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LEXINGTON, Ky. (July 28, 2015) —Two University of Kentucky College of Health Sciences faculty members will receive the highest award given by the American Speech-Language-Hearing Association (ASHA). Robert C. Marshall, and Joseph C. Stemple, professors in the Division of Communication Sciences and Disorders, will be recognized with the Honors of the Association at the ASHA annual convention, which will be held in in November in Denver.
The Honors of the Association recognizes members for their distinguished contributions to the discipline of communication sciences and disorders and is the highest honor the association bestows. The Honors of the Association recognize individuals whose contributions have been of such excellence that they have enhanced or altered the course of the field of speech, language and hearing professions.
Marshall and Stemple are the first from Kentucky to receive the Honors of the Association.
“This award of national prominence demonstrates the excellence of our faculty,” said Scott M. Lephart, dean of the College of Health Sciences. “The fact that Drs. Marshall and Stemple are the first recipients from the Commonwealth further underscores the importance of the work we are doing at the College of Health Sciences. Our faculty is making a local, statewide, and national impact.”
“It’s a tremendous honor for Drs. Marshall and Stemple that exemplifies one of the highest levels of achievement in communication sciences and disorders,” said Anne Olson, division director Communication Sciences and Disorders. “Dr. Marshall’s career in aphasia and Dr. Stemple’s career in clinical voice disorders have been experienced through multiple lenses: clinical, academic, and research. Thus they understand the impact of speech and language disorders from both the human and scientific dimensions. As colleagues, we are proud of them, but more importantly we are thrilled for our graduate students in speech language pathology who have the opportunity to learn from true giants in their respective fields.”
Marshall’s selection was based on his years of sustained research, scholarship, teaching and service activities within the profession that spanned from the public schools, to the Veterans Administration and academia in Oregon, Rhode Island and Kentucky. He has held clinical and leadership positions in all employment settings and is widely regarded for his scholarly expertise in aphasia.
“Receiving the Honors of the American Speech-Language-Association is a high point of a very satisfying professional career. I am humbled by this award,” Marshall said. “I am grateful to my sponsor, Dr. Lee Ann Golper, my co-sponsors Drs. Kathryn Yorkston and Rosemary Lubinski, and the many professional colleagues who supported my nominations. I feel blessed to have been taught by those who overlooked my weaknesses and nurtured my strengths and inspired by my patients, students, professional colleagues, and employers. These forces, along with the support of my family every step of the way, have been the ‘wind beneath my sails.’ I feel very blessed to have had a job in which going to work every day was something to truly look forward to.”
Stemple’s selection was based on his unique ongoing research, scholarship, teaching and service activities within the profession, that include his development of centers of excellence for voice care, voice research and educational opportunities, his prolific publication record, including textbooks and scholarly manuscripts, as well as his international reputation as a dynamic presenter on issues related to the voice across the lifespan.
The UK College of Health Sciences offers undergraduate and graduate/professional programs in: Athletic Training, Clinical Leadership and Management, Clinical Nutrition (in collaboration with the College of Medicine), Communication Sciences and Disorders, Human Health Sciences, Medical Laboratory Science, Physical Therapy, Physician Assistant Studies, and Rehabilitation Sciences.
Media Contact: Ann Blackford at 859-323-6442 or email@example.com
LEXINGTON, Ky. (July 27, 2015) — Who would think that an innocent looking tiny green flower would produce copious amounts of pollen, making us miserable with a stuffy, runny nose, itchy throat and eyes? This member of the daisy family is the culprit for hay fever, also known as ragweed allergies.
Ragweed season rears its ugly head in late summer through November with pollen counts at its highest levels in mid-September in most regions of the U.S. Some people with hay fever also develop asthma symptoms, such as coughing, wheezing, and trouble breathing.
People whose parents or siblings have allergies to plant pollen are more likely to develop ragweed allergies. Also, people who have allergies to dust, animals, grass or mold tend to develop allergies to pollens, and people who already have an allergy to one type of plant pollen tend to develop allergies to other pollens.
Seasonal allergies develop when the body's immune system in a genetically susceptible person becomes sensitized and makes allergic antibodies to something in the environment that causes no problem in most people.
Some things you can do to avoid or limit contact with ragweed pollen are:
· Wash your hands often
· Limit time outdoors when ragweed counts are high and avoid mid-day when counts peak
· Windows closed, air conditioning on
· Wear a dust mask if working outside
· Don't wear outdoor work clothes inside to avoid bringing pollen in the house
· Clean and replace HVAC filters often using HEPA filters which remove at least 99 percent of pollen and other particles
· Use a clothes dryer rather than outdoor clothes lines
Climate can affect the level of pollen particles, which in turn influences symptom severity. Kentucky has recently experienced an unusual amount of rainfall, and pollen counts can actually soar after rain. Ragweed pollen thrives during cool nights and warm days. Mold grows quickly in heat and high humidity.
There is little we can do about the weather, but preparing for ragweed season now might avoid misery later. Some allergy medicines should be taken one to two weeks before ragweed season begins. Ask your allergist which medicine(s) you should take, and begin your regimen now.
Your health care provider may also recommend allergy shots. The shots contain a tiny but increasing amount of the allergen you're sensitive to. Over time, your body becomes used to the allergen and no longer reacts to it. Alternatively, sublingual drops for ragweed are also available, although this treatment will only treat ragweed allergy.
Dr. Beth Miller is division chief of Allergy and Immunology at the University of Kentucky and director of UK Allergy, Asthma and Sinus Clinics.
This column appeared in the July 26, 2015 edition of the Lexington Herald-Leader
LEXINGTON, Ky. (July 24, 2015) – Few people think of a health care facility where they go to see their physician as a 'home,' but that's exactly the kind of environment Dr. Jonathan Ballard, medical director for the University of Kentucky's Family and Community Medicine (FCM) Clinic, and a team of health care providers strive to give every patient that walks through the clinic doors. Their efforts to make the care and comfort of every patient, from the beginning of life through the golden years a priority, has earned UK Family and Community Medicine the national recognition of being a 'Patient Centered Medical Home.'
The National Committee for Quality Assurance (NCQA) announced recently that UK Family and Community Medicine has received NCQA Patient-Centered Medical Home (PCMH) Recognition for using evidence-based, patient-centered processes that focus on highly coordinated care and long-term, participative relationships.
The NCQA Patient-Centered Medical Home is a model of primary care that combines teamwork and information technology to improve care, improve patients' experience of care and reduce costs. Medical homes foster ongoing partnerships between patients and their personal clinicians, instead of approaching care as the sum of episodic office visits. Each patient's care is overseen by clinician-led care teams that coordinate treatment across the health care system. Research shows that medical homes can lead to higher quality and lower costs, and can improve patient and provider reported experiences of care.
"NCQA Patient-Centered Medical Home Recognition raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients," said NCQA President Margaret E. O'Kane. "Recognition shows that the University of Kentucky Family & Community Medicine has the tools, systems and resources to provide its patients with the right care, at the right time."
To earn recognition, which is valid for three years, the practice demonstrated the ability to meet the program's key elements, embodying characteristics of the medical home. NCQA standards aligned with the joint principles of the Patient-Centered Medical Home established with the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Osteopathic Association.
The UK Family and Community Medicine is a primary care clinic recently relocated to the UK HealthCare Turfland location on Harrodsburg Road. The pristine new space, roughly the size of two football fields, provides ample free parking, is easy to navigate.
The clinic employs faculty physicians, resident physicians, nurses, psychologists, and patient care coordinators who are divided up into teams. Each patient is assigned to a team, led by a personal clinician, that follows them in all aspects of their care throughout their life. The staff are trained to assist with insurance, referrals, and other issues within the health care system that can often be difficult for patients to navigate.
"The system as a whole works to function more efficiently to streamline care and provide a more positive experience for the patient which is first and foremost in everything we do," Ballard said.
Arnold and Earlene Cool from Lancaster, Kentucky, became patients because they followed their physician, Dr. Ginny Gottschalk, from her Danville practice to Lexington, and their bond with the doctor has only intensified since that time because of their positive experience with her and UK Family and Community Medicine.
Initially, Arnold Cool accompanied his sister to an appointment at the clinic and Gottschalk came out to the waiting room to say hello.
"She is a wonderful, caring doctor and I was really touched that she took the time to come out and speak to me," Cool said. "The facility is gorgeous and the care and efficiency of the staff is outstanding. There are no long lines and we don't have to wait long to be seen. We're very impressed with the clinic."
Media Contact: Ann Blackford at 859-323-6442 or firstname.lastname@example.org
LEXINGTON, Ky. (July 22, 2015) — UK HealthCare employees are collecting supplies to assist with relief efforts in Johnson County after flash floods swept through the area July 14.
On July 22 and July 23, faculty, staff and employees at UK HealthCare are encouraged to donate rescue and cleanup supplies at one of four locations on the medical campus. Donations will be transported to the Johnson County Relief Center, which is assisting members of the Flat Gap community who were affected by the flood. More than 150 homes were destroyed by the floodwaters, with hundreds more damaged by water and debris. After two people died from drowning in floodwaters, officials continue to search for several residents of Flat Gap who were reported missing during the flood.
Jessica LaRue, a native of the flood-prone city of Inez in Martin County, realized the immense devastation of the July 14 flood through photos and posts on Facebook. LaRue works in the Department of Pediatrics at UK HealthCare, and coordinated the donation drive in collaboration with the help of UK HealthCare administrative leadership.
Items requested for the relief effort include:
· Fans and extension cords
· Water hoses
· Laundry detergent
· Large trash cans
· Heavy-duty trash bags and work gloves
· Large zip lock bags and paper plates
Drop off stations are located in the North Lobby of Pavilion H in the UK Chandler Hospital from 7 a.m. to 3 p.m. and for night shift employees at the Pavilion H Information Desk from 8 p.m. to 9 p.m. on July 22 and July 23. Donations will be accepted at a station in Room CC401B on the fourth floor of the Markey Cancer Center from 8:30 a.m. to 5 p.m. UK Good Samaritan employees can drop off donations at the administrative offices on the ground floor.
MEDIA CONTACT: Elizabeth Adams, email@example.com
LEXINGTON, Ky. (July 22, 2015) -- Although the term didn’t surface until the 1980s, the concept of biomarkers has been around for almost a century. Today, doctors routinely test blood for signs of anemia or the antigen associated with prostate cancer. Urine samples can hint at the presence of infection or diabetes, and EEGs diagnose electrical abnormalities in the brain.
But scientists are now advancing the concept, looking for ways to identify a host of diseases early in the process to provide opportunity for early intervention and improve the chances that treatment will be effective.
This is particularly true for Alzheimer’s disease (AD), where evidence points to the fact that the disease process begins long before someone has clinical symptoms, and the ramifications of the disease – both financial and emotional – are disastrous.
At the University of Kentucky’s Sanders-Brown Center on Aging, researchers are looking for biomarkers that might serve as an early warning system for AD. The process is not without complications, but these scientists possess a collective “Rosie the Riveter” spirit.
Mark Lovell is one of them. According to Lovell, the only definitive way to diagnose AD is through autopsy, though other options, such as PET imaging to identify the presence of AD pathology, are becoming more widely used. The challenge, explains the bioanalytical chemist and Jack and Linda Gill Professor of Chemistry, is finding a biomarker that 1) is an accepted predictor of the disease and 2) can easily be identified by a physician at the clinic level.
“Multiple studies show alterations in levels of the proteins associated with AD – tau and beta amyloid-- in cerebrospinal fluid, but a spinal tap to obtain that fluid is often a hard sell for patients”, Lovell said. “Furthermore, there appears to be variability in the data connecting the levels of these proteins in CSF and the diagnosis of AD, which has limited the use of beta amyloid and tau clinically."
But in the spirit of Sanders-Brown’s iconic first director and Lovell’s research mentor, William Markesbery, Lovell is willing to explore unconventional ideas so he started searching for alternative biomarkers.
Working with Bert Lynn, director of UK’s Mass Spectrometry Center, Lovell began to sort proteins in CSF samples by weight. As the results came in, two particular proteins (transthyretin and prostaglandin-d-synthase) caught his attention.
“We were able to tease out that these two proteins, when subjected to oxidative damage, tended to stick together and fractionate at a higher molecular weight than expected,” said Lovell.
Further study suggested that these proteins may signal dysfunction in the choroid plexus, a brain region responsible for the production and filtration of cerebrospinal fluid.
Since, in AD, current data suggest there are changes in the transfer capacity of the choroid plexus it made sense to Lovell and Lynn that these two proteins might make a good biomarker for AD.
The next step, says Lovell, was to go “downstream” to blood or urine, for example to determine whether this same protein combination appears there as well.
“I’ve historically been skeptical that blood can be as strong a predictor of Alzheimer’s disease as cerebrospinal fluid (CSF), but I was pleasantly surprised to see that there was a reasonable correlation in samples of CSF and blood taken from the same patients,” Lovell said.
Lovell cautions that further evaluation in larger sample populations is necessary before this can be called a definitive success, but if the hypothesis is borne out, “we will have a blood based biomarker that might be more predictive than amyloid beta peptide.”
Ultimately, Lovell thinks AD will be diagnosed by a panel of three or four biomarkers, rather than a single “up or down” test. And that’s where Brian Gold comes in.
Gold, a cognitive neuroscientist, is fascinated by CSF protein biomarker findings of Lovell and others and is conducting his own research in the hopes of using brain imaging to find non-invasive AD biomarkers. However, up until now, Gold explains, most MRI studies of preclinical AD have been restricted to structural volumetric characteristics of the brain.
“We’ve instead been focusing on microstructural brain changes detectable with a form of MRI called diffusion tensor imaging (DTI), which assesses the diffusion of water molecules in the brain," said Gold. "As cellular structures begin to degenerate, tissue barriers degenerate as well, allowing for increased water diffusion DTI-based changes in the brain are thus somewhat analogous to hairline cracks in a house’s foundation that precede visible structural damage.”
Gold and his colleagues are one of just a handful of U.S. groups exploring how CSF protein biomarkers correlate with microstructural brain changes using DTI and dynamic physiological changes using functional MRI.
His work, published last year in the Neurobiology of Aging, found tantalizing correlations between reduced white matter microstructure in the brain and the presence of CSF markers of AD.
“In other words, if our findings using DTI and functional MRI are highly correlated with Lovell’s CSF biomarkers, we have potentially uncovered a minimally invasive way to diagnose pre-clinical AD.”
While Gold and Lovell look prospectively for the Holy Grail, others at Sanders-Brown are taking a retrospective look using big data.
Dick Kryscio and Erin Abner help manage the Alzheimer's Disease Center (ADC) database, a collection of thousands of data points from more than 1300 research volunteers enrolled in the Biologically Resilient Adults in Neurological Studies cohort. With literally thousands of blood samples, CSF samples, results from cognitive testing, medication history, physical and neurologicalexaminations, and medical history, the database size probably approaches the inventory of a mid-sized grocery store. Abner and Kryscio troll the reams of data looking for consistencies that might constitute an early warning of disease.
Kryscio notes that biomarkers serve two purposes -- as a predictor of disease and as a means to a diagnosis. While most biomarkers today serve the latter function, "a marker truly earns its keep when a person is on his or her way to disease," he says.
And, while not a biomarker in the strictest sense, their most promising work in predicting disease has been in the area of self-reported memory complaints.
Both Abner and Kryscio have published studies in Neurology and Journal of Prevention demonstrating a link between self-reported memory complaints and the development of cognitive impairment later in life.
"In other words, people usually are the best judges of their own memory -- they can detect subtle problems years before there are more obvious symptoms," says Abner. She points out that it's an enormous oversimplification. "You aren't likely to have AD just because you can't remember where you put your keys one day," she said but added it has potential as a candidate for the "panel of tests."
Abner and Kryscio's efforts have international ramifications, as they are two of the gatekeepers for the ADC biospecimens, which are shared worldwide.
"The number of data parameters, and the longitudinal nature of the data available, makes this database world-class, but there are nonetheless a finite number of studies for which we can provide specimens before the supply is exhausted," Kryscio said. "It's a service to our research participants to help researchers with a study design that eliminates waste and maximizes the quality of the science, and we don't take that responsibility lightly."
Regardless of the path -- whether looking forward or backward -- the ability to detect AD at its earliest stages will have huge ramifications on the race to treat and eventually cure the most expensive malady currently known to man.
Media Contact: Laura Dawahare; Laura.Dawahare@uky.edu; (859)257-5307
"UK Healthcare has developed a robust response plan for communicable diseases, such as Ebola," said Dr. Derek Forster, UK HealthCare enterprise medical director for infection prevention and control. "This plan includes screening and triage, patient transport, provision of care, laboratory testing and staffing of our volunteer communicable disease team."
Media Contact: Kristi Lopez, firstname.lastname@example.org
MCKEE, Ky. (July 20, 2015) — Governor Steve Beshear and Congressman Hal Rogers joined public health and university officials today to announce a new dentist recruitment program aimed at promoting sustained oral health and well-being in eastern Kentucky.
The new loan forgiveness program is supported by $500,000 in state funds and is available for dental students who practice in the region. The dental schools at the University of Kentucky and University of Louisville will administer the program, providing two to five awardees $100,000 each for a two-year commitment.
“Reversing the oral health issues facing eastern Kentucky has been a major goal of mine throughout my administration,” Beshear said. “The vast majority of both childhood and adult dental problems could be avoided through routine dental care and other preventive efforts. This unique program and partnership will truly expand dental hygiene and help counter oral disease as a major health risk for our people.”
“One of the reasons why access to dental care has been traditionally low in our region is the sheer fact that we have shipped our talent out for education, with very little incentive to return home to practice dentistry,” said Rogers. “This program will help address the outmigration of our talented young Eastern Kentuckians and serves as another step to improving dental healthcare for our people.”
“The University of Kentucky is deeply invested in improving the health of eastern Kentucky – our work and strategic priorities are focused on transforming those we serve and answering Kentucky questions,” said UK President Eli Capilouto. “The Appalachian Dental Loan Forgiveness Program allows Kentucky’s leading dental education programs to put more practitioners on the front lines and improve the oral health of our Appalachian region.”
“This loan repayment program fits within our mission at the University of Louisville to enhance the lives of Kentuckians,” said UofL President James Ramsey. “This program will help UofL dental graduates establish practices in underserved, rural areas to ensure ALL people of the Commonwealth have access to oral health care.”
The announcement today was made in conjunction with the Shaping Our Appalachian Region or SOAR Executive Board meeting at the Jackson Energy Cooperative in McKee.
According to the American Dental Association (ADA), dentists completing dental school now come out with a debt of around $280,000. With that in mind, the Kentucky Department of Public Health (DPH) worked with staff at the University of Kentucky and University of Louisville colleges of dentistry to develop a loan forgiveness program as an incentive to attract more providers to eastern Kentucky.
DPH is funding the program, and the universities will offer awardees a $50,000 “up front” payment and $50,000 at the end of the first two-year award cycle.
Eastern Kentucky counties as defined by the Appalachian Regional Commission (ARC) will be the designated location for the program. Additionally, priority will be given to dental students from eastern Kentucky wishing to return to practice in the designated geographic area.
Eligible candidates include someone who is establishing or joining a new private practice, or purchasing an existing practice in an ARC distressed county. The original intent of the program is to recruit current graduates. Recent graduates are also eligible.
“Many of our UK and UofL dental graduates from the Appalachian counties want to return home to practice – but high levels of student debt complicate their decisions about starting a practice in rural Kentucky,” said M. Raynor Mullins, associate director of the Kentucky Oral Health Research Network. “This new program will help a new cohort of dental graduates return home to serve and realize their dreams.”
“Clearly, one of the greatest obstacles that are evolving in oral health care is that the cost of education has escalated to the point that student debt in some instances is in excess of $300,000,” said John Sauk, dean of the University of Louisville School of Dentistry. “Such economic burdens are limiting many individuals in their choice of where and how to practice. Consequently, going home to serve the community in which they grew up is often not a feasible economic option. The dental loan repayment program that the governor is announcing today will significantly enhance the opportunity for our young highly trained dentists to establish or join a rural practice and ensure oral health care manpower for rural Kentucky. I personally thank Gov. Beshear for his vision and commitment to oral health within the Commonwealth.
According to the Kentucky Department for Public Health, Kentucky ranks 41st in annual dental visits; 45th in the percentage of children with untreated dental decay; and 47th in the percentage of adults 65 and older missing six or more teeth.
“Oral disease is a major health risk for Kentuckians of all ages – particularly our children,” said Cabinet for Health and Family Services Secretary Audrey Tayse Haynes. “These problems are even more pronounced in many of our Appalachian counties where access to care is limited,” “With this new program to recruit providers – along with other initiatives to increase access to care and provide clinical services like screenings and varnish treatments – we have reasons to be optimistic about fixing the problems plaguing Kentuckians’ health.”
As part of his statewide health initiative, kyhealthnow, Gov. Beshear identified oral health as one of the seven target areas for improvement. Specifically, the program aims to reduce the percentage of children with untreated dental decay by 25 percent and increase adult dental visits by 10 percent by the year 2019.
In fact, Beshear created the Smiling Schools initiative in 2011 to provide a protective tooth varnish treatment for elementary-age children in Appalachia during the 2011-2012 school year. The Governor is looking to provide another round of varnishing this school year, as well as expand the number of counties participating in this year’s initiative. His office hopes to make this announcement in the coming weeks.
LEXINGTON, Ky. (July 20, 2015) – To most people, a "family doctor" is who they visit when they aren’t feeling their best. For Dr. Ana Lia Castellanos, the term takes on a whole new meaning.
Castellanos, a nephrologist with the University of Kentucky Transplant Center, comes from a family of physicians – her father, uncle and cousin are practicing nephrologists in her home country of Honduras. With the help of her family and some of her colleagues here at UK, she's helping develop a kidney transplant program back in Honduras.
Honduras has one of the highest rates of end-stage kidney disease in Latin America, and overall kidney disease is on the rise. The country's current lack of a transplant program means there are many sick patients traveling for countless hours to undergo dialysis at the few medical centers that offer it. Castellanos' own family had tried to create a transplant program many years ago, but it eventually stalled due to several bureaucratic issues and lack of funding.
Castellanos thought it was time to try again. Shortly after she arrived at UK, Castellanos met a Honduran patient who had come to Kentucky for a kidney transplant because she could not receive it back home. The patient had insurance and the means to travel outside of her country for the procedure, but there were many others back in Honduras who did not have that luxury.
“I talked to my family about it, and I said I really wanted to help the patients with kidney disease in Honduras,” Castellanos said.
In September 2013, Castellanos traveled to Honduras with transplant surgeon Dr. Roberto Gedaly and urologist Dr. Stephen Strup. They began training a team of physicians in Honduras to complete kidney transplants on their own, allowing the program to be sustainable. During their first trip, the team performed four transplants.
According to Castellanos, the Honduran medical care system is completely different from medical care in the U.S. There is no organ donor program in Honduras, so all kidney transplants will have to be performed using living volunteer donors.
Many people living with kidney disease in Honduras die before they can get proper treatment due to lack of readily available care and high costs. A fully developed transplant program could make an enormous impact on mortality in this patient population.
"The goal is to create a team that is self-sufficient and can do these procedures on their own," Castellanos said. "The impact of this is going to be larger than just affecting four people."
In April 2015, Castellanos, Gedaly and Strup returned to Honduras for a second round of training and performed four more transplants. So far, all patients are doing well post-op and their health is being monitored by Castellanos’ family in Honduras.
The lives of the patients helped by the UK physicians and the team in Honduras have improved greatly following the transplants. No longer having to undergo constant dialysis is one of the major benefits, saving the cost and time of travel.
“These are patients who really want to do well and improve their health,” Castellanos said. “One of the patients who received a transplant during our first trip was traveling to the dialysis unit two hours away from his home on a bus three times a week to receive treatment.”
As for their next steps, Castellanos hopes to work with the team in Honduras at least one more time, by either traveling to the country again for more training, or by bringing the team here to UK to meet and work with more members of the transplant team.
One of the best parts of the experience, she said, was working with her own family to initiate such a huge, life-changing program for her home country.
“It was really rewarding to be able to give back, with my family at my side, to the country that trained me,” Castellanos said. “Seeing that the patients are so grateful and that you can really change their life is amazing.”
MEDIA CONTACT: Allison Perry, (859) 323-2399 or email@example.com
LEXINGTON, KY. (Jul. 20, 2015) — Have you ever noticed that a family member becomes confused, irritable or restless as night falls? Or as the night progresses, they become agitated and pace throughout the house? This person could be showing signs of sundowning, a phenomenon commonly associated with Alzheimer’s disease and dementia.
Sundowning, or Sundown Syndrome, is the materialization of different symptoms that occur at a specific time of day. Symptoms present most commonly as the day changes from day to dusk, hence the name "sundowning." Symptoms can vary and include restlessness, irritability, becoming disoriented or confused, pacing and mood swings.
While doctors are unsure of what causes sundowning, many think that someone’s internal body clock gets altered with the progression of Alzheimer’s and dementia. In people with Alzheimer’s, doctors know that the area of the brain that controls sleep patterns (waking up, falling asleep) deteriorates. This could also explain sundowning.
Though sundowning typically occurs late in the day, other "triggers" have been shown to cause symptoms. Lots of activity or noise and even nonverbal cues from another person can cause a shift in behavior.
Although sundowning can be frustrating for everyone involved, there are many ways to cope with and reduce the gravity of the symptoms:
· Keep the house well-lit. Shadows can cause disorientation and can be frightening.
· Maintain a sleep schedule and try to reduce daytime napping. Keeping a daily routine will emphasize sleeping at a certain time and will make it easier for he or she to sleep at night.
· Avoid stimulants like caffeine.
· Avoid alcohol, which can disrupt sleep patterns.
· At night, try to stifle any background noise or stimulation that could be upsetting.
· Maintain a familiar environment, which can be more soothing.
· Try to avoid over-the-counter sleep aids and other medicines, such as Benadryl or Chlor-Trimeton, which cause drowsiness.
· Research shows that a low dose of melatonin, a naturally occurring hormone that aids in sleeping, can be helpful. However, talk to a doctor before starting a melatonin regimen.
If a loved one is presenting with symptoms of sundowning, as a caregiver it is important to remain calm and not get flustered. Nonverbal indicators of frustration can further agitate an already irritated individual. Instead, approach your loved one calmly and reassure them that everything is okay. Ask if there is anything that he or she needs to be comfortable. If he or she needs to pace, let them do so but continue to supervise them. Try to avoid arguing at all costs, which could exacerbate the situation.
If you or someone you love is showing symptoms similar to sundowning, it could be a sign of Alzheimer’s disease. Sundowning usually presents during the middle phases of Alzheimer’s disease and goes away as the disease progresses. If you are concerned, contact your family doctor or neurologist.
Ronan Murphy is an assistant professor of neurology at the University of Kentucky Sanders-Brown Center on Aging.
This column appeared in the July 19, 2015, edition of the Lexington Herald-Leader.
LEXINGTON, Ky. (July 17, 2015) — Positioned beside a large poster and wearing a short white lab coat, high school student Julie Volpeheim rationalized findings from a study on Kawasaki’s Disease in the UK College of Pharmacy Atrium.
Volpeheim, who spent the past two weeks immersed in scholarly research at the Area Health Education Center (AHEC) Heath Researchers Youth Academy, employed the terminology of a doctoral-level student to describe the study’s methodology and results. Showing mastery of the science with her co-presenter Hayley Anderson, Volpeheim suggested future studies should address the genetic origins of a rare disease of the pediatric coronary arteries.
When asked if she foresees subsequent research on Kawaski’s Disease in her future, Volpeheim, an incoming senior from Boone County, wouldn’t rule out the possibility. But Anderson, who is from Versailles, Kentucky, expressed ambitions in other areas of the medical field.
“I’m more of a ‘neuro’ person,” Anderson said, referring to the field of neuroscience.
This summer, 51 high school students from around Kentucky explored future careers in health research and the medical profession during the Summer Enrichment Program for incoming juniors and the Health Researchers Youth Academy for incoming seniors. The camps are designed to prepare Kentucky’s youth for careers within the health care industry and expose students to the processes involved with scientific research at an early stage of academic decision-making. The academy concluded July 10 with poster presentations of scientific studies, which were chosen by pairs of students during the camp.
Only 40 new campers were selected from 285 applicants to attend the competitive Summer Enrichment Camp. During the four-week program, students were housed on campus and attended biology, chemistry and physics classes. The students participated in clinical rotations every Wednesday and attended presentations by representatives from the six health colleges on UK’s campus.
Simultaneously, the two-week Health Researchers Youth Academy imparted the importance of medical research to students who are interested in non-clinical career paths in health care. During the camp, students attended morning physiology classes and spent time examining laboratory research. Teams of students are partnered with a current graduate student, who provides guidance for developing a final research presentation.
Twelve participants in the Health Researchers Youth Academy were graduates of the 2014 Summer Enrichment Program. Carlos Marin, assistant dean for community and cultural engagement in the UK College of Medicine/AHEC Program Director, said previous graduates of the programs have entered successful research and medical careers at UK and other academic institutions.
“Since it was start 10 years ago, this program has served as a starting point for youth who want to know about opportunities in medicine, and more specifically medical research,” Marin said. “At many points during the camp, our faculty members and graduate students create memorable experiences that will follow the students for a lifetime. These camps help them decided early on if a career in research and medicine is right for them.”
Senior Isaac Li, who is from Kenton County, presented a study from Duke University, which tested whether a virus can be used to treat a cancer of the brain and spine. During the camp, Li and his camp partner J.D. Roe gained a greater appreciation of how medical research can translate to improved treatment options for patients with cancer.
“I like how this just happened — it’s a new study,” Li, who said he might want to become a researcher one day, said. “It’s really ground-breaking.”
Roe, on the other hand, learned he’s not cut out for a career in academic research. He thinks he’ll either become a farmer or a radiologist. The study he chose for his presentation took 25 years to complete, which Roe said requires extraordinary patience and persistence.
“You have to be really dedicated,” Roe said of what he learned about careers in research.
LEXINGTON, Ky. (July 14, 2015) – The 12th annual Keeneland Concours d'Elegance at Keeneland Race Course on July 18 will showcase a diverse array of exciting classic cars while raising funds to benefit Kentucky Children’s Hospital.
Celebrating the 100th anniversary of famed Italian automaker Maserati, the featured marque for 2015, the event will display two classes of historic and modern Maserati automobiles on the field. The show runs 9 a.m. to 4:30 p.m. Saturday, July 18, at the Keeneland Race Course, 4201 Versailles Road, in Lexington. Tickets are $20 at the gate and $15 in advance online.
Classics scheduled for the Saturday show range from cars of the early 20th century such as Dodge, Marmon and Ford, to later beauties such as Auburn, Packard and Pierce Arrow as well as coach-built rarities such as Bugatti and Stutz. Other classes include European sports cars such as Jaguar and Porsche, American performance cars, and pick up trucks. Racecars on display range from a 1914 Duesenberg to a 2001 Audi LeMans racer. A class of rare micro cars from the Lane Motor Museum in Nashville, Tennessee, joins the lineup this year.
Saturday’s event includes a silent auction, an exhibition of world-class automotive artists, a Porsche raffle, the Wells Fargo stagecoach and a number of other attractions throughout the day. Food and beverages will be available for purchase on the grounds.
As part of a campaign to introduce children to classic cars, free automotive coloring books will be handed out to young attendees. Additionally, car owners who are willing to talk with children and their parents about their cars will be wearing a “Kid-Friendly Car” sticker. Since many Concours automobiles are priceless and irreplaceable, each car owner will decide the degree of interaction children can have with their cars.
“We hope this program will help the children develop an appreciation for classic cars and continue the hobby when they get older,” Tom Jones, Concours co-chair, said.
Tickets are still available for the Hangar Bash on Friday, July 17 at the door or visiting the website www.keenelandconcours.com. The bash is held at the Aviation Museum of Kentucky at Bluegrass Airport. The event includes music and heavy hors d’oeuvres, and vintage airplanes, including a PT-19, PT-22, and AT-6 warbirds, along with a selection of classic cars, will be parked in the hangar for the evening. Tickets are $75.
The Concours weekend also includes the Bourbon Tour on Thursday, July 16, and the Tour d'Elegance on Sunday, July 19. Tickets for all events are available on the website.
The event is ranked as a Top 20 Event by the Southeast Tourism Society as well as a Top 10 Festival by the Kentucky Travel Industry Association. The Concours was featured on a recent episode of My Classic Car with Dennis Gage.
Since the first event in 2004, the Keeneland Concours d’Elegance has showcased the finest in automobiles and the attractions of central Kentucky on the lush grounds of the Keeneland Race Course. Proceeds benefit Kentucky Children’s Hospital to help bring better health care to the children of Kentucky. For more information, visit www.keeenelandconcours.com
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LEXINGTON, Ky. (July 14, 2015) – His big brown eyes stare up at the camera dolefully, as if to say, "I couldn't help myself, can you forgive me?"
Apparently, this isn't the first time Sarge has had to beg for Myrl Sizemore's forgiveness. The 116-pound lab has a reputation around Manchester, Kentucky, for his antics.
"For starters, he happily accepts – and then rips apart – all packages delivered to our home," Myrl said with a laugh. Then he ticks off some of Sarge's other more dubious accomplishments:
1. Eating the driver's seat in Myrl's ATV
2. Chewing the wires on the underside of Myrl's camper
3. Ripping the running boards off of Myrl's SUV
4. Eating the Sizemore's patio umbrella
However, according to Myrl's wife Leslie, Sarge has now shown his true worth. That's because Sarge helped save Myrl's life.
Myrl hadn't been feeling well for weeks. The 50-year-old had no reason to believe he was desperately ill; his BMI was 25, his cholesterol numbers were excellent and he didn't smoke. He had been diagnosed with Type 2 diabetes two years ago, but it was well under control. Myrl thought he had a bronchitis he just couldn't shake.
One evening in late January as he returned from work, Myrl collapsed in his front yard. Inside the house, his family had no idea Myrl was in serious trouble.
But Sarge was out. He licked Myrl's face and shoved his nose under Myrl's shoulders to wake him, then supported Myrl as he crawled back into the house.
At first, Myrl refused to go to the hospital. By the next morning, however, Leslie said he "looked gray" and insisted he see the doctor. An abnormal EKG in the offices of Dr. Neeraj Mahboob and Karen Cheek earned him a trip to the Emergency Department at Manchester Memorial Hospital (MMH).
The Gill Heart Institute at the University of Kentucky had just recently formalized a partnership called the Gill Affiliate Network to provide MMH staff with supplemental expertise for their sickest patients. Chief of Staff Dr. Jeffrey Newswanger at the MMH Emergency Room knew Myrl needed that expertise: Myrl was having a massive heart attack.
Myrl was transferred to ARH Hazard, where Dr. Rao Podapati determined Myrl's ejection fraction (EF), a measure of the heart's ability to pump blood, was just 7 percent. A normal EF is 55-60 percent.
"Dr. Podapati was baffled that Myrl could even walk and talk," Leslie said. Then he gave them "horrific" news: Myrl likely needed a heart transplant. An ambulance would take Myrl to Lexington for further evaluation.
When Gill cardiovascular surgeon Dr. Ted Wright met Myrl in Lexington, he had a hunch: there had been discussion among the Gill faculty about a relatively new concept called "hibernating viable myocardium," and one of Wright's colleagues, Dr. Vince Sorrell, had a particular interest in this condition.
Sorrell uses the metaphor of a hibernating bear to illustrate.
"If you come across a hibernating bear, you might think it's actually dead because its temperature is low, its heartbeat is down and its respirations are slow, but as we know that bear will be wide awake come springtime," he said. "In some cases, our heart muscle is so sick that it actually hibernates to conserve itself. An ECHO test will look like the heart muscle is dead and a nuclear scan will usually look the same. But a contrast-enhanced cardiac MRI can tell us whether heart muscle is hibernating (alive) or dead (scarred). If it's hibernating, restoring blood flow to the heart with bypass surgery is usually sufficient treatment and obviously preferable to a heart transplant."
"That MRI changed our lives," Leslie said. Instead of a heart transplant, Gill Surgical Director Dr. Michael Sekela gave Myrl a triple bypass.
"He just flew through the surgery," Sekela said. Myrl's ejection fraction has improved to 45 percent – a statistic Sorrell pronounces "phenomenal."
It has long been an institutional philosophy at UK to partner with other health care institutions so that patients could stay as close to home as possible for their treatment, bringing only the very sickest patients to Lexington. There is perhaps no better example of the effectiveness of this team approach than the journey Myrl Sizemore took. At each level of care, the best expertise pointed Myrl in the right direction: from Mahboob to Newswanger to Podapati to Wright to Sorrell to Sekela.
Leslie is convinced that having the Gill Network in place made a huge difference in Myrl's outcome.
"I serve on the board of Manchester Memorial Hospital, and I'm very proud of their work," she said. "I'm grateful they had the foresight to partner with Gill, and now I know first-hand the benefit the network provides for our citizens."
"We were able to use high-tech to justify a less dangerous, more 'low-tech' treatment for Myrl's condition," Wright said. "In doing so, we avoided a lifetime of costly and high-risk care for Myrl."
Last May, Myrl walked his daughter Maggie down the aisle.
"Sarge was not invited for obvious reasons," Leslie said. "But he will be a trusted and beloved member of our family forever, and will always share a special bond with Myrl."
MEDIA CONTACT: Laura Dawahare, firstname.lastname@example.org
LEXINGTON, Ky. (Jul. 13, 2015) – Macrophages are cellular sentinels in the body, assigned to identify “attacks” from viruses, bacteria or fungi and sound the alarm when they are present. However, these cells are a “double-edged sword” in spinal cord injury, providing both neural repair-promoting properties and pathological functions that destroy neuronal tissue
“We know from previous research that macrophages are versatile, and signals at the injury site can stimulate repair or destruction—or confusingly, both,” John Gensel, Ph.D., assistant professor of physiology in the Spinal Cord and Brain Injury Research Center at the University of Kentucky, said. “But the mechanisms through which these signals stimulate the good and/or bad functions in macrophages are not known. So the next big question to answer in the efforts to understand and treat SCI was, ‘Why?’”
Gensel teamed up with Phillip Popovich, Ph.D, professor in the Department of Neuroscience and director of the Center for Brain and Spinal Cord Repair (CBSCR) at The Ohio State University, to explore the mechanisms governing the positive and negative processes that occur in macrophages following spinal cord injury.
“On the cellular level, the body’s response to spinal cord injury is similar to the immune response to attacks by bacteria or viruses,” Gensel said. “The functions that macrophages adopt in response to these stimuli were the focus of our study.”
Gensel and Popovich looked at more than 50 animals with spinal cord injury to try to identify which macrophage receptors promoted neuronal repair and which directed the destructive process.
“We found that activating bacterial receptors boosted the macrophage response and limited damage to the spinal cord following injury, while activating fungal receptors actually contributed to pathology,” Gensel said.
While this study oversimplifies the complex process by which macrophages promote repair and destruction of neuronal tissues, it nonetheless sheds light on opportunities to modulate macrophage responses after spinal cord injury, potentially reducing – or even reversing – damage and the resulting side effects.
“The implications are exciting: we now can look for treatments targeted to the receptors that jump-start the macrophage’s restorative effects without activating the receptors that modulate the destructive processes in that same cell.”
The study has been published as a Featured Article in the most recent issue of the Journal of Neuroscience.
LEXINGTON, Ky. (July 9, 2015) – At an early age, Jaime Hernandez was drawn to science. While other children started reading Dr. Seuss books, Hernandez gravitated toward books about rain cycles and nature.
Now 15 years old and contemplating his future, Hernandez believes his passion for science will eventually translate to a career in health care. But he’s hesitant to commit to a future in the medical profession without first talking to real health care providers and exploring all career opportunities within the medical industry.
“I want to make sure, at a young age, that having a medical career is something for me,” Hernandez said. “I can keep talking about how I want to be a doctor or nurse, but someone learning to be in that profession has to be very dedicated and ambitious. Even though I have those qualities, there could be something that I don’t like – I want to find out now rather than 10 years later.”
Hernandez, a native of Mexico who lives with his family in Paris, Kentucky, was one of 47 students to participate in the first Northeastern Kentucky Migrant Education Program hosted at the University of Kentucky in partnership with the Area Health Education Center (AHEC). During the 2015 camp held June 15-18, high school students from Eastern Kentucky visited UK’s campus to explore career options in health care, engineering, law enforcement, business and more. Throughout the week, faculty members from the UK College of Nursing, UK College of Engineering, the UK Gatton College of Business, the UK Graduate School and UK College of Medicine presented information about academic programs and career possibilities at the University of Kentucky.
For the past eight years, the Northeastern Kentucky Migrant Education Program has provided educational support programs for migrant students from 37 Eastern Kentucky counties. A similar program has operated solely in Fleming County for 20 years. In accordance with the recently revised College and Career Readiness requirements in Kentucky, the program prepares children of migrant families to pursue post-secondary education or alternative career paths. In recent years, summer camps camps have taken place at two regional universities. This year marks the first time students and parents selected the University of Kentucky as the host site. The AHEC program at UK developed a curriculum and schedule for the students based on input from parents and areas of interest identified by students.
“This summer, the University of Kentucky played a major role in guiding Kentucky’s migrant youth toward rewarding career paths,” Carlos Marin, assistant dean for community and cultural engagement at AHEC, said. “It’s our hope that students left their camp experience with greater knowledge and awareness of career possibilities in health care, as well as other professions.”
Highlights of the camp included a live minimally invasive surgery performed by Kentucky Children’s Hospital pediatric surgeon Dr. Joseph Iocono, a tour of Bluegrass Community and Technical College Campus and a chemistry lab experiment. Hernandez was most excited about looking inside a real trauma center during the group’s tour of the UK Chandler Hospital. He was encouraged by an inspirational talk from UK Provost Timothy Tracy given the final day of the camp.
“He talked about never giving up and to always go the extra mile because it would pay at the end,” Hernandez said. “It was a really awesome experience hearing him talk, and I will never forget it.”
LEXINGTON, Ky. (July 7, 2015) — Walk into many hospitals and health care facilities today and you're likely to see the bare and sterile hallways of the past are now filled with artwork, most often of nature scenes. And whether you are an inpatient, outpatient or visitor, there's a good chance that you may hear or see live or recorded music and even have an opportunity to participate in other creative art therapies.
These artistic features can be lovely to look at or provide some entertainment for those in the medical facilities. But these features and offerings aren't just about aesthetics. There continues to be a growing understanding of the science behind the connection between art and healing.
Just a couple of decades ago, most hospitals looked very different, with stark and sterile environments. Today, these plain surroundings have been transformed with a planned and evidence-based focus on creating a healing environment.
Currently, more than 50 percent of hospitals in the U.S. have arts programs, which include art therapy classes, music therapy and visual arts. In addition to art, health care environments also are incorporating evidence-based design that enhances the healing environment.
Research suggests that art can:
Studies show a direct link between the content of images and the brain’s reaction to pain, stress and anxiety. In particular, research suggests patients are positively affected by nature themes and figurative art. Because of this, hospitals are choosing artwork based on the evidence and giving it a higher priority than just to decorate sterile rooms and hallways.
Furthermore, now in many health care settings, funds for art are being provided through philanthropy as well as being built into construction project budgets.
In addition to artwork, music and music therapy – including creating, singing, moving to, and/or listening to music – has been shown to calm neural activity in the brain, which may decrease anxiety and restore emotional balance. Music therapy differs from music at the bedside in that it is a doctor-ordered intervention to address a particular patient issue.
Additional outcomes relevant to arts-health research include clinical indicators such as the lowering of blood pressure rates, stabilizing heart rates, as well as in some studies lessening the intake of pain medication.
Art therapy is also available in many health care programs as a form of expressive therapy that uses the creative process of making art to improve physical and mental health and emotional well-being. Artistic talent isn't necessary and can provide healing benefits such as helping to resolve and manage behaviors and feelings, reduce stress, and improve self-esteem and awareness.
Overall, the fundamental role of all the arts in the healing environment is to deliver patient-centered care, whether it be through design, natural light, indoor and outdoor gardens, music, art or music therapy or visual art.
Jackie Hamilton is the director of the UK Arts in HealthCareThis article first appeared in the Sunday, July 5, 2015 edition of the Lexington Herald-Leader
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