1. The Glutamate Receptor o2 Subunit in Cerebellar LTD
Satoshi Yawata, Hiroshi Tsuchida, Mineko Kengaku, and Tomoo Hirano

The glutamate receptor subunit o2 has been an enigma. It does not fit with the functional grouping of glutamate receptors, but it is selectively expressed in cerebellar Purkinje cells (PNs) and is required for induction of long-term depression (LTD) at parallel fiber-Purkinje cell synapses. This week, Yawata et al. identified a proximal cytoplasmic domain in o2 that is necessary for LTD and for interaction with PICK1 (protein interacting with C kinase 1). The authors transfected GluRo2-deficient PNs with various deletion mutants. The PDZ (postsynaptic density 95/Discs large/zona occludens-1)-binding region was not required for localization to dendritic spines or for LTD. A mutant truncated after the first 21 amino acids of the C terminus rescued LTD, whereas one containing only 13 amino acids of the C terminus did not. Expression of a peptide containing amino acids C14-20 acted as a dominant negative, blocking LTD perhaps by interfering with a o2-PICK1 interaction.

2. Growing Axons Find NG2 Cells Attractive
Zhongshu Yang, Ryusuke Suzuki, Stephen B. Daniels, Christopher B. Brunquell, Christopher J. Sala, and Akiko Nishiyama

This week, Yang et al. examined the effect on neurite outgrowth of glial cells that express the chondroitin sulfate proteoglycan NG2. The authors refer to these cells as NG2 cells, but as they differentiate into oligodendrocytes, they are more commonly called oligodendrocyte precursor cells. NG2 can inhibit neurite outgrowth, but the authors found that neurites of hippocampal neurons in short-term cultures preferred to make contact with NG2 cells rather than with a polylysine-coated surface or mature oligodendrocytes. In vivo, axonal growth cones made extensive contact with NG2 cells in the corpus callosum. Neurons extended processes on astrocytes or NG2 cells that were twice as long as those on fibroblasts or a polylysine surface. NG2 cells overexpressing NG2 did not inhibit neurite outgrowth; neither did NG2 cells with reduced NG2 expression. Thus, an attractant or adhesive role of NG2 cells appears not to depend on expression levels of NG2.

3. Explicit and Implicit Processes in Motor Learning
Pietro Mazzoni and John W. Krakauer

In this week’s Journal, Mazzoni and Krakauer set up a conflict between implicit and explicit processes in visuomotor adaptation. Subjects rotated their hand to control a computer cursor that they tried to place within a target: one of eight radially arrayed circles. In a “rotation” condition, the cursor was rotated 45° counterclockwise, offsetting subject movements. In a “rotation plus strategy” condition, subjects were informed of the offset and given a strategy to cheat the system by aiming for the circle clockwise of the actual target. This cognitive strategy initially succeeded in canceling errors but ultimately failed as subjects implicitly adapted to the rotation at the expense of making correct responses. Interestingly, the rate of adaptation was the same with or without an explicit strategy. Thus, the motor system, with a mind of its own, overrides explicit strategies involving subject awareness. Sometimes it’s better not to think too much, it seems.

4. Imbalanced Neural Activity in Parkinsonian Rats
Nicolas Mallet, Berangere Ballion, Catherine Le Moine, and Francois Gonon

The loss of dopaminergic inputs to the striatum in Parkinson’s disease (PD) inevitably alters the balance of neural activity in striatal projections to substantia nigra pars reticulata (direct output) and the pallidum (indirect output). This has been attributed directly to a loss of dopamine receptor stimulation (e.g., striatonigral neurons express D1 receptors, whereas striatopallidal neurons express D2 receptors). This week, Mallet et al. suggest that other network factors may also play a role. The authors examined activity of medium size spiny neurons, GABAergic projection neurons that comprise the bulk of striatal neurons. The authors made unilateral injections of 6-hydroxydopamine, rendering rats hemiparkinsonian; then, they made extracellular recordings in anesthetized animals. Striatonigral neurons were inhibited by the loss of dopaminergic input, but striatopallidal neurons were activated. This imbalance stemmed partly from decreased activity of cortical neurons that project specifically to striatonigral neurons. Feedforward inhibition from fast spiking inhibitory interneurons remained intact, thus exacerbating the activity imbalance.

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Contact: Sara Harris
sharrissfn
Society for Neuroscience Continue reading →

Clinical testing of a new, innovative method to treat Alzheimer’s disease began in March 2008 at Karolinska University Hospital, Stockholm. (See press release from April 7, 2008: karolinska.se/Pressmeddelanden). Six patients have now received brain implants of small capsules containing protein-producing cells.

Cells in the implanted capsules produce a protein called NGF (Nerve Growth Factor). NGF can stimulate the survival and growth of cholinergic nerve cells. These cells, essential for memory, time perception, problem solving, and other functions, break down in Alzheimer’s disease. The new treatment method aims to prevent these cells from breaking down, thereby inhibiting disease progression.

“Although implantation of encapsulated cells is a new method for treating Alzheimer’s disease, our extensive experience in stereotactic surgery at Karolinska University Hospital enables us to perform the procedure in a safe and controlled manner,” says Professor Bengt Linderoth at the Department of Neurosurgery.

Three patients received NGF-producing cell capsules (developed by NsGene A/S Denmark) in March, and three additional patients received the implants in September 2008. The procedures were completed without complications, and the patients are well. “Using this unique method we can deliver drugs directly to the brain in a controlled way and over a longer period,” says Maria Eriksdotter J?¶nhagen, Associate Professor, Department of Geriatrics, and Principal Investigator for the study. Outcomes are being rigorously assessed through examinations such as memory testing and radiography.

Karolinska Institutet Continue reading →

The National Hospice and Palliative Care Organization along with several national leadership organizations issued a consensus statement regarding the principles of hospice care and protection of the Medicare Hospice Benefit. The organizations standing together in sharing this unified message about end-of-life care are the American Association of Hospice and Palliative Medicine, Hospice and Palliative Nurses Association, National Association for Home Care & Hospice, National Hospice and Palliative Care Organization, National Hospice Work Group, and Visiting Nurses Association of America.

Since the inception of the Medicare Hospice Benefit in 1982, hospice has grown into a $10 billion industry that last year alone served more than 1.4 million dying Americans and their family caregivers. The Medicare Hospice Benefit is responsible for millions of people living as fully as possible up until the end of life and the hospice community is dedicated not only to preserving the benefit but enhancing it so it appropriately serves the unique and changing needs of dying Americans. Hospice and palliative care providers, through the support that comes from Medicare, are recognized as the leading providers of the interdisciplinary, holistic care considered to be the gold standard of end-of-life care.

MedPAC, the congressional advisory committee, has been looking at growth in hospice in recent years which has increased in number of providers and people served. Recommendations from MedPAC involving hospice reimbursement are expected to be released shortly. This consensus statement affirms key issues on which these leadership organizations agree.

Consensus Statement on Hospice Reform

There is broad agreement that the Medicare hospice benefit has been a resounding success. Since its addition to the Medicare system in 1982, tens of millions of patients and families have availed themselves of its unique, interdisciplinary and cost effective approach to end of life care. Moreover, patient and family satisfaction with this high quality health care delivery system is extremely high. Quoting from a recent independent economic study from Duke University, clearly demonstrating the cost effectiveness of the Medicare hospice benefit, “…the Medicare program appears to have the rare situation whereby something that improves quality of life also appears to reduce costs.”

Each year, a growing number of patients and families are accessing hospice care when they or their loved ones are facing the end of life. Health care professionals, as well as the public, are increasingly recognizing the value of this health care delivery system. Based upon demonstrated patient and family satisfaction with the care, the cost savings involved and the inherent compassionate philosophy of care that serves as a foundation for hospice, this growth has been encouraged by consumers and policymakers alike. Indeed, sound policy should foster growth in the Medicare hospice benefit.

Since 1982, patient demographics, treatment protocols, and public attitudes about healthcare have changed and the Medicare hospice benefit needs to keep pace with these dynamics in order to serve an ever larger, and more diverse, portion of our dying population and their families.

Payment policy is one of the areas that needs to stay current so that payment appropriately recognizes changes in patient demographics and treatment protocols. Updates should be carefully considered and evidence based to ensure that behavioral consequences are understood prior to implementation. The present payment methodology has served the hospice community and the public well since its inception, virtually without change. Analysis of both current and historical patient level data is necessary to fully understand and predict future behavior and needs, and make changes that continue to provide benefits to patients and to the Medicare system.

As with any payment system, dramatic changes to the hospice benefit from established patterns of reimbursement are sure to produce displacements and unintended negative consequences. Given the nature of hospice referrals and the unique characteristics of the end of life patient demographics, unintended consequences of such changes are inherently difficult to predict. Any number of issues might warrant attention, but effectively quantifying such items in terms of behavior changes of patients and providers would be difficult. Payment reforms should be incremental, based on adequate data analysis, and need to be undertaken carefully, with effects on the patient and family in mind.

Over the past several years, MedPAC has undertaken a review of the Medicare hospice benefit. While specific reforms and enhanced accountability measures are laudable and should be encouraged, those changes should be framed in the context of a comprehensive review of the various and complex components of end of life care and how the continuum of care can be expanded to increase access for patients and families. Included in this comprehensive review of hospice should be payment methodologies, fiscal constraints review, alternative eligibility criteria, and testing of new models of care, as well as any number of other issues. The hospice community is committed to work toward these goals.

Guiding this review ought to be several clear principles. Among them are:

– Advancing hospice and palliative care providers as the recognized providers of end of life care.

– Preserving and enhancing the Medicare Hospice Benefit.

– Recognizing high quality as the standard to which all providers must subscribe.

– Ensuring accountability through transparency and fair regulatory scrutiny.

– Promoting increased access through expansion and collaboration.

Responses to draft MedPAC Recommendations, dated 11/6/08:

Recommendation 1: The Congress should change the current Medicare payment system for hospice to reduce payments per day as the length of the episode increases. The revised payment system should include a payment adjustment to reflect hospices’ higher costs associated with patient death at the end of the episode.

A payment system that more closely matches or “tracks” actual cost curves of patient care, such as a “first and last periods of care” system, done on a budget neutral basis, has merit. There are key issues in developing such a design that need to be substantiated and tested against comprehensive and broad-based data. Only after such data is collected, analyzed, and understood, can it serve as the basis for rational and appropriate payment reform.

Recommendation 2a: The Congress should direct the Secretary to:

– Require that a hospice physician or advanced practice nurse personally visit the patient to determine continued eligibility at 180 days and at each subsequent recertification and attest that such visits took place;

– Require that certifications and re-certifications include a brief narrative describing the clinical basis for the patient’s prognosis; and

– Require that all stays in excess of 180 days be reviewed by the applicable medical director of the Medicare claims processing contractor for hospices with an average length of stay greater than 120 days.

Certain additional safeguards might be put into place given changing patient demographics and, in some isolated instances, very long lengths of stay for patient. Included in this area is the need for a hospice physician or advanced practice nurse to personally visit the patient to determine continued eligibility after receiving hospice care for 180 days and, at each subsequent recertification and to attest that such visits took place. In addition, re-certifications should include a brief narrative describing the clinical basis for the patient’s terminal prognosis. With regard to hospices with very long lengths of stay, fiscal intermediaries already have existing responsibility to monitor patients’ continuing eligibility. Special consideration should be given to the unique issues facing rural and small hospice providers in assessing the impact and implementation of such measures.

Recommendation 2b: The Secretary should direct the OIG to investigate the prevalence of financial relationships between hospices and nursing facilities that may represent a conflict of interest and influence admissions to hospice, differences in patterns of nursing home referrals to hospice, and the appropriateness of hospice marketing materials. The Secretary should make this information available through data use agreements.

With increased utilization of hospice care and growth in the number of providers, it is prudent to encourage appropriate local, state and federal government entities to review financial and contractual relationships between hospice and other health care facilities that may give the appearance of a conflict of interest and potentially influence referrals to hospice. If any instances of fraud and abuse are discovered, they should be immediately reported to the appropriate authorities. In addition, appropriate resources should be directed to undertake more timely and regular surveys of hospice programs, at least as frequently as every three years. Such surveys should be undertaken by highly trained and competent governmental professionals using the recently revised conditions of participation in mind.

Recommendatio 3: As a condition of payment, the Secretary should require that hospices report information on all visits provided to the hospice patient on hospice claims, including length of visit.

In order to facilitate better and more complete data collection, hospices should report comprehensive information on patient visits (including telephonic contacts) on hospice claim forms, including length of visits or interactions. This enhanced and comprehensive data collection should be collected and compiled with a clear and stated purpose in mind.

Recommendation #4: The Secretary should change cost reports to reflect new data on hospice claims, add new data fields to capture the full range of hospice revenues in order to provide a more accurate picture of hospices’ financial performance, and increase the accuracy of cost report data through audits or other processes so that these data can be used in setting, adjusting, or rebasing payments, as warranted.

Hospice cost reports should be changed, to better reflect new data on hospice claims, adding new data fields to capture the full range of hospice revenues in order to provide a more accurate picture of hospices’ financial performance. These changes would increase the accuracy of cost report data through audits or other processes so that these data can be used more reliably in analyzing hospice payment issues. Such an effort should be undertaken with hospice community input and cooperation.

The shared mission of all hospice providers, to bring compassionate, high-quality care to appropriately eligible patients and families coping with life-limiting illness continues to resonate strongly at the heart of the hospice community. As we as a nation move forward, facing the growing health care needs and demands of our diverse population, hospice is committed to serving the most vulnerable of our population, the dying.

National Hospice and Palliative Care Organization
nhpco Continue reading →

A team of scientists from The Scripps Research Institute have successfully reengineered an important antibiotic to kill the deadliest antibiotic-resistant bacteria. The compound could one day be used clinically to treat patients with life-threatening and highly resistant bacterial infections.

The results were published in an advanced online issue of the Journal of the American Chemical Society.

“[These results] have true clinical significance and chart a path forward for the development of next generation antibiotics for the treatment of the most serious resistant bacterial infections,” said Dale L. Boger, who is Richard and Alice Cramer Professor of Chemistry at The Scripps Research Institute and senior author of the new study. “The result could not be predicted. It really required the preparation of the molecule and the establishment of its properties.”

The compound synthesized is an analogue of the well-known commercial antibiotic vancomycin.

The new analogue was prepared in an elegant total synthesis, a momentous achievement from a synthetic chemistry point of view. “In addition to the elegantly designed synthesis,” said Jian Xie, postdoctoral fellow in Boger’s group and first author on the publication, “I am exceedingly gratified that our results could have the potential to be a great service to mankind.”

A Single Atom Changes Everything

Vancomycin is an antibiotic of last resort, which is used only after treatment with other antibiotics has failed. Clinically, it is used to treat patients that are either infected with the virulent methicillin-resistant Staphylococcus aureus (MRSA), individuals on dialysis, or those allergic to beta-lactam antibiotics (penicillin, cephalosporins).

The drug was first used clinically in the 1950s, and the first vancomycin-resistant bacterial strains were isolated in the 1980s.

Vancomycin normally works by grabbing hold of and sequestering the bacterial cell-wall making machinery, a peptidoglycan (carbohydrate and peptide containing molecule). Only Gram-positive bacteria have a cell wall, which is a membrane on the cell’s outer surface.

The antibiotic binds so tightly to the peptidoglycan that the bacteria can no longer use the machinery to make their cell wall and thus die.

Unfortunately, bacteria have found a way to alter the peptidoglycan in such a way that the antibiotic can no longer grab hold. Think of it as trying to hold a ball without any fingers. Biochemically the bacteria express a mutant form of the peptidoglycan in which properties of a key atom used in the recognition process are changed. This simply means where there once was something attractive there is now something repulsive. Chemically, the bacteria replace an amide (carbonyl, RC=O linked to an amine) with an ester (a carbonyl, RC=O linked to an oxygen, O).

This one atom change changes the entire game and renders vancomycin ineffective. Until now.

Reengineering Vancomycin

Like magnets, molecular interactions can be attractive (oppositely charged) or repulsive (identically charged). What chemists in the Boger lab have done is made this key interaction no longer repulsive, but attractive.

So now the new vancomycin analogue can grab hold of the mutant peptidoglycan, and again prevent the bacteria from making the cell wall and killing the resistant bacteria. But what is so remarkable about the design is that the redesigned antibiotic maintains its ability to bind the wild type peptidoglycan as well.

Changing the properties of a key amide at the core of the natural products structure required a new synthetic strategy that only the most talented chemists could achieve in the lab. The preparation of the entire structure took a great deal of time and a fresh approach.

The new compound has an amidine (an iminium, RC=NH+ linked to a nitrogen, N) instead of an amide at a key position buried in the interior of the natural product. However, to install such a functional group, the chemical properties of the amide carbonyl were not useful, as the natural product has seven of them.

Instead, the group relied on the chemical properties of sulfur (S), oxygen’s downstairs neighbor in the periodic table, to install the desired nitrogen. To do this, a second analogue was prepared in which the key amide was chemically altered to a thioamide. “The thioamide allowed us to make any modification at the residue 4 amide that we would like to make, such as the amidine, but we could also make the methylene analogue,” said Boger citing work published in another paper (B. Crowley and D. L. Boger, J. Am. Chem. Soc. 128: 2885-2892). “And there are other modifications that we are making at the present time that we haven’t disclosed. We are just getting to that work.”

The most fundamental finding in the synthesis was that the installation of the amidine could be done in the last step, as a single-step conversion, on the fully unprotected thioamide analogue. Providing an elegant and novel approach to the analogue, which contrasts other published multistep procedures. This chemical behavior was, as Boger said, “an astonishing result as there are no protecting groups and it is a single step reaction… in the end it was the simplest and most straightforward way to prepare the amidine.”

Although it is still at its early stages and there is much work ahead. Currently, the only route known to make the new antibiotic is the one published by Boger and his co-workers, which presently provides laboratory amounts of the compound. So Professor Boger now looks forward and will continue to investigate the “host of alternative approaches” for the preparation of the molecule “such as reengineered organisms to produce the material or semi-synthetic approaches to the analogue. That is going to be part of the next stage of the work.”

The work was funded by the U.S. National Institute of Health (CA041101) and the Skaggs Institute for Chemical Biology. Continue reading →

Lasers have been used to fabricate tiny scaffolds to be used as delivery vehicles to drop cells off at damaged locations and help treat diseases such as Alzheimer’s and Parkinson’s.

Owing to the versatility and accuracy of lasers, the structures have shown significant potential for facilitating the growth of cells and could be designed specifically to meet the individual needs of a variety of cells.

In their study published today, Tuesday 20 September, in IOP Publishing’s journal Biofabrication, researchers used lasers to create intricate scaffolds, with features one thousand times smaller than a millimetre, and demonstrated their ability to effectively harness the growth of neuronal cells.

The repairing of neural tissue – for example peripheral nerves, spinal cord and the brain – has long been investigated using a technique known as tissue engineering and is now becoming a realistic treatment as technology advances.

A multidisciplinary field in which tissues and organs are formed by growing cells onto materials outside of the body, tissue engineering relies heavily on the creation of scaffolds which determine the efficiency, size, shape and orientation of cell growth.

By fine-tuning the make-up and design of these scaffolds, they could be used as a delivery vehicle to drop cells off at a specific damaged location, help them attach and grow, and then become degraded in the body without any damage to the cells or the host.

In this study, the researchers, from the University of Crete and the University of Sheffield, fabricated a scaffold from a commonly used polymer, polylactic acid (PLA). This synthetic, biocompatible material degrades in the human body to form lactic acid, a naturally occurring chemical that can easily be removed, leaving the regenerated tissue behind in the required size, shape and structure.

An ultra-fast, titanium sapphire laser was tightly focused on the PLA material and moved through three dimensions to create complicated sub-micrometer structures. Within the structures, small struts and holes were fabricated to ensure stability and the efficient delivery of nutrients to the cells; both are essential for tissue generation.

Taking the fabrication one step further, 3D sea-shell structures were created from the polymer to demonstrate the intricacy of the laser technique.

To test the compatibility of the structures, the researchers grew neuronal cells on them and observed, using high powered microscopes, how the cells proliferated and aligned.

The neuronal cells showed good compatibility with the PLA structures with less than 10% of the cells dying after five days.

Study co-author Professor Frederik Claeyssens said, “This is the first time we have been able to structure polylactide with such high resolution and the first time that direct laser writing has been applied to tissue engineering.

“Compared to other techniques, direct laser writing allows the scaffold to be created in a user-defined manner on the micrometer level and provides the possibility to explore the relationship between structure of, and cell growth on, the scaffold.”

An Institute of Physics spokesperson said, “The fabrication of appropriate scaffolds is a vital step in the process of tissue engineering and must be fine-tuned if treatments for Alzheimer’s and Parkinson’s are to be realised.” Continue reading →

The January issue of the Journal of the American Dietetic Association features research studies focusing on everyday eating habits of consumers. Researchers look at why sack lunches may not always meet the nutritional needs of preschool children and how making time for meals directly influences diets of young adults.

Packing a Lunch for Preschoolers May Not Be a Good Idea

Approximately 13 million children in the United States eat three or more meals and snacks each day at one of the country’s 117,000 regulated child-care centers. Due to increasing cost of food preparation and storage, more and more of these centers are requiring parents to provide food for their children.

But sack lunches sent from home may not regularly provide adequate nutrients for the growth and development of young children, according to a study conducted by researchers at the University of Texas at Austin and Third Coast Research and Development Inc. of Galveston, Texas. The study included 74 three to five-year-olds attending full-time child-care centers that required parents to provide lunches. Lunch contents were observed and recorded for three consecutive days.

The researchers found more than 50 percent of lunches provided less than minimum amounts of calories, carbohydrates, vitamin A, calcium, iron and zinc, and 96 percent of lunches provided less than minimum recommended amounts of dietary fiber. The lunches did contain 114 percent of the recommended amount of sodium.

When parents were asked if lunch provides an important opportunity for their children to receive nutrients, all 97 agreed. But 63 percent responded that they tend to pack only foods they know their child will eat.

The researchers concluded that, even though parents understand the importance of lunch, they may not know how to consistently pack a nutritious sack lunch for their children. “When parents do not consistently pack a nutritious sack lunch they miss an opportunity to teach and reinforce good dietary habits to their children. As child-care centers shift the responsibility for providing meals and snacks to parents, they must address the practices that affect the long-term health and well-being of the children they serve,” the researchers said.

Young Adults Need to Make Time for Healthy Meals

While young adults enjoy and value time spent eating with others, 35 percent of men and 42 percent of women say they do not have time to sit down for a meal, according to a study by researchers at the University of Minnesota.

The study of 1,687 adults ages 18 to 25 found a majority agreed they enjoy social eating, and feel it is important to have social eating experiences and to have regular meals. But because of constraints on their time from school or work, a significant portion of respondents regularly have to “eat on the run.”

The researchers found eating dinner with others was significantly associated with a healthier diet including fruits and vegetables. “Eating on the run” tended to include more soft drinks, fast food, total fat and saturated fat.

The researchers concluded, “Postsecondary institutions and businesses employing young adults should be encouraged to support good nutrition by providing scheduled time and access to facilities for meals, along with healthful meal and snack options.”

Other studies published in the January 2009 Journal of the American Dietetic Association include:
Total Antioxidant Content of Alternatives to Refined Sugar

Diet and Physical Activity Patterns of School-Aged Children

Peer-Modeling Influences Girls’ Snack Intake

Effect of Portion-Size Information on Food Intake

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The Journal of the American Dietetic Association is the official research publication of the American Dietetic Association and is the premier peer-reviewed journal in the field of nutrition and dietetics. Conclusions of research studies do not necessarily reflect the official positions of the American Dietetic Association, and ADA does not assume responsibility for opinions expressed by authors of Journal articles.

The American Dietetic Association is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy. Visit the American Dietetic Association at eatright/.

Source: Jennifer Starkey

American Dietetic Association Continue reading →

Using revolutionary medical imaging technology, researchers at Rochester Institute of Technology are providing a better understanding of the human body and its many secrets.

Led by Richard Doolittle, RIT’s director of the department of medical sciences, and Paul Craig, professor of chemistry, a team of students has created never-before-seen virtual images of the pancreas, detailed pictures of the human skull and DNA-level images of protein molecules. Their findings were presented today in a virtual tour entitled “3D Visualization in Science, from molecules to cells to organs.”

“We are now able to create virtual images of the human body at the microscopic level,” Doolittle notes. “These images have never been produced before and will help us better understand human development while also having tremendous implications for the diagnosis and treatment of numerous diseases.”

The presentation was the culmination of a dual summer research project undertaken by Doolittle and Craig, including students from the College of Science and College of Imaging Arts and Sciences. An RIT Provost Learning and Innovation Grant funded the project and students from the team were able to conduct some of their research at Brookhaven National Lab through additional funds provided by the National Science Foundation.

“I am incredibly proud of the hard work and dedication all of the students brought to this project,” Craig adds “We could not have gotten these results without their efforts and my ultimate hope is this experience will create a passion for scientific research that carries them into their professional careers.”

The imaging process created by the team will eventually be used by RIT researchers and teachers to provide better insight into how to image and understand disease states at the microscopic level, shed new light on bone development and help better understand how proteins bond with other molecules. The team hopes to expand their research in the future to include virtual imaging of other organs including the liver and brain.

DVDs of the images presented at the conference are available upon request.

William Dube
wjdunsrit.edu
585-475-4954
Rochester Institute of Technology
rit.edu Continue reading →

Over 90% of people with mental, neurological, and substance use (MNS)
disorders in low and middle income countries go untreated, an inequity
known as
the mental health “treatment gap.” This week PLoS Medicine kicks off a
major new series aimed at helping to close the gap.

The series coincides with the October 9th 2009 launch of the Centre for
Global Mental Health, a collaborative initiative of the London School of
Hygiene & Tropical Medicine and the King’s Health Partners Academic Health
Sciences Centre.

The new six-part series explores how best to treat MNS disorders in low-
and middle-income countries. It examines the evidence on which treatments
should be scaled up and how these should be delivered in settings where
specialists are scarce.

The series covers six disorders that have a major global burden across the
life course: depression (which is the first article in the series),
epilepsy, schizophrenia, alcohol use disorders, dementia, and ADHD.
Throughout the series, authors outline “packages of care”-combinations of
treatments aimed at improving the recognition and treatment of diseases to
achieve the best possible outcomes.

Vikram Patel (Professor of International Mental Health and Wellcome Trust
Senior Clinical Research Fellow at the London School of Hygiene & Tropical
Medicine, who is based in Goa, India) and Graham Thornicroft (Professor of
Community Psychiatry at the Institute of Psychiatry, King’s College
London) acted as Guest Editors for the series.

In a Perspective article, Patel and Thornicroft say that although the
specific treatments differ between disorders, there are also “many shared
themes related to the delivery of these treatments.” For example:

— Detection and diagnosis of the more common disorders (like depression
and alcohol use disorders) can be reliably carried out using brief
screening
questionnaires

— A combined package of medication and psychosocial treatments works for
treating these six disorders, but not all patients need all of the
treatments

— People with almost all of these disorders need continuing care and help
to maintain regular use of medication for extended periods to achieve the
best outcomes

— Non-specialist health workers can safely and effectively deliver
treatments for MNS disorders within a functioning primary health care
system. But
collaborative care models (where non-specialists get expert input from
specialists) greatly enhance the effectiveness and sustainability of such
non-specialist health worker-led care programs.

“To the best of our knowledge,” say Patel and Thornicroft “the series is
the first attempt to collect comprehensive reviews of six leading, and
mostly neglected, MNS disorders in an open access venue that allows
immediate and full access to everyone including those living and working
in low
and middle income countries.”

The Guest Editors intend that the series will serve as a “valuable
resource for health professionals, policy makers, and health workers
working to
improve the care and treatment of those struggling with MNS disorders in
settings where specialist resources are scarce and where treatment gaps
are
large.”

The October 9th 2009 launch of the Centre for Global Health is being held
at John Snow A Lecture Theatre at the London School of Hygiene & Tropical
Medicine from 5-6.30 pm UK time. Dr Benedetto Saraceno, the Director of
the World Health Organization’s Department of Mental Health and Substance
Abuse, will delivery the keynote address. The Centre aims to build on the
existing collaborations and complementary strengths of the London School
of
Hygiene & Tropical Medicine and the King’s Health Partners Academic Health
Sciences Centre, to foster research and training in policy, prevention,
treatment and care in global mental health.

First article in the series:

Citation:
“Packages of Care for Depression in Low- and Middle-Income Countries.”
Patel V, Simon G, Chowdhary N, Kaaya S, Araya R (2009)
PLoS Med 6(10): e1000159. doi:10.1371/journal.pmed.1000159

Funding:
VP is supported by a Wellcome Trust Senior Clinical Research
Fellowship in Tropical Medicine. The funder played no role in the decision
to
submit the article or in its preparation.

Competing Interests:
The authors have declared that no competing interests
exist.

Perspective about the series:

Citation:
“Packages of Care for Mental, Neurological, and Substance Use Disorders in Low- and Middle-Income Countries.”
Patel V, Thornicroft G (2009)
PLoS Med 6(10): e1000160. doi:10.1371/journal.pmed.1000160

Funding:
No specific funding was received for this piece.

Competing Interests:
The authors have declared that no competing interests exist.

Source
PLoS Medicine Continue reading →

University of Queensland researchers will be at the forefront of fighting cancer thanks to a new $3.2 million grant from the Australian Cancer Research Foundation (ACRF).

The ACRF funding will allow scientists from UQ’s Diamantina Institute for Cancer, Immunology and Metabolic Medicine (DI), and their partners from the Queensland University of Technology, to buy the latest high-tech tools to help them discover genes linked to cancer.

“We will be able to sequence nearly a billion DNA bases per day, where before it took many months,” said Professor Tom Gonda, who leads the Cancer Biology research program at the DI.

He said the new instruments will be integrated to form the ACRF Comprehensive Cancer Genomics Facility, which will be located at the Princess Alexandra Hospital, and in three years’ time will move to a more spacious research building, the Translational Research Institute, with a remit to develop new treatments for cancer and other diseases.

“Identifying genes linked to common cancers such as cervical and prostate cancer will help doctors spot individuals at high risk at an early stage when the cancer can be easily treated or even prevented, avoiding the need for unnecessary surgery and radiotherapy later on,” he said.

Professor Gonda said the new tools would give Queensland’s cancer research community access to the latest in instrumentation that would “open up whole new areas of study”.

“For example, other new technologies in the Facility would allow scientists to identify genes that may be targets for new anti-cancer drugs,” he said.

“We will have the ability to screen thousands of genes, something we couldn’t do without the degree of automation offered by this equipment.”

The latest grant brings total ACRF funding to UQ since 1995 to nearly $14m.

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Source: Andrew Dunne
Research Australia Continue reading →

At a meeting sponsored by the National Council on Aging (NCOA) and the Medicare Diabetes Screening Project (MDSP), former Senate Majority Leader Tom Daschle, experts in diabetes research and education, and representatives of senior-serving organizations from a four-state area gathered in Washington, DC to draw attention to the need for increased screening for diabetes among older adults ages 65 and older insured by Medicare.

“Diabetes is a major health threat for seniors and a driver in escalating Medicare costs,” said Daschle. “Screening and early diagnosis are critical to managing diabetes effectively and to prevent the onset of the disease for those at risk. And yet, less than 10 percent of Medicare beneficiaries are screened annually for diabetes, even though Medicare offers a free diabetes screening benefit. We have to do better.”

“When diabetes is undiagnosed and untreated, it can be devastating, and new government statistics show that older adults are especially vulnerable,” said Nancy Whitelaw, Senior Vice President and Director, Center for Healthy Aging of NCOA. “That’s why it is crucial that we create awareness of the benefits that Medicare offers for diabetes screening, and coach our seniors to ask their health care providers about being tested for diabetes, and if diagnosed, take up ways to improve their self-management of this dangerous disease.”

According to a study in the February 2009 issue of Diabetes Care, led by one of today’s speakers, Catherine Cowie, PhD, of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 32% of adults ages 65 and older have diabetes. What’s more, almost half of those seniors with diabetes (46%) don’t know they have it — they have not been diagnosed.

In addition to those with diabetes, another 40% of adults ages 65 and older have pre-diabetes, putting them at very high risk of developing diabetes and heart disease, and it is likely that most of them are unaware of their status.

For people who are ages 65 and older and have one risk factor for diabetes, Medicare offers a free diabetes-screening test in a health care provider’s office, with no deductible and no co-pay. If seniors are found to have pre-diabetes, they are eligible for another free screening in six months.

“Since 2005, Medicare has offered benefits for diabetes screening, but usage of these benefits has been minimal, hovering around 10 percent,” said Michael Mawby, Chief Government Affairs Officer for Novo Nordisk, one of the co-chairs of the MDSP along with the American Diabetes Association and the Healthcare Leadership Council. “That’s why the Medicare Diabetes Screening Project and NCOA have joined forces and are launching today a new program to go directly to senior-serving organizations and urge them to promote Medicare’s benefits for diabetes screening in their communities.”

The new program is called “Diabetes Screening: Medicare Benefits for Better Health,” and consists of outreach to leaders of organizations, agencies and companies that serve older adults, informing and educating them about Medicare’s benefits for diabetes screening and encouraging these community leaders to make presentations and distribute information to older adults across the country. A key element of the program is a comprehensive kit of materials that includes information for the public and health care providers, as well as ready-to-go presentations with instructions and notes for speakers who can spread the word about diabetes screening.

Additionally, NCOA and MDSP are planning additional “train-the-trainer” sessions in Illinois and Florida later in the year. At these sessions, leaders from senior-serving organizations will learn about the new program and will receive training in using the program’s informational materials, as well as learning how to train other community leaders to help spread the word.

At the session today in Washington, DC, participants heard from Sen. Tom Daschle, former Senate Majority Leader, about plans for health care reform coming from the Obama Administration. Those in attendance learned about the enormous human and economic toll of diabetes from Dr. William Rowley of the Institute for Alternative Futures. They also saw how one community — Columbus, Georgia — came together to successfully implement the Medicare Diabetes Screening Project.

Additionally, participants heard from Jill Jackson-Ledford, MSW, Vice President, Health Promotion, Center for Healthy Aging, NCOA, and Kate Lorig, RN, DrPH, Director of the Stanford Patient Education Research Center and Professor of Medicine, Stanford School of Medicine, about what might be done at the community level to better inform, educate and motivate seniors to take better care of their health, especially those who have been diagnosed with diabetes. Susan Vaeth, Administrator, Howard County, Maryland Office of Aging spoke about how her office used an award from the MDSP to reach out to seniors with the news that Medicare covers diabetes screening.

The National Council on Aging (NCOA) is a non-profit service and advocacy organization headquartered in Washington, DC. NCOA is a national voice for older Americans — especially those who are vulnerable and disadvantaged — and the community organizations that serve them. It brings together non-profit organizations, businesses, and government to develop creative solutions that improve the lives of all older adults. NCOA works with thousands of organizations across the country to help seniors find jobs and benefits, improve their health, live independently and remain active in their communities.

The Medicare Diabetes Screening Project is a national effort to reach and motivate seniors who have undiagnosed diabetes or pre-diabetes, and encourage them to see their doctors or other health care providers and take advantage of the free diabetes screening benefits offered by Medicare.

Source: National Council on Aging Continue reading →