Medicine and Health Sciences Commons^™

Next Generation Public Health Delivery: Optimizing Health And Economic Impact, Glen P. Mays

Health Management and Policy Presentations

Improving population health in the context of significant policy and economic change will require governmental public health agencies to rethink their roles within the U.S. health and social services systems, giving much greater attention to "catalytic" functions intended to mobilize, direct, and coordinate the actions of others. A growing body of evidence and experience suggests that such changes are likely to be feasible, effective, and efficient.

Lrp5 And Lrp6 Exert Overlapping Functions In Osteoblasts During Postnatal Bone Acquisition, Ryan C. Riddle, Cassandra R. Diegel, Julie M. Leslie, Kyle K. Van Koevering, Marie-Claude Faugere, Thomas L. Clemens, Bart O. Williams

Internal Medicine Faculty Publications

The canonical Wnt signaling pathway is critical for skeletal development and maintenance, but the precise roles of the individual Wnt co-receptors, Lrp5 and Lrp6, that enable Wnt signals to be transmitted in osteoblasts remain controversial. In these studies, we used Cre-loxP recombination, in which Cre-expression is driven by the human osteocalcin promoter, to determine the individual contributions of Lrp5 and Lrp6 in postnatal bone acquisition and osteoblast function. Mice selectively lacking either Lrp5 or Lrp6 in mature osteoblasts were born at the expected Mendelian frequency but demonstrated significant reductions in whole-body bone mineral density. Bone architecture measured by microCT revealed …

Withaferin A Effectively Targets Soluble Vimentin In The Glaucoma Filtration Surgical Model Of Fibrosis, Paola Bargagna-Mohan, Sunil P. Deokule, Kyle G. Thompson, John Wizeman, Cidambi Srinivasan, Sunil Vooturi, Uday B. Kompella, Royce Mohan

Ophthalmology and Visual Science Faculty Publications

Withaferin A (WFA) is a natural product that binds to soluble forms of the type III intermediate filament (IF) vimentin. Currently, it is unknown under what pathophysiological contexts vimentin is druggable, as cytoskeltal vimentin-IFs are abundantly expressed. To investigate druggability of vimentin, we exploited rabbit Tenon's capsule fibroblast (RbTCF) cell cultures and the rabbit glaucoma filtration surgical (GFS) model of fibrosis. WFA potently caused G₀/G₁ cell cycle inhibition (IC₅₀ 25 nM) in RbTCFs, downregulating ubiquitin E3 ligase skp2 and inducing p27(Kip1) expression. Transforming growth factor (TGF)-ß-induced myofibroblast transformation caused development of cell spheroids with numerous elongated invadopodia, which WFA blocked …

Evidence-Based Practice For Medical Students In A Family Medicine Clerkship: Collaborative, Active Learning For Clinical Decision Skills, Tagalie Heister, Frank Davis, Rick Brewer, Archana Kudrimoti, Janice Kuperstein, Shari Levy

Library Presentations

Objectives: This active learning experience was designed to enhance the information literacy knowledge and skills of medical students for patient-centered, evidence-based decisions at the point of care. It includes formulating clinical questions using patient/problem, intervention, comparison, outcome (PICO), accessing the highest level of evidence-based medicine (EBM) information available in an effective manner, and evaluating the information in relation to a specific patient in an outpatient setting.

Methods: Third-year medical students participate in a small-group collaborative, patient-centered learning experience during the family medicine clerkship, coordinated by the clerkship directors with participation by two medical librarians. At orientation, the clerkship directors provide …

Oral Transmission Of Listeria Monocytogenes In Mice Via Ingestion Of Contaminated Food, Elsa N. Bou Ghanem, Tanya Myers-Morales, Grant S. Jones, Sarah E. F. D'Orazio

Microbiology, Immunology, and Molecular Genetics Faculty Publications

L. monocytogenes are facultative intracellular bacterial pathogens that cause food borne infections in humans. Very little is known about the gastrointestinal phase of listeriosis due to the lack of a small animal model that closely mimics human disease. This paper describes a novel mouse model for oral transmission of L. monocytogenes. Using this model, mice fed L. monocytogenes-contaminated bread have a discrete phase of gastrointestinal infection, followed by varying degrees of systemic spread in susceptible (BALB/c/By/J) or resistant (C57BL/6) mouse strains. During the later stages of the infection, dissemination to the gall bladder and brain is observed. The …

Synthesis And Biological Evaluation Of Novel Folic Acid Receptor-Targeted, Β-Cyclodextrin-Based Drug Complexes For Cancer Treatment, Juan-Juan Yin, Sonali Sharma, Stepan P. Shumyak, Zhi-Xin Wang, Zhi-Wei Zhou, Yangde Zhang, Peixuan Guo, Chen-Zhong Li, Jagat R. Kanwar, Tianxin Yang, Shyam S. Mohapatra, Wanqing Liu, Wei Duan, Jian-Cheng Wang, Qi Li, Xueji Zhang, Jun Tan, Lee Jia, Jun Liang, Ming Q. Wei, Xiaotian Li, Shu-Feng Zhou

Nanobiotechnology Center Faculty Publications

Drug targeting is an active area of research and nano-scaled drug delivery systems hold tremendous potential for the treatment of neoplasms. In this study, a novel cyclodextrin (CD)-based nanoparticle drug delivery system has been assembled and characterized for the therapy of folate receptor-positive [FR(+)] cancer. Water-soluble folic acid (FA)-conjugated CD carriers (FACDs) were successfully synthesized and their structures were confirmed by 1D/2D nuclear magnetic resonance (NMR), matrix-assisted laser desorption ionization time-of-flight mass spectrometer (MALDI-TOF-MS), high performance liquid chromatography (HPLC), Fourier transform infrared spectroscopy (FTIR), and circular dichroism. Drug complexes of adamatane (Ada) and cytotoxic doxorubicin (Dox) with FACD were readily …

An Ehealth System Supporting Palliative Care For Patients With Non-Small Cell Lung Cancer: A Randomized Trial, David H. Gustafson, Lori L. Dubenske, Kang Namkoong, Robert Hawkins, Ming-Yuan Chih, Amy K. Atwood, Roberta Johnson, Abhik Bhattacharya, Cindy L. Carmack, Anne M. Traynor, Toby C. Campbell, Mary K. Buss, Ramaswamy Govindan, Joan H. Schiller, James F. Cleary

Community & Leadership Development Faculty Publications

BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non-small cell lung cancer (NSCLC).

METHODS: In total, 285 informal caregiver-patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks …

Omega-3 Fatty Acids Reduce Adipose Tissue Macrophages In Human Subjects With Insulin Resistance, Michael Spencer, Brian S. Finlin, Resat Unal, Beibei Zhu, Andrew J. Morris, Lindsey R. Shipp, Jonah D. Lee, R. Grace Walton, Akosua Adu, Rod Erfani, Marilyn S. Campbell, Robert E. Mcgehee Jr., Charlotte A. Peterson, Philip A. Kern

Clinical and Translational Science Faculty Publications

Fish oils (FOs) have anti-inflammatory effects and lower serum triglycerides. This study examined adipose and muscle inflammatory markers after treatment of humans with FOs and measured the effects of ω-3 fatty acids on adipocytes and macrophages in vitro. Insulin-resistant, nondiabetic subjects were treated with Omega-3-Acid Ethyl Esters (4 g/day) or placebo for 12 weeks. Plasma macrophage chemoattractant protein 1 (MCP-1) levels were reduced by FO, but the levels of other cytokines were unchanged. The adipose (but not muscle) of FO-treated subjects demonstrated a decrease in macrophages, a decrease in MCP-1, and an increase in capillaries, and subjects with the most …

Effectiveness Of Community Health Workers (Chws) In Coordinating Diabetes Self Management Education (Dsme) For High-Need Appalachian Clients, Frances J. Feltner, Willie Bates

Center of Excellence in Rural Health Presentations

Objective

Examine effectiveness of CHWs in supporting a nurse-led DSME intervention among clients who are characterized by high rates of poverty and poor education.

Methods

Study Population/Research Design: New Kentucky Homeplace clients (3,217) ages 18-65+ from a 26-county study area who were processed prior to study starting date July 1, 2011. The 30.6% (983) of clients who had been told by a health professional they were diabetic, could speak English, and were willing to sign IRB consent were eligible to participate. Women who were diagnosed with diabetes during pregnancy were not eligible. Clients were able to enroll on a first-come …

The Value Of Public Health Financial Data, Glen P. Mays

Health Management and Policy Presentations

Effective policy and administrative decision-making in public health requires reliable information on the amount of resources invested in governmental public health programs and how these resouces are allocated and used across the U.S. public health system. This session examines current and potential uses of public health financial data in the U.S., and considers expanded roles for research in informing policy and administrative decisions.

Effects Of Perinatal Oxycodone Exposure On The Cardiovascular Response To Acute Stress In Male Rats At Weaning And In Young Adulthood, Thitinart Sithisarn, Henrietta S. Bada, Richard J. Charnigo, Sandra J. Legan, David C. Randall

Pediatrics Faculty Publications

Oxycodone (OXY) is one of the most commonly abused opiates during pregnancy. Perinatal opiate exposure (POE) is associated with neurobehavioral and hormone changes. Little is known about the effects of perinatal OXY on the cardiovascular (CV) responses to stress.

Objectives: to determine the effects of POE on: (1) CV responses to acute stress and ability to discriminate using a classical conditioning paradigm; (2) changes in CV response to the paradigm and retention of the ability to discriminate from postnatal day (PD) 40 to young adulthood.

Methods: Pregnant rats were given i.v. OXY or vehicle (CON) daily. OXY and CON males …

Glycosylate Derivatives Of Mithramycin, Method Of Preparation And Uses Thereof, Jürgen Rohr, Irfan Baig, Jose Antonio Salas Fernandez, Alfredo Fernandez Brana, Maria Perez Solares

Pharmaceutical Sciences Faculty Patents

The present invention provides compounds characterized by the formula (I), where each of the substituent radicals is described in the specification. The invention also describes the use of said compounds in the treatment of various diseases, including: cancer or tumoral processes in general, Paget's disease, hypercalcaemia, hypercalciuria and neurological diseases (inter alia, Parkinson's, Alzheimer's, Huntington's).

A Study Of Small Rnas From Cerebral Neocortex Of Pathology-Verified Alzheimer's Disease, Dementia With Lewy Bodies, Hippocampal Sclerosis, Frontotemporal Lobar Dementia, And Non-Demented Human Controls, Sébastien S. Hébert, Wang-Xia Wang, Qi Zhu, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

MicroRNAs (miRNAs) are small (20-22 nucleotides) regulatory non-coding RNAs that strongly influence gene expression. Most prior studies addressing the role of miRNAs in neurodegenerative diseases (NDs) have focused on individual diseases such as Alzheimer's disease (AD), making disease-to-disease comparisons impossible. Using RNA deep sequencing, we sought to analyze in detail the small RNAs (including miRNAs) in the temporal neocortex gray matter from non-demented controls (n = 2), AD (n = 5), dementia with Lewy bodies (n = 4), hippocampal sclerosis of aging (n = 4), and frontotemporal lobar dementia (FTLD) (n = 5) cases, together accounting for the most prevalent …

Caveolar Fatty Acids And Acylation Of Caveolin-1, Qian Cai, Ling Guo, Haiqing Gao, Xiang-An Li

Pediatrics Faculty Publications

PURPOSE: Caveolae are cholesterol and sphingolipids rich subcellular domains on plasma membrane. Caveolae contain a variety of signaling proteins which provide platforms for signaling transduction. In addition to enriched with cholesterol and sphingolipids, caveolae also contain a variety of fatty acids. It has been well-established that acylation of protein plays a pivotal role in subcellular location including targeting to caveolae. However, the fatty acid compositions of caveolae and the type of acylation of caveolar proteins remain largely unknown. In this study, we investigated the fatty acids in caveolae and caveolin-1 bound fatty acids.

METHODS: Caveolae were isolated from Chinese hamster …

Vital Statistics: The State Of The Public Health Pbrn Program, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Public Health PBRN Program has continued to expand during the 2013 program year with new networks, new research projects, and expanded translation and dissemination initiatives. The program plays an increasingly powerful role in helping to transform the U.S. public health enterprise into a rapid-learning system for health improvement.

Testing Integrated Primary Care And Public Health Models For Prevention Delivery, Glen P. Mays

Health Management and Policy Presentations

Improving the delivery of evidence-tested prevention interventions to populations at greatest risk requires strong coordination between primary care providers and public health organizations. This presentation reviews current research on models for integrated delivery of primary care and public health services, and identifies emerging research needs and opportunities. Of particular interest are the roles that practice-based research networks (PBRNs) can play in building this evidence.

Svsxp: A Strongylus Vulgaris Antigen With Potential For Prepatent Diagnosis, Ulla V. Andersen, Daniel K. Howe, Sriveny Dangoudoubiyam, Nils Toft, Craig R. Reinemeyer, Eugene T. Lyons, Susanne N. Olsen, Jesper Monrad, Peter Nejsum, Martin K. Nielsen

Veterinary Science Faculty Publications

BACKGROUND: Strongyle parasites are ubiquitous in grazing horses. Strongylus vulgaris, the most pathogenic of the large strongyles, is known for its extensive migration in the mesenteric arterial system. The lifecycle of S. vulgaris is characterised by a long prepatent period where the migrating larvae are virtually undetectable as there currently is no test available for diagnosing prepatent S. vulgaris infection. Presence of S. vulgaris larvae in the arterial system causes endarteritis and thrombosis with a risk of non-strangulating intestinal infarctions. Emergence of anthelmintic resistance among cyathostomins has led to recommendations of reduced treatment intensity by targeting horses that exceed a …

Public Health Roi: Evidence, Experience And Remaining Questions, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health and prevention strategies holds considerable potential for improving health outcomes and constraining costs across the U.S. health system. Unfortunately, lingering certainties about the costs required to expand public health delivery systems and about the health and economic effects of such expansions has muted private and public support for increased public health expenditures. This lecture examines recent evidence from public health services and systems research studies that examine the health and economic value of public health delivery, and identifies remaining research needs for the field.

The P38Α Mapk Regulates Microglial Responsiveness To Diffuse Traumatic Brain Injury, Adam D. Bachstetter, Rachel K. Rowe, Machi Kaneko, Danielle Goulding, Jonathan Lifshitz, Linda J Van Eldik

Sanders-Brown Center on Aging Faculty Publications

Neuropathology after traumatic brain injury (TBI) is the result of both the immediate impact injury and secondary injury mechanisms. Unresolved post-traumatic glial activation is a secondary injury mechanism that contributes to a chronic state of neuroinflammation in both animal models of TBI and human head injury patients. We recently demonstrated, using in vitro models, that p38α MAPK signaling in microglia is a key event in promoting cytokine production in response to diverse disease-relevant stressors and subsequent inflammatory neuronal dysfunction. From these findings, we hypothesized that the p38α signaling pathway in microglia could be contributing to the secondary neuropathologic sequelae after …

Prevalence And Risk Factor Analysis Of Resistant Escherichia Coli Urinary Tract Infections In The Emergency Department, Abby M. Bailey, Kyle A. Weant, Stephanie N. Baker

Emergency Medicine Faculty Publications

BACKGROUND: Escherichia coli (E. coli) is a frequent uropathogen in urinary tract infections (UTI). Widespread resistance to sulfamethoxazole-trimethoprim (SMX-TMP) and increasing resistance to fluoroquinolones amongst these isolates has been recognized. There are limited data demonstrating risk factors for resistance to both SMX-TMP and fluoroquinolones.

OBJECTIVE: This study was conducted to assess for the prevalence of community resistance amongst E. coli isolates to SMX-TMP and levofloxacin in ambulatory patients discharged from the emergency department (ED).

METHODS: Adults presenting for evaluation and discharged from the ED with a diagnosis of an E. coli UTI were retrospectively reviewed. Utilizing demographic and clinical data …

Workers Killed Due To Driver Distraction, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To Prevent Driver Distraction,

Employers should:

• Provide training on the importance of being attentive and not engaging in distracting tasks or behaviors while driving
• Develop policies that minimize or eliminate the use of in-vehicle devices while driving

Employees should:

• Not use dispatching devices while driving
• Not text or manually dial a cell phone while driving
• Refrain from activities such as reading, writing or map reading while driving

Bepcp: Media Campaign To Promote Smoke-Free Facilities, Linda Napier, Diane Kronemeyer, Melissa A. Slone, Beth Bowling, Carol Riker, Jessica Akers, Kellie Watts

Center of Excellence in Rural Health Presentations

Kentucky continues to have the highest lung cancer rate in the nation and is in the top 10 states for heart disease. Despite progress in local smoke-free policies, rural populations remain disproportionately affected by secondhand smoke (SHS) exposure. Due to the longstanding cultural heritage of tobacco, many rural residents think of SHS as a nuisance rather than a serious health hazard.

Transforming Our Parks And Beaches, Chizimuzo T.C. Okoli

Nursing Presentations

This presentation covers a study that examines the health and health equity impact of the newly implemented smoke-free policy for Vancouver’s parks and beaches.

Biodistribution And Biopersistence Of Ceria Engineered Nanomaterials: Size Dependence, Robert A. Yokel, Michael T. Tseng, Mo Dan, Jason M. Unrine, Uschi M. Graham, Peng Wu, Eric A. Grulke

Pharmaceutical Sciences Faculty Publications

The aims were to determine the biodistribution, translocation, and persistence of nanoceria in the brain and selected peripheral organs. Nanoceria is being studied as an anti-oxidant therapeutic. Five, 15, 30, or 55 nm ceria was iv infused into rats which were terminated 1, 20, or 720 h later. Cerium was determined in blood, brain, liver, and spleen. Liver and spleen contained a large percentage of the dose, from which there was no significant clearance over 720 h, associated with adverse changes. Very little nanoceria entered brain parenchyma. The results suggest brain delivery of nanoceria will be a challenge.

FROM THE …

The Mathematics Of Drug Dose Individualization Should Be Built With Random-Effects Linear Models, Francisco J. Diaz, Jose De Leon

Psychiatry Faculty Publications

No abstract provided.

Nutrition Intervention To Decrease Symptoms In Patients With Advanced Heart Failure, Terry A. Lennie, Debra K. Moser, Martha J. Biddle, Darlene Welsh, Geza G. Bruckner, D. Travis Thomas, Mary Kay Rayens, Alison L. Bailey

Nursing Faculty Publications

For a majority of patients with advanced heart failure, there is a need for complementary, non-pharmacologic interventions that could be easily implemented by health care providers to provide palliative care. Three major pathologic pathways underlying heart failure symptoms have been identified: fluid overload, inflammation, and oxidative stress. Prior research has demonstrated that three nutrients-sodium, omega-3 fatty acids, and lycopene-can alter these pathologic pathways. Therefore, the purposes of this study are to test the effects of a 6-month nutrition intervention of dietary sodium reduction combined with supplementation of lycopene and omega-3 fatty acids on heart failure symptoms, health-related quality of life, …

Cost Estimation Methods: Strategies And Examples For Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

This webinar reviews methods for conducting cost studies in public health settings, including strategies for estimating the financial and ecnomic costs of delivering public health services, and analytic approaches to identifying factors that influence delivery costs. These types of studies are of increasing importance to policy and practice stakeholders given the need for evidence about the return-on-investment (ROI) generated through public health delivery.

Osteoblast-Restricted Disruption Of The Growth Hormone Receptor In Mice Results In Sexually Dimorphic Skeletal Phenotypes, Vandana Singhal, Brian C. Goh, Mary L. Bouxsein, Marie-Claude Faugere, Douglas J. Digirolamo

Internal Medicine Faculty Publications

Growth hormone (GH) exerts profound anabolic actions during postnatal skeletal development, in part, through stimulating the production of insulin-like growth factor-1 (IGF-1) in liver and skeletal tissues. To examine the requirement for the GH receptor (GHR) in osteoblast function in bone, we used Cre-LoxP methods to disrupt the GHR from osteoblasts, both in vitro and in vivo. Disruption of GHR from primary calvarial osteoblasts in vitro abolished GH-induced signaling, as assessed by JAK2/STAT5 phosphorylation, and abrogated GH-induced proliferative and anti-apoptotic actions. Osteoblasts lacking GHR exhibited reduced IGF-1-induced Erk and Akt phosphorylation and attenuated IGF-1-induced proliferation and anti-apoptotic action. In …

Community Asset Identification In Support Of A Place-Based, Early Childhood Obesity Prevention And School Readiness Initiative, Cristi Carman, Bernice Raveche Garnett, Josefine Wendel, Justeen Hyde, Virginia Rall Chomitz

Frontiers in Public Health Services and Systems Research

Despite extensive community efforts that have resulted in obesity decreases in Cambridge, MA over the last decade, obesity among Black youth remains disproportionately high. Likewise, racial/ethnic academic achievement disparities persist and are evident at early ages.

Prior research and emerging national policy recommendations confirm the need for place-based, early childhood interventions to address persistent racial/ethnic disparities in obesity and school readiness. A community-based participatory research initiative is developing an intervention targeted to pre-kindergarten children and their families in a diverse Cambridge neighborhood. The intervention will partner with a Cambridge Public Schools (CPS) program designed to support school readiness through extended …

Do Phab Accreditation Prerequisites Predict Local Health Departments’ Intentions To Seek Voluntary National Accreditation?, Gulzar H. Shah, Kate Beatty, Carolyn Leep

Frontiers in Public Health Services and Systems Research

Accreditation has been identified as a crucial strategy for strengthening the public health infrastructure. As agencies prepare for accreditation, it is important to understand how intentions to seek accreditation are related to the current level of readiness based on the three Public Health Accreditation Board (PHAB) prerequisites. Using the National Association of County and City Health Officials’ (NACCHO) 2010 Profile Study, we examined the relationship between the PHAB accreditation prerequisites and local health department (LHD) intentions to seek PHAB accreditation using multinomial logistic regression. Our results indicate that completion of a community health assessment (CHA) or community health improvement plan …