Digital Commons Network^™

Variation In The Potentially Inappropriate Use Of Antipsychotic And Benzodiazepine Medications Among Individuals Receiving Residential Medication Management Reviews, Mouna J. Sawan, Alexander J. Clough, Jodie Hillen, Andrew R. Zullo, Daniela C. Moga, Natalie Soulsby, Danijela Gnjidic

Epidemiology and Environmental Health Faculty Publications

Objectives To describe the variation in the use of potentially inappropriate antipsychotic and benzodiazepine medications in residents who have received a medication review and to evaluate the extent to which this variation is associated with aged care home (ACH) and resident characteristics. Methods This cross-sectional, retrospective study used pharmacist-extracted data from 15,442 residents across 342 Australian ACHs who had a medication review during 2019. The proportion of residents receiving ≥1 potentially inappropriate antipsychotic and benzodiazepine medication according to Beers criteria were classified into quintiles by facility usage (Q1-Q5). Quintile characteristics were compared using descriptive analysis of facility and resident data. …

Comparison Of The Association Between Covid-19 And New Onset Diabetes In A Regional And National Dataset, Mary E. Lacy, Aaron P. Smith, Lindsey R. Hammerslag, Kory R. Heier, James Aaron, Alicia Fields, John L. Fowlkes, Simon J. Fisher, Jeffery Talbert, Philip A. Kern

Epidemiology and Environmental Health Faculty Publications

Aims: This study examined new onset diabetes following COVID-19 infection in large datasets. Methods: A retrospective cohort study design was used in three distinct databases: data from a large academic medical center (University of Kentucky Healthcare, UKHC), claims data from privately insured patients in the Merative MarketScan (MarketScan) database, and a subset of the MarketScan database with lab tests. Control groups included patients from the prepandemic timeframe (prepandemic cohort), as well as COVID-era patients without documented COVID infection (COVID − cohort). Results: Incident diabetes in COVID infected patients was higher in all datasets. In the UKHC and MarketScan datasets, the …

Detecting Spatial Clusters Of Crimean Congo Hemorrhagic Fever In Iraq In 2023, Hanan Abdulghafoor Khaleel, Riyadh Abdulameer Alhilfi, Sabrina Brown

Epidemiology and Environmental Health Faculty Publications

Background: Since the start of the first large outbreak of Crimean Congo Hemorrhagic Fever (CCHF) in Iraq in 2022, there has been no assessment of clustering of cases by district. The aim of this study is to identify clusters of high and low incidences of human CCHF to guide preventive and control measures, and distribute limited resources. Methods: This is a cross-sectional study of reported and confirmed CCHF cases in Iraq from January 1, 2023 to December 11, 2023. We used a retrospective purely spatial Poisson scan statistic model to identify clusters of high and low incidences of CCHF at …

Wetland Treatment Systems For Municipal Wastewater At A Bourbon Distillery And Potential Value Of Incorporating Stillage For Water Treatment Enhancement, Katherine Ristola, Tiffany Messer, Czarena Crofcheck, Tyler Barzee, Wayne Sanderson

Epidemiology and Environmental Health Faculty Publications

The use of constructed treatment wetlands as a secondary treatment method for wastewater effluent from package treatment plants and distillery stillage has the potential to be an innovative, sustainable method for improving water quality. However, the use of constructed wetlands to treat bourbon whole stillage and a distillery bottling facility’s wastewater treatment plant effluent has been limited. Therefore, the objectives of this study were to (1) quantify constructed wetland water quality improvement as a secondary treatment method for a distillery’s municipal wastewater, (2) optimize treatment design to meet wastewater effluent discharge limits, and (3) quantify the potential to enhance constructed …

Development Of A Health And Wellness Assessment For Kytc Personnel, Gabriel Dadi, Farshid Taherpour, Caitlin Pope

Kentucky Transportation Center Research Report

Highway construction workers operate in high-stress, hazardous settings where they have to perform physically taxing labor in environments where exposure to variable weather conditions, heavy equipment, high volumes of vehicle traffic, and other conditions that induce stress and anxiety are the norm. Up to 70% of workers in this industry have reported experiencing mental health issues, including secondary traumatic stress, post-traumatic stress disorder, depression, anxiety, and substance abuse disorders. Few state departments of transportation, however, offer adequate resources staff can draw on to effectively manage their psychological well-being. To help Kentucky Transportation Cabinet (KYTC) roadway maintenance and construction workers develop …

Using Photovoice To Define “Community” In Substance Use Disorder Research Engaging Service Users, Providers, And Policymakers, Mcgladrey Margaret L, Marisa Booty, Ramona Olvera, Peter Balvanz, Hilary L. Surratt, Shannon Matthews, Susannah Stitzer, Owusua Yamoah, Sylvia Ellison, Kevin Campbell, Amy Farmer, Bethany Gealy, Mike Greenwell, Felicia Harris, Amy Kuntz, Sara Szelagowski, Alexandrea Shouse, Carrie B. Oser

Sociology Faculty Publications

(197 words)The ideals of community-engaged health research are challenging to realize ethically and methodologically, particularly when focused on substance use disorder (SUD), in which the power differentials inherent to stigma marginalize people with lived experience (LE) as full community participants. This study provides a typology and exploratory data generated through Photovoice to understand relationships among community members with different roles related to LE of SUD (i.e., SUD service providers, service users, and the public) in the context of a large-scale community-engaged opioid overdose reduction intervention. A team of 14 participants and researchers used an adapted thematic analysis method to interpret …

Inferring The Timing Of Antiretroviral Therapy By Zero-Inflated Random Change Point Models Using Longitudinal Data Subject To Left-Censoring, Hongbin Zhang, Mckaylee Robertson, Sarah L. Braunstein, David B. Hanna, Uriel R. Felsen, Levi Waldron, Denis Nash

Biostatistics Faculty Publications

We propose a new random change point model that utilizes routinely recorded individual-level HIV viral load data to estimate the timing of antiretroviral therapy (ART) initiation in people living with HIV. The change point distribution is assumed to follow a zero-inflated exponential distribution for the longitudinal data, which is also subject to left-censoring, and the underlying data-generating mechanism is a nonlinear mixed-effects model. We extend the Stochastic EM (StEM) algorithm by combining a Gibbs sampler with a Metropolis–Hastings sampling. We apply the method to real HIV data to infer the timing of ART initiation since diagnosis. Additionally, we conduct simulation …

The Positive Association Of Physical Activity On Sadness And Suicide Behaviors For Youth Who Have Been Bullied, Katelon Kerns, Kahir Jawad, Yana Feygin, V. Faye Jones, W. David Lohr, Jennifer Le, Kiana Fields, Jennifer Porter, Sarah Ouellette, Theresa Kluthe, Deborah Winders Davis

Biostatistics Faculty Publications

Background: Youth mental health is a public health crisis. Bullying has been associated with adverse mental health outcomes including depression and suicidal ideation. We aimed to update information regarding the associations between bullying and sadness and three suicide-related outcomes, along with the potential moderating effect of physical activity (PA). Methods: Using the 2017–2021 Youth Risk Behavior Surveillance System (YRBSS) with students in grades 9–12 we used descriptive statistics, chi-square tests, and multivariable logistic regressions to examine the association between students who have been bullied and who reported feeling sad or hopeless, as well as considered, planned, and/or attempted suicide, within …

Characterizing Risk And Protective Factors For Alzheimer's Disease And Related Dementias In American Samoa, Danielle Eakins, Jessica Williams-Nguyen, Nancy Schoenberg, Va'atausili Tofaeono

Anthropology Faculty Publications

No abstract provided.

Exploring The Impact Of Mitoquinone Supplementation On Glycan Profiles In A Repeated Mild Traumatic Brain Injury Mouse Model, Mona Goli, Akeem Sanni, Sakshi Gautam, Khalil Mallah, W. Brad Hubbard, Mohammad Reslan, Muhammad Ali Haidar, Karim Halabi, Joseph Walker, Stefania Mondello, Firas Kobeissy, Yehia Mechref

Physiology Faculty Publications

Traumatic brain injury (TBI) represents a significant cause of injury-related deaths and disabilities. Repeated exposure to mechanical impact can lead to metabolic and ionic imbalance, which can cause oxidative stress and worsen the cellular dysfunction initiated by the initial mild TBI (mTBI). Currently, no FDA-approved drug targets repeated mTBI (rmTBI) and its potential sequelae. Mitoquinone (MitoQ) is a mitochondrion-targeted drug that has proven beneficial in different brain-related diseases. We have previously demonstrated the neurotherapeutic effects of MitoQ at a 30-day chronic time point in a similar rmTBI mouse model, where we observed decreased neuroinflammation, enhanced behavioral outcomes, and diminished oxidation. …

From Gains To Liver Pain, Benjamin I. Burke, John J. Mccarthy, Ahmed Ismaeel

Physiology Faculty Publications

A recent study from Liu et al. described the role of skeletal muscle-derived extracellular vesicles in promoting liver fibrosis as an outcome of chronic overtraining in mice. Here, we highlight this work and discuss its implications within the fields of exercise physiology and inter-organ communication.

Male Layer-Type Birds (Lohmann Brown Classic Hybrid) As A Meat Source For Chicken Pâtés, Nikolay Kolev, Desislav Balev, Stefan Dragoev, Teodora Popova, Evgeni Petkov, Krasimir Dimov, Surendranath Suman, Ana Paula Salim, Desislava Vlahova-Vangelova

Animal and Food Sciences Faculty Publications

The valorisation of underutilized male layer-type chickens offers a sustainable and ethically aligned opportunity for the poultry industry. This study evaluated the feasibility of male layer-type chicken meat in the production of chicken pâtés and compared the effects of different meat sources—commercial broiler (CP), and 5 (5wP) and 9-week-old (9wP) male layer-type chickens—on product quality during refrigerated storage using the general linear model with the Tukey–Kramer post-hoc test. Pâtés made from 5wP meat exhibited the most favourable technological properties, including the lowest (p < 0.05) total expressible fluid (TEF), highest (p < 0.05) water retention (TEF_Water), and lowest (p < 0.05) fat content (TEF_Fat) than CP and 9wP indicating superior emulsion stability. The 5wP …

Overdose Education And Naloxone Distribution Among Women With A History Of Oud Transitioning To The Community Following Jail Release, Michele Staton, Megan F Dickson, Mary M Levi, Martha Tillson, Patricia R Freeman, Laura C Fanucchi, J Matthew Webster, Carrie B Oser

Sociology Faculty Publications

BACKGROUND: The criminal legal system (CLS) provides a critical intervention point for women at high risk for overdose, and the need continues to rise as the number of incarcerated women increases. Effective, targeted prevention interventions to reduce overdose risk for CLS-involved women are needed, such as naloxone distribution. This study describes the overdose education and naloxone distribution (OEND) procedures used in the Kentucky-hub of the Justice Community Opioid Innovation Network (JCOIN).

METHOD: Participants included women incarcerated in nine Kentucky jails (N = 900) who were randomly selected, screened for opioid use disorder, and consented for the study. They were followed …

Impact Wv: Adapting Patient Navigation Models Of Care To Improve Services To Caregivers Of Infants Exposed To Substances In Utero, Charlotte S. Workman Bsms, Ccrp, Lesley Cottrell, Mawyah Bashatah, Aisha Hashmi, Kayla Richard, Poornima Murthy, Susan Harrison, Ashleigh Mckinsey, Amy Bott, Sydney Leary, Cody Smith, Melina Danko

Journal of Appalachian Health

Patient navigation (PN) is a healthcare service delivery model designed to partner clients with service providers to reduce challenges to health care, as well as to improve access to care by identifying opportunities to coordinate services for clients. The IMPACT WV project at the West Virginia University Center for Excellence in Disabilities (WVU CED) implemented PN models of care for caregivers of infants exposed to substances in utero. The purpose of this program was to reduce burden for potentially at-risk families and improve caregiver and infant outcomes as a result. To understand the processes that influence the implementation of PN …

Drive Time Analysis Of New Gynecologic Oncology Patients At West Virginia University, Kassandra Whitfield, Ariel Cohen, Krista Pfaendler, Kristy Ward

Journal of Appalachian Health

Introduction: West Virginia is a rural mountain state; access to medical care, especially specialty care, can be difficult for patients.

Purpose: The purpose of this study is to analyze the geographic status and transportation times of new gynecologic oncology patients.

Methods: Home zip codes for new patient gynecologic oncology patients were analyzed for drive times to the cancer center. Zip codes of oncology providers in the state were compared to the location of patients.

Results: A total of 1,097 new gynecologic oncology patients lived within a 240-minute drive of MBRCC; nearly half (48.9%) of them drove greater than 60 minutes. …

Tailoring Statewide Training For Local Impact: A Burke County Public Health Case Study, Miranda Smith, Ashley Jarrett, Danny Scalise, Samantha Simmons

Journal of Appalachian Health

Addressing health-related social needs is crucial for improving health outcomes, especially for vulnerable populations. NCCARE360 is North Carolina’s statewide coordinated care platform powered by Unite Us.¹ Burke County Public Health (BCPH) identified gaps in the standardized NCCARE360 training, prompting a tailored approach. Using the Plan-Do-Study-Act cycle, BCPH refined training materials with interactive guides, real-life scenarios, and one-on-one sessions. This adaptation led to increased staff engagement and improved referral outcomes. Recognized as a model for local implementation, BCPH’s approach signifies the importance of customizing statewide initiatives to meet local operational realities. This case highlights the value of iterative training improvements …

Patient-Clinician Communication In The Appalachian Region: A Scoping Review, Kawther Al Ksir, Hadii M. Mamudu, Chidiebube J. Ugwu, Emily K. Flores, Tracy Fasolino, Holly Wei, Rick L. Wallace, Florence M. Weierbach

Journal of Appalachian Health

Introduction: Effective communication between patients and clinicians is a critical component of quality health care, influencing disease prevention, management, and outcomes. In regions with unique socioeconomic and geographic challenges, communication barriers can further exacerbate health disparities. Understanding the factors that facilitate or hinder patient-clinician communication is essential for developing targeted interventions that improve health care delivery.

Purpose: This review explores the existing literature on patient-clinician communication concerning cardiovascular disease (CVD) in the Appalachian Region with the aim to understand existing gaps and interventions.

Methods: PubMed and Web of Science databases were utilized to conduct a systematic search. The Population, Concept, …

Using Photovoice To Define The Experiences, Needs, Strengths, And Priorities Of Gay Men In South Central Appalachia, Ana D. Sucaldito, Lilli Mann-Jackson, Jorge Alonzo, John W. Chaffin, Scott D. Rhodes

Journal of Appalachian Health

Introduction: Gay, bisexual, queer, and other men who have sex with men and transgender and nonbinary persons living in rural Appalachia experience profound health disparities. Limited research, however, has focused on the needs, strengths, and priorities of these communities.

Purpose: This study sought to better understand the lived experiences of the vulnerable, underrepresented, and underserved Appalachian gay male community by working with a small group of self-identified gay Appalachian men.

Methods: As part of a larger community-based participatory research study (the Appalachian Access Project), four self-identified gay men participated in a photovoice project. Participants took photos based on …

Determinants Of Willingness To Share Wearable Health Data With Health Care Providers In Appalachian Populations: An Exploratory Study, Gilbert Munoz Cornejo, Joonghee Lee

Journal of Appalachian Health

Background: Wearable health devices capture metrics (e.g., physical activity, ECG, sleep) that can enhance care when shared with providers. Yet, willingness to share wearable data may differ in Appalachia, where chronic disease burdens, mistrust, and limited infrastructure pose unique challenges.

Objective: This study explored (1) which sociodemographic, health, and digital behaviors correlate with willingness to share wearable data and (2) how these insights can guide region-specific interventions in Appalachia.

Methods: We analyzed 320 Appalachian respondents from the Health Information National Trends Survey (HINTS 6). Descriptive statistics and logistic regression models examined willingness to share wearable data. Because of small cell …

Heartache In The Heartland: Unraveling The Social Roots Of Deaths Of Despair In Kentucky, Lyndsey K. Blair, Madeline M. Tomlinson, Michele Abee-Biskis, Jessica Hume, Gabri Warren

Journal of Appalachian Health

Introduction: Deaths of despair (DoD), encompassing suicides, drug overdoses, and alcohol-related liver diseases, have emerged as a critical public health crisis in the United States, with their rise particularly pronounced from 1995 to 2013 and exacerbated by the COVID-19 pandemic. Kentucky, grappling with high rates of substance use disorder, poor mental health, and economic hardship, is at the forefront of this issue, particularly in its rural and Appalachian regions.

Purpose: This study explores the social determinants contributing to DoD in Kentucky, focusing on economic and social factors that influence rising rates of suicide, drug overdose, and alcohol-related liver disease. The …

Finding Freedom In Appalachia: Evaluating A Mental Health Intervention In West Virginia, Elizabeth A. Claydon, Karen Haring, Jessica Haring, Kelsey Riggi, Beth Currence

Journal of Appalachian Health

Introduction: Rural areas have limited capacity to provide comprehensive mental health treatment and resources. This creates the need for interventions to ensure individuals with mental health concerns have access to resources to improve their mental health.

Purpose: The purpose of this mixed-methods evaluation was to assess the effectiveness and impact of Libera, a mental health program tailored for girls and women within the Appalachian region.

Methods: Quantitative surveys, including validated measures for depression, anxiety, and eating disorder symptoms, and life satisfaction, were collected pre- and post-Libera intervention for participants. Simultaneously, annual surveys were sent to Listeners in addition to qualitative …

Time And Location: Physical Activity Trends In Parents And Children In A Rural Region During Covid-19, Brooke C. Towner, Robert Broce, Rebecca A. Battista

Journal of Appalachian Health

Introduction: COVID-19 restrictions altered the structure of the school and workday for families with children and led to changes in active transportation. Continued restrictions impacted access to many community locations and led to changes in physical activity (PA) behavior.

Purpose: The objectives of the study were to describe the changes in the 1) amount of PA time per day, 2) frequency of PA, and 3) sitting time. Information about how PA changed for parents and children during the COVID-19 pandemic will have potential implications for education, public health, and recreation management.

Methods: This cross-sectional study enlisted participants via an online …

Children Living With Type 1 Diabetes In The Public School System, Madison M. Wilson

Kentucky Undergraduate Journal for the Health Humanities

Type 1 Diabetes is a worldwide chronic condition that typically develops during adolescence and requires life-long treatment and management. Management of this disease is extremely complicated for a child to manage on their own and requires a community of individuals to help them. With children spending most of their days at school, the school’s teachers and staff are vital to the care and management of their condition while attending public school. Children with Type 1 Diabetes in public school systems face many disparities and a reform is needed. Looking at this population through a holistic health science lens can help …

Rural Access To Certified Community Behavioral Health Clinics (Ccbhcs), Aaron P. Smith, Jeffrey Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

▪ The number of Certified Community Behavioral Health Clinics (CCBHCs) expanded from 2022 to 2023, increasing from 371 to 480. Most of the growth was driven by rural counties (57.9% increase, 126 to 199) while urban counties increased by 14.7% (245 to 281).

▪ The number of services offered at CCBHCs is similar in both rural and urban localities, but urban CCBHCs were more likely to offer services that cater to a diverse client base, such as speaking different languages, and nicotine cessation programs. Rural CCBHCs were more likely to have programs for minors, veterans, and …

Maternal Occupational Exposure To Noise, Kristen W. Van Buren, Carissa M. Rocheleau, I. Chen Chen, Wayne T. Sanderson, Leslie A. Macdonald, Elizabeth A. Masterson, Eirini Nestoridi, Elizabeth C. Ailes

Epidemiology and Environmental Health Faculty Publications

Objectives We investigated associations between occupational noise and gestational diabetes mellitus, pregnancy-related hypertension (including pre-eclampsia/eclampsia), preterm birth and small for gestational age (SGA) infants. Methods Data were analysed for 7889 singleton, live-born infants without major birth defects or chromosomal disorders and their mothers from the National Birth Defects Prevention Study from 1997 to 2011. Typical maternal occupational noise exposure in all jobs held from 1 month prior to conception through the end of pregnancy was estimated by expert rater and categorised as quiet (<60 A-weighted decibels (dBA)), low (60-75 dBA), moderate (76-84 dBA) or loud (>85 dBA). Multiple logistic regression was used to estimate associations (adjusted ORs and 95% CIs) between …

Fentanyl Test Strip Use And Overdose Risk Reduction Behaviors Among People Who Use Drugs, Rachel A Vickers-Smith, Kitty H Gelberg, Janet E Childerhose, Denise C Babineau, Redonna Chandler, James L David, Lauren D'Costa, Megan Dzurec, Barry Eggleston, Amanda Fallin-Bennett, Laura C Fanucchi, Soledad Fernandez, Jace Gilbert, Louisa Gilbert, Megan E Hall, Brooke E Hiltz, Michael W Konstan, Kathryn E Lancaster, Beth Linas, Katherine R Marks, Nichole Michaels, Jennifer Miles, Fernando Montero, Haley J Ramsey Harden, Carter Roeber, Mary R Russo, Rachel Taylor, Melissa A Theis

Epidemiology and Environmental Health Faculty Publications

IMPORTANCE: Illegal fentanyl is driving overdose mortality, and fentanyl test strips (FTS) can be used to test drugs for fentanyl at the point of consumption. Evidence on whether FTS use is associated with overdose risk reduction behaviors is encouraging, but largely limited to smaller, single-site studies.

OBJECTIVE: To determine whether self-reported baseline FTS use among people who use drugs (PWUD) was associated with overdose risk reduction behaviors and nonfatal overdose over a 28-day follow-up.

DESIGN, SETTING, AND PARTICIPANTS: Multisite, observational cohort study of PWUD conducted from May to December 2023 as an ancillary study of the HEALing Communities Study, which …

Introducing Social Determinants Of Health To The Alzheimer's Disease Research Center Network, Megan Zuelsdorff, Erin L. Abner, Joyce E. Balls-Berry, Gregory A. Jicha, Serggio Lanata, Gladys E. Maestre, Monica Rosselli, Shana D. Stites, Rachel A. Whitmer, Consuelo H. Wilkins, Lisa L. Barnes

Epidemiology and Environmental Health Faculty Publications

The Alzheimer's Disease Research Centers (ADRCs) consortium represents a critical locus of research on Alzheimer's disease and related disorders (ADRD) prevention, diagnosis, and intervention. Through the National Alzheimer's Coordinating Center's (NACC) standardized protocol, the Uniform Data Set (UDS), ADRCs have collected rich, harmonizable clinical and cognitive data. However, the collection of social data has been sparse and Center specific, constraining ADRD science that addresses research priorities on social determinants of health (SDOH) and health equity. Capitalizing on the transition to a revised UDS version 4, an interdisciplinary committee representing 10 ADRCs reviewed the literature and instrumentation, ultimately creating a brief …

Pharmacokinetic Modeling And Model-Based Hypothesis Generation For Dose Optimization Of Clonidine In Neonates With Neonatal Opioid Withdrawal Syndrome, Fei Tang, Chee M. Ng, Jamie Horn, Henrietta S. Bada, Markos Leggas

Epidemiology and Environmental Health Faculty Publications

The No-POPPY study (NCT03396588), a double-blind, randomized trial compared morphine with clonidine therapy for neonatal opioid withdrawal syndrome (NOWS) and found that the duration of treatment was similar across groups. This is significant because perinatal use of morphine has the potential for neurodevelopmental consequences. Still, the clonidine group reached symptom stabilization (Finnegan score (FS) < 8) later than the morphine group and had a more significant number of patients who required adjunct therapy. However, the mean FS was consistently lower in the clonidine group after day 6. This prompted us to use pharmacokinetic (PK) and parametric time-to-event (TTE) modeling to simulate dosage schedules that may decrease the time to stabilization and reduce the need for adjunct therapy. Population PK (popPK) analysis was conducted, and the final model was a one-compartment model with first-order absorption and elimination, incorporating allometric scaling and age effect on apparent clearance (CL/F) and apparent volume (V/F). The population estimates for CL/F and V/F were 13.6 L/h/70 kg and 416 L/70 kg, respectively, similar to the reported values. A Weibull model described the TTE data best, followed by incorporating predicted average concentrations to yield the final Weibull accelerated failure time model. Simulations of dosing strategies showed that increasing both the starting and maximum doses could potentially shorten the time to stabilization, and thus, length of treatment and hospital stay. Given the hypothesis-generating nature of this analysis, the recommended dosing regimens should be tested prospectively to evaluate their benefits.

Hypercoagulable And Autoimmune Factors In Patients With Moyamoya Syndrome, Justin F. Fraser, Min Jian Hou Ma, Christopher Mclouth, Laura Whitnel, Jessica Lasslo, David Dornbos Iii, Jill Roberts

Neuroscience Research Data

Moyamoya is a progressive cerebrovascular condition leading to stenosis of the internal carotid arteries (ICA) and formation of abnormal vasculature at the base of the brain. Patients ultimately suffer from ischemic and/or hemorrhagic stroke. In Kentucky, patients often present with comorbidities, which classifies them as having moyamoya syndrome (MMS). In this prospective observational study, we measured coagulable- and autoimmune-related factors in MMS subjects to identify possible therapeutic targets and help inform clinical care. Venous blood samples were collected from adult subjects diagnosed with MMS and analyzed by the UK Healthcare Clinical Laboratory. Blood samples, demographics, and medical records were obtained …

Beyond The Legislature’S Website: Strategies And Tools For State Legislative Research That Informs Advocacy Work, Jennifer Horne

Library Faculty and Staff Publications

As the nation’s state legislatures increasingly decide the issues that affect citizens most directly, the ability to identify, track, and understand state legislation is key to successful advocacy efforts. While all state legislative websites provide the status and authoritative text of the bill, this may be insufficient to understand what the bill seeks to do and why the change is being proposed. To find plain English summaries and necessary context and background information on proposed bills, advocates may also need to find appropriate news sources and identify key stakeholders—those who care the most about the bill or are the most …