Digital Commons Network^™

Prolonged Invasive Mechanical Ventilation Is Associated With Decreased Survival After Lung Transplantation Among Recipients With Primary Graft Dysfunction, Meghan Aversa, Shaf Keshavjee, Tereza Martinu, Marcelo Cypel, Andrew T. Sage, Joshua M. Diamond, Jonathan P. Singer, Scott M. Palmer, Krishna Pandya, Edward Cantu, Jason D. Christie, Michaela R. Anderson

Surgery Faculty Publications

Introduction: Prolonged invasive mechanical ventilation (IMV) after lung transplantation is an appealing early prognostic outcome as it can be reproducibly assessed both prospectively and retrospectively. Whether use of IMV at 72 h after lung transplantation is associated with post-transplant graft survival is unknown. Methods: We performed a retrospective cohort study of 1511 participants in the multi-center Lung Transplant Outcomes Group cohort (2011–2018). Using Cox proportional hazards models and restricted mean survival time, we investigated whether IMV at 72 h was associated with post-transplant graft survival. We secondarily evaluated whether IMV at 72 h was concordant with severe primary graft dysfunction …

Mouse Models For Post-Sepsis Syndrome, John Matthew K. Ang, Stephanie F. Mori, Erick Lewis, Maria E.C. Bruno, Arnold Stromberg, Hiroshi Saito

Surgery Faculty Publications

Background – Sepsis survivors commonly suffer from chronic Post-Sepsis Syndrome (PSS). To understand the mechanisms of PSS, it is critical to utilize appropriate animal models. While cecal ligation and puncture (CLP) is a widely used model of sepsis, a concern exists regarding its suitability for studying long-term outcomes. Alternatively, we previously optimized a highly reproducible murine cecal slurry (CS)-injection model of sepsis. The objective of this study was to compare the suitability of CS and CLP models for investigating PSS. Methods – Male 4-month-old C57BL/6 mice were divided into 7 groups: (1) Naïve control; (2) Sham: laparotomy control; (3) CL: …

Scrolling, Searching, And Self-Diagnosing: Examining How Social Media Influences Self- Diagnosis And Shapes Mental Health Literacy, Conceptualization, And Identity Development, Sara Elaine Hamilton

DSW Capstone Projects

This capstone examines the influence of social media on the growing issue of self-diagnosis of mental health disorders through three scholarly works: a systematic literature review (SLR), a conceptual paper, and practice application paper. Accessibility, anonymity, and social isolation are identified as contributing factors of self-diagnosis, as individuals increasingly prioritize convenience over traditional help-seeking methods. Research suggests that self-diagnosis is influenced by misinformation and reinforced by validation and a sense of belonging, leading individuals to internalize mental health disorders as part of their identity. Findings further indicate that social media plays a significant role in the dissemination of misinformation about …

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Effect Of Substrate Dispersion Method And Particle Size On In Vitro Digestibility, Gas Production Kinetics And Composition, And Fermentation Characteristics In Different Feed Types, Luiz C. O. Sousa, Ellem M. A. Matos, Ronald J. Trotta, Edenio Detmann, David L. Harmon

Animal and Food Sciences Faculty Publications

Our objective was to evaluate the influence of substrate dispersion method and particle size on in vitro digestibility, gas production kinetics and composition, and fermentation characteristics of different feed types. Alfalfa hay, tall fescue hay, ground corn, soybean meal, and a total mixed ration (TMR) were used as substrates. Treatments were designed according to a 2 × 2 × 5 factorial arrangement: two substrate dispersion methods (loose substrate and in filter bags), two particle sizes (1 mm and 2 mm), and five feeds. Filter bags decreased (P ≤ 0.001) digestibility and gas production compared with loose samples. Filter bags decreased …

Soybean Meal Mitigates Vasoconstriction And Serotonin Suppression During Fescue Toxicosis In Beef Cattle, Luiz C.O. Sousa, Brittany E. Davis, David L. Harmon, Ronald J. Trotta

Animal and Food Sciences Faculty Publications

Legume supplementation has been shown to mitigate fescue toxicosis in beef cattle. However, no studies have directly compared the use of soybean-based feeds to alleviate symptoms of fescue toxicosis under controlled environmental heat and equalized feed intake. The objectives were to evaluate the effects of soybean hulls, whole soybeans, or soybean meal (SBM) supplementation on the mitigation of vasoconstriction, heat stress, and inflammatory responses in beef cattle during fescue toxicosis. Ten ruminally-cannulated Angus × Holstein steers were used in a 5 × 10 Latin rectangle design. Five treatments were evaluated: 1) non-toxic endophyte-infected tall fescue seed (NTE), 2) toxic endophyte-infected …

The Relationship Between Estradiol And Progesterone Concentration Levels, Alcohol Consumption, And Inhibitory Control, Layne Elizabeth Robinson B.S.

Theses and Dissertations--Psychology

Alcohol use is increasing among women, with estimates for binge drinking having risen to levels similar to those seen in men. Despite this trend, sex differences regarding mechanisms of alcohol consumption have seldom been investigated. Our group and others have found evidence to suggest that ovarian sex hormones are associated with alcohol consumption and mechanisms that might be related to alcohol consumption, such as executive function deficits. The current study sought to extend this prior research in a larger sample with higher drinking rates and more rigorous methods, and to explore inhibitory control associations with drinking. Across the two samples …

A Mixed Method Investigation On The Effects Of Information And Motivation On Self-Regulation Skills And Fruit And Vegetable Consumption, Kristen Buford

Theses and Dissertations--Psychology

Introduction: The purpose of this research study is to understand the interplay between health information and health motivation on eating behaviors in African American emerging adults. Greater knowledge of nutrition is linked to healthier eating outcomes, but the motivations that individuals possess about their ability to improve their health also play a pivotal role. However, the joint effect of such constructs (i.e., information and motivation) on eating behaviors is unknown. Emerging adults are still developing their capacities to exercise their health autonomy, and this developmental period represents an opportunity to intervene before the onset of age-related chronic diseases in middle …

Correlates Of Recovery Capital Among Women In Jails: Leveraging A Dimensional Recovery Framework, Amanda Fallin-Bennett, Martha Tillson, Jaxin Annett, Hartley Feld, Michele Staton

Nursing Faculty Publications

Background: Recovery capital encompasses internal and external factors that support recovery from substance use disorder, such as employment, social support, and physical and mental health. There is a need for more research on recovery capital among women who are incarcerated, who often face complex barriers to recovery, such as poverty, unemployment, and histories of trauma.

Methods: Women (N ¼ 900) were recruited from Kentucky jails as part of the broader NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative project. Measures from baseline interviews (during incarceration) were selected in alignment with the Substance Abuse Mental Health Service Administration (SAMHSA)’s four …

“Being Treated As The Expert:” A Blueprint For A Community Advisory Board Approach To Elevate The Voice Of People With Living Experience With Substance Use In Academic Research, Trevor Moffitt, Survivors Union Of The Bluegrass, Bryson Henson, April M. Young, Sharon L. Walsh, Rachel Vickers-Smith, Junior Cruz, Jeremy Byard, Brook West, Amanda Fallin-Bennett

Nursing Faculty Publications

Introduction: Researchers have traditionally engaged Community Advisory Boards (CABs) to meaningfully involve community members in the research process. However, CABs are often formed only after a grant is funded, leading to criticisms of functioning merely as “ethical approvers.” For substance use researchers, the inclusion of people with living experience (PWLE; current experience with drug use) across all stages of research is especially important as they have historically been the experts in the needs of their community.   Methods: In response to this need for community engagement in research, the University of Kentucky, in partnership with a local recovery community center (RCC; …

Coalition Building And Citizen Science For Radon Risk Reduction, Stacy Stanifer, Kathy Rademacher, Whitney Sedio, Naomi Cheek, David Gross, Caitlyn Curtis, Amanda Thaxton-Wiggins, Mary Kay Rayens, Ellen J. Hahn

Nursing Faculty Publications

We evaluated the implementation of local coalitions led in partnership with citizen scientists, community-based organizations, and public libraries in four rural communities to lower exposure to radon in the home. The objectives were to (1) describe the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) of four radon coalitions, and (2) compare RE-AIM factors among citizen scientists who participated in the coalitions and those who did not. A larger community-engaged research project embedded coalition building using a citizen science approach. Three of the four coalitions focused on health and wellness more broadly (18–34 members); one focused solely on radon (10 members). Coalition membership and activities varied …

Evaluation Of A Tobacco Treatment Specialist Training Program Targeted To Behavioral Health Professionals, Chizimuzo T. C. Okoli, Sarret Seng, Bassema Abu Farsakh, Emily Koyagi, Heather Beck, Audrey Darville

Nursing Faculty Publications

Tobacco use remains disproportionately high among adults living with mental illnesses (MIs), contributing to excess morbidity and mortality, particularly in high-burden states such as Kentucky. Behavioral healthcare providers are well-positioned to address this disparity but often lack formal training in evidence-based tobacco treatment. Tobacco Treatment Specialist (TTS) training provides healthcare providers with skills to deliver evidence-based tobacco treatment; however, traditional TTS training models often rely on synchronous, in-person or live virtual formats, which may limit accessibility for some healthcare workforces. Asynchronous, web-based delivery models may reduce these barriers. This study evaluates a targeted, asynchronous TTS training program designed for providers …

Financial Status, Fatalism, And Self-Care Of Cardiovascular Disease Risk Factors Among Rural Adults Living In Socioeconomically Distressed Areas, Ashmita Thapa, Geunyeong Cha, Dustin Hodges, Jia-Rong Wu, Misook L. Chung, Martha J. Biddle, Jennifer L. Smith, Debra K. Moser

Nursing Faculty Publications

Purpose: Adults with fewer financial resources often have poor self-care. Rural dwellers commonly have fewer financial resources than urban dwellers and are often stereotyped as fatalistic about health. We examined whether fatalism mediates the association of financial status with cardiovascular disease (CVD) self-care in rural adults in economically distressed areas. We hypothesized that those with fewer financial resources would have poorer self-care, and fatalism would mediate this relationship.

Methods: We enrolled 1,122 adults (53 ± 15 years) at risk for CVD. Financial status was reflected by individuals’ perceptions of how well they made “ends meet” with their financial resources, fatalism …

The Making Of Modern Kentucky, Melanie Beals Goan

Open Educational Resources

Kentucky has always been something of an enigma, never fitting neatly into regional categories of north, east, south, or west. It is a borderland, and its unique blend of glitz and glamour juxtaposed with its rough and wild reputation continue to make it a place that is hard to pin down. Designed for college students, both those born here and those who are making the state their temporary home, this book provides an introduction to Kentucky's history, moving beyond simplistic stereotypes to consider the forces that have shaped its development over more than two centuries.

The book can also be …

Preserving Large-Scale Railroad Infrastructure Sites: The Louisville And Nashville Ravenna Yard As A Case Study, Zachary Jones

Graduate Final Projects

This project consists of a draft National Register of Historic Places (NRHP) nomination for the Ravenna Louisville and Nashville Railyard, located in Irvine, Kentucky. Developed in the early twentieth century as the operational center of the L&N Railroad’s Eastern Kentucky Division, the rail yard played a significant role in the transportation of coal and other natural resources while contributing to the growth of the towns of Ravenna and Irvine. Through the review of historical resources, field documentation, and examination of preservation scholarship, this project evaluates the historical significance and integrity of the surviving rail yard resources and argues for their …

Evaluation Of The Healthy Eating And Recovery Together (Heart) Digital Health Intervention To Support Head And Neck Cancer Caregivers And Survivors, Katherine R. Sterba, Jessica L. Burris, Rong Duan, Benjamin A. Toll, Kent Armeson, Christina Sithideth, Bhishamjit Chera, Kenneth Ruggiero, Evan M. Graboyes

Psychology Faculty Publications

Background: Head and neck cancer (HNC) survivors and their caregivers face significant challenges at the end of treatment and interventions are critically needed to support their needs. The Healthy Eating and Recovery Together (HEART) intervention includes a needs assessment and tailored care plan for dyads and an application (App) for caregivers. The objectives of this trial were to evaluate the feasibility, acceptability, and short-term effects of HEART on unmet needs and depression in HNC survivors and caregivers.

Methods: In a single arm clinical trial, HNC caregivers and survivors (n=23 dyads) completed baseline surveys followed by an in-person or virtual HEART …

Catching The Drift, Jason S. Tsukahara, Anthony P. Zanesco, Brooke Schwartzman, Ekaterina Denkova, Amishi P. Jha

Psychology Faculty Publications

Sustained focus is essential for effective goal-directed behavior. Yet, as sustained attention tasks drag on, the occurrence of mind wandering increases. Recent studies suggest that such increases in mind wandering correspond with increases in response time variability and declines in accuracy with greater time-on-task. Relatively little is known about how large-scale brain dynamics unfold over similar timescales. EEG microstates offer a way to characterize these dynamics by capturing brief, quasi-stable topographical patterns that index distinct large-scale neural configurations. Prior work has shown that microstate C corresponds with episodes of mind wandering, whereas microstate E corresponds with task-focused periods. The present …

Charities Can Use Visual Progression Appeals To Communicate Solution Longevity, Josh Lundberg, John Peloza, Adam W. Craig

Psychology Faculty Publications

Donors seek to make donations that will generate sustainable, long-term changes. However, little is known about how charities can communicate their ability to effect lasting change. Across several charitable donation contexts, this work demonstrates that charities can use progression images to heighten perceptions of solution longevity and yield greater prosocial support than traditional before-and-after images. The authors also establish two moderators for this effect, showing that the presence of copy that outlines how the charity creates lasting change mitigates the effects of progression images and that charities not known as competent are well positioned to capitalize on the benefit of …

Listening To Teachers, Deborah Rivas-Drake, Victoria Vezaldenos, Laura Ann Jacobs, Dawn P. Witherspoon, Jozet Channey, Enrique Neblett, Christia Spears Brown, Tiffany Yip, Gabriela Livas

Psychology Faculty Publications

Teachers are uniquely positioned to promote racial and immigration justice in schools. This study draws on interviews with a U.S. educator sample (N = 26; 50% ethnoracially minoritized; 42.3% pre-K or elementary, 15.4% middle school, 34.6% high school) from a needs assessment for a public scholarship effort aimed at providing resources to advance anti-racism and anti-xenophobia. Combining a rigorous and accelerated data reduction (RADaR) method and reflexive thematic analysis, we developed 8 themes: 5 pertaining to substantive issues, 2 to format concerns, and 1 integrating both substance and format issues. Our expansive approach in the present study, including educators from …

Racial/Ethnic Identity Moderates Changes In Skill Use And Therapeutic Alliance But Not Anxiety Or Depression In The Unified Protocol, Matthew W. Southward, Alex G. Urs, Thomas G. Adams, Shannon Sauer-Zavala

Psychology Faculty Publications

Cognitive-behavioral therapy (CBT) patients with minoritized racial/ethnic backgrounds report similar outcomes as White patients but may report weaker alliances and less frequent CBT skill use. Given its transdiagnostic utility, we tested how racial/ethnic background impacted treatment outcomes, the alliance, and therapy skill use in the Unified Protocol (UP). Participants (N = 70, M_age = 33.7, 67% female, 74% White) with emotional disorders completed six sessions of core UP modules. Participants rated their past-week anxiety, depression, and skill use before each session and the strength of the alliance after each session. We tested whether racial/ethnic background moderated the slopes of …

Phonics And Friends: A Critical Multimodal Discourse Analysis Of Popular Teacher Influencers' Content, Zachary T. Milford

University of Kentucky Doctoral Dissertations

This critical multimodal discourse analysis examined how five teacher-influencers aligned with the Science of Reading (SoR) movement performed authority, constructed discourses, and used affective and semiotic resources in viral TikTok videos about reading instruction. Drawing on Kress and van Leeuwen's (2001) multimodal social semiotics, Fairclough's (1992) critical discourse analysis, Foucault's (1977, 1982) theorizations of power, Papacharissi's (2014) theory of affective publics, Ong's (1982) secondary orality, and Taussig's (1993) mimesis and alterity, this interpretive, qualitative, multiple-case study analyzed fifty viral TikTok videos and four semi-structured interviews with teacher-influencers. Data were analyzed through within-case and within-mode coding, cross-modal analysis, and cross-case analysis …

An Ethical Analysis Of International Graduate Student Workers' (Igsws) Employment Vulnerability, Adeola F. Oladeji

University of Kentucky Doctoral Dissertations

International graduate student workers (IGSWs) occupy a distinctive position within U.S. higher education as students, employees, and temporary visa holders. Their academic progress, financial support, and legal authorization to remain in the United States are often closely intertwined, creating dependencies that heighten their vulnerability to exploitation, unequal treatment, and institutional power imbalances. Although previous scholarship has documented these challenges from empirical, legal, and policy perspectives, comparatively little attention has been given to universities' ethical responsibilities toward IGSWs.

This dissertation examines how U.S. higher education institutions should fulfill their ethical responsibilities to international graduate student workers. Grounded in Dewey's pattern of …

Comparing Strength Testing Measures And The Association Of Strength And Body Composition In Young Children, Abigayle R. Spong

Theses and Dissertations--Kinesiology and Health Promotion

Muscle strength is an important component of physical fitness; however, measuring it with isokinetic dynamometry (IKD) is expensive and requires dedicated space. Handheld dynamometry (HHD) provides a practical alternative for field and clinical settings. Thus, the purpose of this study was to compare peak knee flexion and extension torque measured by IKD and HHD in 37 children (ages 5-11 years) and examine relationships with body composition. Participants completed a RAMPing protocol at 90^o knee flexion consisting of two warm-up contractions at 50% and 75% effort followed by three maximal voluntary isometric contractions. Body composition was assessed via DXA scans. …

Perceptions Of Sport Psychology Efforts And Access In Women's Wheelchair Basketball, Lindsay C. Cohen

Theses and Dissertations--Kinesiology and Health Promotion

As the field of sport psychology grows, services and training programs must evolve to properly serve the evolution of athletes seeking care. This could mean discovering new measures, testing different types of interventions, or developing programs that can better accommodate specific populations that are looking for sport psychology services. One such population is para athletes, and although they have expressed interest in learning more about the field of sport psychology and how to implement mental skills efficiently, athletes have reported a lack of access to sport psychology services and sport psychology consultants (SPCs) (Dieffenbach et al., 2009). The purpose of …

Biomechanical Effects Of Exercise-Based Interventions In Chronic Nonspecific Low Back Pain: A Systematic Review And Meta-Analysis, Lara De Vecchi Machado

Theses and Dissertations--Kinesiology and Health Promotion

Chronic nonspecific low back pain (CNLBP) is the leading cause of years lived with disability worldwide and represents a complex, multifactorial, and heterogeneous condition. It is characterized by substantial interindividual variability in muscle activation patterns, lumbo-pelvic coordination, and movement strategies. Although exercise is widely recommended as a first-line intervention and its clinical benefits are well established, the biomechanical mechanisms underlying functional improvement remain fragmented in the literature and are rarely synthesized quantitatively.

This dissertation conducted a systematic review with meta-analysis to investigate the biomechanical effects of exercise-based interventions in individuals with CNLBP. A total of 39 studies were included and …

Impact Of A Workshop On Rural Healthcare Delivery On Medical Student Attitudes, Robert L. Snedegar, Ryan Hayes, Jun Xiang, Treah Haggerty, Kendra Unger, Jason Oreskovich, Amie M. Ashcraft

Journal of Appalachian Health

Introduction: Rural residents in the United States (U.S.) experience significant health disparities due to social determinants such as poverty, geographic isolation, and limited healthcare access. Physician shortages in rural areas further exacerbate these challenges.

Purpose: This study evaluates the impact of an educational workshop on medical students’ attitudes toward rural healthcare barriers, aiming to determine whether targeted education can enhance their understanding and interest in rural practice.

Methods: Third-year medical students at the West Virginia University School of Medicine participated in a workshop that included a 20-minute pre-recorded lecture and a 90-minute interactive virtual session. Pre- and post-surveys assessed students’ …

Geospatial Analysis Of Breast Cancer Incidence, Mortality, And Access To Screening In Rural And Appalachian Virginia, Jennifer Osher, Caleb Brown, Phillip Nichols, Tariq Ayubi, Jeremy Powers

Journal of Appalachian Health

Introduction: Breast cancer is the most common malignancy among women in the United States (U.S.), despite recent survival rates improving nationally. However, rural and Appalachian regions have experienced slower mortality declines. These communities face unique health care-related challenges that may contribute to observed disparities.

Purpose: The purpose of this study is to assess differences in breast cancer incidence, mortality, and mortality-to-incidence ratio (MIR) between Appalachian and non-Appalachian counties, as well as rural and non-rural counties in Virginia (VA). Furthermore, we aim to evaluate whether availability of mammography is associated with these differences.

Methods: County-level breast cancer incidence and mortality data …

Understanding Breastfeeding Practices In Tennessee: Goals, Duration, And Reasons For Discontinuation, Amir Alakaam, Chia-Lin Chang, Hannah Jeffery

Journal of Appalachian Health

Introduction: Breastfeeding is widely recognized as the optimal source of infant nutrition, offering many health benefits.

Purpose: The purpose of this study was to examine goals, exclusivity, and duration of breastfeeding and explore factors that influence breastfeeding practices among individuals in Tennessee (TN).

Methods: A cross-sectional study was conducted among individuals (N = 1,249). Participants were recruited and data were collected from June – September 2021. The data were entered and analyzed from September 2022 – March 2023. Descriptive statistics, chi-square test, and ANOVA were used to analyze the data and identify associations between variables.

Results: About 32% of the …

Pathways To Better Sleep, Mairead E. Moloney, Emily Slade, Joon Chung, Kory Heier, Daniela C. Moga

Sociology Faculty Publications

Background: Rural Appalachia has some the highest rates of sleep and health disparities in the United States. This study investigates the relationship between social support and insomnia severity in rural Appalachian adults, with specific attention to the potential mediating roles of depression, anxiety, and stress. Methods: Participants from 12 rural Eastern Kentucky counties completed validated measures of insomnia severity, social support, depression, anxiety, and perceived stress. Using R, we calculated descriptive statistics and fit mediation models for depressive symptoms, anxiety symptoms, and stress, with social support as the exposure and insomnia severity as the outcome. Results: Aligning with regional demographics, …

Migratory Songbirds As Potential Ectozoochorous Protist Dispersal Vectors, Silas E. Fischer, Joy J. Jackson, Elise C. Hoffman, Henry M. Streby, Trisha L. Spanbauer

Earth and Environmental Sciences Faculty Publications

Protist biogeography, speciation, and systematics continue to generate debate and inquiry because protist distributions and dispersal remain poorly resolved. Identifying potential vectors and basibionts for epibiont protists would contribute to our limited understanding of their ecology. Migratory animals seasonally link disparate landscapes, incidentally transporting other organisms in the process. Waterbirds are known microbe dispersers, but evidence for other avian groups is limited-such as taxa that often migrate longer distances. We asked whether terrestrial songbirds (Passeriformes) host diatoms (Bacillariophyta) by sampling tail plumage of four thrush species (Hermit Thrush Catharus guttatus, Swainson's Thrush C. ustulatus, Wood Thrush Hylocichla mustelina, American Robin …