Exosomes as potential biomarkers of radiation exposure

Exosomes = potential biomarkers of radiation in the Read more

Before the cardiologist goes nuclear w/ stress #AHA17

Measuring troponin in CAD patients before embarking on stress testing may provide Read more

Virus hunting season open

Previously unknown viruses, identified by Winship + UCSF scientists, come from a patient with a melanoma that had metastasized to the Read more

nursing

Microbiome enthusiasm at Emory

At what point did the human microbiome become such a hot topic?

When it was shown that babies born by Cesarean section are colonized with different bacteria than those born vaginally? With the cardiovascular studies of microbial byproducts of meat digestion? With the advent of fecal transplant as a proposed treatment for Clostricium difficile infection?

The bacteria and other microbes that live within the human body are thought to influence not only digestive health, but metabolic and autoimmune diseases as well, possibly even psychiatric and neurodevelopmental disorders. The field is being propelled by next-generation sequencing technology, and Nature had to publish an editorial guarding against hype (a major theme: correlation is not causation).

At Emory, investigators from several departments are involved in microbiome-related work, and the number is expanding, and assembling a comprehensive list is becoming more difficult. Researchers interested in the topic are planning Emory’s first microbiome symposium in November, organized by Jennifer Mulle (read her intriguing review on autism spectrum disorders and the microbiome).

Microbial genomics expert Tim Read, infectious diseases specialist Colleen Kraft and intestinal pathologist Andrew Neish have formed an Emory microbiome interest group with a listserv and seminars.

Microbiome symposium sponsors: ACTSI, Hercules Exposome Center, Emory University School of Medicine, Omega Biotek, CFDE, Ubiome. Read more

Posted on by Quinn Eastman in Immunology, Neuro Leave a comment

Healthcare Heroes at Emory

Healthcare Heroes award winners Dean Thomas Lawley and Dr. Ursula Kelly

This week’s issue of the Atlanta Business Chronicle spotlights the winners of its annual Healthcare Heroes Awards, recognizing the contributions of top medical professionals in the Atlanta health care community. Emory was well represented again this year among the impressive list of winners and finalists. Winners included:

 

Finalists included:

 

  • Linda Cendales, MD, assistant professor of Surgery at Emory University School of Medicine, nominated in the Healthcare Innovations category for successfully performing the state’s – and one of the nation’s – first hand transplants on a college student from Orlando, Fla. (see Emory article)
  • Katherine L. Heilpern, MD, professor and chair of the department of emergency medicine, nominated in the Physician category for her contributions to emergency and trauma care and for her leadership among 5 hospitals in Metro Atlanta which receive 250,000 patient visits per year.
  • Curtis Lewis, MD, assistant professor of radiology, Emory University School of Medicine, nominated in the Physician category for his management and training of physicians and residents in his role as chief of staff and senior vice president of medical affairs at Grady.

 

 

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The science of caring

Handprints

“It is the oncology nurse whose ‘fingerprints’ are on the entire matrix of therapies,” said Seliza Mithchell.

A keynote presentation on “fingerprints” might be more suited to a police convention than an oncology nursing symposium.  That is unless Selinza Mitchell is the speaker. Mitchell, a nurse educator and presenter was the keynote speaker at the third annual Winship Oncology Nursing Symposium, held March 18 and 19 at the Evergreen Conference Center in Stone Mountain, Georgia.

Mitchell’s presentation focused on the impact oncology nurses have on the hundreds of patients and families they touch, both literally and figuratively.  It is the oncology nurse whose “fingerprints” are on the entire matrix of therapies, from administration of today’s latest targeted-therapy drugs to helping patients and families navigate an increasingly complex health care system.

That concept also formed the basis of many of the discussion groups that were part of the symposium.  “The entire model of care delivery is changing,” says Amelia Langston, MD, professor of Hematology and Medical Oncology at the Winship Cancer Institute.  “Care delivery is more of a team approach and is less physician-centered.  Therefore there is great interest in the expanding role of nurses, nurse practitioners, and physician assistants.”

Amelia Langston presenting at the Winship Oncology Nursing Symposium

Amelia Langston presenting at the Winship Oncology Nursing Symposium

The Winship Oncology Nursing Symposium has grown in three short years into one of the most informative and influential among this growing market of nursing continuing education opportunities.  Among the topics covered in this year’s meeting were cancer genetics, image-guided medicine, minimally invasive treatment, disease-specific topics and the expanding role of non-physician providers against the backdrop of health care reform.

“The health care system is demanding cost effective, clinically relevant continuing education programs in nursing and specifically in oncology nursing,” says Joan Giblin, MSN, FNP, a course director for the symposium and Manager of Patient Access at Winship.  “Offering a high quality, regional program that can provide the latest information on advanced nursing practice, research, and other issues is central to meeting that need.”

In addition to Joan Giblin, course directors for the event were Deena Gilland, RN, MSN, Director of Nursing at Winship, and Kevin Schreffler, RN, MSN, Clinical Nurse Specialist at Winship.

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Transplant nursing pioneer revisits Emory Transplant Center, 45 years later

Millie Elliott

Nearly 45 years after she cared for Georgia’s first organ transplant recipient, Millie Elliott, 84, visited the Emory Transplant Center outpatient transplant clinic to see how things have changed since her time at Emory. Elliott, who was Millie Burns at the time, worked at Emory University Hospital first as an obstetrics nurse, then as head nurse of an NIH-sponsored clinical research unit at Emory from 1961 to 1967. She served as a dialysis nurse on that unit and may have been the Southeast’s first renal transplant coordinator.

During her recent visit to Emory, this former Cadet Nurse Corps nurse and World War II veteran regaled the transplant center staff and kidney transplant program director Thomas Pearson, MD, PhD, with her stories about the first transplant at Emory. Elliott recalled spending a lot of time researching medical sources to prepare herself and her nurses for that remarkable day. The first transplant patient was a 16-year -old boy with renal failure who received a donor kidney from his father.

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Nursing students provide health services to migrant farmers in south Georgia

Emory University Nell Hodgson Woodruff School of Nursing faculty and students traveled to Moultrie, Ga., June 13-25 to provide valuable health care services to migrant farm workers and their families. Nursing faculty and students make the trip annually to the rural, agricultural community three hours south of Atlanta as part of the Farm Worker Family Health Program.

There are more than 100,000 migrant and seasonal farm workers in Georgia. Migrant farm workers face more complex health issues than the general population because of the physical demands of their jobs, pesticide exposure, poor access to health care services, and substandard housing conditions.

“Our clinics may be the only health care they get during the year,” says Judith Wold, a visiting professor in Emory’s School of Nursing and director of the Farm Worker Family Health Program. “The farm workers are very hardworking people and they are so appreciative of the health care we give them.”

By day, the students worked at Cox Elementary School with farm worker children. Each evening, they set up mobile clinics to treat adult farm workers. The students worked alongside other Georgia allied health students in physical therapy, psychology, pharmacy and dental hygiene.

Wold, who has participated in the project since its launch in 1994, estimates that the program has treated more than 14,000 farm workers over the course of its 16-year history.

Read more about the students’ Moultrie experiences on the Emory Nursing blog.

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Gulf residents and workers face heat exhaustion, mental stress

Residents and relief workers along the oil-ravaged Gulf of Mexico could experience a host of short- and long-term health problems, including respiratory ailments, neurological symptoms, heat exhaustion and mental stress.

Emory University environmental health expert Linda McCauley, RN, PhD, is one of more than a dozen national scientists participating in a two-day Institute of Medicine (IOM) workshop in New Orleans exploring some of the potential health risks that people in the Gulf could face.

Short term, McCauley says, there could be reports of respiratory problems from people who’ve inhaled gas fumes as well as neurological issues such as dizziness, headaches, nausea and vomiting. In addition, exposure to oil may cause eye and skin irritation.

Heat stress is also a major concern for workers in the Gulf, says McCauley, dean of Emory’s Nell Hodgson Woodruff School of Nursing.

“On some of the days it’s been so hot they’ve only allowed workers to work 12 minutes out of the hour,” she says. “A lot of new workers are being brought in [to clean up the oil]. These are workers who don’t do this for a living and may never have been exposed to this type of heat before and that’s a serious issue.”

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Studying the doctor and nursing shortage

An increase in the number of the nation’s elderly and the aging population of doctors is causing a doctor shortage in the United States, with estimates that the demand for doctors will outstrip supply by 2020, according to the Association of American Medical Colleges.

The Association of Colleges of Nursing notes a similar dilemma for the nation’s registered nurses. Read Knowledge@Emory for the full article. 

Fred Sanfilippo, MD, PhD

Fred Sanfilippo, MD, PhD, executive vice president for health affairs at Emory, CEO of Emory’s Woodruff Health Sciences Center and chairman of Emory Healthcare, says, “There is an ever-changing cycle of shortages. Advances in technology and treatment can reduce or increase demand for specialists needed in one area or another much more quickly than it takes to train or absorb them.”

For instance, the demand for cardiac surgeons has slowed dramatically as a result of better medications and stents. Changes in insurance and Medicare/Medicaid reimbursement can also impact specialties, he says.

“Since medical school graduates now carry so much debt, the specialty they choose is often influenced by potential income, which is most evident in the low numbers going into primary care.”

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Nursing students give health care in the Dominican Republic

Recently, a group of Nell Hodgson Woodruff School of Nursing students traveled to the Dominican Republic for Alternative Spring Break.

Students team up to provide care in the Dominican Republic

Armed with food, medicine and clothing, the Emory students partnered with Dominican nursing and medical students to serve Haitians now living there after being displaced by the devastating Jan. 12 earthquake in Haiti.

Hunter Keys and Abby Weil were among the team of nursing students that journeyed to Santo Domingo, D.R. to provide health screenings and educational outreach. They also accompanied Dominican nursing students on home visits and elementary school visits.

Hunter and Abby blogged about their transformative experience.  On the second day of their travels, they wrote:

“…there is a huge need for ongoing care, including wound care, physical therapy, and mental health treatment. Dealing with these health issues on top of the terrible tragedy of losing loved ones, homes, and jobs is almost unimaginable. The process of healing will be long and difficult, both mentally and physically. One of the take home messages of the team was that while the great amount of aid pouring into Haiti directly after the earthquake is so useful and greatly needed, there will need to be a sustained effort to provide the services needed to facilitate this healing process.”

Learn more about Hunter and Abby’s travels and see photos from the field.

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New education model for real-world health care

 

Emory’s Nell Hodgson Woodruff School of Nursing has started a new educational concept called the Dedicated Education Unit (DEU).

Launched by the School of Nursing and Emory Healthcare last fall, the DEU pairs a nursing student with a staff nurse for one-on-one clinical instruction in the medical-surgical unit at Emory University Hospital or Emory University Hospital Midtown.

Nursing senior Ivey Milton (left) checks on a patient’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, “Our DEU initiative relies on these concepts and the skills of nurses and faculty to help students transition into the real world of nursing. It’s a win-win situation for both sets of professionals since faculty and clinical nurses are in short supply because of the nursing shortage.

“Both of our hospitals are committed to making students feel that they are part of the unit so they’ll want to work there after they graduate,” she adds. “They will already have a sense of what Emory’s health care system is about, and their transition into the real world of health care will be less stressful.”

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Reducing stress in cancer patients and caregivers

Emory’s Susan Bauer-Wu, PhD, RN, is recognized both nationally and internationally for her understanding of the mind-body connection and enhancing the quality of life for individuals affected by cancer. Her research programs aim to make a difference in the care that cancer patients receive and in the health of family caregivers. She is a national leader in palliative care and integrative medicine and health.

Susan Bauer-Wu, PhD, RN

Susan Bauer-Wu, PhD, RN

Bauer-Wu, nurse scientist and Georgia Cancer Coalition Distinguished Cancer Scholar, joined Emory’s Nell Hodgson Woodruff School of Nursing and Emory Winship Cancer Institute faculties in 2007.

Bauer-Wu studies whether psycho-behavioral interventions have a positive effect on psychological and physical health. She is currently conducting a large randomized clinical trial that looks at whether meditation affects subjective symptoms as well as lab findings such as stress hormones or how long a patient’s white blood cells take to recover after a bone marrow transplant.

This National Institutes of Health (NIH)-funded study has enrolled 241 patients at Emory and the Dana-Farber Cancer Institute, where Bauer-Wu previously served as director of the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services. The study will finish in 2010. Bauer-Wu is also involved in research with neuro-imaging to see what parts of the brain respond to such interventions.

Bauer-Wu says mindfulness meditation provides skills for the cancer patient to better cope with stressful circumstances, and in turn, the stress response can be minimized, and a sense of well-being ensues, and the cancer patient feels more relaxed, in control and physically comfortable. Bauer-Wu’s interest in cancer patients began early in her career when she worked as an oncology nurse.

In addition, she recently received a $3.5 million NIH grant for a study aimed at reducing heart disease risk and improving health and wellbeing among family caregivers of dementia and heart failure patients.

Recently, the American Academy of Nursing inducted Bauer-Wu into its new Fellowship class of 98 top national nursing. Fellows are elected through a highly selective process that recognizes individuals who have made major contributions to nursing and health care and whose work has influenced health policies benefiting all Americans.

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