Digital Commons Network^™

Treatment Outcomes For Opiate Addicted Pregnant Women, Jennifer L. Roth Parr

DNP Projects

The problem of opiate addiction is complex enough but compounded when the patient is pregnant. Substance use during pregnancy produces harmful and costly effects to both the mother and the fetus (Veilleux, Colvin, Anderson, York & Hines, 2010). The rate of opiate addiction among pregnant women in the U.S. has been increasing in epidemic numbers since the beginning of the 21st century. This paper looks at research on the origin of the problem, the demographics of the average pregnant opiate addicted patient, the effects on the woman and her unborn child, and available treatment options.

Primary Care Providers’ Knowledge And Experience With Pediatric Acute Watery Diarrhea And Hemolytic Uremic Syndrome, Krista Marie Cassel

DNP Projects

The purpose of this capstone is to investigate the potential for hemolytic uremic syndrome (HUS) risk reduction in children through the evaluation of current evidence as well as pediatric primary care providers' knowledge and experience with children at risk for HUS. The goals of this capstone are to 1) evaluate the current literature to determine best practice for prevention of HUS, 2) assess primary care provider knowledge of HUS and experience with children with acute watery, and 3) develop a guideline for the initial management and referral of these children at risk for HUS.

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

An Evaluation To The Adherence Of A Sepsis Protocol At A Central Kentucky Community Hospital, Somer K. Robinson

DNP Projects

Background: Sepsis is defined as a “systemic response to an active infectious process in the host” and “represents the systemic inflammatory response to the presence of infection” (American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, 1992, p.865). In 2008, an estimated 727,000 patients were hospitalized with a diagnosis of sepsis, an increase from 326,000 in 2000, or a 55% increase in prevalence over the eight-year period (Hall, Williams, DeFrances, & Golosinskiy, 2011). Early identification of sepsis with early and effective management strategies has been shown to improve patient outcomes and decrease mortality and prevent organ dysfunction (Levy …

Dual Component Educational Program To Improve Medical-Surgical Nurses’ Knowledge And Self-Efficacy Of Severe Sepsis And Septic Shock, Duska S. Bethel

DNP Projects

Sepsis is manifested by a spectrum of clinical signs and symptoms that are produced by an immune response to an infection. The continuum of sepsis ranges from simple sepsis to septic shock and without timely and appropriate intervention leads to death. The purpose of this practice inquiry project is to implement a dual component educational program at Baptist Health Madisonville, a hospital part of the Baptist Healthcare System in Madisonville, Kentucky, and evaluate the changes in nurse knowledge and self-efficacy levels after they receive didactic and interactive education. The first manuscript is an integrative literature review of studies published between …

Case 213: Primary Spenic Angiosarcoma, John J. Krol, Vera V. Krol, Adrian Dawkins, Halemane S. Ganesh

Radiology Faculty Publications

A 75-year-old woman with a medical history of gastroesophageal reflux disease and type II diabetes presented to the hospital with a 3-month history of gradually worsening headaches, vague upper abdominal pain, and lower back pain. The patient denied fevers, night sweats, contact with sick individuals, occupational exposure to infection, bleeding, immunodeficiency, intravenous drug use, alcohol or tobacco abuse, history of malignancy, family history of genetic disorders, and international travel. Physical examination revealed a skin-colored mass protruding from the right side of her forehead, but there were no other notable abnormalities. Her diabetes was managed with diet, and the only prescription …

The Economics Of Implementing Population Health Strategies: Progress In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …

Uk Ag Equine Programs 2015 Calendar: A 12-Month Planning Calendar For The Care And Use Of Your Horses, Jason Phillips, Glenn Mackie, Don Sorrell, Nicholas L. Carter, Paula A. Jerrell, Brian Newman, Daniel Wilson, Christopher Jeffcoat, Karen Douglas, Katheryn L. Cerny, Fernanda Camargo, Robert Coleman, Essie Rodgers, Jim Smith

Agriculture and Natural Resources Publications

The information in this calendar is provided to aid owners in planning for the care and use of their horses. When necessary, information is discussed in the month prior to application to allow horse owners adequate time to plan for activities such as weed control, soil testing, and vaccinations.

Contact your local veterinarian for health-related issues and your county extension agent for further information. Phone numbers are listed at the end of the calendar.

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Health Management and Policy Presentations

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .

Evidence-Informed Guidelines For Pediatric Pandemic Planning And Response, Ginny Sprang, James J. Clark, Miriam Silman, Phyllis W. Leigh, Candice M. Jackson, A. Scott Lajoie

Center on Trauma and Children Reports

From the executive summary:

Pandemic events are unpredictable and inevitable. When they occur, the impact is both all-encompassing and asymmetrical; each pandemic targets specific, vulnerable populations, but ultimately impacts individuals, families and communities throughout the world. Regardless of origin or circumstances, the next pandemic will certainly count infants, children, and adolescents among its most vulnerable targets. As evidenced by the 2009 H1N1 influenza pandemic, children may be at higher risk than populations more typically seen as susceptible to pandemic illness (the elderly, those with weakened immune systems, etc.). Children also can function as disease vectors, spreading the virus through their …

What Is Criminal Restitution?, Cortney E. Lollar

Law Faculty Scholarly Articles

A new form of restitution has become a core aspect of criminal punishment. Courts now order defendants to compensate victims for an increasingly broad category of losses, including emotional and psychological losses and losses for which the defendant was not found guilty. Criminal restitution therefore moves far beyond its traditional purpose of disgorging a defendant's ill-gotten gains. Instead, restitution has become a mechanism of imposing additional punishment. Courts, however, have failed to recognize the punitive nature of restitution and thus enter restitution orders without regard to the constitutional protections that normally attach to criminal proceedings. This Article deploys a novel …

Ending Failures, Showing Results, Improving Population Health: Insights From Research & Reform In The U.S., Glen P. Mays

Health Management and Policy Presentations

A growing body of empirical research supports the value of aligning the delivery systems for public health, medical care, and social services for populations with shared needs and risk factors. This presentation reviews selected studies from the field of public health services & systems research (PHSSR) in the U.S. that suggest pathways for achieving greater system alignment in the Canadian context.

Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Health Management and Policy Presentations

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.

Self-Reported Memory Complaints: Implications From A Longitudinal Cohort With Autopsies, Richard J. Kryscio, Erin L. Abner, Gregory E. Cooper, David W. Fardo, Greg A. Jicha, Peter T. Nelson, Charles D. Smith, Linda J. Van Eldik, Lijie Wan, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVE: We assessed salience of subjective memory complaints (SMCs) by older individuals as a predictor of subsequent cognitive impairment while accounting for risk factors and eventual neuropathologies.

METHODS: Subjects (n = 531) enrolled while cognitively intact at the University of Kentucky were asked annually if they perceived changes in memory since their last visit. A multistate model estimated when transition to impairment occurred while adjusting for intervening death. Risk factors affecting the timing and probability of an impairment were identified. The association between SMCs and Alzheimer-type neuropathology was assessed from autopsies (n = 243).

RESULTS: SMCs were …

Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays

Health Management and Policy Presentations

Research on the organization and financing of public health strategies offers valuable insight for governmental public health agencies seeking to adapt to a population health improvement perspective under health system reform.

Chemical Control Of Turfgrass Diseases 2015, Paul C. Vincelli, Gregg Munshaw

Agriculture and Natural Resources Publications

Turgrasses under intensive management are often subject to outbreaks of infectious diseases. Diseases usually are most damaging when weather or cultural conditions favor the disease-causing agent but not plant growth and vigor. Cultural conditions that predispose turfgrass to diseases include close mowing, inadequate or excessive nitrogen fertility, light or frequent irrigation, excessive thatch, poor drainage, and shade.

Wound Healing: Biologics, Skin Substitutes, Biomembranes And Scaffolds, Krishna S. Vyas, Henry C. Vasconez

Surgery Faculty Publications

This review will explore the latest advancements spanning several facets of wound healing, including biologics, skin substitutes, biomembranes and scaffolds.

Enhancing Immunomodulation On Innate Immunity By Shape Transition Among Rna Triangle, Square And Pentagon Nanovehicles, Emil F. Khisamutdinov, Hui Li, Daniel L. Jasinski, Jiao Chen, Jian Fu, Peixuan Guo

Center for Research on Environmental Disease Faculty Publications

Modulation of immune response is important in cancer immunotherapy, vaccine adjuvant development and inflammatory or immune disease therapy. Here we report the development of new immunomodulators via control of shape transition among RNA triangle, square and pentagon. Changing one RNA strand in polygons automatically induced the stretching of the interior angle from 60° to 90° or 108°, resulting in self-assembly of elegant RNA triangles, squares and pentagons. When immunological adjuvants were incorporated, their immunomodulation effect for cytokine TNF-α and IL-6 induction was greatly enhanced in vitro and in animals up to 100-fold, while RNA polygon controls induced unnoticeable effect. The …

Clones Of Streptococcus Zooepidemicus From Outbreaks Of Hemorrhagic Canine Pneumonia And Associated Immune Responses, Sridhar Velineni, John F. Timoney, Kim Russell, Heidi J. Hamlen, Patricia Pesavento, William D. Fortney, P. Cynda Crawford

Maxwell H. Gluck Equine Research Center Faculty Publications

Acute hemorrhagic pneumonia caused by Streptococcus zooepidemicus has emerged as a major disease of shelter dogs and greyhounds. S. zooepidemicus strains differing in multilocus sequence typing (MLST), protective protein (SzP), and M-like protein (SzM) sequences were identified from 9 outbreaks in Texas, Kansas, Florida, Nevada, New Mexico, and Pennsylvania. Clonality based on 2 or more isolates was evident for 7 of these outbreaks. The Pennsylvania and Nevada outbreaks also involved cats. Goat antisera against acutely infected lung tissue as well as convalescent-phase sera reacted with a mucinase (Sz115), hyaluronidase (HylC), InlA domain-containing cell surface-anchored protein (INLA), membrane-anchored protein (MAP), SzP, …

Editorial Comment: Temporal Trends In Preparedness Capacity, Gulzar H. Shah

Frontiers in Public Health Services and Systems Research

In view of the critical role local health departments (LHDs) play among agencies responsible for responding to natural and man-made emergencies, Bevc et al. examined the LHDs’ emergency preparedness and capacity. They compared LHDs in North Carolina with those across the country for preparedness along eight domains. Significant declines in emergency preparedness were noted from 2010 to 2012 for five out of eight domains, raising questions about our national priority concerning this important function of public health agencies. These findings have numerous implications, some of which are covered in this commentary.

Novel Synergistic Protective Efficacy Of Atovaquone And Diclazuril On Fetal-Maternal Toxoplasmosis, Helieh S. Oz

Internal Medicine Faculty Publications

Over 1 billion people globally are estimated to be infected with Toxoplasma gondii with severe or unknown consequences and no safe and effective therapies are available against congenital or persistent chronic infection. We propose that atovaquone and diclazuril synergistically protect against fetal-maternal toxoplasmosis.

METHODS: Programmed pregnant mice were treated with atovaquone and diclazuril monotherapy, or combined (atovaquone + diclazuril) therapy and infected with tachyzoites (0, 300, 600) and the course of infection was studied.

RESULTS: Infected dams with low dose (300) developed moderate toxoplasmosis complications and treatments were similarly effective with minor differences between monotherapies. In contrast, major differences were …

Maternal And Congenital Toxoplasmosis, Currently Available And Novel Therapies In Horizon, Helieh S. Oz

Internal Medicine Faculty Publications

Over one billion people worldwide are predicted to harbor Toxoplasma infection frequently with unknown lifelong health consequences. Toxoplasmosis is an important cause of foodborne, inflammatory illnesses, as well as congenital abnormalities. Ubiquitous Toxoplasma has a unique tropism for central nervous system with a mind-bugging effect and is transmitted sexually through semen. Currently available therapies are ineffective for persistent chronic disease and congenital toxoplasmosis or have severe side effects which may result in life-threatening complications. There is an urgent need for safe and effective therapies to eliminate or treat this cosmopolitan infectious and inflammatory disease. This investigation discusses pathogenesis of maternal …

Will Hiv Vaccination Reshape Hiv Risk Behavior Networks? A Social Network Analysis Of Drug Users' Anticipated Risk Compensation, April M. Young, Daniel S. Halgin, Ralph J. Diclemente, Claire E. Sterk, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Background

An HIV vaccine could substantially impact the epidemic. However, risk compensation (RC), or post-vaccination increase in risk behavior, could present a major challenge. The methodology used in previous studies of risk compensation has been almost exclusively individual-level in focus, and has not explored how increased risk behavior could affect the connectivity of risk networks. This study examined the impact of anticipated HIV vaccine-related RC on the structure of high-risk drug users' sexual and injection risk network.

Methods

A sample of 433 rural drug users in the US provided data on their risk relationships (i.e., those involving recent unprotected sex …

Vcam-1/Α4Β1 Integrin Interaction Is Crucial For Prompt Recruitment Of Immune T Cells Into The Brain During The Early Stage Of Reactivation Of Chronic Infection With Toxoplasma Gondii To Prevent Toxoplasmic Encephalitis, Qila Sa, Eri Ochiai, Tomoko Sengoku, Melinda E. Wilson, Morgan Brogli, Stephen Crutcher, Sara A. Michie, Baohui Xu, Laura Payne, Xisheng Wang, Yasuhiro Suzuki

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Reactivation of chronic infection with Toxoplasma gondii can cause life-threatening toxoplasmic encephalitis in immunocompromised individuals. We examined the role of VCAM-1/α4β1 integrin interaction in T cell recruitment to prevent reactivation of the infection in the brain. SCID mice were infected and treated with sulfadiazine to establish a chronic infection. VCAM-1 and ICAM-1 were the endothelial adhesion molecules detected on cerebral vessels of the infected SCID and wild-type animals. Immune T cells from infected wild-type mice were treated with anti-α4 integrin or control antibodies and transferred into infected SCID or nude mice, and the animals received the same antibody every other …

Animal Arterivirus Infections, Denis Archambault, Udeni B. R. Balasuriya, Raymond R. R. Rowland, Hanchun Yang, Dongwan Yoo

Veterinary Science Faculty Publications

No abstract.

Learning From Networks: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays

Health Management and Policy Presentations

Social network analysis methods offer many avenues of inquiry for studying new developments in health policy and health care delivery. The expanding availability of large linkable electronic clinical and administrative data sources allows for novel SNA applications with dependent data structures. Opportunities include the study of delivery patterns within accountable care organizations (ACOs), and other multi-provider networks, price and quality competition within new health insurance exchanges, and population health effects attributable to complex community-level interventions.

Secretory Iga Is Concentrated In The Outer Layer Of Colonic Mucus Along With Gut Bacteria, Eric W. Rogier, Aubrey L. Frantz, Maria E. C. Bruno, Charlotte S. Kaetzel

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Antibodies of the secretory IgA (SIgA) class comprise the first line of antigen-specific immune defense, preventing access of commensal and pathogenic microorganisms and their secreted products into the body proper. In addition to preventing infection, SIgA shapes the composition of the gut microbiome. SIgA is transported across intestinal epithelial cells into gut secretions by the polymeric immunoglobulin receptor (pIgR). The epithelial surface is protected by a thick network of mucus, which is composed of a dense, sterile inner layer and a loose outer layer that is colonized by commensal bacteria. Immunofluorescence microscopy of mouse and human colon tissues demonstrated that …

Practice-Based Learning: Opportunities And Implications For Stem Education, Glen P. Mays

Health Management and Policy Presentations

This presentation examines how practice-based research strategies have been used to produce new knowledge and stimulate learning about how to improve the organization, financing, and delivery of public health services. I consider how practice-based research strategies can be adapted to advance knowledge and practice related to science, technology, engineering and mathematics (STEM) education and application.

Equine Arteritis Virus Does Not Induce Interferon Production In Equine Endothelial Cells: Identification Of Nonstructural Protein 1 As A Main Interferon Antagonist, Yun Young Go, Yanhua Li, Zhenhai Chen, Mingyuan Han, Dongwan Yoo, Ying Fang, Udeni B. R. Balasuriya

Veterinary Science Faculty Publications

The objective of this study was to investigate the effect of equine arteritis virus (EAV) on type I interferon (IFN) production. Equine endothelial cells (EECs) were infected with the virulent Bucyrus strain (VBS) of EAV and expression of IFN-β was measured at mRNA and protein levels by quantitative real-time RT-PCR and IFN bioassay using vesicular stomatitis virus expressing the green fluorescence protein (VSV-GFP), respectively. Quantitative RT-PCR results showed that IFN-β mRNA levels in EECs infected with EAV VBS were not increased compared to those in mock-infected cells. Consistent with quantitative RT-PCR, Sendai virus- (SeV-) induced type I IFN production was …