News

Pride Week keynote to address meeting the health-care needs of LGBT older adults

The 2017 Pride Week HSC Campus keynote address will feature leading scholar and researcher Noell Rowan, Ph.D., addressing the unique challenges of the aging LGBT population, the clinical and social needs of LGBT communities and specific strategies professionals can employ to improve the health of LGBT populations, especially in later life.

Rowan is professor and associate director at the School of Social Work, University of North Carolina Wilmington. She is the former director of the bachelor of social work program at the Kent School of Social Work at UofL (2007-2013). She earned both bachelor’s and master’s degrees in social work from the University of Georgia and her doctorate in social work from the University of Louisville/University of Kentucky joint program. She has authored more than 20 publications in the research areas of gerontology, LGBT populations, alcohol and other drug addictions, and interprofessional education.

Presented by the University of Louisville LGBT Center and the Institute for Sustainable Health & Optimal Aging, the event will be held in the HSC Auditorium in Kornhauser Library, on Tuesday, Oct. 31 from noon to 1:00 p.m. Lunch is provided by the School of Public Health and Information Sciences Student Council.

A part of the LGBT Health Certificate as well as Grand Rounds for the Department of Family and Geriatric Medicine, this lecture is designed for mental health and primary care professionals, however it is open to all community members. Medical CME and Social Work CEU credit are offered. 

Click here to register. 

More than 150 girls expected at first UofL STEM+H event

School of Medicine co-hosts event to interest girls in science, technology, engineering, mathematics and health careers
More than 150 girls expected at first UofL STEM+H event

An attendee at the E-Expo 2018, the forerunner of the Girls Rule STEM+H Summit 2019.

To demonstrate the kinds of careers available to women in the science, technology, engineering, mathematics and health (STEM+H) fields, the University of Louisville is hosting its first Girls Rule STEM+H Summit event, Saturday, April 6.

More than 150 girls and young women ages 8-18 are registered to attend the 9 a.m.-2 p.m. event at the Belknap Academic Building. While the 3rd to 12th-grade students participate in hands-on workshops and activities, accompanying adults will be offered information sessions on how to prepare for higher education and careers in STEM+H.

Among the workshops, all taught by UofL students and faculty, will be robotics, medicine and genetics.

While UofL has hosted STEM introductory events for girls in past years, 2019 marks the first year health education and careers will be included. The event is co-sponsored by the J.B. Speed School of Engineering, the School of Medicine and the UofL Army ROTC program.

 “We are delighted to once again open our doors and show girls and women the variety of careers in these exciting areas,” said Emmanuel G. Collins, dean of the Speed School. “These careers of the future need more women and under-represented minorities and we hope to inspire by example.”

A short informational video can be found here.

For further information, contact Kari Donahue, 502-852-6279, kari.donahue@louisville.edu.

New York LGBT care coordination director selected as UofL Health Sciences Center LGBT Center director

New York LGBT care coordination director selected as UofL Health Sciences Center LGBT Center director

Bláz Bush of New York will join UofL Feb. 25 as the director of the LGBT Center at the Health Sciences Center.

A professional with almost a decade in caring for patients who identify as lesbian, gay, bisexual, transgender, gender non-binary and those born with differences in sex development has been selected to lead the LGBT Center at the University of Louisville Health Sciences Center.

Bláz Bush of New York will join UofL Feb. 25. He brings a skill set particularly attuned to the needs of the LGBT community at the HSC, said Vice Provost for Diversity and International Affairs Mordean Taylor-Archer.

“Bláz combines a wealth of experience in LGBT health care with a collaborative, inclusive leadership style,” Taylor-Archer said. “These qualities make him perfectly positioned to take the HSC LGBT Center to the next level of success in serving our students, faculty, staff, community and ultimately patients.”

Bush comes to UofL after serving as the director of care coordination of the Callen-Lorde Community Health Center, one of the largest LGBT community health centers in the world, serving 18,000 patients annually.

At Callen-Lorde, Bush oversaw 40 case managers, patient navigators and prevention and outreach counselors. He also led the health center in a number of initiatives, including improving community HIV viral-suppression rates and developing interventions to address social determinants of health.

Bush also served on the Health and Human Services HIV Planning Council of New York’s Integration of Care subcommittee, working with city leaders to develop HIV/AIDS programs focused on transgender and non-binary gender health disparities, housing, opioid-use reduction, food and nutrition and care coordination programs.

Prior to Callen-Lorde, Bush was with the New York Blood Center’s Infectious Diseases Research Program. He earned a master’s degree with a focus in community counseling from the University of Oklahoma.

UofL is a leader in the field of educating medical students in the needs of LGBT patients, serving as the pilot program for the Association of American Medical Colleges recommendations to embed training in the care of these patients throughout the medical school curriculum. UofL’s project, eQuality, won the 2016-2017 Innovation in Medical Education Award from the Southern Group on Educational Affairs.

“The work being done at the University of Louisville to educate future generations of health care providers in lesbian, gay, bisexual and transgender and gender non-binary health care needs is essential, lifesaving and radical,” Bush said. “Having worked at an LGBT health center, I understand the vital importance of adequate training and the desperate need for sensitive, quality health care to be widespread and accessible for all communities, especially for communities of color.

“The University of Louisville is already the leader in creating an LGBT-inclusive campus and is an innovator in creating LGBT educational programs. I am humbled and excited for this opportunity to help lead the Health Sciences Center forward and continue its progressive leadership in educating the caregivers of tomorrow.”

 

 

 

 

 

 

 

 

UofL oncologist leads study showing combination therapy better than single drug in treating melanoma

UofL oncologist leads study showing combination therapy better than single drug in treating melanoma

Jason Chesney, M.D., Ph.D.

Jason Chesney, M.D., Ph.D., acting director of the University of Louisville James Graham Brown Cancer Center, was study investigator on the Phase 2 ‘264 study that demonstrated Imlygic® (talimogene laherparepvec) in combination with the immune checkpoint inhibitor Yervoy® (ipilimumab) more than doubled objective response rate, defined as the proportion of patients with tumor size reduction, compared to Yervoy alone in patients with unresectable stage IIIB-IV melanoma. The results were presented at the 53rd Annual Meeting of the American Society of Clinical Oncology on June 3.

The analysis showed that 38.8 percent of patients treated with Imlygic plus Yervoy achieved an objective response versus 18 percent of patients treated with Yervoy alone. Patients in the combination arm also experienced nearly double the complete response rate compared to Yervoy alone (13.3 percent versus 7 percent).  It was the first randomized study to evaluate the combination of Imlygic, an oncolytic viral therapy, with a checkpoint inhibitor.

“The results from this study demonstrate the potential of combining the complementary mechanisms of action of an oncolytic viral immunotherapy and a checkpoint inhibitor to enhance anti-tumor effect in patients with advanced melanoma,” one of the most difficult-to-treat types of cancer, said Chesney, who also serves as chief of the Division of Medical Oncology in UofL’s Department of Medicine.

Responses in the study were not limited to injected lesions. Among patients with visceral disease treated with IMLYGIC plus YERVOY, 35 percent had a reduction in size of visceral lesions by at least 50 percent. The rate was 14 percent in patients in the YERVOY arm.

The ‘264 study is a Phase 1b/2, multicenter, open-label trial evaluating the safety and efficacy of IMLYGIC in combination with YERVOY compared to YERVOY alone in patients with unresectable stage IIIB-IV melanoma. The primary endpoint of the Phase 2 portion of study is ORR. Secondary endpoints include duration of response, disease control rate, PFS, OS and safety. The study randomized 198 patients, 98 in the IMLYGIC plus YERVOY arm and 100 in the YERVOY arm.

Patients in the IMLYGIC plus YERVOY arm experienced a median progression-free survival (PFS) of 8.2 months (median follow-up at 68 weeks) versus 6.4 months in the YERVOY arm. While the effect was not statistically significant, the PFS analysis was not event-driven and is still ongoing, with only approximately 50 percent of PFS events reported at this time.

IMLYGIC is designed to rupture cancer cells causing the release of tumor-derived antigens, which along with granulocyte-macrophage colony-stimulating factor (GM-CSF), may help to initiate an anti-tumor immune response. However, the exact mechanism of action is unknown. This may be complementary to YERVOY’s mechanism of action, as the blockade of cytotoxic T-lymphocyte-associated antigen-4 has been shown to augment activation and proliferation of tumor infiltrating T-effector cells.

For more details, including safety information,  visit the Imlygic website.

Top brain cancer specialists to speak on primary gliomas July 8

Second annual James Graham Brown Cancer Center Neuro-oncology Symposium
Top brain cancer specialists to speak on primary gliomas July 8

Kosair Charities Clinical and Translational Research Building

Some of North America’s most respected physician researchers in neuro-oncology will share their expertise with physicians and the public at the second annual James Graham Brown Cancer Center Neuro-oncology Symposium on July 8 at the University of Louisville.

“Management of Primary Glioma in Adults,” co-hosted by the UofL Department of Neurology and the James Graham Brown Cancer Center, a part of KentuckyOne Health, will be Friday, July 8 from 7:15 a.m. to 1 p.m. at the Kosair Charities Clinical and Translational Research Building, 505 South Hancock Street on the University of Louisville Health Sciences Campus.

Conference director Eric Burton, M.D., assistant professor in the UofL Department of Neurology and director of neuro-oncology at JGBCC, will provide an overview of adult glioma, a tumor that develops in the supportive tissue of the brain. Presenters from MD Anderson Cancer Center, University of California, San Francisco, Toronto General Hospital and the University of Louisville will then address best current practices and future treatment directions for patients with primary gliomas using surgery, radiation and chemotherapy, as well as a discussion of molecular markers in adult glioma.

“These are some of the most influential and highly respected physician researchers in neuro-oncology and neuropathology,” Burton said. “This is an excellent opportunity for physicians across the region, as well as patients and their families, to learn about the latest developments in the pathology and treatment of brain tumors.”

In addition to Burton, presenters include:

Kenneth Aldape, M.D., senior scientist and director of MacFeeters-Hamilton Brain Tumor Centre at Toronto General Hospital and professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. Aldape is a neuropathologist with a research interest in primary brain tumors. His work includes the identification of biomarkers in gliomas, characterizing glioma subtypes and identifying clinically relevant molecular alterations in these tumors. In 2014, Aldape received the Guha Award for Excellence in Neuro-Oncology Research from the Society for Neuro-Oncology.

Michael Prados, M.D., Charles B Wilson Chair in Neurosurgery and professor emeritus at the University of California San Francisco. Prados led the North America Brain Tumor Consortium for 15 years and was co-project leader of the Adult Brain Tumor Consortium until 2014. He formed and is co-project leader of the Pacific Pediatric Neuro-Oncology Consortium, a consortium of 15 major academic centers across the United States, and is co-project leader of a pediatric brain tumor SPORE project at UCSF. Prados has been NIH/NCI funded continuously since 1994 and is a member of the NCI/CTEP Brain Malignancies Steering Committee. In 2014, he was awarded the Victor Levin Award for lifetime clinical research excellence from the Society of Neuro-Oncology.

Raymond Sawaya, M.D., chair and professor of the Department of Neurosurgery at the University of Texas MD Anderson Cancer Center in Houston. He is director of the Brain Tumor Center at MD Anderson and served as professor and chair of the Department of Neurosurgery at Baylor College of Medicine from 2005-2014. His awards include the Joseph P. Evans Award in Neurosurgery at the University of Cincinnati and the Charles Wilson Award from the National Brain Tumor Society. He is past chairman of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors. Sawaya has particular expertise in primary and metastatic brain tumors and is renowned for his strides in enhancing the accessibility and safety of brain tumor surgery.

Shiao Woo, M.D., chair and professor in the UofL Department of Radiation Oncology, professor in the UofL Department of Pediatrics and the Kosair Children’s Hospital/Norton Healthcare Chair in Pediatric Oncology. His clinical focus and research is on brain and spine tumors, pediatric cancer and lung cancer. Woo has received Clinical Fellowship Awards from the American Cancer Society, Teacher of the Year Award from the Association of Residents in Radiation Oncology and the Patient Golden Apple Award from the MD Anderson Cancer Center. He also served as president of the MD Anderson Radiation Oncology Gilbert H. Fletcher Society.

“We have invited speakers with varied areas of expertise with the intention of creating a collaborative environment that will improve the regional standard of care,” Burton said.

Continuing education credit is available for health care providers. The event is free for UofL-affiliated providers, $15 for nurses and $20 for all others. For additional information, visit the conference website or contact Emily Rollins at emily.rollins@louisvilleneuroscience.com.

September golf tourneys benefit UofL cancer center

September golf tourneys benefit UofL cancer center

Two golf tournaments in September will benefit the University of Louisville’s James Graham Brown Cancer Center, a part of KentuckyOne Health.

The 7th Annual Don Happel Memorial Golf Tournament will be held Saturday, Sept. 12, at Eagle Creek Golf Course in La Grange, Ky., and the 5th Annual Hammertime Golf Scramble will be Monday, Sept. 14, at Iroquois Golf Course in Louisville.

About the Don Happel Tournament

The Happel Tournament tees off at 8:30 a.m., Sept. 12, with a shotgun start. The tournament is a scramble and has payouts for the 1st, 2nd and “Lucky” 13th” holes. Cost is $300 per team of four and each player can purchase two red tees for $10. Hole sponsorships are available for $50 each.

The Eagle Creek Golf Course is located at 2820 S. Highway 53, La Grange. Since the tournament’s inception, it has raised almost $18,000 for the cancer center, helping to provide education, transportation and other non-clinical services.

Registration deadline is Aug. 29. For details, contact Bret Happel at 502-253-2207 or Cindy Hall at 502-767-3752.

About the Hammertime Golf Scramble

The Hammertime Scramble benefits the Larry Smith Lung Cancer Fund at the cancer center and will start at 1 p.m.  on Aug. 14. The event features a putting contest, long drive contest, silent auction, door prizes and the chance to win a new car. Individual fee is $75 and a team of four is $300. Sponsorships range from $100 to $3,500.

The Iroquois Golf Course is at 1501 Rundill Road, Louisville. The tournament is affiliated with the UofL Alumni Association. The tournament’s goal is $50,000 to help fund a new cancer screening van that will provide cancer screenings to underserved populations across Kentucky.

For details and to register, go to the tournament web page or contact Linda Dame at linda.dame@louisville.edu.

About the James Graham Brown Cancer Center

The James Graham Brown Cancer Center is a key component of the University of Louisville Health Sciences Center. As part of the region's leading academic, research and teaching health center, the cancer center provides the latest medical advances to patients, often long before they become available in non-teaching settings. The JGBCC is a part of KentuckyOne Health and is affiliated with the Kentucky Cancer Program. It is the only cancer center in the region to use a unified approach to cancer care, with multidisciplinary teams of physicians working together to guide patients through diagnosis, treatment and recovery. For more information, visit our website, http://browncancercenter.louisville.edu.

UofL institute awarded $2.55 million to create Kentucky Rural & Underserved Interprofessional Education Program

UofL institute awarded $2.55 million to create Kentucky Rural & Underserved Interprofessional Education Program

Anna Faul, D.Litt.

The Institute for Sustainable Health & Optimal Aging at the University of Louisville, now in just its 15th month of operation, has garnered a major grant to further efforts to bring health care to rural and medically underserved Kentuckians.

The Health Resources and Services Administration of the Department of Health and Human Services has awarded $2.55 million to institute researchers to create the Kentucky Rural & Underserved Geriatric Interprofessional Education Program (KRUGIEP).

This three-year initiative will be headed by Dr. Anna Faul, executive director of the Institute for Sustainable Health & Optimal Aging at UofL, and will include a group of transdisciplinary faculty at UofL along with partnering organizations from six rural counties in Kentucky: Hart, Metcalfe, Barren, Bullitt, Henry and Shelby.

In the six counties, KRUGIEP addresses the following needs:

  1. The shortage of the geriatric and primary care work force
  2. The need to train health care providers that can deliver culturally appropriate services to Kentucky’s growing Hispanic population
  3. The need to decrease the chronic disease burden in rural Kentucky
  4. The lack of supportive environments to promote health, specifically for older rural populations
  5. The need for supportive education and resources in Alzheimer’s disease and related dementias (ADRD)

With the grant funding, KRUGIEP will develop an interprofessional education center for geriatric education at UofL for students and professionals in medicine, nursing, social work, dentistry, pharmacy, community health and law; help primary care sites deliver integrated patient-centered geriatric primary care; and provide training and community engagement resources to create ADRD-friendly communities in the six-county region.

“This project is unique in its integration of community health teams and mental health specialists within geriatric primary care delivery systems,” said Institute Executive Director Anna Faul, D.Litt., who is principal investigator on the grant. “We are going to use a systemic approach of collaborative care and develop an inter-agency consortium that strengthen the links among related services for older adults.”

Within UofL, the grant will initially draw upon resources and faculty from the Brandeis School of Law, Kent School of Social Work, School of Dentistry, School of Medicine and School of Nursing. Partner sites in the first year of the grant will be Glasgow Family Medicine Clinic serving Barren, Hart and Metcalfe counties; Shelby Family Medicine and Mercy Medical in Shelby County; Kentucky River Medical Partners in Henry County and UofL Geriatrics Home Care Practice in Bullitt County. Additionally, partnering organizations are KIPDA in Louisville and the Barren River Area Agencies on Aging and Independent Living.

Although three of the six counties – Henry, Shelby and Bullitt – are classified within the Louisville Metro region, large percentages of the population are seen as rural, based on population density, count and size thresholds. The total population of the six counties is just 202,726, with 13 percent age 65 and older.

Crucially, the projected population growth of those 65 and older in the six counties is projected to be 149 percent by the year 2050 – 35 percent greater than both the projected growth rates of 114 percent for the same group in Kentucky and the United States.

Growth in the Hispanic population in the six counties also is above the state and national average. From 2000 to 2010, the Hispanic population change was 144 percent as compared to 122 percent in Kentucky and 43 percent in the United States during the same time frame.

“This grant represents exactly why the Institute for Sustainable Health & Optimal Aging was created,” said Terry Singer, Ph.D., dean of the Kent School who is involved with work funded by the grant. “The need for transdisciplinary approaches to examine issues that our aging population faces is significant because no issue stands on its own; all are inter-related from a health, social science, legal and policy perspective.”

The University of Louisville Institute for Sustainable Health & Optimal Aging seeks to transform the aging process at the local, national and international levels. In partnership with the university and community partners, the institute works to empower older adults to flourish by engaging in biopsychosocial transdisciplinary research, innovation leading to age-friendly product commercialization, evidence-based practice models of care and creative didactic and experiential education. For more information, visit www.OptimalAgingInstitute.org or on Facebook, Facebook/OptimalAgingInstitute.

 

Dried sea monkeys and frozen wood frogs - Beer with a Scientist, Oct. 16

UofL biologist explains how animals that survive extreme conditions are game changers for human medicine
Dried sea monkeys and frozen wood frogs - Beer with a Scientist, Oct. 16

Michael Menze, Ph.D.

Some animals have developed the ability to survive in extreme conditions such being frozen, drying or with a complete lack of oxygen.

At this month’s Beer with a Scientist, Michael Menze, Ph.D., associate professor in the Department of Biology at the University of Louisville, will discuss how the mechanisms behind these animals’ survival in impossible conditions can be used to transform human medicine.

“I am fascinated with how these animals can survive the limits of life, so my research focuses on decoding the molecular mechanisms that protect animals exposed to harsh environmental factors,” Menze said. “Understanding how life can survive these intense insults allows us to solve medical challenges ranging from long-duration space travel to securing the human blood supply.”

Menze’s talk begins at 7 p.m. on Wednesday, Oct. 16, at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer or other items is not required but is encouraged. Organizers encourage Beer with a Scientist patrons to drink responsibly.

UofL cancer researcher Levi Beverly, Ph.D., created the Beer with a Scientist program in 2014 as a way to bring science to the public in an informal setting. At these events, the public is invited to enjoy exactly what the title promises:  beer and science.

New teaching physician guidelines announced

To comply with recent CMS changes, UofL Physicians has modified current attending attestation statements and have added some resident attestations.
 
For billing purposes, CMS wants a summarization of the teaching physician role in the care of the patient. For the most part, current attending attestations are fine, but providers must briefly summarize key portions of the visit. Depending on the workflow, these changes may make it easier for attending physicians by essentially allowing the resident to document for them. 

For questions regarding documentation, please contact Laura Gilbert, director, Compliance & Audit Services with ULP, at laura.gilbert@ulp.org or 502-588-6462.

How plans for a trip to Mars bring home our dependence on Earth’s environment - Beer with a Scientist, June 12

Ted Smith, Ph.D., will discuss insights gleaned from the space program
How plans for a trip to Mars bring home our dependence on Earth’s environment - Beer with a Scientist, June 12

Ted Smith, Ph.D.

At a recent workshop at the Massachusetts Institute of Technology to discuss health risks associated with a potential manned mission to Mars, it became clear just how vitally we humans depend on our Earth’s environment.

“Those discussions forced us to think about how our physiology depends on the attributes of our home planet. The question about what to include in the Mars transport vehicle is a wake-up call for those insensitive to the elimination of biodiversity and poorly conceived urbanization globally,” said Ted Smith, Ph.D., deputy director of the Christina Lee Brown Envirome Institute at the University of Louisville. Smith also is a member of the Scientific Advisory Board for NASA’s Translation Research Institute for Space Health (TRISH) and organized the workshop.

At the next Beer with a Scientist, Smith will discuss what planning for long-range space travel reveals about the need to preserve our home planet’s health for our own survival.

Smith’s talk will begin at 7 p.m. on Wednesday, June 12, at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer or other items is not required but is encouraged. Organizers encourage Beer with a Scientist patrons to drink responsibly.

UofL cancer researcher Levi Beverly, Ph.D., created the Beer with a Scientist program in 2014 as a way to bring science to the public in an informal setting. At these events, the public is invited to enjoy exactly what the title promises:  beer and science.

Upcoming Beer with a Scientist events:

July 17:  Jason Chesney, M.D., Ph.D., will discuss recent advances in using our own immune cells to cure cancer.

Rate of prescribing psychotropic drugs to Kentucky kids studied at UofL

Current prescribing rate in Kentucky almost double national average
Rate of prescribing psychotropic drugs to Kentucky kids studied at UofL

Gilbert Liu, M.D.

Researchers with the Child and Adolescent Health Research Design and Support Unit (CAHRDS Unit) at the University of Louisville have begun a study to examine one of Kentucky’s most vexing children’s health issues: the higher-than-average rate of psychotropic medication being prescribed to children in the Bluegrass State.

Psychotropic medications (PMs) alter chemical levels in the brain that impact mood and behavior. Antipsychotics, antidepressants, drugs for attention deficit disorder and attention deficit hyperactivity disorder, anti-anxiety medications and mood stabilizers are some of the more commonly used psychotropic drugs. While they produce good results among most patients, they also can cause worrisome side effects in others, and their interactions with each other can create problems as well.

Of the almost 600,000 children receiving Medicaid in Kentucky, one in seven – 14 percent – has been prescribed at least one of these powerful psychiatric drugs. Equally troublesome, almost half – 42 percent – of the children in Kentucky’s foster care system have been prescribed at least one.

Both statistics are almost twice the national average. Nationally, just 7.4 percent of kids receiving Medicaid and 26.6 percent of kids in the foster care system have been prescribed a PM.

An eight-member team at the CAHRDS Unit, a part of the UofL Department of Pediatrics, is working to find out why these drugs are given to Kentucky children at almost twice the national rate.  The team has been awarded a $75,000 Improved Health Outcomes Program grant from Passport Health Plan, the nonprofit community-based health plan administering Kentucky Medicaid benefits to more than 200,000 people statewide.

“Passport Health Plan has a common concern and this grant represents an opportunity, in addition to the programs we already have in place, to address this concerning trend.” said Stephen J. Houghland, M.D., Passport Health Plan’s chief medical officer.

“It’s very concerning to us that the rate of prescribing in Kentucky is higher than the national average,” said Gilbert Liu, M.D., the study’s principal investigator and the chief of the Division of General Pediatrics at UofL. “We also are concerned that children are getting prescriptions for psychotropic medications that are not FDA-approved. Also worrisome is that some children are being prescribed two or more of these very potent drugs.”

“Are these children getting a clear diagnosis?” said Charles Woods, M.D., director of the CAHRDS Unit and vice chair for faculty development of the UofL Department of Pediatrics. “Is there a primary care provider involved? Are they getting the appropriate psychiatric services they need along with these medications? These are the questions we intend to pose in this study.”

Three-phased study will take a year

The year-long study will consist of three phases. The researchers will first assess Kentucky Medicaid claims data to see if prescribing patterns emerge across geographic regions of the state as well as racial, ethnic, gender and socioeconomic class. The first phase also will include an examination of what type of providers are prescribing PMs to children – primary care providers, psychiatrists, pediatricians or others.

During the second phase of the study, the researchers will talk with providers who have higher-than-average rates of prescribing to find out why these higher rates occur. “It could be that in some cases, the higher rate of prescribing is medically warranted,” said Michael Smith, M.D., a clinician and researcher with UofL Physicians-Pediatrics. “However, it also could be that if appropriate psychiatric services are not available, a primary care physician feels this is the only way he has at his disposal to treat children who need these services.”

The third phase of the study will “get to the heart of the matter,” Liu said, in developing informed and thoughtful approaches to correcting overuse of PMs where it occurs. “We do not want to get in the way of providers with their patients,” he said. “However, we believe that with their help, we can provide alternate ways to care for children needing psychiatric services that lessens the need for PMs.”

“In Kentucky, we need to better understand patterns of PM use along with non-drug treatments and monitoring for children receiving Medicaid,” Woods said. Our intent is to develop the best solutions possible for improving the care of these vulnerable children.”

Multidisciplinary team of researchers

In addition to Woods, Liu and Smith, other members of the research team include Deborah Winders Davis, Ph.D., David Lohr, M.D., John Myers, Ph.D., Michelle Stevenson, M.D., and Michael Rowland, Ph.D.

“This is the type of work that calls for a multidisciplinary approach,” Woods said. “Among our group we are fortunate to have clinical and research expertise in general pediatrics, child and adolescent psychiatry, early childhood development, emergency medicine, biostatistics, qualitative data analysis and informatics. We look forward to being able to make a difference for children through our collective efforts on this project.”

Parents with concerns about PM use or those wanting more information about the study can contact Liu at 502-852-3737.

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About Passport Health Plan

Passport Health Plan is a provider-sponsored, non-profit, community-based Medicaid health plan serving more than 200,000 people around Kentucky. Recently named the No. 19 Medicaid health plan in the United States and the top Medicaid plan ranked in Kentucky by the National Committee for Quality Assurance (NCQA), Passport has been contracted with Kentucky’s Cabinet for Health and Family Services to administer Medicaid benefits since 1997 and has been serving the entire Commonwealth since Jan. 1, 2014. For additional information about Passport Health Plan, go online to passporthealthplan.com.

 

The Affordable Care Act in Kentucky, One Year Later

UofL physician notes successes in 'New England Journal of Medicine' follow-up article
The Affordable Care Act in Kentucky, One Year Later

One year ago, Michael Stillman, M.D., and his colleague, Monalisa Tailor, M.D., both physicians with the University of Louisville Department of Medicine, wrote a New England Journal of Medicine “Perspective” article about “Tommy Davis,” their pseudonym-named patient who delayed seeing a doctor because he lacked health insurance.

After spending a year experiencing severe abdominal pain and other symptoms, Davis finally sought care in the emergency room. The diagnosis? Metastatic colon cancer.

“If we’d found it sooner,” Davis said to the physicians, “it would have made a difference. But now I’m just a dead man walking,” a phrase so evocative, the physicians chose it as the headline of their article.

Today, however, Stillman and his colleagues are witnessing what another of his patients terms a “sea change in health care” because of the passage and implementation of the Affordable Care Act (ACA) in Kentucky.

Stillman has authored a follow-up “Perspective” article in the New England Journal of Medicine this week that notes the changes brought about by the ACA and Kentucky Gov. Steve Beshear’s decision to accept federal funding for Medicaid expansion that the act brought about.

One year later, the ACA rollout in Kentucky has been a success, he says. “…Our Commonwealth’s citizens – among the poorest and most (medically) underserved in the country – finally gained broad access to health insurance,” he says. “… allowing us to provide data-driven and thorough care without first considering our patients’ ability to pay.”

The contrast between last year and today is stark, writes Stillman. “Before … Medicaid expansion, the 60 percent of my clinic patients and 650,000 Kentuckians who lacked health insurance received disjointed and disastrous care.” Many avoided routine and preventative care because of worries over cost.

“But during the past year,” Stillman writes, “many of my lowest-income patients have, for the first time as adults, been able to seek non-urgent medical attention.” In Kentucky, 413,000 people gained medical coverage who did not have it prior to the ACA implementation.

The ACA has brought about other unexpected benefits as well. Expanded health care coverage has greatly improved residency training in Kentucky, enabling the doctor to spend more time doctoring and less time serving as a financial advisor.

“One year after the law’s implementation, residents at my hospital can finally provide guideline- and evidence-based care,” without first considering the cost, he writes. “Since 92 percent of our patients are now insured, we no longer receive fretful looks when we recommend laboratory tests; we screen for colorectal cancer with colonoscopies rather than with less sensitive fecal blood cards; and we spend more time examining patients and less time helping them knit together limited public-assistance resources.”

Another unanticipated benefit has been an increase in competition for patients. Before the ACA, patients without health insurance had a limited number of facilities in which they could receive care.

Today, however, “with increased enrollment in Medicaid and commercial (health) plans, these same patients are pursued by medical groups and hospitals and can be selective in choosing their sites of care.”

Stillman notes that the ACA remains threatened, both in Kentucky where its success is verified by data, and in other states throughout the country.

“Some Kentuckians question the adequacy of the newly purchased plans and are concerned that despite being ‘insured,’ people who have bought low-premium, high-deductible plans may (still) wind up accruing substantial medical debt,” he writes.

Also, he notes that 21 states have yet to expand Medicaid eligibility despite the example Kentucky shows of the success in doing so. Physicians, however, can help.

“First, we can challenge our elected officials to do a better job of seeing to their constituents’ needs,” he writes. “Furthermore, we can delineate for our patients the often-subtle links between current affairs and their own health,” including asking them if they are registered to vote and reminding them of candidates’ support of or opposition to the legislation that has palpably benefited them.

“I hope that an increasing number of state legislatures will help their vulnerable citizens receive the services they need and that the next generation of physicians will be shocked that our current efforts at health care inclusion were ever seriously questioned.”

 

Kentucky receives $7 million to lead first-of-its-kind collaboration to reduce burden of lung cancer

University of Louisville, University of Kentucky and Lung Cancer Alliance lead effort with grant from Bristol-Myers Squibb Foundation
Kentucky receives $7 million to lead first-of-its-kind collaboration to reduce burden of lung cancer

On Nov. 12, the University of Kentucky, the University of Louisville, and Lung Cancer Alliance announce the Kentucky LEADS (Lung Cancer. Education. Awareness. Detection. Survivorship) Collaborative, a project that will focus on reducing the burden of lung cancer in Kentucky.  Kentucky has more cases of lung cancer than any other state and its lung cancer mortality rate is nearly 50 percent higher than the national average.

The Kentucky LEADS Collaborative is a first of its kind project that brings together an interdisciplinary team of community partners and lung cancer prevention and control experts to assess novel approaches for identifying lung cancer earlier to improve survival. The project will also develop and evaluate interventions to improve quality of life and survivorship for individuals with lung cancer and their caregivers. These efforts are supported through a $7 million grant from the Bristol-Myers Squibb Foundation’s Bridging Cancer Care initiative.

“As Kentucky leads the nation in lung cancer mortality rates, we must step up to be a leader in finding solutions toward preventing, curing and coping with this destructive disease”, said Kentucky Governor Steve Beshear.  “I strongly support this collaborative, wide-ranging effort as it coincides with this administration’s KyHealthNow goals of reducing statewide cancer and smoking rates by 10 percent by 2019.  By working together, we can and will find a way to diminish the burden of this crisis in Kentucky."

Lung cancer is the most common cancer worldwide and kills more Americans than breast, prostate and colon cancer combined. In Kentucky, the burden of this illness is even more dramatic and will take over 3,500 lives this year alone.

"Historically there's not been a lot of research or effort put into lung cancer survivorship because, unfortunately, there hasn't been much survivorship," said Jamie Studts, PhD, associate professor of behavioral science at the University of Kentucky and director of the Kentucky LEADS Collaborative. "This project is an effort across several domains to help providers, patients, caregivers and health care programs do the best job possible to achieve better care and increase lung cancer survivorship."

One in two patients diagnosed with lung cancer will die within a year. After five years, only 16 in 100 patients will be alive. "Those are sobering statistics,” said John Damonti, president, Bristol-Myers Squibb Foundation. “The timing of diagnosis is critical. Patients diagnosed at Stage 1 have a 57 percent chance of achieving five-year survival. That drops to 4 percent when patients have a late-stage diagnosis. Early detection and treatment of lung cancer, combined with education and patient support, is key to increased survival for patients living with lung cancer.”

The first component of the program, provider education, led by Connie Sorrell of the Kentucky Cancer Program West and Dr. Goetz Kloecker at the University of Louisville, will review the practice patterns and factors affecting referral and treatment of lung cancer patients across the state. Primary care providers play a key role in the management of lung cancer, and this component of the project will familiarize them with best practices in caring for patients who are at high risk of developing lung cancer or are diagnosed with the disease.

“It is our goal to help primary care providers throughout Kentucky to identify people at high risk of lung cancer and be aware of the significant improvements in diagnosis and treatment of lung cancer,” Kloecker said. “We will give providers evidence-based information that enables them and their patients to receive the best possible care. An important part of this is the detection of cancer at an early stage. Once the cancer is diagnosed it is important for patients to receive the most effective treatments in order to have the best chance of cure, survival and quality of life.”

Studts will lead the second component of the project, which will develop a lung cancer-specific survivorship program that promotes quality of life and well-being for individuals diagnosed with lung cancer, as well as their caregivers, throughout the continuum of the disease. This will include care that addresses a combination of acute and late or long-term effects of the illness and treatment.  Studts and his team will also develop a training program for lung cancer navigators and mental health providers to sustainably administer the survivorship program to patients and caregivers statewide.

Lung cancer screening guidelines have recently changed, creating a unique opportunity to implement rigorous, statewide screening programs that can save lives. The third component of the project, led by Dr. Timothy Mullett and Dr. Jennifer Redmond Knight at the University of Kentucky, will therefore promote evidence-based prevention and early detection of lung cancer. Lung cancer is often diagnosed too late to treat because symptoms tend to emerge only after the disease has spread. For this reason, increasing high-quality lung cancer screening is critical to reducing deaths from the disease.

Lung Cancer Alliance will partner with UK on the survivorship and screening components of the project, contributing to program design, administration, communications support and dissemination.

“We are so thrilled and proud to be a partner in this unprecedented public health coalition intent on bringing heartfelt support and life-saving services to Kentucky citizens impacted by lung cancer,” said Laurie Fenton Ambrose, Lung Cancer Alliance president & CEO.  “Such ‘can do’ attitude not only will lead to a first-ever coordinated plan of action to reduce lung cancer’s foot print in Kentucky – but will stimulate other states to follow in its shoes in the months ahead. It is truly a momentous time worth celebrating.”

Additional collaboration on this project comes from the Kentucky Cancer Consortium, the Kentucky Clinical Trials Network, the Markey Cancer Foundation, the Kentucky Cancer Foundation and a broad range of community-based stakeholder groups, collaborators, partnering organizations, and healthcare systems throughout Kentucky and nationally.

About the James Graham Brown Cancer Center:

The James Graham Brown Cancer Center is a key component of the University of Louisville Health Sciences Center. As part of the region's leading academic, research and teaching health center, the cancer center provides the latest medical advances to patients, often long before they become available in non-teaching settings. The JGBCC is a part of KentuckyOne Health and is affiliated with the Kentucky Cancer Program. It is the only cancer center in the region to use a unified approach to cancer care, with multidisciplinary teams of physicians working together to guide patients through diagnosis, treatment and recovery. For more information, visit www.browncancercenter.org.

About University of Kentucky Markey Cancer Center

The Markey Cancer Center is a dedicated matrix cancer center established as an integral part of the University of Kentucky and UK HealthCare enterprise.  In 2013, Markey was designated by the National Cancer Institute (NCI) to receive research funding and many other opportunities available only to the nation’s best cancer centers. Markey is the only NCI-designated center in Kentucky and one of only 68 in the country. The clinical programs and services of the Markey Cancer Center are integrated with the UK Albert B. Chandler Hospital. Markey's cancer specialty teams work together with UK Chandler Hospital departments and divisions to provide primary patient care and support services as well as advanced specialty care with applicable clinical trials. For more information, visit www.markey.uky.edu.

About Lung Cancer Alliance

Lung Cancer Alliance is the leading national non-profit organization dedicated to saving lives and advancing research by empowering those living with or at risk for lung cancer. Recently rated as the highest lung cancer organization in the nation by Charity Navigator, Lung Cancer Alliance offers free personalized support, information and referral from professionally trained and caring staff; advocates for increased research funding and access to treatments and diagnostics; conducts national awareness campaigns about the disease, risk and early detection. For more information, visit www.lungcanceralliance.org.

About the Bristol-Myers Squibb Foundation

The Bristol-Myers Squibb Foundation is an independent 501(c)(3) charitable organization whose mission is to reduce health disparities and improve health outcomes around the world for patients disproportionately affected by serious disease. Focusing on southeastern U.S. states that have the highest lung cancer incidence and mortality rates in the country, the Foundation’s Bridging Cancer Care initiative seeks to transform community-based care and support for lung cancer.  For more information, visit www.bms.com/foundation.

UofL provides funding for "End Alz" Alzheimer's awareness license plate effort

UofL provides funding for "End Alz" Alzheimer's awareness license plate effort

Thanks to a donation from the Institute for Sustainable Health & Optimal Aging at the University of Louisville, the $25 application fee for an “End Alz” license plate will be waived for the remaining applications needed to reach the required 900 for issuance of plates. This limited opportunity is available on a first-come, first-serve basis to constituents throughout Kentucky.

“The Institute for Sustainable Health & Optimal Aging is honored to be able to support the Alzheimer’s Association and all Kentuckians who have been touched by Alzheimer’s disease. We believe that this license is a powerful symbol of our enduring love for those affected by Alzheimer’s, our unwavering support for their family members, and our commitment to working with our communities and the Alzheimer’s Association to end Alzheimer’s,” said Dr. Anna Faul, Executive Director of the Institute.  

The Alzheimer’s Kentucky specialty license plate features a “forget-me-not” flower on a purple background with the words: “Honor. Remember. Care. End Alzheimer’s.” It is an eye-catching design and phrase capturing both the hope and devastation of this disease.  “The Alzheimer’s Association is grateful to the Institute for Sustainable Health & Optimal Aging for understanding the value of helping to finalize this stage of the initiative.  Getting the End Alz plate on the roads of Kentucky has been a labor of love for the Association.  This awareness will shine an even brighter light on the impact of this disease for affected individuals and families as well as the vital need to find effective prevention, treatment and cure,” said Bari Lewis, Director of Community Outreach for the Association. 

Alzheimer’s affects 70,000 Kentuckians and over 5 million people nationwide.  There are over 270,000 Alzheimer’s family caregivers in Kentucky.  Every 67 seconds, someone in America develops Alzheimer’s and the number of people with Alzheimer’s is projected to triple by 2050.

Alzheimer’s is the sixth leading cause of death in the United States, the fifth for people over 65.  Research has not yet found a way to stop or reverse this disease. As many as half of people with dementia have never received a diagnosis, yet they could benefit from a variety of available medical and support services.

It is a disease that touches virtually everyone – including Faul. Her own father, the Rev. Japie Vermeulen of Ceres, South Africa, recently died after a 16-year battle with the disease.

“My education and training as a social worker specializing in older adults gave me knowledge about the hardship families endure when caring for a loved one with Alzheimer’s,” Faul said. “It was caring for my own father, however, that showed me the emotional burden this dreaded disease takes on both caregivers and the patients themselves.”

In order to receive a plate, constituents should fill out the application form located on alz.org/kyin and return to Alzheimer’s Association, 6100 Dutchman’s Lane, Suite 401, Louisville, KY 40205 or email to infoky-in@alz.org. Applicants will be notified by their local county clerk when plates are ready to be picked up. Plates will be available approximately three months after the 900 commitments are secured.

About the Alzheimer’s Association

The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer’s research, care and support. Our mission is to eliminate Alzheimer’s disease through advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. For more information, visit www.alz.org/kyin.

 

Survey for older adults designed to assess social service needs

Survey for older adults designed to assess social service needs

ISHOA and KIPDA

Senior citizens who live in Jefferson and surrounding Kentucky counties are encouraged to take a brief survey online or over the phone to help analyze social service needs for older adults and individuals with disabilities.

For the second year, the University of Louisville Institute for Sustainable Health and Optimal Aging will conduct a community needs assessment on behalf of the Kentuckiana Regional Planning & Development Agency (KIPDA).

Led by the institute’s Executive Director, Anna Faul, Ph.D., and Director of Health Innovation and Sustainability, Joe D’Ambrosio, Ph.D., the 2018 KIPDA needs assessment surveys people across the seven KIPDA counties – Bullitt, Henry, Oldham, Shelby, Spencer, Trimble and Jefferson. It looks at each county in regards to housing, outdoor spaces and buildings, transportation and streets, health and wellness, social participation, inclusion and education opportunities, volunteering and civic engagement and job opportunities.

The survey results, together with an analysis of current community services and gaps, will allow the institute to make specific and strategic recommendations to KIPDA. If adopted, these recommendations are designed to ensure that older adults and individuals with disabilities have their immediate social service needs met while more broadly enabling them to lead lives of dignity and independence.

Anyone living in the designated counties is invited to complete the Community Needs Assessment Survey. The more people that participate, the more likely service gaps can be addressed. Older adults, caregivers, and persons with disabilities are especially encouraged to participate in this research study. Survey participants do not have to be recipients of KIPDA services.

The assessment can be found online or by calling 502-852-8953. The institute can provide a paper copy upon request or at senior centers within the seven counties. The deadline to complete the assessment is Feb. 1, 2018.

For more information, visit www.optimalaginginstitute.org/kipda or contact Dr. D’Ambrosio at joe.dambrosio@louisville.edu or 502-852-7811.

Brothers provide Thanksgiving turkeys to patients at James Graham Brown Cancer Center

Brothers provide Thanksgiving turkeys to patients at James Graham Brown Cancer Center

The sons of Mary Jane Gift, center, have established a fund in her memory to help patients at the James Graham Brown Cancer Center.

Two brothers are working together to ensure that patients at the University of Louisville James Graham Brown Cancer Center have a happy Thanksgiving.

Alex and Tommy Gift lost their mother to a 20-plus year battle with cancer in 2010. In her memory, they established the Mary Jane Gift Quality of Life Fund at the cancer center in 2013.

Cancer treatment can be costly and leave many families with little resources during the holidays. The fund helps patients and their families enjoy life while facing a cancer diagnosis.

On Wednesday, Nov. 23, the brothers will distribute turkeys to more than 100 patients at the cancer center in memory of their mother. This will be the fourth annual turkey distribution sponsored by the Gift brothers.

“We experienced how cancer treatment can impact a family throughout my mother’s illness,” said Alex Gift. “Establishing this fund in her memory is our way of giving back to those who supported us and helping improve the lives of others battling cancer.”

 

 

Kentucky First Lady Jane Beshear launches Horses and Hope campaign for new cancer screening van

Churchill Downs, Kroger provide initial gifts totaling $115,000; van based at UofL Kentucky Cancer Program will screen for 7 cancer types

First Lady Jane Beshear on Jan. 6, along with representatives from the Kentucky Cancer Program, the University of Louisville’s James Graham Brown Cancer Center and KentuckyOne Health, launched a new Horses and Hope campaign to raise $1 million for a mobile unit to provide free or significantly reduced cost cancer screenings to underserved populations across Kentucky.

To start strong out of the gate, Mrs. Beshear announced a $90,000 commitment from Churchill Downs and a $25,000 donation from Kroger for the new van.

“For years, the Horses and Hope program has been one of the driving forces behind the portable mammography unit that travels throughout the state offering breast cancer screenings and promoting the message that early detection saves lives,” Mrs. Beshear said. “We now have the opportunity to expand these services to screen for six additional forms of cancer, and continue our efforts to improve the health and wellness of Kentuckians throughout the Commonwealth.”

Kentucky has the highest incidence and death rates in the nation for several cancers, with an overall cancer incidence rate that is 14 percent greater than the national average. The new van will focus on educating Kentuckians about cancer prevention, and offer screenings for seven cancer types, including breast, cervical, colon, lung, prostate, skin and head/neck.

“When it comes to cancer, the people of our state suffer dearly,” said Dr. Donald Miller, director of the University of Louisville James Graham Brown Cancer Center, a part of KentuckyOne Health. “Through the First Lady’s leadership with Horses and Hope, we have been able to bring early detection about breast cancer to women throughout the state. Once we have this new van on the road, we will be able to have the same impact on so many more people, with the very achievable goal of reducing cancer deaths in Kentucky.”

“KentuckyOne has made it a priority to transform the health of the communities we serve with a special focus on vulnerable populations,” said Mark Milburn, Vice President of Oncology Services, KentuckyOne Health. “Through our partnership with the First Lady and Horses and Hope, the Kentucky Cancer Program and the University of Louisville, we have the resources available to dramatically reduce disparities in health access and enhance the health of our communities throughout the state.”

The custom-built coach will be 40 feet in length, with an exterior design featuring a Horses and Hope theme and acknowledgment of project partners. The interior will include a reception area with monitors for educational videos, patient changing rooms, a patient examination room with exam table, digital mammography equipment, space for supportive laboratory services and a passenger cab area. A motorized retractable awning on the outside of the coach will provide expanded space for patient reception, registration, and education.

Services and screenings will be delivered through the James Graham Brown Cancer Center, which has a Nationally Accredited Breast Center licensed by the American College of Radiology, KentuckyOne Health, and supported by the Kentucky Cancer Program.

“Our mission is to educate the people of Kentucky about cancer screening and prevention,” said Connie Sorrell, director of the Kentucky Cancer Program at the James Graham Brown Cancer Center. “The expansion of screenings and educational materials that will be available through this new, modern van should significantly enhance the lives of literally thousands of people throughout the Commonwealth.”

Horses and Hope

In 2008, the First Lady’s office partnered with the Kentucky Cancer Program to create Horses and Hope. The program’s mission is to increase breast cancer awareness, education, screening and treatment referral among Kentucky’s horse industry workers and their families.

Horses and Hopehas hosted several breast cancer race days at Kentucky racetracks in the past six years, reaching nearly 1 million race track and horse show fans and educating nearly 16,000 equine employees. The program has screened nearly 700 workers and detected breast cancer in two individuals, both of whom have received treatment.

For more information and donation opportunities, visit the official Horses and Hope website at http://www.horsesandhope.org/.

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About the Kentucky Cancer Program: The Kentucky Cancer Program is the state mandated cancer control program jointly administered by the James Graham Brown Cancer Center at the University of Louisville and the Lucille Parker Markey Cancer Center at the University of Kentucky.  The mission of the Kentucky Cancer Program is to reduce cancer incidence and mortality by promoting cancer education, research and service.  For more information, visit our website, www.kycancerprogram.org or call 502-852-6318.

About the James Graham Brown Cancer Center: The James Graham Brown Cancer Center is a key component of the University of Louisville Health Sciences Center. As part of the region's leading academic, research and teaching health center, the cancer center provides the latest medical advances to patients, often long before they become available in non-teaching settings. The JGBCC is a part of KentuckyOne Health and is affiliated with the Kentucky Cancer Program. It is the only cancer center in the region to use a unified approach to cancer care, with multidisciplinary teams of physicians working together to guide patients through diagnosis, treatment and recovery. For more information, visit our web site, www.browncancercenter.org.

About KentuckyOne Health: KentuckyOne Health, the largest and most comprehensive health system in the Commonwealth, has more than 200 locations including hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies in Kentucky and southern Indiana. KentuckyOne Health is dedicated to bringing wellness, healing and hope to all, including the underserved. The system is made up of the former Jewish Hospital & St. Mary’s HealthCare and Saint Joseph Health System, along with the University of Louisville Hospital and James Graham Brown Cancer Center. KentuckyOne Health is proud of and strengthened by its Catholic, Jewish and academic heritages.

UofL leads new study to map disease genes in horses

UofL leads new study to map disease genes in horses

Ted Kalbfleisch, Ph.D.

Morris Animal Foundation has awarded a three-year, $155,000 grant to a team of Kentucky and Danish researchers to build a new reference genome sequence for the domestic horse. The sequence will be a much needed tool for animal researchers worldwide and the equine industry in particular because it will significantly improve our ability to understand the role of genetics in animal health and well being.

Ted Kalbfleisch, Ph.D., of the University of Louisville Department of Biochemistry and Molecular Biology, is the principal investigator on the grant. He will be joined in the research with Ludovic Orlando, Ph.D., of the Centre for GeoGenetics at the National History Museum, University of Copenhagen; and James MacLeod, V.M.D., Ph.D., of the Gluck Equine Research Center at the University of Kentucky.

Genome sequencing allows researchers to read and decipher genetic information found in DNA and is especially important in mapping disease genes – discovering the diseases a horse might be genetically predisposed to developing.

“In 2009, Morris Animal Foundation helped fund the first genome reference sequence for the domestic horse,” Kalbfleisch said. “We intend to build on this earlier work. In the past five years, there have been dramatic improvements in sequencing technology as well as the computational hardware and algorithms required to analyze the data generated by the technology. Therefore, we now have the tools necessary to vastly improve the reference genome for the horse.”

The current reference genome for the horse, known as “EquCab2,” has been beneficial in studying horses and their genetic predisposition to disease, but it is not without its shortcomings, Kalbfleisch said.

“The horse research community is working to understand the relationship among genomic structure, variation found within it and complex diseases and traits in the domestic horse,” he said. “The EquCab2 reference genome was developed prior to the development of today’s highly sophisticated technology.

“With the application of new high-throughput technologies we have available today, we will map the genome with a focus on what is known as the ‘GC-rich regulatory regions.’”

These GC-rich regulatory regions control how genes are expressed (turned on) in order to participate in normal cellular processes. This work will enable scientists to better catalog genetic variation in these regions and understand how it affects health and performance.

“We expect our research to have substantial impact because the horse research community has actively moved to the translational application of genomics in examining important questions in equine science,” Kalbfleisch said. “The improved reference genome we will map will directly improve both the quality and productivity of research being carried out in the equine industry.”

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About Morris Animal Foundation
Morris Animal Foundation is a nonprofit organization that invests in science to advance animal health. The Foundation is a global leader in funding scientific studies for companion animals, horses and wildlife. Since its founding in 1948, Morris Animal Foundation has invested more than $92 million toward 2,300 studies that have led to significant breakthroughs in diagnostics, treatments, preventions and cures for animals. Learn more at www.MorrisAnimalFoundation.org.

UofL researchers are first to discover role of gene mutations involved in more than 75 percent of glioblastomas, melanomas

UofL researchers are first to discover role of gene mutations involved in more than 75 percent of glioblastomas, melanomas

Researchers at the University of Louisville’s James Graham Brown Cancer Center have identified for the first time mutations that destabilize a DNA structure that turns a gene off. These mutations occur at four specific sites in what is known as the “hTERT promoter” in more than 75 percent of glioblastomas and melanomas.

The research is published in the online journal PLOS ONE and is authored by Brad Chaires, Ph.D., John Trent, Ph.D., Robert Gray, William Dean, Ph.D., Robert Buscaglia, Shelia Thomas and Donald Miller, M.D., Ph.D.

Telomerase is an enzyme largely responsible for the promotion of cell division. Within DNA, telomerase activation is a critical step for human carcinogenesis through the maintenance of telomeres. However, the activation mechanism during carcinogenesis – why cancer gets turned “on” – is not yet wholly understood. What is known is that transcriptional regulation of the human telomerase reverse transcriptase (hTERT) gene is the major mechanism for cancer-specific activation of telomerase.

Miller and his colleagues have been interested in turning genes off therapeutically for some time. “We know that human telomerase is over-expressed in most human cancers, but we’ve never known why,” he said.

In 2013, two studies published in Science and another in Proceedings of the National Academy of Sciences gave the researchers a direction to explore. “These papers said that in most melanomas, mutations existed in the promoter of this telomerase gene. This was the first time that anyone reported common mutations in these promoters,” said Miller, who is director of the James Graham Brown Cancer Center and a specialist in the treatment of melanoma.

The UofL team has now shown that the mutations all occur in a region of the hTERT promoter that previously has been shown to form quadruplex DNA. Using a combination of biophysics and molecular modeling, a new form of a quadruplex transcription regulation element is reported. The formation of these quadruplexes in telomeres has been shown to decrease the activity of telomerase.

“We speculated that the occurrence of these mutations could destabilize or alter the recognition of quadruplexes formed by this sequence,” Miller said. “We found that the mutations inactivate the gene’s ‘off’ switch so it becomes locked on, destabilizing the quadruplex and allowing it to be over-expressed.

“This over-expression then drives the cells to continue to divide, which is the cause of the cancer.”

The researchers are next examining how to unlock the switch from on to off, Miller said. “What we have described in this PLOS ONE article is the on-off switch and provided an entirely new model for that structure. Our next step is to look at how to turn it off that will help lead us to new therapeutics to prevent the occurrence of cancer.”

The paper was posted online Dec. 19 in PLOS ONE.

 

 

 

 

University of Louisville Hospital to host bone marrow drive Dec. 17

In partnership with Be The Match (National Marrow Donor Program) and the Kentucky Organ Donor Affiliates (KODA), University of Louisville Hospital, part of KentuckyOne Health, will host a bone marrow/organ donor registry drive to encourage people to join each registry.
Marrow Registry: Every year, 12,000 people with a blood cancer such as leukemia, or other disease such as sickle cell anemia, need a marrow transplant to live.
Organ Registry: Currently, nearly 124,000 people are awaiting organ transplants in the United States, and many of them would be life-saving transplants.
WHAT:
Bone Marrow/Organ Donor Drive
WHERE:
University of Louisville Hospital
Ambulatory Care Building Basement – outside cafeteria
530 S. Jackson St.
Louisville, KY 40202
WHEN:
Wednesday, December 17
10 a.m. to 2 p.m. and 6 p.m. to 8 p.m.
FOR MORE INFORMATION:
David McArthur, Senior Manager
502.587.4230 or 502.648.3411