Digital Commons Network^™

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 …

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …

Sociocultural Predictors Of White Veterans’ Attitudes Towards Va Mental Health Care, Elyssa Christine Berney

Theses and Dissertations--Educational, School, and Counseling Psychology

U.S. Veterans are less likely to seek help than their civilian counterparts despite having higher levels of self-reported distress, in part due to comparatively poorer attitudes towards seeking mental health treatment. While some aspects of cultural socialization (e.g., gender role expectations, certain types of stigma) have been established to influence Veterans’ attitudes towards mental health treatment, other aspects of health care access (e.g., trust in health care institutions or individual providers) may benefit from increased focus. Additionally, one aspect of cultural socialization that is understudied in white Veterans is that of racial-cultural socialization (i.e., whiteness). Much of the research into …

Defining Sagittal Plane Gait Mechanics And Joint Loading In People With Marfan Syndrome, Justin Melan Pol

Theses and Dissertations--Biomedical Engineering

Marfan syndrome (MFS) is a genetic condition that is associated with altered muscle composition, which leads to muscle dysfunction. People with MFS exhibit high instances of lower extremity (LE) joint pain that inhibits their ability to perform activities of daily living, such as walking. Despite these detrimental impacts of MFS, there have been no attempts to characterize the effects of MFS on LE joint loading and health during walking that are associated with LE pain and dysfunction. As people with MFS exhibit a high incidence rate of osteoarthritis (OA), the need to understand the potential alterations in LE extremity mechanics …

3-Dimensional Muscle Constructs: Using Hydrogels In Order To Model The Effects Of Exercise In Disease Conditions, Mark Mchargue

Theses and Dissertations--Biomedical Engineering

Currently, there is no standard in vitro model for studying the effects of mechanical stimulation on muscle in type II diabetes. Existing models primarily utilize electrical stimulation, which does not fully recapitulate the effects of exercise. In this thesis, we create a standardized in vitro model of murine muscle that can recapitulate the benefits seen in exercise when mechanically stimulated. Moreover, we show that a type II diabetes environment has similar effects on the muscle in vitro as well as in vivo.

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 …

Drop Wetting And Sliding On Soft, Swollen Elastomers, Zhuoyun Cai

Theses and Dissertations--Chemical and Materials Engineering

Soft, slippery surfaces have gained increasing attention due to their wide range of potential applications, for example in self-cleaning, anti-fouling, liquid collection, and more. One design approach in creating slippery surfaces is using a swollen elastomer, which is a polymer network swollen with a lubricant. This type of surface may be beneficial for longer-term use than standard lubricant-infused surfaces, and provides a versatile surface with tunable mechanical properties. Hence, understanding the physics of soft surface interactions is important for fundamental soft matter physics, biomaterials, adhesives, and coatings. This research experimentally investigates wetting on soft infused networks, with the aim of …

Effects Of Confinement On Ionic Liquids And Deep Eutectic Solvents For The Design Of Catalytic Systems, Electrochemical Devices, And Separations, Andrew Drake

Theses and Dissertations--Chemical and Materials Engineering

Confinement of ionic liquids (ILs) and deep eutectic solvents (DESs) within mesoporous materials such as silica helps to control the local environment within the pores for applications such as catalysis, electrochemistry, and absorption. Silica thin films with 2.5 and 8 nm pores and micron-sized silica particles with pore diameters of 5.4 and 9 nm were synthesized to study the effect of nanoconfinement on ILs 1-butyl-3-methylimidazolium hexafluorophosphate ([BMIM][PF₆]), 1-butyl-3-methylimidazolium chloride ([BMIM][Cl]), and DESs reline and ethaline (choline chloride and urea or ethylene glycol). Silica thin films with vertically aligned, well ordered, and accessible pores were synthesized via the evaporation-induced …

Practical Ai Value Alignment Using Stories, Md Sultan Al Nahian

Theses and Dissertations--Computer Science

As more machine learning agents interact with humans, it is increasingly a prospect that an agent trained to perform a task optimally - using only a measure of task performance as feedback--can violate societal norms for acceptable behavior or cause harm. Consequently, it becomes necessary to prioritize task performance and ensure that AI actions do not have detrimental effects. Value alignment is a property of intelligent agents, wherein they solely pursue goals and activities that are non-harmful and beneficial to humans. Current approaches to value alignment largely depend on imitation learning or learning from demonstration methods. However, the dynamic nature …

Anthology Of A Mess, Yusuf Akman

Theses and Dissertations--English

Anthology of a Mess is a collection of poems by Yusuf Akman, written at the University of Kentucky. Poems in this thesis deal examine the journey of a poet in three chapters. The first chapter examines myth-making, ekphrasis, and language. While the second one is a genre-defying work in which the modes of mockumentary, lyric essay, and fairy tale co-exist. Last but not least, the final chapter contains autobiographical poems, starting in Turkey and continuing in Kentucky. These poems explore eco-homo eroticism, roadkill, religion, and what it is like to be a queer Turk in Kentucky/the South. Throughout these sections, …

Vapr, Henry Knollenberg

Theses and Dissertations--English

vapr is a collection of short stories loosely interconnected via an anthropoid of smoke self-titled the Antimmanuel. vapr is an acronym for VOID & AUGURY & PRESENCE & RESIDUE; there is nothing else, and it is all ephemeral. The Antimmanuel is the guide; it is there with us even when god is not – within capitalism, within religion, within mental health crises, etc. Although very much not a work of Realism, this collection of eight stories grasps for, at the very least, its own author’s understanding of the real – what it feels like to live in middle America in …

Together Now, Alfonso Zapata

Theses and Dissertations--English

Together Now is a collection of poems by Alfonso Zapata, with work written between 2021 and 2023 at the University of Kentucky. This thesis contains poems which examine the close relationship between families, art, and the histories each contain. These poems use these subjects in order to illustrate the emotional and physical impact communities have upon those who live in them; art can evolve a person, shape them in beautiful ways, and give us the ability to process tragedy together; on the other end of the spectrum, societal neglect, environmental crisis, and food insecurity can rip these communities apart potentially …

Kill On The Left Foot, Daniel Collins

Theses and Dissertations--English

This collection of essays and short stories represents experiences during and related to my military service as a Tactical Air Control Partyman in the United States Air Force. Recurrent themes in this collection involve patriotism, fatherhood, masculinity, trauma, and recovery. The work itself represents the study and practice of the elements of fiction and foundational concepts related to creative nonfiction.

Emerging Hues: Essays From The Teneral Stage, Lucy Jayes

Theses and Dissertations--English

This collection of essays features work created and revised over two years in the Masters of Fine Arts in Creative Writing Program. They reflect a period of intense evolution in the author’s life and delve into topics of modern-day motherhood and cycles of intimate partner violence.

The Reflexitve Fritz Lang: Meta-Cinematic And Genre Critiques In His American Films, Justin J. Roberts

Theses and Dissertations--English

Director Fritz Lang is best remembered and most celebrated for the films he made in Germany, including Metropolis (1927) and M (1931), between 1919 and 1933. But he spent over half of his career working in Hollywood. This dissertation is a reconsideration of his American films, focused on how Lang used various Hollywood genres to question and critique the way Hollywood films and genres functioned, as well as trends within those genres. This dissertation is a roughly chronological reading of twelve of Lang’s American films, sorted by genre. We can see how his thinking about the function of film and …

Conceive And Control: Cultural-Legal Narratives Of American Privacy And Reproductive Politics, Emily Naser-Hall

Theses and Dissertations--English

Law and literature share a foundation in narrative. The literary turn in legal scholarship recognizes that the law itself is a form of narrative, one that simultaneously reflects socio-cultural norms and creates social and political regulations with a complex matrix of power. Cultural narratives from the 1950s to the mid-1970s pertaining to reproductive politics, domesticity, and national identity both produce and are productive of legal rulings that govern and restrict private acts of sexuality and speech. The Supreme Court used cases concerning sex and reproduction to enumerate, explicate, and complicate the right to privacy, which appears nowhere in the U.S. …

Stick With Me: Essays, Clay Shields

Theses and Dissertations--English

A small-town Appalachian deviant confronts the frequent, recurrent grief of the opioid crisis and its mortal, psychological, and communal consequences. This collection endeavors to explore substance use, addiction, geopolitical exploitation of Kentucky, central Appalachia, and surrounding areas, while also celebrating the lives of individual loved ones lost to deaths by suicide, drug overdose, and alcoholism. Here, the common narrative of depravity surrounding addiction is challenged through the rendering of full characters capable of love, trust, friendship, humor, mental health management, and personal growth. Time and place factor fundamentally into the stories told here—whether based in central Kentucky or central Appalachia, …

From Jane Austen To Meghan Markle: The Persistence Of British Imperialism In White Popular Feminism, Kathryn M. Kohls

Theses and Dissertations--English

This dissertation traces the persistent threads and values of white womanhood from the nineteenth-century British Empire to modern American popular culture. The figure of the white woman was significant to upholding colonialism and empire in the literary mass media and culture of the nineteenth century, and I argue that this figure continues to be used in popular media and online content today to surreptitiously uphold white supremacy and obscure race and gender inequalities. This dissertation will explore the overlaps between nostalgia, historical revisionism, white womanhood, white supremacy, and white feminism in modern American popular culture. The connections between, and the …

Echoed Malice: Identity And The Doubled Voice In Gothic Horror, Brandon West

Theses and Dissertations--English

My dissertation argues we would benefit from focusing on the voice when analyzing gothic and horror texts. That is, I contend, there remains significant fertile ground for us to till in these texts if we shift our focus to the voice and its various iterations across these texts’ long history. To demonstrate this point, I delineate three variations of this theme: the doubled voice in the possession narrative, the split voice in the ventriloquist-dummy dynamic, and the inherent uncertainty of the voice without discernable origin. Each of these variations, I argue, offers fruitful readings of oft-studied texts and, moreover, offers …

Myth, Mockery, & Misery: An Evolution Of Disillusion In Modern-War Expression, Richard W. Halkyard

Theses and Dissertations--English

Industrialization in 19th-Century America yielded a regrettable by-product: the modernization of warfare. Mass armies, technological innovation, and unprecedented rates of industrial productivity prompted the creation of machines designed to inspire fear, increase destructive capability, and inflict mass-death. The modernization of warfare altered forever the way war was experienced and represented literarily. Authors who attempted to represent the Civil and Spanish-American Wars, as well as World War I, articulated modernized warfare with a disillusionment which stems from the tragically dehumanizing effects of mechanical violence on an industrial scale. Myth, Mockery, & Misery argues that as far back as 1862, romantic idealization …

Representations Of Military Women In Contemporary War Stories, Deborah Daley

Theses and Dissertations--English

Representations of Military Women in Contemporary War Stories seeks to understand how war stories influence our perception of who belongs in military service. With the canon of western war writing dominated by the memoirs and stories of white men, what happens when service women enter into and author war stories, and how does their appearance destabilize questions of who is fit for military service? War literature provides an important lens through which to observe how military service is scripted by culturally and socially constructed expectations of one’s gender, race, and occupation. In male-dominated workplaces, women must not only perform in …