UK study finds smoke-free laws lead to reduced rates of lung cancer

A recent study by UK’s BREATHE (Bridging Research Efforts and Advocacy Toward Healthy Environments) shows that fewer new cases of lung cancer were found in communities with strong smoke-free workplace laws.

Strong smoke-free laws are known to improve public health by lowering rates of heart attack, stroke, asthma and emphysema. This study, led by Ellen Hahn, PhD, director of BREATHE and professor in the UK College of Nursing, is the first to show that new cases of lung cancer are lower when communities enact strong smoke-free laws.

The results of the study were published in Cancer, an American Cancer Society journal dedicated to providing clinicians with information on diagnosis, treatment and prevention.

Benefits of stronger smoke-free laws

Kentucky has more cases of lung cancer than any other state, and its mortality rate is 50 percent higher than the national average. Hahn and her team studied whether new cases of lung cancer in Kentucky were lower, higher or stable in communities with smoke-free laws.

“Kentucky has one of the highest adult cigarette smoking rates and the highest rate of new lung cancer cases in the nation,” Hahn said. “Only one-third of Kentuckians are protected by strong smoke-free workplace laws.”

Though other environmental factors play a part in the development of lung cancer, smoking and secondhand smoke exposure are the root cause of the disease.

“This new study shows that having strong smoke-free workplace laws in place to prevent exposure to secondhand smoke is one more way we can help protect our citizens from this devastating disease,” said Dr. Mark Evers, director of the UK Markey Cancer Center.

Creating more smoke-free workplaces

Using data compiled from the Kentucky Cancer Registry, the Cancer Research Informatics Shared Resource Facility and Markey, researchers looked at 20 years of new lung cancer diagnoses among Kentuckians age 50 and over in communities with strong, moderate and weak smoke-free laws.

Lung cancer incidence was 8 percent lower in communities with strong smoke-free workplace laws compared to communities without smoke-free laws. Researchers did not find differences in lung cancer rates between communities with moderate or weak smoke-free laws and those without any smoke-free laws.

These findings could be used to prompt legislation to create more communities with strong smoke-free workplace laws in Kentucky.

“Local government can play a critical role in preventing lung cancer,” said Hahn. “Elected officials can ensure that all workers and the public are protected from secondhand smoke by passing strong smoke-free laws with few or no exceptions.”

BREATHE is a multi-disciplinary research, outreach, and practice collaborative of the UK College of Nursing. Its mission is to promote lung health and healthy environments to achieve health equity through research, community outreach and empowerment, advocacy and policy development and access to health services.

For more information about BREATHE, visit www.breathe.uky.eduClick here to see the map and listings of smoke-free ordinances in Kentucky.


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UK researcher using $2.9M grant to treat cocaine-use disorder

Does reducing the use of cocaine, but not abstaining from the substance entirely, produce health benefits? There’s currently little research available that answers that question.

William Stoops, PhD, professor in the UK College of Medicine and director of regulatory knowledge and support for the UK Center for Clinical and Translational Science, has received a $2.9 million grant from the National Institute on Drug Abuse (NIDA) to find more answers.

Stoops hopes his research will contribute to the evolving knowledge of treatment for cocaine-use disorder (CUD), a substance-use disorder that currently has no well-established treatment methods.

“Facilities treating cocaine-use disorder are doing what they can, but there is no common practice,” Stoops said.

And while medications are available for other common substance-use disorders including opioid-use disorder and alcohol-use disorder, no medication is available to treat CUD.

Finding a more successful treatment model

Another challenge is that under the current model, CUD treatment is considered “successful” only if a patient abstains entirely from using the substance. Stoops points out that although abstinence is the ideal outcome, such a “total” fix is not the same measure of success used in treating other chronic diseases.

“Abstinence may be too high of a bar to set. We don’t do that with other chronic diseases – we focus more on reduction or management, like when treating someone for high blood pressure,” he said.

Stoops, along with interdisciplinary team members from the departments of behavioral science, psychiatry, internal medicine and psychology at UK, hope to determine if reduced cocaine use confers health benefits to individuals with CUD. He hypothesizes that a reduction will lead to improved health, and abstinence will yield even more benefits.

Health and economic benefits

The study will take place over five years and aims to enroll 200 participants (about 40 per year). Participants, who must be between 18 and 65 years old, will be asked to participate in a 12-week intervention. During the intervention, participants will need to be available three days a week for short visits. After the initial 12-week period, there will be long-term follow-up. The clinical component of the study will be conducted through the clinical services unit of the UK Center for Clinical and Translational Science.

In addition to helping people manage and treat their CUD, Stoops and the research team are also aware of the economic benefits to more people entering recovery.

“Substance use disorders in general, and CUD specifically are very expensive to the taxpayer. They lead to billions of dollars in lost productivity and healthcare costs each year,” Stoops said.

“Not having an effective, broadly used treatment, combined with the lack of a strong evidence base about whether reduced cocaine use can confer benefit, hampers our ability to help people with CUD.”

If you are interested in participating in or learning more about the study you can find more information at clinicaltrials.gov.


Next steps:

  • Researchers are working hard to identify new treatments and strategies to improve health, but they need healthy participants and those with medical conditions to participate in clinical studies. Find out how you can participate in clinical research at UK HealthCare.
  • Read how UK researchers are using an NIH grant to fight drug abuse in rural Kentucky.

UK transplant patient shares emotional bond with family of donor

By early 2016, Conrad Webster was battling to stay alive.

Cardiomyopathy and polycystic kidney disease had destroyed his heart and kidneys, and his health had been deteriorating for nearly a decade. A combined heart-kidney transplant was his only remaining option.

After being turned away by multiple regional transplant centers, he came to the UK Transplant Center, where he was admitted right away and listed for transplant.

In April 2016, West Virginian Tim Maris suffered from pneumonia and a brain hemorrhage that ultimately took his life. Before passing, Tim told his family that he wished to be an organ donor.

Tim’s request saved three lives: One patient received his liver, another received a kidney and Conrad received both his heart and a kidney.

‘I was just so happy to know Tim is still out there’

Working through Kentucky Organ Donor Affiliates, Tim’s mother, Evelyn, sent a card to Conrad expressing her desire to meet. They began corresponding via letters and phone calls, and made plans for their families to meet in person at KODA’s Donor Family Recognition Ceremony in Lexington.

Conrad, his wife Leticia, and two of their children drove down from Ohio to meet members of Tim’s family: Evelyn, his sister Penny and brother-in-law Howie, and his nephew, Caleb.

“I couldn’t really get any sleep [the night before],” Conrad said. “My nerves were just built up so much.”

The two families spent several hours chatting before the ceremony, sharing stories and pictures from their lives. Representatives from KODA provided a stethoscope to allow Evelyn, Penny and Howie the chance to hear Tim’s heart beating in Conrad’s chest.

Evelyn says that meeting Conrad and his family provided her with some much-needed closure.

“My heart was about to burst, we were so excited,” she said. “It was a joy. I was just so happy to know Tim is still out there.”

A life-changing experience

For Conrad, Tim’s gift completely changed his life. After years of chronic illness, he’s able to do things he never thought he’d have the chance to do again, like travel, prepare his youngest daughters for college and meet his grandchild.

And last October – just six months after receiving his transplant – Conrad and Leticia got married in Florida after 11 years together.

Because of their experiences, members of both families have decided to become organ donors themselves.

“Someone saved my husband, and kids’ father,” Leticia said. “Why not join Donate Life to help another family or multiple families in need?”

Becoming an organ donor

Although hospitals are obligated by law to identify potential donors and inform families of their right to donate, anyone can sign up to become an organ donor by joining the Kentucky Organ Donor Registry. The registry is a safe and secure electronic database where a person’s wishes regarding donation will be carried out as requested.

To join the registry, visit www.donatelifeky.org or sign up when you renew your driver’s license. The donor registry enables family members to know that you chose to save and enhance lives through donation. Kentucky’s “First Person Consent” laws mean that the wishes of an individual on the registry will be carried out as requested.

UK Transplant Patient Thankful to Meet Donor Family from University of Kentucky on Vimeo.

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UK nursing leaders and alumnae honored for excellence

Current and retired faculty members and distinguished alumnae in the UK College of Nursing have been honored by a number of organizations for their work in the fields of teaching and health care.

Carolyn Williams, dean emeritus of the UK College of Nursing and former president of the American Academy of Nursing, was one of five nurse leaders to receive the academy’s designation of Living Legend, the organization’s highest honor, at a special ceremony in Washington, D.C. on Oct. 5.

The Academy recognizes a small number of fellows as Living Legends each year. To be eligible, the Living Legend must have been an academy fellow for at least 15 years and have demonstrated extraordinary, sustained contributions to nursing and healthcare.

Williams was honored for her work in public health epidemiology and nursing education. Her groundbreaking work advocates for community health through population-focused research and care. She was actively involved in efforts that led to the creation of the National Institute for Nursing Research. As dean of the UK College of Nursing, she launched the nation’s first doctor of nursing practice (DNP) program. As president of the American Association of Colleges of Nursing, she pressed for development of the DNP nationally.

Janie Heath, current dean of the UK College of Nursing, was recognized as a distinguished alumna by her alma mater, the University of Oklahoma College of Nursing on Oct. 27. The award was established by the college and the Alumni Board of Directors to recognize graduates who demonstrate “outstanding leadership related to the field of nursing or healthcare” and who have made “significant clinical, academic, research or other contributions to nursing or health care on a local, state, national or international level.”

In addition, the UK College of Nursing honored five new inductees in its Hall of Fame on Nov. 10 at 21C Hotel in Lexington. The honorees are:

  • Karen S. Hill ’87, chief operating officer/chief nursing officer for Baptist Health in Lexington.
  • Sheila H. Ridner ’78, director at Vanderbilt University School of Nursing.
  • Marcia K. Stanhope ’67, former director of Good Samaritan.
  • Colleen H. Swartz ’87 DNP ’11, chief nurse executive/chief administrative officer at UK HealthCare.
  • Gail A. Wolf ’78, former chief nursing officer, University of Pittsburgh Health Care System.

Established in 2006, the College of Nursing Hall of Fame identifies distinguished graduates and their extraordinary contributions to the nursing profession.

“Drs. Hill, Ridner, Stanhope, Swartz and Wolf are pioneers who truly embody the Wildcat spirit – a spirit of curiosity and determination,” said Heath. “One that impacts nursing practice through teaching with excellence, advancing scholarly practice, generating nursing science and embracing differences.”


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Markey receives NCI grant to expand tobacco cessation treatment

The UK Markey Cancer Center is one of 22 cancer centers nationwide to receive funding to build and implement tobacco cessation treatment programs via the National Cancer Institute’s Cancer Center Cessation Initiative.

In 2017, NCI launched the Cancer Center Cessation Initiative as part of the NCI Cancer Moonshot℠ program. Through this initiative, Markey will receive $253,000 over the next year to help enhance the delivery of tobacco cessation treatments through four major efforts:

  • Refining electronic medical records and clinical workflows to ensure the systematic identification and documentation of smokers and the routine delivery of evidence-based tobacco cessation treatment services.
  • Overcoming patient, clinician, clinic and health system barriers to providing tobacco cessation treatment services.
  • Achieving institutional buy-in that treating tobacco use is a component of organizational “Standard of Care.”
  • Creating mechanisms to sustain tobacco cessation treatment services so that they continue beyond the funding period of the initiative.

Kentucky has more cases of lung cancer than any other state, and its mortality rate is 50 percent higher than the national average. Though other environmental factors play a part in the development of lung cancer, smoking and other uses of tobacco are the root cause of the disease.

“This grant award provides the means for Markey to embark on a clinically important, two-pronged approach to tobacco treatment, one that includes both provider education and patient care,” said Jessica Burris, assistant professor of psychology in the UK College of Arts & Sciences and member of the Markey Cancer Prevention and Control program.

“The goal is to quickly and reliably assess the tobacco use status of each and every patient, and to deliver evidence-based cessation treatment to all tobacco users. With this initiative, the promise of a marked, positive impact on the lives of Markey patients is clear because tobacco treatment is cancer treatment.”


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College of Nursing faculty member receives grant to fight opioid abuse among pregnant women

Kristin Ashford, PhD, APRN, WHNP-BC, FAAN, associate professor and associate dean of Undergraduate Faculty Affairs in the UK College of Nursing, has been awarded the Hillman Innovations in Care Program grant from the Rita & Alex Hillman Foundation for her work in addressing the opioid epidemic and its impact on maternal-fetal health.

The $600,000 award will enable Ashford to continue to expand both the Perinatal Assistance and Treatment Home (PATHways) and Beyond Birth programs. The PATHways program integrates evidence-based knowledge through a comprehensive approach to perinatal opioid use disorder, offering buprenorphine maintenance treatment for both opioid use disorder and neonatal abstinence syndrome, peer support and education, legal support, prenatal and postnatal health services for mother and baby, and health system navigation during delivery.

PATHways has been expanded to include the Beyond Birth program, which provides wraparound services and access to resources to aid in maintaining recovery in the two years following delivery. 

“After women give birth, they experience the highest amount of stress in their lifetime, and this is when they need the most support in their recovery,” said Ashford.

The grant will be used to expand access to the program in communities that may not have the resources available to provide this type of multidisciplinary care to mothers with opioid use disorder. The grant will also be used to provide training to clinicians in high-need low-resource communities including Hazard and Morehead.

“The most important part of this program is helping mothers be the parents that they want to be,” Ashford said. “The Hillman Innovations in Care Program grant will enable the team to reach and help more women.”


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Listen: UK at the Half discusses exciting KCH partnership

Dr. James Quintessenza, chief of pediatric cardiothoracic surgery at UK HealthCare, and Dr. Scottie Day, interim chair of the UK Department of Pediatrics and physician in chief at Kentucky Children’s Hospital, were featured during “UK at the Half,” which aired during the UK vs. Utah Valley basketball game radio broadcast on Nov. 10.

The doctors talked about UK’s new partnership with Cincinnati Children’s Hospital that will offer the best pediatric heart care in the area.

“UK at the Half” airs during the halftime of each UK football and basketball game broadcast and is hosted by Carl Nathe of UK Public Relations and Marketing.

To hear the latest episode, click on the play button below.


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UK dean’s outstanding research recognized by the American Heart Association

The American Heart Association (AHA) awarded its Population Research Prize for 2017 to Donna K. Arnett, dean of the UK College of Public Health and professor of epidemiology, “for insightful research successfully blending the basic molecular sciences with population studies to produce a highly relevant new understanding of major aspects of cardiovascular disease including risk prediction, hypertension and heart failure.”

Arnett received the prize during Sunday’s opening of the American Heart Association Scientific Sessions 2017, a premier global exchange of the latest advances in cardiovascular science for researchers and clinicians, which was held at the Anaheim Convention Center in California. The annual prize honors important studies of cardiovascular disease patterns in populations.

“Throughout her praise-worthy career, Dr. Arnett has worked to integrate molecular science with population studies, using her extensive training in both disciplines, to produce broadly relevant results for the health of the public,” said Dr. John Warner, president of the AHA.

“Her personal success is evident in both her publication record and her funding,” he noted. “She has published more than 500 peer-reviewed reports in high-impact journals in multiple fields, including seminal work she has led identifying genetic biomarkers and in risk prediction, hypertension, heart failure, imaging and methods development.”

Arnett also has played a key role in the development of the population research portfolio of the AHA, where she served as a bridge between the population and molecular research communities.

“Her many years of service have included time as a high-profile role model for population research during her presidency of this association, in 2012-2013,” Warner said.

An NIH-funded researcher for 20 years, Arnett studies genes related to hypertensive disorders and organ damage that results from hypertension. She has published more than 450 peer-reviewed papers and two books.


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UK HealthCare takes proactive approach to nurse recruitment

Kentucky, like most states nationwide, is experiencing a shortage of qualified nurses. For UK HealthCare, which sees some of the sickest and most severely injured patients in the Commonwealth, this presents a particular problem. But UK HealthCare is working to combat the shortage by offering a wide variety of recruitment incentives and professional development opportunities.

A shortage of registered nurses, whether they are in hospital or clinic setting, is a multifaceted dilemma. The aging “baby boomer” population places a strain on healthcare resources, and the expansion of the Affordable Care Act means that more people are seeking treatment. The high number of Kentuckians with diabetes, cancer, heart disease and strokes also increases the demand for trained nurses.

“We have some serious health issues in our state,” said Colleen Swartz, chief nurse executive and chief administrative officer of UK HealthCare. “It’s no longer, ‘I have a fractured hip,’ it’s ‘I have a fractured hip and I’m a diabetic and I have congestive heart failure. That has created care that is very complex.”

Educational incentives

To address both the shortage and the complex health issues with which nurses must contend, UK HealthCare and the College of Nursing have instituted education incentives designed to attract new nurses and provide current UK nurses with opportunities for professional development. These incentives include tuition assistance, loan-repayment programs and continuing education programs.

One such program is Nursing Professional Advancement, which rewards nurses with pay differentials added to their base pay for participating in development opportunities. The nurse residency program for new graduate nurses is a one-year educational and support program that provides regular contact with experts and mentors to help with the transition from student to professional.

“We try to provide students with the best learning environment we possibly can,” said Swartz.

The UK College of Nursing awards over 300 undergraduate and graduate degrees each year. The PhD program is ranked among the top eight programs in the U.S. by the National Research Council, and the Doctor of Nursing Practice (DNP) was the first of its kind the U.S. Online continuing education programs are available, as well as a number of graduate certificates geared toward preparing advanced practice registered nurses for national certification eligibility and licensure in a new or additional specialty area.

Expanding skills

“The registered nurse of today is not the registered nurse of a decade ago,” said Swartz. “There is an increase in demand on their performances and their understanding of complexities.”

While other healthcare centers offer monetary incentives, such as sign-on bonuses for new hires, UK focuses on recruiting nurses looking to expand their skill set or to advance their careers.

The hospital’s reputation is a factor as well. UK HealthCare was named the best hospital in Kentucky by the U.S. News & World Report, and has achieved top 50 rankings in cancer treatment, neurology, geriatrics, and diabetes and endocrinology.

“[Another benefit] is the culture of the environment such as hospitals with magnet status that treat employees with respect,” said Janie Heath, dean of the College of Nursing. “We recognize and promote their outstanding efforts to meet the mission of care delivery excellence.”


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colleen swartz hall of fame

UK HealthCare’s Dr. Colleen Swartz inducted into College of Nursing Hall of Fame

Dr. Colleen Swartz

Dr. Colleen Swartz

Congratulations to Dr. Colleen Swartz, the chief nurse executive and chief administrative officer at UK HealthCare, for her recent induction into the UK College of Nursing Hall of Fame!

Dr. Swartz earned her bachelor’s degree in nursing in 1987 and her doctoral degree in nursing practice in 2011 from the UK College of Nursing. Established in 2006, the UK College of Nursing Hall of Fame identifies distinguished graduates and their extraordinary contributions to the nursing profession.

Dr. Swartz became chief nurse executive for UK HealthCare in December 2008 and was appointed chief administrative officer in February 2017. Dr. Swartz oversees UK HealthCare’s more than 4,000 nursing service employees, which includes more than 2,000 full-time registered nurses. With the help of Dr. Swartz’ leadership and vision, our nurses play a vital role in enhancing our patients’ healing process and are instrumental in providing the world-class care available at UK HealthCare.

Among her many accomplishments at UK HealthCare, Dr. Swartz helped us earn Magnet recognition from the American Nurses Credentialing Center (ANCC) in February 2016. Magnet status is the gold standard for nursing excellence, and out of nearly 6,000 healthcare organizations in the United States, fewer than 7 percent have achieved Magnet designation.

Her prior experience includes serving as chief nursing officer at a regional community hospital, director of emergency and trauma services, flight nursing and as director of the Capacity Command Center for UK HealthCare.

Congratulations on this awesome recognition, Dr. Swartz!


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