This year's CCTS conference acknowledges the significant challenges of translating knowledge into new interventions for individual and community health.

UK HealthCare modifies visitation policy for flu season

To help protect the health and well-being of patients and healthcare workers during this flu season, UK HealthCare has temporarily amended the inpatient hospital visitation policy. The temporary restriction on visitations goes into effect on Thursday, Feb. 16 and includes:

  • No visitors under the age of 12 (except in Bone Marrow Transplant, where no visitors under the age of 18).
  • No visitors with any symptoms of flu-like illness.
  • Only two visitors will be permitted in a patient’s room at one time.
  • Visitors may be issued masks or other protective clothing for use when visiting.
  • Additional restrictions may be in place in special care units such as women’s and children’s units, critical care and oncology units.
  • Compassionate visitation exceptions will be made on a case-by-case basis.

This will continue for an undetermined amount of time as we monitor the presence of influenza in our communities.

We apologize for any disruption this may cause to your family time, but assure you that all of us at UK HealthCare are working to provide the very best care for your loved one in the safest environment possible. Please join with us in our effort to keep your loved one’s risk of exposure to a minimum.

If you have not already received a flu shot, we highly recommend that you and everyone in your household receive one. Please get one at your local pharmacy or primary care physician’s office.

Please remember that thorough and frequent handwashing is the best defense against the spread of disease.

Thank you for your understanding and please let us know if you have any questions.

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10 things to know about women's heart health

Top 10 things to know about women’s heart health

By Dr. Gretchen Wells, director of the UK Gill Heart & Vascular Institute’s Women’s Heart Health Program.

Dr. Gretchen Wells

Dr. Gretchen Wells

Heart disease is the No. 1 killer of women, but it often goes unnoticed until it’s too late. Part of that comes from the fact that women’s hearts are different from men’s in certain ways, which can affect the way women develop heart disease and experience heart attack symptoms.

People assume all heart attacks feel like a crushing in the chest, but often, and for women in particular, the symptoms of a heart attack can be quite different. That’s why it’s so important to teach women what to look for and how to take the best care of their hearts.

Check out my top 10 list of things women should know about their hearts, and be sure to listen to an interview I did recently about heart health below!

1. Know your symptoms

  • Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
  • As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
  • If you’re having symptoms, call 911!

2. Quit smoking. Just do it. You know you should. UK HealthCare has resources to help you quit. Check them out.

3. “Waist it.” Watch what you eat! Women have an increased risk of heart attack if their waist circumference is big.

4. Move it! The Nurses’ Health Study demonstrated that women who exercise (brisk walking) 30 minutes five out of seven days a week reduce their risk of a heart attack by 50 percent.

5. Know your numbers! Know your blood glucose (sugar), cholesterol, blood pressure, etc. If these are abnormal, talk to your healthcare provider about ways to improve them.

6. Don’t be sweet! If you’re diabetic, get treatment. This is a far greater risk factor in women than in men.

7. And while we’re at it – treat your blood pressure, too.

8. Talk to your doctor about whether or not you should be taking an aspirin (or any other medications for that matter). Women over the age of 65 should take a daily aspirin for prevention. The recommendations vary in other groups.

9. Don’t worry, be happy! The type-A personality has been strongly associated with heart attacks in men, and we’re learning more about optimism and positivity in women.

10. Call your mother (that’s my mother’s suggestion). Find out from her about your family history. Heart disease runs in families. Find out exactly what type of heart disease your family has and discuss it with your doctor.

Dr. Wells was recently interviewed on Behind the Blue, the University of Kentucky’s podcast. She was joined by Gail Cohen, a patient who experienced firsthand the dangers of undetected heart disease. Listen below to hear Gail’s story as well as tips from Dr. Wells about how you can improve your heart health.

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Cold or flu? It’s a question that comes up every winter. Knowing the subtle and not-so-subtle difference between the two illnesses, though, is important.

Is it a cold or the flu?

Cold or flu? Knowing the subtle and not-so-subtle differences between the two is important, since seeking early treatment when you have the flu can shorten its duration and severity.

Key differences

Colds and flu have many of the same symptoms, but here are some differences:

  • Body aches. With flu, they are much more severe.
  • Stuffy/runny nose usually signals a cold. The same is true for sneezing.
  • With a cold, a cough usually creates yellow or green mucus. The flu tends to appear with a dry, unproductive cough.
  • Sore throat. Could be either cold or flu.
  • Nausea. A cold does not produce nausea (unless in cases of severe nasal drainage that upsets the stomach).
  • Fever. Usually signals the flu, particularly if it’s 100° or higher.
  • Chills and sweats. It’s the flu.
  • Onset of symptoms. A cold comes on over time. The flu makes a much more sudden appearance.

If you’re still unsure whether you have the flu or a cold, consider seeing your healthcare provider for a definitive diagnosis. Anti-viral medications are available to reduce the longevity and severity of the flu, if it’s caught early. Most colds can be treated with over-the-counter medications. Check with your pharmacist to choose the medications right for your specific symptoms.

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A floater is a dark spot or squiggly line that enters your vision when the eye moves. They can be bothersome, but how can you tell if they're serious?

Eye floaters are common with age but may signal a more serious problem

Dr. Claire Fraser

Written by Dr. Claire Fraser, an ophthalmologist at UK Ophthalmology and Visual Sciences.

Have you ever noticed the sudden appearance of a black dot in your field of vision that moves around when you move your eyes? It could also look like a cob web. You try blinking, but it just won’t go away. It’s called a floater, and it can be quite bothersome especially if you’re trying to read or do other close work. But what exactly are floaters?

A floater may appear as a dark gray or black spot, circle, or squiggly line that drifts in the vision as the eye moves. Floaters are most noticeable in bright sunlight or when looking at a white background. What we see as a floater is actually a shadow cast by a small condensation of something inside the eye called vitreous gel.

Does everyone have floaters?

No, but they are very common and are more likely to occur with age. Vitreous gel liquefies with age, causing spots of condensation within the gel. Those become the floaters that we see. Eventually the vitreous gel separates from the retina, forming a posterior vitreous detachment (PVD).

This happens to most people at some point during their lives. A new central floater often appears when the PVD occurs and intermittent light flashes may be present. The risk of a retinal tear is highest during the month after a PVD occurs because gel that is stuck to the retinal surface may cause a tear as it separates.

When should I be concerned?

You should seek immediate evaluation by an ophthalmologist if you see new floaters, the floaters are accompanied by flashing lights or part of your vision becomes dark. Floaters that appear red could indicate bleeding inside the eye, which is another indication for urgent evaluation.

Symptoms like flashing lights, multiple new floaters, decreased vision or bleeding inside the eye can be the first sign of a retinal tear or retinal detachment, which can lead to permanent vision loss. Early treatment offers the best chance for preservation and recovery of vision. A retinal tear can often be treated with an in-office laser procedure to prevent retinal detachment and loss of vision.

Other important causes of floaters include diabetes, injury to the eye, inflammation (uveitis) and infection.

Will my floaters go away?

Over time, the brain learns to ignore floaters in the eyes. This process usually takes months. The floaters themselves may also settle to the bottom of the eye and move out of center vision.

Occasionally floaters can impair vision enough that a surgical procedure called a vitrectomy is needed to remove the vitreous gel. Most people find that floaters become much less noticeable over time and surgery is not needed.

Laser treatment of floaters to break them up into small particles has significant risk and has not yet gained wide acceptance. Eye drops and diet modification have not been shown to decrease floaters.

Most patients find that time is the best medicine.

UK Ophthalmology, now known as UK Advanced Eye Care, is moving! Beginning March 20, all appointments will be located in leased space within the new Shriners Medical Center for Children building, just across South Limestone from UK Albert B. Chandler Hospital.  This new space is not only beautiful, it’s state-of-the-art and will allow us to better serve our patients. We hope you’re as excited as we are.

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If you feel especially lethargic or depressed during winter, you may suffer from Seasonal Affective Disorder, or SAD. Here's what to do about it.

Here’s what you can do about Seasonal Affective Disorder, or SAD

With daylight in short supply, you may find yourself feeling lethargic, craving carbohydrates and going to bed earlier. Rather than dismissing those feelings as the winter continues, you may be suffering from Seasonal Affective Disorder (SAD).

Knowing the symptoms

SAD is a type of depression that occurs as daylight wanes in late fall and often continues until early spring. Symptoms of SAD include:

  • Loss of interest or pleasure in activities.
  • Social withdrawal.
  • Sensitivity to rejection.
  • Irritability and anxiety.
  • Guilt and hopelessness.
  • Fatigue or low energy levels.
  • Decreased sex drive.
  • Decreased ability to concentrate.
  • Trouble thinking clearly.
  • Weight gain.
  • Physical problems, such as headaches.

Understanding SAD

Anyone can get SAD, but it is more common in women, people between the ages of 15 and 55 (the risk goes down as you age) and those who live farther from the equator. Experts are unsure of what causes SAD, though they think it might be connected to the lack of sunlight upsetting sleep-wake patterns, or the short days affecting a brain chemical called serotonin. Melatonin, a sleep-related hormone, also has been linked to SAD.

If you’re experiencing any of the symptoms of SAD, it is important to see a healthcare professional who can help you sort through the cause of your depression and discuss treatment. He or she can also check for other possibilities such as low thyroid, which can present similar symptoms. A mental health assessment may be performed to get a better idea of how you feel and how your depression is affecting your ability to think, reason and remember.

Tips for treatment

Treatment for SAD often consists of light therapy, spending more time outside, psychotherapy and antidepressants. Remember, people rarely “snap out of” a depression, but there are things you can do yourself to help relieve symptoms:

  • Set realistic goals. Don’t take on too much. Break large tasks into small ones, set priorities and do what we can as we can.
  • Try to be around other people. Being around others usually makes you feel better.
  • Do things that make you feel better. Going to a movie or taking part in religious, social or other activities may help. Doing something nice for someone else can also help you feel better.
  • Get regular exercise.
  • Eat healthy, well-balanced meals.
  • Stay away from alcohol and drugs. These can make depression worse.
  • Delay big decisions until the depression has lifted.

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Caring for someone with dementia can be exhausting, so be sure to practice self-care. Doing so can help you take better care of yourself as well as others.

Caring for a loved one with dementia? Don’t neglect self-care.

Written by Robin Hamon, senior social worker with the UK Sanders-Brown Center on Aging.

Caring for someone with dementia can be exhausting, but many caregivers ignore their own needs in order to care for others – at the expense of their own health and welfare. You might think you have too much on your plate or feel guilty about doing anything for yourself when someone else desperately needs you. But you can be a more effective caregiver when you carve out some time to renew and re-energize.

Here are some tips to add caring for yourself while you are providing care for someone else.

  • Stay positive. Seek out what makes you feel happy. It can be as simple as spending time with a pet, listening to music or taking a walk in your neighborhood. Take one day at a time. Avoid trying to anticipate every bad thing that might happen. Replace negative thoughts and habits with positive ones (make lists of beautiful sights you have seen, spend 10 minutes stretching or focus on your breathing for a few minutes).
  • Empower yourself. People assume there is no way to get help without draining their bank account. There are some free or reduced-cost assistance programs that provide support, information and respite. Educate yourself to avoid these false assumptions. By doing so, you’ll feel better equipped to deal with even some of the hardest situations.
  • Accept that you can’t do it all and prioritize accordingly. Don’t let chores and obligations compete with “you” time. Forgive yourself for being less than perfect, find help with household chores, drop outside responsibilities that you don’t enjoy. Be true to your diet, medicine and exercise routines. Do something fun every day.
  • Stay connected. Find opportunities where you can safely “let off steam” and get positive reinforcement. If family and friends aren’t available, there are support groups, church families and other activity groups that can provide fresh ideas to help you redirect or de-stress – and maybe even have fun while you are doing it.

Taking care of yourself is one of the best things you can do for the person you’re caring for. By focusing on your well-being, you can improve quality of life for all involved.

You can call the Alzheimer’s Association at 800-272-3900 for additional resources, or you can visit the Family Caregiver Alliance’s website.

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Read some tips for buying healthier foods to reduce fat, sugar and salt, which are associated with a higher risk for obesity, heart attack and diabetes.

Want to eat better? Grocery shop like a cardiologist.

Susan Smyth, MD, PhD

Susan Smyth, MD, PhD

Written by Susan Smyth, MD, PhD, the medical director of the UK Gill Heart & Vascular Institute.

Many of us vowed to eat healthier foods in the new year but don’t know how to begin. Here are some tips for healthy grocery shopping that’ll help you reduce the amount of dietary fat, sugar and salt in your diet, which can help prevent obesity, heart attack, diabetes and other diseases.

Start in the produce section

Make your meal healthier by substituting foods with lots of color from natural sources (not artificial colors) for foods that are white or brown. Start in the produce section with fresh fruits and veggies, which are high in vitamins and fiber and low in fat. Be sure to check labels on processed foods like guacamole or prepared salads with dressing; they may contain high amounts of fat, sodium and/or sugar.

Tips for dairy and deli

In the dairy section, stick with low-fat options where possible. Beware of flavored yogurts, which can contain as much as half of the recommended daily allowance of sugar. Recent research indicates that eggs are fine in moderation, but check with your doctor first.

At the butcher shop, lean meats like chicken and fish are the healthiest options. Processed meats, like lunch meat or hot dogs, contain high amounts of sodium.

Choose wisely in the bakery

The bakery department can be tricky. While breads and other baked goods can have a place at your dinner table, the hidden sugars and sodium in bread might surprise you. Just two slices of packaged white sandwich bread may account for as much as a quarter of your recommended daily sodium intake. Instead, select breads made from whole grains, which can lower your LDL (bad cholesterol) and decrease the risk of diabetes by almost a third.

Spend less time in the interior aisles

The interior aisles of the grocery store are treacherous. Almost everything in a plastic wrapper is highly processed and loaded with fat, salt, sugar or all three. If you spend a lot of time in the middle aisles, do a lot of label-reading and look for healthier substitutes. Plain canned beans in water are a good choice, as are some nuts and dried fruit. Also, be aware of serving sizes per package: for example, canned soups are sometimes advertised as low sodium – but if the serving size is half a can, and you’re accustomed to eating a full can of soup, you’ll be getting double the dose of sodium.

Consider frozen options

In the frozen food aisle, frozen veggies without added sauces and fruits without added sugar can substitute for fresh varieties. Choose low-fat ice cream over regular versions. And be very careful of frozen pizzas, dinners and snacks, which can be loaded with sodium.

Perhaps the easiest way to eat better is to make a grocery list that emphasizes naturally colorful foods – the more vegetables, the better — and stick to it.

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Chizimuzo Okoli tried his first and last cigarette when he was 6. He wound up in the ER, but the experience led him to study mental illness and tobacco use.

One puff leads UK researcher to study tobacco and mental illness

UK College of Nursing Assistant Professor Chizimuzo Okoli picked up his first and last cigarette when he was 6 years old. The mistake landed him in the emergency room, but the experience inspired his life’s work studying mental illness and substance use among marginalized and underrepresented populations.

Many people living with schizophrenia, bipolar disorder and other severe mental illnesses do not have access to tobacco treatments derived from evidence-based research.

“There are many reasons for that, but I believe it is primarily because of the stigma that comes with their illnesses, which has caused them to be neglected,” Okoli said.

Okoli found that the smoking rate among people with mental illness in the U.S. had stayed the same since the 1950s, compared to a decrease in population smoking rates overall – an alarming fact that lit a fire in him to dig deeper and get to the root of the problem.

“These patients don’t die from schizophrenia or bipolar disorder – they die because of COPD (chronic obstructive pulmonary disease), cardiovascular disease or cancers primarily related to tobacco use or secondhand smoke exposure,” Okoli said. “I wanted to bring tobacco treatment to this population because they’ve been severely underserved.”

Creating a tailored treatment plan

To combat this issue and better serve this population, he currently works with patients living with schizophrenia at Eastern State Hospital (ESH) to create a tailored tobacco treatment program for people mental disorders. In his study, he elicits the experiences of smoking cessation among current and former smokers living with schizophrenia.

“Patients living with schizophrenia often smoke to reduce side effects of their psychotropic medications,” he said. “But it also allows them to sensory-gate for a short period of time, meaning they are able to concentrate more easily.”

As the director of Tobacco Treatment Services and Evidence-Based Practice at ESH, Okoli got involved in the hospital’s PALS (Providing Acceptance, Love & Support) program that aims to boost patient morale and mood through community engagement. The program was initiated in July 2015 by ESH nursing staff when they realized only 10 percent of the approximately 2,900 patients ESH treats every year receive visitors.

“Volunteers for PALS provide friendship and support to patients. They spend one-on-one time playing games, reading or simply talking and listening,” Okoli said. “Afterward, we look at patient, volunteer and staff satisfaction to understand their experiences and identify if the volunteers’ perspective toward patients, particularly stigma, has altered.”

‘An exceptional colleague and scientist’

Okoli also serves as the director of the Tobacco Treatment and Prevention Division of the Tobacco Policy Research Program. In this role, he has addressed secondhand tobacco smoke exposure policy in indoor and outdoor public spaces as well as using biomarkers of tobacco exposure. Okoli was an integral part of the research team assisting his mentor Ellen Hahn, the Marcia Dake Endowed Professor of Nursing, in the implementation of Lexington’s smoke free law in 2004.

“Dr. Okoli is an exceptional colleague and scientist,” Hahn said. “His caring and compassion for helping individuals with mental illness quit using tobacco is the driving force for his timely and important research program.”

Okoli was born in Nigeria, but earned his bachelor’s, master’s and doctorate degrees at UK.

He completed two postdoctoral research fellowships in Canada after studying at UK. His research career flourished in Vancouver, where he was involved in opening a clinic for tobacco treatment for people with substance use disorders and mental illness. Now, in 2016, there are 13 of these clinics open in Vancouver.

“Dr. Okoli’s dedication to serving those who need it the most is uplifting and resonates so well with the nursing profession,” said Janie Heath, PhD, the dean of the UK College of Nursing. “He has truly found his calling and we are honored to stand alongside him in his endeavors to change the stigma around those with mental illness and substance use disorders.”

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age-related macular degeneration

5 questions about age-related macular degeneration

Dr. Claire Fraser

Dr. Claire Fraser

Written by Dr. Claire Fraser, an ophthalmologist at UK Ophthalmology & Visual Sciences. Dr. Fraser specializes in treating macular degeneration, an eye disease that can cause vision loss. Here, she addresses five of the most frequently asked questions about age-related macular degeneration.

Age-related macular degeneration (AMD) is very common in the United States and in Kentucky. It is one of the leading causes of vision loss in people over the age of 50.

What kind of vision loss is experienced in AMD?

In general, AMD affects central vision and tasks such as reading, writing and driving. Patients with AMD may notice blurred central vision, blind spots and distorted vision with straight lines appearing wavy or crooked. Early AMD may have no symptoms.

Are you at risk for developing AMD?

Risk factors include:

  1. Age over 60 (but it can occur sooner).
  2. Smoking, which increases risk of the disease and rate of progression.
  3. Race. AMD is more common in Caucasians.
  4. Nutrition. A high-fat, high-cholesterol diet can increase the risk of AMD.
  5. Family history. Having a family member with a history of AMD increases your risk.

What is the difference between dry and wet AMD?

Dry AMD is most common and is usually milder than wet AMD. Visual changes in dry AMD are caused by changes in the retinal pigment epithelium under the retina. Dry AMD can progress to wet AMD. Wet AMD is less common and usually has more severe and rapid vision loss. Loss of vision in wet AMD is caused by abnormal blood vessels developing under the retina that can bleed or leak fluid.

What can be done to reduce the risk of developing AMD or slow the progression of the disease?

  1. Avoid smoking.
  2. Exercise regularly.
  3. Maintain normal blood pressure and cholesterol levels.
  4. Eat a diet rich in green, leafy vegetables and fish.

Can AMD be treated?

  • Vitamin supplementation using the Age-Related Eye Disease (AREDS 2) formula may reduce the risk of progression from dry AMD to wet AMD by up to 25 percent in some patients.
  • Wet AMD treatments include medications such as Avastin, Lucentis and Eylea, which may reduce abnormal blood vessel growth and leakage. These medications are administered directly to the eye, and may result in some visual recovery.

If you are at risk or suspect you have symptoms of AMD, it is important to see an eye specialist for evaluation including a dilated eye exam and any additional indicated testing.

UK Ophthalmology, now known as UK Advanced Eye Care, is moving! Beginning March 20, all appointments will be located in leased space within the new Shriners Medical Center for Children building, just across South Limestone from UK Albert B. Chandler Hospital.  This new space is not only beautiful, it’s state-of-the-art and will allow us to better serve our patients. We hope you’re as excited as we are. 

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Stress is an inevitable part of life, but it can have very negative impacts on health. However, there are ways to manage it, such as mindful breathing.

Stressed? Try mindful breathing, says UK expert

John A. Patterson, MD, MSPH

Written by John A. Patterson, MD, MSPH, an associate professor of family and community medicine at UK.

Stress is an inevitable part of life, but it can affect every organ system and cause negative impacts to your health. While we can’t always eliminate our problems, we can learn to manage and relate to stress so that it doesn’t cause so much suffering. Research shows that the regular practice of mindfulness can help you prevent or manage a range of stress-related symptoms, including pain, headache, emotional distress, poor sleep and digestive problems.

Mindful breathing is a portable mindfulness practice that is always available to you for the skillful, non-pharmacological management of stress. Even one minute of mindful breathing can restore a sense of mastery over your life.

Although mindfulness practices may allow reduction of some medications, these instructions are not meant to replace prescribed medication without consultation with your prescriber.

Instructions for mindful breathing

  • Assume a comfortable position lying down, seated or reclining. Closing your eyes improves focus and reduces distractions.
  • Allow your muscles to relax, especially the neck, shoulders, jaw, face, back and anywhere you are tense.
  • Take a few deep breaths, paying attention to the physical sensation of breathing.
  • Notice the pause at the end of the out-breath. Without prolonging that pause or thinking about it, experience its calmness, quietness and peacefulness.
  • Shifting your attention to your belly, allow your belly to be soft, rising with the in-breath and falling with the out-breath. A soft belly increases the movement of the diaphragm. This stimulates the parasympathetic (‘rest and digest’) impulses of the vagus nerve, which runs through the diaphragm, acting as an antidote to the sympathetic (‘fight or flight’) impulses of the stress response.
  • Finally, simply feel the physical sensations of the breath in the nostrils, throat, chest and belly. Notice when the thinking mind wanders and, without judging yourself, simply return attention to feeling the breath.

To maximize the benefits of mindful breathing, practice 5-20 minutes once or twice daily. Practicing before meals may aid digestion. Taking just one mindful breath can re-connect you to the present moment, the only time in which you ever truly are alive. After your practice and throughout your day, be grateful for this inner resource and the gift you are giving yourself.

Mindful breathing is part of the eight week Mindfulness-Based Stress Reduction (MBSR) course, offered January-March and March-May at Mind Body Studio in Lexington. UK Wellness offers a reduced rate for UK employees. Find more details at

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