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Economic Inequality And Family Formation In The United States, Elizabeth S. Krause

Theses and Dissertations--Economics

This dissertation evaluates economic inequality and family formation in the United States in three essays. In Essay 1, I estimate the effect of providing subsidized access to immediate postpartum contraceptives on birth spacing and infant health among low-income teen mothers. The intent-to-treat estimates indicate a 20% reduction in the monthly short-interval birth rate among teens 12-14 months after policy enactment. I also find evidence that the policy increased the average interval between births and reduced preterm and low-birth weight births and NICU admission rates. In Essay 2, I provide evidence that single mothers and single women without children are important …

Metabolism As A Regulator Of Sleep And Cortical Activity In Health And Alzheimer’S Disease, Nicholas J. Constantino

Theses and Dissertations--Neuroscience

Metabolic flexibility is essential for maintaining normal physiological function, enabling an organism to sense, flux, utilize, and switch fuel sources in response to changing energetic availability, demand, and cellular needs. Energetic demands are state-dependent, with wake and sleep exhibiting distinct metabolic profiles. Sleep is highly sensitive to changes in metabolism and requires metabolic flexibility to both transition into and maintain sleep stability. Alzheimer’s disease (AD) is increasingly recognized as a disease of altered metabolism yet is often framed as a disease of energetic failure. We instead define AD as a disease of metabolic inflexibility, characterized not by insufficient energy availability, …

Beyond The Veil: Critical Black Kantianism And The Ethics Of Structural (In)Visibility, Paradise A. Stanford

Theses and Dissertations--Philosophy

This dissertation develops what I call Critical Black Kantianism, a reconstructive approach to Kantian moral philosophy that centers race, recognition, and the structural conditions under which moral agency is formed. While Kantian ethics typically presumes idealized agents operating within just social contexts, this project argues that such abstraction obscures how racial domination actively shapes autonomy, dignity, and self-consciousness. Drawing on W.E.B. Du Bois’ account of double consciousness, Black feminist thought, and contemporary theories of recognition, I show that moral agency is not merely exercised within social environments but is constituted through them—often under conditions of misrecognition that fracture autonomy.

Against …

Linking S‑Pillar Empirical Criteria With Boundary And Finite Element Models For Underground Stone Pillar Analysis, Benjamin Diddle

Theses and Dissertations--Mining Engineering

The objective of this thesis is to strengthen the relationship between empirically based stone pillar design methods and two numerical modeling techniques by calibrating boundary element and finite element models to the S‑Pillar empirical criteria and observed pillar behavior in underground stone mines. The first component of the research investigates the displacement‑discontinuity boundary element method implemented in LaModel, quantifying the influence of the lamination thickness and element size on stone pillar safety factor predictions. Results showed that optimal thickness depends on overburden modulus, while larger element sizes introduce significant SF differences from S-Pillar values once the grid size exceeds 5 …

Reciprocity-Based Transfer Function Techniques For Acoustic Source Reconstruction, Spring Isolator Characterization And Structural Damping Assessment, David Pum Thian Lal Paite Neihguk

Theses and Dissertations--Mechanical and Aerospace Engineering

Reciprocity implies that a system responds identically when the source and receiver positions are interchanged. This dissertation applies this principle to address three practical challenges in noise and vibration characterization, where conventional approaches are limited by inaccessible interfaces, constrained excitation conditions, or metrics that do not fully capture vibroacoustic behavior.

The first study develops and validates an inverse method to characterize ducted acoustic sources using acoustic free velocity. Acoustic reciprocity is applied to simplify transfer function measurements. The method is extended to large cross-section ducts, where the source is reconstructed as a collection of point sources along a plane. Validation …

Human Resource Policy And Practice In The American Regional Theatre: The Intersection Of The Actors’ Equity Association And The League Of Resident Theatres, Kathleen Holland

Theses and Dissertations--Arts Administration

Human resource management plays a critical yet understudied role in the American regional theatre, an industry characterized by project-based labor, mixed union and nonunion workforces, and deeply ingrained cultural norms that prioritize artistic production over worker well-being. This dissertation examines how institutional human resource policies intersect with the Actors’ Equity Association (AEA) collective bargaining agreement and the League of Resident Theatres (LORT), and the implications of these intersections for human resource practice in regional theatre organizations. While entertainment-industry unions predate the formalization of contemporary human resource management, little scholarship has examined how union agreements may shape or substitute for organizational …

A Tale Of Two Serpins: Pathologic And Protective Roles Of Agt And Pai-1 In Metabolic And Cardiovascular Disease, Alex C. Pettey

Theses and Dissertations--Physiology

Metabolic and cardiovascular diseases are leading causes of morbidity and mortality worldwide. Conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD), aortic aneurysm, and cardiac fibrosis have limited pharmacological therapies, underscoring the need for deeper mechanistic investigations. Serine protease inhibitors (serpins) have been implicated in these pathologies and represent potential therapeutic targets. Despite structural homology, serpins regulate diverse physiological processes through both protease inhibition and non-inhibitory mechanisms. This dissertation examines the roles of two serpins, angiotensinogen (AGT) and plasminogen activator inhibitor-1 (PAI-1), in preclinical models of metabolic and cardiovascular disease to identify novel mechanisms that may inform future therapeutic strategies. …

Investigation Into The A/Ss Of Cervical Cancer And Its Effects On Tumor Control Probability In Radiation Therapy, Cameron Thayer-Freeman

Theses and Dissertations--Radiation Medicine

The standard of care for locally advanced cervical cancer is chemoradiation, consisting of conventional external beam therapy (EBT) followed by a boost of high dose rate (HDR) brachytherapy. These two radiation treatments will illicit different degrees of biological response depending on the tissue in question, and quantifying the overall effect the combined treatments will have require some form of biological modeling. The linear quadratic (LQ) model of cell survival is the most widely used radiobiological model in clinics across the nation.

It is quantified by the parameters a and ß, which model how radiation generates lethal damage in a population …

Seasonal Population Dynamics And Interspecific Interactions Of Drosophila Suzukii, Eleanor Mccabe

Theses and Dissertations--Entomology

Invasive species are a growing problem, and it is important to investigate how invasives interact with novel ecosystems, which are characterized by distinct abiotic and biotic factors. In this dissertation, I investigate abiotic and biotic factors affecting two invasive pests in central Kentucky, Drosophila suzukii and Zaprionus indianus. In Kentucky, seasonality, and landscape features on population dynamics and fitness are unknown. I found that D. suzukii overwinters in Kentucky and that wild berry species improve winter survival. I used local weather data to identify meteorological variables that best predict D. suzukii populations. I tested the extent to which D. suzukii …

Managing Dietary Nonstructural Carbohydrates In Insulin Dysregulated Horses: Pasture, Long-Stem Forage, And Restrictive Grazing Strategies, Morgan J. Askins

Theses and Dissertations--Veterinary Science

Insulin dysregulation (ID) is a complex endocrine disorder, impacting a large percentage of the equine population. ID is the defining characteristic of equine metabolic syndrome (EMS). Within the various classifications of EMS horses, the commonality is ID and their higher risk of laminitis. To mitigate insulin response and laminitis risk in ID horses, current management focuses on restricting pasture exposure and feeding low nonstructural carbohydrate (NSC) rations. Minimal studies have evaluated how ID horses respond to pasture of various NSC, long-stem forages, and restrictive grazing strategies. Providing horse owners and managers with improved nutritional management recommendations for ID horses with …

Between The Rails: Experiential Education And Its Impact On Compliance And Consistency In Racetrack Surface Management, Heather Mackenzie

Theses and Dissertations--Community & Leadership Development

Recent regulatory requirements within the Thoroughbred racing industry have increased expectations for consistent collection and reporting of racetrack surface data. Despite clear standards, implementation in daily operations remains inconsistent, highlighting a gap between regulation, knowledge, and practice. This study examined the impact of an experiential education curriculum on racetrack personnel’s self-efficacy and reporting consistency.

Using a quantitative design, data were collected through pre- and post-surveys measuring self-efficacy and records of the number of days surface data were entered. Descriptive statistics, paired-samples t-tests, and effect size analyses were used. Results showed a statistically significant increase in self-efficacy (p < .001) with large effect sizes, indicating meaningful gains in confidence and comfortability. Reporting consistency did not show a statistically significant change (p = .885).

Overall, experiential education …

Understanding Knowledge And Perceptions Of The Beef Industry On A Land-Grant University Campus, Allison E. Reaves

Theses and Dissertations--Community & Leadership Development

A well-researched phenomenon in the agricultural industry is the effects of constant innovation coupled with an increasing divide between producer and consumer. This issue has been presented as especially prevalent within animal agriculture and the beef industry, a predominant concern considering Kentucky’s agricultural commodities. This study (n = 31) utilized a mixed-methods approach to understand the knowledge, perceptions, and behavior of beef consumers on a land-grant university campus. Methodologies included Python’s DeepFace emotion recognition, semi-structured interviews, and the JMALI agricultural literacy assessment. Findings revealed participants to be below expected agricultural literacy levels of high school graduates (M=11), with no …

“They Don't Care If I'M Here Or Not”: The Impact Of Exclusionary Discipline On Black Boys In Elementary Schools, Arielle Gulley

DSW Capstone Projects

Disproportionate and exclusionary school discipline practices continue to affect African American boys as early as elementary school, with significant implications for their mental health, academic engagement, and long-term educational trajectories. This capstone project examines how racially biased discipline contributes to disparities in belonging, emotional well-being, and student-teacher relationships, and advances the need to reframe discipline as a site of mental health intervention rather than punishment.

The systematic literature review synthesizes peer-reviewed research to examine the relationship between exclusionary discipline and mental health outcomes among African American boys in elementary settings, with particular attention to patterns emerging in early educational environments. …

Unseen To Unstoppable: Critically Redefining Care For Rural Women With Alcohol Use Disorders, Nicole Gerace

DSW Capstone Projects

Research reveals that rural women with alcohol use disorders (AUDs) are up to 90% less likely to seek treatment than men or urban women. This Doctor of Social Work capstone project brings together a systematic literature review (SLR), a conceptual paper, and a practice application paper to examine the clinical social work practice problem of rural women with AUDs underutilizing treatment. Collectively, these products investigate factors contributing to these disparities, identify gaps in care, and propose more equitable and responsive approaches to treatment for these women. This project began with an SLR (2020–2025) that investigated clinical treatment interventions that demonstrated …

Establishing An Advanced Practice Provider-Led Transient Ischemic Attack Clinic: A Quality Improvement Initiative, Brittany A. Young

DNP Projects

Background: Due to lack of subspecialized neurological care in many rural community settings, care in tertiary hospitals is in demand. Insufficient care pathways can lead to lack of bed and provider availability. Advanced Practice Provider Transient Ischemic Attack clinics have been shown to be safe alternatives to hospital admission, for patients who meet criteria. This study targeted practice change at a 1000 bed tertiary academic hospital.

Methods: The quasi-experimental study sample inclusion criteria included Transient Ischemic Attack patients presenting to the emergency department with an ABCD2 < 4, complete symptom resolution, and no new cardiac changes on monitoring. A pre and post survey with educational PowerPoint intervention was provided to all emergency department and Neurology providers and nurses. A Transient Ischemic Attack clinic was established with a corresponding order set to be utilized for streamlined outpatient work up.

Results: During the pilot period, 29 admissions were deferred with 69% …

Stronger Together: Exploring The Impact Of Peer Support Meetings On Stress And Burnout In Ambulatory Nurse Managers, Sara Wellman

DNP Projects

Background

Nurse manager (NM) burnout is common and leads to decreased staff productivity, departmental effectiveness, and leadership capacity. This results in decreased staff morale, poor conflict management, and ineffective communication. Stress reduction and resilience programs have been shown to reduce burnout and enhance resilience in NMs, but more focus needs to be directed toward NMs who work in ambulatory settings.

Purpose

The aim of this project was to evaluate the effectiveness of a peer-to-peer resilience intervention in reducing stress and burnout among ambulatory nurse managers.

Methods

This project used a pre-test/post-test survey design and a convenience sample of ambulatory NMs. …

Rural Oral Health Access Coordination Program Proposal, Anna Luu

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

Oral health disparities remain a major public health issue in the United States, particularly in rural Kentucky, with barriers such as limited access to preventive dental services, transportation, and insurance coverage contributing to delayed treatment and worsening oral health outcomes. In response, the proposed Rural Oral Health Access Coordination Program aims to improve care access by strengthening referral systems, integrating oral health screenings into public health settings, and enhancing care coordination for high-risk populations. The program intends to focus on the Kentucky River District Health Department Region, connecting individuals to existing services rather than providing direct clinical care. Expected outcomes …

Exploring The Influence Of Quadriceps Peak Torque And Rate Of Torque Development On Running Mechanics After Anterior Cruciate Ligament Reconstruction, Amit M. Gohil, Gregory S. Hawk, Darren L. Johnson, Christopher S. Fry, Brian W. Noehren

Physical Therapy Faculty Publications

Background: After anterior cruciate ligament reconstruction (ACLR), chronic changes in knee joint biomechanics during higher level tasks, such as running, may negatively impact long-term knee joint health. Among the factors that contribute to these chronic changes, the influence of quadriceps strength on knee joint biomechanics during running is not well understood.   Hypothesis: Higher involved limb quadriceps strength (peak torque and rate of torque development [RTD]) and limb symmetry index (LSI) will be positively associated with greater peak knee flexion angle and peak knee extensor moment during running.   Study Design: Cross-sectional study.   Level of Evidence: Level 3.   Methods: Peak knee extensor …

Prevalence And Incidence Of Heart Failure Phenotypes Among Transgender And Gender-Diverse Adults In The United States, Ian K. Everitt, Emily K. Quinn, Meredith S. Duncan, Chris Grasso, Sari L. Reisner, Guneet K. Jasuja, Tonia Poteat, Ayelet Shapira-Daniels, Howard Cabral, Vin Tangpricha, Michael K. Paasche-Orlow, Emelia J. Benjamin, Monica Mukherjee, Carl G. Streed

Biostatistics Faculty Publications

BACKGROUND: Prevalent and incident heart failure (HF) and its comorbidities have not been characterized in transgender and gender-diverse (TGD) populations. This study determines the prevalence and incidence of HF phenotypes by gender identity. METHODS: A retrospective cohort analysis was performed using deidentified administrative claims from the Optum Labs Data Warehouse (2006-2022). TGD adults and a sample of demographically similar cisgender comparators were identified using a validated algorithm, and gender identity was categorized as cisgender man, cisgender woman, transmasculine, transfeminine, or unclassified TGD. Prevalent and incident HF, including systolic, diastolic, and unclassified phenotypes, were assessed using diagnosis codes. Multivariable logistic and …

Unexpected Longevity In Myasthenia Gravis, Bhupendra O. Khatri, Scott Schutten, Sergey Tarima

Biostatistics Faculty Publications

Background: This study compares age at death in patients with myasthenia gravis (MG) and multiple sclerosis (MS) with the general U.S. population and examines age at death patterns during a period preceding modern high-efficacy therapies. Objective: To compare age at death among individuals with MG and MS with the general population and assess differences in age at death between MG and MS. Design: Retrospective population-based study using death certificate data from four U.S. states (Florida, Wisconsin, Texas, and New York) for 2000, 2005, 2010, and 2015. Methods: Individuals with MG or MS listed on death certificates were identified. Age at …

Catwalk Xt Enables Sensitive Detection Of Locomotor Deficits After C2 Hemisection And Integrates Readily Into Ongoing Experimental Workflows In Adult Female Rats, Aaron L. Silverstein, Christopher M. Calulot, Christopher J. Mclouth, John C. Gensel, Warren J. Alilain

Biostatistics Faculty Publications

Over half of all spinal cord injuries (SCIs) in the United States occur at the cervical level and often cause both life-threatening breathing dysfunction and profound locomotor deficits. Although the C2 hemisection (C2Hx) model is vital for study of breathing dysfunction after experimental SCI, post-C2Hx locomotor deficits have only been assessed by metrics such as the Martínez Scale and ladder tests, which require time-intensive scoring by human observers. However, the CatWalk XT Gait Analysis system (Noldus Information Technology) delivers automated, quantitative assessment of interlimb coordination, gait cycle, and paw function, providing robust locomotor data in a time-efficient and practical manner. …

Integration Of Community-Engaged Research Technology And Methods To Guide Tobacco Regulatory Science In Rural Communities, Melissa H. Abadi, Stephen R. Shamblen, Mary Kay Rayens, Kirsten T. Thompson, Amy Wildman, Kathy Rademacher, William Wieczorek, Raphael Nishimura, Shyanika W. Rose, Mikhail N. Koffarnus, Seth Himelhoch, Ellen J. Hahn

Biostatistics Faculty Publications

Objective – This study aims to build a rural Appalachian cohort to examine how US Food and Drug Administration (FDA) Center for Tobacco Products (CTP) regulatory policies influence tobacco and nicotine product use across levels of rurality. Methods – The AppalTRUST (Appalachian Tobacco Regulatory Science Team) Cohort integrates four inter-connected Community-engaged Research + Technology (CEnRT) elements to support recruitment and retention: (1) building trust and cultural relevance; (2) addressing barriers to participation in research; (3) focusing on ethics and confidentiality; and (4) fostering ongoing and consistent collaboration between the scientific and field teams. The study uses a dual sampling design …

Raising The Profile Of Collaborative Biostatisticians In Team Science, Margaret R. Stedman, C. Christina Mehta, Emily Slade, Patricia L. Hibberd, Glenn M. Chertow, Robert H. Podolsky, Sowmya R. Rao

Biostatistics Faculty Publications

Recent emphasis on transdisciplinary teams in science offers an opportunity for biostatisticians to assume roles beyond data management and analysis. Biostatisticians contribute to all phases of research, from hypothesis formulation and rigorous study design to data analysis and interpretation. Yet, their contributions are often underrecognized. We argue for better integration of biostatisticians in research training and team structures. Postgraduate physician-scientist training should include mentorship from biostatisticians and education on collaborative skills. Fully integrating biostatisticians as co-investigators improves rigor, reproducibility, and innovation. Institutional support, including protected time and updated promotion criteria, is essential to support sustained collaboration. Structural changes must address …

Reimagining Hospital Medicine For Long-Term Sustainability, Samantha Murray-Bainer, Margaret Shyu, Rachel Peterson, Michael Hendricks, Christine Welles, Gopi Astik, Khoosh Dayton, Kristen Mcquerry, Joy Engblade

Biostatistics Faculty Publications

Background: High rates of burnout and turnover exist in the field of hospital medicine. Factors that make the career less sustainable and impact hospitalists as they age are not well understood. Objective: To identify factors that promote or impede hospitalist career longevity and understand job- and age-related challenges faced by older hospitalists. Design: Mixed-methods study of semi-structured qualitative focus groups within a national hospitalist consortium followed by a brief participant survey. Focus group discussions were recorded, summarized, and analyzed using matrix analyses to identify themes and subthemes. Participants: Thirty-seven attendees of the HOMERuN collaborative session in November 2024 participated in …

Rethinking Team Science Metrics Through Collaborative Guideposts, Kristen J. Mcquerry, Kelsey Karnik, Megan E. Hall, Caitline Phan, Yana Feygin, Emily Slade

Biostatistics Faculty Publications

Introduction – The increasing reliance on interdisciplinary and transdisciplinary teams has reshaped how science is conducted, yet evaluating the success of such teams remains a persistent challenge. Traditional metrics, such as publication counts, impact factors, and citation indices, fail to capture the full scope of team contributions, particularly in contexts where success may be defined by community engagement, mentorship, or long-term collaboration. Methods – In this Perspective, we introduce Collaborative Guideposts, a framework designed to align success metrics with a team’s organizing priorities. We illustrate this approach through two contrasting team models from a biostatistical collaboration center: Team A, a …

The Influence Of Support From Family, Friends, And Community On Perceived Mental Health Status In Diabetes, Courtney L. Ortz, Meredith S. Duncan, Oluwatosin Leshi, Suraksha Khanal, Brittany Smalls

Biostatistics Faculty Publications

Strong social support is a protective factor in diabetes and mental health management. The purpose of this study was to examine the influence of the type of support on perceived mental health status among people with diabetes. We used data from the 2021 Household Component of the Medical Expenditure Survey (MEPS). Regression models assessed the association between mental well-being (outcome) and expected help from family, friends, and the community (exposure). Support from both friends and family were significantly associated with better mental well-being, adjusting for covariates. Secondary analyses showed that those who reported greater anticipated support from family were more …

From County To Commonwealth: A Study Of Kentucky County Election Office Websites And Collaborative Solutions For Strengthened Voter Information Accessibility, Marissa A. Robinson, Marina E. Smart

MPA/MPP/MPFM Capstone Projects

In 2022, the League of Women Voters discovered inconsistencies across Kentucky county clerk websites in how they offer voter information and in website accessibility and clarity. County clerk websites serve as an important source of accessible voting procedural information, trusted by constituents. Through an audit of county clerk websites and interviews with county clerks, this project identifies how county election office websites can better provide equitable, accurate, comprehensive, and consistent voting information. Recommendations based on the findings include linking the Kentucky State Board of Elections Voter Information Portal universally, adding website training, and state-established website guidelines.

The Political Economy Of Pfas Treatment And Water Regionalization In Harrison County, Kentucky, Jackson S. Patru, Rajan Sampat

MPA/MPP/MPFM Capstone Projects

The discovery of per- and polyfluoroalkyl substances (PFAS) in the water supply of Harrison County, Kentucky has prompted an urgent reevaluation of local treatment infrastructure. This situation has exposed a complex political economy between the City of Cynthiana, which owns and operates the municipal water plant, and the Harrison County Water Association (HCWA), which represents the majority of the ratepayers supplied by the plant. Using a qualitative research design grounded in inductive thematic analysis, semi-structured interviews were conducted with leadership from both Cynthiana and HCWA, as well as operators at the treatment plant, to evaluate two proposed solutions: a $14 …

Narrowing The K-12 Excellence Gap In Kentucky Schools: Lessons On High Achievement From High Achievers, Jimmy M. W. Bartlett, Johnathan K. Hurley

MPA/MPP/MPFM Capstone Projects

Disparities in high-level academic achievement – known as excellence gaps – remain a persistent equity challenge in K–12 education, particularly in access to advanced mathematics learning. This study examines school-level practices associated with narrower excellence gaps in Kentucky public schools. Principals of schools demonstrating higher-than-expected advanced achievement and relatively small gaps by gender and economic status were invited to semi-structured interviews. The interviews cover seven schools, spanning grade levels and other characteristics. Guided by the Excellence Gap Intervention Model, a hybrid inductive–deductive thematic analysis reveals that narrower excellence gaps are not driven by isolated programs or policy mandates, but by …

Comparing Economic Development And Blight Remediation Tax Increment Financing: Design, Governance, And Measurable Outcomes, Leigh Compton

MPA/MPP/MPFM Capstone Projects

Tax Increment Financing (TIF) is a widely used local government tool for redevelopment and economic growth, yet its expanding application has raised questions regarding its design, governance, and measurable outcomes. This study compares two primary uses of TIF: blight remediation and economic development. While remediation-focused TIF is intended to address identifiable market failures in distressed areas, economic development TIF is typically used to attract or accelerate private investment in more competitive environments.

Using a structured comparative analysis of selected Kentucky TIF districts, this research evaluates how differences in statutory justification, financing mechanisms, governance structures, and performance measures align with each …