentucky teachers have experienced change in their organization, but may have not yet changed their professional practice. This recently revised framework for teacher evaluation requires teachers to reflect on their practice, create professional growth plans, seek opportunities for professional development, set goals for student academic growth, analyze student progress, and participate in observations conducted by a peer and their principal. The framework for teachers centers on the belief that …

Applying Community-Based Participatory Research Partnership Principles To Public Health Practice-Based Research Networks, Nancy L. Winterbauer, Betty Bekemeier, Lisa Vanraemdonck, Anna Goodman Hoover

Preventive Medicine and Environmental Health Faculty Publications

With real-world relevance and translatability as important goals, applied methodological approaches have arisen along the participatory continuum that value context and empower stakeholders to partner actively with academics throughout the research process. Community-based participatory research (CBPR) provides the gold standard for equitable, partnered research in traditional communities. Practice-based research networks (PBRNs) also have developed, coalescing communities of practice and of academics to identify, study, and answer practice-relevant questions. To optimize PBRN potential for expanding scientific knowledge, while bridging divides across knowledge production, dissemination, and implementation, we elucidate how PBRN partnerships can be strengthened by applying CBPR principles to build and …

Change Is Conflict: Exploring Relationships Between Preferred Cognitive Styles And Conflict Management Styles Of University Administrators At A Large Flagship University, Sandra L. Gillilan

Theses and Dissertations--Educational Leadership Studies

As pressures continue for colleges and universities to find new ways of doing business, the calls for change heighten and the potential for conflict ensues. The purpose of the research study was to explore change as conflict via an exploration of organizational change related to preferred cognitive style, as measured by the Kirton Adaption-Innovation (KAI) instrument, and conflict management style, as measured by the Rahim Organizational Conflict Inventory-II (ROCI-II) instrument. The two instruments were administered to 72 university administrators at a large flagship university. The results indicate that the preferred cognitive style of university administrators is not significantly different from …

Traditional Liberal Arts Colleges' Consideration And Adoption Of Online Education: A Presidential Perspective, Ericka T. Hollis

Theses and Dissertations--Education Sciences

National research studies have indicated that students are enrolling in more online courses annually (Allen & Seaman, 2010, 2014, 2015); yet, not all higher education institutions are adopting online education. In order to understand more about adoption of online education in higher education and presidents’ perceptions of online education, this study investigated the adoption of online education by traditional liberal arts colleges(TLACs). These institutions and their presidents currently face numerous challenges and threats as TLACs try to remain relevant in the 21st century while maintaining their liberal arts mission. The importance of this study lies in the realization that many …

Impact Of Health Information Technology Patient Education With "Teach-Back" On Patient Satisfaction And Hospital Readmissions, Judi Dunn

DNP Projects

Background: With the advances in medical care, patients are being asked to manage more complicated self-care regimens, and there is often a gap between what the nurse teaches and what the patient understands. This can lead to re-hospitalizations that are burdensome for patients and are costly to the American healthcare system. The Department of Health and Human Services (DHHS) challenged healthcare organizations to leverage technology that engages patients in self-management support and encourages clinician use of patient-centered communication techniques, such as teach-back.

Purpose: The purpose of this project is to evaluate the use of health information technology along with an …

Improving The Identification, Delivery Of Care, And Outcomes Of Hospital-Acquired Sepsis, Nicholas James Welker

DNP Projects

Sepsis syndromes that develop among a hospital inpatient population can be difficult to differentiate from other disease processes that share systemic inflammatory response syndromes. A bedside nurse-driven screening process was developed at Baptist Health Lexington to aid with early sepsis identification and foster prompt goal-directed therapy. This retrospective study of 26 patients identified over a 6 month period measures intensive care length of stay, mortality, and sepsis severity. Exclusion criteria were pregnancy and Do Not Resuscitate orders.

Screening compliance was poor at 23.1 percent (n=6). Complete compliance with goal directed therapy was 7.7 percent, though some components of therapy such …

Web Of Ties: The Effect Of Relationship Ties On Government Funding For Nonprofit Organizations, Anthony Heath Rico

Theses and Dissertations--Public Policy and Administration

Chapter 1 raises the research question guiding this study. Do relationships that board members of nonprofits have to officials in other agencies affect the likelihood of acquiring grants? The objective of this study was to examine the role that relationship ties played in the nonprofit sector’s ability to receive grants.

Chapter 2 ties the research agenda to existing research. Nonprofit organizational and financial behavior was explained in terms of resource dependence. Since nonprofit organizations face uncertainty in resource allocation, the behavior of the organization and the board members change in reaction to uncertainty. The relationships that board members possess serve …

Evaluation Of Early Mobilization Strategies In The Mechanically Ventilated Patient Population, Katherine B. Stewart

DNP Projects

Purpose

This practice inquiry project was designed to evaluate current mobility practice and identify associations between mobility practice and specific patient characteristics in a cardiovascular intensive care unit.

Population and Setting

The sample consisted of electronic medical records of adult patients that required mechanical ventilation in a 16-bed cardiovascular intensive care unit in a private, urban hospital in Southern U.S. Of the selected participants, 48 were male and 52 were female with an average age of 64.49 (SD = 14.58).

Inclusion Criteria

Inclusion criteria for this study were patients who 1) were aged 18 and older; 2) were mechanically ventilated …

Organizing For Change: A Case Study Of Grassroots Leadership At A Kentucky Community College, Andrea Rae Borregard

Theses and Dissertations--Educational Policy Studies and Evaluation

Community colleges constitute a special type of higher education organization: their complex mission, dynamics, personnel structures, and values require a distinct set of understandings and skills to lead and manage them well. Most of the research on leadership in community colleges focuses on leaders in positions of power (presidents, provosts, etc.) and not on grassroots or bottom-up leadership. Bottom-up leaders are individuals who perpetuate change without having the backing of a formal position of authority to do so. Recent leadership research validates the importance of having change agents at all levels of an organization in order to further the mission …

Pipelines To Leadership: Aspirations Of Faculty In The Community College Kentucky Community And Technical College System, Erin C. Tipton

Theses and Dissertations--Educational Policy Studies and Evaluation

Community colleges are challenged to find their next set of leaders who can respond to the diverse challenges of leading the institution. This study examined the impact of institutional and personal factors on faculty aspirations to leadership roles within the community college through the utilization of the Social Cognitive Career Theory framework. A case study research design utilizing mixed-methods investigated the perceived and preferred organizational culture(s) and the manner in which institutional and personal factors influence faculty aspirations to assume leadership roles at Southcentral Kentucky Community and Technical College.

The findings of the research indicate that affecting change and being …

Pipelines To Leadership: Aspirations Of Executive-Level Community College Leaders To Ascend To The Presidency, Reneau Waggoner

Theses and Dissertations--Educational Policy Studies and Evaluation

One of the challenges facing community colleges in the United States is the looming retirements of executive/senior-level leadership, particularly the president, on a wide scale. This study explored the career aspirations of executive-level leaders within the community college using Social Cognitive Career Theory as the conceptual framework. Within the context of a three-person collaborative dissertation project, a mixed methods case study approach was utilized for the research design. It first examined the perceived and preferred organizational culture(s) by administering the Organizational Culture Assessment Instrument (OCAI). Building upon results of the OCAI, interviews with executive-level leaders explored how personal and institutional …

The Sensemaking Experience Of Newly Appointed District Teacher Leader Coordinators: A Case Study, Jill L. Janes

Theses and Dissertations--Education Sciences

In an effort to address diverse needs in K-12 education, policymakers have proposed initiatives to increase the leadership opportunities for classroom teachers. Although teachers have undertaken leadership roles in schools throughout history, the notion of teacher leadership spurred by policy is in the emergent stages. As educators and leaders in various roles implement teacher leadership policy, learning must ensue at both an individual and collective level to adapt schools to a new model of leadership.

This study examined how district-level teacher leader coordinators in one Iowa region came to understand their role as leaders. A case study approach illuminated the …

Higher Education System Governance: An Exploratory Study Of Presidential Decision Making In The Kentucky Community And Technical College System, Sarah Jill Page

Theses and Dissertations--Educational Leadership Studies

There are more than 40 higher education systems across the United States enrolling more than 5.6 million students. Literature on higher education systems is well-documented; however, variations in system structures and governance are apparent. The limited research on governance in community college systems merits examination. This study explored presidential decision making in the Kentucky Community and Technical College System using quantitative and qualitative procedures. As a two-phase, sequential exploratory study using surveys, interviews, and documents, this study considers decision making from an organizational and environmental perspective to understand how presidents share academic, administrative, and personnel decision making. This study extends …

Openness To Change: Experiential And Demographic Components Of Change In Local Health Department Leaders, Emmanuel D. Jadhav, James W. Holsinger Jr., David W. Fardo

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: During the 2008-2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders' demographic and organizational characteristics and to characterize the underlying relationships.

MATERIALS AND METHODS: The study utilized Spearman rank correlations test …

Neuron-Based Heredity And Human Evolution, Don M. Gash, Andrew S. Deane

Neuroscience Faculty Publications

It is widely recognized that human evolution has been driven by two systems of heredity: one DNA-based and the other based on the transmission of behaviorally acquired information via nervous system functions. The genetic system is ancient, going back to the appearance of life on Earth. It is responsible for the evolutionary processes described by Darwin. By comparison, the nervous system is relatively newly minted and in its highest form, responsible for ideation and mind-to-mind transmission of information. Here the informational capabilities and functions of the two systems are compared. While employing quite different mechanisms for encoding, storing and transmission …

Parents' Expressed Educational Dissent In Middle School Education Systems, Marjorie M. Buckner

Theses and Dissertations--Communication

Hoy and Miskel (2008) and Weick (1976) conceptualize schools as organizational systems of which parents comprise part of the organization. Specifically, parent involvement includes such behaviors as assisting students with homework, participating in policy decisions, and providing feedback (Barge & Loges, 2003). Parent involvement is largely championed in K12 education and particularly in middle schools (e.g., Coalition of Essential Schools, 1993; Texas Education Agency, 1991). In fact, both parents and teachers value building positive parent-teacher relationships (Kalin & Steh, 2010) and may communicate regarding a variety of topics including student academic performance, classroom behavior, preparation, hostile peer interactions, and health …

Firm Characteristics And Organizational Change: The Effects Of Electronic Commerce In The United States Manufacturing Industry, Candice Y. Wallace

Theses and Dissertations--Geography

This dissertation seeks to provide insight to how e-commerce adoption and utilization change the condition of U.S. Manufacturing establishments, by answering two interrelated questions: (1) What are the characteristics of manufacturing establishments that were early adopters of e-commerce activities?; (2) Once e-commerce is adopted, how has adoption affected employment within manufacturing establishments? The U.S. manufacturing industry was selected for analysis as manufacturing has been and continues to be an important sector for employment and the overall U.S. economy and has been the primary sector responsible for the majority of Business-to-Business e-commerce activity.

Using two econometric models, seemingly unrelated regression (SUR) …

Insights Into Perspectives On Environmental Sustainability, Amber R. Shobe

Theses and Dissertations--Community & Leadership Development

As scientists become more aware of the imposing threats associated with climate change, university leaders are encouraged to become familiar with the principles of sustainability. Abundant research already supports the relevance of environmental sustainability in higher education; however, there exists a gap in the literature which investigates an understanding of environmental sustainability and the implementation of its practices. By examining colleges at the University of Kentucky, this study identifies organizational barriers to recognizing a thorough understanding of environmental sustainability at the departmental level. The results indicate that out of the eight colleges selected, two have no existing environmental sustainability programs …