Foundation for a Healthy Kentucky gives UK $1 million for endowed co-chairs in rural health policy

Tyrone "Ty" Borders in the University of Kentucky College of Public Health's Department of Health Services Management, and Brady Reynolds in the UK College of Medicine's Department of Behavioral Science, have been named the Foundation for a Healthy Kentucky endowed co-chairs in rural health policy.

A $1 million gift from the foundation to the College of Medicine was matched by the state Research Challenge Trust Fund, better known as "Bucks for Brains." The gift has the goal of enriching Kentucky's research capabilities in regards to rural health issues and rural health policy.

Reynolds earned doctoral and master's degrees in life-span developmental psychology from West Virginia University. He also holds a master's degree in general/experimental psychology and a bachelor's degree (magna cum laude and with distinction) from James Madison University. His research has focused on nicotine use by adolescents, drug use, gambling and other addictive behaviors. In recent years Reynolds has begun research to promote smoking cessation among pregnant smokers in rural Appalachia.

Borders earned doctoral and master's degrees in health administration, as well as a master's degree in epidemiology from the University of Iowa, and a bachelor's degree in psychology from the University of Kansas. His research focuses on the conduct and analysis of population-based studies to identify subgroups of persons at risk for poor health and problems obtaining health services, with an emphasis on rural populations.

“Drs. Reynolds and Borders have skills in intervention research and rural health policy expertise that can help the University remain at the forefront of rural health policy work in today’s rapidly changing healthcare environment,” said Susan Zepeda, president and CEO of the foundation.

The mission of the foundation is to addresses the unmet health care needs of Kentuckians. Mission objectives are advanced through two initiative areas: promoting responsive health policy and a new children’s initiative named “Investing in Kentucky’s Future.” Foundation work aims to improve access to health care, reduce risks and disparities, promote health equity and healthy lifestyles. Since 2001, over $22 million has been invested in health policy research and demonstration grant projects across Kentucky

UK quickens drumbeat of tobacco-free policy through report line

The University of Kentucky promotes compliance and enforcement of its tobacco-free policy through a community report line, among many other measures.  Although the report line was established last spring, its mention in recent campus communications suggests a hightened emphasis on compliance measures. 

The line to report violations of the smoking ban engages the community in developing an environment in which compliance is expected, said Dr. Ellen Hahn, a nursing professor and co-chair of UK's Tobacco-free Taskforce and director of its Kentucky Center for Smoke-free Policy.

"Since these policies are self-enforcing, we need a mechanism by which everyone on campus can easily report violations," Hahn said. "Most people do not feel comfortable approaching a violator, so this is a way to encourage everyone to be involved in promoting compliance." She said the report line was a suggested "best practice" from other campuses with similar policies.

Implementation of the policy, the ultimate goal of the policy is to promote a healthy place to live, work and learn, has been a success, Hahn said: The air is healthier, and exposure to secondhand smoke has decreased. Also, since the policy was established in the fall of 2009, there has been a four-fold increase in the use of nicotine replacement to quit using tobacco, and UK has many low- or no-cost options to help students and employees do so.

Click here to report a violation of the tobacco-free policy, here for a tobacco-free brochure. 

Participating in a clinical trial can give patients access to advanced health care

Access to advanced care does not require big bucks or Cadillac insurance; it is offered on a limited basis through trials of new medical procedures at the University of Kentucky.  People in the university's health-service region can access cutting-edge health care through participation in clinical trials, according to a UK press release. The University of Louisville also does clinical trials.

Clinical trials are necessary to evaluate a drug, device or mode of therapy for a disease. UK investigators recruit individuals willing to contribute to science to participate in various types of trials; some may require participants with specific conditions, while others require healthy participants.  These participants are able to reap the benefits of advanced medical treatment while gaining access to top clinicians and the latest medical information.

"I would tell anyone who has a condition and is thinking about becoming part of a clinical trial that it is one of the most empowering things that people can do," said Dr. Leslie Crofford, chief of the UK Division of Rheumatology and director of Center for the Advancement of Women's Health. "It allows you to learn about a condition that may afflict you or a family member. It allows access and contact with investigators that are very knowledgeable about the condition. It allows a sense that you are doing something active to help not only yourself, but other people with the condition."

As a research insititution, UK is careful about the safety, privacy and oversight of clinical trials and it's important that participants understand the trial methodology, purpose and procedures. The UK Center for Clinical and Translational Science has compiled a helpful list of questions for clinical-trial participants. There are several ways to connect with clinical-trial opportunties and anyone can view currently available clinical trials at the university. Participants may also connect with clinical trials through their physician, or through national listings. (Read more)

UK has its pediatric heart program under review; chief is on leave, and patients are being referred to other hospitals

Kentucky Children's Hospital at the University of Kentucky is reviewing its cardio-thoracic surgery program and referring surgical patients to other hospitals, "but the reasons why are unclear," Brenna Angel reported Dec. 21 for WUKY-FM, the university-owned station.

Angel did identify "the surgeon at the center of the review," Dr. Mark Plunkett, left, who is on a leave of absence but "remains on staff at UK with a $700,000 annual salary," as chief of cardio-thoracic surgery. "UK denied an open-records request for the date of his most recent surgery and his patient mortality rate," citing privacy rules in the federal Health Insurance Portability and Accountability Act. It was unclear how release of such statistics, without any personally identifying information, would compromise privacy. Plunkett and officials of the medical center refused to be interviewed.

"It's been pretty hush-hush," Tabitha Rainey of Lexington, the mother of a Plunkett patient, told Angel, who reported: "Plunkett and his assistant Dr. Deborah Kozik operated on Waylon seven days after he was born. Tabitha was later told that Dr. Plunkett was taking a leave of absence." Rainey told Angel, "Months went past and they lost another patient, who was a dear friend of mine, and it was pretty heavy in the unit at the time. Then soon after I guess they decided to stop doing the surgeries and review the entire program."

Angle was able to get some records from UK and reported they showed that "The number of children Dr. Plunkett operated on this year is down around 43 percent from two years ago." UK Trustee Dr. Charles Sachatello, a surgeon who sits on the Board of Trustees' health-care committee, told Angel, "I was not aware of that, and that was never announced at the Board of Trustees meeting." Sachatello told Angel that UK should merge its pediatric heart program with the one at the University of Louisville because of the high operational costs of such programs. (Read more)

UK study: Old, perhaps obsolete heart drug increases deaths in patients with atrial fibrillation

A drug widely used against heart disease can increase the possibility of death when used by patients with atrial fibrillation, a common heart rhythm problem, according to a study by University of Kentucky researchers. Digoxin, a derivative of the foxglove plant, is an old yet controversial heart drug. Though considered obsolete by some, it is still widely used.

The study, published in European Heart Journal, analyzed data from 4,060 atrial-fibrillation patients. It was led by Dr. Samy Claude Elayi, associate professor of medicine at UK HealthCare's Gill Heart Institute. The results of the study indicate that further review by the Food and Drug Administration is warranted to determine if stronger warnings about its use should be required. (Read more)

Soon-to-be published UK study begins to unravel why prescription pain-killing drug Tramadol is habit-forming

In an attempt to get closer to understanding the plague of prescription pain-killer abuse, a study by a team of University of Kentucky researchers has shed new light on the potential habit-forming properties of the popular pain medication Tramadol. The research was funded by the National Institute on Drug Abuse. The paper is slated to appear in an upcoming edition of the academic journal Psychopharmacology.

"The important thing about this is I think we all assumed that any abuse of Tramadol or any abuse potential Tramadol had was because of the way it activated the opioid receptors in the brain and that may not be the case," said lead study author William W. Stoops of the UK College of Medicine Department of Behavioral Science, the UK Center on Drug and Alcohol Research (CDAR) and the UK College of Arts and Sciences Department of Psychology. "It's pretty well accepted that with opioid drugs like oxycodone, hydromorphone and hydrocodone, when you block the opioid receptors in the brain, folks aren't going to abuse the drug. That is not the case for Tramadol. Opioid receptors are important in Tramadol use and abuse, but they appear to not be the entire story."

Other University of Kentucky researchers involved in the study are Michelle R. Lofwall, Paul A. Nuzzo, Lori B. Craig, Anthony J. Siegel and Sharon L. Walsh.

UK researcher part of team that has identified Usher Syndrome gene, responsible for genetic loss of sight and hearing in babies

A University of Kentucky physiologist has teamed with researchers from several institutions to report a novel type of gene associated with Usher Syndrome, a hereditary disease that causes individuals to lose both hearing and sight. The work of Gregory Frolenkov, associate professor at the University of Kentucky College of Medicine, and others led by Zubair M. Ahmed from the University of Cincinnati and Cincinnati Children's Hospital Medical Center, is being published in the November 2012 issue of Nature Genetics.

 In the United States, approximately six of every 100,000 babies have Usher Syndrome. About 3 to 6 percent of all children who are deaf and another 3 to 6 percent of children who are hard of hearing have Usher Syndrome. According to the National Institute on Deafness and Other Communication Disorders, parents who have normal hearing and vision usually do not know if they are carriers of an Usher gene mutation. It is not yet possible to determine whether a person who does not have a family history of Usher syndrome is a carrier. Several genes associated with different types of Usher Syndrome have been identified.

Eastern Kentucky native wants to alert Appalachian women about their high rate of cervical cancer and how to prevent it

University of Kentucky physician and Pike County native Baretta Casey, right, has spent most of her career providing health care and education throughout the state, with a focus on Appalachian Kentucky. The health disparities between Eastern Kentucky and the rest of the state, especially high rates of cancer, are of "special concern" to Casey, reports Ann Blackford of UKNow.

Cancer is prevalent in her Casey's own family, and this is why she "has taken on the challenge of helping reduce cancer rates in Kentucky, especially cervical cancer and other Human papillomavirus cancers," Blackford reports. Cervical cancer rates are highest in rural and Appalachian Kentucky. According to the Kentucky Cancer Registry from 2005 to 2009, the cervical cancer rate in the region was 9.85 per 100,000 people. The state rate was 8.6. The average of deaths per year in the region from cervical cancer was 258.

"We have the tools to change these high rates and make a real difference in people's lives," Casey said. "I feel the best thing I can do for the people of Eastern Kentucky is to educate about prevention and screening of cervical cancer." Casey became the director of the Cervical Cancer-free Kentucky Initiative at UK's College of Public Health's Rural Cancer Prevention Center in 2010. Through this position, she makes connections with county health departments, community organizations and health advocacy groups that provide education and funding for cervical cancer prevention projects.

"Casey is passionate about educating people on the importance of vaccinating their children against HPV," Blackford writes. She said she wants people to look past the controversy of vaccinating their children and realize the importance of the vaccine. "The vaccine given for the appropriate reason can save a life," Casey said. (Read more)

UK nanotechnology study shows promise for more effective cancer treatment compared to chemotherapy

Dr. Peixuan Guo, one of the three top
nanobiotechnology experts in the world

A new study by University of Kentucky researchers shows promise for developing ultrastable RNA nanoparticles that may help treat cancer and viral infections by regulating cell function and binding to cancers without harming surrounding tissue. The study, published in Nano Today, was carried out in the laboratory of Peixuan Guo, the William S. Farish Endowed Chair in Nanobiotechnology at the UK Markey Cancer Center, in collaboration with Dr. Mark Evers, director of the UK Markey Cancer Center.

 "A major problem with cancer treatments is the ability to more directly and specifically deliver anti-cancer drugs to cancer metastases," Evers said. "Using the nanotechnology approach that Peixuan Guo and his group have devised may allow us to more effectively treat cancer metastasis with fewer side effects compared to current chemotherapy." To read more about the study, read the University of Kentucky press release here. To read study in Nano Today, go here.

Work of UK prof was cited in decision on health care

Professor Nicole Huberfeld.
University of Kentucky photo.

The work of a University of Kentucky law professor helped shape the U.S. Supreme Court's ruling on the constitutionality of the federal health-care reform law. 

Two of the major issues in question was whether the government could be force people to buy health insurance — often referred to as the individual mandate — and if the federal government could use its fiscal powers top make states expand Medicaid eligibility to 133 percent of the federal poverty level. The mandate was upheld, as was the Medicaid expansion, though the ruling will allow states to choose whether or not they want to expand their programs.

Justice Ruth Bader Ginsburg cited the work of UK professor Nicole Huberfeld "in a portion of her concurring opinion dealing with the expansion of Medicaid," reports Brian Powers for Business Lexington. In her work, Huberfeld has focused on the program for the poor and disabled and had researched "the intersection of constitutional law and health-care law," Powers reports.

When Huberfeld was told her work had been cited she said it was "amazing," as well as "thrilling ... humbling." She added, "We sometimes feel that we perform our research and publish it and get it out there, and to know that someone is actually reading it is really gratifying. When you write, you hope that someone reads your research." (Read more)

UK doctors first to perform triple ablation, a special form of cardiac catheterization

Ollie Whitaker of Whitesburg is the first known patient to have undergone triple ablation surgery, in which a catheter is inserted through a patient's blood vessels to remove a faulty electrical pathway and tissue from the patient's heart. The procedure was performed at the University of Kentucky's Gill Heart Institute.  (UK photo of Whitaker, Dr. Sammy Claude Elayi and Dr. Gustavo Morales)

"Typically, the catheter is placed into the patient's femoral artery, internal jugular or subclavian vein. The catheter is guided toward the heart, and high-frequency electrical impulses are used to induce the arrhythmia and then destroy (or ablate) the abnormal tissue causing it," reports Jodi Whitaker for UK Public Relations.

"Performing two ablations during one procedure is commonly done, but three with this complexity is basically unheard of," said Dr. Sammy Claude Elayi, a UK cardiologist. "But in this patient's case, despite the risk, I believed that we could perform three ablations."

"I'm so very pleased," said Whitaker, who had a massive heart attack 30 years ago at age 42 and had been suffering severe after-effects ever since. "I can work in my flower bed outside and do more around the house." (Read more)

Three of four UK's research professorships fund work in health

Three of the four University of Kentucky research professorships awarded for the 2012-13 school year will fund health-related work. Each award is worth $40,000.

Mark Filmore, right, who teaches in UK's Department of Psychology, will research the role that cognitive processes have in promoting risk-taking behavior. It will have an emphasis on recreational drug use, including alcohol abuse and dependence.

Douglas Andres, left, professor and vice chair of the Department of Molecular and Cellular Biochemistry,  "had begun to define the molecular pathways that control adult neurogenesis, and have shown that Rit, a Ras family G-protein, plays a critical role in the survival of newborn adult neurons following traumatic brain injury," a press release reads. If that is the case, strategies that target Rit activation may be effective in helping recover or repair the injury.

In the Department of Internal Medicine, Mark Dignan, right, leads a program that focuses on cancer prevention and control in community settings using community-based participatory methods. Using the funds of his professorship, he plans to expand his training, "allowing him to conduct translational research with teams that include basic and clinical scientists as they continue their work to reduce cancer health disparities," the press release reads.

Christopher Pool, professor in the Department of Anthropology, is the fourth professorship recipient. (Read more)

Effects of concussions outlast symptoms, UK prof finds; another study says they affect thinking of teenagers more than others

A University of Kentucky assistant professor has found that the effects of a concussion may last longer than the symptoms, a finding that could influence how and when athletes are allowed to get back into a game.

Scott Livingston (UK photo), director of the UK Concussion Assessment Research Lab, used an electrophysiological measurement to arrive at his conclusion. With 18 college athletes, he placed electrodes on a limb while a magnetic-stimulating device was put over their head. They then received a brief pulse of magnetic stimulation to their brain. The amount of time it took for the athlete's limb to receive the response from the brain after the stimulation was then recorded. Nine of tyhe athletes had gotten concussions in the past 24 hours and nine had not.

The athletes were evaluated for 10 days, based on self-reported symptoms such as memory loss, headache and confusion; a computerized neurocognitive test; and the electrophysiological measurement. While symptoms from the concussion were greater within 24 to 72 hours after the injury and lessened over time as measured by self-reporting and neurocognitive testing, electrophysiological measurements show physiological changes increased as symptoms decreased.

Further investigation is needed, "especially to assess how long the disturbances in physiological functioning continue after those initial 10 days post-injury," Livingston said. "But in the meantime, sports medicine personnel caring for concussed athletes should be cautious about relying solely on self-reported symptoms and neurocognitive test performances when making return-to-play decisions." (Read more)

Meanwhile, a study at the University of Montreal has found that "Concussions affect the thinking of teenagers more than they do that of adults or children," reports Nancy Shute of National Public Radio. "But all three age groups show lasting problems with working memory after sports concussions." (Read more)

Funding available to help communities fight cervical cancer

For the second year, agencies, coalitions and community groups are invited to apply for funding to improve cervical cancer screening rates and human papillomavirus (HPV) vaccinations in their areas. Cervical Cancer-Free Kentucky, housed in the University of Kentucky College of Public Health, has funding available and will be awarding mini-grants in the coming year, Ann Blackford of the UK news service reports.

In August, 13 agencies received CCFKy funding ranging from $7,000 to 20,000 for projects that will help residents in 19 Kentucky counties.

"CCFKy saw great results from the first year of funded projects," said Dr. Baretta R. Casey, director of CCFKy. "The projects' outcomes convinced our team that increasing the number of funded agencies in the second year will move our mission of a cervical cancer-free Kentucky forward. Let's stop the deaths of women in Kentucky from this preventable and curable disease."

About 391 women are diagnosed with cervical cancer every year in Kentucky and 66 Kentucky women die. (Read more)

Seven UK docs-to-be off to Morehead to train in rural medicine

Learning how to practice in rural areas is the goal of seven University of Kentucky medical students, who are off to Rural Physician Leadership Program in Morehead. (From left: Shea Poynter, Lesley Jackson, Katherine Johnson, Nathan Hudson, Katrina Winkler, Crystal Norgren and Miranda Smith)

The program "trains physicians to become practitioners and leaders for rural areas," Julie Meador writes for UKNow, the university's news service. "It was created in response to the growing health care needs evident in rural areas of Kentucky and the rest of the nation."

The training is primarily done at St. Claire Regional Medical Center and with physicians with the Northeast Area Health Education Center, who are serving as preceptors. The students will also take courses at Morehead State University's Department of Business and Public Affairs on the medical use of information technology, financial issues and debt management and community engagement for health policy.

UK gets $7 million for Alzheimer's research

The University of Kentucky has received a $7 million grant to continue its research on Alzheimer's disease. The research is conducted at the Sanders-Brown Center on Aging and involves clinical trials and comparing brains diseased by Alzheimer's to those that are not.

"It is the second major grant announcement for UK in two days," reports the Lexington Herald-Leader's Cheryl Truman. "On Monday, UK received a $14.5 million grant to develop pollution-catching technologies for coal-fired power plants."

The grant proves UK "is not only able to compete among the big boys but be one of the big boys" when it comes to Alzheimer's research and treatment, said Michael Karpf, UK's executive vice president of health administration.

At the Sanders-Brown center, more than 700 research volunteers from around Kentucky take part in clinical trails and a brain donation program, which allows researchers to compare Alzheimer's-affected brains to those that aren't. (Read more)

New network including UK, Ohio State and Marshall joins leading researchers to address health issues in Appalachia

Seven academic centers and community organizations have come together to pool their resources and improve the health of Appalachian residents. They have formed the Appalachian Translational Research Network, which includes experts representing The Ohio State University, the University of Kentucky, Marshall University and the Appalachian Regional Commission.

"The causes of health issues in this region are multifactorial — poverty, education, access to care," said Kelley Kelleher, director of the Community Engagement Program at OSU's Center for Clinical and Translational Science. "A collaborative approach that pairs experts from many different specialties with organizations already working within the Appalachian community will help us reach better solutions faster."

"We are dedicated to seeing this region escape from being one of the sickest parts of America," said Phillip Kern, director of UK's Center for Clinical and Translational Science and Barnstable Brown Diabetes and Obesity Center.

Experts with the ATRN were among those who organized and attended the recent Appalachian Health Summit. It focused on the obesity epidemic, a major chronic health issue in the region. It also featured many research projects related to or complicated by obesity, including one to evaluate web-based smoking cessation programs with teen smokers; one using church communities to address obesity; and one to establish more than 60 diabetes community collaboratives in nine Appalachian states.

Appalachia runs from southern New York to northern Mississippi. With a population of 24.8 million, it stretches across all of West Virginia and part of 12 other states, including 54 Kentucky counties. Residents of many Appalachian counties are three times more likely to die from diabetes than others either living in the same state or in non-Appalachian states, Centers for Disease Control and Prevention numbers show.

UK loses branding for high-quality nursing care

The University of Kentucky hospital has lost magnet status, a designation given to facilities that offer high-quality nursing care, the Lexington Herald-Leader's Mary Meehan reports.

The recent review says UK, which advertised the designation by flying its flag (H-L photo by Charles Bertram), did not have a "structure for supporting a culture of patient safety." Nurses did not meet the grade when it came to "friendliness/courtesy," "promptness/response to call," and "attention to special/personal needs." Their attitudes toward requests also were apparently lacking.

Dr. Richard Lofgren, chief clinical officer for UKHealthcare, downplayed the loss. "It is a recognition from a professional society," he said. "You can get recognition from a whole lot of professional societies." But other hospital officials say "the designation means so much to them that they make meeting the expensive and time-consuming application process part of the job responsibilities of employees," Meehan reports.

Kentucky facilities that have magnet status include: Baptist East Hospital in Louisville; Central Baptist Hospital in Lexington; Frankfort Regional Medical Center in Frankfort; Kosair Children's Hospital in Louisville; and St. Elizabeth Healthcare in Northern Kentucky.

Rural teens more likely to abuse prescription meds; Operation UNITE launches 'Accidental Dealer' to guard medicine cabinets

A University of Kentucky study has shown rural teenagers in Kentucky are 26 percent more likely to abuse prescription drugs than those living in urban areas, the Lexington Herald-Leader's Mary Meehan reports. The study concludes 13 percent of teenagers living in rural areas have said they used prescription drugs recreationally. Only 10 percent of urban youths have tried them.

Dr. Jennifer Havens, right, spearheaded the study. She is a professor of epidemiology at UK's Department of Behavioral Science in the College of Medicine. "This is one of the first studies to show that hard data," she said.

Karen Kelly, director of Operation UNITE, a federally funded anti-drug program for Eastern Kentucky, said she was pleased to have the data. "We were excited when we heard about those numbers," she said. "A lot of times in small communities, people don't think there is anything to be concerned about."

The study looked at data from 17,872 participants ages 12 to 17 in the 2008 National Survey on Drug Use and Health. It showed teens are getting pills from medicine cabinets in their home, which has prompted UNITE to launch "Don't Be an Accidental Drug Dealer. The program, which Meehan reports started in Knox, Clay and Wolfe counties last week, will inform communities about prescription drug abuse through town hall-style meetings and public service announcements. (Read more)

The program has also started in Breathitt County, with a training meeting last Thursday to make volunteers and key personnel "aware about keeping the lid locked on prescription and over-the-counter medications," Jeff Noble reports for the Jackson Times-Voice. "For some that attended, the session was more than just basic information – it was an eye-opener that mirrored their concerns," Noble writes, citing a statement from Kelly: “In Eastern Kentucky, the average age of first-time drug abuse is 11 years old, so this is a particularly critical issue.” Karen Bunn, chair of the Breathitt UNITE Coalition, told Noble that the program needs volunteers to work. (Read more)

UK, Central Baptist get millions in federal incentives to use electronic health records

University of Kentucky HealthCare and Central Baptist Hospital in Lexington are the first hospital systems in the United States to receive funds from the Centers for Medicare and Medicaid Services' electronic health records incentive program.

UK received $2.8 million, Central Baptist $1.3 million, according to a press release from the state Cabinet for Health and Family Services. Kentucky is one of only four states to begin receiving the federal dollars, which are meant to encourage hospitals and physicians to transition to computerized patient records. The funds are part of the 2009 economic-stimulus legislation.

Another 25 Kentucky providers have started the application process. In the next four years, Kentucky hospitals should receive more than $100 million in incentive funds, the release states. "Electronic records can do so much to improve efficiency, reduce medical error and, ultimately, change the face of the American health care system," Gov. Steve Beshear said.

Kentucky is among the first to receive the funding because its providers were "farthest along in the process in moving down the path to adopting these types of systems," said Beth Fisher, spokeswoman for the Cabinet for Health and Family Services. "This means we're pretty far ahead than a lot of other states." (Read more from Business First; for the original press release, go here.)