Medicine and Health Sciences Commons^™

Prospective Analysis Of Early Lapse To Drinking And Smoking Among Individuals In Concurrent Alcohol And Tobacco Treatment [Post-Print], Laura Holt

Faculty Scholarship

The aims of the current study were to examine, prospectively, (a) dynamic changes in affective state, self-efficacy, and urge in the hours before initial smoking and drinking lapses among individuals in concurrent alcohol and smoking treatment, and (b) the extent to which self-efficacy, urge to use, and/or the use of one substance predicted lapse to the other substance. Ninety-six men and women recruited for a clinical trial of concurrent alcohol and tobacco treatment were eligible for inclusion. Only data from those who experienced an initial lapse to drinking (n = 29) or smoking (n = 32) were included. Two outpatient …

Investigating And Improving Medical Education And Library Resources At The Tamale Teaching Hospital In Northern Ghana : A Case Report Part 2., John Chenault

Faculty Scholarship

In part one of this case report, published in the Spring Issue of Kentucky Libraries (Volume 76, Number 2), I described my journey to Tamale, Ghana to provide a series of training workshops at the Tamale Teaching Hospital (TTH), Nursing Training School (NTS), and the University of Development Studies (UDS), and to conduct a needs assessment to gather information to develop a series of grant proposals to assist the local health sciences libraries with improving their collections. Part two of this report briefly describes the consultations that took place and the planning and project outcomes to-date.

Purines And Neuronal Excitability: Links To The Ketogenic Diet [Post-Print], Susan A. Masino, Masahito Kawamura Jr., David N. Ruskin, J D. Geiger, D. Boison

Faculty Scholarship

ATP and adenosine are purines that play dual roles in cell metabolism and neuronal signaling. Acting at the A(1) receptor (A(1)R) subtype, adenosine acts directly on neurons to inhibit excitability and is a powerful endogenous neuroprotective and anticonvulsant molecule. Previous research showed an increase in ATP and other cell energy parameters when an animal is administered a ketogenic diet, an established metabolic therapy to reduce epileptic seizures, but the relationship among purines, neuronal excitability and the ketogenic diet was unclear. Recent work in vivo and in vitro tested the specific hypothesis that adenosine acting at A(1)Rs is a key mechanism …

Investigating And Improving Medical Education And Library Resources At The Tamale Teaching Hospital In Northern Ghana : A Case Report., John Chenault

Faculty Scholarship

This article discusses a service-learning trip I took in the summer of 2011 to conduct a series of consultations and workshops for librarians, administrators, faculty, and students at Tamale Teaching Hospital (TTH) and the University of Development Studies (UDS) in Northern Ghana. The visit was organized in support of a series of programs and collaborations that have been ongoing for several years between the University of Louisville (U of L) School of Public Health and Information Science (SPHIS) and TTH and UDS. The goal of the visit was twofold: to provide a series of training workshops to improve the research, …

Dialogues, Dilemmas, And Disclosures: Genomic Research And Incidental Findings, Lynn W. Bush, Karen H. Rothenberg

Faculty Scholarship

No abstract provided.

The Nervous System And Metabolic Dysregulation: Emerging Evidence Converges On Ketogenic Diet Therapy, David N. Ruskin, Susan A. Masino

Faculty Scholarship

A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high fat, low-carbohydrate ketogenic diet (KD) debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, KD therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. Cellular metabolic dysfunction in the nervous system has …

Genes And Plays: Bringing Elsi Issues To Life, Karen H. Rothenberg, Lynn W. Bush

Faculty Scholarship

Ethical complexities surround the promise of genomic technology and the power of genetic information as they alter conceptions of identity and dynamics within personal and professional relationships. Creative approaches such as dramatic vignettes offer a unique analytical stage for imagining the bioethical past and future. Dramatic narratives can bring to life images of differing perspectives and values when experiencing innovations in medicine. Although the scientific landscape shifts, concerns expressed in theatre from 50 years ago parallel many contemporary ELSI (ethical, legal and social implications) issues, highlighting the ongoing struggle to appreciate the impact of emerging genetic technologies on relationships. To …

Manipulating Fate: Medical Innovations, Ethical Implications, Theatrical Illuminations, Karen H. Rothenberg, Lynn W. Bush

Faculty Scholarship

Transformative innovations in medicine and their ethical complexities create frequent confusion and misinterpretation that color the imagination. Placed in historical context, theatre provides a framework to reflect upon how the ethical, legal, and social implications of emerging technologies evolve over time and how attempts to control fate through medical science have shaped -- and been shaped by -- personal and professional relationships. The drama of these human interactions is powerful and has the potential to generate fear, create hope, transform identity, and inspire empathy -- a vivid source to observe the complex implications of translating research into clinical practice through …

Accountable Care Organizations In The Affordable Care Act, Frank Pasquale

Faculty Scholarship

No abstract provided.

The Cumulative Impact Of Unemployment On Risks Of Acute Myocardial Infarction, Guangya Liu, Matthew E. Dupree, Linda K. George, Eric D. Peterson

Faculty Scholarship

Background: Employment instability is a major source of strain affecting an increasing number of adults in the United States. Little is known about the cumulative effect of multiple job losses and unemployment on the risks for acute myocardial infarction (AMI).

Methods: We investigated the associations between different dimensions of unemployment and the risks for AMI in US adults in a prospective cohort study of adults (N=13 451) aged 51 to 75 years in the Health and Retirement Study with biennial follow-up interviews from 1992 to 2010. Unadjusted rates of age-specific AMI were used to demonstrate observed differences by employment status, …

Financial Conflicts Of Interest In Science, Joanna K. Sax

Faculty Scholarship

This article proposes that an analysis of behavior may be utilized to create an effective policy addressing financial conflicts of interest. Importantly, this article focuses on the academics that conduct basic science.

An understanding of the background of the public-private interaction is critical to fully appreciate the rise of the financial conflicts of interest in biomedical science. Part II of this Article describes the rise of financial conflicts of interest and the types of harms that can occur in the absence of effective policy to regulate financial conflicts of interest.

Part III describes the current system addressing conflicts of interest, …

Application Of Default Rules To Address Financial Conflicts Of Interest In Academic Medical Centers, Joanna K. Sax

Faculty Scholarship

A recent report issued from the Institute of Medicine contains an extensive analysis of financial conflicts of interest (FCOIs) in biomedical science. In brief, an FCOI exists when a profit-seeking motive either unduly influences or appears to influence an academic scientist’s primary obligations. The cornerstone of current policy to address FCOIs at academic medical centers (AMCs) is disclosure; however, disclosure does not appear to appropriately regulate, manage, or eliminate FCOIs.

Although the relationships between intramural scientists and industry and extramural scientists and industry may be structurally different, they both can lead to FCOIs that threaten scientific integrity. Overall, the NIH …

Multisite Recruitment And Data Collection Among Older Adults : Exploring Methods To Conserve Human And Financial Resources., Valerie Lander Mccarthy, Karen Cassidy

Faculty Scholarship

The purpose of this article is to describe strategies that were effective in recruitment and data collection among older adults in 3 quantitative studies while decreasing costs in terms of time and money. Factors effective in reducing use of investigators' time and expenses included limiting exclusion of data because of abnormal Mini-Cog scores by careful initial screening and avoiding repeated reminders or follow-up, collecting data in small groups, collapsing consent, dementia screening, and data collection into single sessions, as well as accommodating for sensory and literacy deficits. The cross-sectional, descriptive studies were conducted among community-dwelling older adults attending senior citizen …

Neuroscience And The Child Welfare System, Clare Huntington

Faculty Scholarship

Increasingly, scholars and policymakers are calling for programs that take a preventive approach to child abuse and neglect, rather than our current tendency to respond only after a crisis. There are significant social and economic arguments supporting this shift. The Nurse-Family Partnership, developed by David Olds and discussed in this symposium, illustrates how specific investments in family functioning can lower rates of child abuse and neglect, leading to a host of positive outcomes for children and society, from greater educational attainment to less involvement in the criminal justice system. Thinking about child well-being more broadly, the Nobel laureate James Heckman …