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Highlights:
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Predictions
coming true
Easy rider
Woodruff Foundation makes historic contribution
Pounds off, VERB on
Positive
press
What we learn from chimpanzees
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Stemming
nurse migration
Saving sight with microneedles and fish oil Virtually
no smoking permitted here
Supporting staff
Your brain on progesterone
Milestones |
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Predictions
coming true
With
continuing support from the Woodruff Fund, $10 million in new funding
from Emory University, $3 million from an anonymous donor, and talks
under way with other potential partners, the Emory/Georgia Tech
Predictive Health Initiative has switched to overdrive. Director
Ken Brigham says the additional support has speeded up four steps
in the quest to build a new model of health care that can predict
disease and intervene before it ever develops.
Faculty and staff soon will get a
look at how this predictive health care model will differ from even
the most modern-day medical care facilities. Early in 2007, a new
Center for Health Discovery and Well-Being designed by Manuel Zeitlin
Architects opens on the 18th floor of the Medical Office Tower (MOT)
at the Emory Crawford Long Hospital midtown campus. There’s
nothing like this anywhere, says Brigham. The center will follow
several hundred generally healthy people,
collecting physical, medical, and lifestyle histories and performing
up to 50 different blood and plasma tests that target known critical
predictors of health and illness (for example, measures of inflammation,
immune health, metabolic health, and DNA analysis for some genes
that may confer risk). Based on these profiles and increasingly
sophisticated, integrated predictive risk models, each participant
will be prescribed a personalized health program designed to address
individual risks.
In addition to trying to stay healthy,
participants in the Center for Health Discovery and Well-Being will
serve as research partners, providing new information on risk and
participating in clinical trials that test predictive models and
novel interventions. A new predictive health research program is
being launched simultaneously with the clinical program, with the
goal of developing and validating novel biologic markers (biomarkers)
to predict health, disease risk, and prognosis. Some biomarkers
may be specific to diseases such as cancer or atherosclerosis, while
others may prove generic to all diseases. This scientific core will
combine expertise and funding from the Georgia Tech systems biology
program, the joint Emory/Tech biomedical engineering program, and
the new Emory program in computational and life sciences. It also
reflects the initiative’s multidisciplinary approach to predictive
health, says Brigham, with its ties to anthropology, ethics, behavior,
health policy, law, business, and religion.
Even as physical space is being built
out in the MOT, the virtual Predictive Health Initiative also is
growing, thanks to expanded funding from the Woodruff Fund. Eighteen
research projects are now under way across the Emory and Georgia
Tech campuses, more than double the number last year. Examples include
a predictive treatment for Lous Gehrig’s disease, a search
for biologic predictors of progression in chronic lung disease,
early infancy predictive health modeling, and a new strategy for
developing vaccines for neurologic diseases.
It is only the beginning, says Michael
Johns, CEO of the Woodruff Health Sciences Center. Predictive Health
and Society is one of the initiatives being targeted by Emory’s
strategic plan, and excitement and support for the initiative is
growing. In fact, says Johns, discussions are already taking place
about building a freestanding predictive health facility on the
Emory Crawford Long midtown campus. –Sylvia
Wrobel |
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Easy
rider
It’s almost ghostly. On streets around Emory, hundreds
of cars have vanished. Shuttle buses named Cliff zip along
without gasoline. Traffic lights behave as if they cared about the
mental health of commuters. Some commuters are smiling for the first
time in years. Others are asleep.
These recent changes have nothing
to do with Stephen King and everything to do with Emory’s
vision to ease congestion and improve quality of life in the community
by reducing the number of single occupancy vehicles on the roads.
The effort is supported by the Clifton Community Partnership, a
collaboration between Emory, local businesses, and the neighborhood
to improve vitality of the area. Laura Ray, associate vice president
for transportation and parking, lists four initiatives making it
happen:
Hop on board, whoever you are. As of October, Emory’s
expanded and rebranded (Cliff for Clifton, of course) “Park-n-Ride”
shuttle service operates between the Clifton Corridor area and malls
at North DeKalb, Northlake, and South DeKalb. Other locations are
being discussed. Cliff also travels between the campus and downtown
Decatur, with numerous stops in between. All shuttles are free and
available to anyone, no ID required. And why not? Cars are cars
are cars, says Ray, and every shuttle rider means one less car on
the road. Some commuter shuttles begin as early as 5AM, running
every 15 minutes until after 7PM. Campus shuttles operate continuously.
As Emory moves closer to becoming a completely pedestrian campus
per the university master plan, shuttle routes and stops sometimes
shift slightly (from the back to the front of the hospital for example).
See schedules
and other information.
Oil for fuel. Almost half of Emory’s shuttles
buses now operate on biodiesel fuel made from cooking oil recycled
from the university’s own kitchens, the Centers for Disease
Control and Prevention, Children’s Healthcare of Atlanta,
and local restaurants. (Emory dining services alone produce about
5,500 gallons every month.) The brainchild of a recent Emory graduate,
the cooking oil-to-fuel program is managed in partnership with the
Southern Alliance for Clean Energy. The other half of Emory’s
59 buses operate on compressed natural gas or electricity. No, the
shuttles do not smell of fried chicken—nor do they save Emory
money. The program is cost neutral, says Ray, but recycling a product
that would otherwise be dumped fits well with Emory’s commitment
to sustainability and is good for the environment.
Good things for doing the right thing. Bikers,
walkers, van and carpoolers—whose numbers currently exceed
1,000—as well as employees using public transportation can
register with Emory and receive incentives like free use of a “Flex
car,” guaranteed rides home in case of emergencies, and chances
to win prizes. Free MARTA passes are a big draw with 2,000 Clifton
Corridor employees participating, and Emory also plans to provide
passes for the Clayton, Cobb, and Gwinnett transit systems. See
Emory's Transportation site.
Getting the green light. After studying travel
during peak commute hours on six major corridors in the Clifton
community, Emory worked with DeKalb County to “re-time”
33 traffic signals. Results: 31% reduction in average travel time,
55% reduction in average number of starts and stops, and estimated
savings of 327,000 traffic hours and 196,000 gallons of gas each
year. Traffic flow is monitored, and adjustments are made as needed.
Working with the Clifton Corridor
Transportation Management Association (CCTMA) and the Georgia Department
of Transportation, Emory hopes to further expand transit options
through a light commuter rail through campus, using the existing
CS railway and three streetcar lines throughout the greater Emory
community. The federal government gave CCTMA a grant to study the
feasibility of the project.
Thanks to all of the above, Emory
was named one of 72 “Best Workplaces for Commuters”
in a first-time ever list of schools compiled by the U.S. Environmental
Protection Agency. “We’re
proud,” says Ray, “but we’re even prouder of how
willing our employees have been to jump on board with these initiatives
and leave their cars at home.” –SW
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Woodruff
Foundation makes a historic contribution
More
than 50 years ago, the late legendary leader of Coca Cola, Robert
Woodruff, helped establish The Emory Clinic. Today, his support
comes full circle as the Robert W. Woodruff Foundation
contributes $261.5 million for construction of a model patient-centered
health care system for the 21st century and for additional
university priorities. One of the largest financial commitments
ever
made in American higher education, the support includes $240 million
to modernize and transform the clinic’s outpatient facilities,
enabling its physicians and researchers to create a place for an
ideal experience for patients, from parking and arrival all the
way to treatment and discharge. Another $12.5 million establishes
the Presidential Fund, which will be invested in initiatives that
advance Emory University’s strategic plan, and $9 million
will renovate the administration building of the Woodruff Health
Sciences Center. Future issues of Momentum will follow
the accomplishments that are enabled by this extraordinary vision.
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Pounds off, VERB on
Five years ago, the Centers for Disease Control and Prevention
started VERB, a social marketing campaign to promote physical activity
and reduce obesity in children ages 9 to 13. Despite positive
results, the program lost its funding in September 2006.
The demise of VERB is indicative of
a larger problem of countering childhood obesity in the United States.
Currently one-third of American children and youth are either obese
or at risk of becoming obese, according to a new report from the
Institute of Medicine
(IOM). The rate for children and youth increased from 16% in 2002
to 17.1% in 2004, and is projected to rise to 20% by 2010, if the
current trajectory continues.
Progress to reverse those rates is
slow. Efforts of government, industry, communities, schools, and
families are fragmented. Furthermore, the programs that have been
developed go largely unevaluated to see if they work. And national
leadership for this public health issue is lacking.
“The good news is that Americans
have begun to recognize that childhood obesity is a serious public
health problem, and initiatives to address it are under way,”
says Jeffrey Koplan, vice president of academic health affairs at
Emory and chair of the IOM committee that studied progress on childhood
obesity. But awareness is only the beginning, he says. It must be
enhanced by strong leadership, effective polices and programs that
have been shown to work, and sufficient resources.
The IOM report found that short-term
outcomes are being achieved through a variety of programs. Several
federal policies have changed to encourage better nutrition and
physical activity in schools, and many communities have built sidewalks
and bike paths to encourage physical activity, for examples. A new
law requires local school wellness policies to be in effect for
the 2006–2007 school year. An alliance of industry, foundation,
and government representatives has established guidelines to limit
children’s portion sizes and calories from sweetened beverages
during the school day. An industry group is currently reviewing
guidelines of the Children’s Advertising Review Unit to more
closely examine product placement in television programs, among
other marketing techniques. Families, too, are enrolling students
in after-school activities, emphasizing the importance of eating
breakfast and substituting healthier beverages for sugar-sweetened
drinks.
Still, the committee members found
a dearth of evaluation efforts to target programs that work. In
general, they recommend four key steps to curtail childhood obesity:
increased and sustained leadership and commitment; broader implementation
and evaluation of policies and programs; improved monitoring and
surveillance of progress; and wider dissemination of promising practices.
One specific recommendation called for continued support for VERB.
Its termination “calls into question the commitment of both
the government and other stakeholders,” says Koplan. See
more details of the IOM report. |
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Positive
press
The
Emory Clinic is akin to a small city, offering broad services for
approximately 1 million patient visits each year. It has 140 possible
points of entry, 66 locations, 930 physicians, and 3,000 employees.
Its sheer size offers the advantages of multi-specialty medical
practices and quality health care. However, the size of that network
also can be its Achilles’ heel. How to keep it all moving
forward on track and on time?
In 2004, the clinic embarked on a
plan to improve its service culture and patient satisfaction with
its many services. But rather than take on the whole range of challenges
all at once, clinic administrators decided to focus on one priority
at a time. “Our goal
was to work smarter, not just harder,” says Donald Brunn,
COO of The Emory Clinic.
That strategy paid off this fall when
the clinic was one of only six national recipients of the annual
Press Ganey Success Story Awards and the only medical practice group
among the winners. Press Ganey is a firm that gathers data to help
health care facilities improve services provided to patients, from
front-line staff to clinicians. Each month, it sends out surveys
to allow patients to provide anonymous feedback about how they were
treated in a range of categories.
The Emory Clinic used the results
of approximately 23,000 returned surveys per year to learn what
its patients wanted most. At the top of the wish list was to be
informed when and why appointments were delayed. “We strive
to eliminate needless waiting,” says Reid Willingham, administrator
of clinical operations. “However, caring for people and their
health does not always fit predictable time slots. Patients expect
their time will be respected and valued. As a result, they expect
to receive information on delays.”
Still, turning a city the size of
The Emory Clinic around on even one priority required not only the
leadership’s commitment but also several approaches. Among
other initiatives, the clinic relied on the patient ambassador program
to provide on-site consultations, lead patient satisfaction conferences,
and assist sections with specific process and service improvement
initiatives. Patient ambassadors, recognized by their red coats,
now number seven and are the face of the clinic. Along with a priority
focus on informing patients of any delays, the clinic also implemented
an automated appointment reminder system, giving patients an opportunity
to actively confirm or cancel appointments while delivering a custom
reminder of specialty-specific directions. A pay-for-performance
review process motivated employees to link their individual goals
with the institution’s patient satisfaction goals, with these
goals then being tied to annual pay increases. Formation of daily
five-minute huddles in all clinic locations allowed staff to kick
off the day with a review of schedules, anticipating operational
snags and planning contingencies. And a campaign—“If
patients wait, they deserve an update”—was launched,
along with quarterly conferences where employees shared their ideas
about enhancing the service culture and spread internal best practices.
These efforts and many more culminated
in an improvement to the overall medical practice score on Press
Ganey surveys from 83.5 to 86.8 in five years. In measuring specific
responses to waits and delays, the clinic’s score went from
72.1 to 76.7 in just under two years—an increase that earned
it one of the six coveted spots in national recognition.
“I believe the traction we’ve
gained in patient satisfaction is the direct result of having created
actionable service standards, which are rehearsed during daily huddles
in each of our clinics,” says Brunn, “combined with
the enthusiasm and engagement of staff who want to see the clinic
recognized for providing an outstanding service experience.”
In announcing this year’s winners,
Press Ganey Associates noted that the winners “indicate strong
and ongoing commitment to customer satisfaction.” And indeed
The Emory Clinic is continuing its efforts to improve patient satisfaction
with services. Next on this little city’s docket—promptness
in returning calls. And there’s a slogan to go with the effort:
“Patients will never feel alone, if we are helpful on the
phone.” |
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What
we learn from chimpanzees
Some
geneticists have calculated the differences in human and chimpanzee
DNA as just over 1%, some at 1.6%, and others at 1.8%. But
no matter the actual number, what the scientific studies boil down
to is that human and chimps have very similar genes. What may be
most useful in comparing the two genomes lies not in the similarities
but in that less than 2% contrast.
As humankind’s closest ancestors,
chimps are a vital resource in exploring what causes some of the
most devastating diseases in people—a theme that emerged repeatedly
during a recent conference at Yerkes National Primate Research Center.
Yerkes Director Stuart Zola organized the conference to give scientists
a forum for discussing the latest developments in research involving
chimpanzees. Without this research, many of the most dramatic medical
advancements of the past decades would have been impossible. For
example, chimps have been critical and continue to be so to discoveries
about HIV and in the development of vaccines and drugs for other
infectious diseases, such as hepatitis A, B, and C, says Zola.
The assembled scientists heard the
latest developments in research on AIDS, hepatitis C, cognitive
and behavioral studies, genomics, and more. One session covered
research on monoclonal antibodies (mAbs), antibodies that are identical,
being produced by one type of immune cell. Scientists can create
mAbs that specifically bind to a substance, making them useful in
genetic treatments. Currently, 18 mAbs are available in the market
for treating cardiovascular and autoimmune diseases, cancer, allergies,
and
respiratory diseases, and many more are being tested. “The
enormous promise of mAbs is indisputable,” says John VandeBerg,
of the
Southwest National Primate Research Center, who spoke at the conference.
“Millions of people may receive treatment as a result, but
many applications can’t be developed without research in chimps.”
Many mAbs bind poorly or not at all
in species other than hominoids (great apes and humans). Also, new
mAb therapies must be tested in an animal model that doesn’t
recognize the antibodies as foreign and consequently reject them.
Nonhominoid systems, for example, rodents and even monkeys, do recognize
mAbs as foreign and therefore quickly clear them from their systems.
Despite compelling arguments, mAbs
are not always tested in chimps before proceeding to clinical trials
in humans. A recent example is a tragic March 2006 experiment in
the United Kingdom where an mAb drug known as TGN 1412 was given
to six volunteers after being tested in macaque monkeys. TGN 1412
was developed to treat a type of leukemia and rheumatoid arthritis.
Within 12 hours of receiving the drug, the six male volunteers had
systemic multi-organ failure and experienced massive swelling of
the skin and mucous membranes. The blood cells of all six almost
completely vanished after several hours. While these men were treated
and eventually able to go home, they continue to have an abnormally
low number of regulatory T cells, and they face a lifetime of contracting
cancers and autoimmune diseases.
The catastrophe may have been avoided
had the drug first been tested in chimps, according to VandeBerg.
Although the dosage given to these men was only 1/500th of the dose
given to the macaques, the difference in the monkey and hominoid
reaction was striking.
Two conference presenters discussed
how chimpanzees have contributed to an understanding of the role
of the immune system in hepatitis C. Arash Grakoui, from Yerkes
and the Emory Vaccine Center, presented findings about CD4 T cells,
which when activated can help CD8 T cells recognize infection from
the hepatitis C virus (HCV). However, in the absence of CD4 T cells,
HCV infection is prolonged rather than being cleared. “Currently,
there is a black box as to when, where, and why anti-HCV T cell
response fails,” he says. Chris Walker from the Columbus Children’s
Research Institute presented findings on HCV-specific T cells, showing
they are long-lived in animals that subsequently recover from infection.
Walker’s team studied genetic mutations in the HCV-specific
T cells of Ross, a chimp who was infected with HCV that failed to
clear. Many scientists studied Ross for 13 years, with the investigations
leading to important findings and major research papers about hepatitis
C. The HCV strain from Ross was transferred into four chimps, in
which massive replication of the virus occurred. However, the new
group of animals acquired genetic mutations in their T cells that
allowed them to mostly clear the virus with only low levels remaining
within one year. A statistical analysis of the pattern of genetic
mutations allowed investigators to hypothesize that the changes
resulted from immune selection pressure rather than chance. “Without
the chimp model, we’d have a much cloudier idea of what is
going on in hepatitis C,” says Walker.
Not only are Grakoui’s and Walker’s
studies on the genetic mutations of HCV difficult to carry out in
humans but also they are hampered by the small supply of chimps
for research. And those numbers are diminishing. This dwindling
resource presents a great threat to researchers’ abilities
to find answers to the biggest medical questions, says Zola. “We
need a long-term commitment to chimpanzee research if we are to
continue to make medical advances,” he says.
Research with chimpanzees is needed
not because they are the same as humans, says Ajit Varki of the
University of California at San Diego and the last presenter at
the conference, but precisely because they are not the same. “It
is what we discover in the differences that is useful to human biology.”
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Stemming
nurse migration
He was the only hospital-based psychiatrist in all of the Democratic
Republic of Congo. He had no telephone and few supplies. When it
rained, it rained in his office. Unfortunately, this doctor’s
circumstances are common in many parts of Africa, according to Manuel
Dayrit of the World Health Organization (WHO), who met the doctor
on a trip to Africa.
WHO has identified 57 countries with
a critical shortage of health care workers, 36 of them in Africa.
But this problem extends beyond the developing world. The reasons
for the worldwide shortage are
complex, according to Davrit, who spoke at the Global Government
Health Partners forum in November.
The conference, hosted by the Lillian
Carter Center for International Nursing of Emory’s Nell Hodgson
Woodruff School of Nursing, brought together chief nursing and medical
officers from 113 countries to hear about national and international
nursing shortages and to collaborate on the development of human
resources action plans. During the weeklong conference, participants
heard from experts on trade policy, migration, and health systems
and from each other on human resources strategies. The conference
also included a workshop at the Centers for Disease Control and
Prevention on avian flu.
Among other discussions at the forum,
many nurses expressed the opinion that closing the door on immigration
falls short of an end-all fix for worldwide nursing shortages. Many
health care workers in undeveloped countries do migrate for financial
reasons and better working conditions, but internal factors such
as a heavy death rate from AIDS and bureaucratic tangles also play
a role. For example, in one African country, the registration process
to work takes on average 18 months after training is completed.
A few developed countries have partially
stemmed the shortage. In the Philippines, the private sector pays
for nurses’ training programs and requires service after graduation.
The United Kingdom developed a comprehensive plan in 1997 that included
a temporary reliance on international recruitment underpinned by
an ethical code of conduct for such hires. The plan has resulted
in a 26% increase in nurses and a 52% increase in medical and dental
residents.
There are other positive signs, says
Mireille Kingma of the International Council of Nurses. Some studies
suggest workers return to their home country after five years on
average. Additionally, job opportunities are improving worldwide,
especially for women. But Kingma and others at the conference believe
the greatest change will occur when poor countries achieve their
benchmarks of global development, such as clean water, lowered infant
and maternal mortality, and a thriving economy. –Kay
Torrance |
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Saving
sight with microneedles and fish oil
For
disorders such as age-related macular degeneration (AMD) and ocular
tumors, the best treatments often involve several injections through
the white part of the eye, the sclera, into the eye’s interior
gel-like filling, the vitreous. Yet it is especially difficult
to get the right amount of medication to the light-sensitive retina,
and these injections can be painful and risky, with complications
ranging from infection to retinal detachment. The National Eye Institute
(NEI) has awarded one of only three R-24 grants ever to Emory, Georgia
Tech, University of Nebraska, and University of Pennsylvania to
develop new ways to deliver therapeutic drugs to the back of the
eye.
“We’re looking at better
ways to go through the sclera, which is large and soaks up drugs
like a sponge,” says Henry Edelhauser, director of research
at the Emory Eye Center and a co-principal investigator of the five-year,
$7 million NEI grant. Among different transport modes the researchers
are pursuing are microneedles coated with nanoparticles and placed
in the sclera to provide slow absorption of the drugs through the
eye. They also are placing fibrin sealants (a tiny clot of medication
or nanoparticles mixed with either synthetic or human collagen)
adjacent to the sclera, which will work like a patch to slowly release
the treatment. On a third tack, the researchers are developing microbeads
to regulate absorption. And finally they are studying the effect
of trans-scleral electrophoresis, or charged proteins, on fibrin
sealants that are placed on the sclera.
The researchers will use some of the
cancer-fighting medications that already have shown promise in preventing
the wet form of AMD, the single largest cause of blindness in people
over the age of 55. In a prior study, Emory retina specialist Baker
Hubbard found that monthly doses of Lucentis can maintain the vision
of 90% of newly diagnosed wet AMD patients and potentially improve
the vision of more than a third of patients. The FDA approved the
drug for AMD last July.
Hubbard’s colleague, Emory retina
specialist Daniel Martin, soon will begin a new clinical trial to
compare Lucentis with its newer and lower-cost cousin, Avastin.
“We want to determine whether the benefits of Lucentis, which
can cost $2,000 an injection, compare
favorably with those of Avastin, which can cost $19 an injection
but is not FDA approved yet for AMD patients,” Martin says.
Both of these agents, which treat colorectal and lung cancers and
are made by Genentech, protect central vision by inhibiting new
blood vessel formation and leakage in the retina’s central
focal point, the macula.
Martin is principal investigator of
another multi-center NEI trial for AMD, the Age-Related Eye Disease
Study 2 (AREDS2). The study tests a new combination of vitamins,
minerals, and fish oil to halt vision loss from the disease. AREDS2
further refines results from the first AREDS study released five
years ago that found oral doses of antioxidants, vitamins C and
E, and beta-carotene plus zinc and copper effectively reduce the
risk of patients with dry AMD, the more common precursor form, from
developing into wet AMD. According to Martin, “AREDS2 is a
more precisely targeted study to see if a new combination of nutrients
can reduce AMD progression even further. This study may help people
at high risk for advanced AMD maintain useful vision for a longer
time.” The new combination adds lutein and zeaxantin, plant-derived
yellow pigments that accumulate in the retina, and the omega-3 fatty
acids DHA and EPA from fish and vegetable oils to the original study
formulation. –Lee Jenkins
Cartoon
by Verle Mickish. See The Last Word
for related story.
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Virtually
no smoking permitted here
In
an office on the Emory Crawford Long campus, volunteers pull on
bulky headsets and enter the most mundane of virtual reality scenarios:
a gas station, a traffic jam, a party, a restaurant. The
smells of cigarettes and coffee begin filtering out of a small black
machine, and a virtual person asks: “Do you want a smoke?”
It’s all part of a new joint
Emory-University of Georgia (UGA) research study that tests virtual
reality as a way to teach behavioral coping skills. The study’s
directors hope that if smokers can learn to
turn away in virtual reality from environmental triggers, they may
have better odds at quitting for good.
At Grady Memorial Hospital, 30% of
the patient population smokes, according to Fernando Holguin, who
heads Grady’s asthma and allergy clinic and co-directs the
virtual reality research. “People who smoke have increased
risk for emergency room visits and increased medication requirements,
and they may be less likely to respond to standard treatments,”
he says. “If virtual reality does work, then the bottom line
is you are reducing the course of addiction by using a method that’s
really very accessible. And it’s virtually devoid of negative
side effects.”
For the study, a control group is
receiving a full course of nicotine patches, while a second group
is using patches and participating in
10 weeks of virtual reality treatment (complete with behavioral
debriefings and homework). After the initial 10-week period, the
researchers will track the patients for six months to see who relapses
and who doesn’t.
UGA’s Patrick Bordnick designed
the study after his previous research in addiction showed that virtual
reality is realistic enough to actually trigger cravings for cigarettes,
alcohol, and cannabis. Using the same technology to help people
respond to those cravings was natural step. “If we can create
scenarios that are believable enough,” Bordnick says, “then
we can teach people coping skills.”
Implications carry far beyond Holguin’s
asthma patients and Bordnick’s addiction research. If the
researchers find virtual reality does help, they’ll craft
a similar study to target alcohol abuse. They’re also exploring
how virtual reality could help educate patients. “We’ve
talked about using this technique to teach people how to use their
asthma medications better and to avoid asthma triggers,” Holguin
says. “The virtual reality could have a real role in teaching
people and promoting prevention.” –Dana
Goldman
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Supporting
staff
Research
administrators work under constant deadlines and changing regulations.
However, until recently they sometimes lacked deserving
recognition. That is changing at the Woodruff Health Sciences Center
(WHSC), where leaders have created a new professional track for
the staff with the skills to successfully traverse a complicated
landscape of grant management.
Research administrators work behind
the scenes to keep track of the daily details of research grants.
They help manage the grants’ financial minutia, assist with
proposal preparation, and stay mindful of ever-changing university
and national compliance policies and federal regulations that affect
the process. Last year, they helped manage the WHSC’s sizeable
$331,404,816 million in sponsored research projects, ranging from
a $1.3 million grant from private and federal agencies to search
for X chromosome genes related to autism to a five-year, $20 million
grant from the National Cancer Institute to create a joint Emory/Georgia
Tech nanotechnology center for early cancer detection and treatment.
“Most important, they allow
our top-notch researchers who attract grants to stay focused on
the science,” says Trish Haugaard, assistant dean of research
for Emory School of Medicine (SOM).
The new career track encourages these
grant staffers to become certified research administrators (CRA)
through the national Research Administrators Certification Council.
And the WHSC is providing incentive, splitting the cost of the intensive
CRA training and rigorous exam process as well as providing a $1,500
bonus for earning the certificate. To take the exam, research administrators
must have a bachelor’s degree, three to four years of related
experience, and support from their department chairs. They also
must be well versed in Emory’s policies and procedures. The
Emory Professional Research Administrative Council enables the administrators
to keep up to date, advance their careers, and network with each
other.
Sidnee Paschal, a financial analyst
in the SOM’s administration office, is one of 15 CRAs. “The
certificate is one way to validate your career formally,”
she says. “More than that, it opens your eyes to regulations
not directly related your job. It broadens your experience.”
–LJ |
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Your
brain on progesterone
Progesterone
is widely considered a sex steroid, well known as a treatment for
menstrual disorders. However, this substance is naturally
present in small but measurable amounts in the brains of both males
and females.
Emory scientist Donald Stein was the
first to discover that progesterone has protective effects on the
brain. His lab did much of the foundational work that has led researchers
to believe that progesterone is critical for the normal development
of neurons in the brain and may have protective effects on damaged
brain tissue.
When given progesterone shortly following a brain injury, male and
female rats developed less brain swelling and recovered more completely.
“The hormone seems to slow or block damaging chemicals that
are released after a brain injury,” says Stein, “protecting
the brain from the death of brain cells.”
An Emory team led by David Wright
and Arthur Kellermann in emergency medicine decided to see if the
lab findings would apply to people with a serious brain injury.
They recently concluded a study with 100 participants at Grady Memorial
Hospital that showed that progesterone may indeed reduce the risk
of death and degree of disability when given to trauma victims shortly
following brain injury. They also found the treatment was safe,
as reported in the October issue of Annals of Emergency Medicine.
According to Wright, researchers found
a 50% reduction in the rate of death in the progesterone-treated
group and a significant improvement in functional outcome and level
of disability among patients who were enrolled with a moderate brain
injury. Approximately 30% of patients given placebo died within
30 days of head injury, compared with only 13% of those given progesterone.
Most patients who died had a severe traumatic brain injury. Because
more severe TBI patients in the progesterone group survived, it
is not surprising that they had a higher average level of disability
at 30 days than survivors in the placebo group. |
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Milestones
In
August, Emory Hospitals said goodbye to two medical directors
who had each served Georgia’s citizens for nearly half a century.
In August, Robert B. Smith III retired from Emory University Hospital
and Harold Ramos from Emory Crawford Long Hospital. Smith, who also
had served as acting chair and associate chair of Emory’s
Department of Surgery, combined administrative roles with clinical
duties as a vascular surgeon throughout his career. An award-winning
teacher, he served as a member of the Leadership Council of The
Emory Clinic and won a distinguished service award from the Atlanta
VA Medical Center for his 19 years as chief of surgical service
there. Ramos, a professor of medicine at Emory School of Medicine,
developed a medical teaching program at Emory Crawford Long, helped
establish it coronary care unit, and served on the Woodruff Health
Sciences Center Board. Among other public service efforts, he will
be remembered for serving as co-chair with his wife, Barbara, of
the 2003 Atlanta Heart Ball that raised more than $1 million for
the American Heart Association.
Emory
University Hospital was awarded Primary Stroke Center Certification
from the Joint Commission on the Accreditation of Health Care Organizations.
The distinction recognizes a multi-specialty team’s efforts
at the hospital to rapidly diagnose and treat stroke patients and
to foster better outcomes in stroke care.
New
rankings from the National Institutes of Health (NIH) place
Emory School of Medicine (SOM) 19th among all U.S. medical schools
in total NIH awards support for the second year in a row. During
the past decade, the school has climbed 12 places in the NIH rankings.
The
National Institutes of Health has awarded Emory, Georgia
Tech, and the Medical College of Georgia a grant to partner on a
Nanomedicine Development Center that will focus on DNA damage repair.
With up to $10 million in funding, the center will be Emory’s
and Georgia Tech’s third NIH-funded nanomedicine/nanotechnology
center in less than two years. |
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