Medicine and Health Sciences Commons^™

Clinician Identified Barriers To Treatment For Individuals In Appalachia With Opioid Use Disorder Following Release From Prison: A Social Ecological Approach, Amanda M. Bunting, Carrie B. Oser, Michele Staton, Katherine S. Eddens, Hannah K. Knudsen

Sociology Faculty Publications

Background: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia.

Methods: A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals …

Blocking Drug Activation As A Therapeutic Strategy To Attenuate Acute Toxicity And Physiological Effects Of Heroin, Ting Zhang, Xirong Zheng, Kyungbo Kim, Fang Zheng, Chang-Guo Zhan

Molecular Modeling and Biopharmaceutical Center Faculty Publications

Heroin is a growing national crisis in America. There is an increasing frequency of heroin overdoses. All of the currently used therapeutic approaches to treatment of heroin abuse and other opioid drugs of abuse focus on antagonizing a brain receptor (particularly µ-opiate receptors). However, it has been known that the therapeutic use of certain µ-opiate receptor antagonist may actually increase heroin overdose. Once overdosed, heroin addicts may continue to get overdosed again and again until fatal. Here we report our design and validation of a novel therapeutic strategy targeting heroin activation based on our analysis of the chemical transformation and …

Perceived Importance Of Substance Use Prevention In Juvenile Justice: A Multi-Level Analysis, Jessica M. Sales, Gail Wasserman, Katherine S. Elkington, Wayne Lehman, Sheena Gardner, Larkin Mcreynolds, Tisha Wiley, Hannah K. Knudsen

Behavioral Science Faculty Publications

Background: Youth under juvenile justice (JJ) supervision are at high-risk of adverse outcomes from substance use, making prevention important. Few studies have examined prevention-related attitudes of JJ employees, yet such attitudes may be important for implementing prevention programs. Attitudes toward prevention may reflect individual characteristics and organizational contexts.

Methods: Mixed effects regression was used to analyze data from 492 employees in 36 sites participating in the Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) cooperative agreement. JJ employees' perceived importance of substance use prevention was measured. Staff-level variables included attitudes, job type, and demographic characteristics. Site-level …

A Model For Rigorously Applying The Exploration, Preparation, Implementation, Sustainment (Epis) Framework In The Design And Measurement Of A Large Scale Collaborative Multi-Site Study, Jennifer E. Becan, John P. Bartkowski, Danica K. Knight, Tisha R. A. Wiley, Ralph Diclemente, Lori Ducharme, Wayne N. Welsh, Diana Bowser, Kathryn Mccollister, Matthew Hiller, Anne C. Spaulding, Patrick M. Flynn, Andrea Swartzendruber, Megan F. Dickson, Jacqueline Horan Fisher, Gregory A. Aarons

Center on Drug and Alcohol Research Faculty Publications

Background

This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.

Methods

The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the …

A Systematic Review Of Consumer Preference For E-Cigarette Attributes: Flavor, Nicotine Strength, And Type, Samane Zare, Mehdi Nemati, Yuqing Zheng

Agricultural Economics Faculty Publications

Objective

Systematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type.

Method

A systematic search of peer-reviewed articles resulted in a pool of 12,933 articles. We included only articles that meet all the selection criteria: (1) peer-reviewed, (2) written in English, and (3) addressed consumer preference for one or more of the e-cigarette attributes including flavor, strength, and type.

Results

66 articles met the inclusion criteria for this review. Consumers preferred flavored e-cigarettes, and such preference varied with age groups and smoking status. We also found that several flavors were …

The Epidemic Of Neonatal Abstinence Syndrome, Historical References Of Its Origins, Assessment, And Management, Enrique Gomez-Pomar, Loretta P. Finnegan

Pediatrics Faculty Publications

Neonatal abstinence syndrome (NAS) refers to a constellation of signs that are present in some newborn infants resulting from the abrupt cessation of passive transfer of maternal opioids used during pregnancy. The classic NAS refers to infants born to mothers who used opioids during pregnancy, but the term has broadened to include infants whose mothers have used or abused other psychoactive substances during pregnancy that contribute to the expression of the syndrome. Pregnant women who use opioids do so illicitly, and/or as medically prescribed for pain relief, and/or as medication assisted treatment for opioid dependence. The first case of NAS …

Modified Single Prolonged Stress Reduces Cocaine Self-Administration During Acquisition Regardless Of Rearing Environment, Rebecca S. Hofford, Mark A. Prendergast, Michael T. Bardo

Psychology Faculty Publications

Until recently, there were few rodent models available to study the interaction of post-traumatic stress disorder (PTSD) and drug taking. Like PTSD, single prolonged stress (SPS) produces hypothalamic-pituitary-adrenal (HPA) axis dysfunction and alters psychostimulant self-administration. Other stressors, such as isolation stress, also alter psychostimulant self-administration. However, it is currently unknown if isolation housing combined with SPS can alter the acquisition or maintenance of cocaine self-administration. The current study applied modified SPS (modSPS; two hours restraint immediately followed by cold swim stress) to rats raised in an isolation condition (Iso), enrichment condition (Enr), or standard condition (Std) to measure changes in …

The Winding Road To Relapse: Forging A New Understanding Of Cue-Induced Reinstatement Models And Their Associated Neural Mechanisms, Mark D. Namba, Seven E. Tomek, M. Foster Olive, Joshua S. Beckmann, Cassandra D. Gipson

Psychology Faculty Publications

In drug addiction, cues previously associated with drug use can produce craving and frequently trigger the resumption of drug taking in individuals vulnerable to relapse. Environmental stimuli associated with drugs or natural reinforcers can become reliably conditioned to increase behavior that was previously reinforced. In preclinical models of addiction, these cues enhance both drug self-administration and reinstatement of drug seeking. In this review, we will dissociate the roles of conditioned stimuli as reinforcers from their modulatory or discriminative functions in producing drug-seeking behavior. As well, we will examine possible differences in neurobiological encoding underlying these functional differences. Specifically, we will …

The Time Has Come For Dimensional Personality Disorder Diagnosis, Christopher J Hopwood, Roman Kotov, Robert F. Krueger, David Watson, Thomas A. Widiger, Robert R. Althoff, Emily B. Ansell, Bo Bach, R. Michael Bagby, Mark A. Blais, Marina A. Bornovalova, Michael Chmielewski, David C. Cicero, Christopher Conway, Barbara De Clercq, Filip De Fruyt, Anna R. Docherty, Nicholas R. Eaton, John R. Edens, Miriam K. Forbes, Kelsie T. Forbush, Michael P. Hengartner, Masha Y. Ivanova, Daniel Leising, W. John Livesley, Mark R. Lukowitsky, Donald R. Lynam, Kristian E. Markon, Joshua D. Miller, Leslie C. Morey

Psychology Faculty Publications

No abstract provided.

A Qualitative Analysis Of Gabapentin Misuse And Diversion Among People Who Use Drugs In Appalachian Kentucky, Rachel Vickers Smith, Elaine M. Boland, April M. Young, Michelle R. Lofwall, Alexa Quiroz, Michele Staton, Jennifer R. Havens

Center on Drug and Alcohol Research Faculty Publications

Gabapentin, an anticonvulsant and analgesic for postherpetic neuralgia, has been thought to have no abuse potential despite numerous published reports to the contrary. Gabapentin has been linked with impaired driving and opioid use, highlighting the need to more fully understand its risk profile. Thirty-three individuals reporting recent nonmedical use of gabapentin were recruited from two ongoing longitudinal studies of drug users in Appalachian Kentucky to participate in focus groups. Four sessions were held (two in the community and two in jail settings), during which participants responded to questions regarding their personal experiences with gabapentin misuse. Focus group participants were similar …

Mindfulness And Multiple Sclerosis, Mandakini Sadhir

Pediatrics Faculty Publications

Multiple sclerosis is a chronic, debilitating autoimmune condition with unknown etiology. It can have significant impact on quality of life and overall sense of wellbeing. It can be associated with poor sleep, fatigue, mental health disorders such as anxiety, depression and affect interpersonal relationships. Impact of mindfulness based interventions in mental health conditions, chronic illness as well as multiple sclerosis in adults has been widely studied. Several studies have concluded that mindfulness based intervention can be beneficial in improving quality of life, mental health and physical symptoms such as fatigue in adult patients with multiple sclerosis. Current literature suggest that …

Modeling Geographic Factors And Assessing Their Accuracy In Identifying Health Disparities In Fayette County, Ian Jones

Lewis Honors College Capstone Collection

The purpose of this capstone is to conduct a review of existing literature to determine the effects of a variety of geographic variables on health and wellness. The student will use their findings to create a visual aid to displaying these geographic factors and their distributions within Fayette County. Furthermore, the student will analyze the intersection of these variables to predict potential pockets of discrepancy within Fayette County. Based on this analysis, the student will propose possible interventions with a basis in current literature. This project will provide the student with the opportunity to conduct a study of existing literature, …

Healthcare Providers’ Perceptions Of Pregnant Women, Allison Goderwis

Theses and Dissertations--Family Sciences

Health care providers’ (N = 421) implicit perceptions of pregnant women based on age, race or ethnicity, marital status, and socioeconomic status are assessed through a true-experiment design. Ordinal and binary regression analyses revealed that respondents felt more pity for an unmarried than married pregnant woman and more anger toward an unemployed pregnant woman without health insurance compared to a pregnant woman who was employed with health insurance. Male, Asian, and Hispanic respondents were less likely to help the pregnant woman, Black and protestant respondents were more likely to express some degree of anger toward the pregnant woman, and …

Development And Preclinical Evaluation Of Long-Lasting Cocaine Hydrolases For Cocaine Overdose And Cocaine Use Disorder Treatment, Ting Zhang

Theses and Dissertations--Pharmacy

Cocaine is a plant-based illicit drug commonly involved in substance use disorder. Although cocaine overdose and cocaine use disorders cause adverse health consequences to individuals and the economic burden on their family and society, there are no FDA (Food and Drug Administration) approved medications for treatment. Recently, it has been recognized that delivery of cocaine hydrolase (CocH) is a promising therapeutic strategy. Human butyrylcholinesterase (hBChE), the primary enzyme involved in cocaine metabolism in human, have advantages over other candidates for the development of CocH. Previous studies in our laboratory have designed and characterized hBChE mutants that have ~4,000-fold improved catalytic …

Evaluation Of A Peer Mentor Program On Adult Heroin Overdose Patients In The Emergency Department, Christina Schipper

DNP Projects

Abstract

PURPOSE: According to the Centers for Disease Control and Prevention (CDC), the rate of heroin use and heroin overdoses has greatly increased in the last decade, regardless of sex, age, race or income. The emergency department (ED) is a common place heroin users present, often as an overdose or due to a complication from their drug use. To address the current opioid epidemic, the CDC calls for increased access to substance abuse treatment services. Peer Mentors placed in the ED serve as a link for the patient to recovery services. The purpose of this study is to evaluate the …

Quitting Together: Formative Research To Develop A Social Marketing Plan For Smoking Cessation Among Women In A Residential Treatment Facility For Substance Abuse Recovery, August D. Anderson

Theses and Dissertations--Communication

Both smoking addiction and illicit substance abuse are prevalent issues in the United States today. Furthermore, these are issues that have significant impact on women’s health and mental state. Despite research that shows that smoking cessation coupled with substance abuse recovery can decrease likelihood of relapse post-recovery, few substance abuse recovery facilities today offer smoking cessation programming options. To address the issue of smoking addiction on top of substance abuse recovery, formative research was conducted through this study to determine the underlying causes of smoking habits coupled with recovery efforts and the attitudes. Through focus group sessions with women in …

Evaluating The Relationship Between Phq9 And Global Pain Scale (Gps) Scores In Opioid Dependent Adults: A Retrospective Correlational Study, Lori Nolan

DNP Projects

Background: Depression, chronic pain and opioid dependence are conditions commonly encountered in primary care settings. These comorbidities create treatment challenges while negatively influencing outcomes of care. The Patient Health Questionnaire (PHQ9) and Global Pain Scale (GPS) are valid screening tools used to score depression and pain symptoms. The purpose of this study was to determine the relationship between the PHQ9 and Global Pain Scale (GPS) scores in opioid dependent adults with chronic pain to determine whether both tools are necessary.

Methods: This was a descriptive study using a retrospective correlational research design. Data was obtained from the electronic medical records …

Provider Adherence And Influencing Factors To Implementation Of An Alcohol Withdrawal Protocol, Ashley Sellers

DNP Projects

Abstract

PURPOSE: The purpose of this study was to assess provider adherence of an initial alcohol withdrawal protocol among adult inpatients, correlate outcome variables with protocol initiation, and examine the factors influencing provider decisions to implement all parts of the protocol.

METHODS: This multi-center descriptive evaluation utilized a retrospective medical record review and qualitative survey. A convenience sample of 313 inpatients represented 395 separate admissions between January and June 2018 in the four adult hospitals of a large health care system. Twenty-four providers participated in an anonymous online survey.

RESULTS: The protocol was implemented in its entirety three times (1%) …

Diabetes-Related Distress Screening: A Survey Of Primary Care Providers' Knowledge, Attitudes, And Practices In Treating Patients With Difficulty Meeting Glycemic Goals., Michele Patrice Paxton

DNP Projects

A patient with diabetes is two to three times more likely to be depressed than the general population. Furthermore, the combination of diabetes and depression is associated with increased morbidity and mortality. However, research has shown that treatment for depression does not correlate with lower HbA1c levels or a decrease in morbidity and mortality. Recently, a body of evidence has shown that increased HbA1c levels and depression are associated with the emotional burden of managing diabetes. The emotional burden is caused by the constant behavioral and mental demands of managing the disease and the worry and fear of the impending …

Efforts To Reduce Concomitant Opioid And Benzodiazepine Prescribing At The Lexington Veterans Affairs Medical Center, Kaitlyn A. Staton

MPA/MPP/MPFM Capstone Projects

The United States is in the throes of an opioid epidemic. Any person who uses an opioid medication may experience an intentional or unintentional overdose. An overdose is more likely to occur when an individual ingests an opioid in combination with certain classes of medications, such as benzodiazepines or nonbenzodiazepines (Z-drugs). These medications are more likely to cause sedation and respiratory depression when taken together. Veterans, due to their unique mental and physical health challenges, are more likely to experience an overdose when they receive a combination of opioid therapy with benzodiazepine or Z-drug therapy as opposed to a single …

Evaluating The Attitudes And Practices Of Exercise Prescription Among Psychotherapists, Igor Vasilj

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

Exercise has been shown to improve mood, anxiety, stress, and promote neuroplasticity (Conn, 2010; Donaghy, 2007; Josefsson, Lindwall, & Archer, 2014; Silveria et al., 2013; Stathopoulou et al., 2006). However, limited research on the topic suggests that many psychologists and mental health providers are not incorporating exercise into psychological treatment, and many lack the confidence to do so (Burton, Pakenham, & Brown, 2010; Weir, 2011). The purpose of this study was to evaluate current exercise prescription trends among practicing psychologists and trainees, including identifying their current beliefs, attitudes, training, and the perceived barriers hindering psychotherapists from recommending and prescribing exercise. …

The Effect Of A Single-Session Group Songwriting Intervention On Grief Processing In Hospice Clinicians, Melissa Deaton

Theses and Dissertations--Music

The purpose of this study was to determine the effect of a single-session group music therapy songwriting session on grief processing in hospice clinicians. The study design was quasi-experimental. Participants were cluster randomized into a control group and a treatment group. The researcher led a 50-minute songwriting session focused on sharing and processing experiences of grief-related stress and burnout in hospice work. Grief processing was measured using a self-report survey for n=25. Overall differences between control and treatment groups were not found to be statistically significant. Significant differences were also not found in treatment score differences for type of …

Assessment Of The Need For Provider Education On Screening For Depression In Patients With Select Dermatologic Problems, Sarah B. Zerhusen

DNP Projects

PURPOSE: The purpose of this project is to evaluate the knowledge, attitudes, perceptions, skills, and self-efficacy of dermatology providers’ assessment of depression in patients with chronic skin disease to determine the need for continuing education programs.

METHODS: This is a single practice, multi site, quantitative correlational design study to assess provider use, comfort, and proficiency of screening and discussion of depression in patients suffering from plaque psoriasis and atopic dermatitis. Data was collected through the use of a questionnaire dispensed in January of 2018. The sample consisted of 23 dermatology providers in a dermatology practice with clinics in Louisville, Lebanon, …

Cocaine Choice: A Novel Procedure For Investigating Neuronal Activation Mediating Cocaine Preference, Jonathan Jenn-Sheng Chow

Theses and Dissertations--Psychology

Cocaine use disorder is a significant health problem, negatively impacting individuals afflicted. While preclinical self-administration research has provided invaluable insight into the neurobehavioral mechanisms that underlie cocaine abuse, cocaine use outside of the laboratory occurs within an environment where other goods are also available ubiquitously. Although there is an ever-increasing literature investigating drug vs. non-drug choice in rodent models and how alternative goods can compete with the subjective value of cocaine, the neurobiological mechanisms that are associated with cocaine preference remains largely unknown. Additionally, current drug vs. non-drug choice studies use procedures that confound preference with intake, such that preference …