At the sleep research meeting in San Antonio this year, there were signs of an impending pharmaceutical arms race in the realm of narcolepsy.
The big fish in a small pond, Jazz Pharmaceuticals, was preparing to market its recently FDA-approved medication: Sunosi/solriamfetol. Startup Harmony Biosciences was close behind with pitolisant, already approved in Europe. On the horizon are experimental drugs designed to more precisely target the neuropeptide deficiency in people with classic narcolepsy type 1 Read more
Their analysis shows â€œcollege education as a discrete indicator of socioeconomic status was an independent predictor of survival.â€
A key thing to remember when looking at this data is that most of the people in the cath lab at a given moment are not actually having a heart attack — just 13 percent are. (Abstract/poster available upon request). However, thereâ€™s enough suspicion or history of heart disease for doctors to take a look inside; most of them have hypertension and coronary artery disease, and many have had a heart attack in the past. The group is mostly men, average age 63. Read more
Biochemist Paul Doetschâ€™s recent appearance in a Science magazine feature on laboratory leadership led to a conversation with him about the challenges of graduate school.
He emphasized that scientific research is a team sport, and brilliance on the part of the lab head may not yield fruit without a productive relationship with the people in the lab. Doetsch suggested talking with Lydia Morris, a graduate student in the Genetics and Molecular Biology graduate program. Morris has been working in Doetsch’s lab for several years and is about to complete her degree. She has been examining the in vivo distribution of DNA repair proteins.
In this video, Morris and Doetsch talk about the differences between turn-the-crank and blue-sky projects, and the importance of backup projects, communications, high expectations and perseverance.
Georgia Tech biomedical engineer Steve Potter explained his work harnessing the behavior of neurons grown on a grid of electrodes. The neurons, isolated from rats, produce bursts of electrical signals in various patterns, which can be â€œtunedâ€ by the inputs they receive.
â€œThe cells want to form circuits and wire themselves up,â€ he said.
As for future opportunities, he cited the technique of deep brain stimulation as well as clinical trials in progress, including one testing technology developed by the company Neuropace that monitors the brainâ€™s electrical activity for the purpose of suppressing epileptic seizures. Similar technology is being developed to help control prosthetic limbs and could also promote recovery from brain injury or stroke, he said. Eventually, electrical stimulation that is not modulated according to feedback from the brain will be seen as an overly blunt instrument, even â€œbarbaric,â€ he said.
Mike Kuhar, a neuroscientist at Yerkes National Primate Research Center, introduced the topic of cognitive enhancers or â€œsmart drugs.â€ He described one particular class of proposed cognitive enhancers, called ampakines, which appear to improve functioning on certain tasks without stimulating signals throughout the brain.Â Kuhar questioned whether â€œsmart drugsâ€ pose unique challenges, compared to other types of drugs. From a pharmacology perspective, he said there is less distinction between therapy and enhancement, compared to a perspective imposed by regulators or insurance companies. He described three basic concerns: safety (avoiding toxicity or unacceptable side effects), freedom (lack of coercion from governments or employers) and fairness.
â€œEvery drug has side effects,â€ he said. â€œThere has to be a balance between the benefits versus the risks, and regulation plays an important role in that.â€
He identified antidepressants and treatments for attention deficit-hyperactivity disorder or the symptoms of Alzheimerâ€™s disease as already raising similar issues. The FDA has designated mild cognitive impairment associated with aging as an open area for pharmaceutical development, he noted.
James Hughes, a sociologist from Trinity College and executive director of the Institute for Ethics and Emerging Technologies, welcomed new technologies that he said could not only treat disease, but also enhance human capabilities and address social challenges such as criminal rehabilitation. However, he did identify potential â€œUlysses problemsâ€, where users of new technologies would need to exercise control and judgment.
In contrast, historian and Judaic scholar Hava Tirosh-Samuelson, from Arizona State University, decried an â€œoverly mechanistic and not culturally-based understanding of what it means to be human.â€ She described transhumanism as a utopian extension of 19th century utilitarianism as expounded by thinkers such as Jeremy Bentham.
â€œIs the brain simply a computational machine?â€ she asked.
The use of military metaphors â€“ such as â€œthe war on cancerâ€ â€“ in the context of mental illness creates the false impression that everything is correctable or even perfectable, she said.
A new pilot simulation laboratory at Emory University Hospital Midtown (EUHM) is providing medical students, residents, nursing students and staff with hands-on training to develop, perfect and maintain their skills. Located in the former obstetrics/gynecology (OB/GYN) operating rooms, space that wasnâ€™t currently being utilized, the lab focuses on team building, clinical competencies and research. This is the first simulation lab of its kind at EUHM.
The simulation lab is a joint venture of Emory Healthcare and Emory University School of Medicine, both providing equipment to outfit the lab and a wealth of expertise. Nursing Education, a department within Emory Healthcare, and the Emory School of Medicine have worked together in the development of the simulation lab. Some equipment being used has been donated or given to the hospital for training purposes.
One side of the simulation lab is set-up to train OB/GYN residents and students in deliveries and laparoscopic surgeries, cardiac arrests, mock codes and low volume/high risk procedures.
The other side of the lab focuses on nursing training, nursing education, central-line and intravenous insertion and medication dispensing. It is also being used by nursing for competency validation for new nursing employees and for annual skills assessment of current nursing staff.
Those instrumental in setting up the nursing side of the simulation lab are Sharlene Toney, PhD, RN, executive director, Professional Nursing Practice for Emory Healthcare, and Beth Botheroyd, RN, BSN, MHA/INS, nursing education coordinator for Emory Healthcare.
Toney says the lab is a critical part of the training and education of new nurses and current nursing employees, while also focusing on process improvement activities concentrated on patient safety. Nurses also have the opportunity to test their skills on training simulators and new equipment while in the lab.
Ander describes the lab as a â€œproof of conceptâ€ center, with the small set-up being only the first step in the process. Down the road, he envisions a larger simulation center for all Emory Healthcare employees, Emoryâ€™s School of Medicine and even the community.
Arluck observes as resident Hudson performs an ultrasound on Noelle, the birthing simulator.
Arluck says she uses the simulation lab regularly with OB/GYN residents, teaching them the basics of laparoscopic surgery on a training module and monitor. She also teaches students with the help of an adult-size doll named Noelle, which simulates delivering a baby and going into cardiac arrest.
The simulation lab has also opened the door to medical education research. Emory pulmonary critical care fellow, Jenny Han, MD, is studying to see if a standardized, advanced cardiac life support simulation training has any effect on real patient outcomes in the hospital.
In the future, plans include adding cardiac catheterization simulator capabilities, as well as emergency department and nursing station simulation space.
The Monarch School Program is dedicated to providing information and resources to families and school systems throughout Georgia for the education of K-12 students with autism / autistic spectrum disorder.
Educators have known for a long time that children with Autism Spectrum Disorder (ASD) can learn a lot by being in a classroom with typical children. Inclusion (educating students within the general education classroom) gives children with special needs the opportunity to learn in a natural environment and the opportunity to learn social skills from interacting with their classmates. In addition, Inclusion can eventually lead to greater acceptance of these children in the community.
Unfortunately, teachers are not always trained how to help children with special needs function in a typical classroom, nor in ways to ensure successful imitation of the positive role models.
â€œTeachers do not necessarily have the specific training required to teach these children yet, too often, the children with ASD are placed in the classroom with the expectation that the teacher, or the student, will learn to adapt,â€ says Sheila Wagner, M.Ed., assistant director of the Emory Autism Center. â€œWithout the training, many times the student faces failure, when success was the goal.â€
In order to provide some guidance to the school system, the Emory Autism Center received a grant from the Childhood Autism Foundation (CADEF) in 1994 to develop a program that would address Inclusive Education for students with ASD.Â With the help of CADEF, the Monarch Program was created. The program implemented a nationally recognized Inclusion Project that has reached hundreds of students with ASD, thousands of teachers through on-site technical assistance and training, and assisted thousands of typical students in learning about the autism spectrum and children with different behaviors and abilities.
â€œThe Monarch Program has grown to provide school systems with a network of support from curriculum training, to teacher and home/school collaboration, to consultations and social skills curriculum,â€ says Wagner, who serves as the Program Manager of the Monarch School-Age Program at Emory.
â€œBecause of the Monarch Inclusion Project, students with ASD are increasingly able to enjoy exposure to typical students, and teachers are offered some guidance in providing a positive classroom experience.â€
Wagner began her experience in the field of autism more than 30 years ago and has published three books on inclusive programming for students with ASD, as well as a brochure on Aspergerâ€™s syndrome, and a chapter in Grandin & Attwoodâ€™s book Aspergers and Girls.
The guest speaker, and first to be recognized with this award, is Michael Gazzaniga, PhD, a scientist and author considered one of the pioneers in the emerging field of cognitive neuroscience.
â€œDr. Gazzaniga is a world renowned scientists who, in addition to his other accomplishments, pioneered the study of split-brained patients and so revealed how the different hemispheres of our brains function,â€ says Paul Root Wolpe, PhD, director of the Emory University Center for Ethics.
â€œHe has won our First Annual Emory Neuroscience and Ethics Award because, throughout his career, he has tried to apply his scientific understandings to improve the human condition, including serving on President Bushâ€™s Bioethics Commission and publications such as his book The Ethical Brain.Â I can think of no finer choice to be the first recipient of this Award.â€
Gazzaniga founded and presides over the Cognitive Neuroscience Institute and is editor-in-chief emeritus of the Journal of Cognitive Neuroscience, which he also founded.Â In addition, he is the one of the co-founders of the Cognitive Neuroscience Society, which was named in the late 1970â€™s.
In 1997, Gazzaniga was elected to the American Academy of Arts & Sciences.Â He is the past-president of the Association for Psychological Science, served on the Presidentâ€™s Council on Bioethics and, in 2005, was elected to the National Academies Institute of Medicine. In 2009, he presented the Gifford Lectures at the University of Edinburgh.
Gazzanigaâ€™s book The Ethical Brain describes in laymenâ€™s language how the brain develops a value system, and the ethical dilemmas facing society as our comprehension of the brain expands.
The scientific part of the AIDS Vaccine 2010 meeting began Tuesday evening with an exciting summary of issues facing the field from NIAID director Tony Fauci. But before that, participants in this yearâ€™s conference got a chance to warm up with several â€œsatellite sessions.â€
One of them, â€œEffective Community Engagement in HIV Vaccine Research Among Communities and Researchers,â€ was organized by Paula Frew, PhD, director of health communications and applied community research at Emoryâ€™s Hope Clinic.
Two prominent themes emerged from this session. The first was that community members should be involved in clinical trials at every step of the process: from design and recruitment to dissemination of results.
â€œIn the past, scientists often came to the community late in the process, after a protocol for a study was already approved, and said: â€œWill you support what weâ€™ve already decided?â€ said Steve Wakefield of HIV Vaccine Trials Network. â€œThis doesnâ€™t work.â€
The Joint United Nations Programme on HIV/AIDS and AVAC presented proposed guidelines for â€œgood participatory practice,â€ analogous to good clinical practices.
Nursing senior Ivey Milton (left) checks on a patientâ€™s medication, guided by Jackie Kandaya, her medical-surgical instructor at Emory University Hospital Midtown
A first at Emory and in Georgia, the DEU is based on the model implemented by the University of Portland School of Nursing and its clinical partners in the early 2000s.
Kelly Brewer, who holds a joint appointment with the School of Nursing and Emory Healthcare as DEU coordinator, says, â€œOur DEU initiative relies on these concepts and the skills of nurses and faculty to help students transition into the real world of nursing. Itâ€™s a win-win situation for both sets of professionals since faculty and clinical nurses are in short supply because of the nursing shortage.
â€œBoth of our hospitals are committed to making students feel that they are part of the unit so theyâ€™ll want to work there after they graduate,â€ she adds. â€œThey will already have a sense of what Emoryâ€™s health care system is about, and their transition into the real world of health care will be less stressful.â€
Diabetes is running rampant among the U.S. and one of the groups most affected is Latinos. Factors such as lack of English skills and cultural rules keep many Cheap Oakleys Latinos from recognizing diabetes as a problem and seeking treatment.
Dr. Guillermo E. Umpierrez of Emory University is working to change that. Not only does he work daily at the Diabetes and Endocrinology Department at Atlanta’s Grady Memorial Hospital, but he recently spearheaded production an educational video aimed at the Latino population. Titled “Viva mas y majorâ€¦ con su diabetes bajo control” (“Live longer and better… with your diabetes under control,” the video is aimed at empowering patients to live their healthiest by controlling their diabetes. The vidoe was video produced by the Emory Latino Diabetes Education Program (ELDEP).
The 30-minute video is available online in five parts. Part one is below. The other segments are viewable on the Woodruff Health Sciences web site and on YouTube.