Digital Commons Network^™

Building Emergency Savings Through Employer-Sponsored Rainy-Day Savings Accounts, John Beshears, James J. Choi, Mark Iwry, David John, David Laibson, Brigitte C. Madrian

Faculty Publications

Many Americans live paycheck to paycheck, carry revolving credit balances, and have little liquidity to absorb financial shocks. One consequence of this financial vulnerability is that many individuals use a portion of their retirement savings during their working years. For every $1 that flows into 401(k)s and similar accounts, between 30¢ and 40¢ leaks out before retirement (Argento, Bryant, and Sabelhaus 2015). We explore the practical considerations and challenges associated with helping households accumulate liquid savings that can be deployed when urgent pre-retirement needs arise. Automatically enrolling workers into an employer-sponsored “rainy- day” or “emergency” savings account—terms that we use …

Built Environment Ecosystems Framework Towards Sustainable Urban Housing Infrastructure, Anna Dyson, Naomi Keena, Alan Organschi, Lisa Gray, Nick Novelli, Kipp Bradford, Mohamed Aly-Etman, Matt Gindlesparger, Hind Wildman, Jonathan Duwyn, Martina Otto, Sophie Loran, Catherine Beltrandi, Mark Radka

College of Architecture and the Built Environment Faculty Papers

As the rates of urbanization increase to unprecedented levels, the urgent need for sustainable housing and infrastructure has become a widespread global challenge with social, economic and ecological implications. The housing sector directly impacts the majority of the United Nations (UN) Sustainable Development Goals (SGDs). However, striving to achieve these goals in a compartmentalized or siloed manner has impeded the implementation of transformational solutions that increase the security and wellbeing of urban populations. Here, we introduce the Built Environment Ecosystems (BEE) framework, alongside a case study from the Ecological Living Module (ELM) UNEP Program, through an integrated systems approach with …

Voices “Herd”: A Social And Sentiment Analysis Of Consumers Perceptions Of Fair Oaks Farms, Jacelyn De'nae Nesmith

Theses and Dissertations--Community & Leadership Development

Americans are searching for more information than just cost and quality of their food. Today, consumers are searching for information regarding the production practices and how animals are treated during the process. As consumers do not always have a first-hand source for this information, they are often referring to social media to have their questions answered. Social media has the reputation to negatively influence public perceptions of the agricultural industry. An example of an organization experiencing the consequences of social media influencing public opinion is Fair Oaks Farms. In 2019, an undercover animal rights activist group made accusations of poor …

Establishing Exclusive Breastfeeding And The Influence Of Hospital Support, Martha Monroe

Theses and Dissertations--Nursing

Maternal-child health authorities recommend that infants breastfeed exclusively for the first six months of life. Currently, 25% of infants in the United States do so. Breastfeeding specific care that mothers receive from their postpartum nurses and lactation specialists is integral to successfully initiating exclusive breastfeeding. Due to the time sensitive nature of establishing milk supply, interrupting the process of lactogenesis with supplementation puts infants at high risk for early termination of breastfeeding. The purpose of this dissertation is to examine the relationship of breastfeeding care received during the postpartum hospital stay, defined as the first 48-72 hours of life, and …

Responses To Symptoms Among Patients With Heart Failure, Chin-Yen Lin

Theses and Dissertations--Nursing

Patients with heart failure (HF) suffer from chronic and progressive symptoms. Failure to respond appropriately to escalating symptoms of HF causes a delay in seeking care, which results in worse symptom status, frequent rehospitalizations, and contributes to higher mortality. In order to enhance HF self-care, promote timely care-seeking, and improve outcomes, identification of factors that affect patients’ responses to symptoms and their decisions to seek care is essential. Thus, the purposes of this dissertation were to (1) identify factors associated with patients’ responses to worsening HF symptoms, and (2) determine the impact of responses to symptoms on outcomes in patients …

Extensively Drug-Resistant Pseudomonas Aeruginosa In Vitro Susceptibility And Mechanisms Of Resistance, Chanah Gallagher

Theses and Dissertations--Pharmacy

Pseudomonas aeruginosa causes severe healthcare-associated infections. Forty-eight extensively drug-resistant (XDR)-P. aeruginosa isolates were selected from 287 isolates collected for evaluation based on clinical susceptibility data. In vitro activity of commonly utilized antimicrobials (i.e. antipseudomonal beta-lactams, aminoglycosides, fluoroquinolones, and polymyxins) plus ceftolozane-tazobactam, ceftazidime-avibactam, and aztreonam-avibactam against XDR-P. aeruginosa were determined. The mechanism of resistance profile was determined through phenotypic expression analysis. Overall, polymyxin B and colistin were 100% susceptible. Apart from the polymyxins, ceftolozane-tazobactam had the highest susceptibility (94%) followed by ceftazidime-avibactam (90%) and amikacin (83%). Ceftolozane-tazobactam activity was not significantly different from ceftazidime-avibactam (p=0.6831). Only 40% of isolates …

Opioid Use In Vulnerable Populations, Gyeon Oh

Theses and Dissertations--Epidemiology and Biostatistics

Opioid-related negative health outcomes, such as substance use disorder, misuse, and overdose deaths, have risen as long-term opioid use has increased. The benefit of using long-term opioids for pain is yet to be established. The Centers for Disease Control and Prevention provides guidelines for opioid prescribing in chronic pain, but detailed recommendations on opioid prescribing for vulnerable populations are missing due to lack of evidence-based studies. The purpose of this dissertation is to describe patterns and predictors of opioid use and assess outcomes related to prescribing opioid medications in vulnerable populations, specifically older adults with various levels of cognitive function, …

Embodying Inequality: Three Papers On The Role Of Gender And Discrimination In The Lives Of Women, Stefana I. Moldovan

Theses and Dissertations--Social Work

Women experience different forms of discrimination throughout their lives such as unfair treatment in interpersonal interactions in the public spheres and in the private sphere, as prescribed by societal gender roles, women can also experience inequality and discrimination as a disproportionate share of household work and caregiving, limited participation in decision making, unequal access and share of financial resources and leisure, and as well as in cases, of emotional, and physical, or sexual abuse. Limited research explored the potential joint effect of these forms of discrimination. The questions explored in this dissertation were: (1) How does gendered intra-household inequality, experienced …

Breast Implant-Associated Anaplastic Large Cell Lymphoma: Molecular Features, Epidemiological Risk Factors, And Evidence-Based Clinical Recommendations, Ryan Decoster

Theses and Dissertations--Clinical and Translational Science

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging cancer of the immune system that can form around textured-surface breast implants. In this dissertation, the cellular and molecular mechanisms of BIA-ALCL are reviewed with a focus on the role of oncogenic JAK-STAT3 signaling in BIA-ALCL tumorigenesis and progression. Herein, the epidemiology of BIA-ALCL is systematically studied to better define the risk of BIA-ALCL and to determine the oncologic safety of smooth surface devices relative to BIA-ALCL formation. Next, a systematic review is conducted which critically appraises current clinical guidelines in order to establish an evidence base to better inform …

Impact Of Nicu Design On Feeding-Related Outcomes In Preterm Infants, Emma Kate Calvert

Theses and Dissertations--Communication Sciences and Disorders

Many NICUs around the country are moving away from traditional open-bay designs in favor of single-family rooms (SFRs) as more is understood about the impact of the sensory environment on neurodevelopment in preterm infants. SFRs house one infant and their family for the length of the infant’s stay and are associated with improvements in numerous outcomes, including increased milk intake and weight gain and earlier transition to enteral feeding. Oral feeding remains a critical requirement for NICU discharge; however, the impact of NICU design on feeding outcomes remains unknown.

The purpose of this study was to compare feeding outcomes between …

Transcriptomic And Cellular Response To Mechanical Overload And The Underlying Role Of Macrophages In Extracellular Matrix Remodeling, Bailey D. Peck

Theses and Dissertations--Rehabilitation Sciences

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. Upon mechanical loading, including resistance exercise, which alter muscle fiber contractile activity, size, orientation and connectivity, remodeling processes must occur that involve both ECM deposition and degradation. ECM remodeling involves many cell types in muscle, but the focus of our research was directed towards macrophages, which participate in the early immune response to damage and loading. We have consistently demonstrated a significant increase in skeletal muscle macrophage abundance using pan macrophage markers (CD11b/CD68) and anti-inflammatory markers (CD206/CD163) following exercise training in …

The Effects Of Dietary Nitrate And Vitamin C On Endothelial Function And Oxidative Stress Biomarkers, Reem Basaqr

Theses and Dissertations--Pharmacology and Nutritional Sciences

Background: Endothelial dysfunction is associated with a decline in the vasodilator nitric oxide (NO) and presents alongside other cardiovascular risk factors in the early stages of atherosclerosis. Independently, inorganic nitrate and vitamin C supplementation have shown promise in providing some restoration of NO bioavailability, reduced oxidative stress, and improvements in endothelial function. Some preliminary evidence has suggested that vitamin C may augment the reduction of nitrite to further liberate NO and improve cardiovascular health. However, co-supplementation has not been adequately studied. Our objective was to compare the effect of inorganic nitrate in the form of concentrated beetroot juice (CBJ) with …

Functional Impact Of Angiotensinogen Specific Domains On Angiotensin Ii-Mediated Functions, Chia-Hua Wu

Theses and Dissertations--Pharmacology and Nutritional Sciences

Angiotensinogen (AGT) is the only substrate for all angiotensin peptides in the renin angiotensin system (RAS). Cleavage of AGT by renin is a rate-limiting step of angiotensin peptides productions in the RAS and regulates angiotensin peptides-associated pathophysiological functions. Only ten N-terminal residues are cleaved by renin and the functions of remaining part of AGT protein, which is called des(angiotensin I)AGT, remain unclear. Despite of pivotal roles of AGT in the RAS, studies related to how AGT is metabolized and how des(angiotensin I)AGT regulates AGT functions or AngII-mediated functions are limited.

Renin cleavage of AGT shows species specificity. It has been …

Divergence In Neuronal Calcium Dysregulation In Brain Aging And Animal Models Of Ad, Adam Ghoweri

Theses and Dissertations--Pharmacology and Nutritional Sciences

Neuronal calcium dysregulation first garnered attention during the mid-1980’s as a key factor in brain aging, which led to the formulation of the Ca²⁺ hypothesis of brain aging and dementia. Indeed, many Ca²⁺-dependent cellular processes that change with age, including an increase in the afterhyperpolarization, a decrease in long-term potentiation, an increased susceptibility to long-term depression, and a reduction in short-term synaptic plasticity, have been identified. It was later determined that increased intracellular Ca²⁺ with age was due to increased Ca²⁺ channel density, elevated release from intracellular Ca²⁺ stores, and decreased Ca²⁺ buffering …

Role Of Pancreatic Amylin In Alzheimer’S And Brain Microvascular Pathologies, Han Gia Ly

Theses and Dissertations--Pharmacology and Nutritional Sciences

Alzheimer disease (AD) and cerebral vascular disease (CVD) are common causes of impaired cognition and behavior in humans. Epidemiological studies have shown that AD and CVD development and progression associated with metabolic risk factors including type 2 diabetes (T2D). However, the underlying molecular mechanisms remain elusive, which hampers the development of treatment and prevention strategies. Research results from our laboratory and others have shown that amylin, a hormone secreted by the pancreas and involved in glucose homeostasis, induces small-vessel-type pathologies and modulates amyloid composition in both familial (genetically predisposed) and sporadic forms of AD. The results indicate amylin as a …

Apoe As A Metabolic Regulator In Humans, Mice, And Astrocytes, Brandon C. Farmer

Theses and Dissertations--Physiology

Altered metabolic pathways appear to play central roles in the pathophysiology of late-onset Alzheimer’s disease (AD). Carrier status of the E4 allele of the APOE gene is the strongest genetic risk factor for late-onset AD, and increasing evidence suggests that E4 carriers may be at an increased risk for neurodegeneration based on inherent metabolic impairments. A new appreciation is forming for the role of APOE in cerebral metabolism, and how nutritional factors may impact this role. In chapter 1, the literature on nutritional interventions in E4 carriers aimed at mitigating disease risk is reviewed. Studies investigating the mechanism by which …

Apparel Sizing And Fit For Girls: Variation Of Select Companies, And Parent Opinions, Peggy Sowah, Ashia

Theses and Dissertations--Retailing and Tourism Management

The act of shopping for girl's clothes is a delight of most parents. It ignites the pleasure of being a parent. However, many parents and their girls have experienced the frustration of inconsistent sizing and fit of their girl's clothes across brands. The purpose of this study was to understand the sizing and fit problems of girls ages 7-12 and to evaluate how brands utilize the current sizing standards. A structured questionnaire was used to collect data from a population of 150 (N=150) female parents. A survey was administered to help gain a better understanding and assess parent opinion of …

Ecosystem Of Bagged Grain Stored Under Naturally Ventilated Warehouse: Analysis And Modelling, Michael Ayodele Omodara

Theses and Dissertations--Biosystems and Agricultural Engineering

Grain in Africa and indeed most developing parts of the world are stored in polypropylene or jute bags arranged in stacks of varied dimensions in naturally ventilated warehouses. This practice is, however, associated with high postharvest losses due to poor temperature and moisture management during storage. This constitutes a major economic and food security challenge in these countries. Therefore, this study characterizes changes in moisture content and temperature occurring in a stack of bagged corn by determining the permeability of bag materials that influence moisture transfer and developing a mathematical model of heat and mass transfer which incorporates the unique …

Aggregation Behavior In The Bed Bug, Cimex Lectularius L., Paul D. Baker

Theses and Dissertations--Entomology

The bed bug, Cimex lectularius L., is a common household pest that feeds on the blood of its human hosts. Unlike many other hematophagic arthropods, bed bugs have not demonstrated the ability to vector disease; yet its presence in a household often leads to fear and anxiety amongst its human host victims. Bed bugs spend the majority of their time aggregating in enclosed and hidden locations, making it difficult to detect and eradicate them. One of the significant mediators of aggregation behavior is an aggregation pheromone. The pheromone has been identified to be six chemical compounds, five volatile compounds that …

An Educational Pilot Intervention To Increase Environmental Health Literacy Among Rural Kentucky Youth Attending Summer Camp, Ashley Rose Mattingly

Theses and Dissertations--Nutrition and Food Systems

Risk factors, including exposure to environmental pollutants, poor dietary and overall health outcomes, and low environmental health literacy (EHL), place the rural Appalachian youth population at increased risk for chronic diseases. Implementation of nutrition and pollution curriculum into two week-long summer day camps for youth ages 5-12 years that focus around healthy lifestyles and environmental stewardship has the potential to increase health protective action in this community. This research utilized qualitative interviews of 30 Kids on the Creek Camp attendees to determine the efficacy of the implementation of an active learning lesson to increase EHL by explaining the link between …

Evaluation Of Kentucky Grown Soft Red Winter Wheat With Sensory Evaluation For Bread-Making Capabilities And Quality, Asa Conkwright Iii

Theses and Dissertations--Nutrition and Food Systems

Soft red winter (SRW) wheat is a type of wheat that is best suited to grow in Kentucky. However, due to its low protein content, it is an undesirable flour for bread and is usually used for cakes, cookies, crackers, and pastries. This is problematic because this limits the ability for commercial bakers to have a local source of flour, forcing them to purchase from sources outside the state. In doing so, bakers are sacrificing freshness and quality. It also removes the opportunity to keep profits in Kentucky, contributing to the state’s economy. The purpose of this study was to …

Appetite-Regulating Hormones In Energy Compensation With Exercise, Jack Moreland

Theses and Dissertations--Nutrition and Food Systems

Background: The appetite-regulating hormones may influence compensatory increases in energy intake with exercise, although this causal relationship has been difficult to prove in a longitudinal trial.

Methods: 37 participants (29 female) aged 18 to 40 years performed aerobic exercise 6 days (6d), 2 days (2d), or 0 days per week for 12-weeks. Concentrations of ghrelin, leptin, glucagon-like peptide 1 (GLP-1), and insulin were assessed before (fasting, minute 0) and after a standardized meal at minute 15, 30, 45, 60, 90, 120, 150, and 180. Linear mixed-effects models were used to model the relationships between time point (12 weeks vs. baseline) …

Cardiac Effects Of Obesity During Pregnancy In C57bl/6j Mice, Kayla Lynn Dudick

Theses and Dissertations--Nutrition and Food Systems

Objective: Pregnancy requires profound cardiac and metabolic adaptation. Left ventricular (LV) mass is increased in response to pregnancy, but is not associated with cardiac damage. In contrast, obesity-mediated cardiac hypertrophy is pathological. Data from animal studies indicate dietary fatty acid composition may have a protective effect during states of extreme cardiac physiological adaptation. In contrast, aberrant cardiac metabolism is a hallmark of disease. Over a third of reproductive-age women in the United States are obese, but there is a paucity of data describing the effect of obesity on maternal cardiac adaptation to pregnancy. The objective of this study was to …

Parents Vs. Physicians: Treatment Decisions For Compromised And Severely Ill Newborns, Oyinkansola Lapite

Student Works

No abstract provided.

Health Care For All, Sarah Diyanidh

Student Works

No abstract provided.

The Costs And Benefits Of Affordable Housing: A Partial Solution To The Conflict Of Competing Goods, Michael R. Diamond

Georgetown Law Faculty Publications and Other Works

In this Article, I extend a prior inquiry into the costs borne by society due to the lack of enough decent, affordable housing units. I previously outlined those costs and suggested a combination of public cost savings and public and private benefits that would accrue by providing that housing. I posited that the savings and benefits, in the aggregate, could at least substantially offset the costs and might even exceed them. If that is so, I queried, why has society not produced the needed units? In answering that question, I offered several possible responses: inadequate resources, racism, and public choice …

Advancing Human Services Education: Exploratory Study Of International Service Learning And Digital Pedagogy, Narketta Sparkman-Key, Anthony Vadja, T'Airra Belcher

Counseling & Human Services Faculty Publications

This study focuses on advancing the understanding of human services education in international service learning focused study abroad programs. There is a gap in the literature pertaining to service-learning education for human services students. This study explores the integration of service-learning, reflection, and technology in human services education. Case study methodology and document review analysis are used to examine the use of ePortfolio as a reflective tool in addition to the skill development of upper-level undergraduate human services students through service learning. Seven themes arose from the findings, which suggest that international service-learning assists students in human services skill development …

Occupational Therapy: Addressing Mental Health Needs In Permanent Supportive Housing, Jessica Drady, Drew Mapes

Occupational Therapy Capstones

Title: Occupational Therapy: Addressing Mental Health Needs in Permanent Supportive Housing

Introduction: The availability and implementation of occupational therapy services in supportive housing are limited. According to Schultheis (2018), out of the 550,000 people in America who experienced homelessness on a given night in 2017, 1 in 5 had a mental illness. Choy-Brown, Padgett, Smith, and Tiderington (2016) found that 92% of individuals with mental illness stated that secure housing was the foundation of their recovery. When housing acts as a cornerstone to recovery, it is important, as occupational therapists, to capitalize on the opportunity and resources stable housing provides …

Occupational Gearing For Child Rearing: Occupational Therapy’S Role In Helping New Mothers Succeed After Giving Birth, Alana Grabarkewitz, Lydia Swanson

Occupational Therapy Capstones

The purpose of this scholarly project is to provide occupational therapists with access to an educational website that helps fill the current gaps in care for mothers and advocates for the occupational therapy profession to contribute to a mother’s care team.

A substantial literature review was completed to gather information about difficulties mothers encounter and how occupational therapy can assist mothers with the difficulties. To find reliable and trustworthy information on what issues and conditions a mother may experience and how occupational therapy can help mothers, various search engines were used. The findings from the literature review were used to …

Hand Therapy Outcomes: Therapists’ Perceptions Of Occupation-Based Interventions In Practice, Cheyenne Hanson, Molly Maudal

Occupational Therapy Capstones

Purpose: It is well known that hand therapists frequently use biomechanical-based interventions in their treatment of upper extremity injuries and pathologies. There is a push to return to the occupational therapy profession’s roots of occupation-based practice, which has recently been further reinforced with the introduction of the American Occupational Therapy’s (AOTA) Choosing WiselyⓇ Initiative (Gillen et al., 2019). Hand therapy is one area in which occupation-based practice could become more prevalent. This study will enhance the existing research on occupation-based hand therapy through the use of focus group interviews with occupational therapists who have a majority of their caseload classified …