News

Newswise — Bethesda, Md. — A new study finds that dietary nitrate—a compound that dilates blood vessels to decrease blood pressure—may reduce overstimulation of the sympathetic nervous system that occurs with heart disease. The research team looked specifically at beetroot juice, a source of dietary nitrate, to explore its use as a future targeted treatment option for people with cardiovascular disease. The study, published ahead of print in the American Journal of Physiology—Heart and Circulatory Physiology, is the first to study the effects of nitrate supplementation on sympathetic nerve activity. Activation of the sympathetic nervous system—caused by increased sympathetic nerve activity—include elevated heart rate and blood pressure and blood vessel constriction. Sympathetic nerve activity (sympathetic outflow) also increases with some forms of cardiovascular disease, including high blood pressure and heart failure. The aim of the study was to show that “acute nitrate supplementation using beetroot juice can decrease muscle sympathetic outflow at rest and during exercise,” the Canadian research team wrote. Twenty young adult volunteers (average age: 27) participated in two separate testing visits in which they blindly received either a nitrate supplement or a placebo. On both visits, the research team recorded the blood pressure, heart rate and muscle sympathetic nerve activity (MSNA) and measured muscle activity at rest and during handgrip exercise with the participants’ non-dominant hand. Measurements were recorded at the beginning of the visit and then again after the volunteers drank nitrate-rich beetroot juice or a placebo and had rested on their backs for three hours. MSNA burst rate, denoting the frequency of nerve activity, was lower when the volunteers drank beetroot juice compared to when they drank the placebo. Sympathetic nerve activity also decreased during exercise. “Surprisingly, no differences in blood pressure were detected at rest or during exercise,” the research team noted. “These results provide proof-of-concept that dietary nitrate supplementation can modulate central sympathetic outflow and suggest that the established cardiovascular benefits [of dietary nitrate] are likely to involve a neural contribution.” The article, “Acute beetroot juice supplementation on sympathetic nerve activity: A randomized, double-blind, placebo-controlled proof-of-concept study,” is published ahead of print in the American Journal of Physiology—Heart and Circulatory Physiology.

Newswise — While cotton tip applicators can be used for household cleaning, crafts and applying cosmetics, they are unfortunately also causing injuries to children. A study conducted by Nationwide Children’s Hospital researchers found that over a 21-year period from 1990 through 2010, an estimated 263,000 children younger than 18 years of age were treated in U.S. hospital emergency departments for cotton tip applicator related ear injuries – that’s about 12,500 annually, or about 34 injuries every day. “The two biggest misconceptions I hear as an otolaryngologist are that the ear canals need to be cleaned in the home setting, and that cotton tip applicators should be used to clean them; both of those are incorrect,” said Kris Jatana, MD, senior author of the study from the Department of Pediatric Otolaryngology at Nationwide Children’s Hospital and Associate Professor in the Department of Otolaryngology at The Ohio State University Wexner Medical Center. “The ears canals are usually self-cleaning. Using cotton tip applicators to clean the ear canal not only pushes wax closer to the ear drum, but there is a significant risk of causing minor to severe injury to the ear.” The study, recently published online in The Journal of Pediatrics, found that the majority of injuries occurred as a result of using cotton tip applicators to clean the ears (73%), playing with cotton tip applicators (10%), or children falling when they have cotton tip applicators in their ear (9%). Most of the injuries occurred when the child was using the cotton tip applicator by themselves (77%), followed by injuries that happened when a parent (16%) or sibling (6%) used the cotton tip applicator to clean the child’s ear. About two out of every three patients were younger than eight years of age, with patients aged 0-3 years accounting for 40% of all injuries. The most common injuries were foreign body sensation (30%), perforated ear drum (25%) and soft tissue injury (23%). Foreign body sensation was the most common diagnosis among children aged 8-17 years, while perforated ear drum was the most common among children younger than 8 years of age. Almost all of the patients seen in emergency departments for these injuries (99%) were treated and released. In more serious cases, damage to the ear drum, hearing bones, or inner ear, can lead to dizziness, problems with balance, and irreversible hearing loss. “While the number of overall injuries from cotton tip applicators did decrease during the 21 years we looked at in our study, it is still unacceptably high,” said Dr. Jatana. “These products may seem harmless, but this study shows how important it is that they not be used to clean ears.” Data for this study were obtained from the National Electronic Injury Surveillance System (NEISS), which is operated by the U.S. Consumer Product Safety Commission. The NEISS database provides information on consumer product-related and sports- and recreation-related injuries treated in hospital emergency departments across the country. This study was conducted collaboratively between the Department of Otolaryngology and the Center for Injury Research and Policy at Nationwide Children’s Hospital. The Center for Injury Research and Policy (CIRP) of The Research Institute at Nationwide Children’s Hospital works globally to reduce injury-related pediatric death and disabilities. With innovative research at its core, CIRP works to continually improve the scientific understanding of the epidemiology, biomechanics, prevention, acute treatment and rehabilitation of injuries. CIRP serves as a pioneer by translating cutting edge injury research into education, policy, and advances in clinical care. For related injury prevention materials or to learn more about CIRP, visit www.injurycenter.org.   SEE ORIGINAL STUDY

What The eighth annual “Polly’s Run” raises awareness for pancreatic cancer, honors pancreatic cancer survivors and all those who face the disease, and raises money for pancreatic cancer research. Albuquerque Pet Memorial Services sponsors the event. All proceeds benefit The University of New Mexico Comprehensive Cancer Center.   Why Polly Rogers battled pancreatic cancer for 11 months before finally succumbing to it in June, 2009. She was a healthy, non-smoking wife and mother of three boys, an elementary schoolteacher and a running coach for young students. “Seeing her suffer for 11 months was a difficult thing to do,” says Josh Rogers, her middle son. Rogers, his brothers and Polly’s best friend started Polly’s Run in 2009 to honor Polly’s memory and to fight back against the disease. “The time for action is now,” Rogers says. According to the National Cancer Institute’s Surveillance, Epidemiology and End Results program, fewer than one in 10 people with pancreatic cancer live for five years or more after their diagnosis. Pancreatic cancer accounts for only 3.2 percent of all new cancer cases but accounts for 7.2 percent of all cancer deaths. There are no screening tests for it. Polly’s Run organizers hope to change these grim statistics by supporting pancreatic cancer awareness and research. The event has grown to more than 600 runners and walkers and raised more than $30,000 last year. Many who take part have lost family members to pancreatic cancer. “The group that we’ve created is very passionate about the cause and finding a cure,” says Rogers. “They understand that it is absolutely critical to carry on this fight.”   Who Runners and walkers of all ages and abilities are welcome. The event features a 5K walk/run and a “Kids’ K” for the youngest runners and walkers. Those unable to attend on Race Day may complete a “Virtual Run” from anywhere in the world. Donations are welcome. Pancreatic cancer survivors are especially invited to take part in the event. Register, donate and learn more at www.pollysrun.com.   When Sunday, June 4, 20178:30 a.m. to 11:30 a.m., MDT   Where Tiguex Park1800 Mountain Road NorthwestAlbuquerque, NM 87104   Interviews Josh Rogers, Polly’s Run Organizer   Contact Dorothy Hornbeck, JKPR, 505-340-5929, dhornbeck@jameskorenchen.com     About the UNM Comprehensive Cancer Center The University of New Mexico Comprehensive Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in a 500-mile radius. Its 125 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with more than 500 other cancer healthcare professionals (nurses, pharmacists, nutritionists, navigators, psychologists and social workers), provided cancer care for nearly 60 percent of the adults and children in New Mexico affected by cancer. They treated 11,249 patients in 84,875 ambulatory clinic visits in addition to in-patient hospitalizations at UNM Hospital. These patients came from every county in the State. More than 12 percent of these patients participated in cancer clinical trials testing new cancer treatments and 35 percent of patients participated in other clinical research studies, including tests of novel cancer prevention strategies and cancer genome sequencing. The 130 cancer research scientists affiliated with the UNMCCC were awarded almost $60 million in federal and private grants and contracts for cancer research projects and published 301 high quality publications. Promoting economic development, they filed more than 30 new patents in FY16, and since 2010, have launched 11 new biotechnology start-up companies. Scientists associated with the UNMCCC Cancer Control & Disparities have conducted more than 60 statewide community-based cancer education, prevention, screening, and behavioral intervention studies involving more than 10,000 New Mexicans. Finally, the physicians, scientists and staff have provided education and training experiences to more than 230 high school, undergraduate, graduate, and postdoctoral fellowship students in cancer research and cancer health care delivery. Learn more at cancer.unm.edu.

Newswise — Baltimore, Maryland – Surgeons have successfully used a remote controlled robotic system to operate inside the human eye, paving the way for future robotic assistance in clinical treatments that require extreme precision and stability, such as the controlled delivery of gene therapy and stem cells. The research is being presented at the 2017 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) this week in Baltimore, Md. Twelve patients requiring surgery on their retinas were recruited into the randomized clinical trial. Six had surgery with the robot and six received the standard human manual approach. In the robot group, the total number of retinal micro-hemorrhage events (bleeding) was two, compared with five in the manual group. Abstract title: Results from the first use of a robot to operate inside the human eye Presentation start/end time: Monday, May 8, 2017, 8:30 – 8:45am Location: Ballroom 3 Abstract number: 1185 # # # The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include nearly 12,000 eye and vision researchers from over 75 countries. ARVO advances research worldwide into understanding the visual system and preventing, treating and curing its disorders.  All abstracts accepted for presentation at the ARVO Annual Meeting represent previously unpublished data and conclusions. This research may be proprietary or may have been submitted for journal publication. Embargo policy: Journalists must seek approval from the presenter(s) before reporting data from paper or poster presentations. Press releases or stories on information presented at the ARVO Annual Meeting may not be released or published until the conclusion of the presentation.

UCLA Research Alert   Quality of care for peripheral artery disease is low   FINDINGS Less than half of individuals with peripheral artery disease, which is a narrowing of arteries to the limbs, stomach and head, are treated with appropriate medications and lifestyle counseling. These findings highlight the need to improve the quality of care for this high-risk group of individuals.   BACKGROUND Peripheral artery disease affects an estimated 200 million people around the world. It is becoming more prevalent due to the world’s aging population, which is at higher risk for the disease. People with this disease are also at high risk for coronary heart disease, heart attacks and strokes. Peripheral artery disease causes claudication, which is cramping and pain in the legs and buttocks during physical activity. The disease can also lead to gangrene and limb amputation. From a societal perspective, the consequences of the disease are significant. It is, however, easily diagnosed and can be managed with lifestyle changes and medication.   METHOD The researchers used data from 1,982 outpatient visits from people with the disease that was taken from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, a nationally representative assessment of office-based and hospital outpatient department practices.   They found an average of 3.8 million ambulatory visits in the United States for peripheral artery disease over eight years. Comorbid coronary artery disease, which is a combination of both peripheral artery and coronary artery disease, was present in 24.1 percent of the visits. Medication use was low for cardiovascular prevention and symptoms of claudication. The researchers also found that aspirin was used in only 37.8 percent of the cases; statins were prescribed 35 percent of the time; blood pressure medication use was at 31.1 percent; and cilostazol was prescribed in 5 percent of visits. Cilostazol is an FDA-approved medication for treating claudication in patients with peripheral artery disease.   Counseling on diet or exercise was provided in only 20.1 percent of visits. Smoking cessation counseling or medication was given only 36.3 percent of the time to current smokers with peripheral artery disease. There was no significant change in medication use or lifestyle counseling over time. Compared to visits for individuals with peripheral artery disease alone, patients with both peripheral artery disease and coronary artery disease were more likely to be prescribed antiplatelet therapy, statins, blood pressure medications, and counseled for smoking cessation.   IMPACT The findings clearly show underuse of cardiovascular prevention medication in individuals with peripheral artery disease. Because of this underuse, a considerable number of individuals with the disease remain at increased risk for adverse outcomes. This study is a “call to action” to identify and implement effective physician-targeted and patient-targeted strategies aimed at improving quality of care. These strategies should take advantage of recent advances in behavior change, including leveraging an individual’s social support network to help them make lifestyle changes, and providing physicians with feedback about the quality of care they provide to patients with peripheral artery disease.   AUTHORS Joseph Ladapo of UCLA and Jeffrey Berger of New York University.   JOURNAL The study is published online by the Journal of the American College of Cardiology.   FUNDING The National Heart and Lung Blood Institute of the National Institutes of Health (R01HL114978), a K23 Career Development Award (K23 HL116787) from the National Heart, Lung and Blood Institute, and the Robert Wood Johnson Foundation (74140) funded this research.   DISCLOSURES Berger receives research funding from Astra Zeneca and served on the Executive Committee for the EUCLID trial of antiplatelet therapy in patients with peripheral artery disease. He also receives consulting fees from Janssen and Merck. Ladapo has no disclosures.   Media Contact: Enrique Rivero 310-267-7120 erivero@mednet.ucla.edu      

Newswise — New York, NY — A study of more than 100,000 men and women revealed that dietary gluten is not associated with heart disease risk in people without celiac disease. The findings also suggest that limiting whole grains as part of a low-gluten diet may increase the risk of heart disease in people who do not have celiac disease. The study, led by researchers at Columbia University Medical Center and Massachusetts General Hospital/Harvard Medical School, was published online today in the BMJ. “Gluten is clearly harmful for people with celiac disease,” said lead author Benjamin Lebwohl, MD, MS, assistant professor of medicine and epidemiology at CUMC, director of clinical research in the Celiac Disease Center at Columbia University and gastroenterologist at NewYork-Presbyterian/Columbia University Medical Center. “But popular diet books, based on anecdotal and circumstantial evidence, have pushed the notion that a low-gluten diet is healthy for everyone. Our findings show that gluten restriction has no benefit, at least in terms of heart health, for people without celiac disease. In fact, it may cause some harm if they follow a low-gluten diet that is particularly low in whole grains because those grains appear to have a protective effect against heart disease.” Celiac disease is an autoimmune disorder where the ingestion of gluten, a protein found in wheat, rye, and barley, causes inflammation of the small intestine, preventing the absorption of nutrients. Over time, celiac disease can lead to other health issues, including heart disease, anemia, and osteoporosis. Celiac disease can be effectively treated with a gluten-free diet. Celiac disease is estimated to affect about 1 in 100 Americans. Another segment of the population has a condition called non-celiac gluten sensitivity, in which gluten triggers some symptoms in the absence of celiac disease. However, estimates of the number of Americans with non-celiac gluten sensitivity vary widely. “Despite the relatively low prevalence of celiac disease and non-celiac gluten sensitivity, surveys suggest that about one-third of Americans are trying to cut down on gluten,” says Dr. Lebwohl. “This certainly benefits companies that sell gluten-free products. But does it benefit the public? That is the question we wanted to answer.” To assess the effects of a low-gluten diet on heart health, Dr. Lebwohl and his colleagues analyzed diet and coronary heart disease data on 65,000 women in the Nurses Health Study and 45,000 men in the Health Professionals Follow-up Study, excluding anyone who had been diagnosed with celiac disease. Each participant filled out detailed diet questionnaires every four years, from 1986 to 2010. The participants were divided into five levels of estimated gluten consumption. “We decided to look at heart disease because it’s a leading killer, and because it’s generally understood that heart health can be affected by diet,” said Dr. Lebwohl. The researchers found that there was no association between gluten intake and risk of coronary heart disease, defined as fatal or non-fatal heart attacks. “Even those with the lowest amount of gluten consumption experienced the same rate of heart disease as those who were consuming the most gluten,” said senior investigator Andrew Chan, MD, MPH, gastroenterologist and Chief of the Clinical and Translational Epidemiology Unit in the Massachusetts General Hospital Division of Gastroenterology and associate professor of medicine, Harvard Medical School. “Based on our data, recommending a low-gluten diet solely for the promotion of hearth health does not appear warranted.” In subsequent studies, the researchers plan to look at the effect of gluten intake on other health outcomes, including cancer and autoimmune disease. The study is titled, “Long-term Gluten Consumption in Adults without Celiac Disease and the Risk of Coronary Heart Disease: Prospective Cohort Study.” The other contributors are: Yin Cao (Massachusetts General Hospital and Harvard Medical School, Boston, MA); Geng Zong (Harvard T. H. Chan School of Public Health, Boston, MA), Frank B. Hu (Harvard T. H. Chan School of Public Health, Brigham and Women’s Hospital, Boston, MA, and Harvard Medical School); Peter H.R. Green (CUMC); Alfred I. Neugut (CUMC); Eric B. Rimm (Harvard T. H. Chan School of Public Health, Brigham and Women’s Hospital, and Harvard Medical School); Laura Sampson (Harvard T. H. Chan School of Public Health), Lauren W. Dougherty Harvard T. H. Chan School of Public Health); Edward Giovannucci (Harvard T. H. Chan School of Public Health, Brigham and Women’s Hospital, and Harvard Medical School); Walter C. Willett (Harvard T. H. Chan School of Public Health, Brigham and Women’s Hospital, and Harvard Medical School); Qi Sun (Harvard T. H. Chan School of Public Health, Brigham and Women’s Hospital, and Harvard Medical School). The study was funded by grants the National Institutes of Health (K24 DK098311, UM1 CA186107, UM1 CA167552, R01 HL035464, R01 HL060712, R01 HL034594) and by an American Gastroenterological Association Foundation Research Scholar Award. The authors declare no financial or other conflicts of interest.  ###

Researchers have discovered that a new anti-rejection drug that is gentler on the kidneys after liver transplant also reduces weight gain, which is common after surgery and can lead to serious complications for transplant patients. Researchers from the Intermountain Medical Center Transplant Program in Salt Lake City, led a randomized, international multi-center study of more than 700 patients, which also included researchers from Northwestern University, Novartis Pharmaceuticals Corp., and Mayo Clinic. For the study, researchers compared a new drug, Everolimus, to Tacrolimus, a routinely prescribed anti-rejection drug. Researchers found that transplant patients taking Everolimus gained less weight – and kept it off at one and two years after starting the drug. Weight gain after liver transplantation can lead to serious complications and increase the risk of post-transplant metabolic syndrome, cardiovascular events, and kidney failure. Components of post-transplant metabolic syndrome include diabetes, obesity, high blood pressure, and abnormal fat and cholesterol blood levels, which can cause heart disease and related adverse events such as heart attack and stroke. Researcher will present results of the study at the American Transplant Congress in Chicago on Tuesday, May 2. The study is also published in the American Journal of Transplantation. After transplant, patients must take anti-rejection drugs so their immune systems don’t attack and destroy the transplanted organ. The research was originally undertaken to see if Everolimus is gentler on the kidneys than Tacrolimus, the most commonly prescribed immunosuppressant drug. “Everolimus did have less impact on kidney function, and the Food and Drug Administration approved the drug based on that finding for use in liver transplant patients,” said Michael M. Charlton, MD, researcher and clinician from the Intermountain Medical Center Center Transplant Program, and the study’s lead author. Early-stage research had shown Everolimus prevented weight gain in fruit flies and other animals, so the researchers wondered if that finding would hold in human subjects, as well. To find out, they randomized a total of 719 patients between 25 and 35 days after liver transplant into three study arms. The first group of 245 patients received Everolimus and reduced dose of Tacrolimus; the second group of 243 received the usual dose of Tacrolimus and served as the control group; and the final group of 231 patients were prescribed only Everolimus to suppress their immune systems. “We found that the two Everolimus groups in this study gained around 10 pounds less than patients in the tacrolimus arm,” said Dr. Charlton. “It used to be that rejection was a big deal and that was the most common cause of liver rejection or death. Now, the most common cause of death following liver transplantation is related to cardiovascular events and cancers, with kidney function increasingly important as well. Cardiovascular disease, cancers, and renal disease are driven in part by weight.” The reduced weight gain was seen both one and two years after transplant. Dr. Charlton said the second most-common reason people need liver transplant today is weight-related liver failure. “Since nearly everyone who receives a liver transplant gains weight after the surgery, this could be an easy way to avoid or limit the need for a transplant,” he said.                                                             ###

Newswise — ANN ARBOR, MI – Fifty years ago this spring, entrepreneur Heinz Prechter moved his company to Detroit, to answer car buyers’ fast-growing demand for sunroofs. But even as his products brought light into more than a million vehicles, he fought darkness in his own life. He struggled to keep his bipolar disorder hidden, until his suicide in July 2001 shocked the automotive industry.   Heinz’s wife, Waltraud “Wally” Prechter, resolved to fight the stigma that led her husband to hide his mental illness, and to address the lack of scientific understanding about the condition and how best to treat it. She channeled her energy into helping the University of Michigan Depression Center do both, by donating and raising money for a U-M bipolar research fund in her husband’s name. Today, U-M named its entire bipolar disorder research program for Heinz Prechter, in honor of a new gift commitment of up to $5 million by the World Heritage Foundation - Prechter Family Fund. But the gift comes with a challenge to others who care about bipolar disorder: The Prechter family will match every dollar given to U-M bipolar disease research up to $5 million. This will double the value of every donation, and the Prechter family gift will be available to researchers faster, if others step in to support the cause. Donations can be made at http://victors.us/prechtercampaign. Once the challenge is met, the Prechter family’s total giving to U-M bipolar research since Heinz Prechter’s death will be well over $10 million. Philanthropic gifts, including individual, foundation and corporate gifts, are critical to the effort and account for more than half of the research funding in any given year. The Prechter family set up this gift as a match to encourage more philanthropic support of research into bipolar disorder. “I think that if you can — if you truly believe in something — you owe it to yourself to help, to give, and to make a difference. Because ultimately, that is all you leave behind,” says Wally Prechter.   Says U-M president Mark Schlissel, M.D., Ph.D., “I deeply appreciate Wally Prechter’s commitment to advancing bipolar disease research that will give hope to millions of people around the world. The Heinz C. Prechter Bipolar Research Program will enhance the University of Michigan’s longstanding research initiatives and drive new medical discoveries to combat this devastating disorder.” Building new innovation and advancing bipolar science “When we lost Heinz to his disease, it took Wally’s bravery and generosity to help us create incredible good out of such a tragic loss,” says John Greden, M.D., who was working with Heinz and Wally Prechter to create the U-M Depression Center at the time of Heinz’s death. Greden is the Depression Center’s director and a professor of psychiatry at Michigan Medicine, the U-M academic medical center. “Without Wally Prechter’s leadership over the past decade, we would not have been able to develop the world’s first bipolar-specific stem cell lines, discover new genetic links, explore environmental factors or bring experts worldwide together as we have,” says Melvin McInnis, M.D., who is the Thomas B. and Nancy Upjohn Woodworth Professor of Bipolar Disorder, professor of psychiatry, and director of the newly named Heinz C. Prechter Bipolar Research Program. The Prechter family is committed to increasing scientific understanding and treatment options that will enable people with bipolar disorder to lead healthy and productive lives. The new gift will grow the endowment that provides for the continuation of the Prechter Longitudinal Study of Bipolar Disorder, which has been ongoing for 11 years. The Longitudinal Study allows researchers to track symptoms, response to treatment and overall health over time like never before. Already, more than 1,200 dedicated individuals have partnered with the research team to track personal and medical information for this long-term study. “Our participants are the real heroes,” says Wally Prechter. “The goal of the Prechter Program is to identify effective solutions for people with bipolar disorder.” Volunteers can also donate samples of their blood, giving scientists the chance to study tiny differences in DNA that may play a role in how the disorder develops, why it runs in families, how it affects people over time and what makes people vary in their response to treatment. The “bank” of DNA from hundreds of research participants over the last decade is called the Heinz C. Prechter Bipolar Genetics Repository, and it is the nation’s largest privately funded bipolar genetics repository.  “We look forward to fueling new discoveries, and involving hundreds more people with bipolar and their families in the search for better treatments. The new funding, from the Prechters and others who believe in our work, will allow us to accelerate our pace of discovery,” says McInnis. The Heinz C. Prechter Bipolar Research Program will be the umbrella program over the Longitudinal Study of Bipolar Disorder and other bipolar research studies. About bipolar disorder Bipolar disorder is a devastating, chronic mental illness with recurring episodes of mania (highs) and depression (lows). The illness causes unusual and dramatic shifts in mood, energy and behavior. Presently, 30 percent of individuals with bipolar disorder attempt suicide during their lives, and 20 percent die by suicide. Although the direct cause of bipolar disorder is unclear, it has long been understood that genetic, biochemical and environmental factors play a role. Bipolar disorder runs in families, tends to recur throughout the life span and is affected by genes and life experiences. Learn more about the entire Prechter-funded effort, and the research and team it has fueled, at http://www.prechterfund.org/. More information about participating in Prechter Bipolar Research Program studies is available by calling 1-877-UM GENES (1-877-864-3637) or emailing bpresearch@umich.edu.

Newswise — WASHINGTON, D.C.,  – More than 100 radiation oncologists from across the United States are on Capitol Hill urging Congress to grow its investment in cancer research and to protect patients’ access to high quality cancer care. The doctors are in Washington to meet with Congressional leaders on Tuesday as part of the 14th annual Advocacy Day organized by the American Society for Radiation Oncology (ASTRO). Radiation oncologists are emphasizing four priorities as they meet with policymakers and their staffers: (1) supporting cancer research by increasing the National Institutes of Health (NIH) budget by $2 billion; (2) avoiding disruptions in health insurance coverage for cancer patients; (3) preserving patients’ access to quality health care by stabilizing Medicare payments while pursuing innovative models of physician reimbursement; and (4) protecting access to radioactive isotopes. Infographics are available for each of these key issues. Federal investment in cancer research has played a role in every major innovation in the fight against cancer and has led to a decline in the overall number of cancer deaths in the United States, yet funding for cancer research is under threat. The President’s proposed 2018 budget would cut $6 billion from the $32 billion earmarked for NIH, which could lead to a roughly 20 percent cut in the National Cancer Institute’s (NCI) budget. This drastic cut would derail the progress toward improved outcomes for cancer patients and cause leading scientists to leave the cancer research field. Cuts also would erase the commitment Congress made in late 2016 by passing the 21st Century Cures Act, which was widely-supported, bipartisan legislation that pledged nearly $5 million in additional support for the NIH. “There are more than two hundred types of cancer, and only through research can we learn which treatments, including radiation therapy, will be most effective to fight the many different forms of this illness. We ask that Congress reject proposed cuts to federal cancer research funding and instead support an increase in the budget to eradicate cancer,” said Brian Kavanagh, MD, MPH, FASTRO, president of ASTRO and chair of the department of radiation oncology at the University of Colorado School of Medicine. As Congress and the administration debate the future of American health care, ASTRO members are encouraging policymakers to prioritize reforms that avoid coverage disruptions for cancer patients. Studies have demonstrated that a lack of adequate health insurance leads to delayed diagnosis and treatment, resulting in higher mortality rates. Inadequate coverage also leads to higher costs that are felt throughout the economy. ASTRO strongly supports bipartisan solutions that protect cancer patients from losing their health insurance or not being approved for coverage following a cancer diagnosis, including maintaining bans on pre-existing condition exclusions and annual and lifetime caps; preserving guaranteed issue and guaranteed renewability provisions; and safeguarding access to clinical trials. ASTRO members also are urging Congress to protect access to care by stabilizing Medicare reimbursement rates and fully supporting the transition to a health system that rewards quality over quantity. Congress unanimously passed the Patient Access and Medicare Protection Act in 2015, freezing payment rates for key radiation treatment services in freestanding clinics through 2018 at levels set in 2016 and requiring the Secretary of HHS to report to Congress on the development of alternative payment models (APMs) in radiation oncology.  With the support of key Congressional leaders, we have much-needed stability in radiation oncology payments, and ASTRO has been working on the development of an APM that incentivizes adherence to nationally-recognized clinical guidelines through an episode-based payment framework across five primary cancer sites: breast, lung, prostate, colorectal, and head and neck.  Radiation oncologists are on Capitol Hill to remind Congress of the multidisciplinary nature of cancer care and call for the opportunity to meaningfully participate in the nationwide transition to value-based health care.  “When Medicare inappropriately ratchets down on payments for cancer treatments, it jeopardizes whether patients have access to the care they need,” said David C. Beyer, MD, FASTRO, chair of the ASTRO Board of Directors and medical director of Cancer Centers of Northern Arizona at Sedona. “In the past decade, radiation oncologists in community-based practices have sustained as much as a 20 percent drop in their Medicare payments. We’re urging Congress to prevent additional cuts and support physician-led efforts to drive value-based care.” Finally, ASTRO members are advocating to preserve access to radioactive isotopes. Any effort to abandon radioactive source-based technology in health care would limit patients’ access to certain radiation therapy treatments, which could interfere with treatment decisions and result in higher mortality and recurrence rates. A recent Nuclear Regulatory Commission analysis found no violations with safety or security consequences over the past 30 years, demonstrating the culture of safety and security among domestic radioisotope users. Moreover, radiation oncologists and medical physicists receive extensive training in the safe use and security of radioactive isotopes. ASTRO members are urging Congress to reject attempts to limit access to radioactive isotopes and promote policies that enhance the safe and effective use of these materials.

Newswise — Rural, older Floridians encounter a multitude of factors that put them at higher risk for developing Alzheimer’s disease (AD) such as limited education, decreased health literacy, low income, increased heart disease, lack of insurance, and limited access to health care. Minorities face an additional risk – African-Americans are nearly twice as likely and Hispanics are 1.8 times more likely than Whites to develop AD. These disparities are especially prevalent in the culturally diverse, rural community of Belle Glade located in south central Florida in Palm Beach County, which has a higher percentage of residents over the age 65 (26.5 percent compared with the national average of 18 percent). More than one-third of the residents live below the poverty level. Belle Glade is designated as a Medically Underserved Area and a Health Professional Shortage Area for primary and specialty care. With only two local physicians and two public primary care health clinics in the area, patients have to wait hours to see a health practitioner and cannot make appointments in advance. For older patients, this is a major barrier to seeking health care. Even if these rural older adults are aware of the need for cognitive assessment, there are insufficient providers to screen, diagnose, and treat the illness. These facilities are overwhelmed with waiting lists of patients needing appointments, and there are no urgent-care facilities available in the area. Consequently, residents treat the emergency room as the clinic. Researchers from the Christine E. Lynn College of Nursing at Florida Atlantic University have received a $95,133 grant from the Ed and Ethel Moore Alzheimer’s Disease Research Program of the Florida Department of Health to test a novel mechanism in Belle Glade for early detection, diagnosis and treatment of AD in the home setting to reduce AD-related costs in underserved communities. The long-term goal of the study is to create a model for increasing early detection and treatment of AD that can be replicated in other underserved communities in Florida. A key outcome of this study is to delay earlier transitions to skilled nursing facilities, which could decrease health care costs by up to 30 percent for people with AD. Prior studies have shown that Medicaid can provide home care based services to three people for the cost of caring for one person in a long-term care institution. “The lack of easily accessible, culturally proficient, and gerontology-trained providers creates a unique challenge for older adults in rural communities and really warrants further investigation,” said Lisa Wiese, Ph.D., principal investigator of the study and an assistant professor in FAU’s College of Nursing. “We anticipate that offering health care access to a nurse practitioner at either a rural clinic site or home health visit will be more effective than the current practice of waiting until symptoms develop. We also expect that home-based dementia screening and detection services will be more effective than screening and treatment at a local clinic.” The study will examine a cohort of diverse rural residents’ perceptions and behaviors regarding health screenings and follow-up in the home as compared to a clinical setting and will compare the effectiveness of home-based or clinic screenings and follow-up evaluations. Gerontology-trained and culturally competent nurse practitioners will conduct dementia-specific geriatric assessments in individuals identified as being at risk through the home or clinic screening efforts. Continuing care management by a nurse practitioner will be provided. The researchers will pilot-test a referral program, “ROAD (Rural Older Adults with Dementia)-Next-Steps,” modeled after the Alzheimer’s Association Next Steps’ program of following patients after cognitive assessment to ensure that rural Florida residents receive continuing support as needed. “Providing earlier cognitive assessment to facilitate earlier management of cognitive decline issues can assist with aging-in-place and decreased health care costs,” said Marlaine Smith, Ph.D., dean of FAU’s College of Nursing. “With more convenience, a less threatening environment and elimination of barriers like cost, transportation and long wait times, we can help individuals in rural areas live with greater independence at home and avoid admission to acute or long-term care institutions.” In Florida, nearly 38 percent of individuals who have AD are undiagnosed, and more than 50 percent of Americans with dementia do not receive a cognitive assessment before they are institutionalized. FAU’s College of Nursing is internationally known for its commitment to nursing as a discipline focused on nurturing the wholeness of persons and the environment through Caring. The College advances Caring knowledge through education, practice, research and scholarship to transform care locally, nationally and globally. Currently, the College of Nursing offers bachelor’s, master’s, DNP and Ph.D. degree programs with approximately 1,600 nursing students enrolled in its programs. For more information, visit www.nursing.fau.edu. - FAU – About Florida Atlantic University: Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University, with an annual economic impact of $6.3 billion, serves more than 30,000 undergraduate and graduate students at sites throughout its six-county service region in southeast Florida. FAU’s world-class teaching and research faculty serves students through 10 colleges: the Dorothy F. Schmidt College of Arts and Letters, the College of Business, the College for Design and Social Inquiry, the College of Education, the College of Engineering and Computer Science, the Graduate College, the Harriet L. Wilkes Honors College, the Charles E. Schmidt College of Medicine, the Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Science. FAU is ranked as a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. The University is placing special focus on the rapid development of critical areas that form the basis of its strategic plan: Healthy aging, biotech, coastal and marine issues, neuroscience, regenerative medicine, informatics, lifespan and the environment. These areas provide opportunities for faculty and students to build upon FAU’s existing strengths in research and scholarship. For more information, visit www.fau.edu.