John Myers

• PhD
• Professor (Full) at University of Louisville

Background Coal-fired power plants are a major source of air pollution that can impact children’s health. Limited research has explored if proximity to coal-fired power plants contributes to children’s neurobehavioral disorders. Objective This community-based study collected primary data to investigate the relationships of residential proximity to...

Objective: This study aimed to evaluate prescribing patterns of antipsychotic medication and factors that predict duration of use among low-income, preschool-age children. Methods: State Medicaid claims from 2012 to 2017 were used to identify antipsychotic medication use for children <6 years old. ICD-9 and ICD-10 codes were used to describe chi...

Manganese (Mn) is an essential element, however, children with moderate to high Mn exposure can exhibit neurobehavioral impairments. One way Mn appears to affect brain function is through altering dopaminergic systems involved with motor and cognitive control including frontal – striatal brain systems. Based on the risk for motor and attention prob...

The purpose of this preliminary study was to determine smartphone usage, expressed level of interest, and intent to use mHealth apps among adults with comorbid type 2 diabetes (T2D) and depression. A convenience sample of adults (N=35) completed a Demographic and Mobile App Survey and the CESD-R-10. A majority reported using mobile apps (n=23, 65.7...

Environmental exposures have been linked to childhood problems with overactivity, attention, and impulse control, and an increased risk of attention deficit hyperactivity disorder (ADHD) diagnosis. Two approaches to identify these types of exposure-related neurobehavioral problems include the use of computerized tests, such as the Behavioral Assess...

Objective: Rates of pediatric bipolar disorders have increased and some are concerned about diagnostic accuracy. Disruptive mood dysregulation disorder (DMDD) was added to the DSM-5 in 2013. The purpose of this study was to assess diagnostic trends of bipolar disorders and DMDD and to identify predictors of receiving the DMDD diagnosis since imple...

Cefdinir is frequently prescribed for pediatric infections despite lack of first-line indications. We reviewed Kentucky Medicaid claims from 2012 through 2016. Cefdinir prescriptions and spending significantly increased over the study period. Upper respiratory infections accounted for the majority of use. Inappropriate cefdinir use should be a prio...

The World Society for Pediatric and Congenital Heart Surgery has endorsed the establishment of an international platform for the exchange of knowledge and experience for those that treat patients with a congenital heart defect. On January 1, 2017, the release of the World Database for Pediatric and Congenital Heart Surgery opened a new era in evalu...

Purpose: To identify a relationship between patient satisfaction with the hospital experience and health-related quality of life (HRQOL), as well as determine predictors of each variable. Participants & setting: 50 patients with cancer in two adult oncology units in an academic health sciences center. Methodologic approach: A descriptive, cros...

Background Cefdinir is frequently prescribed to pediatric outpatients with respiratory infections despite a lack of first-line indications. The use of cefdinir should be limited given its poor efficacy against Streptococcus pneumoniae, suboptimal pharmacokinetic and pharmacodynamic parameters, and high cost. We describe cefdinir use over time in th...

Background Increasing rates of hepatitis C virus (HCV) infection are directly linked to the opioid and intravenous drug (IVD) epidemic. White and rural young adults have been affected disproportionately and most are unaware of their status. However, the CDC recommends HCV screening in persons born between 1945 and 1965 (baby boomers) with screening...

Background: Postpartum depression in Latina immigrant mothers can lead to adverse outcomes in both mothers and babies, yet depression treatment remains suboptimal. Aims: The aims were to determine predictors of intention to seek depression treatment and to determine if intention to seek depression treatment differed in those with significant sympto...

Background: The factors influencing parents' willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents' willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with wil...

Purpose: The primary purpose of this study was to evaluate acceptability by new mothers of postpartum depression (PPD) screening and education about community resources by hospital-based perinatal nurses. A secondary purpose was to determine further screening for PPD that women received by community providers in the first few weeks after birth. M...

The objectives of this study were to investigate the correlation between thromboelastography (TEG) and conventional measures of anticoagulation, and to determine optimum values for citrated kaolin TEG R time (TEG RCK) and anti-Xa activity that would minimize both bleeding and thrombotic complications in pediatric and neonatal patients requiring ext...

Background: The rates of mental health diagnoses in children have increased. Children in poverty have the highest rates. The use of psychotropic medication for children has been increasing, which is concerning because of the unknown long-term effects and the increased burden on the health care system. The state of Kentucky ranks among the highest...

Success in testing research outcomes requires identification of effective recruitment strategies in the targeted population. In this paper, we present the protocol for our NIH‐funded study as well as success rates for the various recruitment strategies employed. This longitudinal observational study is: developing a phenotyping algorithm for asthma...

Background: The diagnosis of asthma is not always straightforward and can be even more challenging in older adults. Asthma is ideally confirmed by demonstration of variable expiratory airflow limitation. However, many patients with asthma do not demonstrate airflow obstruction nor show bronchodilator reversibility. We aimed to investigate predicto...

Approximately 400,000 adolescents give birth in the USA annually. Although one-half experience depressive symptoms, less than 25% comply with referrals for depression evaluation and treatment. The current study tested the effectiveness of an Internet-based depression intervention on seeking depression treatment. Based upon the theory of planned beh...

Given the heterogeneity of autism spectrum disorder (ASD), research has investigated how sensory features elucidate subtypes that enhance our understanding of etiology and tailored treatment approaches. Previous studies, however, have not integrated core developmental behaviors with sensory features in investigations of subtypes in ASD. Therefore,...

The use of monthly intranasal mupirocin was associated with a significant reduction in the rate of methicillin-resistant Staphylococcus aureus transmission and Staphylococcus aureus invasive infection in a large neonatal intensive care unit. Resistance to mupirocin emerged over time, but it was rare and was not associated with adverse clinical outc...

Purpose: The purpose of this study was to describe new mothers' knowledge related to maternal mortality. Study design and methods: Using a cross-sectional design, new mothers were recruited from a postpartum unit of an academic health sciences center where the population was predominately low-income women. Before hospital discharge, they answere...

Objective: To evaluate the ability of the Perinatal Grief Intensity Scale (PGIS) when used within 8 weeks of perinatal loss to predict intense anxiety and severe depression symptoms in women 3 months later (Time 2 [T2]). Design: Prospective survey. Setting: Participants were recruited from hospitals in Louisville, KY and via the Internet. Par...

Pain crisis in children with sickle cell disease (SCD) is typically managed with intravenous fluids and parenteral opioids in the pediatric emergency department. Electrical cardiometry (EC) can be utilized to measure cardiac output (CO) and cardiac index (CI) non-invasively. Near-infrared spectroscopy (NIRS) measuring cerebral (rCO2) and splanchnic...

Pain crisis in children with sickle cell disease (SCD) is typically managed with intravenous fluids and parenteral opioids in the pediatric emergency department. Electrical cardiometry (EC) can be utilized to measure cardiac output (CO) and cardiac index (CI) non-invasively. Near -infrared spectroscopy (NIRS) measuring cerebral (rCO2) and splanchni...

Fragmentation in behavioral and mental health care to children has resulted in suboptimal care and high rates of psychotropic medication use, especially antipsychotic medications (APM). A qualitative study, based on the Theory of Planned Behavior (TPB), aimed to better understand prescribing practices, barriers to optimal treatment, and potential i...

Background Kentucky (KY) has the Second highest rate of Hepatitis C (HCV) infections among pregnant women in the USA, largely due to IV drug use. HCV screening is recommended in children born to those women. HCV-exposed infants are also at risk for HIV and syphilis as well as neonatal abstinence syndrome (NAS). A substantial portion of HCV-exposed...

Background Kentucky (KY) has the second highest prescription rate of antibiotics in the US. Prior studies based on anonymous pharmacy claims have been unable to determine whether this high rate is attributable to prescribing to a greater proportion of the population as compared with other states or to recurrent antibiotic use in a more limited grou...

Background Enormous advances in treating/curing patients suffering from Hepatitis C (HepC) infection have occurred; resulting in many states mandating screening for HepC for older individuals. Unfortunately, no protection of screening exists for newborns. In Kentucky, rates of HepC among pregnant women are the second highest within the U.S., which...

Objective: The Perinatal Grief Intensity Scale (PGIS) was developed for clinical use to identify and predict intense grief and need for follow-up after perinatal loss. This study evaluates the validity of the PGIS via its ability to predict future intense grief based on a PGIS score obtained early after a loss. Methods: A prospective observation...

Purpose: To determine if findings from our preliminary study related to patient and nursing satisfaction with a pain management intervention could be replicated in a changed environment, and if contextual factors could impact the effectiveness of a pain management intervention on patient satisfaction with nursing staff's management of pain. Metho...

Allergy skin prick testing (SPT) is commonly performed during the work-up of allergic asthma. We examined a cohort of older asthmatics who underwent allergy SPT following a standardized medication hold protocol in use at the University of Louisville. The protocol attempts to address the impact concurrent medication use has on skin prick test outcom...

Objective: The aim of this study was to test predictors of nursing empowerment and job satisfaction in nurses. Background: Nursing professional development leaders and Magnet® coordinators need foundational data on which to build interventions that will support and empower nurses on the journey toward American Nurses Credentialing Center Magnet®...

Purpose: The purpose was to critique existing parenting apps using established criteria and health literacy guidelines. Study design: Descriptive methodology was used. Methods: The Apple App Store was searched using the terms parenting, child health, and infant health. To be included, the apps had to have relevant content (parenting, child hea...

To evaluate the effectiveness of a pain management intervention on patient satisfaction with the nursing staff’s management of pain

In the US there were 400,000 home fires resulting in 2755 deaths, 12,450 injuries, and $6.9B lost. The purpose of this study was to evaluate the content-validity of photographs taken in the home for use as an educational instrument to teach about “safe” and “unsafe” fire safety practice for adults and older adults. A total of 73 home fire safety ex...

A retrospective review of 77 pediatric and neonatal ECMO patients who received recombinant antithrombin III (ATIII) for ATIII activity >80% was conducted.Anticoagulation management was per institutional protocol. An ATIII activity >80% was targeted. Diagnosis, reason for ECMO cannulation, blood product usage, heparin dosing, ATIII activity and dose...

Background Low-dose theophylline has been recognized for its ability to restore histone deacetylase-2 activity which leads to improved steroid responsiveness and thus improved clinical outcome. We retrospectively evaluated the effect of low-dose theophylline therapy in pediatric patients hospitalized for an acute asthma exacerbation as a proof of c...

To evaluate the effectiveness of an intervention related to pain management on patient satisfaction with the nursing staff’s management of pain

Changes in U.S. fireworks laws have allowed younger children to purchase fireworks. In addition, the changes have allowed individuals to purchase more powerful fireworks. The purpose of this study is to examine the epidemiology of pediatric firework-related burn injuries among a nationally representative sample of the United States for the years 20...

Background: Successful treatment of both pediatric autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP), specifically those that are refractory to first-line therapies, remains unsatisfactory in terms of long-term remission and medication side effects. Here, we propose a novel combination therapy of mycophenolate mofetil (M...

The rate of maternal mortality is rising in the United States, and patient education is key to help women recognize signs and symptoms of complications of pregnancy. Health care providers should always ask a woman of childbearing age if she has experienced a recent pregnancy or birth, and women should remind health care providers at every encounter...

The purpose of this study was to describe the home fire safety quality improvement model designed to aid organizations in achieving institutional program goals. The home fire safety model was developed from community-based participatory research (CBPR) applying training-the-trainer methods and is illustrated by an institutional case study. The mode...

Transparency document.

Purpose Eliciting and understanding patient and research participant preferences regarding return of secondary test results is a key aspect of genomic medicine. A valid instrument should be easily understood without extensive pre-test counseling, while still faithfully eliciting patients’ preferences. Methods We conducted focus groups with 110 adu...

Background: Parents of infants hospitalized in the neonatal intensive care unit (NICU) frequently need guidance to prepare them for the care and health promotion of their child after hospital discharge. The health literacy of the parents should be considered so that education can be tailored to meet their needs. It is also important to understand...

Objective: The objective of this study was to examine the relationships of demographic characteristics with diabetes biomarkers and physical activity adherence in African American adults with type 2 diabetes mellitus. Methods: Data for this secondary analysis were collected in a controlled trial conducted at an ambulatory internal medicine clini...

Background Adherence to guidelines for the treatment of hospitalized elderly patients with community-acquired pneumonia (CAP) has been associated with improved clinical outcomes. This study evaluated the cost-effectiveness of adherence to guidelines for the treatment of CAP in an elderly hospitalized patient cohort. Methods Data from an internation...

Objective: To evaluate factors affecting attendance or nonattendance at an initial interprofessional pediatric weight management visit after referral. We hypothesized that increased severity of obesity, farther distance from the program, lower education level of the primary caregiver, public insurance or no insurance, and lower socioeconomic statu...

The implementation of the Research Champions program was an effective strategy to increase the confidence of direct care nurses in research skills, a goal for staff development educators. Postprogram questionnaires conducted at 12 months assessed participants' confidence in specific areas: critique of research manuscripts, comprehension of research...

Background: No instrument exists to measure parent beliefs about early social-emotional development, which is foundational for child outcomes. We developed and tested an instrument to measure parent beliefs. Methods: Positive parenting was defined from the literature and 84 items were developed based on the theory of planned behavior (TPB). The...

Objective: The current study aimed to better understand trends and risk factors associated with non-fatal drowning of infants and children in the USA using two large, national databases. Methods: A secondary data analysis was conducted using the National Inpatient Sample and the Nationwide Emergency Department Sample databases. The analytic samp...

Background: Erythrocytapheresis procedures are increasingly used in sickle cell disease. Serum ferritin and noninvasive magnetic resonance imaging measurements of liver iron concentration (LIC) are frequently used to monitor iron overload secondary to hypertransfusion. There is a paucity of data describing the impact of long-term erythrocytapheres...

Context Early and aggressive use of hydroxyurea (HU) in sickle hemoglobinopathies has been in practice at our comprehensive sickle cell center since 2012 when standardized protocols were still evolving. The consensus treatment protocol for hydroxyurea therapy in sickle cell disease (SCD) documented in the "Evidence-Based Management of Sickle Cell D...

Background: Printed health educational materials are commonly issued to prepare patients for hospital discharge. Teaching methods that engage multiple senses have been shown to positively affect learning outcomes, suggesting that paper materials may not be the most effective approach when educating new mothers. In addition, many written patient ed...

This article examines role stress, key psychosocial variables, and well-being in adults recently diagnosed with rheumatoid arthritis. Patients recently diagnosed with rheumatoid arthritis must often learn to balance disease and role-related responsibilities. This was cross-sectional, descriptive study (N = 80). Data were analyzed using correlation...

Previous studies have shown that residential proximity to a roadway is associated with increased cardiovascular disease risk. Yet, the nature of this association remains unclear, and its effect on individual cardiovascular disease risk factors has not been assessed. The objective of this study was to determine whether residential proximity to roadw...

Parental depression has been associated with adverse child outcomes. However, the specific parenting behaviors that may result in such child outcomes and the effect of family-centered care (FCC) on positive parenting behavior of depressed parents has not previously been examined. Data from the National Survey of Early Childhood Health was used (n =...

Older adults are more likely to experience problems that contribute to an increase in burn-related morbidity and mortality. The purpose of the current study was to determine if the educational home fire safety (HFS) intervention was an effective method of improving HFS knowledge over time in two groups of urban older adults, home bound and communit...

BACKGROUND: While theophylline has traditionally been used in high dose as a bronchodilator, more recently it has increasingly been used in lower doses for anti-inflammatory properties. Specifically, theophylline has been recognized for its ability to restore histone deacetylase-2 (HDAC2) activity which leads to improved steroid responsiveness and...

BACKGROUND: Theophylline has been used in asthma for over 80 years. While initially used in high doses as a bronchodilator, it has been more recently used in lower doses for its anti-inflammatory properties. Specifically, theophylline has been recognized for its ability to restore histone deacetylase-2 (HDAC2). We hypothesized that since in severe...

Educational materials used by healthcare agencies frequently do not follow national health guidelines for plain talk. Adolescent mothers are a vulnerable population in need of accurate and accessible health information to promote their own health and that of their baby. The aims of our study were to: Determine acceptability of simple, written educa...

To determine if prenatal diagnosis improves the chance that a newborn with critical congenital heart disease will survive to undergo planned cardiac surgery. A systematic review of the medical literature identified eight studies which met the following criteria: compared outcomes between groups of newborns with prenatal and postnatal diagnosis of c...

Patients undergoing treatment for head and neck cancer commonly experience signi•cant changes in quality of life (QoL) and levels of symptom distress. It is not known if a telehealth intervention would mitigate these changes. To evaluate the impact of a telehealth intervention on QoL and symptom burden in patients undergoing initial treatment for h...

In children under 1 year of age, the proportion of unintentional burns increases with infant age and mobility. Infants are not able to avoid burns and are dependent on parental or adult help. Treatment of burns in young children is expensive in terms of the life-long costs. The purpose of this study was to examine changes in home fire safety (HFS)...

Introduction The epidemiology and hospital course of children with retropharyngeal abscess (RPA) or parapharyngeal abscess (PPA) have not been fully described at the national level in the United States.

Objective To examine the construct validity of the Perinatal Grief Intensity Scale (PGIS) and the associations of grief intensity with psychological well-being and the quality of intimate partner relationships of women in the subsequent pregnancy after perinatal loss. The consequences of intense grief due to perinatal loss may include significant c...

Women with type-2 diabetes (DM2) are at high risk of cardiovascular disease (CVD) which may be partly due to increased ovarian androgen production. Since the association of bilateral oophorectomy (BSO) with CVD remains controversial, we evaluated whether BSO is inversely associated with CVD among DM2. Data were obtained from a national sample of 95...

Parenting anticipatory guidance is one way to promote optimal child health and development and minimize disparities between children from lower socio-economic status families and their higher income peers. However, low rates of attendance at and completion of parenting programs has been demonstrated. Understanding barriers to participation has impo...

Hospitals vary widely in the services they offer to care for pediatric burn patients. When a hospital does not have the ability or capacity to handle a pediatric burn, the decision often is made to transfer the patient to another short-term hospital. Transfers may be based on available specialty coverage for children; which adult and non-teaching h...

Background: Observational studies and randomized clinical trials have demonstrated that RBC transfusions can alleviate or prevent many complications of sickle cell disease (SCD). Obligatory iron loading is most problematic for those receiving chronic simple transfusions and is managed with chelation therapy to prevent hepatic, cardiac, and endocrin...

Background: Multiple epidemiological investigations have established that roadway proximity is associated with adverse cardiovascular conditions. Recent literature indicates circulating angiogenic cells (CACs), types vascular progenitor cells, may be indicators of exposure to roadway-generated pollutants. Our study advances cardiovascular science b...

Background: Benzene is an aromatic hydrocarbon found in high amounts in vehicular exhaust and tobacco smoke. Exposure to traffic pollutants or chronic tobacco smoke exposure induces cardiovascular injury, suppresses circulating angiogenic cells (CACs), and increases thrombosis and atherogenesis. The purpose of this study was to examine whether benz...

Background: Vitamin D supplementation may be an inexpensive intervention to reduce heart failure (HF) incidence. However, there are insufficient data to support this hypothesis. This study evaluates whether vitamin D plus calcium (CaD) supplementation is associated with lower rates of HF in postmenopausal women and whether the effects differ betwe...

Background: Our study compares breast cancer survivors without a secondary diagnosis of uterine cancer (BC) to breast cancer survivors with a diagnosis of uterine cancer (BUC) to determine clinical characteristics that increase the odds of developing uterine cancer. Methods: A total of 7,228 breast cancer survivors were surveyed. A case-control...

ProblemLittle is known about how adolescent mothers use social media and the Internet, especially to access health information.Methods In this cross-sectional, descriptive study, adolescent mothers were recruited from an academic medical center after the birth of their child (n = 94) or from a state-funded, home visitation program during the first...

Increasing burn prevention (BP) knowledge in nurse practitioners leads to better care for patients who suffer a burn injury. Web-based and classroom-based approaches to increasing an individual's knowledge, in general and specifically to BP knowledge, is currently an area of interest for researchers. As a result, the purpose of this study was to te...

Treatment of pediatric burn patients is costly and may require long length of stay in the hospital (LOS) . Establishing where these LOSs and charges are highest is warranted. The current study investigated whether pediatric burn patients had higher total charges and longer LOS when seen at teaching hospitals, when compared with nonteaching hospital...

The health care team identified the causes of health care-associated infections (HAI) and developed interventions in a pediatric intensive care unit in Gaza. A quasi-experimental pretest-posttest design was used. All 26 full-time staff members in the pediatric intensive care unit participated. The HAI rate decreased significantly from the first to...