News

UofL’s public car-share program expands to Health Sciences Center, serves downtown

UofL’s public car-share program expands to Health Sciences Center, serves downtown

May 18, 2016

The University of Louisville car-share program is expanding to the Health Sciences Center to serve the downtown area with a new fuel-efficient vehicle available to the public for hourly, overnight and daily rentals.

Reservations have increased 30 percent since 2014 when UofL’s Enterprise CarShare program, which has been operating on the main Belknap campus since 2012, was opened to the public.

“UofL and the city of Louisville are committed to reducing pollution and the number of cars on the road,” said Justin Mog, UofL’s assistant to the provost for sustainability initiatives. “Having cars available to share allows people to commute via bus, carpool, bike or foot, knowing that a vehicle is accessible if needed for an appointment or errand. It also allows residents on or near campus to avoid the expense and hassle of owning a car. Millennials are totally into that.”

The new UofL CarShare vehicle will be parked outside UofL’s Kornhauser Library at 500 S. Preston St. Four other CarShare vehicles are located on Belknap Campus. All cars are cleaned, maintained, insured and fueled by Enterprise CarShare as part of the hourly rental charge.

Anyone over 18 with a valid driver’s license can use the cars, which are available year-round, 24 hours a day. Once users purchase a low-cost annual membership, they can access the vehicles whenever needed for $8 per hour or $56 per day. Details can be found at enterprisecarshare.com.

For more information, email Mog or call 502-852-8575.

Health professionals can expand primary care skills through UofL dentistry continuing education courses

Health professionals can expand primary care skills through UofL dentistry continuing education courses

UofL School of Dentistry faculty member performs an oral health screening on a child.

As health care providers seek to better meet the needs of their patients, interdisciplinary practice has become increasingly crucial.

This summer, health professionals from several disciplines can expand their skillset with new courses offered through the University of Louisville School of Dentistry’s Office of Continuing Education.

The first course, “Local Anesthesia for Advanced Nursing: Acute Dental Pain Management in a Primary Care Setting,” set for June 18 from 8a.m. – 3:30p.m., will teach nurses how to address acute dental pain when patients can’t immediately visit a dentist. The course, which costs $150, will focus on how to administer block and infiltration oral anesthesia.

“If a patient shows up in a primary care office with tooth pain late on a Friday afternoon or in a hospital emergency room over the weekend, a trained health professional could inject a long-acting local anesthetic to help manage the pain until the patient could get to a dentist the following week,” said Dedra Hayden, M.S.N., A.P.R.N.-B.C., School of Nursing assistant professor.

The School of Dentistry also will offer the course, “Integrating Oral Health into the Primary Care Setting Through Allowable Reimbursement Techniques” on July 9 from 8a.m. – 12:30p.m. The course, geared toward physicians, physicians’ assistants, registered nurses, advanced practice registered nurses and dental hygienists, informs these health care providers about their allowed role in conducting state required oral health screenings for Kentucky children entering Kindergarten, and understand that it is a billable service. The screening involves looking into a child’s mouth for signs of decay and reporting it on a required form.

The course will focus on optimizing oral health for evidence-based, patient-centered care and will include recent federal recommendations on prevention of tooth decay in children ages 5 and younger in the primary care setting. The class is $75 through advance online registration and $110 for on-site registration.

Both continuing education courses are part of the interdisciplinary collaboration between the UofL schools of dentistry and nursing, established through a $1.2 million grant from the U.S. Department of Health & Human Services Health Resources and Services Administration to integrate nursing and dental students in practice.

Since 2013, the schools’ collaboration has focused on the connection between oral and systemic health.

“Over the past several decades, there has been a tremendous amount of research directed at discovering the links between oral health and overall body health,” Hayden said. “The primary care provider can perform an oral exam and identify lesions in the mouth to indicate a systemic disease and the dental provider can identify when to consult primary care, therefore developing a reciprocal referral process.”

UofL nursing and dental students have engaged in joint seminars, standardized patient learning and clinical experiences to better identify and manage systemic diseases sometimes linked to oral health, such as diabetes and cardiovascular disease.

“Our interprofessional collaboration has focused on the continued improvement of oral health across the lifespan and has contributed to the development of cutting edge providers in our community,” said Daniel Fadel, D.M.D., director of the School of Dentistry Office of Continuing Education.

For more information on the courses and to register, click here.

 

May 11, 2016

UofL Dept of Neurology hosts 8th Annual Advances in Neurology May 21 at Churchill Downs

Update in Movement Disorders and Multiple Sclerosis course provides CME for physicians, nurses and allied health practitioners
UofL Dept of Neurology hosts 8th Annual Advances in Neurology May 21 at Churchill Downs

Neurology

The University of Louisville Department of Neurology will host the 8th annual Advances in Neurology course in conjunction with the annual spring meeting of the Commonwealth Neurological Society. This year’s focus will be on Movement Disorders and Multiple Sclerosis, two of the more challenging therapeutic areas in neurology. The conference will present the latest update in the evaluation and management of multiple sclerosis, including the newer options in disease-modifying therapy. Neuroophthalmologic evaluation of the patient with movement disorders or multiple sclerosis will be discussed. The latest available treatment options, both medical and surgical, for the patient with movement disorders will be discussed.

Visiting faculty include David Charles, M.D., professor of neurology in the Division of Movement Disorders at Vanderbilt University and Aaron Miller, M.D., professor of neurology at Icahn School of Medicine at Mount Sinai and medical director of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis.

The event begins at 7:00 a.m., May 21, 2016, in the Derby and Oaks rooms at Churchill Downs, 700 Central Avenue. Program concludes at 2:30 p.m.

The seminar is free for UofL faculty, staff, residents and students, UofL Physicians nurses, and members of the Commonwealth Neurological Society.  Cost is $40 for all others. For a copy of the full agenda, CME credit information and a registration link, go to:  http://louisville.edu/medicine/cme/events/neurology16/#Brochure

Science, politics and the giant moose

Learn how Thomas Jefferson used an oversized moose to influence Europeans’ views of America at the next Beer with a Scientist, May 11
Science, politics and the giant moose

Lee Dugatkin, Ph.D.

Lee Dugatkin, Ph.D., professor of biology at the University of Louisville, will regale guests at the next Beer with a Scientist with the story of how a Revolutionary War-era dispute over natural history took on important political overtones in European-American relations.

The story involves three individuals:  Thomas Jefferson, author of the Declaration of Independence; George-Louis Leclerc de Buffon, a French count and world-renowned naturalist who claimed that all life in America was "degenerate," weak and feeble; and a very large, dead moose. Jefferson believed the moose could help quash early French arrogance toward the fledgling United States and demonstrate that America was every bit the equal of a well-established Europe.

Despite Jefferson's passionate refutation, the theory of degeneracy far outlived both him and Buffon and continued to have scientific, economic and political implications for 100 years.

Dugatkin has written a book, Mr. Jefferson and the Giant Moose, on the impact of the disputeand has spoken on the topic at the Smithsonian Institution and Jefferson’s Monticello estate.

The program begins at 8 p.m. on Wednesday, May 11 at Against the Grain Brewery, 401 E. Main St. A 30-minute presentation will be followed by an informal Q&A session.

The Beer with a Scientist program began in 2014 and is the brainchild of UofL cancer researcher Levi Beverly, Ph.D. Once a month, the public is invited to enjoy exactly what the title promises:  beer and science.

Admission is free. Purchase of beer, other beverages or menu items is not required but is encouraged.

Organizers add that they also encourage Beer with a Scientist patrons to drink responsibly.

For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook.

 

May 4, 2016

Certified nurse midwife to discuss hormones’ role in labor, childbirth

Certified nurse midwife to discuss hormones’ role in labor, childbirth

Damara Jenkins, CNM, APRN

A pregnant woman’s body undergoes a complex set of interconnected, mutually beneficial phases that prepare her and her baby for childbirth. The hormonal actions occurring in one phase anticipate and usher in subsequent phases.

These phases are known collectively as the hormonal cascade of childbirth, and a Certified Nurse Midwife at the University of Louisville Center for Women & Infants will present a continuing education session on the topic for nurses, midwives, lactation consultants and other professionals involved in childbirth.

“Normal Physiologic Birth and Supporting the Hormonal Cascade of Childbirth” will be presented by Damara Jenkins Tuesday, May 3, at Babyology, 3934 Dutchman’s Lane, beginning at 6 p.m. The presentation is sponsored by Kentuckiana Lactation Improvement Coalition, a chapter of the United States Lactation Consultant Association that provides support and education on breastfeeding in Kentucky and Southern Indiana.

Jenkins will discuss practices that encourage normal physiologic birth, the role of certified nurse midwifery in supporting normal childbirth and the phases of hormonal childbirth:

  • Late pregnancy and early labor: There is an increase of hormones and receptor systems in the woman’s body that prepares her for an efficient labor and birth; efficient lactation that leads to bonding and attachment with the baby; and the well-being of the fetus during labor and the transition to a newborn.
  • Active labor: Hormonal processes during active labor prepare the body for effective postpartum contractions and hemorrhage prevention; the health transition of the newborn; and breastfeeding and bonding.
  • Birth and the hours that follow: The process of giving birth and skin-to-skin contact between mother and baby immediately after birth promote a hormone release that is thought to further reduce hemorrhage risk, initiate mother-baby bonding and help establish success in breastfeeding.

“The hormonal cascade of childbirth shows us how the body perfectly times the release of hormones in each phase and ensures that labor, birth and breastfeeding all happen according to the body’s design,” Jenkins said.

Jenkins, who also is an Advanced Practice Nurse, is one of three Certified Nurse Midwives who practice with UofL Physicians-Certified Nurse Midwife Program in tandem with the UofL Physicians-OB/GYN & Women’s Health practice. While pregnancy and childbirth care is her primary practice, she provides care to women across the entire lifespan, partnering with them to enable them to live their healthiest life.

Jenkins received her undergraduate degrees from the University of Louisville in 1999 and Bellarmine University in 2000 and received her MSN degree from Frontier Nursing University in 2009. She is president of the Kentucky Affiliate of the American College of Nurse Midwives and received the Frontier Nursing University 75th Anniversary Pioneer Award in 2014. She is on the board of the Friends of the Louisville Birthing Center and a member of the Kentucky Coalition of Nurse Practitioners and Nurse Midwives.

Continuing education credit will be provided for some disciplines, and pre-registration is requested but not required for the presentation. For more information, contact Kentuckiana Lactation Improvement Coalition member Peggy Rinehart at rinehart.peggy@gmail.com.

Fireworks-related burns requiring hospital stays skyrocket among kids

New research from UofL shows loosening U.S. laws that let people buy pyrotechnics at younger ages is tied to increased incidence and severity of fireworks-related burns in children

April 30, 2016

As states relaxed laws related to fireworks sales during the past decade, emergency doctors saw an increase in both the number of fireworks-related injuries among children and the severity of those injuries, according to new research being presented by faculty from the University of Louisville at the Pediatrics Academic Societies 2016 Meeting.

An abstract of the study, “Effect of Fireworks Laws on Pediatric Fireworks Related Burn Injuries," will be presented at the PAS meeting in Baltimore on May 3.

Researchers looked at federal and state data from the National Inpatient Sample, with data on 8 million hospital stays each year, and the Nationwide Emergency Department Sample, which annually compiles information on 30 million discharges from emergency medicine facilities.

They determined the number of patients under age 21 treated and released by emergency departments between 2006 and 2012 rose modestly. Significantly larger increases were seen in injuries requiring inpatient hospital admission, which skyrocketed from 29 percent of cases in 2006 to 50 percent in 2012.

“The increase in fireworks-related injuries and the severity of these injuries in children since 2006 are very concerning,” said Charles Woods Jr., M.D., one of the study’s authors and associate chair of pediatrics at the University of Louisville. “Although our findings do not prove a direct link to relaxations in state laws governing fireworks sales, it may be time for lawmakers to reassess this issue. Parents and caregivers of children also should be aware of these increasingly serious injuries and the potential dangers involved in allowing young children to handle and play with fireworks.”

Lead author John Myers, Ph.D., a researcher in the Department of Pediatrics at the University of Louisville, will present the abstract, “Effect of Fireworks Laws on Pediatric Fireworks Related Burn Injuries," at 7:30 a.m. on Tuesday, May 3 in Exhibit Hall F at the Baltimore Convention Center. To view the abstract, visit http://www.abstracts2view.com/pas/view.php?nu=PAS16L1_4135.266.

“Pediatric fireworks-related burn injuries have increased in incidence, apparent severity of injury, the proportion requiring hospitalization and length-of-stay in the hospital in a time period of relaxed fireworks laws in the United States,” Myers said. “These findings suggest that policy-makers should revisit current fireworks laws for the safety of children.”

# # #


About the Pediatric Academic Societies Meeting:

The Pediatric Academic Societies (PAS) Meeting brings together thousands of individuals united by a common mission: to improve child health and wellbeing worldwide. This international gathering includes pediatric researchers, leaders in academic pediatrics, experts in child health, and practitioners. The PAS Meeting is produced through a partnership of four organizations leading the advancement of pediatric research and child advocacy: the Academic Pediatric Association, American Academy of Pediatrics, American Pediatric Society, and Society for Pediatric Research. For more information, visit the PAS Meeting online at www.pas-meeting.org, follow us on Twitter @PASMeeting and #PASMeeting, or like us on Facebook.

 

 

UofL pediatrician elected chair of national committee

UofL pediatrician elected chair of national committee

Charles Woods Jr., M.D.

Charles R. Woods Jr., M.D., has been elected the incoming chair of the Executive Committee of the American Academy of Pediatrics’ (AAP) Section on Epidemiology, Public Health and Evidence (SOEPHE). His one-year term begins Nov. 1.

The AAP is a professional membership organization of 64,000 primary care pediatricians, pediatric medical sub-specialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

The SOEPHE supports development high quality practice guidelines for children’s health care and fosters informed use of data to improve the health of children.  It is composed of AAP members who practice or have interests in the fields of public health and epidemiology.

Woods is board certified in pediatrics and pediatric infectious diseases. He is Associate Chair of the UofL Department of Pediatrics and director of the department’s Child & Adolescent Health Research Design & Support Unit. He has been at UofL since 2006.

In addition to the AAP, his professional affiliations include the Pediatric Infectious Diseases Society, Infectious Diseases Society of America, Society for Healthcare Epidemiology of America and HIV Medicine Association. He also has been elected to membership in the American Pediatric Society and Society for Pediatric Research.

He earned his bachelor’s degree from Samford University and his medical degree from Baylor College of Medicine. He completed a pediatric residency followed by a pediatric infectious diseases fellowship at Texas Children’s Hospital. He later earned a master’s degree in epidemiology from Wake Forest University.

Woods practices with University of Louisville Physicians-Pediatric Infectious Diseases.

 

 

CPR training at the state fair wins top award for UofL cardiologist

CPR training at the state fair wins top award for UofL cardiologist

Lorrel Brown, M.D.

It stands to reason: If you want to educate large numbers of people, go where large numbers of people go.

In Dr. Lorrel E. Brown’s case, that place was the Kentucky State Fair – and the nation’s premier cardiology association has presented her an award for her innovative thinking.

Brown, assistant professor of medicine in UofL’s Division of Cardiovascular Medicine, won first place in the category of “Young Investigator Awards in Cardiovascular Health Outcomes and Population Genetics” from the American College of Cardiology earlier this month. The award was presented at the organization’s 65th Annual Scientific Session in Chicago. It also was published in the April 5 issue of the Journal of the American College of Cardiology.

Brown headed a group of researchers that included Dr. Glenn Hirsch, associate professor of medicine, cardiology fellows Dr. Wendy Bottinor and Dr. Avnish Tripathi, medical student Travis Carroll, Dr. Bill Dillon who founded the organization Start the Heart Foundation and Chris Lokits  of Louisville Metro Emergency Medical Services, Office of Medical Direction and Oversight. They tackled the problem of surviving cardiac arrest – the sudden stopping of the heart – by increasing the number of people trained in hands-only cardiopulmonary resuscitation (CPR).

Titled “CPR at the State Fair: A 10-minute Training Session is Effective in Teaching Bystander CPR to Members of At-risk Communities,” the research effort brought CPR training to the Kentucky State Fair’s Health Pavilion in August 2015.

Nearly 400,000 people in the United States have out-of-hospital cardiac arrest each year, she said, or nearly 40 people every hour. Only one in 10 survives.

“The vast majority of people who suffer cardiac arrest don’t experience it in a well-equipped hospital with highly trained medical staff,” Brown said. “They experience it as they go about their daily lives, and just 30 percent of cardiac arrest victims receive CPR, usually from bystanders. Yet we know that bystander CPR dramatically improves chances for survival.”

The group created a 10-minute training module that uses a short video and hands-on coaching to teach people the basics of hands-only CPR. To further determine their mastery of CPR, participants completed a post-training survey and were asked to return to the training site at the fair one hour after training to re-test their CPR ability.

The state fair location also provided an additional benefit: the ability to reach people from communities and counties throughout Kentucky with low rates of bystander CPR.

“In Jefferson County alone, bystander CPR rates vary dramatically according to zip code, ranging from 0 percent to 100 percent,” Brown said. “We know there is the same variation throughout the state, and 77 percent of the Jefferson County residents we trained at the fair were from zip code areas with bystander CPR rates under the national average of 31 percent.”

Since the 2015 fair, Brown has led efforts to conduct bystander CPR training at other locations. “Through the Take It to the Heart tour with KentuckyOne Health, we provided this training in hospital lobbies throughout the state, at UofL women's and men's basketball games and even at the Capitol in Frankfort with the Kentucky Senate,” she said. “Through these efforts, we have trained more than 1,000 individuals in CPR and educated another 43,000. We hope that these efforts not only raise the rates of bystander CPR and survival from cardiac arrest in our own communities, but also serve as a model for other communities.”

Brown will bring the training back to the Kentucky State Fair again this year. “These results suggest that by providing brief trainings in public venues, such as the state fair, we can effectively train people and potentially improve the rate of bystander CPR in this country,” she said.

Organizations or businesses also can schedule their own bystander CPR training session via the Start The Heart Foundation, for which Brown serves as a board member, by calling 502-852-1837.

###

About the Young Investigator Awards

The American College of Cardiology’s Young Investigator Awards encourages and recognizes young scientific investigators of promise. To be considered for a Young Investigator Award, candidates submitted an abstract summarizing any problem relating to cardiovascular disease. Five finalists were selected in each of four award categories and invited to attend the Scientific Session to present their work during the Young Investigator Awards Competition.

About the American College of Cardiology

The American College of Cardiologyis a 52,000-member medical society that is the professional home for cardiovascular care physicians. The mission of the college is to transform cardiovascular care and to improve heart health. The college operates national registries to measure and improve care, offers cardiovascular accreditation to hospitals and institutions, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications.

 

More activities added to Cancer Awareness Show

Hillview event on May 21 benefits UofL’s James Graham Brown Cancer Center
More activities added to Cancer Awareness Show

The Horses and Hope pink Mustang will be on display May 21 at the Cancer Awareness Show at the Hillview Community Center, 298 Prairie Drive.

More activities have been added to the lineup of the Cancer Awareness Show, set for Saturday, May 21, from 11 a.m. to 5 p.m. at the Hillview Community Center, 298 Prairie Drive. Proceeds from the day’s activities will benefit research, community outreach and patient support programs of the James Graham Brown Cancer Center at the University of Louisville.

The Zoneton Fire Department will have its Fire Safety House for participants to walk through, and the Kentucky Cancer Program at UofL will display the pink Horses and Hope Mustang for breast cancer awareness.

Hobbies Café food truck also will be on hand, joining a variety of other vendors at the show, which has sold out its indoor booth spaces, said organizer Richard Luce Jr. Outdoor booth spaces remain available at $20 each.

The Cancer Awareness Show has something for the entire family with three shows-within-the-show: a model train show including 9X9, 4X16 and 3X6 layouts; an arts and crafts show; and “Cruizin’ for Cancer,” a car, truck and motorcycle show and a model car show.

The Zoneton Fire Department’s Fire Safety House is a walk-through model that helps teach children how to best respond to a house fire situation. The house is designed to provide a realistic environment for teaching basic fire prevention and survival skills. Kids learn about smoke detectors, how to determine escape routes from a fire in advance, and the importance of not hiding during a fire.

Former Kentucky First Lady Jane Beshear and the organization she founded, Horses and Hope, commissioned the pink Mustang from Paul Miller Ford for the 2011 NASCAR Sprint Cup race at the Kentucky Speedway. Since then, the Mustang tours the state to share life-saving breast cancer information. Horses and Hope works with the state’s equine industry to provide breast cancer education, screening and treatment referral.

Also included are prize and cash raffles. Representatives from Be The Match will be on hand to provide information about bone marrow donation. The James Graham Brown Cancer Center also will disseminate information on cancer prevention and treatment.

Admission is a cash donation to the James Graham Brown Cancer Center.

Liberty Tire and Recycling is a sponsor of the Cancer Awareness Show. The car, truck and motorcycle show is sponsored by the South Louisville Antique and Toy Mall and the model car show is sponsored by Dan’s Chips and Toys. Additional sponsorships for the show also are available: Platinum, $1,000; Gold, $500; Silver, $300; and Bronze, $100.

For information on vendors, sponsorships or the show, contact Luce at Bigscoby4@yahoo.com, CancerAwareness15@yahoo.com or 502-802-8308.

 

A new player revealed in nerve growth process

Role of adaptor protein CD2AP in neuron sprouting discovered by UofL researchers could lead to therapies for Alzheimer’s disease, stroke recovery and spinal cord injury
A new player revealed in nerve growth process

Benjamin Harrison, Ph.D., Jeffrey Petruska, Ph.D. and Kristofer Rau, Ph.D.

University of Louisville researchers have discovered that a protein previously known for its role in kidney function also plays a significant role in the nervous system. In an article featured in the April 13 issue of The Journal of Neuroscience, they show that the adaptor protein CD2AP is a key player in a type of neural growth known as collateral sprouting.

In the first research to be published on this protein’s role in the nervous system, Benjamin Harrison, Ph.D., a postdoctoral fellow in the Department of Anatomical Sciences and Neurobiology and lead author of the article, and his colleagues show that CD2AP, an adaptor protein, orchestrates a complex arrangement of other proteins that controls the branching of nerve axons, the tendrils reaching out from the nerve cell to connect to other nerve cells, skin and organs. This nerve growth occurs in uninjured nerve cells as they extend their reach and create new connections.

“CD2AP brings in all the correct players, forms a multi-protein complex and coordinates that multi-protein complex to achieve growth of the neurons,” Harrison said. “There are a whole bunch of proteins that it could bring together, but it only brings together the correct proteins to create the correct response. In this case, it changes the structure of the axons through sprouting and elongation.”

This axon sprouting may be helpful, but too much of it can be harmful. In normal adult cells, this growth creates new connections and can lead to improved functionality after an injury or stroke. However, if the axons sprout uncontrollably, the result can be exacerbated epilepsy, blood pressure spikes or neuropathic pain. The researchers hope this new understanding of the nerve growth process will lead to therapies that can improve healing and recovery of function following nerve damage while minimizing excessive growth.

“Through targeting this molecule, we could help the body’s natural healing process to coordinate the appropriate growth,” Harrison said.

The research team, based in the lab of Jeffrey Petruska, Ph.D., associate professor in the Department of Anatomical Sciences and Neurobiology and the Department of Neurological Surgery and the article’s corresponding author, identified CD2AP as a player in the neurological system via a screen to detect genes associated with neuron growth. Their research examined how CD2AP interacts with various molecules in controlling the neural sprouting process, in particular they studied its relationship with nerve growth factor (NGF).

“People have been studying nerve growth factor and the responses it induces for a while, but this protein (CD2AP) forms a nice link between NGF and the response in the cell,” Harrison said.

Previous research also has associated CD2AP with genetic changes among individuals with Alzheimer’s disease and it may be helpful in understanding the mechanisms involved in Parkinson’s Disease, Huntington’s Disease and spinal cord injuries.

Petruska says this work relates closely to other research being conducted at UofL’s Kentucky Spinal Cord Injury Research Center (KSCIRC). He says that understanding these molecular processes could one day be used to amplify the activity-based therapies such as locomotor training now being done with spinal cord injury patients by UofL faculty at Frazier Rehab Center, a part of KentuckyOne Health. Locomotor training helps spinal cord injury patients achieve functional recovery through standing and stepping activity.

“We are starting to discover that there are different modes of nerve growth and different sets of genes that control different kinds of growth,” Petruska said. “This is particularly important as it relates to locomotor training. When you train, you enhance the growth factor environment of the injured spinal cord, and those growth factors are involved in the axon plasticity. This mode that we study is dependent on the growth factors.”

Harrison, who also is part of the Kentucky Biomedical Research Infrastructure Network (KBRIN), plans to pursue research aimed at developing a drug to provide appropriate nerve growth for spinal cord injury patients.

“My dream,” Harrison said, “is to one day do a clinical trial with a drug that targets this protein and can enhance the ability of the patients to respond to the activity-based rehabilitation (locomotor training) that they are doing at Frazier Rehab Center.”

High school student Cassa Drury earned co-authorship on publication of original research

One member of the research team and a co-author on the publication that first described the role of CD2AP in the nervous system is Cassa Drury, a junior at Louisville’s duPont Manual High School. Drury has worked in the lab of Jeffrey Petruska, Ph.D., associate professor in UofL’s Department of Anatomical Sciences and Neurobiology, since he mentored her during middle school science fair competitions. As a middle schooler, Drury competed in science fairs at the national and international level with her research on the neurological systems of planaria worms under Petruska’s guidance.

In the team’s research into CD2AP, Drury recorded and analyzed changes in the nerve cells for the publication’s primary author, Ben Harrison, Ph.D., a postdoctoral fellow in the Department of Anatomical Sciences and Neurobiology and the article’s lead author. Drury, a high school sophomore at the time, was working in the lab as part of a self-directed learning program offered by her high school.

Drury recorded the length and number of branches in images of neural cells that had been treated with different amounts of CD2AP and those that were not treated to determine the protein’s effect on nerve growth.

“I put them into a program and I was able to trace them. The tracing allowed us to see whether they were growing more than they would normally,” Drury said.

“Cassie was the one who did measurements in the cultured neurons to determine that the protein was a positive regulator of growth,” Harrison said.

That work earned Drury a listing as fifth author on the publication, released in the April 13 edition of The Journal of Neuroscience. A total of 14 authors are credited on the article.

“It was not a gift,” Petruska said. “She did important work for this research and she understands what the work is about.”

Drury is eager to follow the research to which she has contributed.

“I am really interested to see where this research goes,” Drury said. “This connection is a really strong one and I am excited to see what comes out of it and what Ben ends up doing. I hope he can hand them a drug. That would be wonderful.”

This summer, Drury will be attending a science ethics leadership seminar at the University of Notre Dame on the ethical considerations of scientific research. After high school, she plans to study science in college, perhaps along with communications.

“One of the things that allowed Cassie to have such success in the science fair is that she is very good at communicating her results and her experiment design. She is good at answering questions,” Petruska said.

 

This work was supported by the CDRF International Consortium on Spinal Cord Injury Research, Kentucky Spinal Cord and Head Injury Research Trust Grant 09-12A, Paralyzed Veterans of America Fellowship, National Institutes of Health Grants P20RR016481, 3P20RR016481-09S1, P20GM103436, P30GM103507, R21NS080091, R21NS071299 and R01NS094741.

Researchers discover previously unknown method by which allostery occurs

Findings have implications for improved focus in drug research, development
Researchers discover previously unknown method by which allostery occurs

Donghan Lee, Ph.D.

Posted April 13, 2016

Two scientists at the University of Louisville, together with German researchers, have discovered a method unknown up to this time by which the biological process of allostery occurs, a finding that has implications for better focused therapeutic treatments with fewer side effects.

Donghan Lee, Ph.D. and David Ban, Ph.D., both with the Department of Medicine and the James Graham Brown Cancer Center at UofL, joined with researchers from the Max Planck Institute for Biophysical Chemistry in Goettingen, Germany, in looking at allostery, the process in which biological macromolecules such as proteins transmit the effect of binding at one site to another, often distant, functional site.

“This important study documents the significance of very basic cancer research and will likely lead to the identification and development of novel targeted treatments which otherwise would not have been discovered,” said Donald M. Miller, M.D., Ph.D., director of the James Graham Brown Cancer Center, a part of KentuckyOne Health.

At the atomic level, the UofL and German research group found a previously unidentified way for allostery to occur through the collective motion of an entire protein structure.

“Much drug development focuses on targeting a protein,” Lee said. “The thinking is that if you block a certain action of a certain protein, then you can cure or at least, delay progression of a disease.

“However, in order to understand what to block, you must understand the function of the protein structure. That is the direction we took.”

The group used ubiquitin, a small protein that is highly abundant in cells of higher organisms. With newly developed computational algorithms, the research team was able to determine atomic structures representing what was the previously invisible allosteric motion within ubiquitin.

That motion was fast, said the researchers. “There have been limitations in the ability to observe fast protein motions,” Ban said. “However, we developed a technique that overcame the previous experimental limitations. Having a better, more precise and more accurate ability to measure the movement, we can now build an atomic model that enables us to visualize what the motion actually looks like.”

Lee likens the process to stopping a wide receiver on the football field. The wide receiver has to catch the ball with his arms and hands while also running with his legs and feet. The speed of his legs is affected by the action of catching the ball with his arms.

“So if we just block one leg, his ability to run and actually catch the ball will be impaired,” Lee said.  “That’s what we did in the lab: We saw we could block one thing to affect others.”

A single peptide bond was key, Ban said. “In looking at the functional aspect of this protein, it all boiled down to a single peptide bond that flipped in or out. That is amazing: we could affect a distant region by manipulating a single peptide bond.

“We were able to make mutants of this certain protein that would lock it in one state or another.”

The potential therapeutic benefit of the findings could result in more focused treatments with fewer side effects.

“Chemotherapy, for example, attacks multiple, different proteins and there are a lot of side effects,” Lee said. “But conceivably, we need only one protein blocked – just like we only need to block one leg of the wide receiver to stop him. Our study begins to help us target that one correct protein without impairing others.”

“Our findings give us, for the first time, the tools to look at many different systems,” Ban said. “We can apply this to other medically and biologically relevant systems.”

Other members of the research team are Colin A. Smith, Supriya Pratihar, Karin Giller, Maria Paulat, Stefan Becker, Christian Griesinger and Bert L. de Groot. The group’s study, “Allosteric switch regulates protein-protein binding through collective motion,” was published in March in the Proceedings of the National Academy of Sciences.

UofL Physicians’ Movement Disorders Clinic named national Huntington’s disease Center of Excellence

UofL Physicians’ Movement Disorders Clinic named national Huntington’s disease Center of Excellence

Kathrin LaFaver, M.D.

University of Louisville Physicians’ Movement Disorders Clinic has been named a national Center of Excellence in treating Huntington’s disease and received a $10,000 grant from the Huntington’s Disease Society of America.

The designation recognizes work at UofL Physicians to help improve the lives of people affected by the disease. HDSA Centers of Excellence provide an elite multidisciplinary approach to care and research. There are currently 39 across the United States, including UofL Physicians.

“We are proud to be the first center in Kentucky to be recognized as a HD Center of Excellence,” said Dr. Kathrin LaFaver, a neurologist who leads the Huntington’s disease program at UofL Physicians. “We are planning to expand our involvement with the HD community and offer participation in future research studies.”

Patients at the Centers of Excellence benefit from expert neurologists, psychiatrists, therapists, counselors and other professionals who have deep experience working with patients and families affected by Huntington’s disease, and who work collaboratively to help them plan the best program of care throughout the disease’s course.

Debbie Holloway, who is affected by Huntington’s disease, is currently enrolled in a clinical trial at UofL Physicians. She had in the past regularly traveled four hours round trip to a center in Indiana for treatment because of its designation as a Center of Excellence.

“We feel so thankful and blessed to now have a Center of Excellence here in Louisville,” she said.  “My family is affected and we definitely want to do anything we can to help find a cure. Now when a new research program comes in, someone in my family may be able to participate. And it is wonderful to have my doctor here.”

Huntington’s disease (HD) is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person’s physical and mental abilities during their prime working years and to date has no cure. Patients affected by the disease develop chorea (involuntary movements), difficulties with cognition and often psychiatric manifestations such as depression and irritability.

HD is inherited in an autosomal dominant fashion, meaning every child of a parent with HD has a 50/50 chance of carrying the disease mutation. Today, there are approximately 30,000 symptomatic Americans and more than 200,000 at risk of inheriting the disease.

Many describe the symptoms of HD as though they have ALS, Parkinson’s and Alzheimer’s simultaneously.

As part of the efforts to help patients with the disease, patients are being recruited for the ENROLL-HD worldwide observational study for HD families. The goal is to track HD progression and create a database that doctors can learn from and use for treatment studies as they emerge.

Patients who are interested in enrolling can find more information at www.enroll-hd.org.

For more information on Huntington’s disease Centers of Excellence, visit the Huntington’s Disease Society of America’s web page at www.hdsa.org/about-hdsa/centers-of-excellence.

 

 

In the lineup

Symposium draws all-star list of speakers

Nathan Berger, M.D., the Hanna-Payne Professor of Experimental Medicine and director of the Center for Science, Health and Diversity at Case Western Reserve University, holds the Louisville Slugger bat he was given as a speaker at the first symposium honoring the late co-division chief of the Blood and Bone Marrow Transplantation Program at UofL. The Geoffrey P. Herzig, M.D., Memorial Symposium for Hematologic Malignancies and Bone Marrow Transplantation drew a stellar cast of presenters April 8-9 at the Jewish Hospital Rudd Heart & Lung Conference Center. Herzig came to UofL in 2000 as co-division chief with his brother, Roger Herzig, M.D., shown second from left. The symposium was created by current division chief William Tse, M.D., at far left, with another presenter, Hillard Lazarus, M.D., the George & Edith Richman Professor and Distinguished Scientist in Cancer Research at Case Western Reserve, at far right. Twenty-six physicians and other scientists from the United States, Canada and England presented the symposium, covering the latest advances in treating leukemias, myelomas and other blood-borne cancers. (Robert Burge Photography)

Home IV antibiotics unnecessary for children with complicated pneumonia

UofL study shows bacterial pneumonia with empyema in children successfully treated with video-assisted thoracoscopic surgery (VATS) and early transition to oral antibiotics
Home IV antibiotics unnecessary for children with complicated pneumonia

Claudia Espinosa, M.D., M.Sc.

Treating children with pneumonia complicated by infected fluid in the chest (called empyema) can take longer than other infectious diseases, and typically requires surgical intervention and intravenous (IV) antibiotics. A study published in the April issue of The American Surgeon by University of Louisville assistant professor of pediatrics Claudia Espinosa, M.D., M.Sc., and colleagues, shows that the disease can successfully be treated with a course of broad-spectrum oral antibiotics once the children are released from the hospital, thus making administration of IV antibiotics at home unnecessary.

Espinosa and several colleagues at the UofL School of Medicine conducted a retrospective study of 61 patients treated using a standardized approach of video-assisted thoracoscopic surgery (VATS) and IV antibiotics administered in the hospital, with transition to broad-spectrum oral antibiotics about five days after surgery or when the patients were discharged. The study showed a 92 percent rate of recovery without complications using this approach, which is comparable to that achieved with prolonged courses of IV antibiotics continued at home, but avoids potential complications associated with home IVs.

“Given the adverse effects of IV antibiotics and the potential possible complications of PICC lines, transitioning to oral antibiotics and providing a shorter course than previously advised is a good strategy,” Espinosa said. “The outcomes appear to be good even when cultures are negative and the choice of antibiotic is an empiric one.”

The children in the study, all previously healthy children with community-acquired bacterial pneumonia and empyema, were admitted to Kosair Children’s Hospital from 2008 to 2012. All of the children were treated with prompt VATS and early transition to oral antibiotics, which continued for an average of two weeks after discharge.

“Many physicians believe that placing a chest tube and giving fibrinolytics is better than VATS for treatment of empyema,” Espinosa said. “In this study, we show good outcomes, short length of stay, minimal complications and short course of antibiotics for pediatric patients with empyema who underwent VATS.”

Horses and Hope, UofL Kentucky Cancer Program host Breast Cancer Awareness Day at Keeneland

Horses and Hope, UofL Kentucky Cancer Program host Breast Cancer Awareness Day at Keeneland

Former Kentucky First Lady and longtime cancer awareness activist Jane Beshear will join with the Kentucky Cancer Program at the University of Louisville to host Horses and Hope: A Breast Cancer Awareness Day at the Races, Wednesday, April 13, at Keeneland  race track in Lexington.

Doors open at 10:30 a.m. with lunch served at 11:30 a.m. at the Keene Barn and Entertainment Center. First post time for the day’s racing card will be 1:05 p.m.

Breast cancer survivors and guests are invited to enjoy lunch and a Derby Fashion Style Show sponsored by Talbots, The Spa at Griffin Gate, Kroger, Keeneland and WKYT-TV and emceed by WKYT anchor Amber Philpott. Following the program, participants will be escorted to reserved seating in Keeneland’s Grandstand where the day’s racing will feature a Horses and Hope race honoring breast cancer survivors.

Horses andHope™ is a project of Beshear and the Kentucky Cancer Program. The mission is to increase cancer awareness, education, screening and treatment referral among Kentucky’s horse industry workers and other special populations. Screenings and events are held across the state in collaboration with the new Horses and Hope Cancer Screening Van launched earlier this year with KentuckyOne Health.

Ticket packages are $30 per person and include reserved parking, track admission, lunch, covered grandstand seating, racing program and a special Horses and Hope souvenir. Participants are encouraged to wear pink for breast cancer awareness.

Seating is limited so registration by April 11 is advised. To make reservations, call 859-254-3412. For additional information, call toll-free, 877-326-1134.

Health professional students called to address social justice

Health and Social Justice Scholars will learn methods for improving health equity in disadvantaged communities
Health professional students called to address social justice

UofL Health Sciences Center students performing community service

Health-care professionals often are aware of larger social issues facing their patients in disadvantaged communities but feel powerless as individual practitioners to change these health disparities. The University of Louisville’s new Health and Social Justice Scholars Program is accepting applicants who will be trained to work with other professionals in communities to bring about changes to benefit underserved and disadvantaged populations.

Students in the UofL schools of Dentistry, Medicine, Nursing and Public Health and Information Sciences who are dedicated to social justice are encouraged to apply for the program, where they will learn techniques for working interprofessionally and with community members to improve the overall health of the populations through community engagement and scholarly activities. The students will work with faculty mentors to combat issues such as youth violence, public water safety and depression in adolescents in West Louisville and other disadvantaged communities.

“As a pediatrician, I know that a physician can’t do it alone,” said V. Faye Jones, M.D., Ph.D., M.S.P.H., assistant vice president for health affairs – diversity initiatives at UofL. “You have to have different perspectives and different skills to move that needle. We cannot work in silos; we have to work as a team to accomplish the goal of health equity.”

One second-year student from each of the four schools in the UofL Health Sciences Center will be selected for the first cohort of scholars for the 2016-2017 academic year. The Health and Social Justice Scholars will conduct interprofessional, community-based research along with a faculty mentor, participate in community service projects and attend monthly discussions. In addition, the scholars will receive annual financial support of $10,000 toward their education programs. Scholars are expected to continue in the program for three years.

“We want students who are dedicated to community engagement and who are passionate about making a difference,” said Jones, who oversees the program. “Eventually, these professionals will be leaders in advocating for policy changes to improve the overall health of the community.”

Applicants for the program must be entering their second year of a doctoral program in the school of Dentistry, Medicine, Nursing or Public Health and Information Sciences (Au.D., D.M.D., D.N.P., M.D. or Ph.D). They will be required to submit an essay describing a health concern in the community with a proposed path for improvement, a summary of their research experience, letters of recommendation and transcripts.

Applications will be accepted through May 31. For additional information and to apply, visit the Health and Social Justice Scholars web page, or contact the UofL Health Sciences Center Office of Diversity and Inclusion at 502-852-7159 or hscodi@louisville.edu.

 

About the UofL HSC Office of Diversity and Inclusion

The UofL Health Sciences Center Office of Diversity and Inclusion welcomes and embraces the community of students, faculty and staff. The office seeks to encourage and foster all constituents’ growth and development to allow for everyone to be successful at UofL. By augmenting a culture and climate that demonstrate a belief that diversity and inclusion add value to intellectual development, academic enrichment, patient care, research and community engagement, the office intends to place HSC at the forefront of opportunity and innovation. Its mission is to conceptualize, cultivate and coordinate partnerships across the schools of Dentistry, Medicine, Nursing, and Public Health and Information Sciences by building organizational capacity and expanding leadership competency for HSC diversity and inclusion efforts. The office aspires to be a model for innovation for health equity driven by excellence in education, community outreach and research.

Beer with a Scientist: Will GMO crops doom the planet or save it?

Learn exactly what genetically modified plants are and why they are modified at the next Beer with a Scientist, April 13
Beer with a Scientist:  Will GMO crops doom the planet or save it?

Paul Vincelli, Ph.D., University of Kentucky

You may have heard about genetically modified organisms (GMOs) along with predictions of dire consequences for the planet or claims the technology is necessary to feed the Earth’s growing population. At the April edition of Beer with a Scientist, Paul Vincelli, Ph.D., professor in the Department of Plant Pathology at the University of Kentucky College of Agriculture, Food and Environment, will set the record straight with peer-reviewed science.

Vincelli will make the trip across I64 to share his expertise on the scientific understanding of GMOs based on the substantial body of scientific literature. He will explain exactly what constitutes a genetically engineered crop, whether eating recombinant DNA is safe, and why scientists would want to change a plant’s genes in the first place.

At UK, Vincelli serves as coordinator for the United States Department of Agriculture (USDA) Sustainable Agriculture Research and Education Program. He provides science-based outreach on risks and benefits of genetically engineered crops in Kentucky, the nation and internationally.

The program begins at 8 p.m. on Wednesday, Apr. 13 at Against the Grain Brewery, 401 E. Main St. A 30-minute presentation will be followed by an informal Q&A session.

The Beer with a Scientist program began in 2014 and is the brainchild of UofL cancer researcher Levi Beverly, Ph.D. Once a month, the public is invited to enjoy exactly what the title promises:  beer and science.

Admission is free. Purchase of beer, other beverages or menu items is not required but is encouraged.

Organizers add that they also encourage Beer with a Scientist patrons to drink responsibly.

For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook.

Advances in operating room ultrasound discussed at daylong workshop

Advances in operating room ultrasound discussed at daylong workshop

The latest advances in the use of ultrasound in the operating theater will be shared in a daylong workshop on May 14 sponsored by the University of Louisville.

The latest advances in the use of bedside ultrasound in the operating theater will be shared at a daylong conference for health care professionals.

The Perioperative Ultrasound and Echocardiology Workshop will be held Saturday, May 14, in the Paris Simulation Center in the University of Louisville School of Medicine Instructional Building, 500 S. Preston St. Registration opens at 7 a.m. and the workshop will be held from 7:45 a.m. to 4:30 p.m.

The workshop is designed for anesthesia providers, anesthesiologists, intensivists, residents and nurses in the perioperative environment, said Jiapeng Huang, M.D., Ph.D., clinical professor of anesthesiology and perioperative medicine at UofL, an attending cardiac anesthesiologist at Jewish Hospital, a part of KentuckyOne Health, and president of medical staff for Jewish Hospital & St. Mary’s Healthcare.

Perioperative ultrasound, also known as point-of-care or bedside ultrasound, enables the anesthesiology staff to have real-time ultrasound images in the operating room environment that are equal in accuracy to x-ray or CT scan without exposing patients to potentially harmful radiation. Echocardiography is a diagnostic test that uses ultrasound waves to create an image of the heart. Ultrasound of the nerves and blood vessels also enables health care professionals see these structures in real time to guide nerve blocks and central line placement. Ultrasound makes these invasive procedures much safer and more efficient.

“This course will provide anesthesiologists and others involved in perioperative care the most up-to-date and practical ultrasound skills required for safe and the highest quality anesthesia care,” Huang said.

The workshop has sliding registration fees based on profession and hospital affiliation. Continuing education credit also is available. Breakfast and lunch are provided.

For details and to register, go to the workshop website.

Final call for abstracts for inaugural UofL Optimal Aging Conference, June 12-14

Final call for abstracts for inaugural UofL Optimal Aging Conference, June 12-14

Abstracts are due midnight of Thursday, March 31, for the Inaugural Optimal Aging Conference. Abstracts can be submitted here. More conference information can be found at www.OptimalAgingInstitute.org.

The Optimal Aging Conference will be held June 12-14 in Louisville at the Brown Hotel, 335 W. Broadway. This conference is jointly presented by the Institute for Sustainable Health & Optimal Aging at the University of Louisville and the Kentucy Association for Gerontology (KAG).

The Optimal Aging Conference focuses on aging as an opportunity for indiduals and socieities, and not a disease. This conference is transdisciplinary and as such, individuals across a wide variety of perspectives and backgrounds are welcome to submit abstracts, including academics, health care professionals, social service professionals, business professionals working in health care, age care disrupters and older adults.

The conference features a variety  conference tracks, including:

  • Aging in Community
  • Healthcare & Aging
  • Building Coordinated Care Networks
  • LGBTQ Aging
  • Business & Aging
  • Mental Health & Aging
  • Caregiving
  • Multicultural Aging
  • Creativity & Lifelong Learning
  • Spirituality & Religion
  • Health & Wellness
  • Legal & Ethical Issues

The 2016 Optimal Aging additionally features several pre-conference opportunities:

  • June 11-12: Chief Resident Immersion Traing (CRIT), a leadership training for Chief Residents, Program Directors and geriatrics faculty
  • June 12: Continuing education for Social Work professionals

For information about the conference and abstract submission, visit www.OptimalAgingInstitute.org or call 502-852-5629.

 

 

UofL School of Medicine supports the Obama Administration’s new actions to address prescription opioid abuse, heroin epidemic

UofL School of Medicine supports the Obama Administration’s new actions to address prescription opioid abuse, heroin epidemic

On March 29, the University of Louisville School of Medicine joined with 60 other schools and colleges of medicine from throughout the United States in support of new actions to address prescription opioid abuse and the national heroin epidemic.

President Barack Obama joined individuals in recovery, family members, medical professionals, law enforcement officials and other leaders at the National Rx Drug Abuse and Heroin Summit in Atlanta, Georgia. The annual summit is organized by Operation UNITE, which was launched by Kentucky Rep. Hal Rogers.  As part of the event, the President announced these additional public and private sector actions to escalate the fight against the prescription opioid abuse and heroin epidemic, which is claiming the lives of tens of thousands of Americans each year.

The President has made clear that addressing this epidemic is a priority for his Administration, and today’s actions represent further steps to expand access to treatment, prevent overdose deaths and increase community prevention strategies.  These actions build on the President’s proposal for $1.1 billion in new funding to help every American with an opioid use disorder who wants treatment get the help they need.

As part of the March 29 event, the President announced the following Administration actions:

    Expanding Access to Treatment:

      The Department of Health and Human Services (HHS) is issuing a proposed rule to increase the current patient limit for qualified physicians who prescribe buprenorphine to treat opioid use disorders from 100 to 200 patients with the goal of expanding access to this evidence-based treatment while preventing diversion.  The proposed rule aims to increase access to medication-assisted treatment and behavioral health supports for tens of thousands of people with opioid use disorders.

      HHS released $94 million in new funding to 271 Community Health Centers across the country earlier this month to increase substance use disorder treatment services, with a specific focus on expanding medication-assisted treatment of opioid use disorders in underserved communities.  This funding is expected to help health centers treat nearly 124,000 new patients with substance use disorders.

      The Substance Abuse and Mental Health Services Administration (SAMHSA) is releasing a new $11 million funding opportunity for up to 11 states to expand their medication-assisted treatment services.  SAMHSA also is distributing 10,000 pocket guides for clinicians that include a checklist for prescribing medication for opioid use disorder treatment and integrating non-pharmacologic therapies into treatment.  SAMHSA also will coordinate trainings to increase the number of doctors qualified to prescribe buprenorphine, which will be held in targeted states in greatest need.

        Establishing a Mental Health and Substance Use Disorder Parity Task Force: The President signed a memorandum on March 29 directing the creation of an interagency Task Force, to be chaired by the Domestic Policy Council, to advance access to mental health and substance use disorder treatment; promote compliance with best practices for mental health and substance use disorder parity implementation; and develop additional agency guidance as needed.  Federal parity protections are intended to ensure that health plans’ coverage of mental health and substance use disorder benefits is comparable to their coverage of medical and surgical benefits.  The Task Force will work quickly, with an Oct. 31 deadline, across Federal Departments and with diverse stakeholders to ensure implementation of these important parity protections.

            Implementing Mental Health and Substance Use Disorder Parity in Medicaid:  HHS is finalizing a rule to strengthen access to mental health and substance use services for people enrolled in Medicaid and Children’s Health Insurance Program (CHIP) plans by requiring that these benefits be offered at parity, meaning  that they be comparable to medical and surgical benefits.  These protections are expected to benefit more than 23 million people in Medicaid and CHIP.

                Preventing Opioid Overdose Deaths: SAMHSA is releasing a new $11 million funding opportunity to states to purchase and distribute the opioid overdose reversal drug, naloxone, and to train first responders and others on its use along with other overdose prevention strategies.

                    Expanding Public Health-Public Safety Partnerships to Combat the Spread of Heroin:  The Office of National Drug Control Policy is expanding its heroin initiative among regional High Intensity Drug Trafficking Areas (HIDTAs) by adding Ohio and Michigan to the effort.  These states will join the Appalachia, New England, Philadelphia/Camden, New York/New Jersey, and Washington/Baltimore HIDTAs in accelerating local partnerships between law enforcement and their counterparts in public health to combat heroin use and overdose.

                        Investing in Community Policing to Address Heroin:  The Department of Justice’s COPS program is announcing a $7 million funding opportunity called the COPS Anti-Heroin Task Force Program to advance public safety and to investigate the distribution of heroin, unlawful distribution of prescription opioids and unlawful heroin and prescription opioid traffickers.  These grants will provide funds directly to law enforcement agencies in states with high rates of primary treatment admissions for heroin and other opioids.

                          Tackling Substance Use Disorders in Rural Communities: On March 28, the Department of Agriculture announced that its $1.4 million Rural Health and Safety Education Grant Program to enhance the quality of life in rural areas through health and safety education projects has been expanded to include a focus on addressing the critical challenges related to substance use disorders in rural communities across the country.
                          Implementing Syringe Services Programs: HHS is issuing guidance for HHS-funded programs regarding the use of Federal funds to implement or expand syringe services programs for people who inject drugs.  Syringe services programs are an effective component of a comprehensive approach to preventing HIV and viral hepatitis among people who inject drugs.  The bipartisan budget agreement signed by the President last year revised a longstanding ban on these programs and allows communities with a demonstrated need to use Federal funds for the operational components of syringe services programs.

                            New Private Sector Commitments to Address the Epidemic

                            In connection with the March 29th Federal announcements, more than 60 medical schools announced that, beginning in fall 2016, they will require their students to take some form of prescriber education, in line with the newly released Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain, in order to graduate. Schools include:

                            • University of Louisville School of Medicine
                            • A.T. Still University of Health Sciences, Kirksville College of Osteopathic Medicine
                            • A.T. Still University of Health Sciences, School of Osteopathic Medicine in Arizona
                            • Baylor College of Medicine
                            • Boston University School of Medicine
                            • Burrell College of Osteopathic Medicine at New Mexico State University
                            • Chicago College of Osteopathic Medicine of Midwestern University
                            • David Geffen School of Medicine at the University of California – Los Angeles
                            • Dell Medical School at The University of Texas at Austin
                            • East Carolina University Brody School of Medicine
                            • Edward Via College of Osteopathic Medicine - Auburn Campus
                            • Edward Via College of Osteopathic Medicine - Carolinas Campus
                            • Edward Via College of Osteopathic Medicine - Virginia Campus
                            • Georgia Campus – Philadelphia College of Osteopathic Medicine
                            • Hébert School of Medicine Uniformed Services University of the Health Sciences
                            • Icahn School of Medicine at Mount Sinai
                            • Kansas City University of Medicine and Biosciences College of Osteopathic Medicine
                            • Lincoln Memorial University DeBusk College of Osteopathic Medicine
                            • Loyola University Chicago Stritch School of Medicine
                            • Marian University College of Osteopathic Medicine
                            • Marshall University Joan C. Edwards School of Medicine
                            • Mercer University School of Medicine
                            • NYU School of Medicine
                            • Ohio State University College of Medicine
                            • Ohio University Heritage College of Osteopathic Medicine
                            • Oklahoma State University Center for Health Sciences College of Osteopathic Medicine
                            • Oregon Health & Science University School of Medicine
                            • Perelman School of Medicine at the University of Pennsylvania
                            • Philadelphia College of Osteopathic Medicine
                            • Rocky Vista University College of Osteopathic Medicine
                            • Rowan University School of Osteopathic Medicine
                            • Rutgers Robert Wood Johnson Medical School
                            • Saint Louis University School of Medicine
                            • State University of New York Upstate Medical University
                            • The Commonwealth Medical College
                            • The Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
                            • Touro College of Osteopathic Medicine - New York
                            • Touro University College of Osteopathic Medicine - California
                            • Touro University College of Osteopathic Medicine – Nevada
                            • Tufts University School of Medicine
                            • Tulane University School of Medicine
                            • University of Arizona College of Medicine – Tucson
                            • University of California – Davis School of Medicine
                            • University of Central Florida College of Medicine
                            • University of Colorado School of Medicine
                            • University of Kansas Medical Center
                            • University of New England College of Osteopathic Medicine
                            • University of North Carolina School of Medicine
                            • University of North Texas Health Science Center at Fort Worth, Texas College of Osteopathic Medicine
                            • University of Oklahoma College of Medicine
                            • University of Pikeville - Kentucky College of Osteopathic Medicine
                            • University of Rochester School of Medicine and Dentistry
                            • University of Tennessee College of Medicine
                            • University of Texas Southwestern Medical Center
                            • University of Wisconsin School of Medicine and Public Health
                            • Virginia Commonwealth University School of Medicine
                            • West Virginia School of Osteopathic Medicine
                            • West Virginia University School of Medicine
                            • Western University of Health Sciences College of Osteopathic Medicine of the Pacific
                            • Western University of Health Sciences College of Osteopathic Medicine of the Pacific Northwest
                            • William Carey University College of Osteopathic Medicine

                            Rite Aid has trained over 8,400 pharmacists on naloxone and is dispensing naloxone to patients without needing an individual prescription in 10 states with plans to expand to additional states.  Kroger currently dispenses naloxone without an individual prescription at its pharmacies in seven states with plans to expand to at least 12 more by the end of the year.  AmerisourceBergen/ Good Neighbor Pharmacy will provide educational materials to encourage their 4,000 independently owned and operated retail pharmacy locations to provide naloxone without an individual prescription.

                            Updates on Federal Actions and Private Sector Commitments

                            In October 2015, as part of his visit to West Virginia to discuss the prescription opioid abuse and heroin epidemic, the President announced a number of new public and private sector actions, including a Presidential Memorandum requiring Federal Departments to provide training on appropriate opioid prescribing to Federal health care professionals and requiring Departments to develop plans to address barriers to opioid use disorder treatment in Federal programs.  Departments are ahead of schedule in fulfilling the President’s directive that Federal agencies ensure that all employees who prescribe these drugs are trained in appropriate opioid prescribing practices by 2017.  Approximately 75 percent of federal prescribers have been trained to date.  In addition, since the President’s Memorandum was released, Departments have taken numerous steps to expand access to opioid use disorder treatment, including medication-assisted treatment, such as:

                            • TRICARE: The Department of Defense issued a proposed rule to implement parity protections in TRICARE, including expanding mental health and substance use disorder treatment to include coverage of intensive outpatient programs and treatment of opioid use disorders with medication-assisted treatment.  TRICARE currently has an estimated 15,000 to 20,000 beneficiaries with opioid use disorder who, under the current benefit, cannot access medication-assisted treatment.
                            • FEHBP: The Office of Personnel Management released a 2017 Call Letter to health plans participating in the Federal Employees Health Benefits Program (FEHBP) making opioid use disorder treatment a priority and calling on health plans to review and improve access to medication-assisted treatment.
                            • Medicare: The Centers for Medicare and Medicaid Services (CMS) released a 2017 Call Letter to plans participating in the Medicare Prescription Drug Program reiterating that reducing the unsafe use of opioids is a priority and making clear that Part D formulary and plan benefit designs that hinder access to medication-assisted treatment for opioid use disorder will not be approved.
                            • Medicaid:  CMS released a guidance document to states identifying “Best Practices for Addressing Prescription Opioid Overdoses, Misuse and Addiction” including effective Medicaid pharmacy benefit management strategies, steps to increase the use of naloxone to reverse opioid overdose, and options for expanding Medicaid coverage of and access to opioid use disorder treatment.  This builds on Medicaid’s work with states over the past year to increase access to Medicaid substance use disorder treatment services.
                            • Health Insurance Marketplace: In the last month, CMS finalized a 2017 Marketplace payment notice that clarified that both essential health benefits requirements and Federal mental health and substance use disorder parity requirements apply to qualified health plan coverage of medications to treat opioid use disorder, and additional guidance is forthcoming.

                            Earlier this month, the Centers for Disease Control and Prevention issued its Guideline for Prescribing Opioids for Chronic Pain – the Agency’s first-ever recommendations for primary care clinicians on prescribing opioids.  The Guideline provides recommendations for clinicians on appropriate prescribing, including determining if and when to start prescription opioids for chronic pain treatment; guidance on medication selection, dose, and duration, including when to discontinue medication, if needed; and guidance to help assess the benefits and risks and address the harms of prescription opioid use.

                            The Food and Drug Administration recently announced safety labeling changes for all immediate-release opioid pain medications, including requiring a new boxed warning about the serious risks of misuse, abuse, addiction, overdose and death associated with these drugs.  The Agency also issued a draft guidance intended to support the development of generic versions of abuse-deterrent opioids.  Abuse-deterrent drug formulations are designed to make the drug more difficult to abuse, including making it harder to crush a tablet in order to snort the contents or more difficult to dissolve the product in order to inject it.

                            The Drug Enforcement Administration (DEA) recently announced it will hold its 11thNational Prescription Drug Take-Back Day on Saturday, April 30, providing a safe, convenient, and responsible way of disposing of unneeded prescription drugs.  More than 5.5 million pounds of medication have been collected over the last ten Take Back Days.  Local communities are also establishing ongoing drug take-back programs.

                            Examples of private sector actions taken to date include the following:

                            In conjunction with the October event, more than 40 health care provider groups announced a commitment to ensure that more than 540,000 health care providers will complete training on appropriate opioid prescribing in the next two years.  In the first five months of this initiative, the provider coalition reports that more than 75,000 providers have completed prescriber training.  In addition, more than 2,200 additional physicians have committed to completing training to prescribe buprenorphine as part of the coalition’s effort to double the number of buprenorphine prescribers in the next three years.

                            As part of their commitment announced at the October 2015 event, the National Association of Counties, National Governors Association, National League of Cities and United states Conference of Mayors, with the U.S. Communities Purchasing Alliance and Premier, Inc., announced in January they had secured discounts on naloxone and medication-assisted treatment drugs through their purchasing program for State and local agencies.

                            In February, Walgreens announced it will install safe medication disposal kiosks in more than 500 drugstores across the country, primarily at locations open 24 hours. The program will make the disposal of medications — including opioids and other controlled substances — easier and more convenient while helping to reduce the misuse of medications.  Walgreens also will make naloxone available without needing an individual prescription at its pharmacies in 35 states and Washington, D.C. throughout this year.

                            CVS Health has worked to increase access to naloxone by establishing standing orders or collaborative practice agreements.  By the end of March 2016, CVS Pharmacy locations in 23 states will be able to dispense naloxone to patients without needing an individual prescription, increasing to 35 states by the end of 2016 as part of its program expansion announced at the October 2015 event.  CVS Health has also launched a drug abuse prevention program called Pharmacists Teach, which brings CVS Pharmacists into schools across the country to educate students about the dangers of drug abuse.  To date, more than 30,000 students have participated in the program.