Digital Commons Network^™

Tackling Social Stigma: An Ethical Obligation In Healthcare Intervention To Involuntary Childlessness, Persis Naumann

Electronic Theses and Dissertations

The stigma associated with involuntary childlessness has negatively affected health and well-being for several decades. This situation is particularly exacerbated for women within the Tamil socio-cultural context, resulting in feelings of shame, neglect, denial, isolation, and constituting a significant barrier to long-term access to healthcare services. Although advancements have been made in the provision of biomedical care, the psychosocial support remains inadequately addressed. Moreover, there are currently no healthcare interventions that specifically target the stigma associated with this issue, which hinders open communication with healthcare providers, delays necessary treatments, and adversely impacts overall health outcomes. The central thesis of this …

The Ethical Imperative Of The Renewal Of Virtue Within The Moral Community Of Catholic Healthcare, Amanda Altobell

Electronic Theses and Dissertations

Catholic healthcare is one of the largest nonprofit organizations and providers in the United States, offering medical care to many diverse communities. The fundamental mission of Catholic healthcare is to bring about Christ’s healing ministry and live out the fundamental principle of caring for the vulnerable in pursuit of the common good. However, there have been many missteps, not only due to a more polarized and secular community but also to scandals and conflict due to previous hierarchical and rules-based anthropology that often misses the person's lived experience. Therefore, this dissertation will argue that for Catholic healthcare to survive the …

On The Deconstruction Of Nothingness In Digital Communication, Matthew S. Lindia

Electronic Theses and Dissertations

This project argues that digital technologies call for a new problematic of communication, centered around the conditions of (im)possibility for creating perfect digital profiles of users as generated from user data. Beginning with Edmund Husserl’s analysis of essentially occasional expressions, this dissertation posits that user data occurs on three levels: (1) the level of expression, where a user wants-to-say something through their inputs, (2) the level of facticity, where biometric data are involuntarily produced by the user, and (3) the level of nothingness, where the user’s inaction, such as not-answering, is taken as data. Moving beyond what Husserl’s framework can …

A Theory-Based Intervention To Mitigate Weight Bias Among Nurses: A Pilot Study, Gregory S. Marler

Electronic Theses and Dissertations

Background: As obesity rates continue to rise, a growing number of individuals living with obesity will seek medical care, increasing their exposure to weight-biased healthcare providers. This bias presents a significant risk, as it can lead to compromised care, diminished trust in medical professionals, and ultimately poorer health outcomes. Nurses, as frontline caregivers, must recognize the harmful impact of weight bias and take proactive steps to mitigate its effects. Addressing this bias is essential to ensuring equitable, high-quality care and improving patient outcomes.

Aim: The study explored the acceptability, feasibility, and preliminary efficacy of an intervention for acute care …

Development Of A Portable Electroencephalogram With Display, Seth D. Davis

Electronic Theses and Dissertations

In this experiment, the goal was to design, build, and test an Electroencephalogram (EEG) circuit that would then be paired with a touchscreen display as a portable unit for use in Schizophrenic research at East Tennessee State University at the Quillen College of Medicine. The requirements for this prototype denoted that the device had to be able to obtain a signal from two electrodes placed on the head of an individual with a third attached to the ankle as a ground, amplify and filter the signal, and display the results on a touchscreen display for recording and analyzing. The circuit …

Advancing Research On Retinitis Pigmentosa: An Investigation Of Natural History, Visual System Plasticity, And Mutation-Independent Treatment., Cecilia A. Attaway

Electronic Theses and Dissertations

Retinitis Pigmentosa (RP) is an inherited retinal disease characterized by rod and then cone photoreceptor degeneration. ~25% of cases are caused by a genetic mutation that results in autosomal dominant RP (adRP). There has been a lack of exploration of the progression of degeneration in adRP models. In Chapter Two, I examined visual acuity (VA) changes, retinal structure, and function from early to late-stage disease in a murine P23H Rho ‘knock-in’ mouse model (Rho^P23H/+), the most common form of adRP in North America. To establish a natural history, I evaluated behavioral VA, using the visual water task, …

“Souls Cannot Rest In Contested Places”: An Ethnographic Case Study And Archeological Environmental Assessment Of The North Shore Cemeteries., Henrietta K. Ransdell

Electronic Theses and Dissertations

This thesis is an ethnographic case study and archeological-environmental assessment of the North Shore Cemeteries to derive condition commentary and care recommendations for the landscape, cultural resources, descendant community, and Great Smoky Mountains National Park. Framed by theories of space-place culture, dispossession, and public lands co-management, this multi-methods, interdisciplinary thesis combines historical context, environmental conditions, archeological documentation, participant observations, and ethnographic interviewing of NPS and community affiliates to derive applied strategies for cemetery repair, operational efficacy, and this specific, public lands “co-management” relationship. With data from 12 interviews, eight participant observations, and six condition assessment surveys, it’s argued that perceptions …

Multimodal Emotion Recognition For Human-Robot Interaction Across Neuro-Diverse Populations., Ruchik Mishra

Electronic Theses and Dissertations

This dissertation explores the integration of multimodal data streams and artificial intelligence pipelines to understand human affect in neurotypical and children with Autism Spectrum Disorder (ASD). This dissertation captures human affect in the context of human-robot interaction. For this, multiple studies have been presented with both children with ASD and neurotypical adults. This dissertation makes four contributions: 1) The first study introduces autonomy during perspective-taking teaching sessions by making verbal content generation through large language models (LLMs). This system is the first of its kind for teaching perspective-taking in a semi-autonomous manner under the supervision of domain experts. Furthermore, this …

The Dynamic Role Of Hyaluronan In Acute Cardiac Wound Healing., Danielle T. Little

Electronic Theses and Dissertations

During acute myocardial infarction (MI), the composition of the extracellular matrix (ECM) undergoes significant changes. While collagen accumulation is one of the most well-documented ECM alterations, hyaluronan (HA) is equally abundant. However, the cellular sources, enzymatic regulation, and functional significance of HA accumulation remain largely unexplored. Here, we hypothesized that activated cardiac fibroblasts produce HA via hyaluronan synthase 2 (HAS2), facilitating scar formation and stability. Our findings demonstrate that HA accumulates post-MI and persists for at least four weeks. Through HA sizing techniques, we determined the molecular weight of this persistent HA. Additionally, RNA sequencing analysis of failing human hearts …

Achieving Racial Equity In An Urban School District: Historical Conditions, Critical Policy Analysis, And Community Perspective., Whitney Taylor

Electronic Theses and Dissertations

This dissertation examines the development and impact of the Jefferson County Public Schools (JCPS) Racial Equity Policy through a historical analysis and the perspectives of African American community leaders. The study explores how systemic inequities, rooted in a legacy of racial discrimination, continue to shape the educational experiences of Black students within JCPS. Drawing on archival research and interviews with key community figures, it evaluates the policy’s intended role in dismantling structural barriers and the community’s cautious optimism regarding its effectiveness. Findings highlight persistent disparities in educational access and outcomes, emphasizing the enduring influence of deep-rooted biases and limitations of …

New Bayesian Methods For Longitudinal Data Analysis With Complex Dependence Structures., Anish Mukherjee

Electronic Theses and Dissertations

Longitudinal data in real-world settings are frequently found to be heterogeneous and exhibit intricate spatio-temporal dependence structures. Analyzing such complex data to obtain reliable estimation while quantifying uncertainty necessitates using sophisticated Bayesian methodology. In this work, we present novel Bayesian methods developed to address these challenges. We often observe heterogeneity in longitudinal data, where the mean and variance for certain profiles meaningfully differs from the rest. Some profiles may also exhibit outliers at a limited number of measurements. Using a standard mixed effects model, which assumes homogeneity, can lead to overestimating the residual variance and inefficient estimation. In this work, …

Teacher Perspectives On A Teacher Mentorship Program And Its Influence On A Sense Of Belonging And Professional Growth., Hyun Kang Wilson

Electronic Theses and Dissertations

Teacher retention is crisis in the U.S. and globally. Literature suggests the first five years of teaching is a crucial time range to determine if teachers stay in the profession or quit. Teachers will leave the profession due to lack of support, poor school culture, feeling isolated, high work-related stress, poor compensation, and challenging student behaviors. Research suggests that new teacher mentorship programs are effective in addressing teacher support, ultimately improving teacher retention. Literature also suggests that employees are more likely to stay with a company if they feel belonged. To explore the further into a new teacher mentorship program …

“Nothing Can Prepare You For It”: An Interpretative Phenomenological Analysis Of The Lived Experiences, Well-Being, And Relational Connections Of First-Time Mothers Navigating Intensive Mothering Ideals And Expectations., Mona A. Dajani

Electronic Theses and Dissertations

Becoming a mother is a life-changing experience that alters how mothers view and experience their emotional, familial, occupational, and relational worlds. As mothering stories tend to be underrepresented and largely absent from the field of social work, this qualitative study utilized Interpretative Phenomenological Analysis (IPA) to center the voices of eleven first-time mothers navigating a culture of intensive mothering ideals and expectations. As a result, the main research questions of this study are: 1) What are the lived experiences of mothers navigating a culture with deep-rooted intensive mothering expectations and ideals? 2) How is well-being experienced and described in the …

Affective Teacher Tok: A Sociomaterial Analysis Of Teachers’ Digital Literacy Practices On Social Media., Jessica Nicole Gottbrath

Electronic Theses and Dissertations

Mass media often depicts teachers in oversimplified terms, as heroic saviors or dangerous agents of indoctrination, flattening the complex realities of their daily work and lived experiences. This polarization contributes to the ongoing deprofessionalization of teaching, where educators’ expertise is increasingly questioned and politicized. In response to these reductive portrayals and the everyday pressures of the profession, some teachers have turned to short-form social media videos as a creative outlet to share personal and professional insights. To explore how teachers reclaim agency through their digital literacy practices, this study employs mixed-methods research to investigate how educators use networked microvideos to …

From Slaveship To Championship: Pan-Africanism, The Black Atlantic, And Reframing The Rumble In The Jungle., Garret S. Mccorkle

Electronic Theses and Dissertations

The “Rumble in the Jungle” is often remembered as Muhammad Ali’s triumphant return to boxing glory, yet its deeper historical and cultural context remains understudied. This thesis reframes the 1974 heavyweight championship in Zaire as a global spectacle shaped by Pan-Africanism and Paul Gilroy’s theory of the Black Atlantic. More than a fight, it was a performance of Black identity, unity, and cultural return. However, this work argues that these themes—though deeply meaningful to many—were also strategically deployed by figures like Don King and Mobutu Sese Seko for promotional and financial gain. Through an analysis of marketing materials, fighter personas, …

Genetic Influence Of Allelic Variation On The Phenotypic Variability Of Cognitive Outcomes In Individuals With Williams Syndrome., Marinie P. Joseph

Electronic Theses and Dissertations

Williams syndrome (WS) is caused by a rare microdeletion of 25 – 27 genes on chromosome 7q11.23, characterized by a distinctive cognitive profile with considerable phenotypic heterogeneity. However, the genetic factors underlying this phenotypic variability remain unclear. I explored two genetic mechanisms—parent-of-origin (PoO) effects and genome-wide polygenic variation, as measured by polygenic scores (PGSs)—to elucidate possible influences on cognitive variability in WS. The first study examined PoO effects on cognitive abilities in two overlapping samples of children with WS (N = 211, N = 251). PoO refers to which parental homolog of chromosome 7 contains the WS deletion. Despite …

Building A Future Of "Vision, Passion, And Possibilities" In Eastern Kentucky: How Veteran Educators Understand And Suggest Improving Teacher Retention., Robert Brian Collins Jr.

Electronic Theses and Dissertations

This qualitative study investigates the root causes of teacher attrition, retention, and turnover in Eastern Kentucky through the perceptions and lived experiences of highquality veteran educators—those who have persisted in the profession for five or more years. Grounded in participatory action research, asset-based community development, and future-creating methodologies, the study centers the voices of experienced teachers not only as subjects of inquiry but as co-constructors of knowledge and potential solutions. Drawing on empathy interviews with educators across Eastern Kentucky districts, the research identifies core tensions contributing to attrition, including policy misalignment, lack of autonomy, and emotional exhaustion. Simultaneously, it illuminates …

The Role Of Tgfβ-Activated Kinase 1 In Fibroblast Differentiation And Cardiac Remodeling After Injury., Daniel Chien Nguyen

Electronic Theses and Dissertations

Immediately following myocardial injury, a robust reparative response is orchestrated through intercellular communication. While various cell populations play critical roles in this process, cardiac fibroblasts have long been recognized as essential mediators of collagen synthesis and scar maturation; however, recent investigations have uncovered significant heterogeneity within the cardiac fibroblast population, revealing distinct subpopulations with roles that extend beyond their traditional functions. Notably, after tissue injury, fibroblasts exposed to damage signals can transition to an inflammatory phenotype, utilizing paracrine and autocrine signaling to coordinate immune cell recruitment and activation. Yet, the mechanisms underlying inflammatory cardiac fibroblast differentiation and their influence on …

Black Women Under The White Gaze: Resistance From Enslavement To Incarceration And Reentry., Barbie C. Parker

Electronic Theses and Dissertations

Black women in the United States who are currently incarcerated or have previously served time in prison have a particular need for protection as they move through the criminal “injustice” system because they frequently act as the primary caregivers for their families. Consequently, Black female convicts have historically had to create their social networks inside and outside carceral spaces as a form of resistance to white supremacist ideologies and as a site of protection. By highlighting Black women’s history of enslavement and incarceration, the different forms of resistance, and centering their narratives, we can paint a more complex picture of …

Everyday Justice And Neighborhood Associations., Rebecca Wells-Gonzalez

Electronic Theses and Dissertations

This study explores the lived experiences of residents in marginalized neighborhoods, focusing on the impact of neighborhood associations on perceived justice and resilience. Utilizing a feminist qualitative approach, the Everyday Justice and Neighborhood Associations (EJANA) framework integrates Human Capabilities, Everyday Life Experiences, and Resilience Justice frameworks. Semi-structured interviews across three distinct neighborhoods (Bashford Manor, Oakdale, and Shelby Park in Louisville, Kentucky) revealed that neighborhood associations were often perceived as inaccessible and ineffective, failing to address prevalent inequities. Participants reported feelings of alienation and marginalization, highlighting a disconnect between association activities and community needs. This study emphasizes the need for inclusive, …

Perceptions Of Unstructured Recess And Classroom Behaviors In Elementary School Settings., Allison Shockley

Electronic Theses and Dissertations

The priority on core curriculum areas such as math and reading has resulted in limited physical activity and regular recess routines. With the increased time spent on core curriculum, teachers and administrators have shifted their focus towards standardized student testing achievement. This focus has resulted in limiting or doing away with unstructured recess with the hopes that students will gain more core curriculum knowledge. This dissertation will focus on educators' perceptions of elementary school student behavior with varying recess time structures. This study began by examining the history of recess while analyzing the trickled- down historical inequities elementary students experience …

Volatile Organic Compounds And Their Relation To Sympathetic Activation And Autonomic Balance In Humans., Cameron Kyle Stopforth

Electronic Theses and Dissertations

Cardiovascular disease (CVD) is a multifaceted pathology that affects almost half of Americans ≥20 years old. One modifiable risk factor associated with CVD is air pollution exposure. The intricacy of air pollution exposure and CVD can make it difficult to elucidate on the multitude of mechanisms underpinning these associations. In this dissertation, we selected a relevant exposure (i.e., volatile organic compounds (VOC)) and an intermediate outcome (i.e., autonomic balance) that may represent one of these pertinent mechanisms. We tested the central hypothesis that higher VOC exposures would lead to increased sympathetic activation and autonomic imbalance. Aim 1 (Chapter III …

Investigating Factors That Influence Rural Student Degree Attainment At Urban Institutions., Kevin Kelleher Buckley

Electronic Theses and Dissertations

Decades of research have shown that rural students attend college at rates lower than their non-rural peers. When they do attend college, they tend to stay closer to home. Considering that over two-thirds of higher education institutions in the United States are in urban areas, this presents two challenges—rural students limit their options for where to attend college, and urban institutions face difficulty attracting and retaining rural students. Very little quantitative research is available that explains what may make a rural student more likely to be successful at an urban institution or if the geographic origin of a student plays …

What Happens To Soil And Native Plant Life After Removal Of Lonicera Maackii In An Urban Temperate Forest?, Sheryl A. Gipson Hammond

Electronic Theses and Dissertations

In evaluating the potential effects of nitrogen cycles and pH on plant diversity and richness after the removal of Lonicera maackii in a temperate urban forest in Louisville, Kentucky, data was collected including nitrogen, pH, canopy, stem count, and plant surveys. The cutting and treatment with chemicals to remove L. maackii were successful one year after the treatments, but legacy effects ensued about five years thereafter. Native diversity waned as monoculture proliferated in some areas, including second invasions of the invasive. It was expected that nitrogen and pH would explain the success (or lack thereof) of native plant response as …

Racial Disparity And Environmental Influences On Perinatal Health In Jefferson County, Kentucky., Felicia A Pugh

Electronic Theses and Dissertations

Background: Severe maternal morbidity (SMM) risk has tripled over the past 30 years. Adverse infant birth outcomes in the U.S. have also increased with substantial Black-White disparities. Objectives: This work compares the frequency of adverse maternal and infant birth outcomes by maternal race (Black vs White) and examines associations between maternal ambient heavy metal exposures and birth outcomes in Jefferson County, Kentucky, 2017-2022. Methods: Jefferson County inpatient hospital delivery and birth certificate records of self-identified Black or White birthing parents were used. Incidence of SMM, stillbirth, preterm birth (PTB), and small for gestational age (SGA) with 95% confidence intervals (CI) …

The Effects Of Ethanol And Tributyrin On Alzheimer's Disease Pathogenesis In 3×Tg-Ad Mice., Lucy June Sloan

Electronic Theses and Dissertations

Alzheimer’s disease (AD) is a complex progressive neurodegenerative dementia with clinical hallmarks of amyloid-β plaques, hyper-phosphorylated tau in neurofibrillary tangles (NFTs), and neurodegeneration. Chronic, excessive alcohol consumption is associated with an increased risk for developing AD and other dementias. Both AD and chronic alcohol consumption are associated with dysbiosis in the gut microbiome (GM) characterized by a significant loss of beneficial butyrate-producing bacteria within the Firmicutes phylum. Previous studies demonstrate that chronic alcohol consumption accelerates AD pathogenesis in the 3×Tg-AD mouse model and that oral tributyrin (TB) supplementation in 3×Tg-AD mice reduces age-associated GM dysbiosis and AD-associated neurobehavioral deficits and …

Advancing Speech Intelligibility Assessment: Comparing School-Based Speech-Language Pathologists, Laypersons, And Speech Recognition Software., Hannah Stewart

Electronic Theses and Dissertations

This non-experimental study utilized a convenience sample (N = 86) to investigate the comparability of school-based speech-language pathologists (SLPs), laypersons, and speech recognition software in the assessment of speech intelligibility for children with phonological disorders. Eighty-nine percent of participants were female, and 92% were white. All participants completed a survey comprised of 25 audio recordings of single-word utterances from an AI-generated voice of a four-year-old male with a phonological disorder and were asked to select what word they believed was heard from a pool of 12 options. The survey also included a passage read by the same AI-generated voice, and …

Applying Residence Time Distribution Theory To Coronary Thermodilution Curves., Jacob Michael Miller

Electronic Theses and Dissertations

Cardiovascular diseases remain the leading cause of death worldwide and coronary microvascular dysfunction is one cardiovascular disease which is particularly challenging to diagnose and treat. Coronary thermodilution is a widely used, invasive procedure to evaluate microvascular function by generating physiological indices such as coronary flow reserve and the index of microvascular resistance. Although commonly cited as an indicator dilution method in the cardiovascular literature, current coronary thermodilution techniques lack rigorous application of the accompanying mathematical framework, thereby leaving potentially valuable diagnostic information unexploited. This study bridges that gap by demonstrating the equivalence between indicator-dilution theory and residence time distribution theory …

An Automatic Colorectal Polyps Detection Approach For Ct Colonography., Mohamed Yousuf

Electronic Theses and Dissertations

Colon cancer, also known as colorectal cancer, is a significant health concern, with increasing incidence rates, particularly among individuals under 50. This rise has led experts to recommend the introduction of regular screenings at 45 years of age for adults at average risk. Early detection through such screenings can identify precancerous polyps, allowing their removal before they develop into cancer. This proactive approach has the potential to reduce colorectal cancer deaths by up to 60%. In addition, research indicates that people diagnosed before age 50 have better survival rates, which emphasizes the importance of early diagnosis. Therefore, adhering to recommended …

Long-Term Changes In Bolus Parameters During Swallowing Post-Chemoradiation Treatment., Brittany Rebecca Smiley

Electronic Theses and Dissertations

Current treatment for oropharyngeal cancer involves chemoradiation, which can have profound effects on swallowing function. Submental muscle activity is critical for airway protection and bolus transit but is highly susceptible to radiation-related swallowing impairments. This study examined whether chemoradiation targeting the submental muscles leads to measurable changes in esophageal distension during swallowing in a rodent model. We hypothesized that rats receiving chemoradiation would exhibit aberrant esophageal distension compared to chemotherapy-only controls. Twenty male rats underwent four cycles of cisplatin concurrently with either radiation or sham radiation. High-speed videofluoroscopy swallow studies were conducted pre- and post-treatment with thin liquids to analyze …