Digital Commons Network^™

An Exploratory Statistical Method For Finding Interactions In A Large Dataset With An Application Toward Periodontal Diseases, Joshua Lambert

Theses and Dissertations--Epidemiology and Biostatistics

It is estimated that Periodontal Diseases effects up to 90% of the adult population. Given the complexity of the host environment, many factors contribute to expression of the disease. Age, Gender, Socioeconomic Status, Smoking Status, and Race/Ethnicity are all known risk factors, as well as a handful of known comorbidities. Certain vitamins and minerals have been shown to be protective for the disease, while some toxins and chemicals have been associated with an increased prevalence. The role of toxins, chemicals, vitamins, and minerals in relation to disease is believed to be complex and potentially modified by known risk factors. A …

Healthy Aging In The North: Sociocultural Influences On Diet And Physical Activity Among Older Adults In Anchorage, Alaska, Britteny M. Howell

Theses and Dissertations--Anthropology

Increasing rates of overweight, obesity, and related cardiovascular diseases among older adults in the United States present unique public health challenges. Cross-cultural research has shown marked variation in health across the world’s elder populations because aging is a biological process rooted in sociocultural context. The sociocultural environment contributes to complex negotiations of food and physical activity patterns for older adults. It is well established in the literature that urban residents report low levels of physical activity and have easy access to fast food outlets, which tend to be concentrated in lower-income neighborhoods. I utilize a biocultural framework, integrating nutritional anthropology …

New Year, Old Blues, Joy Bowman

Theses and Dissertations--English

This collection aims through the use of folktale and familial history to investigate the bounds of gender and memory against a rural Appalachian landscape. The work utilizes superstition, myth, and the commonplace to search the shadows for the forbidden and unspoken, in an attempt to redefine and reconcile personal dissonance through an observational and at times, voyeuristic lens.

Protection From Aortic Aneurysm By Bmal1 Deletion From Smooth Muscle Cells, Jenny Lutshumba

Theses and Dissertations--Physiology

Abdominal aortic aneurysm (AAA) is a devastating condition that occurs primarily among older people with high mortality when a rupture occurs. Currently there is no proven pharmacological therapy for AAA due to poor understanding of the underlying pathogenesis. The brain and muscle transcription factor ARNT-like (Bmal1), which is known to regulate circadian rhythm, has been implicated in vascular pathologies including atherosclerosis and vascular remodeling, but its role in AAA has not been explored.

Vascular smooth muscle is a central player in aneurysm formation and development because it is critical in all three aortic aneurysm hallmark processes including (a) degradation of …

Synthesis And Characterization Of Poly(Simvastatin) - Incorporated Copolymers And Blends For Bone Regeneration, Theodora Asafo-Adjei

Theses and Dissertations--Biomedical Engineering

Common biodegradable polyesters such as poly(lactic acid) (PLA), poly(lactic-co-glycolic acid) (PLGA) and poly(ε-caprolactone) (PCL) are used as drug delivery vehicles for tissue regenerative applications. However, they are typically bioinert, with drug loading limitations. Polymerizing the active agent or precursor into its respective biodegradable polymer would control drug loading via molar ratios of drug to initiator used for synthesis. Simvastatin was chosen due to its favorable anti-inflammatory, angiogenic, and osteogenic properties. In addition, its lactone ring lends itself to ring-opening polymerization and, consequently, the synthesis of poly(simvastatin) with controlled simvastatin release.

Simvastatin was first polymerized with a 5kDa methyl-terminated poly(ethylene glycol) …

Social Participation In Schools: Developing The Role Of Occupational Therapy Practitioners, Kelly L. Leigers

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation is to build the repertoire of occupational therapy practitioners so that they are better prepared in the provision of services addressing social participation of students with disabilities in the general education classroom. Students with disabilities in general education classrooms tend to have greater difficulty establishing and maintaining friendships (Wight & Chapparo, 2008), have fewer reciprocated friendships (Kemp & Carter, 2002), and lower stability in relationships than peers without disabilities. Furthermore, studies indicate that students with disabilities are less social accepted (Ekornas, Heimann, Tjus, Heyerdahl, & Lundervold, 2011) and are more isolated (Nadeau & Tessier, 2006). …

Shape Memory Behavior Of Dense And Porous Niti Alloys Fabricated By Selective Laser Melting, Soheil Saedi

Theses and Dissertations--Mechanical Engineering

Selective Laser Melting (SLM) of Additive Manufacturing is an attractive fabrication method that employs CAD data to selectively melt the metal powder layer by layer via a laser beam and produce a 3D part. This method not only opens a new window in overcoming traditional NiTi fabrication problems but also for producing porous or complex shaped structures. The combination of SLM fabrication advantages with the unique properties of NiTi alloys, such as shape memory effect, superelasticity, high ductility, work output, corrosion, biocompatibility, etc. makes SLM NiTi alloys extremely promising for numerous applications.

The SLM process parameters such as laser power, …

Survival And Cause-Specific Mortality Of A Southeastern Kentucky Deer Population, Caleb Anderson Haymes

Theses and Dissertations--Forestry and Natural Resources

White-tailed deer are one of the most sought after game species in Kentucky. While much of the Commonwealth boasts high deer populations, those in southeast Kentucky are viewed as relatively low compared to other regions, even after a decade of restrictive doe harvest and multiple years of population supplementation via translocation. We studied survival and cause specific mortality of a local population of deer near the Redbird District of the Daniel Boone National Forest in Clay and Leslie County, Kentucky from January 2014 - January 2017. We estimated female annual survival at 0.89 (CI: 0.88-0.87), with an overall 3-year survival …

The Effects Of A 16-Week Introductory Nutrition Course On Dietary Habits And Body Composition Of College Students, Emily Ashton

Theses and Dissertations--Nutrition and Food Systems

As the rates of obesity continue to increase among adolescents and young adults, adopting healthy dietary and lifestyle habits is necessary in order to prevent obesity-related chronic disease later in life. Although several studies have addressed nutrition education and its effect on weight in college students, few studies have assessed percent fat as it relates to a semester-long nutrition course. As such, the effectiveness of a formal introductory nutrition course on lifestyle habits and percent fat of college students was examined. The current study aimed to address the relationship between percent body fat and nutrition education over the course of …

All 4 Hardin County Freshman!, Cortney Lynn Gandy

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

Within this application for funding the Lincoln Trail Health Department proposes an evidenced based intervention for implementation into two high schools in the Hardin County with the long term goals of decreasing the rate of sexually transmitted infections in the county. The LTHD based in Elizabethtown, Kentucky services six counties in central Kentucky. The community health needs assessment and community health improvement plans for the county highlighted the problem of sexually transmitted infections in the community. The Centers for Disease Control also produces data about the higher rate of STIs in Hardin county in respect to Kentucky and the US …

Compliance And Treatment Failure Of Hepatitis C With Direct-Acting Antivirals: A 2-Year Retrospective, Observational Study In Kentucky Medicaid Patients, Juequan Nie

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

Background: New generation Direct-acting antivirals (DAAs) for the treatment of chronic hepatitis C infection have been on the market for more than 3 years since late 2013. Whether these medications cure patients at the rates claimed in clinical trials is not clear. Furthermore, as compliance is known to affect treatment outcomes, DAAs compliance rate is worth studying.

Methods: We analyzed the association of social-demographic, DAA use, enrollment with Kentucky Medicaid Managed Care Organizations (MCOs) and comorbidities, and DAA compliance in 1128 Kentucky Medicaid members treated with DAAs between August 07, 2014 and August 06, 2016.

Results: Age, MCOs, liver fibrosis …

Shaping Our Appalachian Region (Soar): Beginning To Now, Samantha Zarycki

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

Introduction

Appalachian Kentucky has been and is currently facing difficult times including low employment rates, low education rates and less-than-favorable healthcare and health status for the people of the region (Estep, 2014). There have been multiple government and non-government agencies who have implemented interventions with the purpose of lifting up the region. Shaping Our Appalachian Region, or SOAR, is a bipartisan organization which began in 2013, and was established for the purpose of caring for the region.

Methods

A qualitative data analysis using confidential interviews with six people involved with SOAR was used for this project. Using the deductive approach …

Planet Health: A School-Based Health Promotion Program, Jane Katherine Landon

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

The Kentucky River District Health Department (KRDHD) proposes implementation of Planet Health, a school-based intervention aimed at increasing healthful nutrition and fitness behaviors in middle- and high-school aged students. Planet Health’s core messaging (increasing fruit and vegetable intake, increasing physical activity, decreasing screen time, decreasing sugar-sweetened beverage and trans-fat intake) contributes to our long-term goal of decreasing childhood obesity in our service area. Planet Health will be offered to 3 counties in our service area (Lee, Letcher and Wolfe) with planned expansion to all counties in the KRDHD service area within 5 years of the original pilot. This project will …

Life Insurance: Nudges And Adverse Selection, Timothy F. Harris

Theses and Dissertations--Economics

Death of a breadwinner can have devastating financial consequences on surviving dependents through lost earnings and medical expenses. Life insurance is designed to help mitigate these financial burdens. Nonetheless, there are documented shortages in life insurance coverage. Adverse selection---where higher risk individuals are more likely to purchase coverage leading to market failure---could be one of the causes of uninsured vulnerabilities. I analyze both the existence of and welfare costs from adverse selection in individual term life insurance and employer-sponsored life insurance (ESLI) at a large public university. In the individual term market, using a representative sample of purchasers, I do …

Smart Moves Bright Bodies: A Rural Adaptation To Combat Obesity Among African-American Teenagers In Wilcox And Lowndes Counties, Alabama, Nicole D. Fields

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

Obesity is a significant problem in the United States; however, it is a burgeoning epidemic among youth in the United States. As of 2016, Alabama is the second-most obese state in the nation¹ and 16% of Alabama adolescents are obese². While obesity is a significant problem across all ethnic groups, minorities bear a disproportionate burden in Alabama: one in five African-American adolescents is obese². This disproportionate burden is demonstrated in two Alabama counties: Wilcox and Lowndes. Both counties are predominately African-American and rank in the bottom ten counties, statewide, for overall health outcomes^9,14. …

Community Based Sexual Education In Hamilton County Ohio, Jennifer Winbigler

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

This project proposes the implementation of a community-based sexual education program in Hamilton County Ohio. The proposed program is Focus on Youth + ImPACT. FOY + ImPACT is an evidenced based intervention focused on providing knowledge and skill based education to both youth (during FOY sessions) and parents (during the ImPACT session). The educational program will be implemented at three sites: the Boys and Girls Club of Greater Cincinnati, Lighthouse Youth Services, and Caracole. Each site was selected for its current infrastructure conducive to youth programming. This included ease of access to youth as well as experience in the provision …

Revamp It: Utilization Of Socioecological Approach To Combat Adolescent Obesity In Knott County, Kentucky, Jonathan Wang

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

The Kentucky River District Health Department proposes the implementation of REVAMP IT in four selected elementary schools in Knott County, Kentucky to improve subjective attitudes towards various aspects of health knowledge, physical activity, social support, and screen-time, as well as reduce biometrically measured television time and increased step count. REVAMP IT is an evidence-based program that utilizes the socioecological model of Public Health to target aspects of the individual, relational, and community level to facilitate changes from multiple aspects. Screen-time and physical activity goals will be individually set by students, and Knott County Elementary School teachers will be responsible for …

Using Structural Equation Modeling To Predict Orofacial Pain-Related Outcomes, Marcia Vanessa Rojas-Ramirez

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

Objectives: To test if the structure of a proposed theoretical model comprised of specific observed variables clustered to measure three latent variables of anxiety, depression, and fatigue exhibited good global fit with the observed data and had adequate reliability using confirmatory factor analysis (CFA). A secondary objective was to use structural equation modeling (SEM) to test the direct effect of the latent variables of depression, anxiety, and fatigue on orofacial pain outcomes.

Methods: Subjects were evaluated and treated at an orofacial pain clinic between 2009 and 2014. Those who completed a battery of psychosocial and pain-related questionnaires were …

Use Of Clonidine In Sedation Dentistry, Asma Kumar

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

Background:

Clonidine is an alpha-2 adrenergic agonist which has been used to treat hypertension for over 40 years. In October 2008, clonidine was approved by the FDA for use as a premedication agent prior to sedation. The overall goal of this study is to determine if clonidine can be used as a pre- operative sedative agent in moderate sedation dentistry and if so, what should be considered a safe level.

The following specific aims were established for this study:

1. To determine whether patients receiving clonidine required less intravenous medications.
2. To determine if clonidine can lower blood pressure and pulse to …

Modeling Deponency In Germanic Preterite-Present Verbs Using Datr, Marie G. Bourgerie Hunter

Theses and Dissertations--Linguistics

In certain Germanic languages, there is a group of verbs called preterite-present verbs that are often viewed as irregular, but in fact behave very predictably. They exhibit a morphological phenomenon called deponency, often in conjunction with another morphological phenomenon called heteroclisis. I examine the preterite-present verbs of three different languages: Old Norse, Modern Icelandic, and Modern German. Initially, I approach them from a historical perspective and then seek to reconcile their morphology with the modern perspective. A criteria is established for a canonical preterite-present verb, and then using a lexical programming language called DATR, I create code that generates the …

Redressing The Adjunct Staffing Model In American Higher Education, Andrew C. Casto

Theses and Dissertations--English

Since their advent as supplemental staff at community colleges four decades ago, part-time instructors, or adjuncts, have since been employed with increasing frequency and in escalating numbers across all institutional types of American higher education. Currently comprising approximately forty percent of all postsecondary faculty, part-time instructors now outnumber full-time nontenure-track, tenure-track, and tenured faculty respectively on many campuses. This pervasive trend has created a professional climate of uncertainty and, in some cases, even hostility as American colleges and universities struggle to adapt to ever changing enrollment populations, market demands, technological innovations, and political pressure. As the sustainability of traditional faculty …