Medicine and Health Sciences Commons^™

Engaging Nurses In Effective Cost Of Care Conversations To Address Cancer-Related Financial Toxicity: Results From An Exploratory Survey, Jean Edward, Abigail Wiggins, Louis G. Baser, Haafsah Fariduddin, Joanna F. Doran, Monica F. Bryant, John A. D'Orazio, Kimberly D. Northrip

Markey Cancer Center Faculty Publications

Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage Cancer® to prepare oncology nurses to identify and assist patients/caregivers facing financial and/or legal barriers to care. Ten pediatric oncology nurses completed the training and pre/post-surveys on behaviors related to financial and legal need screening, frequency and comfort level of answering questions, knowledge, and behavior changes, along with training evaluation questions. At baseline, six nurses reported never …

Association Between Education And Allostatic Load With Risk Of Cancer Mortality Among Hispanic Women, Melissa Lopez-Pentecost, Cynthia Li, Marlo Vernon, Sydney P. Howard, Jessica Amezcua, Justin Xavier Moore

Markey Cancer Center Faculty Publications

Purpose: Cancer remains the leading cause of death among Hispanics in the US. While social determinants of health, such as educational attainment, have been linked to negative health outcomes, their biological mechanisms remain poorly understood. We evaluated the association between educational attainment and allostatic load (AL), a measure of chronic physiologic stress, with risk of cancer mortality in Hispanic women from the National Health and Nutrition Examination Survey (NHANES).

Methods: We performed a retrospective analysis among 5637 Hispanic women in NHANES from 1988 to 2010 with follow-up data through 2019. Educational attainment was categorized into a two-level variable: less than …

Functional Assessment Of Migration And Adhesion To Quantify Cancer Cell Aggression, Lauren E. Mehanna, James D. Boyd, Chloe G. Walker, Adrianna R. Osborne, Martha E. Grady, Brad J. Berron

Markey Cancer Center Faculty Publications

During epithelial-to-mesenchymal transition (EMT), cancer cells lose their cell–cell adhesion junctions as they become more metastatic, altering cell motility and focal adhesion disassembly associated with increased detachment from the primary tumor and a migratory response into nearby tissue and vasculature. Current in vitro strategies characterizing a cell’s metastatic potential heavily favor quantifying the presence of cell adhesion biomarkers through biochemical analysis; however, mechanical cues such as adhesion and motility directly relate to cell metastatic potential without needing to first identify a cell specific biomarker for a particular type of cancer. This paper presents a comprehensive comparison of two functional metrics …

Inclusion Of Surgery In Multimodality Treatment Is Predictive Of Better Survival In Stage Iiia Non-Small Cell Lung Cancer: An Inverse Probability Treatment-Weighting Analysis, Feitong Lei, Janeesh Sekkath-Veedu, Bin Huang, Quan Chen, Mansi Shah-Jadeja, Thomas E. Stinchcombe, Zhonglin Hao

Markey Cancer Center Faculty Publications

Introduction: Stage IIIA non-small cell lung cancers (NSCLC) are treated with surgery-based multimodality approach or definitive chemoradiation therapy plus durvalumab consolidation. It is not clear whether surgery-based multimodality therapy has any survival advantage over definitive chemoradiation plus immunotherapy consolidation.

Method: National Cancer Database (NCDB) was used to identify NSCLC patients at stage IIIA (AJCC8, T3N1/T4N0-1 or T1N2/T2N2) who are treated with surgery-based multimodality approach or definitive chemoradiation plus durvalumab. Survival between groups were compared using inverse probability treatment weighting (IPTW)-adjusted Kaplan Meier curves and Cox proportional hazards regression analysis. Results were independently confirmed by Landmark Inverse and Clone Censor Weight …

M1 Macrophage‑Engineered Vesicles Have Anti‑Cancer Activity In Ovarian Cancer, Connie D. Cao, J. Robert Mccorkle, Derek B. Allison, Donglin Yan, Kristen S. Hill, Lan Li, Rani Jayswal, David Schweer, Charles S. Dietrich Iii, Frederick R. Ueland, Christopher I. Richards, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Background: Ovarian cancer typically presents at an advanced stage, has a poor prognosis, and is a leading cause of cancer-related deaths in women. Extracellular vesicles (EVs) are cell membrane-derived nanoparticles that function in specific cell- to-cell communication and are under development as novel drug delivery vehicles and modulators of the tumor microenvironment. Artificial cell-derived vesicles (ACDVs) from M1 macrophages are able to repolarize macrophages from a M2 to a M1 phenotype and target tumor cells in in vitro studies.

Results: In this study, we generated engineered EVs (EEVs) by membrane disruption of M1 macrophages (MEVs) with and without cisplatin to …

Measuring The Impact Of A Catchment Area Surveillance Tool On Cancer Center Adopters, Todd Burus, Caree R. Mcafee, Natalie P. Wilhite, Pamela C. Hull

Markey Cancer Center Faculty Publications

Background: The University of Kentucky Markey Cancer Center developed the data gathering and visualization platform Cancer InFocus (CIF) as a solution for cancer center catchment area surveillance. CIF was released in June 2022 and made available for use to other institutions through a no‐cost licensing agreement. The purpose of this study was to evaluate the impact CIF has had on cancer centers since its release.

Methods: The authors adapted an existing management evaluation framework to assess the impact of CIF across three spheres—idea dissemination, product engagement, and adopter satisfaction. This assessment included an online survey administered between the dates of …

Tracking Community Outreach And Engagement Activities Among National Cancer Institute-Designated Cancer Centers, Todd Burus, Caree R. Mcafee, Pamela C. Hull, Amy E. Leader, Christopher Mcnair

Markey Cancer Center Faculty Publications

The National Cancer Institute’s (NCI) Cancer Center Support Grant mandates that NCI-designated cancer centers establish a Community Outreach and Engagement (COE) component to help direct efforts at reducing cancer burden within their catchment areas. Despite the critical role of COE offices, little is known about how they track and evaluate outreach activities and outcomes. We gathered information on current practices from representatives of 40 out of 65 COE offices using an online survey. Although nearly all responding centers (97.5%) tracked COE activities, no consensus existed on resources used, and satisfaction with current solutions was mixed (51.0% not satisfied). Respondents expressed …

Biparental Inheritance Of Germline-Specific Chromosomes In The Sea Lamprey And Their Roles In Oocytes, Vladimir A. Timoshevskiy, Nataliya Timoshevskaya, Kaan İ. Eşkut, Kasturi Rajandran, Jeramiah J. Smith

Markey Cancer Center Faculty Publications

Many eukaryotic species undergo programmed elimination of specific chromosomes during embryogenesis, typically retaining these chromosomes only in their germ cells. In some species, programmatic elimination of GRCs, or sex chromosomes, also occurs in a sex-specific manner, with specific chromosomes being transmitted or eliminated by only one sex. As such, these chromosomes provide a unique perspective on the evolution of gene functions that are advantageous to the germline and genetic tradeoffs between somatic vs germline or oocyte vs sperm biology. While GRCs have been extensively characterized in male sea lampreys (Petromyzon marinus), the status of GRCs in females has not yet …

Cryptic To Conventional Cytogenetics: Philadelphia- Like All Presenting With Hypereosinophilia, Zena Chahine, Leonard Yenwong Fai, Sainan Wei, Ayman Qasrawi

Markey Cancer Center Faculty Publications

BCR::ABL1-like B-lymphoblastic leukaemia (B-ALL) neoplasms lack the BCR::ABL1 translocation but have a gene expression profile like BCR::ABL1 positive B-ALL. This includes alterations in cytokine receptors and signalling genes, such as CRLF2, ABL1, ABL2, JAK2, PDGFRB and EPOR. Cases with CRLF2 rearrangements account for approximately 50% of cases of Philadelphia-like acute lymphoblastic leukaemia (Ph-like ALL), and the frequency of specific genomic lesions varies with ethnicity such that IGH::CRLF2 translocations are more common in Hispanics and Native Americans. We report two cases of BCR::ABL1-like ALL, with significant eosinophilia. A Hispanic man in his early 20s and a Hispanic woman in her 50s …

Cabozantinib Selectively Induces Proteasomal Degradation Of P53 Somatic Mutant Y220c And Impedes Tumor Growth, Fang Lin Lv, Lu Zhang, Cheng Ji, Lei Peng, Mingxian Zhu, Shumin Yang, Shunli Dong, Mingxuan Zhou, Fanfan Guo, Zhenyun Li, Fang Wang, Youguo Chen, Jinhua Zhou, Xingcong Ren, Genhai Shen, Jin-Ming Yang, Bin Li, Yi Zhang

Markey Cancer Center Faculty Publications

Inactivation of p53 by mutations commonly occurs in human cancer. The mutated p53 proteins may escape proteolytic degradation and exhibit high expression in tumors and acquire gain-of-function activity that promotes tumor progression and chemo-resistance. Therefore, selectively targeting of the gain-of-function p53 mutants may serve as a promising therapeutic strategy for cancer prevention and treatment. In this study, we identified cabozantinib, a multikinase inhibitor currently used in the clinical treatment of several types of cancer, as a selective inducer of proteasomal degradation of the p53-Y220C mutant. We demonstrate that cabozantinib disrupts the interaction between p53Y220C and USP7, a deubiquitylating enzyme, resulting …

A Comparison Of Adjuvant Therapy Modality And Treatment Outcomes Between Appalachian And Non-Appalachian Patients With High-Risk Endometrial Carcinoma, Josie D. Llanora, Gregory S. Hawk, Laura M. Harbin, Sara Lee, Madison Lane, Madison T. Hickey, Elizabeth Pendygraft, Lauren Baldwin, Megan L. Hutchcraft

Markey Cancer Center Faculty Publications

Objective: The incidence and mortality of endometrial cancer is increasing. After surgical staging, patients with high-risk disease often undergo adjuvant treatment, which may include systemic therapy, radiation therapy, or combined modalities. Patients in rural Appalachia have limited access to subspecialty care needed for optimal disease management. This study aims to compare adjuvant treatment regimens and outcomes among patients with high-risk endometrial cancer living in Appalachian and non-Appalachian regions.

Methods: We retrospectively identified 179 patients with high-risk endometrial carcinoma who underwent surgical staging at a single academic medical center and received adjuvant therapy between 2012 and 2019. Patients were identified as …

African American And African-Born Black Women’S Perspectives And Experiences With A Cervical Health Education And Hpv-Self Sampling Intervention, Shania Jones, Abubakari Wuni, Adaeze Aroh, Adebola Olamide Adegboyega

Markey Cancer Center Faculty Publications

Background/Objectives: A combination of cervical cancer prevention education and the provision of HPV self-collection kits has been found to increase the uptake of HPV testing among women. However, there is limited research evaluating the perspectives and experiences of women who have participated in a cancer prevention education and received a complimentary HPV self-collection kit. We report the experiences of women who took part in Health is Wealth: a cervical health intervention and received a complimentary HPV self-sampling kit for cervical cancer screening.

Methods: This pilot qualitative study enrolled twenty-four women who participated in one-on-one semi-structured interviews to provide feedback and …

A High-Throughput Workflow For Assessing Self-Renewal Using Colony Formation Assays, Majd Al-Hamaly, Jessica S. Blackburn

Markey Cancer Center Faculty Publications

The colony formation assay (CFA) is a widely used method to assess the self-renewal capacity of cancer cells and evaluate how this property is affected by drug treatment. This protocol presents a streamlined, high-throughput CFA workflow optimized for T-cell acute lymphoblastic leukemia (T-ALL), making it suitable for large-scale drug screening projects. Colonies are grown in a methylcellulose-based 3D matrix and quantified using an automated analysis pipeline, allowing robust estimation of colony number and size. This cost-effective approach provides a scalable platform for identifying compounds that impair self-renewal, facilitating prioritization of hits for validation in more complex in vivo models.

An Investigation Into The Prevalence And Perceptions Of Mental Health Disorders In Appalachian West Virginia, Tyann Dotson, Jerry P. Derringer, Lauren Hudson Rose, Nathan L. Vanderford, Amanda Hinkle, Lindsay E. Cormier

Markey Cancer Center Faculty Publications

Introduction Appalachian West Virginia’s population is disproportionately afflicted by mental illness, with Logan County having the highest depression rates in the United States. To further understand the mental health situation in Appalachian West Virginia, this research study aims to evaluate the prevalence and perceptions of mental health disorders among patients of Coalfield Health Center. Methods An online survey was administered to patients at Coalfield Health Center containing 25 questions categorized into three parts: demographic, beliefs/perceptions about behavioral health, and behavioral healthcare access. Findings The data demonstrated that 37% of participants had received a mental illness diagnosis and 82% knew someone …

Analysis Of Facilitators Of And Barriers To Enactment Of State Regulation Of Indoor Tanning By Minors, Carolyn J. Heckman, Anna Mitarotondo, David B. Buller, Julia Berteletti, Kevin Schroth, Jerod L. Stapleton, Robert P. Dellavalle

Markey Cancer Center Faculty Publications

Background: Indoor tanning (IT) causes skin cancers, including potentially deadly melanoma. IT often starts during youth, a critical time for deleterious skin damage. About half of the US states have enacted laws banning IT for minors under age 18.

Purpose: This study reports qualitative findings from interviews with key informants (KIs) involved in IT legislative efforts to identify/describe factors influencing law enactment, based on the multiple streams framework.

Methods: Guided by expert advisors and using snowball-sampling, KIs from 16 states with most recently enacted IT laws regulating minor access and states without restrictions were contacted. In virtual interviews, KIs shared …

Capturing Community Perspectives In A Statewide Cancer Needs Assessment: Online Focus Group Study, Jessica R. Thompson, Keeghan Francis, Caree R. Mcafee, Madeline Brown, Todd Burus, Melinda Rogers, Connie L. Sorrell, Elizabeth A. Westbrook, Lovoria B. Williams, Jennifer Redmond Knight, Elaine Russell, Natalie P. Wilhite, Pamela C. Hull

Markey Cancer Center Faculty Publications

Background: Kentucky has the highest all-site cancer incidence and mortality rates in the United States. Conducting needs assessments in a large geographic area, such as an entire state, poses challenges in collecting qualitative data from diverse rural and urban contexts. In 2021, a steering committee was formed to drive a multimethod, statewide cancer needs assessment (CNA) to identify the future priorities for all cancer-related care in Kentucky.

Objective: We aimed to report on the online focus group component of the CNA by documenting existing community resources and perceived needs across the cancer care continuum. In addition, we aimed to explore …

Characterization Of P53 P.T253i As A Pathogenic Mutation Underlying Li-Fraumeni Syndrome, Nathaniel C. Holcomb, Amanda M. Harrington, Hong Pu, Berina Halilovic, Nathan R. Shelman, Shulin Zhang, Catherine Sears, Terra Armstrong, Brent J. Shelton, Lauren Corum, John A. D'Orazio

Markey Cancer Center Faculty Publications

We identified a germline TP53 c.758C > T (p.T253I) mutation in the TP53 tumor suppressor gene in a pediatric adrenocortical carcinoma (ACC) patient. Characteristic of pathogenic p53 mutations, we observed upregulation of total p53 protein levels in the patient’s ACC and concurrent suppression of the wild-type (WT) TP53 allele. As ACC can be associated with Li-Fraumeni Syndrome (LFS) and the mutation has not yet been linked to LFS, we sought to characterize the functionality of the T253I mutation. We acquired p53^-/-HEK293 cells and stably transduced them with GFP-tagged wild type (T253) or T253I p53 as well as two established …

Cisplatin-Loaded M1 Macrophage-Derived Vesicles Have Anti-Cancer Activity In Osteosarcoma, Namrata Anand, Joseph Robert Mccorkle, David Schweer, Lan Li, Kristen S. Hill, Melissa A. Fath, Derek B. Allison, Christopher L. Richards, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Osteosarcoma (OS) is a relatively rare bone malignancy that primarily affects children and young adults and is associated with significant morbidity and mortality. Cisplatin is a mainstay of treatment, but its efficacy is limited by off-target toxicities. Immunotherapy is not effective due to a poor antigenic tumor microenvironment. Here, we address these challenges by using manufactured M1 macrophage-derived vesicles (MVs) loaded with cisplatin. Human blood and mouse RAW 264.7 M1 macrophages were used to prepare empty (E-MVs) and cisplatin-loaded MVs (C-MVs). Human OS cell lines were used in vitro and in a tibia xenograft mouse model to evaluate the anti-cancer …

Differences In The Cancer Burden And Current Funding Of Nci-Designated Cancer Centers, Todd Burus, Caree R. Mcafee, Pamela C. Hull

Markey Cancer Center Faculty Publications

Importance  National Cancer Institute (NCI)-designated clinical and comprehensive cancer centers are required to define a geographic catchment area (CA) in which they focus research, outreach, and engagement efforts for the purposes of reducing cancer burden, particularly among certain vulnerable populations. A comprehensive analysis of the cancer burden of these catchment areas and their association with cancer center funding through the Cancer Center Support Grant (CCSG) has not been performed.

Objective  To examine CA cancer burden indicators and cancer center CCSG funding during the 2023 federal fiscal year (FY23).

Design, Setting, and Participants  This population-based cross-sectional study assessed cancer center cancer …

Disparities In Human Papillomavirus–Associated Cancer Incidence By Appalachian Residence, Todd Burus, Melina Windon, Yasminka A. Jakubek, Krystle A. Lang Kuhs

Markey Cancer Center Faculty Publications

Importance  Poor socioeconomic conditions and corresponding health disparities have historically characterized the Appalachian region of the US. Low uptake of the human papillomavirus (HPV) vaccine and high rates of cervical cancer have been observed in the region; however, a comprehensive assessment of HPV-associated cancer in Appalachia has not been performed.

Objective  To compare the burden of HPV-associated cancer incidence between the Appalachian and non-Appalachian regions of the US.

Design, Setting, and Participants  This cross-sectional study of HPV-associated cancer incidence rates and trends used the US Cancer Statistics Incidence Analytic Database, covering 99% of the US population and 100% of the …

Examining Associations Between Sociodemographic Characteristics And Ever Breastfed Children, Nhanes 1999–2020, Jessica Amezcua, Lindsey M. West, Camelia Malkami, Marlo M. Vernon, Elinita Pollard, Justin X. Moore

Markey Cancer Center Faculty Publications

Although breastfeeding provides health benefits to both mother and child, this study aimed to explore whether disparities in breastfeeding continue to exist, particularly among non-Hispanic Black (NHB) mothers and children. We performed a cross-sectional analysis among 19,830 children in the United States (US) using the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2020. Breastfeeding initiation and duration rates increased overall from 1999 to 2020. Children who were ever breastfed were more likely to have higher body weight, older mothers, mothers who did not smoke during pregnancy, a higher family poverty–income ratio (PIR), food security, mothers in …

Examining Geographic Disparity: Variation In Cancer Outcomes Within Appalachia, Todd Burus, Pamela C. Hull, Krystle A. Lang Kuhs, Tianyan Gao, Christine F. Brainson, B. Mark Evers

Markey Cancer Center Faculty Publications

BACKGROUND: 

The Appalachian region of the US extends from the Mississippi Delta to southern New York. Although disparities in Appalachian cancer outcomes have long been observed, recent rates and trends have not been assessed.

STUDY DESIGN: 

We calculated 5-year age-adjusted US cancer incidence and mortality rates for 2017 to 2021, stratified into Appalachian and non-Appalachian populations, as well as Appalachian subregions, using the US Cancer Statistics Incidence Analytics Database and National Center for Health Statistics mortality files. Annual rates for 2004 to 2021 were also calculated.

RESULTS: 

In 2017 to 2021, all-site cancer incidence (466.6; 95% CI 465.5 to 467.6) …

Health Care Access Domains And Treatment As Mediators Of Ovarian Cancer Racial Disparities In Survival: A Structural Equation Modeling Analysis In Seer-Medicare, Clare Meernik, Quan Chen, Lauren E. Wilson, Ashwini Joshi, Fariha Rahman, Maria Pisu, Margaret Liang, Kevin C. Ward, Margaret Gates Kuliszewski, Thomas Tucker, Andrew Berchuck, Bin Huang, Tomi Akinyemiju

Markey Cancer Center Faculty Publications

Racial differences in health care access (HCA) may contribute to disparities in ovarian cancer (OC) survival. We used structural equation models (SEMs) to examine associations between race and HCA domains (affordability, availability, accessibility) in relation to overall and OC-specific mortality. Non-Hispanic (NH)–Black and non-Black (Hispanic, NH-White) women diagnosed with OC in 2008-2015 were identified from Surveillance, Epidemiology, and End Results–Medicare. Cox proportional hazards regression was used to conduct mediation analysis for associations between race and HCA domains with overall and OC-specific mortality. SEM models adjusting for demographic and clinical covariates were used to estimate hazard ratios (HRs) and 95% CIs. …

Cancer-Associated Fibroblast Secreted Dkk1 Promotes The Immunosuppressive Tumor Microenvironment And Colorectal Cancer Resistance To Chemotherapy, Zhijie Yin, Yuning Zhou, Xudong Zhu, Ryan A. Goettl, Chi Wang, Heidi L. Weiss, B. Mark Evers, Qingding Wang

Markey Cancer Center Faculty Publications

Chemotherapy is the cornerstone of treatment for colorectal cancer (CRC). However, acquired resistance can lead to a decrease in the efficiency of chemotherapy. Here, we show that cancer-associated fibroblasts (CAFs) play a critical role in acquired resistance to chemotherapy. Treatment with 5-fluorouracil (5-FU), oxaliplatin, or SN38 (an active metabolite of irinotecan) increased DKK1 expression and secretion, activation of MEK/ERK, and upregulation of p53 in CAFs. Knockdown of p53 or inhibition of MEK/ERK blocked the increase in DKK1 expression induced by chemotherapeutic agents in CAFs. Consistently, elevated DKK1 and phospho-ERK levels were found in CAFs isolated from surgically resected samples of …

Hsp47 Drives Obesity-Associated Breast Cancer Progression By Enhancing Asporin Deposition In Adipose Tissue, Gaofeng Xiong, Daheng He, Dana L. Napier, Jing Chen, Haizhu Shi, Chun Li, Paula J. Hurley, Chi Wang, Haining Zhu, Changcheng Zhou, Therese J. Bocklage, Ren Xu

Markey Cancer Center Faculty Publications

Fibrosis is an important feature of adipose tissue in obese individuals; nevertheless, roles of obesity-associated extracellular matrix (ECM) deposition in breast cancer progression largely remain elusive. Here, we show that expression of Hsp47, a chaperone protein involving collagen secretion, is induced in adipose tissue from obese humans and mice. Adipocyte-specific Hsp47 deletion (Adi-KO) suppresses the high-fat diet (HFD)-induced obesity and mammary tumor progression, accompanied by a reduction in ECM deposition. Matrisome analyses lead to the identification of asporin as a new target of Hsp47 in adipose tissue. Co-immunoprecipitation results confirm that the recruitment of Hsp47 enhances asporin secretion in adipocytes. …

Cancer Advocacy Empowers Appalachian Kentucky Youth, Lauren Hudson Rose, Holly Burke, Olivia Thornsbury, Kameron Jackson, Rebecca Spradlin, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky has the highest cancer incidence rate and second highest cancer mortality rate in the United States, and the Appalachian region of the state experiences a disproportionate cancer burden. Cancer-related advocacy, a movement that strives to provide support to cancer patients, families, and organizations, along with policy creation, could help address this disparity by enhancing cancer-related prevention and control efforts. The University of Kentucky Markey Cancer Center’s Appalachian Career Training in Oncology (ACTION) Program partners with the American Cancer Society Cancer Advocacy Network (ACS CAN) to involve Appalachian Kentucky high school and undergraduate students in cancer advocacy activities at the …

Identifying Risk Factors For Adverse Lung Health Outcomes Among Rural Appalachian Women, Jessica R. Thompson, Courtney J. Walker, John C. Flunker, W. Jay Christian, Wayne T. Sanderson, Nancy E. Schoenberg, Steven R. Browning

Markey Cancer Center Faculty Publications

Purpose: Despite high rates of lung disease and lung cancer among women, few studies have focused on adverse lung health risk factors among rural Appalachian women. We aim to describe the prevalence of demographic, behavioral, and economic characteristics among a cohort of rural Appalachian women and ascertain the association between these risk factors and lung function.

Methods: Through a cross-sectional study in two rural Appalachian Kentucky counties (2015–2017), we collected demographics, health history/behaviors, and lung function via pulmonary function tests. Restricting to female participants with interpretable pulmonary function tests (N = 456), we estimated prevalence ratios of the association …

The Implementation Of The Queensland Health Smoking Cessation Clinical Pathway In A Western Australian Private Hospital Setting: A Feasibility, Leah Jane Epton

Theses

As smoking is prohibited on most hospital grounds, hospitalisation presents a valuable opportunity for healthcare professionals to identify smokers, administer smoking cessation treatments, and ensure appropriate inpatient support, as well as continued follow-up on discharge. It has been reported both anecdotally and in published research that encouragement from a health professional is a significant external prompt for a smoker to attempt quitting. It has also been noted in the inpatient setting, one in every 33 conversations will lead to the successful cessation of smoking.

More broadly, a 2012 Cochrane review on smoking cessation interventions for inpatients identified that they are …

Defining Barriers In Pulmonary Hypertension: Pulmonary Hypertension In Remote And Rural Settings In Australia: An Epidemiologic Study Aided By Echocardiography, Pyi Naing

Theses

Pulmonary hypertension (PH) is a common, complex, and potentially lethal haemodynamic condition with many underlying aetiologies. It is poorly understood, and diagnosis is usually made late in the disease process resulting in poor outcomes even in the developed world. An innovative universal framework is required to achieve early and accurate diagnosis for improved outcomes, especially in remote and rural areas. The thesis documents my substantial body of work that unlocks a collective framework to assist patients with PH, particularly in areas not classically serviced by tertiary level PH care.

The first chapter of my thesis outlines the history, important milestones …

Sickle Cell Disease Nursing Education: A Mixed Methods Program Evaluation, Lauren Brooke Clemons

Theses and Dissertations (ETD)

INTRODUCTION AND BACKGROUND: Sickle cell disease (SCD) is a common disorder of the hemoglobin and affects more than 100,000 people in the United States and millions worldwide. In response to a drastic lack of available education a group of SCD experts developed the Sickle Cell Boot Camp to Promote Nursing Excellence Train the Trainer. This initiative provided the first opportunity for nurses worldwide to gain knowledge and skills curated by the leading experts in a safe and interactive environment. By adapting the program to a train the trainer modality, education materials are provided to the attendees, and they are encouraged …