Three of the four University of Kentucky research professorships awarded for the 2012-13 school year will fund health-related work. Each award is worth $40,000.
Mark Filmore, right, who teaches in UK's Department of Psychology, will research the role that cognitive processes have in promoting risk-taking behavior. It will have an emphasis on recreational drug use, including alcohol abuse and dependence.
Douglas Andres, left, professor and vice chair of the Department of Molecular and Cellular Biochemistry, "had begun to define the molecular pathways that control adult neurogenesis, and have shown that Rit, a Ras family G-protein, plays a critical role in the survival of newborn adult neurons following traumatic brain injury," a press release reads. If that is the case, strategies that target Rit activation may be effective in helping recover or repair the injury.
In the Department of Internal Medicine, Mark Dignan, right, leads a program that focuses on cancer prevention and control in community settings using community-based participatory methods. Using the funds of his professorship, he plans to expand his training, "allowing him to conduct translational research with teams that include basic and clinical scientists as they continue their work to reduce cancer health disparities," the press release reads.
Christopher Pool, professor in the Department of Anthropology, is the fourth professorship recipient. (Read more)
Taking opioids is still the best way to treat patients with pain, but the drugs are addictive because they do more than just alleviate physical suffering — they cause patients to feel good too. That's causing big problems in Kentucky, the state with the highest rate of opioid use and overdose.
In Perry County, for example, prescription medicines are the drugs of choice, second only to marijuana, and users may get more of them from relatives than from doctors. And their drug use appears to be part of a social support system.
Those were the findings of three separate studies presented at the second annual Appalachian Health Summit in Lexington last week.
Prescription-drug abuse is "an epidemic" that "seems to have started in rural Appalachia," Jennifer Havens, an associate professor in the University of Kentucky Department of Behavioral Science, said in presenting a study showing how disease spreads through the region.
Havens’ study of Hazard and Perry County found that prescription drug abuse in the county is second to marijuana use, and that painkiller abuse among high school seniors is at the same rate as in adults.
Though it’s not clear why prescription drug abuse is so rampant in the region, Havens speculated that lack of availability of other “hard” drugs, like heroin and cocaine, has led Appalachian drug users to turn to prescription medicine to get high. There are few drug-treatment options for users in the region, and many hospitals aren’t “financially viable” to care for drug abusers, she said.
An earlier study in which Havens was involved revealed that rural adults use more “alternate” methods to take drugs, including snorting and injecting. The study compared drug users in Perry County to those in Louisville and found that more than 40 percent of adults in the Hazard area were injecting prescription drugs to get high, and youth there were 25 percent more likely than those in Louisville to abuse such drugs.
The study found high rates of sharing drug-taking instruments, which increases risk for diseases such as hepatitis and HIV, Havens said. Almost 90 percent of participants said they shared snorting straws, and almost 1 in 3 said they shared syringes. No cases of HIV were found among the participants, but almost 43.7 percent of the 500 interviewed had hepatitis-C, and 11.5 percent had herpes-2.
Eighty percent were lifetime users, and about half first abused Oxycontin through injection. Havens said 28 percent of users had overdosed, and 58 percent had witnessed an overdose.
The study also found that a person’s likelihood of continuing drug use correlated with higher levels of social support, which Havens said contradicts long-held assumptions that drug users continue to abuse prescription pills because of low social support.
“Most people in the study depended on people also using drugs for social support,” Havens said. “As you can imagine, that’s not a good idea.”
No good alternative to prescribing painkillers
Despite widespread opioid abuse in Appalachia, such drugs are “still the best pain therapy,” UK physiology professor Karin Westlund High reported.
The purpose of her study was to determine what effect a high-fat and alcohol diet would have on “visceral pain” in the pancreas, and then what effect opioid gene therapy would have on the organ.
There are clusters of Appalachian counties at high risk for pancreatitis, which can lead to pancreatic cancer. Severe abdominal pain is associated with both, and morphine is typically used to treat it. However, High said, patients usually develop a tolerance to the drug over time.
She and other researchers used rats to test an opioid gene therapy involving herpes simplex-1, which 90 percent of Americans already have, to see if it would reduce pancreatitis pain without building tolerance in the rats. After 10 weeks of treatment, there was no tolerance present and the therapy seemed to be reversing damaged sections of the pancreas caused by the disease.
While opioids are effective in alleviating pain, "There are lots of different kinds of pain, but most opioids act as if they treat the same pain,” said Michelle Lofwall, a UK psychiatry and behavioral science assistant professor. Lofwall set out to discover how pain affects prescription drug abuse, since that is the main reason such drugs are prescribed or first used.
Her study participants, who were all drug users, placed one arm in a cooler of ice to elicit pain, and then were asked about pain levels. The test was repeated after a dose of painkiller. Researchers were attempting to give the drug to treat patients’ pain only, and not to have the patient feel a high when the drug was in their system, but that failed.
“Unfortunately, in my patients I wanted to say, ‘Yes, let’s treat your pain and you won’t feel any good effects’,” Lofwall said. “I wasn’t able to say that to them.” She said they are now trying to help doctors better prescribe pain medication so that habits aren’t formed.
One of the biggest habit-forming painkillers is Oxycontin, which was introduced in 1996 but wasn’t abused on a large scale until doctors had to start documenting pain in 1999, Lofwall said. Sales of, treatment for, and death from prescription drug abuse have increased since then. She noted that Kentucky has the highest rates of opioid use and overdose.
The makers of Oxycontin have reformulated the drug to make it harder to crush, mix with water and snort, but a new drug has risen to take its place: Opana. Lofwall said researchers have been trying to study Opana use, but can’t get a study supply because it is in such high demand. She said she has seen more of a rise in heroin use by her patients because even heroin is easier to get than Opana.
Though legislators are grappling to curb the proliferation of "pill mills" in the state, Lofwall said "doctor shopping" may not be the problem it's been billed to be. According to the National Household Survey on Drug Use and Health, 56 percent of users get their supply from a relative, of whom 85 percent have a prescription from one doctor. The drug abuser may get the drug from the relative as a gift, by paying for it or by stealing it.
Asked about the Kentucky All Schedule Prescription Electronic Reporting system, which allows doctors to search a database for “doctor shoppers” before prescribing pain pills, Lofwall said KASPER is limited because it only covers Kentucky, but “I think the state’s ready to make it better.”
Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
An aging population, a high number of doctors getting ready to retire, and medical students opting to specialize for better pay and hours are all factors contributing to an expected shortage in primary-care doctors in Louisville.
"By 2020, Jefferson County will need 455 new primary-care doctors — almost as many as the number that work in local medical practices now," reports Patrick Howington for The Courier-Journal. (C-J photo by Matt Stone)
"We see a real workforce crisis in the future — in the immediate future," said Bill Wagner, executive director of Family Health Centers, a group of community clinics that serve low-income residents.
One survey of local physicians found about a third of doctors are 56 or older and are planning to retire within 10 years. Couple that statistic with the fact that the number of American medical-school seniors who entered family-medicine residencies fell from 17 percent in 1997 to 8 percent last year, Association of American Medical Colleges figures show. Part of the reason for the drop is the comparatively low salaries primary care physicians make. On average, they are paid as little as half as much as specialists, such as radiologists and invasive cardiologists.
Though doctor shortages have typically been seen as a rural problem, that's not so anymore. "No matter where you're talking about, we clearly have an aging primary care workforce," because primary care has been "so unpopular," said Dan Varga, chief medical officer of Kentucky's St. Joseph hospitals and a former Louisville internist. (Read more)
Though a state bill aimed at quashing "pill mills" by proactively tracking drug prescriptions has so far failed to pass in the Kentucky General Assembly, Republican U.S. Rep. Hal Rogers of Eastern Kentucky's 5th District has joined a federal effort to allow state prescription drug tracking systems to share information. Though 48 states have such systems, there is no way for them to communicate with each other.
On Thursday, federal lawmakers introduced legislation "that would establish technical standards and security and encryption procedures to ease sharing information," James R. Carroll reports for The Courier-Journal.
"While my region of Southern and Eastern Kentucky became ground zero for the abuse of prescription drugs a decade ago, it is now wreaking havoc on communities small and large and cutting across socioeconomic and gender lines," Rogers said in a statement.
About 1,000 people in Kentucky died last year from prescription drug abuse, though the real number is suspected to be higher, due to under-reporting.
Missouri and New Hampshire are the only states that do not have, or don't have plans to set up, a drug-monitoring system that allows "doctors, pharmacists and law enforcement to share information that may identify abuse and misuse of pharmaceuticals," Carroll reports.
"It is high time we get these systems linked up to eliminate the interstate doctor-shopping which has been fueling the pill pipeline around our country," Rogers said.
The proposal would not create a new national database, but would also states to communicate with each other through data hubs already in place. The bill is expected to get the support of the White House administration, Carroll reports. (Read more)
Last week, Gov. Steve Beshear said Kentucky would sign an agreement to share and receive prescription drug dispensing data with at least 20 other states. "The blight of prescription drug abuse is tearing our families and communities apart, and we must use every tool available to attack this deadly scourge on our state," he said. "One of our key strategies is sharing information with surrounding states, so that we can not only cut off access to abusers, but also identify the problem prescribers." (Read more)
A bill to get nursing-home residents better dental services "appears to be dead after the Senate added language from another bill designed to shield the nursing-home industry from litigation," Deborah Yetter reports for The Courier-Journal.
House Bill 510 would have created a pilot project for the state's two dental schools to create "a program to provide better oral-health services to nursing home residents," Yetter writes. "But on Wednesday, the Senate Health and Welfare Committee added language from another bill that had stalled in the House that would require people who want to file malpractice lawsuits against nursing homes to first submit the complaint to a 'medical review panel'." (Read more)
Everything below is true except the Circumcision and converting to Judaism. Shame no one took the rise LOL
In a way you could think 17th Century England meets Da Vinci Code. Cromwell still to this day elicits strong reactions from many people. But what is not really known about him is that he was far less radical than popular opinion would have it and a lot of his great works have been either ignored or made to be the work of others. For instance whilst Cromwell did not forge the New Model Army he was the one who made it a Continental success. The New Model was required to keep order in The Three Kingdoms (Wales was not seen as a Nation) but still saw action in several European Countries. Also not known by many was that our overseas colonies were not a Napoleonic idea but troops were sent out to Jamaica during the Protective. The Royal Navy? Well say thank you Oliver as he made it a priority to out build both the Spanish and the Dutch and through commanders such as Blake was to win important battles that made England master of the waves and something we never let go . With Charles II gaining the thrown he simply took over the navy, renamed the flagship to something more Regal and away he went.
But all this cost money and after the Civil Wars had stripped the land of men and trade the country was struggling. It is firmly believed that Cromwell invited Jews back into England on a purely financial basis. This has a strong argument but does not fully stack up. First of all he was a sucker for Liberty of Conscience and whilst he eventually violently put down the army revolts he only did so once the discussions went from religious to political. Under Cromwell Catholics had more freedom of Religion than under Charles I, so long as they kept their meetings to the household. Cromwell for all this was seen as a zealot, great Victories such as Dunbar he put down to the Glory of God, but it seems he protested to much!
Paxton Hood in his book Oliver Cromwell mentions in his 1st Edition that Cromwell was very close to Judaism and visited their elders more than necessary. Now what is interesting about this was it was removed in the 2nd edition and then on. Several seditious pamphlets were released during the civil wars and after defaming Cromwell and not a few equated him to the devil. But late in his reign a couple linked him to Judaism either directly such as "Cromwell, the Devil and his unholy Jewish Alliance Uncovered". But you just can't trust 17th Century pamphlets as stand alone evidence. It is also clear that Cromwell was in fact a very devout Christian right up to the day he fell from his horse. This brought on another bought of Malaria (picked up in Ireland). By this point Cromwell was a broken man, subject to fits of depression and knowing the Protective was doomed to failure he even picked his successor to be his weak son Richard Cromwell knowing this would speed up the decline and bring about the Restoration. But he did something else as well. He converted his faith and became a Jew. This was very secret (obviously) and all involved had a vested interest in keeping this secret. When Cromwell was exhumed to be hung drawn and quartered he was found to be circumcised and was not in the usual shroud but dressed as that of a Jew. Whilst this was fantastic propaganda for the fledgling King he was forced to suppress the revelation as he was more cash strapped that the Protective and the Jews keen not to be linked any closer to Cromwell were prepared to pay handsomely to keep the secret. And so it has been more or less ever since. The truth has come to light at times but each time it gets light it is driven back in the dark. Even now it seems that Cromwell's conversion is not for open discussion.
OK I am confused. I am in the process of adding the finishing touches to my Baccus French Infantry and am stuck. I have three contraditing sources for buttons. Black Enamel (which I am discounting) wooden and Tin. Anyone know which one is correct so I can finish the figures off?
47 page views but no bites, hope you all had a good day.
