Digital Commons Network^™

Breaking Ground On Self-Efficacy: A Qualitative Exploration Of Intimate Partner Violence Survivors’ Experiences With Therapeutic Horticulture, Rachel Marie Reeves

Theses and Dissertations--Sociology

This dissertation explores how participation in a Therapeutic Horticulture program may support the self-efficacy of survivors of Intimate Partner Violence. Through a thematic analysis of interviews with 45 women living at a domestic violence shelter in Lexington, Kentucky, this study investigates whether and how gardening activities contributed to participants’ belief in their abilities to shape outcomes in their lives.

Findings are organized around Bandura’s four sources of self-efficacy: enactive mastery experiences, vicarious experience, verbal persuasion, and physiological/affective states. These insights contribute to feminist criminology and trauma-informed care literature by illuminating the transformative potential of nature-assisted healing programs.

Emplacing Deaths Of Despair Within The Rural Mortality Penalty: The Spatial Inequality Of Violent Death Across Rural America, Cameron A. Mcalister

Theses and Dissertations--Sociology

American life expectancy continues to diverge from most developed nations. Literature spanning several fields of scholarship has documented an uneven distribution of life expectancy between social groups and across geographic contexts. Frameworks such as “Deaths of Despair” and the rural mortality penalty describe the declining health trends among working class whites and rural America. But, conceptual development around these frameworks is still limited. This dissertation utilizes a rural sociological approach to bridging the gap between the Deaths of Despair framework and the rural mortality penalty by examining violent death patterns across diverse rural contexts. In doing so, I incorporate several …

The Research Examining Factors Associated With The Opioid Crisis Among Urban Adults (Refocus), Mona K.M. Goggins, Paige Orphé, Jovonna Atkinson, Brittany Miller-Roenigk, Kaylee A. Palomino, Danelle Stevens-Watkins

Educational, School, and Counseling Psychology Faculty Publications

Introduction: Deaths due to opioid-related overdoses have increased across the United States. Specifically in the state of Kentucky, African Americans are the only population that continues to experience an increase in opioid-related deaths. Previous literature highlights African Americans having unique drug use patterns due to systematic barriers and how these barriers limit access to protective factors and substance use treatment. The current study aims to specify patterns of African American non-medical prescription opioid use (NMPOU) and how these patterns may differ based on biological sex and generational cohort. Also, this study plans on using this data on patterns to inform …

Navigating Access To Pre-Exposure Prophylaxis (Prep), Carlos C. Mahaffey, Rohan D. Jeremiah, Andrew M. O’Neil, Déjà N. Clement, Isabel Cava, Fracisco R. Ruiz, Randolph D. Hubach, Danelle Stevens-Watkins

Educational, School, and Counseling Psychology Faculty Publications

Pre-exposure prophylaxis (PrEP) has contributed significantly to stabilizing HIV incidence rates across most populations. However, significant disparities in HIV incidence and PrEP uptake persist among Black men who have sex with men (BMSM). This study delved into the individual, sociocultural, and structural factors associated with PrEP access and uptake among 28 BMSM residing in designated HIV hotspots. Participants were recruited from communities identified as “high priority” by the US Department of Health and Human Services’ Ending the HIV Epidemic in the US initiative. Participants completed semi-structured interviews focusing on PrEP awareness, access, and barriers to uptake. Guided by the Socioecological …

Mental Health And Treatment Use In Undergraduate Engineering Students, Matthew D. Whitwer, Sarah A. Wilson, Joseph H. Hammer, Brenna Gomer

Educational, School, and Counseling Psychology Faculty Publications

Background: Engineering students experience high levels of distress and low rates of mental health treatment seeking, yet there is a gap in knowledge around how this compares with that of students in other fields of study. Given the influence of social identity (e.g., gender identity, race/ethnicity) on mental health and treatment seeking, it is important to account for sociodemographic variation across fields when performing such comparisons. Purpose: This study used Andersen's Behavioral Model to compare mental health distress and treatment use between students in engineering and other fields while controlling for sociodemographic factors. Methods: Survey data came from the 2021–2022 …

Engaging Nurses In Effective Cost Of Care Conversations To Address Cancer-Related Financial Toxicity: Results From An Exploratory Survey, Jean Edward, Amanda T. Wiggins, Louis G. Baser, Haafsah Fariduddin, Joanna F. Doran, Monica F. Bryant, John August D'Orazio, Kimberly D. Northrip

Markey Cancer Center Faculty Publications

Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage Cancer® to prepare oncology nurses to identify and assist patients/caregivers facing financial and/or legal barriers to care. Ten pediatric oncology nurses completed the training and pre/post-surveys on behaviors related to financial and legal need screening, frequency and comfort level of answering questions, knowledge, and behavior changes, along with training evaluation questions. At baseline, six nurses reported never …

Urobilin Derived From Bilirubin Bioconversion Binds Albumin And May Interfere With Bilirubin Interacting With Albumin: Implications For Disease Pathology, Kevin I. Williams, Priyanka Suryadevara, Chang-Guo Zhan, Terry D. Hinds Jr., Zachary A. Kipp

Markey Cancer Center Faculty Publications

Background/Objectives: Bilirubin is a hydrophobic molecule that binds the carrier protein albumin for transport through systemic circulation. Bilirubin is cleared from the body through the liver and excreted into the intestines, where the microbiota modifies the chemical structure, forming urobilin, which can be reabsorbed into circulation by the hepatic portal vein. Urobilin has no known function. It is also unknown whether urobilin binds albumin for transport in circulation. We hypothesized that because of the likeness of their chemical structures, urobilin would also bind albumin like bilirubin does. Methods: First, we used in silico docking to predict if urobilin would bind …

Dissecting The Biophysical Mechanisms Of Oleate Hydratase Association With Membranes, William A. Lathram, Robert J. Neff, Ashley N. Zalla, James D. Brien, Vivekanandan Subramanian, Christopher D. Radka

Markey Cancer Center Faculty Publications

This study investigates the dynamics of oleate hydratase (OhyA), a bacterial flavoenzyme from Staphylococcus aureus, and its interactions with lipid membranes, focusing on the factors influencing membrane binding and oligomerization. OhyA catalyzes the hydration of unsaturated fatty acids, playing a key role in bacterial pathogenesis by neutralizing host antimicrobial fatty acids. OhyA binds the membrane bilayer to access membrane-embedded substrates for catalysis, and structural studies have revealed that OhyA forms oligomers on membrane surfaces, stabilized by both protein-protein and protein-lipid interactions. Using fluorescence correlation spectroscopy (FCS), we examined the effects of membrane curvature and lipid availability on OhyA binding to …

Engaging Nurses In Effective Cost Of Care Conversations To Address Cancer-Related Financial Toxicity: Results From An Exploratory Survey, Jean Edward, Abigail Wiggins, Louis G. Baser, Haafsah Fariduddin, Joanna F. Doran, Monica F. Bryant, John A. D'Orazio, Kimberly D. Northrip

Markey Cancer Center Faculty Publications

Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage Cancer® to prepare oncology nurses to identify and assist patients/caregivers facing financial and/or legal barriers to care. Ten pediatric oncology nurses completed the training and pre/post-surveys on behaviors related to financial and legal need screening, frequency and comfort level of answering questions, knowledge, and behavior changes, along with training evaluation questions. At baseline, six nurses reported never …

Measuring The Impact Of A Catchment Area Surveillance Tool On Cancer Center Adopters, Todd Burus, Caree R. Mcafee, Natalie P. Wilhite, Pamela C. Hull

Markey Cancer Center Faculty Publications

Background: The University of Kentucky Markey Cancer Center developed the data gathering and visualization platform Cancer InFocus (CIF) as a solution for cancer center catchment area surveillance. CIF was released in June 2022 and made available for use to other institutions through a no‐cost licensing agreement. The purpose of this study was to evaluate the impact CIF has had on cancer centers since its release.

Methods: The authors adapted an existing management evaluation framework to assess the impact of CIF across three spheres—idea dissemination, product engagement, and adopter satisfaction. This assessment included an online survey administered between the dates of …

Tracking Community Outreach And Engagement Activities Among National Cancer Institute-Designated Cancer Centers, Todd Burus, Caree R. Mcafee, Pamela C. Hull, Amy E. Leader, Christopher Mcnair

Markey Cancer Center Faculty Publications

The National Cancer Institute’s (NCI) Cancer Center Support Grant mandates that NCI-designated cancer centers establish a Community Outreach and Engagement (COE) component to help direct efforts at reducing cancer burden within their catchment areas. Despite the critical role of COE offices, little is known about how they track and evaluate outreach activities and outcomes. We gathered information on current practices from representatives of 40 out of 65 COE offices using an online survey. Although nearly all responding centers (97.5%) tracked COE activities, no consensus existed on resources used, and satisfaction with current solutions was mixed (51.0% not satisfied). Respondents expressed …

Cryptic To Conventional Cytogenetics: Philadelphia- Like All Presenting With Hypereosinophilia, Zena Chahine, Leonard Yenwong Fai, Sainan Wei, Ayman Qasrawi

Markey Cancer Center Faculty Publications

BCR::ABL1-like B-lymphoblastic leukaemia (B-ALL) neoplasms lack the BCR::ABL1 translocation but have a gene expression profile like BCR::ABL1 positive B-ALL. This includes alterations in cytokine receptors and signalling genes, such as CRLF2, ABL1, ABL2, JAK2, PDGFRB and EPOR. Cases with CRLF2 rearrangements account for approximately 50% of cases of Philadelphia-like acute lymphoblastic leukaemia (Ph-like ALL), and the frequency of specific genomic lesions varies with ethnicity such that IGH::CRLF2 translocations are more common in Hispanics and Native Americans. We report two cases of BCR::ABL1-like ALL, with significant eosinophilia. A Hispanic man in his early 20s and a Hispanic woman in her 50s …

African American And African-Born Black Women’S Perspectives And Experiences With A Cervical Health Education And Hpv-Self Sampling Intervention, Shania Jones, Abubakari Wuni, Adaeze Aroh, Adebola Olamide Adegboyega

Markey Cancer Center Faculty Publications

Background/Objectives: A combination of cervical cancer prevention education and the provision of HPV self-collection kits has been found to increase the uptake of HPV testing among women. However, there is limited research evaluating the perspectives and experiences of women who have participated in a cancer prevention education and received a complimentary HPV self-collection kit. We report the experiences of women who took part in Health is Wealth: a cervical health intervention and received a complimentary HPV self-sampling kit for cervical cancer screening.

Methods: This pilot qualitative study enrolled twenty-four women who participated in one-on-one semi-structured interviews to provide feedback and …

Analysis Of Facilitators Of And Barriers To Enactment Of State Regulation Of Indoor Tanning By Minors, Carolyn J. Heckman, Anna Mitarotondo, David B. Buller, Julia Berteletti, Kevin Schroth, Jerod L. Stapleton, Robert P. Dellavalle

Markey Cancer Center Faculty Publications

Background: Indoor tanning (IT) causes skin cancers, including potentially deadly melanoma. IT often starts during youth, a critical time for deleterious skin damage. About half of the US states have enacted laws banning IT for minors under age 18.

Purpose: This study reports qualitative findings from interviews with key informants (KIs) involved in IT legislative efforts to identify/describe factors influencing law enactment, based on the multiple streams framework.

Methods: Guided by expert advisors and using snowball-sampling, KIs from 16 states with most recently enacted IT laws regulating minor access and states without restrictions were contacted. In virtual interviews, KIs shared …

Capturing Community Perspectives In A Statewide Cancer Needs Assessment: Online Focus Group Study, Jessica R. Thompson, Keeghan Francis, Caree R. Mcafee, Madeline Brown, Todd Burus, Melinda Rogers, Connie L. Sorrell, Elizabeth A. Westbrook, Lovoria B. Williams, Jennifer Redmond Knight, Elaine Russell, Natalie P. Wilhite, Pamela C. Hull

Markey Cancer Center Faculty Publications

Background: Kentucky has the highest all-site cancer incidence and mortality rates in the United States. Conducting needs assessments in a large geographic area, such as an entire state, poses challenges in collecting qualitative data from diverse rural and urban contexts. In 2021, a steering committee was formed to drive a multimethod, statewide cancer needs assessment (CNA) to identify the future priorities for all cancer-related care in Kentucky.

Objective: We aimed to report on the online focus group component of the CNA by documenting existing community resources and perceived needs across the cancer care continuum. In addition, we aimed to explore …

Differences In The Cancer Burden And Current Funding Of Nci-Designated Cancer Centers, Todd Burus, Caree R. Mcafee, Pamela C. Hull

Markey Cancer Center Faculty Publications

Importance  National Cancer Institute (NCI)-designated clinical and comprehensive cancer centers are required to define a geographic catchment area (CA) in which they focus research, outreach, and engagement efforts for the purposes of reducing cancer burden, particularly among certain vulnerable populations. A comprehensive analysis of the cancer burden of these catchment areas and their association with cancer center funding through the Cancer Center Support Grant (CCSG) has not been performed.

Objective  To examine CA cancer burden indicators and cancer center CCSG funding during the 2023 federal fiscal year (FY23).

Design, Setting, and Participants  This population-based cross-sectional study assessed cancer center cancer …

Disparities In Human Papillomavirus–Associated Cancer Incidence By Appalachian Residence, Todd Burus, Melina Windon, Yasminka A. Jakubek, Krystle A. Lang Kuhs

Markey Cancer Center Faculty Publications

Importance  Poor socioeconomic conditions and corresponding health disparities have historically characterized the Appalachian region of the US. Low uptake of the human papillomavirus (HPV) vaccine and high rates of cervical cancer have been observed in the region; however, a comprehensive assessment of HPV-associated cancer in Appalachia has not been performed.

Objective  To compare the burden of HPV-associated cancer incidence between the Appalachian and non-Appalachian regions of the US.

Design, Setting, and Participants  This cross-sectional study of HPV-associated cancer incidence rates and trends used the US Cancer Statistics Incidence Analytic Database, covering 99% of the US population and 100% of the …

Examining Associations Between Sociodemographic Characteristics And Ever Breastfed Children, Nhanes 1999–2020, Jessica Amezcua, Lindsey M. West, Camelia Malkami, Marlo M. Vernon, Elinita Pollard, Justin X. Moore

Markey Cancer Center Faculty Publications

Although breastfeeding provides health benefits to both mother and child, this study aimed to explore whether disparities in breastfeeding continue to exist, particularly among non-Hispanic Black (NHB) mothers and children. We performed a cross-sectional analysis among 19,830 children in the United States (US) using the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2020. Breastfeeding initiation and duration rates increased overall from 1999 to 2020. Children who were ever breastfed were more likely to have higher body weight, older mothers, mothers who did not smoke during pregnancy, a higher family poverty–income ratio (PIR), food security, mothers in …

Examining Geographic Disparity: Variation In Cancer Outcomes Within Appalachia, Todd Burus, Pamela C. Hull, Krystle A. Lang Kuhs, Tianyan Gao, Christine F. Brainson, B. Mark Evers

Markey Cancer Center Faculty Publications

BACKGROUND: 

The Appalachian region of the US extends from the Mississippi Delta to southern New York. Although disparities in Appalachian cancer outcomes have long been observed, recent rates and trends have not been assessed.

STUDY DESIGN: 

We calculated 5-year age-adjusted US cancer incidence and mortality rates for 2017 to 2021, stratified into Appalachian and non-Appalachian populations, as well as Appalachian subregions, using the US Cancer Statistics Incidence Analytics Database and National Center for Health Statistics mortality files. Annual rates for 2004 to 2021 were also calculated.

RESULTS: 

In 2017 to 2021, all-site cancer incidence (466.6; 95% CI 465.5 to 467.6) …

Health Care Access Domains And Treatment As Mediators Of Ovarian Cancer Racial Disparities In Survival: A Structural Equation Modeling Analysis In Seer-Medicare, Clare Meernik, Quan Chen, Lauren E. Wilson, Ashwini Joshi, Fariha Rahman, Maria Pisu, Margaret Liang, Kevin C. Ward, Margaret Gates Kuliszewski, Thomas Tucker, Andrew Berchuck, Bin Huang, Tomi Akinyemiju

Markey Cancer Center Faculty Publications

Racial differences in health care access (HCA) may contribute to disparities in ovarian cancer (OC) survival. We used structural equation models (SEMs) to examine associations between race and HCA domains (affordability, availability, accessibility) in relation to overall and OC-specific mortality. Non-Hispanic (NH)–Black and non-Black (Hispanic, NH-White) women diagnosed with OC in 2008-2015 were identified from Surveillance, Epidemiology, and End Results–Medicare. Cox proportional hazards regression was used to conduct mediation analysis for associations between race and HCA domains with overall and OC-specific mortality. SEM models adjusting for demographic and clinical covariates were used to estimate hazard ratios (HRs) and 95% CIs. …

Cancer Advocacy Empowers Appalachian Kentucky Youth, Lauren Hudson Rose, Holly Burke, Olivia Thornsbury, Kameron Jackson, Rebecca Spradlin, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky has the highest cancer incidence rate and second highest cancer mortality rate in the United States, and the Appalachian region of the state experiences a disproportionate cancer burden. Cancer-related advocacy, a movement that strives to provide support to cancer patients, families, and organizations, along with policy creation, could help address this disparity by enhancing cancer-related prevention and control efforts. The University of Kentucky Markey Cancer Center’s Appalachian Career Training in Oncology (ACTION) Program partners with the American Cancer Society Cancer Advocacy Network (ACS CAN) to involve Appalachian Kentucky high school and undergraduate students in cancer advocacy activities at the …

Identifying Risk Factors For Adverse Lung Health Outcomes Among Rural Appalachian Women, Jessica R. Thompson, Courtney J. Walker, John C. Flunker, W. Jay Christian, Wayne T. Sanderson, Nancy E. Schoenberg, Steven R. Browning

Markey Cancer Center Faculty Publications

Purpose: Despite high rates of lung disease and lung cancer among women, few studies have focused on adverse lung health risk factors among rural Appalachian women. We aim to describe the prevalence of demographic, behavioral, and economic characteristics among a cohort of rural Appalachian women and ascertain the association between these risk factors and lung function.

Methods: Through a cross-sectional study in two rural Appalachian Kentucky counties (2015–2017), we collected demographics, health history/behaviors, and lung function via pulmonary function tests. Restricting to female participants with interpretable pulmonary function tests (N = 456), we estimated prevalence ratios of the association …

Factors Impacting Germination, Emergence, And Establishment Of Direct Seeded And Transplanted Hemp (Cannabis Sativa L.), Paul Cockson Dr.

Theses and Dissertations--Plant and Soil Sciences

Industrial hemp (IH) establishment has many challenges including: poor emergence, low stand establishment, and variable plant development in direct seeded hemp. In floral hemp production, quality transplant production is a challenge with seedlings often becoming root bound and etiolated. In both direct seeded and transplant hemp, the relationship between root vigor and vegetative growth has not been studied and may prove insightful for managing emergence and establishment challenges. The goals of this study were three-fold: 1) to measure and describe root system architecture (RSA) and root phenotypes observed in selected IH cultivars especially in regard to identifying agronomically important RSA …

Surface Morphology And Moisture Adsorption/Desorption Characteristics Of Hybrid-Dielectric Moisture Sensors, Ronak Ali

Theses and Dissertations--Electrical and Computer Engineering

Relative humidity sensors are used for high-humidity measurement. Moisture sensors, or dew point sensors are used for low-humidity measurement (< 1 ppm_v). The dissertation contains two parts of studies. In the first part, the effect of surface morphology on the response speed of moisture sensors is studied. Moisture sensors using α-Al₂O₃ films as porous dielectric materials deposited by anodic spark deposition are studied. In this part of the study, a variety of small pores have been studied to investigate the response speed of moisture sensors. Three different surface morphologies have been studied using scanning electron microscopy. One …

Mathematical-Programming Modeling Of Power-Electronics-Based Microgrid Systems, Jack A. Robey

Theses and Dissertations--Electrical and Computer Engineering

The emergence of power-electronics-based microgrid systems is driven by the shift to cleaner energy, transportation electrification, renewable integration, grid modernization through smart grid advancements, and growing demand for energy-efficient solutions. For utilities, these systems present unique opportunities for enhancing grid resilience, improving load management, and enabling distributed energy resource integration. This work presents a modeling and simulation approach for microgrid systems that uses mathematical programming to represent power flow and capture the system dynamics. By solving an optimization problem at each time step, the method enables evaluation of power distribution and system performance under a range of operating conditions, without …

Scalable Hypergraph Structure Learning With Diverse Smoothness Priors, Benjamin T. Brown

Theses and Dissertations--Electrical and Computer Engineering

In graph signal processing, learning weighted connections between nodes from signals is a fundamental task when the underlying relationships are unknown. With the extension of graphs to hypergraphs, where edges can connect more than two nodes, graph learning methods have similarly been generalized to hypergraphs. However, the absence of a unified framework for calculating total variation has led to divergent definitions of smoothness and, consequently, differing approaches to hyperedge recovery. This challenge is confronted in this work through generalization of several previously proposed hypergraph total variations, allowing ease of substitution into a vector-based optimization. To this end, a novel hypergraph …

Electromagnetic Integral Equation Methods For High-Order Field Predictions, Jordon N. Blackburn

Theses and Dissertations--Electrical and Computer Engineering

Methods like the Method of Moments (MoM) or the locally-corrected Nyström (LCN) method are employed to discretize and solve electromagnetic integral equations. This process results in large, dense systems of linear equations that must be solved. In many cases, the elements of the system matrix can be computed analytically or approximated with high-order numerical methods. In this thesis, various approaches are presented to improve the accuracy and efficiency of integral equation solutions.

The second chapter derives a modified form of the low-rank matrix approximation algorithm known as the adaptive cross approximation (ACA). The original ACA has been observed to lose …

Lifecycle Carbon Footprint And Sustainability Evaluation Of Dram-Based Processing In Memory Computing Architectures, Samrat Pravin Patel

Theses and Dissertations--Electrical and Computer Engineering

The use of computing technologies has significantly enhanced several aspects of our day-to-day lives. But it has still revealed significant environmental concerns, primarily related to greenhouse gas emissions and energy consumption. Initially, the primary environmental problems associated with computing were energy consumption during device operation. However, with the rapid advancement of technology and increasing computational demands, attention has shifted towards the embodied carbon footprint. This term refers to the total greenhouse gas emissions throughout a product’s lifecycle from the extraction of raw materials to end-of-life processing. It has become increasingly significant in the context of manufacturing integrated circuits (ICs), such …

Afapbp: Aggregate Function Accelerated Parallel Bit-Pattern Computing, Charles Z. Armstrong

Theses and Dissertations--Electrical and Computer Engineering

Classical computing models have proven sufficient for problems of the complexity class ``P", but problems of a higher complexity class like ``NP", ``NP-Hard", etc. have been shown to be more resistant to efficient computation. Quantum Computing is an alternative computing model that specifically targets performing computations within the ``NP" complexity class in close to linear time. However, Quantum Computing has its own set of problems. Methods for dealing with quantum decoherence, error correction, and difficulty in scaling have all inhibited Quantum Computing from becoming a commonly used computational model. This thesis introduces AFAPBP (Aggregate Function Accelerated Parallel Bit Pattern), a …

Scalable Systems And Devices For Wireless Charging Of Electric Vehicles, Donovin D. Lewis

Theses and Dissertations--Electrical and Computer Engineering

The rising adoption of electric vehicles creates new opportunities that are not possible with conventional gas-powered vehicles such as wireless charging of electric vehicles (EV). Wide-scale implementation of wireless charging could result in benefits unique to EVs such as operation without human intervention, improved charging accessibility, and even in-route wireless charging for charge-sustaining or extended driving range operation. As the technology is in the early stages of development, there are many open-ended challenges to tackle including but not limited to coil and systems cost, weight and size, stray field emissions in high-power, high-frequency operation, and dynamic wireless charging system design …