Digital Commons Network^™

Evaluating The Impact Of Patient Acuity On Nursing Productivity: A Case Study At Uk Healthcare Chandler Hospital, Kara Klein

MPA/MPP/MPFM Capstone Projects

This study examines the relationship between patient acuity and nursing productivity at UK HealthCare (UKHC) Chandler Hospital from June 2022 to April 2024. Patient acuity, characterized by the complexity and intensity of nursing care required by patients (Juvé-Udina et al., 2020), is crucial in determining staffing needs and operational efficiency. The primary objective of this research is to investigate how variations in patient acuity levels impact Full-Time Equivalents (FTE), a key metric for assessing nursing productivity. The study utilized hospital data and applied descriptive statistics, correlation analyses, and regression models to assess the impact of patient acuity on FTE. The …

Enhancing Equity And Economic Growth: A Strategic Review Of Procurement Practices In Prince George’S County, Andrew Stover

MPA/MPP/MPFM Capstone Projects

Procurement represents a substantial portion of public spending in state and local governments, and thus is an essential element of responsible public financial management. This paper explores the procurement process on the local government level and provides research into best practices that are conducive to equity and economic development. It takes a look specifically at Prince George’s County, Maryland and analyzes its procurement function in relation to these best practices. An analysis of the County finds that despite its strides in implementing equitable procurement policies, significant gaps remain in the engagement of disadvantaged classes of businesses. To tackle these challenges, …

From Local Income Tax To Local Sales Tax In Kentucky: An Examination Of Lfucg, Zachary Vogl

MPA/MPP/MPFM Capstone Projects

Property tax revenue is widely known as the largest own source revenue for local governments. However, other taxes such as local sales taxes (LST) and local incomes taxes (LIT) also provide significant revenue streams for local governments. For example, in Kentucky, “[e]xcluding Fayette and Jefferson, counties collected a total of $353.5 million in occupational license fees on payroll and net profits in FY 2022, making up 42.7 percent of all tax revenue” (Smith 2024).

The use of LST and LIT, in addition to property taxes, by local governments allows for flexibility and revenue diversification; but, these taxes also come with …

Role Of Program Activity Data In Allocation Decision-Making For The Community Development Block Grant Program, Carolyn Anne Ferguson

MPA/MPP/MPFM Capstone Projects

The forthcoming study aims to further the conversation on the importance of data for effective, efficient use of public funding by conducting a quantitative, correlational case study of the Community Development Block Grant (“CDBG”) activity obligation approvals for grant allocations administered by the U.S. Department of Housing and Urban Development (“HUD”), Office of Community Planning and Development (“CPD”). The increasing use of data, including but not limited to program outcomes, accomplishments, capacity, sustainability, compliance, efficacy, efficiency, and activity provision, to inform decision-making associated with appropriations, allocations, and awards results in a mounting need to focus on various means of data …

The Fairness Model Of Legal Institutions, James M. Donovan

Law Faculty Books and Chapters

If any group is to endure over time, individual frustrations, while inevitable, must be usually experienced as acceptable, or at least tolerable. Failing that, little would prevent the losers in these conflicts from leaving or revolting, which would be cumulatively debilitating to the group. As opposed to holding law’s job to impose order and police infringers, the second approach suggests that finding the balance between group and individual desires is the ‘major difficulty of all law—the problem of really getting a fresh start in relations between litigants after disposition of a trouble-case. This is the problem not only of keeping …

The Next Frontier In Plan Fee Litigation: Health Plan Fees, Kathryn L. Moore

Law Faculty Books and Chapters

On September 11, 2006, Jerry Schlichter, a personal injury lawyer from Saint Louis, Missouri, filed some of the first lawsuits claiming that excessive fees in 401(k) plans violated ERISA’s fiduciary standards. Since then, hundreds of suits have been filed challenging retirement plan fees, and the Supreme Court has rendered two decisions in cases claiming that excessive 401(k) plan fees violated ERISA’s fiduciary standards. Since the Supreme Court issued the second decision in 2022, retirement plan excessive fee litigation may have begun to slow. There may, however, be a new frontier in plan fee litigation: health care plan fees.

This article …

Past What You Can See: Innocence, Experience, And Realization In Stephen Sondheim’S Into The Woods, Brock Adam Terry

Theses and Dissertations--Music

A deeper appreciation of Stephen Sondheim’s Into the Woods may be achieved by examining the work under a new magnifying glass. After a synopsis of background information of the musical itself, the assertion is made that Into the Woods shows three basic stages of life that occur in a cycle: innocence, experience, and realization. This is supported by the proposition that the idea of innocence is represented by a recurring five-note motive (commonly referred to as the “bean theme”), and that the ideas of experience and realization are revealed through particular musical numbers. The overarching entity that binds the work …

Mapping The Double-Tongue: Incorporating Body Mapping Into The Double-Tonguing Learning Process, Camilla Yoder

Theses and Dissertations--Music

As the articulation technique of double-tonguing is becoming more necessary and desirable for oboists to learn, this document explores the benefits of incorporating Body Mapping methods and kinesthetic awareness exercises into the double-tonguing learning process. These methods of body exploration are applied only to the areas of the body deemed highly relevant to accomplishing double-tonguing: the atlanto-occipital joint, the temporo-mandibular joint, the throat, the tongue, and the roof of the mouth. To explore the effectiveness of this approach, an Institutional Review Board approved research study was conducted, in which eight oboists learned double-tonguing with a preliminary iteration of this method. …

Mediating Authenticity: An Ethnographic Portrait Of Experience At U.S. Popular Music Festivals, Elizabeth Navarra Varnado

Theses and Dissertations--Music

This ethnographic study of U.S. popular music festivals subverts the impression of festivals as strictly ‘presentational’ live music events by utilizing a nuanced approach that is grounded in ethnographic fieldwork, historical analysis, and participant interviews.

Interlocutors, drawn from the author’s personal network of festival attendees, musicians, and promoters, reflect on “particularly positive festival moments,” the social and emotional benefits of festivals, and the corporeality of festival aesthetics. Discourse and published media play a vital role in festival participants’ perception of the festival field and their place within it; therefore, this study draws inspiration from the tripartite focus of iconic festival …

Evaluation Of The Management Of Italian Ryegrass (Lolium Perenne Ssp. Multiflorum) Using Harvest Weed Seed Control At Winter Wheat Harvest In Kentucky, Hayden Love

Theses and Dissertations--Plant and Soil Sciences

With increasing herbicide resistant weed populations in Kentucky winter wheat, producers are looking for new weed control options for Italian ryegrass (Lolium perenne L. ssp. multiflorum Lam.). A field study was conducted to better understand Italian ryegrass seed dispersal and the effectiveness of the Redekop seed control unit at winter wheat harvest in Kentucky. During harvest, the number of Italian ryegrass seeds shattering at the combine header, in the chaff, and contained in the grain tank was not significantly different. When the grain and chaff samples were combined, significantly more Italian ryegrass seed entered the combine. The integrated …

Understanding The Role Of Early-Stage Seed Development On Final Seed Weight By Linking Seed Physiology, Transcriptomics, And Environments In Soybean (Glycine Max (L.) Merr.), Ashwini Shivakumar

Theses and Dissertations--Plant and Soil Sciences

Soybeans, which are widely grown in the United States, are used as food, animal feed, and industrial oil. The rise in plant-based diets highlights the high protein content and versatility of soybean. Understanding seed development is crucial for increasing yield. Soybean seed development includes three phases: lag, seed-filling, and maturation. Post-fertilization, the seed undergoes cell division in the lag phase, forming the embryo, endosperm, and seed coat. The embryo absorbs the endosperm and develops into two cotyledons. During the seed-filling phase, cotyledon cells accumulate starch, proteins, and lipids. During maturation, seeds dry out and become quiescent. Studies indicate that the …

A Case Study On Variations In Network Structure And Cross- Sector Alignment In Two Local Systems Serving Pregnant And Parenting Women In Recovery, Liza M. Creel, Yana Feygin, Madeline Shipley, Deborah Winders Davis, Tiffany Cole Hall, Chaly Downs, Stephanie Hoskins, Natalie Pasquenza, Scott D. Duncan

Biostatistics Faculty Publications

Objective: To describe network structure and alignment across organizations in healthcare, public health, and social services sectors that serve pregnant and parenting women with substance use disorder (SUD) in an urban and a rural community.

Data Sources and Study Settings: Two community networks, one urban and one rural with each including a residential substance use treatment program, in Kentucky during 2021.

Study Design: Social network analysis measured system collaboration and cross-sector alignment between healthcare, public health, and social services organizations, applying the Framework for Aligning Sectors. To understand the alignment and structure of each network, we measured network density overall …

Higher First 30-Day Dose Of Buprenorphine For Opioid Use Disorder Treatment Is Associated With Decreased Mortality, Feitong Lei, Michelle R. Lofwall, Jana Mcanich, Reuben Adatorwovor, Emily Slade, Patricia R. Freeman, Daniela Moga, Nabarun Dasgupta, Sharon L. Walsh, Rachel Vickers-Smith, Svetla Slavova

Biostatistics Faculty Publications

Objective: Buprenorphine is a medication for opioid use disorder that reduces mortality. This study aims to investigate the less well-understood relationship between the dose in the early stages of treatment and the subsequent risk of death.

Methods: We used Kentucky prescription monitoring data to identify adult Kentucky residents initiating transmucosal buprenorphine medication for opioid use disorder (January 2017 to November 2019). Average daily buprenorphine dose for days covered in the first 30 days of treatment was categorized as ≤8 mg, >8 to ≤16 mg, and >16 mg. Patients were followed for 365 days after the first 30 days of buprenorphine …

Slope Unit Maker (Sumak): An Efficient And Parameter-Free Algorithm For Delineating Slope Units To Improve Landslide Modeling, Jacob B. Woodard, Benjamin B. Mirus, Nathan J. Wood, Kate E. Allstadt, Benjamin A. Leshchinsky, Matthew M. Crawford

Faculty, Staff, and Affiliated Publications--KGS

Slope units are terrain partitions bounded by drainage and divide lines. In landslide modeling, including susceptibility modeling and event-specific modeling of landslide occurrence, slope units provide several advantages over gridded units, such as better capturing terrain geometry, improved incorporation of geospatial landslide-occurrence data in different formats (e.g., point and polygon), and better accommodating the varying data accuracy and precision in landslide inventories. However, the use of slope units in regional (> 100 km²) landslide studies remains limited due, in part, to the large computational costs and/or poor reproducibility with current delineation methods. We introduce a computationally efficient algorithm …

Rural And Urban Clinician Views On Covid- 19’S Impact On Substance Use Treatment For Individuals On Community Supervision In Kentucky, Carrie B. Oser, Maria Rockett, Sebastian Otero, Evan Joseph Batty, Marisa Booty, Rachel Gressick, Michele Staton, Hannah K. Knudsen

Sociology Faculty Publications

Background The COVID-19 pandemic produced system-level changes within the criminal legal system and community-based substance use disorder (SUD) treatment system with impacts on recovery efforts. This study examines rural and urban clinicians’ perspectives of COVID-19 on SUD treatment delivery for people on community supervision.

Methods Virtual qualitative interviews were conducted between April and October 2020 with 25 community supervision clinicians employed by Kentucky’s Department of Corrections (DOC), who conduct assessments and facilitate community-based treatment linkages for individuals on probation or parole. Transcripts were analyzed in NVivo using directed content analysis methods.

Results Clinicians were predominantly white (92%) and female (88%) …

Cultural Predictors Of Self-Esteem Among Black Women With Criminal Justice Involvement And Herpes Simplex Virus, Natalie Malone, Jardin N. Dogan-Dixon, Shemeka Thorpe, Shawndaya S. Thrasher, Paris Wheeler, Danelle Stevens-Watkins, Carrie B. Oser

Sociology Faculty Publications

Black women have disproportionately alarming HSV-2 infection rates yet receive little attention in sexual health literature. Using a strengths-based resilience framework, this study sought to determine culturally relevant protective predictors of self-esteem for Black women who are justice-involved and have HSV-2. The authors conducted secondary data analysis on data from the “Black Women in the Study of Epidemics (B-WISE) Project,” a longitudinal prospective study investigating health disparities and health services utilization among Black women with justice involvement. At baseline, N = 151 Black women with HSV-2 who were incarcerated or on probation completed survey measures assessing selfesteem, ethnic identity affirmation …

Development Of Fungal Hydrogels For 3d Bioprinting And Cellular Agriculture, Lauren E. Doyle

Theses and Dissertations--Biosystems and Agricultural Engineering

Hydrogel scaffolds are an important component to cellular agriculture. There is a need for a sustainable alternative to the commonly used gelatin-sodium-alginate hydrogels. Specific edible fungus species may provide a suitable alternative. Many fungi possess high protein contents, ease of cultivation, and strong functional properties. However, functional characterizations and application of fungal flour and protein extracts in cellular agriculture are lacking in the literature. Therefore, this study’s objectives were to 1) Develop processes to create functional fungal protein fractions from different fungal strains and evaluate their characteristics, and 2) Quantify the printability of the resulting fungal gels for the creation …

Pulse-Width Modulation Spray System Performance And Development Of A Novel System To Optimize Spray Use Efficacy, Prashanta Pokharel

Theses and Dissertations--Biosystems and Agricultural Engineering

The overarching objective of this research was to enhance our understanding of pulse width modulation (PWM) based nozzle control system and develop an intelligent nozzle control system for agricultural spray applications. This dissertation focused on measuring and analyzing the transient nozzle pressure characteristics and performance under PWM control. Additionally, it explored the development of an innovative multi-degree-of-freedom (DOF) nozzle control system for precise chemical applications in specialty crop systems.

The pressure dynamics of a PWM system were studied by developing an instrumentation system capable of operating a solenoid valve and recording pressure signals. A nozzle body and two manifolds of …

Caught In The Crosshairs Of Educational Reform: How Teacher Labor Markets Respond To Polarized Education Policies, Danielle Duffy Chipman

Theses and Dissertations--Public Policy and Administration

Since the passage of No Child Left Behind (NCLB) teachers have been caught in the crosshairs of political debates about education policy (Davis, 2014; EPE Research Center, 2013a; Steiner & Woo, 2021; Woo et al., 2022; Zubrzycki, 2016). As political polarization between parties increased in the 2000s, debates about education policy became more acrimonious impacting teachers’ work lives (Heltzel & Laurin, 2020; Iyengar, 2021; Layman et al., 2006). The topic of these debates ranges from curriculum changes such as Common Core and Critical Race Theory (CTR), school shootings and safety, battles over school choice and voucher programs, teacher activism about …

Extracting Social Network Model Parameters From Social Science Literature, Isaac Batts

Theses and Dissertations--Computer Science

When looking at computer modeling of social situations, much of the social science literature does not include ready-to-use statistics or parameters to be included in a social model. I explore studies related to speaking about racism (and other forms of bias), and interventions designed to diminish the occurrence of biased behavior, and use those readings to synthesize plausible parameters for a social computer model.

Inflammation And Tumor Progression: The Differential Impact Of Saa In Breast Cancer Models, Daniel Wilhelm Olivier, Carla Eksteen, Manisha Du Plessis, Louis De Jager, Lize Engelbrecht, Nathaniel Wade Mcgregor, Preetha Shridas, Frederick C. De Beer, Willem J. S. De Villiers, Etheresia Pretorius, Anna-Mart Engelbrecht

Saha Cardiovascular Research Center Faculty Publications

Background: Previous research has shown that the Serum Amyloid A (SAA) protein family is intricately involved in inflammatory signaling and various disease pathologies. We have previously demonstrated that SAA is associated with increased colitis disease severity and the promotion of tumorigenesis. However, the specific role of SAA proteins in breast cancer pathology remains unclear. Therefore, we investigated the role of systemic SAA1 and SAA2 (SAA1/2) in a triple-negative breast cancer mouse model.

Methods: Syngeneic breast tumors were established in wild-type mice, and mice lacking the SAA1/2 (SAADKO). Subsequently, tumor volume was monitored, species survival determined, the inflammatory profiles of mice …

The Integrated Behavioral Model Of Mental Health Help Seeking (Ibm-Hs): A Health Services Utilization Theory Of Planned Behavior For Accessing Care, Joseph H. Hammer, David L. Vogel, Patrick R. Grzanka, Nayeon Kim, Brian T. Keum, Claire Adams, Sarah A. Wilson

Chemical and Materials Engineering Faculty Publications

This article introduces the integrated behavioral model of mental health help seeking (IBM-HS), a theoretical model for understanding the constructs (e.g., systemic, predisposing, and enabling factors; mental health literacy; illness perceptions; perceived need; stigma; shame; perceived benefits, motivation) that influence people’s decision making around seeking professional mental health care and their ultimate access to formal treatment. The IBM-HS is a help-seeking-specific adaptation of the empirically supported integrated behavioral model and integrative model, which are themselves evolutions of the theory of planned behavior and theory of reasoned action. The IBM-HS posits that help-seeking determinants (e.g., structural forces; cultural influences; past help-seeking …

Multi-Jurisdictional Hazard Mitigation Plan For Landslides For The Big Sandy Area Development District, Kentucky, Matt M. Crawford, Hudson J. Koch, Jason M. Dortch

Contract Reports--KGS

Landslides are a complex geologic hazard that occurs worldwide, impacting lives, infrastructure, and property. The Big Sandy Area Development District, Kentucky incurs high landslide activity impacting several municipalities. This hazard mitigation planning project includes landslide susceptibility and risk assessments for the Big Sandy Area Development District. We based the landslide susceptibility model on statistics of hillslope morphological features such as slope, curvature, roughness, aspect, and elevation. Using a dual machine learning approach, we modeled the probability of landslide occurrence, defined as an area that is occupied, or might be occupied in the future, by a landslide. We also developed the …

Surficial Geologic Map Of The Smiths Grove 7.5-Minute Quadrangle, Kentucky, Meredith Swallom, Bailee Nicole Hodelka, Matthew Massey, Hannah Hayes, Charles Wells Iii, Emily Morris

Contract Reports--KGS

The Kentucky Geological Survey (KGS), a state-supported independent research center within the University of Kentucky, is committed to providing accurate and unbiased geologic information on natural resources, environmental issues, and natural hazards in Kentucky. While Kentucky boasts complete coverage by 1:24,000-scale geologic bedrock maps, surficial materials have been largely overlooked, except in regions with thick deposits obscuring the bedrock. Given the increasing trends in economic development and urbanization, detailed surficial geologic mapping has become crucial for supporting geotechnical planning, environmental management, and hazard assessment. In response, KGS has prioritized new, detailed surficial geologic mapping since 2004, specifically targeting areas anticipated …

Cyp6g2 Is The Major P450 Epoxidase Responsible For Juvenile Hormone Biosynthesis In Drosophila Melanogaster, Qiangqiang Jia, Liu Yang, Jiamin Wen, Suning Liu, Di Wen, Wei Luo, Weihua Wang, Subba R. Palli, Li Sheng

Entomology Faculty Publications

Background Juvenile hormones (JH) play crucial role in regulating development and reproduction in insects. The most common form of JH is JH III, derived from MF through epoxidation by CYP15 enzymes. However, in the higher dipterans, such as the fruitfly, Drosophila melanogaster, a bis-epoxide form of JHB3, accounted most of the JH detected. Moreover, these higher dipterans have lost the CYP15 gene from their genomes. As a result, the identity of the P450 epoxidase in the JH biosynthesis pathway in higher dipterans remains unknown.

Results In this study, we show that Cyp6g2 serves as the major JH epoxidase responsible for …

N(Alpha)-Acetyltransferase 40-Mediated Histone Acetylation Plays An Important Role In Ecdysone Regulation Of Metamorphosis In The Red Flour Beetle, Tribolium Castaneum, Sharath Chandra Gaddelapati, Smitha George, Anilkumar Moola, Karthi Sengodan, Subba Reddy Palli

Entomology Faculty Publications

Histone acetylation, a crucial epigenetic modification, is governed by histone acetyltransferases (HATs), that regulate many biological processes. Functions of HATs in insects are not well understood. We identified 27 HATs and determined their functions using RNA interference (RNAi) in the model insect, Tribolium castaneum. Among HATs studied, N-alpha-acetyltransferase 40 (NAA40) knockdown caused a severe phenotype of arrested larval development. The steroid hormone, ecdysone induced NAA40 expression through its receptor, EcR (ecdysone receptor). Interestingly, ecdysone-induced NAA40 regulates EcR expression. NAA40 acetylates histone H4 protein, associated with the promoters of ecdysone response genes: EcR, E74, E75, and HR3, and causes an increase …

The Mechanoreceptor Piezo Is Required For Spermatogenesis In Bombyx Mori, Zhongjie Zhang, Xiaojing Liu, Bo Hu, Kai Chen, Ye Yu, Chenxin Sun, Dalin Zhu, Hua Bai, Subba Reddy Palli, Anjiang Tan

Entomology Faculty Publications

Background The animal sperm shows high diversity in morphology, components, and motility. In the lepidopteran model insect, the silkworm Bombyx mori, two types of sperm, including nucleate fertile eupyrene sperm and anucleate unfertile apyrene sperm, are generated. Apyrene sperm assists fertilization by facilitating the migration of eupyrene spermatozoa from the bursa copulatrix to the spermatheca. During spermatogenesis, eupyrene sperm bundles extrude the cytoplasm by peristaltic squeezing, while the nuclei of the apyrene sperm bundles are discarded with the same process, forming matured sperm.

Results In this study, we describe that a mechanoreceptor BmPiezo, the sole Piezo ortholog in B. mori, …

Tree Species Richness And Ash Density Have Variable Effects On Emerald Ash Borer Biological Control By Woodpeckers And Parasitoid Wasps In Post-Invasion White Ash Stands, Caleb J. Wilson, Toby R. Petrice, Therese M. Poland, Deborah G. Mccullough

Entomology Faculty Publications

Emerald ash borer (EAB) (Agrilus planipennis Fairmaire) (Coleoptera: Buprestidae) is the most destructive insect to invade North American forests. Identifying habitat features that support EAB natural enemies is necessary to enhance EAB biological control. In many forest ecosystems, tree species diversity has been linked with reduced pest abundance and increases in natural enemy abundance. We assessed the influence of tree species richness, ash density, and proportion of total ash basal area on ash canopy condition, EAB larval densities, and biocontrol by woodpeckers and parasitoids in pairs of healthy and declining overstory (DBH > 10 cm) and recruit-sized ash (DBH 2–10 cm) …

The Impact Of Measure 110 On Fatal Overdoses, Property And Violent Crime In Oregon, Hannah Mercado

MPA/MPP/MPFM Capstone Projects

In November 2020, the Drug Addiction Treatment and Recovery Act (also known as Measure 110) was passed in Oregon with the purpose to provide access to treatment and recovery services available to anyone who may need to utilize them, while focusing on a health-oriented approach towards substance use disorder (SUD) across the state through the removal of low-level drug possession criminal penalties (Oregon Health Authority, n.d.). Historically, Oregon has consistently had some of the highest rates of substance use in the U.S., making this a pertinent issue which was addressed through the implementation of Measure 110. Citing a critical need …

Government Grant Receipts And Revenue Volatility: A Correlational Investigation Of Medium-Sized Arts Organizations, Carly Colvin

MPA/MPP/MPFM Capstone Projects

Minimal revenue volatility has been shown to enable more accurate planning by nonprofit managers and contribute to nonprofit financial sustainability. The volatility of government revenues, a major income source for nonprofit organizations, is not a well-researched topic. This capstone presents correlational tests to study the relationship between government grant receipts and revenue volatility within medium-sized nonprofit arts organizations in California. In addition, a data compilation methodology is tested and documented to enable future research. The results do not show a correlation between receipt of government grants and revenue volatility. The ensuing considerations for nonprofit managers along with areas for future …