Community Pharmacy Provision Of Extended-Release Injectable Naltrexone In Kentucky: Perspective Of People Who Use Opioids, Anye Wamucho

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

Aim: To identify demographic, socio-economic, and other factors associated with likelihood of obtaining extended-release injectable naltrexone (EIN) if provided in a private space at a local pharmacy among people who use opioids (PWUO) in rural Appalachian Kentucky.

Methods: People who used opioids in the past 6 months in rural Appalachian Kentucky (n=170) completed interviewer-administered questionnaires eliciting demographic, socio-economic, and other characteristics. Participants were also asked about whether they will be more likely to obtain EIN if provided in a private space at a local pharmacy. Factors associated with increased likelihood to obtain pharmacy-provided EIN were assessed using unadjusted univariate and …

Covid-19 Vaccine Acceptance, Hesitancy, And Refusal Among Educators In Spring Of 2021, Jenifer O'Brien

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

The COVID-19 pandemic provided unprecedented vaccine development and deployment. Educators were among the first non-healthcare occupations to become eligible for the vaccine, and were an early predictor of vaccine hesitancy especially among educated females. By the spring of 2021, 87% of teachers had received at least one dose of the COVID-19 vaccine. Among those who expressed hesitancy, no defining demographic factors were found. Those who expressed hesitancy commonly cited a rushed vaccine development process and fear of long term side effects as reasons against vaccination.

The Meals On Wheels-Breathitt: A Health Campaign For Reducing Food Insecurity Among The Older Adults In Breathitt County, Kentucky., Sarah Haroon

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

The population of the United States of America is aging at a faster rate than ever before. More than 1 in 6 Americans are now 65 or older (The Washington Post, 2023). Since 2010, compared to people under 65, there has been close to a two-hundred percent increase in people 65 and above (The Washington Post, 2023). The rise in the aging U.S. population is due to increased life span and people living longer (U.S. Census Bureau, 2020). Furthermore, life expectancy for the total U.S. population is projected to increase by six years, from 79.7 in 2017 to 85.6 by …

Gambling On Growth: An Analysis Of The Early Impact Of Historical Horse Racing On Kentucky’S Thoroughbred Industry, Barrett W. Kerr

Theses and Dissertations--Agricultural Economics

With a continuous decline in on-track wagering on Thoroughbred racing, racetrack operators are exploring alternative revenue sources to fund purses and create better quality racing. Historical Horse Racing (HHR), which represents one of the most recent advancements in parimutuel wagering, has become a popular system used by many states to offset the live wagering decline. Proponents of HHR suggest that this alternative wagering option will benefit the live racing industry. Using data from Kentucky racetracks from 2002 – 2021, this study examines the relationship between HHR wagering and key industry metrics, such as purses, on-track wagering, sales prices, and foal …

Personality Traits Of Dairy Calves And Their Relationship With Feeding Behavior, Activity, And Performance, Emily A. Michalski

Theses and Dissertations--Animal and Food Sciences

Detection of individual differences in personality traits of animals may prove beneficial for producers to help tailor management for individuals and to make selection decisions. Therefore, the objectives of this thesis were to

1) review and evaluate literature on relationships between individual cattle personality traits and feeding behavior, activity, and performance; and

2) evaluate and develop tests suitable for characterizing crossbred dairy-beef calves’ personalities and associations with behavioral patterns and performance.

The existing literature indicates that growth, intake, activity, and milk production measures from precision technologies have associations with cattle personality traits and behaviors identifiable through standardized tests. This indicates …

Trauma-Informed Legal Advocacy, Laken Albrink

Law Faculty Scholarly Articles

A trauma-informed approach in legal practice can reduce the re-traumatization of victims, provide recognition of the role trauma plays in the attorney-client relationship, and provide legal professionals with the opportunity to increase connections to their clients and improve advocacy.1 Part Two of this article defines trauma and adverse childhood experiences and the impact they have on clients. It then explores indicators of trauma and how they may present case barriers if the attorney is not trauma informed. Part Three explores ways attorneys can tailor their practice of law to be trauma-informed with clients, support staff, and other professionals. It demonstrates …

Transfers And Licensing Of Copyrights To Nft Purchasers, Michael D. Murray

Law Faculty Scholarly Articles

Property as a concept in the law means the right to own and control something and to exclude others from using and controlling it. This concept often is expressed as the rights owner having a monopoly over the thing that is owned. When the term “intellectual” is added to the concept of property, it means that the thing protected is a non-tangible item devised, imagined, developed, or invented by a person or group, and that thing has value deserving of protection in the law. Copyright is one form of intellectual property (“IP”), the others being trademarks, patents, right of publicity, …

Trademarks, Nfts, And The Law Of The Metaverse, Michael D. Murray

Law Faculty Scholarly Articles

This Article discusses the early encounters of NFTs, trademarks, and the legal system. This work will examine the areas where NFT creators are getting into or are likely to get into trouble with the law and policy of trademark infringement, trademark dilution, and the related legal causes of action of false endorsement and false designation of origin. United States law is being applied in lawsuits that already are being adjudicated in the real world concerning subject matter that exists only in cyberspace, the pre-cursor to the metaverse.

Nft Ownership And Copyrights, Michael D. Murray

Law Faculty Scholarly Articles

Non-fungible tokens (NFTs) have made enormous waves in the art, music, entertainment, and collectibles world, but the backwash of this blockchain technology has inundated and overwhelmed many peoples’ understanding of intellectual property (IP) law in general and copyright law in particular when it comes to NFTs and blockchains. Artists and creatives who mint NFTs often have very different understandings and expectations from collectors and investors who purchase and use them when it comes to the copyrights associated with the content linked to an NFT. Art law attorneys may not have gone fully down the rabbit hole that is the current …

Nfts Rescue Resale Royalties? The Wonderfully Complicated Ability Of Nft Smart Contracts To Allow Resale Royalty Rights, Michael D. Murray

Law Faculty Scholarly Articles

Resale royalty rights (also known by the French phrase, droit de suite or “right of continuation” rights) give artists a right to participate in the proceeds realized from the resale of their works. According to DuBoff, “[w]hile copyright laws give the creator of a work the right to control eproduction of the work, many visual artists do not benefit as directly as print authors do from this aspect of copyright protection.” Unlike print authors, who derive their primary economic return on a literary work through the sale of multiple copies, visual artists receive most of their economic returns from the …

Generative Ai Art: Copyright Infringement And Fair Use, Michael D. Murray

Law Faculty Scholarly Articles

The discussion of AI copyright infringement or fair use often skips over all the required steps of the infringement analysis in order to focus on the most intriguing question, “Could a visual generative AI generate a work that potentially infringes a preexisting copyrighted work?” and then the discussion skips further ahead to, “Would the AI have a fair use defense, most likely under the transformative test?” These are relevant questions, but without considering the actual steps of the copyright infringement analysis, the discussion is misleading or even irrelevant. This neglecting of topics and stages of the infringement analysis fails to …

Precious And Dear To Us Is Only This Place: The Transformative Potential Of Monumental Remnants, Zachary A. Bray

Law Faculty Scholarly Articles

When monuments are torn down, what remains, and what should we do with the remains? In the United States as elsewhere, recent political and social conflicts have led to the destruction or relocation of many monuments—sometimes spontaneous, sometimes carefully planned. Much attention has been focused on these processes of removal and relocation, and the laws that hinder or advance these changes. On the other hand, relatively little attention has been paid to what remains behind after monuments are removed or destroyed: the vacant spaces, empty pedestals, fragments of statues, and so forth. Sometimes these remnants are protected by laws that …

Introduction: There Must Be Something In The Water - Or The Bourbon - In Kentucky: Voting Rights In The Bluegrass State, Joshua A. Douglas

Law Faculty Scholarly Articles

Kentucky is best known for three things: horses, bourbon, and basketball. Add positive improvements for the right to vote to the list.

The Bluegrass state has made national news in recent years for its election rules. In 2020, many people in the media and advocacy world pointed to Kentucky as a model for administering an election during the COVID-19 pandemic. Under a bipartisan agreement between the Democratic Governor and Republican Secretary of State, Kentucky initially postponed the 2020 primary to provide for additional planning time. Then it implemented smart rules to ease access to vote-by-mail and made in-person voting safer …

Reading Legal Ethnographies To Re-Map Legal Pluralism: A Pospisilian Corrective To The Prevailing Dichotomous Description Of Afghanistan’S Legal Order, Tomas Ledvinka, James M. Donovan

Law Faculty Scholarly Articles

This article explores several ethnographies (both academic and para-academic) of Afghanistan’s traditional justice (jirgas and shuras) in order to illuminate contrasts of their conceptual approaches at different periods of the country’s history. In this genealogy we identify ethnographic observations of the levels at which various sociolegal authorities operate and which often elude standard international ontology. The article takes the legal ethnographies as signposts for a conceptual reframing of the legal situation in the country by drawing upon Pospisil’s legal-anthropological conceptual approach which offers an alternative to generic global legal models based on binary oppositions such as formal–informal, state–non-state or official–traditional. …

A Multilevel Nonlinear Approach Of Piecewise Regression For Detecting Turning Points: Developing An Alternative Platform With An Application Of Timss, Jing Zhang

Theses and Dissertations--Education Sciences

Studies in recent years have explored the methods of identifying the turning points when dealing with the non-linear relationship. Four approaches applied by researchers, the eyeball approach, the establishment approach, the theory-driven approach, and the data-driven approach, are all under the traditional piecewise regression framework when seeking turning points. Thus, the purpose of this study is to introduce a multilevel piecewise regression model to identify the turning point beyond the traditional piecewise regression, as a completely non-linear approach.

Data used for this study is TIMSS 2019 United States sample. TIMSS is a project guided by the International Association for the …

Rebranding The Battle Against Clinician Burnout, Taylor Albitar

DSW Capstone Projects

The purpose of this capstone project is to take a deep dive into the issue of burnout among marginalized healthcare providers. This paper will dissect key points in history that target wellness and define terms that are relevant to understanding the effects of burnout on a person’s work-life balance. It will be divided into several sections, including an overview of the problem and contributing factors, a thorough review of relevant literature, a conceptual idea that will explore both the problem at hand and theories that can help with its effects, and finally a practice application that will serve as the …

Removing The Masc: Dismantling Gendered Occupations Through Social Work Education, Austin M. Raines

DSW Capstone Projects

The “Masculine mystique” refers to a psychological mask that men wear, enabling them to maintain power and distance themselves from traits associated with femininity” (Kahn, 2009, p. 283). This capstone project seeks to solve the Social Work Grand Challenge of improving the lives that hegemonic masculinity harms and limits. It emphasizes the relationship between the two areas of life (work-home), once thought to exist in different realms but are today more interwoven than ever (Lin & Burgard, 2018; Sok et al., 2014). Men have higher rates of traumatic injuries and exposure to significant physical risks, violence hazards, and stricter normative …

The Strong Black Woman Schema: A Proactive Approach To Conceptualizing And Providing Mental Health Treatment For Black Women Who Identify With The Strong Black Woman Schema, Kendra Mulder

DSW Capstone Projects

The Strong Black Woman Schema is the ideology that Black women should display mental and physical strength, stoicism, and nurturer traits. While Black women who identify with this schema typically associate this term with a positive identity, there are adverse outcomes that stem from this identification. Black women who identify with the Strong Black Woman schema experience higher rates of depression, anxiety, and psychological distress. No treatment modality has been determined to treat Black women who identify with the Strong Black Woman Schema. This capstone presentation will present a systematic literature review that discusses how the Strong Black Woman Schema …

Epidemiology Of Sars-Cov-2 Breakthrough Infections In Kentucky March 1st 2021 - December 31st, 2022, Harrison Hynes

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

Objective: Provide epidemiologic overview of SARS-CoV-2 breakthrough infections in Kentucky considering both demographic and geographic variables.

Background: We believe descriptive information of breakthrough cases for a defined population will provide public health practitioners with useful information relating to SARS-CoV-2 infection control and vaccination efforts.

Methods: We obtained SARS-CoV-2 case data from the Kentucky Department for Public Health COVID-19 case repository, which mirrors National Electronic Disease Surveillance System (NEDSS) data. The study sample used for analysis comprised 147,000 individuals who tested positive for SARS-CoV-2 in Kentucky between the dates of March 1^st, 2021 and December 31^st, 2022. …

Saint Louis, Missouri Maternal Mortality Prevention Program: Rose Program, Abbi Peck

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

In the United States, maternal mortality has become a growing public health concern after recent studies revealed significant disparities in maternal health outcomes when compared to other high-income countries (The Commonwealth Fund, 2020). The World Health Organization (WHO) defines maternal mortality as the death of a pregnant woman or the death of a woman within 42 days of delivery, miscarriage, termination, or ectopic pregnancy (Centers for Disease Control and Prevention, 2022a). From 2017-2019, the maternal mortality in Saint Louis, Missouri, the state’s largest and most populated metropolitan area, was determined to be 36.4 maternal deaths per 100,000 live births. This …

Physical Inactivity And Single-Female Caregivers, Johanna Hoch, Rachel Hogg-Graham Dr., John Lyons Dr., Maureen Jones Dr.

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

Physical activity is vital for human health. However, many adults in the United States and beyond do not reach the pre-determined recommended levels of activity needed for health benefits. Single-female caregivers present a unique and vulnerable population that is often more inactive than their partnered peers or single-male caregivers. The primary purpose of this cross-sectional investigation was to identify the prevalence of physical inactivity in single-family, female-led households and determine differences in personal factors and social determinants of health between single-female caregivers who indicated they were physically active compared to single-female caregivers who indicated they were not physically active. A …

Implementation Of A School-Based Adolescent Pregnancy Prevention Program In Harlan County, Kentucky, Jaycea Frederick

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

Kentucky has the 6^th highest rate of adolescent pregnancy in the United States and Harlan County ranks among the highest rates in the state. Adolescent pregnancy is a public health problem and costs taxpayers in the United States around $9.4 billion each year. Overall, there have been declines in adolescent pregnancy but the national average soars above those in other Western industrialized nations such as the United Kingdom. Implementing a comprehensive sexual health education program in a public school setting is an efficient strategy to reach numerous adolescents and influence sexual health knowledge and help to delay the initiation …

Multiscale And Multimodality Optical Imaging Of Brain Hemodynamics And Function, Mehrana Mohtasebi

Theses and Dissertations--Biomedical Engineering

Frequent measurement of cerebral hemodynamics is crucial for continuous assessment of brain function and health. Low-frequency oscillations (LFOs; < 0.1 Hz) have shown promise as an indicator of altered neurologic activity in the abnormal brain. Moreover, quantification of temporal correlations in LFOs across distinct brain regions enables mapping of regional neurovascular disorders. Portable diffuse optical techniques such as near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS) enable noninvasive and continuous measurements of cerebral oxygenation and cerebral blood flow (CBF), respectively. However, most NIRS/DCS systems use limited numbers of discrete light sources and detectors and thus lack combinations of high temporal/spatial resolution and large field-of-view (FOV) for brain imaging. Recent development of an innovative noncontact speckle contrast diffuse correlation tomography (scDCT) in our lab provides a low-cost and portable tool for high-density imaging of CBF distributions over large FOVs. The scDCT uses a galvo-mirror to remotely deliver coherent point near-infrared light to multiple source positions and a CMOS camera as a high-density 2-D detector array to quantify spatial fluctuations of diffuse laser speckles, resulting from movement of red blood cells. Boundary CBF data were input to a unique finite-element-method (FEM)-based reconstruction algorithm for 3-D imaging of CBF distributions. However, scDCT was hindered for extracting LFOs due to its low sampling rate. In this study, scDCT was optimized to achieve high sampling rates and fast image reconstructions by use of moving window algorithms with parallel computations (Project 1). Power spectral density (PSD) analysis was performed to investigate altered LFOs during transient cerebral ischemia in neonatal piglets. Transient cerebral ischemia caused reductions in both CBF and PSD, supporting inclusion of scDCT in the growing field of LFO analysis. One remaining limitation was the long computational time required for 3-D reconstruction, which prohibited real-time applications. To overcome this limitation, a depth-sensitive diffuse speckle contrast topography (DSCT) method was developed for analyzing scDCT data to achieve fast and high-density 2-D mapping of CBF distribution without the need of complex and time-consuming 3-D reconstructions (Project 2). New head-simulating phantoms with known optical/geometric properties were designed and fabricated to evaluate the spatial resolution and depth sensitivity of DSCT method. In-vivo experiments verified the capability of DSCT in tracking dynamic changes in CBF at different depths during CO₂ inhalation and transient cerebral ischemia in rats. In addition to preclinical studies, a low-cost, wearable, fluorescence eye loupe (FLoupe) device was invented for intraoperative visualization of brain tumor margin in the clinic (Project 3). Consistent results were observed against an expensive, large, standard fluorescence operative microscope for the guidance of tumor resection. Overall, through 3 projects this dissertation demonstrated a variety of noninvasive noncontact optical technologies (scDCT, DSCT, and FLoupe) that enabled multiscale (rodents, piglets, and humans) and …

A Wearable Fiber-Free Optical Sensor For Continuous Measurements Of Cerebral Blood Flow And Oxygenation, Xuhui Liu

Theses and Dissertations--Biomedical Engineering

Wearable technologies for continuous monitoring of cerebral hemodynamics in freely behaving subjects not only advance our understanding of cognitive processing and adaptive behavior, but also provide vital information for diagnosis and therapeutic assessment of cerebral diseases associated with hypoxia/ischemia. Wearable near-infrared diffuse optical techniques have been used at the bedside to probe deep cerebral hemodynamics, including near-infrared spectroscopy (NIRS) for cerebral oxygenation measurement and diffuse correlation spectroscopy (DCS) for cerebral blood flow (CBF) measurement, respectively. However, most systems are relatively large and expensive, and use rigid fiber-optic probes that significantly constrain subject’s movement. A novel, wearable, fiber-free diffuse speckle contrast …

Quantitative Microbial Risk Assessment (Qmra) For Urban Stormwater Reuse After Treatment Through A Bioretention System, Isaac Oluk

Theses and Dissertations--Civil Engineering

Bioretention, also referred to as a stormwater biofilter, is an extensively used low-impact development technology for both stormwater management and water quality gains. However, little attention has been paid to the acceptability and uncertainty of human health risks associated with the treatment performance of bioretention filter media, and non-potable water reuse scenarios to guide decision-making and system design. This study uses bioretention mechanistic modeling paired with quantitative microbial risk assessment (QMRA) under uncertainty to evaluate human health risks from two reference pathogens – Campylobacter jejuni and Cryptosporidium. Consumption of irrigated green salad, consumption of raw green salad washed with effluent, …

Do Transportation Network Companies Affect Road Safety Outcomes: A Spatially Detailed Analysis In San Francisco, Vedant Shriniwas Goyal

Theses and Dissertations--Civil Engineering

US traffic fatal deaths have steadily risen since 2010, with the past few years witnessing an unusual trend increase. To reverse such a dangerous trend, one must understand how and why road crashes occur and which factors are causing them. Emerging transportation technologies have shown the potential to improve mobility and safety. However, such technologies are not inherently beneficial and could worsen road safety if not effectively implemented. One such transportation technology that warrants investigation is the rise of ridesharing services, also called Transportation Network Companies (TNCs). The primary goal of the dissertation is to explore the statistical relationship between …

Prediction Of Chlorine And Disinfection Byproduct Concentration In Water Distribution Systems Using Kypipe And Tthm Regression Models: Application To Two Systems In Kentucky, Yogesh Gautam

Theses and Dissertations--Civil Engineering

The main objective of this research is to study if the hydraulic and water quality models can be used for water quality analysis of chlorine decay and TTHM formation at various locations across a water distribution system. This is particularly important because it is not always easy or economical to take multiple field samples and analyze them in the laboratory. In this study, models of two different water distribution systems (one more urban and efficiently managed system located in a relative flat topography, and other more rural and less efficiently managed system located in a mountainous topography) were developed in …

Estimating The Effectiveness Of Incentives On The Adoption Of Electric Vehicles, Michelle O. Imarah

Theses and Dissertations--Civil Engineering

This study aims to estimate the effectiveness of incentives in increasing the adoption of electric vehicles (EVs) among households in the near future. Five scenarios were tested using a vehicle type choice model estimated from the 2017 National Household Travel Survey (NHTS) data: (1) increasing the number of EV chargers, (2) reducing the purchase price of EVs based on household income, (3) increasing the number of EV models and makes, (4) increasing the EV range, and (5) all scenarios at once. Results showed that all the scenarios were effective in increasing EV adoption amongst households. Some scenarios were more effective …

Digital Twins For Ancillary Transportation Asset Data Management, Ashtarout Ammar

Theses and Dissertations--Civil Engineering

Transportation Asset Management (TAM) is a data-driven decision-making process to maintain and extend the serviceability of transportation assets throughout their lifecycle. TAM is an extensive data process requiring accurate, high-quality information for better decision-making. A significant challenge that state Departments of Transportation (DOTs) face is allocating limited funds to optimize their assets’ performance. The criticality of this challenge increases when state DOTs need to manage a wide variety of assets distributed along with a vast network; thus, they prioritize the management of high-value assets and visible ones such as bridges, and they pay less attention to ancillary assets even though …

Rollout Of A Digital Comprehensive Safety Management System In A Large Public Agency: A Case Study With Kentucky Transportation Cabinet, Salena Pham

Theses and Dissertations--Civil Engineering

It’s understood that construction is extremely dangerous and highway construction has an added risk that comes from the presence of traffic. Many steps and prevention measures can be taken to reduce the risks to workers’ safety in highway work zones. Kentucky Transportation Cabinet (KYTC) realized they had room for improvement and wanted to have a database that would allow for analysis of the common causes of incidents. The new software KYTC wanted to implement is called Origami Risk. Origami Risk is a cloud-based safety management system (SMS) software that offers a huge range of customizable risk management, RMIS, environmental health …