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UK Otolaryngologist Works to Address Rural Disparities of Pediatric Hearing Loss

Thu, 04/10/2014 - 15:24

 

LEXINGTON, Ky. (April 11, 2014) -- LEXINGTON, Ky. (April 11, 2014) -- Dr. Matthew Bush will tell you two things about himself--that he is Appalachian by birth and that he is fascinated with the anatomy and physiology of hearing. And his work clearly reflects both: As an otolaryngologist at the University of Kentucky, he focuses on rural health disparities of pediatric hearing loss, particularly in Appalachia.

 

Not only was Bush born in Appalachia (Charleston, WV), he also attended medical school in Appalachia at Marshall University in Huntington, WV. He completed his residency at UK in 2008, and following a research and clinical fellowship at The Ohio State University, returned to UK as a clinical faculty member in 2011.

 

In the course of his extensive training, Bush "fell in love" with hearing health care, ear surgery, and technologies like cochlear implants that offer revolutionary opportunities for people who are deaf or hard of hearing to rejoin or enter the hearing world.

 

"The reward is in the treatment," he said. "We love to see lives improved."

 

It was during his fellowship at OSU that Bush began to develop research ideas related to disparities of hearing health care for rural populations. While he has a diverse research background, including bench research, interacting with patients influenced his research most profoundly.

 

"Really it was the clinic setting that informed and fueled my efforts and interests because the patients that we see have some tear-jerking stories," he said. "They didn't have access to services, or they were totally unaware that there were options to help their hearing impaired child. So they show up at the clinic very delayed, well past the optimal age for intervention, and the child has already lost a lot of language development potential. Seeing those kinds of heartbreaking situations touched me as a person, as a father, as a clinician, and as an Appalachian. "

 

Pediatric hearing loss is common, affecting about 1 in 1000 children. Bush says that the incidence is slightly higher in Kentucky, about 1.7 in 1000, although the elevated rate might be related to Kentucky's thorough and mature reporting system.

 

As Bush explains, hearing loss is really a public health problem with lifelong impacts for individuals, particularly children. Hearing is vitally important in speech, language, and cognitive development of children, and children with hearing loss are at risk for difficulty in socialization, lower self-esteem, and increased behavioral problems.

 

"It might not seem to be a life threatening problem, but it is very impacting when it comes to the quality of life," he said.

 

The good news is that hearing loss is most often treatable.

 

"Nearly all forms of hearing loss can be treated with hearing aids or cochlear implants," Bush said. "Almost every child can have an option for rehabilitation."

 

However, early diagnosis and intervention for pediatric hearing loss are critical. Current standards of care dictate that diagnosis should occur no later than three months of age, and treatment should be initiated no later than six months of age. Delayed care is associated with language, cognitive, educational, and social development deficits in children, and can affect potential job productivity, employability, and overall economic well-being into adulthood.

 

"If a child receives appropriate intervention in a timely manner, they can be very highly functioning and do the things that they want to do. They wont be limited by their condition," Bush said. "But timing is essential – the consequences of delaying care in the first few years of life are amplified dramatically. "

 

For rural residents, who constitute 20 percent of the national population and experience significant health disparities across the board, delays in pediatric hearing health care are unfortunately common. Children with hearing loss in rural areas are diagnosed later than children in urban areas and subsequently receive interventions like hearing aids and cochlear implants at a later age.

 

Bush finds this reality is concerning, unacceptable, and solvable. He is currently investigating causes and potential solutions for delayed hearing health care among rural residents. The reasons for delays, he says, are multifactorial but are most likely related to distance from health care facilities and lack of knowledge of pediatric hearing loss and the importance of timely care.

 

"There's a direct relationship between distance to a tertiary care center for treatment and the timing of accessing those resources," said Bush. "The patients who are farthest away tend to be the most delayed because there's a lack of services in those communities."

 

To reduce the impact of distance on timeliness of hearing health care, Bush is looking to telemedicine delivery of hearing diagnostic and therapeutic services. These services require the time of experienced clinicians using a “hands on” approach but can likely be delivered effectively and remotely with an appropriate telemedicine set-up.

 

"There has been little research about telemedicine to change long-term hearing outcomes in children and access to hearing health care," he said. "We'd like to investigate the role of telemedicine in rural regions of Kentucky to do diagnostic testing, patient counseling, and hearing loss rehabilitation with hearing aids and implants. These are services that have not been offered before in Appalachia."

 

Lack of parental knowledge about hearing loss and treatments and limited experience of rural health care providers in addressing pediatric hearing loss also contribute to the delayed hearing health care for rural children.  According to Bush's recent research, about 14 percent of rural parents left the birthing hospital without knowing the result of the state-mandated hearing screening.

 

"There's an underlying issue of health literacy and knowledge of your child's condition, the importance of seeking treatment, and what the options are," said Bush. "A child may look completely normal and may be born to parents with no family history of hearing loss, yet may be profoundly hearing impaired."

 

He is currently working on a grant proposal to the National Institutes of Health to pilot a patient navigator program to assist parents in understanding the results of their child's hearing test results and the importance of early diagnostic testing and intervention. Patient navigator models have been successful in improving treatment and outcomes for other conditions, but haven't been employed and studied systematically with congenital hearing loss. The current patient navigator is a parent of cochlear implant recipient, so she has lived through the process and is dedicated to helping others access the care her daughter received.  

 

"We hypothesize it will be cost effective and sustainable because it will involve a lay person with personal knowledge about hearing loss in children, and a passion to provide psychosocial and education support to other parents of hearing impaired children," he said.

 

Another barrier to hearing health care for rural patients is that primary care practices in rural settings might not have experience in navigating the diagnostic and treatment processes for pediatric hearing loss.

 

"This is not something that they're seeing on a daily basis, so provider knowledge about next steps and resources is limited," Bush said. "But this is something that can be improved."

 

To that end, Bush is working to develop solutions that reduce delays of rural children accessing the hearing health care they need. He and his colleagues have assessed primary care provider practices in rural communities and have developed online educational modules with follow-up community accountability that will be circulated to providers. Hopefully, targeted education to rural health care providers will increase their knowledge of the condition and the medical community accountability support will impact their long-term practice.

 

Much of Bush's current research is facilitated by the KL2 Scholars Program of the UK Center for Clinical and Translational Science (CCTS).  The program provides multidisciplinary research mentorship, protected research time, and funding to support junior investigators in obtaining independent research awards. Like many physician-scientist-educators, Bush--who is also enrolled in the CCTS PhD program in clinical and translational science--understands the difficulty of managing competing demands.

 

"The KL2 program is a total game changer," he said. "It's very difficult in this day and age for clinicians to do research - to be able to balance productivity in the clinic and in the research realm while also being an educator."

 

The program is just one component of what Bush appreciates about working as clinician-researcher at UK.

 

"I just have to pinch myself to tell myself that I'm not dreaming," he said. "I'm so thankful to be here -- to have the opportunity to be where I love and do the work I love. My job is to help alleviate fears, provide knowledge, and use our expertise to provide the best care as timely as possible. It's a privilege and an honor to work in this field."

 

Even he will admit that there's much work left to be done to ensure timely access to hearing health care for all children, but he's hopeful about UK's capacity to affect change.

 

"The challenge of health care disparities is something that UK is poised to address as a national leader, with some brilliant researchers who are well-funded and very experienced in trying to address these problems," he said.  "You have to start small and delineate and define what the problem is before you can determine the best fix."

 

Bush, who says that the first doctor he remembers seeing as a child was an ear, nose, and throat doctor, nevertheless has a clear vision for what he and his colleagues can accomplish.

 

"In an ideal world," he said, "we wouldn’t have socioeconomic, educational, or geographic barriers that would prevent a child from getting the hearing healthcare that they need. There would be a seamless transition from the birthing hospital to resources for hearing testing and treatment, whether face-to-face or via telemedicine. We'd like the quality of care and access to care to be the same for all children. That's really what our passion is."

 

 

MEDIA CONTACT: Mallory Powell, mallory.powell@uky.edu

 

UK PT Student Sarah Martin Receives APTA Scholarship

Thu, 04/10/2014 - 14:24

LEXINGTON, Ky. (April 11, 2014) − Sarah Martin, has been awarded the prestigious Mary McMillan Scholarship from the American Physical Therapy Association (APTA). Martin, who is from Lexington, is a student in the University of Kentucky College of Health Sciences Doctor of Physical Therapy program. 

 

“I'm thankful to the APTA for the Mary McMillan Scholarship,” Martin said. “I am so appreciative of the UK Physical Therapy program for nominating me for the award. It is an excellent program, and I’m excited to be able to represent the University as a student member of the APTA and as an award recipient.”

 

The Mary McMillan Scholarship Award recognizes students who exhibit superior scholastic ability and potential for future professional contribution. Awards are made on a competitive basis. Recipients are selected on the basis of the following criteria: superior scholastic performance, past productivity, evidence of potential contribution to physical therapy, and service to the APTA.

 

Martin received her doctorate degree in anatomy and neurobiology from UK in 2008 and entered the Doctor of Physical Therapy (DPT) program in August 2011. She is expected to graduate with her DPT degree in August 2014 with honors. She received the UK College of Health Sciences Academic Excellence Scholarship this year, and she was selected for the Kentucky Physical Therapy Association All-Academic Team this year as well. She currently maintains a 3.9 GPA in her major.  

 

“Sarah’s competence has been demonstrated consistently and with high quality in her lab practical examinations and in her clinical rotations,” said Anne L. Harrison, director of professional studies for the Division of Physical Therapy. “She excels in her understanding of the didactic material, as well as in being able to translate head to hands in the psychomotor domain.” 

 

Martin is one of only five students nationally to receive this $5,000 scholarship. She will be recognized during the APTA’s NEXT Conference and Exposition, June 11 through 14 in Charlotte, N.C.

 

Media Contact: Ann Blackford at 859-323-6442 or ann.blackford@uky.edu

 

UK to Observe National Student-Athlete Day April 14

Thu, 04/10/2014 - 14:21

LEXINGTON, Ky. (April 11, 2014) — Hundreds of events around the nation in the coming days and weeks will mark the 27th annual National Student-Athlete Day, including activities sponsored by the University of Kentucky. Since the anniversary of the actual day fell on a Sunday (April 6) this year, UK will launch a series of events starting Monday, April 14 to mark the occasion.

 

A student-athlete appreciation table will be set up at the Center for Academic and Tutorial Services (CATS) on Monday, April 14.  UK student-athletes will also be involved with several community service events at local schools during the month of April.  A public service announcement featuring UK women’s basketball student-athlete Kastine Evans will air on WKYT during the entire month of April. And, UK student-athletes will be hosting a field day event for elementary school children who participate in Evans’ “Shooting at Success” after-school program sponsored by Lexington Urban Impact. The event will take place from 3:45–6: 30 p.m. Monday, April 14, at the Joe Craft Center and will feature arts and crafts, game stations and athletic instruction in sports such as basketball and soccer.  

 

National Student-Athlete Day honors student-athletes and the network of parents, coaches, teachers and school systems that make it possible for young people to strike a balance between academic and athletic achievement and who use sport as a vehicle for positive social change.  The day, established by the National Consortium for Academics & Sports, is co-sponsored by the NCAA and the National Federation of State High School Associations and Northeastern University's Center for Sport in Society.

 

President Obama has saluted those involved in National Student-Athlete Day activities. In an open letter acknowledging the day, he wrote, "A healthy balance between sports and academics is essential to ensuring that our students are prepared for the challenges of the future."

  

Bob Bradley, associate athletics director for student services at UK, said, "This is a wonderful and important tradition. It gives us a chance to show our appreciation and celebrate our student-athletes who work hard academically, athletically, and personally."

 

Bradley added, "It also gives us the opportunity to thank all of the people involved that make it possible for these students to balance academic and athletic pursuits, while also growing as contributors to their community and the larger society."

 

Governor Steve Beshear previously issued a proclamation recognizing National Student-Athlete Day in the state of Kentucky.

 

More information about National Student-Athlete Day is available at http://ncasports.org/programs/national-student-athlete-day/.

 

 

 

MEDIA CONTACT:  Carl Nathe, 859-257-3200; Dustin Lewis, 859-257-2762.

 

Lexington and UK Medical Group Making Waves in India

Thu, 04/10/2014 - 14:04

LEXINGTON, Ky. (April 14, 2014) − Dr. Thomas Young, a University of Kentucky College of Medicine professor of pediatrics, had dreams from a young age of emulating Albert Schweitzer, an early 1900s medical missionary.

 

Thanks to a group comprised of UK employees and students and Lexington-area medical professionals, Young is closer to those dreams, while making life better for kids with disabilities in India.

 

In 2002, Young started Shoulder to Shoulder Global (STSG), which sent UK faculty and students to a clinic in Ecuador. Now, the organization is expanding its reach into Mayasandra, a rural Indian village.

 

Young and UK pediatric pulmonologist Dr. Mike Anstead were instrumental in establishing a Mayasandra clinic that is dedicated to kids with disabilities. The clinic, which the STSG group hopes to travel to annually after its first exploratory trip there in 2009, is staffed year-round, even when the Lexington professionals aren’t there.

 

Thirteen medical professionals and students traveled to Mayasandra during spring break as part of a multidisciplinary approach to diagnosing and treating Indian children with special healthcare needs. Physical therapists, special educators, a speech and language therapist and pediatric residents were all involved this year.

 

A “local champion” is necessary for these types of projects, Young said, and the STSG group found that person in Dr. M.N. Subramanya, a retired surgeon originally from Mayasandra, whose son-in-law, Dr. Harohalli Shashidhar, used to be a UK physician. Among help from Young, Anstead, Subramanya and Shashidhar, along with other STSG donations, the Mayasandra clinic was able to establish itself and purchase a van used to provide transportation to the clinic for children from 16 surrounding villages.

 

Although kids with disabilities were not the Mayasandra project’s original focus, Young realized during the 2009 exploratory trip, where his group saw 500 children, that the village had unfulfilled needs.

 

“After we saw all those kids, we all noticed the same thing,” Young said. “We saw all these kids with disabilities getting no service. I didn’t envision all this when I first started. You learn and make mistakes, and try to get better next time.”

 

Now, a multidisciplinary approach is being taken into Mayasandra. The Lexington community can pull from a variety of professions, and bring those talents to the village.

 

That approach, which allows physical therapists to work with special educators or speech therapists with medical school students in unprecedented ways, allows for an educational component for students, too.

 

“You’re never going to be operating on an island,” said UK medical student Justin Penticuff, who traveled to Mayasandra this year. “You’re always going to need to work with the whole team.”

 

Working with an entire interdisciplinary team is one part of the equation; getting real-world experience in an environment very different from what they’re used to is something else students can take away from the STSG program in India.

 

“We have to be able to come up with ideas for people who don’t have access to specialty things,” said Erin Sieberkrob, a UK physical therapy student on the trip. “It’s our job as healthcare providers to accommodate them and give them ideas of what they can do. That’s something important we learned just being in India.”

 

The program still has room to grow. Those involved want to build a new clinic in Mayasandra, which would require about $75,000. They want to hire a certified teacher at the clinic year-round. And building vocational programs at the clinic to help teach kids necessary skills is also a dream of STSG’s.

 

If interested in donating to STSG and its efforts in India, contact Dr. Thomas Young at tyoung@uky.edu.

 

Media Contact: Ann Blackford at 859-323-6442 or ann.blackford@uky.edu

 

 

 

 

UPK Author Wins Department of Defense Award for Summerall Memoir

Thu, 04/10/2014 - 12:00

LEXINGTON, Ky. (April 11, 2014) — University Press of Kentucky (UPK) author Timothy K. Nenninger has been awarded the Secretary of Defense Medal for Meritorious Civilian Service from the United States Secretary of Defense, Chuck Hagel. The award given to the editor of the UPK book “The Way of Duty, Honor, Country: The Memoir of Charles Pelot Summerall" was presented April 5, at The Society for Military History’s annual meeting in Kansas City, Mo.

 

The Secretary of Defense Medal for Meritorious Civilian Service was established Nov. 26, 1954, and is the second highest career award that is presented by the Department of Defense to a civilian employee. It is awarded to employees for exceptional devotion to duty and for contributions to the operation of the department. The award recognizes Nenninger’s contributions at the National Archives over three decades in assisting numerous government and academic historians in researching and writing military history that influenced and guided the professional education and decision making of Department of Defense civilian and military leaders at all levels.

 

“The Way of Duty, Honor, Country" chronicles the life and service of Charles Pelot Summerall. After graduating from West Point in 1892, Summerall launched a distinguished military career, fighting Filipino insurgents in 1899 and Boxers in China in 1900. His remarkable service included brigade, division and corps commands in World War I; duty as chief of staff of the U.S. Army from 1926 to 1930; and presidency of The Citadel for 20 years, where he was instrumental in establishing the school’s national reputation.

 

Summerall left behind a detailed manuscript of his life which Nenninger edited and annotated, adding comprehensively researched footnotes and creating an accessible biography that provides a valuable resource for anyone interested in the life of a celebrated soldier who witnessed profound technological, military and social advances.

 

Nenninger is chief of the Textual Records reference staff at the U.S. National Archives and Records Administration. His previous works include “The Leavenworth Schools and the Old Army: Education, Professionalism, and the Officer Corps of the US Army, 1881–1918” and “Soldiers and Civilians: The US Army and the American People.”

 

UPK is the scholarly publisher for the Commonwealth of Kentucky, representing a consortium that now includes all of the state universities, five private colleges and two historical societies. Led by Director Stephen Wrinn, its editorial program focuses on the humanities and the social sciences. Offices for the administrative, editorial, production and marketing departments of the press are found at UK, which provides financial support toward the operating expenses of the publishing operation.

 

 

 

MEDIA CONTACT: Whitney Hale, 859-257-8716whitney.hale@uky.edu

UK MANRRS Chapter Receives National Acclaim

Thu, 04/10/2014 - 11:20

LEXINGTON, Ky. (April 11, 2014) – At the recent 29th annual MANRRS conference, the University of Kentucky College of Agriculture, Food and Environment’s chapter received many awards and honors.

 

MANRRS stands for Minorities in Agriculture, Natural Resources and Related Sciences.

 

The UK chapter was named National Chapter of the Year at the Birmingham, Ala. event for the second consecutive year. This is the first time a school has received back-to-back chapter of the year recognitions. This recognition is based on a written report and an oral presentation focusing on membership, leadership development, promotion of the national society, community service, and activities and events conducted. The UK chapter also won the Region 3 Chapter of the Year for the third consecutive year.

 

“We received this honor over 75 chapters in 38 states,” said Quentin Tyler, UK assistant dean and director of the college’s Office of Diversity. “This award is a direct reflection of the commitment to the development of our students in the UK College of Agriculture, Food and Environment and the total support provided by our administration, faculty and staff, 4-H agents, and groups such as the Ag and HES Alumni Association and Farm Credit Mid-America. Moving forward, students are aware that they can attend our college and receive the support they need to reach their goals and dreams.”

 

In addition to the Chapter of the Year recognitions, Tyler was elected as the National MANRRS president-elect, a three-year term beginning in May.

 

Tyler said, of the 57 UKAg representatives attending the national conference, 36 were college students and 14 were Jr. MANRRS students. The rest included the academic coordinator in Agricultural Economics, the director of program and staff development for the college, one representative from the Department of Forestry, and four Cooperative Extension agents.

 

Other honors include:

 

•           Marcus Tyler Jr. -- Jr. MANRRS National John Deere Scholarship recipient; MANRRS Undergraduate Essay 2nd Place

•           Stephanie Cabrea -- Jefferson County 4-H Jr. MANRRS, third place public speaking. Her 4-H agents are Chanda Hall and Ashley Holt.

•           Anna Stacia Haley -- Christian County 4H Jr. MANRRS, first place impromptu speaking and first place public speaking. Her 4-H agent is Antomia Farrell.

•           Susanna Croney -- Christian County 4-H Jr. MANRRS, second place public speaking. Farrell is her 4-H agent as well.

•           Spencer Tribble – agricultural economics graduate student, one of three students in the country awarded a John Deere MANRRS Internship.

Several students were nominated and elected to the following national officer positions for 2014-2015:

•           Tribble  -- Graduate Region 5 vice president

•           Kelly Moore -- Undergraduate Region 2 vice president, Community and Leadership Development junior.

•           Jessi Ghezi -- Graduate Region 6 vice president, doctoral candidate in Plant and Soil Sciences.

•           Marquel Lett -- Undergraduate president, Environmental Sciences junior

 

REVEAL Research Media: UK Hosts Largest-Ever NCUR

Thu, 04/10/2014 - 09:53

 

Video by UK REVEAL Research Media. LEXINGTON, Ky. (April 8, 2014) — Last week, the University of Kentucky hosted the largest-ever National Conference on Undergraduate Research (NCUR), an event that brings students and their mentors from across the country to present their research and creative endeavors.  This was the largest NCUR in the conference's 28-year history. The event featured poster, oral and performing arts presentations in a variety of topics, from film studies and music, to biology and engineering. The conference not only allowed students to present their work, but to develop their communication and presentation skills while meeting other like-minded students. A career gallery, graduate and professional school fair, art gallery, open houses, plenary speakers, concerts and excursions were also provided for the students. 

Preparation for an event of this size begun over two years ago, and was made possible by the collaboration of many colleges and departments across campus, and by the help of hundreds of student, faculty and staff volunteers.

 MEDIA CONTACT: Jenny Wells, 859-257-5343; jenny.wells@uky.edu

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