Digital Commons Network^™

Assessing A Quality Improvement Project In A Georgia County Health Department, Dayna S. Alexander, William C. Livingood, Nandi A. Marshall, Angela Peden, Russ Toal, Gulzar H. Shah, Alesha Wright, Purity Cummings, Ketty Gonzalez, Lynn Woodhouse

Frontiers in Public Health Services and Systems Research

The study and evaluation of quality improvement among Georgia’s public health systems continues to be a major priority for the Georgia Public Health Practice Based Research Network (GAPH-PBRN). This article focuses on the application and evaluation of a Quality Improvement project in a Georgia County Health Department. The QI team sought to reduce the waiting time in the teen clinic; thereby, increasing the Quality Improvement culture one project at a time in this Health Department. The project revealed that Quality Improvement is a continuous process that requires change and adaptation by employees. This initial Quality Improvement project was the first …

The Relationship Between Quality Improvement And Health Information Technology Use In Local Health Departments, Kendra Johnson, Kim K. Nguyen, Shimin Zheng, Robin P. Pendley

Frontiers in Public Health Services and Systems Research

This research examined if there is a relationship between engagement in quality improvement (QI) and health information technology (HIT) for local health departments (LHDs) controlling for workforce, finance, population, and governance structure. This was a cross-sectional study that analyzed data obtained from the Core questions and Module 1 in the NACCHO 2010 Profile of LHDs. Descriptive statistics, bivariate analyses, and logistic regression analyses were conducted. Findings suggest that LHD engagement in QI has a relationship with utilization of HIT including electronic health records, practice management systems, and electronic syndromic surveillance systems. This study provides baseline information about the HIT use …

Commentary: The Road To Quality In Public Health, A Long But Important Journey, F. Douglas Scutchfield, Glen Mays, Marylou Wallace

Frontiers in Public Health Services and Systems Research

Quality improvement (QI) in public health departments is a focus in this sixth issue of Frontiers. Data is important to the development of quality improvement efforts. As we see growth of and meaningful use of electronic health records, the health department is in a position to take the lead as a data hub and to use this information wisely to both improve their QI efforts and link that QI to outcomes.

Autonomic Nervous System Function Following Prenatal Opiate Exposure, Matthew Todd Hambleton, Eric W. Reynolds, Thitinart Sithisarn, Stuart J. Traxel, Abhijit R. Patwardhan, Timothy N. Crawford, Marta S. Mendiondo, Henrietta S. Bada

Pediatrics Faculty Publications

In utero exposure to opiates may affect autonomic functioning of the fetus and newborn. We investigated heart rate variability (HRV) as a measure of autonomic stability in prenatal opiate-exposed neonates (n = 14) and in control term infants (n = 10). Electrocardiographic data during both non-nutritive and nutritive sucking were evaluated for RR intervals, heart rate (HR), standard deviation of the consecutive RR intervals (SDRR), standard deviation of the differences of consecutive RR intervals (SDDRR), and the power spectral densities in low and high frequency bands. In controls, mean HR increased significantly, 143-161 per min (p = …

Pastures For Goats And Sheep, Greg Brann

Kentucky Grazing Conference

Pasture for sheep is not that different than that for cattle but pasture for goats is very different. Sheep are grazers like cattle whereas goats are browsers like deer. Even though grass and clover are not a goats preference if all of the forage present is grass and clover goats will eat it. Due to goats and sheep being more prey animals than cattle they don’t like to wade off into tall vegetation, also it takes more energy for them to move through tall growth. Many plants that we traditionally consider weeds become desirable forbs when goats or sheep are …

(How I Think About) Kentucky's Pastures: One Of Kentucky's Untapped Resources, Jimmy C. Henning

Kentucky Grazing Conference

One of the privileges of old(er) age is the prerogative to take liberties with assigned tasks. At the risk of confusing producers and offending more scientifically-current forage scientists, the topic of pasture as an untapped resource presented an opportunity to address task from an unexpected angle. Certainly, Kentucky’s pastures are a resource with untapped potential. But the idea that their value as a resource depends on how we think about them is one worth pursuing.

Marijuana: Current Concepts, Donald E. Greydanus, Elizabeth K. Hawver, Megan M. Greydanus, Joav Merrick

Pediatrics Faculty Publications

Marijuana (cannabis) remains a controversial drug in the twenty-first century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis (pot) use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed …

Sorghum Mutant Rg Displays Antithetic Leaf Shoot Lignin Accumulation Resulting In Improved Stem Saccharification Properties, Carloalberto Petti, Anne E. Harman-Ware, Mizuki Tateno, Rekha Kushwaha, Andrew Shearer, A. Bruce Downie, Mark Crocker, Seth Debolt

Horticulture Faculty Publications

BACKGROUND: Improving saccharification efficiency in bioenergy crop species remains an important challenge. Here, we report the characterization of a Sorghum (Sorghum bicolor L.) mutant, named REDforGREEN (RG), as a bioenergy feedstock.

RESULTS: It was found that RG displayed increased accumulation of lignin in leaves and depletion in the stems, antithetic to the trend observed in wild type. Consistent with these measurements, the RG leaf tissue displayed reduced saccharification efficiency whereas the stem saccharification efficiency increased relative to wild type. Reduced lignin was linked to improved saccharification in RG stems, but a chemical shift to greater S:G ratios in RG stem …

Firesetting In Childhood And Adolescence, Joav Merrick, Carrie Howell Bowling, Hatim A. Omar

Pediatrics Faculty Publications

Fire is the rapid oxidation of a material in the exothermic chemical process of combustion, releasing heat, light, and various reaction products. Fire is intriguing and therefore something that will attract a curious child from an early age.

In 2010, the United States fire department responded to 44,900 fires started by someone, usually a child, playing with fire. These fires caused 90 civilian deaths, 890 civilian injuries, and $210 million in direct property damage. Preschoolers and kindergartners are most likely to start these fires, while playing with matches or lighters and most likely to die in these fires. Most fire-play …

Human Sexuality And Adolescence, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Release Of A Wound-Healing Agent From Plga Microspheres In A Thermosensitive Gel, H. A. Machado, J. J. Abercrombie, T. You, Patrick P. Deluca, K. P. Leung

Pharmaceutical Sciences Faculty Publications

The purpose of this research was to develop a topical microsphere delivery system in a thermosensitive 20% poloxamer 407 gel (Pluronic F127) to control release of KSL-W, a cationic antimicrobial decapeptide, for a period of 4-7 days for potential application in combat related injuries. KSL-W loaded microsphere formulations were prepared by a solvent extraction-evaporation method (water-oil-water), with poly (D,L-lactic-co-glycolic acid) (PLGA) (50 : 50, low-weight, and hydrophilic end) as the polymeric system. After optimization of the process, three formulations (A, B, and C) were prepared with different organic to water ratio of the primary emulsion while maintaining other components and …

Asthma And Risk Of Non-Respiratory Tract Infection: A Population-Based Case-Control Study, Duk Won Bang, Hyeon J Yang, Eell Ryoo, Majdi N. Al-Hasan, Brian Lahr, Larry M. Baddour, Barbara P. Yawn, Young J. Juhn

Internal Medicine Faculty Publications

OBJECTIVES: Asthmatics have increased risks of airway-related infections. Little is known about whether this is true for non-airway-related serious infections such as Escherichia coli bloodstream infection (BSI). We assessed whether asthma is associated with a risk of developing community-acquired E coli BSI.

DESIGN: The study was designed as a population-based retrospective case-control study.

SETTING: This population-based study was conducted in Olmsted County, Minnesota.

PARTICIPANTS: The study included 259 all eligible community-acquired E coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-matched, gender-matched and residency-matched controls.

PRIMARY AND SECONDARY OUTCOME MEASURES: Only community-acquired E coli BSI …

Bis-Pyridino Containing Compounds For The Use In The Treatment Of Cns Pathologies, Peter A. Crooks, Linda P. Dwoskin, Joshua Ayers, Vladimir Grinevich, Sangeetha Sumithran

Pharmaceutical Sciences Faculty Patents

N-n-Alkylation of nicotine converts nicotine from an agonist into an antagonist specifically for neuronal nicotinic acetylcholine receptor subtypes mediating nicotine-evoked dopamine release. Conformationally restricted analogs exhibit both high affinity and selectivity at this site, and are able to access the brain due to their ability to act as substrates for the blood-brain barrier choline transporter.

Diabetes And Prostate Cancer Screening In Black And White Men, Maureen Sanderson, Jay H. Fowke, Loren Lipworth, Xijing Han, Flora Ukoli, Ann L. Coker, William J. Blot, Margaret K. Hargreaves

CRVAW Faculty Journal Articles

PURPOSE: Prior studies conducted primarily among white men find a reduced risk of prostate cancer associated with time since developing diabetes. While biologic explanations are plausible, the association may in part arise from more frequent prostate cancer screening among those with a diabetes diagnosis. The purpose of the present study was to investigate the association between diabetes and prostate cancer screening.

METHODS: We examined differences in prostate cancer screening (prostate-specific antigen and/or digital rectal examination) testing practices after a diabetes diagnosis among lower-income persons living in the southeastern United States and enrolled in the Southern Community Cohort Study between 2002 …

Sexual Coercion And Sexual Violence At First Intercourse Associated With Sexually Transmitted Infections, Corrine M. Williams, Emily R. Clear, Ann L. Coker

CRVAW Faculty Journal Articles

BACKGROUND: Violence against women has been associated with subsequent risky sexual behaviors and sexually transmitted infections (STIs). We explored whether sexual coercion or violence at first intercourse was associated with self-reported STIs.

METHODS: Using nationally representative data from the 2006 to 2010 National Survey of Family Growth, we analyzed female respondents aged 18 to 44 (n = 9466) who answered questions on coercion at first intercourse (wantedness, voluntariness, and types of force used) and STIs using logistic regression analyses. We explored degrees of coercion, which we label as neither, sexual coercion (unwanted or nonphysical force), or sexual violence (involuntary or …

Global Kentucky (Fall 2013), University Of Kentucky International Center

Global Kentucky

No abstract provided.

Brazil’S Inverno Inferno: The Growing Pains Of A Rising Giant, Josh Smith

Ex-Patt Magazine

As this emerging international actor readies itself for its grand appearance on the world stage, working-class citizens have seized the opportunity to voice their frustrations while global eyes are steadily turning towards the giant.

Turning The Tide On An Epidemic: A Native Kentuckian Changes The Deadly Trajectory Of Hiv Infection, Dannette Smith Cook

Ex-Patt Magazine

Interview: Dr. Mina Hosseinipour did not know her research would positively change the trajectory of the worldwide HIV epidemic when she graduated with a bachelor’s degree from the University of Kentucky in the early 1990’s.

Nor Any Drop To Drink: Global Water Security Is Key To U.S. Long-Term Security, Cori W. Curtis

Ex-Patt Magazine

No abstract provided.

Retinal Angiogenesis Suppression Through Small Molecule Activation Of P53, Sai H. Chavala, Younghee Kim, Laura Tudisco, Valeria Cicatiello, Till Milde, Nagaraj Kerur, Nidia Claros, Susan Yanni, Victor H. Guaiquil, William W. Hauswirth, John S. Penn, Shahin Rafii, Sandro De Falco, Thomas C. Lee, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Publications

Neovascular age-related macular degeneration is a leading cause of irreversible vision loss in the Western world. Cytokine-targeted therapies (such as anti-vascular endothelial growth factor) are effective in treating pathologic ocular angiogenesis, but have not led to a durable effect and often require indefinite treatment. Here, we show that Nutlin-3, a small molecule antagonist of the E3 ubiquitin protein ligase MDM2, inhibited angiogenesis in several model systems. We found that a functional p53 pathway was essential for Nutlin-3-mediated retinal antiangiogenesis and disruption of the p53 transcriptional network abolished the antiangiogenic activity of Nutlin-3. Nutlin-3 did not inhibit established, mature blood vessels …

Vegetable Production Guide For Commercial Growers, 2014-15, Ricardo Bessin, Kenneth W. Seebold, Shubin Saha, Shawn Wright, John Strang

Agriculture and Natural Resources Publications

Successful vegetable production generally requires the grower to make daily decisions regarding pest management, irrigation, and cultural practices. Would-be growers unwilling to make serious investments of time (and money) should not attempt to expand beyond a space at the farmers’ market. It is important for vegetable growers to have a market outlet for their product before they choose to start production. Good marketing plans start with the customer and work backward to production. Potential growers should first determine exactly what buyers want, how they want it, and when they want it. They then must determine how these crops should be …

Suicide And Suicide Attempts In Kentucky, 2001‐2012, Joshua W. Lambert, Svetla Slavova

Kentucky Injury Prevention and Research Center Special Report

The data sources, methods, and definitions used in this report are based on the State Injury Indicators report: Instructions for Preparing 2011 Data, Atlanta, Georgia, March 2013, a publication of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

The Vancouver General Hospital Smoking Cessation Clinic: Outcomes From A Specialist Cessation Service Within Cardiology, Milan Khara, Chizimuzo T.C. Okoli

Nursing Presentations

PURPOSE: The purpose of our study is to examine pilot treatment outcomes of an outpatient Smoking Cessation Clinic (SCC) provided within Cardiology Services.

RELEVANCE/CONTEXT: Populations with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening cardiac events. Smoking cessation can greatly reduce the risk of further occurrence of a cardiac event and associated mortality. However few Cardiology services in Canada offer smoking cessation services and few Cardiologists refer smoking patients to such services. The Vancouver General Hospital’s SCC is housed within Cardiology Services and offers a longitudinal approach to smoking cessation. This …

Conversion Of Iodide To Hypoiodous Acid And Iodine In Aqueous Microdroplets Exposed To Ozone, Elizabeth A. Pillar, Marcelo I. Guzman, Jose M. Rodriguez

Chemistry Faculty Publications

Halides are incorporated into aerosol sea spray, where they start the catalytic destruction of ozone (O₃) over the oceans and affect the global troposphere. Two intriguing environmental problems undergoing continuous research are (1) to understand how reactive gas phase molecular halogens are directly produced from inorganic halides exposed to O₃ and (2) to constrain the environmental factors that control this interfacial process. This paper presents a laboratory study of the reaction of O₃ at variable iodide (I^–) concentration (0.010–100 μM) for solutions aerosolized at 25 °C, which reveal remarkable differences in the reaction intermediates …

Clinical Inertia In Type 2 Diabetes: A Retrospective Analysis Of Pharmacist-Managed Diabetes Care Vs. Usual Medical Care, Felix K. Yam, Aimee G. Adams, Holly Divine, Douglas Steinke, Mikael D. Jones

Pharmacy Practice and Science Faculty Publications

Background: Evidence suggests that patients with type 2 diabetes (T2DM) suffer from a high rate of “clinical inertia” or “recognition of the problem but failure to act.”

Objective: The aim of this study is to quantify the rate of clinical inertia between two models of care: Pharmacist-Managed Diabetes Clinic (PMDC) vs. Usual Medical Care (UMC).

Methods: Patients in a university based medical clinic with type 2 diabetes (T2DM) were analyzed in this retrospective cohort study. Patients were exposed to either PMDC or UMC. The difference in days to intervention in response to suboptimal laboratory values and time …

Construction Of A Sonchus Yellow Net Virus Minireplicon: A Step Toward Reverse Genetic Analysis Of Plant Negative-Strand Rna Viruses, Uma Ganesan, Jennifer N. Bragg, Min Deng, Sharon Marr, Mi Yeon Lee, Shasha Qian, Manling Shi, Justin Kappel, Cole Peters, Yeon Lee, Michael M. Goodin, Ralf G. Dietzgen, Zhenghe Li, Andrew O. Jackson

Plant Pathology Faculty Publications

Reverse genetic analyses of negative-strand RNA (NSR) viruses have provided enormous advances in our understanding of animal viruses over the past 20 years, but technical difficulties have hampered application to plant NSR viruses. To develop a reverse genetic approach for analysis of plant NSR viruses, we have engineered Sonchus yellow net nucleorhabdovirus (SYNV) minireplicon (MR) reporter cassettes for Agrobacterium tumefaciens expression in Nicotiana benthamiana leaves. Fluorescent reporter genes substituted for the SYNV N and P protein open reading frames (ORFs) exhibited intense single-cell foci throughout regions of infiltrated leaves expressing the SYNV MR derivatives and the SYNV nucleocapsid (N), phosphoprotein …

Unseating Privilege: Rawls, Equality Of Opportunity, And Wealth Transfer Taxation, Jennifer Bird-Pollan

Law Faculty Scholarly Articles

This Article is the second in a series that examines the estate tax from a particular philosophical position in order to demonstrate the relevance and importance of the wealth transfer taxes to that position. In this Article, I explore Rawlsian equality of opportunity, a philosophical position that is at the heart of much American thought. Equality of opportunity requires not only ensuring that sufficient opportunities are available to the least well-off members of society but also that opportunities are not available to other members merely because of their wealth or other arbitrary advantages. Therefore, an income tax alone, even one …

The Role Of Rehabilitation Following Autologous Chondrocyte Implantation: A Retrospective Chart Review, Jenny L. Toonstra, Jennifer Sebert Howard, Timothy L. Uhl, Robert A. English, Carl G. Mattacola

Physical Therapy Faculty Publications

PURPOSE/BACKGROUND: Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post-operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population's demographics, clinical outcomes, and rehabilitation practices. This study aimed to assess the consistency of the documentation process relative to post-operative rehabilitation in order to provide information and guide initiatives for improving …

Cost Estimation Methods And Foundational Public Health Capabilities, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medine recently recommended that the federal government identify the components and costs of a "minimum package of public health services" and "foundational public health capabilities" that should be universally available across the U.S. This presentation reviews costing methods that can be used for identifying the costs required to establish "foundational public health capabilities" at state and local levels within the U.S. public health system.

The Effect Of Snap On Poverty, Laura Tiehen, Dean Jolliffe, Timothy Smeeding

University of Kentucky Center for Poverty Research Discussion Paper Series

On signing the Food Stamp Act of 1964, President Johnson noted that “as a permanent program, the food stamp plan will be one of our most valuable weapons for the war on poverty” (Johnson, 1964). From a humble beginning of 2.9 million recipients per month and $228 million in benefits in 1969 (earliest national figures), the program has grown to serve 47 million persons with benefits of over $74.6 Billion in 2012 (USDA, 2013a). In the late 60’s and early 70’s, when the average monthly benefit was under $20 per month per month, we did not record the effects of …