Clearing up confusion about breast cancer screening.

Confused about when to get a mammogram?

Dr. Margaret Szabunio

Dr. Margaret Szabunio

When should you have your first mammogram? How often should you be screened?

There are a lot of different answers out there, and the result is confusion and frustration for many women. In honor of Breast Cancer Awareness Month, we sat down with Dr. Margaret Szabunio, associate medical director of the UK Comprehensive Breast Care Center, to discuss why mammograms are so important and what she recommends.

How common is breast cancer?

Szabunio: One in eight women will develop breast cancer in her lifetime. Of these women, three in four will have no family history of breast cancer.

Why should women have mammograms?

Szabunio: Despite varying recommendations about timing and frequency, mammography remains the best method we have for finding breast cancer early at a curable stage. Since mammography screening became widespread in the 1990s, the U.S. breast cancer death rate has decreased by 30 percent.

When should women have their first mammogram?

Szabunio: You should have your first mammogram at age 40 and an annual screening every year after that. Why? Because it results in the greatest mortality reduction, the most lives saved and the most life years gained.

Your chances of getting breast cancer increase substantially around age 40. In fact, women ages 40-44 are twice as likely to develop the disease as women ages 35-39. One in six breast cancers occur in women age 40-49.

By not getting annual mammograms starting at age 40, you increase your chances of dying from breast cancer and the likelihood that you will experience more extensive and expensive treatment for any cancers found.

If you have a family history of breast cancer or you are otherwise at increased risk, let your doctor know and discuss the best screening plan for you.

Besides talking with their doctor about mammograms, what else can women do to prevent breast cancer?

Szabunio: A healthy lifestyle decreases risk for cancer and many other diseases. Eat a healthy diet low in fat with plenty of fresh fruits and vegetables, and exercise regularly. Avoid alcohol and cigarettes, both of which increase the risk for breast and other cancers.

But remember, even women with a healthy lifestyle may develop breast cancer, and there is no substitute for screening mammography to find cancers early and reduce deaths from breast cancer.


Next steps:

E-cigarettes are not safe during pregnancy

Written by Kristin Ashford, PhD, WHNP-BC, FAAN, associate professor and assistant dean of research in the UK College of Nursing.

Kristin Ashford, PhD, WHNP-BC, FAAN, is an associate professor and assistant dean of research in the UK College of Nursing.

Kristen Ashford, PhD, WHNP-BC, FAAN

E-cigarettes are increasingly popular, and adult women of childbearing age are the most common users. This is especially true in Kentucky, which has the country’s second highest rate of smoking during pregnancy. Many women try to quit or reduce their smoking while pregnant, and may turn to e-cigs under the belief that they are safer or harmless during pregnancy.

But are e-cigs and other electronic smoking products safe for an unborn child? The short answer is no.

E-cigarettes may be new, but we know they’re harmful

E-cigs and similar products are fairly new, so we are still learning about their full health effects on the body and brain of developing babies, but we do know that e-cigarettes are not safe during pregnancy. Here are the reasons why:

  • Nicotine harms a fetus. E-cigarettes and other electronic smoking products, like vapes, contain nicotine, which we know can cause birth defects and long-term health consequences for the developing brain and body of an unborn child.
  • E-cigs don’t help you quit smoking. Recent research shows that most pregnant women who have used e-cigs end up using both e-cigs and traditional cigarettes (dual use), or relapse back to traditional cigarettes entirely. It is possible that e-cig use could actually increase harm to a fetus as a result of dual use or full relapse.
  • E-cigs contain other harmful chemicals. There is formaldehyde and cancer-causing agents in the cartridges and aerosol (commonly referred to as vapor) of e-cigarettes. A fetus is exposed to these agents if the mother uses e-cigs. E-cigs and similar products were not previously regulated, so it is not always clear what other harmful chemicals they might contain.
  • Secondhand exposure e-cigs is also dangerous during pregnancy. Pregnant women should not be around e-cig aerosol (vapor), just like they should not be around secondhand smoke from traditional cigarettes.

If you are pregnant or might become pregnant and would like to quit smoking or using e-cigs, talk to your nurse midwife, doctor or pregnancy care provider. You can also call the Health Department’s Quit Line, specifically for women who are pregnant or recently had a baby, at 800-784-8669.

At UK, we are conducting a health research study to learn more about the effects of e-cig use during pregnancy. If you are in your first trimester of pregnancy and have used cigarettes or e-cigs in the last three months, we invite you to participate. All information is kept confidential. To learn more, call our research team at 859-333-1572 or visit our website.


Next Steps

Philip A. Kern, MD, talks with Angelique Bell, who participated in a diabetes-related study he led.

Research participation leads to a life-saving personal discovery

On the first of May, 2015, Angelique Bell waited in a hair salon, reading the weekend section of the newspaper. She noticed an ad for a health research study that needed participants who had risk factors for diabetes. Since she met the criteria and had some time to pass, she decided to call about the study right then, from the salon chair. It was her 45th birthday.

“I don’t have diabetes, but I have a strong family history of diabetes and some of the risk factors, and I thought that the information from this study could be something that could benefit me in the future,” Bell said.

She didn’t expect, however, that her impromptu birthday decision to call about the study would potentially save her life.

An unexpected finding

As part of the screening for the study, Bell had to do blood work and an EKG — standard tests to get baseline health data. Her results, however, were anything but standard: they showed extremely low levels of potassium and an arrhythmia in her heart that could be fatal if not treated.

“When she came in, she was having a lot premature ventricular contractions, which is potentially dangerous because your heart could suddenly go into ventricular tachycardia or fibrillation, which can kill you,” said Dr. Philip A. Kern, director of the University of Kentucky Center for Clinical and Translational Science and principal investigator of the diabetes study in which Bell participated.

At the time Bell was taking two medications to help control her blood pressure. One medication was a diuretic, which, unknown to Bell, was causing her to lose too much potassium through her urine. The resulting potassium deficiency was causing the arrhythmia in her heart.

Kern and the research team sent Bell to the UK Gill Heart Institute for further evaluation and treatment. She was taken off the diuretic, had to wear a heart monitor for 48 hours, and received potassium supplements.

“I was 45 years old at the time and I had to wear this heart monitor. Three-fourths of my grandparents had heart attacks. My mother had congestive heart failure. So it was a scary,” Bell said. “I was relieved to find out that the condition had not gotten to a point of causing damage. A really serious problem was averted.”

The importance of participation

Once the arrhythmia was resolved, Bell, undeterred by her own health scare, went back to Kern and participated in the diabetes-related study that she had originally phoned about.

The study was not Bell’s first experience as a research participant, nor was it her last. She had previously participated in two asthma-related studies at other institutions, motivated by her own diagnosis as a child, and she subsequently volunteered again at UK as a healthy participant in a study examining how our bodies process fat intake. Through each experience she learned more about her own health.

“That is one of the good things about being in the study — a lot of times when people get in studies, they find out about other issues with their health,” she said. “There’s a pretty in-depth amount of testing done, and it could uncover something that wouldn’t be found in a routine exam.”

Bell was also familiar with health research through family members’ experiences. Her father participated in a longitudinal study on gout, and her uncle was a researcher with the Centers for Disease Control and Prevention (“he was very excited about science”). Exposure to both researcher and participant experiences has convinced Bell of the importance of empirical, evidence-based information, as well as the need for research participants.

“Having people around who do research, you see how important it is for them to get people in their studies so they have enough evidence,” she said.

She additionally emphasizes the importance of racial and gender diversity among research participants, in order to understand how health conditions and treatments affect people differently, but she simultaneously acknowledges the legacy of the infamous Tuskegee experiment conducted between 1932 and 1972. In the course of that study, hundreds of poor African-American men were knowingly left untreated for syphilis.

When the Tuskegee story was uncovered, it created an understandable distrust of health research, particularly among African-Americans. At the same time, however, the story initiated a host of stringent federal regulations enacted to protect research participants. In 1974, Congress passed the National Research Act and created the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, which developed guidelines for human subject protection, including the landmark Belmont Report.

Health research involving people is now “very highly regulated, with multiple layers of protection,” Kern said. Studies require a process of informed consent and communication of diagnosis, as well as reporting of the study results. Institutions like UK that conduct health research must have institutional review boards (which include community members) to review the plans for all studies. UK also has an Office of Research Integrity that can answer questions and support research participants.

“Because of Tuskegee I think a lot of African-Americans are leery of participating in research studies,” Bell said. “But if you don’t participate in the research then the data that relates to you is not there. Some things do have a genetic factor, and some things might affect people of African descent differently than people of European and Asian descent.”

Improving health for others

If there is residual distrust about health research, there is also a great deal altruism that motivates many people to participate. According to Roxane Poskin, participant recruitment manager at the UK CCTS, a large percentage of volunteers join studies as way to give back to society and contribute to discoveries that improve health for others and future generations.

This is particularly true for healthy participants, who don’t have a health condition they hope to address through a study but who are essential to research that broadens our understanding of what Kern calls “the basic mechanisms of disease and how the body works.” While participants receive information about their health and sometimes receive compensation for participating, they don’t always receive a direct health benefit for themselves.

“They want to be involved and help others even, if it doesn’t help them directly,” Poskin said. “If we didn’t have volunteers, we wouldn’t be able to accomplish research studies. Even the smallest things have been researched, like thermometers and crutches.”

Bell, who has spent her career in non-profit organizations (she currently works with Kentucky Refugee Ministries and ITNBluegrass), says she doesn’t personally know many people who participate in studies, but that she would encourage anyone to participate, either for their own benefit or to advance medical knowledge that could help others.

“We have to have evidence-based research,” she said. “And you get a lot more information about your health than you would in a normal physical.”


Next steps:

5 benefits of breastfeeding

5 benefits of breastfeeding

Breastfeeding is a natural way for mothers to bond with their new baby and provide the vital nutrition the baby needs.

Celebrate World Breastfeeding Week this week by learning more about breastfeeding’s benefits.

  1. Breastfeeding has preventive power. Research has shown that breastfeeding can help prevent allergies, asthma, diabetes, ear infections, childhood obesity, leukemia and even sudden infant death syndrome. Your first milk, colostrum, provides your baby with all your immunity to diseases.
  2. It creates a special bond. Breastfeeding allows you to have a special bond with your baby. Studies have shown that breastfeeding can improve your child’s neurodevelopment. And the hormones released during breastfeeding have been found to decrease maternal stress and increase bonding.
  3. Breast milk is easy on your baby’s tummy. Breast milk is easier to digest than formula, meaning your baby will have fewer stomach aches and develop fewer food allergies. Breast milk also changes to meet your growing baby’s needs
  4. Breastfeeding is good for you, too. Breastfeeding can decrease your risk of heart disease, diabetes, osteoporosis, postpartum depression and some forms of breast and ovarian cancer. The longer you breast feed, the greater your protection. Plus, you burn an extra 500 calories per day breastfeeding!
  5. Breastfeeding saves you money. Formula, bottles and supplies can cost about $3,000 annually, but breast milk is free. There’s no prep time for breast milk, and it’s always the right temperature.

The Birthing Center at UK HealthCare wants your breastfeeding experience to get off to the right start. Our nursing staff and physicians have received special training to help you begin breastfeeding. We also have lactation consultants who will see you during your hospitalization and the Mommy and Me Clinic, located at the Kentucky Clinic, for assistance after you are discharged.

For more information, visit our breastfeeding support services website or contact your physician or the Childbirth Education Coordinator at 859-323-2750.


Next steps:

  • UK HealthCare is a Baby-Friendly Hospital, which means we offer the highest-quality care for newborns and their mothers, emphasizing mother-baby bonding and successful breastfeeding. Learn more out what it means to be Baby-Friendly.
  • Are you expecting or thinking about having a child? Check out our UK Delivers blog, where our experts discuss topics related to pregnancy and childbirth.
Former UK nurse Kristin Ashford has dedicated her life to researching ways to prevent pre-term birth and promote healthy pregnancies.

UK nurse, researcher helps prevent pre-term birth

Working as a labor and delivery nurse for a decade, Kristin Ashford was surrounded by happy beginnings. She helped women and families welcome healthy babies into the world. But Ashford also helped mothers and their families deal with the stressful and heart-wrenching experience of pre-term birth.

As a first-hand witness of the negative outcomes associated with pre-term birth, Ashford was motivated to make a difference. She transitioned from nursing into a researcher, studying risk factors of pre-term birth and creating strategies to prevent them through pregnancy interventions.

“It really got me interested in how to help these women more,” Ashford said of her nursing experience in labor and delivery. “Not only to reduce their risk, but also to help them emotionally cope with pre-term birth.”

Risk factors for pre-term birth

Pre-term birth is defined as delivery prior to 37 weeks gestation. Several risk factors, including smoking, substance abuse, poor socioeconomic conditions and obesity, increase a woman’s chance of experiencing pre-term birth. The consequences for the baby include respiratory illness, gastrointestinal disorders, immune deficiency, hearing and vision problems, and a prolonged hospital sta. There can also be longer-term motor, cognitive, visual, hearing, behavioral, social-emotional, health, and growth problems.

Now, as the assistant dean of research in the UK College of Nursing, Ashford oversees multiple research projects and interventions driven by the common goal of prolonging pregnancy.

“I think that any time that you can prolong a pregnancy, it is a rewarding experience,” she said. “If you can prevent the child from being sick, prevent that family’s stress and prevent life-long complications associated with that risk, that’s extremely rewarding.”

Research and interventions

Ashford’s research covers the issues relevant to pre-natal care, as there are many things that can be changed in order to prevent pre-term birth, like tobacco use. Her interventions aim to prevent tobacco and illicit drug use, manage chronic conditions such as diabetes and obesity, and reduce emotional distress in expectant mothers.

Ashford’s interventions are founded on the CenteringPregnancy model, which prepares women for pregnancy, labor and delivery, and motherhood through a peer support groups led by nursing and other health professionals. Ashford has designed CenteringPregnancy interventions to help pregnant women in high-risk categories like diabetes, tobacco use, substance abuse, or other socioeconomic or ethnic risk factors.

“Our UK program actually wants to put women together that have more in common with one another,” Ashford said. “So, in addition to being put in the group about the same time that they’re pregnant, they also are put in (a group) based on their most high-risk factor for pre-term birth.”

One intervention effort led by Ashford effort seeks to inform pregnant women about the dangers of using tobacco products while pregnant and give them resources to quit. Despite the known risks of using tobacco products during pregnancy, many pregnant women in Kentucky still smoke. Ashford is troubled by the rising popularity of e-cigarettes among women of childbearing age. Her research studies indicate that women are using both e-cigarettes and traditional tobacco products during pregnancy.

“Tobacco causes birth defects in pregnancy — that’s known,” Ashford said. “And so, it’s very clear that electronic cigarettes contain tobacco. Certainly, there’s risks associated with electronic cigarette use in pregnancy.”

Ashford is expanding CenteringPregnancy programs to areas in Eastern and Western Kentucky. She is working with local health departments to provide a Centering support network for pregnant women in high-risk groups.

She said her position in the UK College of Nursing allows her to research and circulate interventions, teach future nurses and nursing researchers, and serve communities by improving the quality of health care.

A UK physician created the PATHways clinic to help pregnant women with opioid addiction get clean and learn how to care for their baby.

UK clinic helps pregnant women with opioid addiction

After coming to UK two years ago, Dr. Agatha Critchfield, an OB-GYN at UK HealthCare Women’s Health, was overwhelmed by the cases of pregnant women with opioid addiction she saw in her practice. So she decided to do something about it.

Dr. Critchfield created PATHways, an opioid treatment clinic for pregnant women recovering from addiction. It combines treatment with prenatal care, counseling and a support group. The program is based on the Centering Pregnancy model, which reduces negative outcomes and prepares women to have a child through group counseling and peer support.

PATHways is special because it works to help patients in three important ways. First, the program treats the medical condition of opioid addiction. Then it delivers specialized prenatal care. Finally, PATHways gives women the skills and knowledge to fulfill their maternal roles once their babies arrive.

The program was born out of necessity to serve a large population of prenatal patients coming to UK with substance abuse disorders. Critchfield said few evidence-based opioid treatment programs were designed for pregnant women. So she started one herself, and it has been successfully treating patients who might have otherwise not been helped.

To learn more about the PATHways program and how it has helped many mothers-to-be, click here.

UK HealthCare looks to improve research and help infertility heartbreak.

Knowing risks, options can aid those with infertility

Written by Patrick Hannon, post-doctoral researcher in the UK Department of Obstetrics and Gynecology.

About 15 percent of couples in the United States experience infertility, which is when a couple has tried to become pregnant for a year without success. Infertility comes as a shock to many couples who have spent years preventing pregnancy.

The inability to become pregnant leads to long-lasting and detrimental effects on a woman’s physical and emotional wellbeing. These detrimental effects include a decreased quality of life as indicated by increased levels of stress, impairments in physical and mental health, and diminished social functioning when compared to fertile women. Research has shown that being diagnosed with infertility has similar emotional and life-altering impacts as being diagnosed with cancer or a heart attack.

Infertility is a major public health concern as the diagnosis and treatment of infertility is estimated to cost society over $5 billion annually. For many couples, equally devastating is the realization that their health insurance does not cover infertility treatment, and all their medical costs must be paid out-of-pocket. It is critically important for UK infertility research to understand the causes of infertility in order to refine treatments, decrease the costs associated with infertility, and benefit the overall wellbeing of those suffering from infertility

Risk factors

The most prominent underlying causes of female infertility are defects in ovulation, or release of the egg from the ovary. The exact cause for defects in the woman’s reproductive tract is not entirely understood, but several risk factors are associated with infertility, including:

  • Untreated sexually transmitted infections
  • Pelvic inflammatory disease
  • Certain cancer treatment regimens
  • Endometriosis
  • Polycystic ovarian syndrome
  • Exposure to environmental toxicants
  • Lifestyle factors such as smoking, drug use, excessive alcohol use, abnormally high levels of stress, and extreme weight gain or loss

Age and female infertility

However, the single most significant contributing factor to female infertility is age. Fertility greatly declines with age due to the natural depletion of eggs within the ovary and decreased quality of the remaining eggs, leading to increased chances of miscarriage. Further, the potential health of the child can be impacted by a woman’s age due to genetic abnormalities in the eggs of older women. As women in today’s society are delaying child birth for personal, professional and financial reasons, age becomes an important factor contributing to infertility.

Combating infertility

To combat infertility, women can undergo treatment from a trained infertility specialist, which includes infertility testing, drug treatment to aid in ovulation, surgery to repair abnormalities in the reproductive tract and assisted reproductive technologies (ART), which includes the commonly used in vitro fertilization (IVF) procedure. In ART, the egg is fertilized outside the body before being placed back into the woman’s uterus. Unfortunately, the challenges of infertility treatments, specifically ART, are that success rates are low (approximately 56 percent) and decline with age.

UK infertility research

Scientists are continuing to refine and improve ART methods, such as working to optimize dosing regimens of the drugs that aid in ovulation, refining the conditions in which fertilization takes place outside the body, enhancing the procedures used to evaluate embryo quality prior to placing the embryo back into the woman, and investigating ways to preserve the fertility of cancer patients by using ovarian cryopreservation.

In our laboratories here at the University of Kentucky, we are determining precisely how ovulation is controlled in women and are identifying novel factors that drive ovulation. Each of these advancements aims to improve effectiveness, while decreasing the time and cost of infertility treatments.

 

Prevent Zika virus in Kentucky with repellent.

What you should know about Zika virus this summer

Talk of the Zika virus is everywhere these days, and it has many people understandably worried. On Tuesday, UK HealthCare experts held a news conference to answer questions about Zika. The bottom line? If you’re here in Kentucky and aren’t planning to travel this summer, your risk of catching Zika is very low. But there are things you can do to be prepared in case that risk increases this summer.

“At the present time, the risk for infection is low for Kentuckians not traveling to areas with active Zika,” said Dr. Phillip Chang, UK HealthCare chief medical officer. “However, the Centers for Disease Control and Prevention (CDC) continue to provide updates and if locally transmitted cases are found in the U.S., the risk could increase.”

What is Zika virus?

The Zika virus is spread through mosquito bites or through sexual contact with an infected person. Currently, virus transmission is happening in many Caribbean and Central and South American countries. Although many people who become infected have mild or no symptoms, pregnant women who contract the disease are at high risk for complications. Zika has been linked to microcephaly, a potentially fatal neurological disorder characterized by an abnormally small head.

Currently, the only cases in the U.S. have been travel-associated. But concern is growing about the possibility of travelers spreading it to mosquitoes in the U.S., which can then infect people who have not traveled to countries with the active virus. The Aedes aegypti mosquito, which is the main carrier of the virus, can be found in the U.S. during the summer months, including Kentucky. This means that the Zika virus in Kentucky could be a real possibility.

“Currently, there is no anti-viral treatment and no vaccine for the Zika virus, so we are focusing on prevention and risk reduction and, if necessary, proper screening for our patients if Zika becomes a concern in the region,” said Dr. Derek Forster, UK HealthCare medical director for infection prevention and control.

Pregnant women and Zika

Since February, UK HealthCare’s obstetrics and gynecology clinics have been educating patients on the risks of Zika, particularly for pregnant patients or pregnant patients with partners who travel to these areas, said Dr. Wendy Hansen,chair of UK Obstetrics and Gynecology.

“We have been telling pregnant patients to postpone travel to areas with outbreaks of Zika virus, which currently is nearly all of Central America and much of the Caribbean and South America,” Hansen said. “We also are counseling and advising patients on what to do if they have partners that plan to or have traveled to these areas.”

According to current CDC guidelines, the following special precautions are recommended for pregnant women:

  • Pregnant women should not travel to any area with Zika.
  • If you must travel to one of these areas, talk to your doctor or other health care provider first and strictly follow steps to prevent mosquito bites during your trip.
  • Until more is known, pregnant women with male sex partners who have lived in or traveled to an area with Zika virus should either use a condom every time they have sex or abstain from sex throughout the pregnancy.

Precautions for everyone

While the Zika virus is most dangerous for pregnant women who risk complications, everyone is urged to take precautions to prevent mosquito bites during the summer months to prevent possible spread of the disease.

Precautions include:

  • Wearing protective clothes, including long-sleeved shirts and long pants. For extra protection, treat clothing with permethrin, a chemical that repels insects and kills mosquitoes and ticks when sprayed on clothing, tents and other gear.
  • Using an EPA-registered insect repellent every day containing one or more of the following active ingredients: DEET, PICARIDIN or IR3535.
  • Using screens on windows and doors, and using air conditioning when available.
  • Keeping mosquitoes from laying eggs in and near standing water near your home.

“Although these precautions are especially important for pregnant women and women of childbearing age who want to become pregnant, we want everyone to educate themselves on how to protect their family members and friends,” Hansen said.

Watch UK HealthCare experts discuss Zika virus below.

 


Next steps:

  • The CDC recommends that testing for the Zika virus be done for pregnant women who have recently traveled somewhere with active Zika or anyone who has traveled and has symptoms.
  • For the most up-to-date information, visit the CDC’s website.

Appalachian Research Day shows community-based health care efforts

For many UK researchers who study health in Appalachia, the Center of Excellence in Rural Health (CERH) is an indispensable partner in conducting community-based research. The Center, located in Hazard, connects researchers with the local community and provides necessary infrastructure, from conference rooms to a team of community health workers, called Kentucky Homeplace, who engage participants and gather data.

This week, researchers shared the findings from these community-based studies at the second annual Appalachian Research Day.

“Today is an opportunity for people who do research with the Center to report back about their findings, and see what we can come up with together to better our lives here in Appalachia,” said Fran Feltner, director of the CERH.

Addressing Appalachian health issues

Rural Appalachian communities in Eastern Kentucky experience some of the nation’s most concerning health disparities, including elevated rates of obesity, diabetes, stroke, heart disease, depression, and cancer incidence and death. Residents of Appalachia might also face challenges in accessing health care, such as distance from providers, lack of insurance, or socioeconomic barriers.

Community-based research is essential in addressing disproportionate rates of poor health by collaboratively identifying problems and developing shared solutions that are a good fit for communities. For this type of research to succeed, it must begin at the local level, built upon the foundation of relationships with individuals, neighborhoods and groups who have common questions and concerns. In Eastern Kentucky, the CERH has enabled community-based studies since 1990, when it was founded to improve health through education, service, and research.

In 2015, the CERH launched Appalachian Research Day as an opportunity to share and discuss research findings with the communities that were involved in the studies. Feltner describes the day as an invitation for everyone involved in community health research to “come sit on the porch” of the Center and talk about their work and ongoing needs. More than 100 researchers, coordinators, community health workers, community advisory board members, students, and staff participated this year, with four podium presentations and 13 poster presentations.

“These research findings drive new and exciting health initiatives that are transforming lives across our rural Appalachian region,” Feltner said.

Researching change

The presen­tations focused on community research related to healthy lifestyles, depression, lung cancer screening, drug use and risk behaviors in Appalachia.

Mark Dignan, professor in the UK College of Medicine and director of the UK Prevention Research Center, discussed his work with faith-based communities to study energy balance, obesity and cancer in Appalachia.  According to the CDC, the national obesity rate in adults is about 29 percent, while in Appalachian states the rate is 31-35 percent. Dignan was particularly interested in how to help people re-engineer their lives to include more physical activity.

“When you do research in the community, hopefully you’ll make change that will be lasting,” he said.

Rates of depression are also higher in Appalachia than the rest of the country. For Appalachian women, the rate of depression is four times higher than the national rate. They are also less likely to receive adequate treatment, according to Claire Snell-Rood, PhD, who shared her research on adapting treatment options for rural settings where the traditional mental health system is both inappropriate and inadequate.

“This research focuses on how to adapt evidence-based programs to address not only limited treatment options in rural areas, but the substantial social and health challenges that impede Appalachian women from obtaining the care they need,” she said.

Snell-Rood worked with Kentucky Homeplace community health workers to conduct interviews with women, and she is currently adopting a collaborative, peer-based practice to support rural individuals in developing their own processes for wellbeing.

Roberto Cardarelli, DO, MPH, professor and chief of community medicine in the UK College of Medicine, also presented his research project, the Terminate Lung Cancer study, which aims to understand the knowledge and attitudes of lung cancer screening among high-risk rural populations. Kentucky’s lung cancer mortality rate dramatically exceeds the national lung cancer mortality rate, with 73.2 deaths per 100,000 in Kentucky versus 49.5 nationally. Cardarelli and his team conducted focus groups in order to develop an effective campaign to promote lung cancer screening in the region.

“We like to focus on research that’s important to communities, and we couldn’t find a more important topic than tobacco cessation and lung cancer screening,” he said.

The final presentation of the day addressed drug use and prescription opioid use in Eastern Kentucky. Michele Staton-Tindall, PhD, associate professor in the UK College of Social Work, conducted research in jails to learn about drug use and health-related risk behaviors among rural women in Appalachia. She said that rates of drug use are “alarmingly high” in this area of Appalachia, with many users injecting.

“Injection is the preferred route of administration, which is coupled with increased public health risks including HCV and HIV,” she said.

Solving problems together

The event was supported in part by the UK Center for Clinical and Translational Science, which aims to accelerate discoveries that improve human health, with particular focus on the Appalachian region.

For Feltner, a nurse who has worked in rural health for 35 years, Appalachian Research Day represents the best qualities of the place she calls home.

“What I love most about Appalachia is the fellowship we have together, as neighbors and friends, working together to solve problems.”

Celebrate International Women's Day with UK HealthCare's health tips.

Women, take charge of your health

In our society, women often care for everyone else – parents, spouses, children – first and neglect themselves. Looking after yourself isn’t selfish – it’s the best way to keep on doing what you do for those around you.

In honor of International Women’s Day today, check out our list of tips that will help you be your healthiest:

  • Understand recommended cancer screenings for your age. Breast, skin, lung and gynecologic cancers are some of most common types affecting women, and regular screening can help catch the disease when it’s most treatable. Check out the American Cancer Society’s guidelines for early cancer screening.
  • Get the HPV vaccine. If you’re 26 or younger, ask your doctor about getting an HPV vaccine, which protects against the types of human papilloma virus that most typically cause cervical cancer.
  • Don’t smoke and avoid second-hand smoke. Smoking is a major risk factor for cancer and heart disease, the No. 1 killer of women in America.
  • Listen to your heart. Women’s hearts are different from men’s in certain ways, which can affect the way women develop heart disease and experience heart attacks. Check out the top 10 things to know about women’s heart health from Dr. Gretchen Wells, director of the UK Gill Heart Institute Women’s Heart Health Program.
  • Protect your skin by using sunscreen and avoiding indoor tanning. Exposure to ultraviolet rays from the sun and tanning beds can cause melanoma, the deadliest type of skin cancer.
  • Stay active. Regular exercise, along with a healthy diet, can lower your risk for several types of cancer and reduce your risk for heart disease. Being overweight can increase your risk of a heart attack and other heart complications.
  • Think about your mental health, too. Some mental illnesses are more common in women or affect women in different ways than men. Conditions such as anxiety, eating disorders and postpartum depression can significantly impact your life. The National Institute of Mental Health has more information specifically for women, but simple things like staying in touch with family and friends, exercising, and getting good sleep can boost your mental health. If you’re unable to shake your symptoms or they keep coming back, talk with your doctor.
  • Be a role model for health. Make sure you’re setting good examples for the girls and young women in your life. Practice healthy eating habits at home and encourage exercise. Encourage the teenage girls in your life to get the HPV vaccination. And for teenage girls especially, emotional support is important. Be available to talk with young women in your life who may be experiencing increased anxiety or depression as they undergo a time of physical and personal growth.

Next steps: