University Times

Nursing scholarships funded

The School of Nursing has received $80,000 from the Robert Wood Johnson Foundation to award eight student scholarships through the foundation’s new careers in nursing scholarship program. The national initiative in conjunction with the American Association of Colleges of Nursing, aims to help alleviate the nation’s nursing shortage by expanding the pipeline of students in accelerated nursing programs.

The scholarship program supports accelerated programs, which offer the most efficient route to licensure as a registered nurse for adults who already have completed a baccalaureate or graduate degree in a discipline other than nursing. Although enrollment in these programs has increased steadily over the past few years, many potential students are unable to enroll because having a college degree disqualifies entry-level students from most federal financial aid programs.

Grants provided to Pitt through this program will be used to maximize diversity and increase the number of students in the School of Nursing’s accelerated baccalaureate nursing program.

Scholarships of $10,000 each will be awarded to entry-level nursing students in accelerated programs during the 2009-10 academic year with preference given to students from groups underrepresented in nursing or from disadvantaged backgrounds.

According to the National Advisory Council on Nurse Education and Practice, diversifying the nursing profession is essential to meeting the nation’s health care needs and reducing health disparities that exist among many underserved populations. Data from the U.S. Health Resources and Services Administration also show that nurses entering the profession at the baccalaureate level are four times more likely than other nurses to pursue a graduate degree in nursing, which is required for teaching. Consequently, bringing more nurses into the profession at the baccalaureate and master’s degree levels will help to address the nation’s nursing faculty shortage.

Engineering grants announced

Professors Albert To and Minhee Yun of the Swanson School of Engineering’s Department of Electrical and Computer Engineering were awarded a two-year National Science Foundation Broadening Participation Research Initiation Grants in Engineering (BRIGE) award of $175,000 for “BRIGE: Experimentally-validated Atomisticscale Modeling and Simulation of Electrodeposited Single Palladium Nanowires.”

The project aims to better understand the interaction of nanoparticles during the growth process of electrodeposited single palladium nanowires and their resulting nanostructure under different experimental conditions.

A longer-term goal will exploit the variety of nanostructures in the nanowires to increase energy conversion efficiency in thermoelectric and hydrogen storage devices.

Results from the proposed research will be integrated into educational and outreach activities, including demonstrating new nanotechnology concepts to students and introducing a new graduate course in computational nanomechanics.

Med school prof awarded NIH funding

Robert Bowser, professor of pathology and neurobiology, has received a new NIH R01 grant for “Peptide and Protein Biomarkers for Amyotrophic Lateral Sclerosis.” The project aims to expand on preliminary data that has identified a number of protein biomarkers in cerebrospinal fluid with a high level of accuracy for diagnosing ALS near the time of clinical symptom onset.

He also has received renewed NIH training grant funding through 2014 to support the McGowan Institute for Regenerative Medicine’s cellular approaches to tissue engineering and regeneration program.

Bowser directs the ALS Tissue Bank and is director of ALS research for the Pittsburgh Institute for Neurodegenerative Diseases and at the Center for ALS Research at Pitt.

Combination of fast food, no car linked to obesity

A study by researchers from the School of Medicine published online and in the September issue of the Journal of Urban Health found that people without cars who live near high concentrations of fast food restaurants were as much as 12 pounds heavier than those who lived in neighborhoods that lacked such restaurants.

Study lead author Sanae Inagami of the Department of Medicine said, “Owning a car is generally associated with a more sedentary lifestyle and excess weight gain because people spend more time in their cars and less time walking.” Yet, when Inagami and her colleagues looked at whether a high concentration of fast food restaurants impacted this association, they found that not owning a car in areas where fast food was more readily available increased the risk of obesity.

“Fast food may be specific to weight gain in particular populations and locations,” she said. “People who are less affluent don’t own cars and can’t go distances for healthier foods. As a result, they may end up opting for the lower-priced and high-caloric foods available at fast food chains.”

The study, part of the Los Angeles Family and Neighborhood Study, was based on a survey of 2,156 adults in 63 neighborhoods in Los Angeles County. Car owners on average weighed 8.5 pounds more than non-car owners except in areas with high fast food concentration, meaning five fast food restaurants per mile.

Non-car owners in high fast food concentration areas were found to weigh 2.7 pounds more than car owners who lived in the same areas, and 12 pounds more than residents of areas without fast food outlets. Those who did not own a car and lived in areas without fast food outlets weighed the least.

“There has been a major focus on fast food and its impact on individual health, but we need to consider the availability of all types of restaurants at individual and community levels,” said Inagami. “Since our study showed that total restaurant density was associated with weight gain in all individuals, not just those who did not own cars, we also need to encourage people to pay more attention to their food environment,” she said.

Infectious disease simulation center funded

The Graduate School of Public Health has received a $13.4 million NIH grant to establish a Center of Excellence in Modeling of Infectious Diseases.

The five-year grant funds the development and testing of computer simulations that ultimately will enable public health officials and policymakers to evaluate intervention strategies to contain infectious disease outbreaks.

The center, led by GSPH Dean Donald S. Burke, uses census and other datasets to build simulations of individuals as they move about and interact with one another through schools, workplaces, households and communities. By modeling their contacts, the Pitt team is working to determine the likelihood a person will spread the disease to others and to evaluate which interventions — such as school closings, travel restrictions, hand washing, vaccines or a combination of these techniques — might be the most effective.

“It is difficult to predict how infectious disease control strategies will work because the spread of infection through a population depends on a multitude of factors,” Burke said.

“But by testing interventions ‘in silico’ before an epidemic occurs, we can work through which strategies will be the most likely to succeed in preventing illness and death.”

Projects funded by the grant include: developing statistical tools to define the features of a pathogen and its spread through a population; identifying personal health behaviors and the social factors that influence decision-making related to prevention; tracking the evolution of infectious diseases over time; studying the impact of the seasons and variations in climate on infectious disease trajectories; putting a system in place to effectively implement an intervention, and providing new computational tools to local health officials. These projects build on large-scale simulations previously developed by Burke and his colleagues to control a threatening avian influenza pandemic.

These models were influential in forming the World Health Organization’s decision about the size of antiviral medicine stockpiles needed to quash a possible avian flu outbreak, and in shaping federal policies about the impact of “social distancing” during an influenza epidemic.

Some left out of liver transplant evaluation

Patient race, gender and insurance status influence decisions about who will go on to receive liver transplants, according to a School of Medicine study in the September issue of the American Journal of Transplantation. The study indicates that women, blacks and Medicare patients who are in end-stage liver disease are less likely to be referred and evaluated for transplants.

“There currently is no comprehensive oversight of liver disease patients as they go through evaluation, referral and are put on a waitlist for transplantation,” said Cindy L. Bryce, study lead author and professor of medicine.

The study, which followed 144,507 patients hospitalized in Pennsylvania with liver-related conditions, sought to determine whether any potential barriers exist at the referral and listing steps in the transplantation process. Bryce and colleagues found that 4,361 of these patients underwent transplant evaluation. Of these, 3,071 were waitlisted and 1,537 went on to transplantation. Patients were significantly less likely to undergo evaluation, waitlisting and eventual transplantation if they were women, black or covered by Medicare.

Disparities were especially apparent in the early stages of the process when evaluation and listing occurs — 61 percent of men were evaluated for transplantation compared to 39 percent of women; 73.8 percent of whites were evaluated compared to 8.6 percent of blacks, and 62 percent of patients with commercial insurance were evaluated compared to 4.7 percent with Medicare only.

“While our study was not designed to identify causes for these disparities, current practices for identifying and referring liver disease patients for transplantation should be made more transparent,” said Bryce. “Although we face a worsening gap in the supply and demand for organs for liver transplantation, race, gender and insurance status should not be factors that preclude patients from being evaluated for transplantation.”

Pitt co-authors were Derek Angus of critical care medicine and Robert Arnold, Chung-Chou Ho Chang, Max Farrell and Mark S. Roberts of medicine.

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health.

Retail clinics cheaper for routine illness care

Retail medical clinics in pharmacies and stores provide care for routine illnesses at a lower cost and similar quality compared to other medical settings, according to a study by researchers at the School of Medicine and RAND Corp.

The study, published in the September issue of the Annals of Internal Medicine, compared 2,100 patients treated for middle ear infections, sore throats and urinary tract infections at retail clinics in Minnesota to those treated for the same ailments in physician offices, urgent care centers and hospital emergency rooms.

Researchers found no difference in the quality of care patients received. Additionally, the costs of treating those illnesses at retail clinics were 30-40 percent lower than in physician offices or urgent care centers and 80 percent lower than in hospital emergency rooms. The differences were caused primarily by lower payments for professional services and lower rates of laboratory testing. Care at retail clinics most often is provided by nurse practitioners rather than physicians.

“These findings provide more evidence that retail clinics are an innovative way to deliver health care,” said lead author Ateev Mehrotra, professor in the Division of General Internal Medicine and a researcher at RAND, a nonprofit research organization.

The researchers found that patients who visited a retail clinic were no more likely to receive a prescription for antibiotics than in the other settings — a concern frequently expressed by medical professionals because many retail clinics are owned by pharmacies. In addition, patients treated in retail clinics received preventive care over the following three months at about the same rate as patients treated elsewhere.

“We need to continue to examine retail medical clinics as they grow in number, but the results we have seen thus far suggest they are a way to provide high-quality care for many ailments in a convenient and cost-effective fashion,” Mehrotra said.

In a second study, also published in the September issue of the Annals of Internal Medicine, RAND researchers noted there are almost 1,000 retail medical clinics in the United States and that about one-third of urban Americans live within a 10-minute drive of one.

The study also found that while three for-profit companies, including industry leader MinuteClinic, operate about 70 percent of the nation’s retail medical clinics, an increasing number of hospital chains and physician groups are becoming involved.

Funding for both studies was provided by the California HealthCare Foundation.

Judith R. Lave of the Graduate School of Public Health was among the study co-authors.

Better biomarker measurement developed

Researchers at the University of Pittsburgh Cancer Institute have developed an accurate way of measuring a biomarker that could predict which cancer patients will respond to certain chemotherapies.

Their findings were published in this month’s online version of Cancer Research, one of the journals supported by the American Association for Cancer Research.

The identification of molecular markers to guide treatment decisions for patients with advanced disease is extremely important, according to senior author Laura J. Niedernhofer, professor of microbiology and molecular genetics in the School of Medicine.

Her team examined the role of ERCC1-XPF, an enzyme that prevents genetic mutations and cancer because of its role in DNA repair. Many commonly used platinum-based chemotherapy agents kill cancer cells by damaging their DNA, so the enzyme’s presence could work against such drugs.

“These chemotherapies are quite toxic, so if we can identify which patients will respond before treatment begins, we can hopefully improve the quality of life for the rest of the patient population by selecting alternative treatments,” Niedernhofer said.

According to Niedernhofer’s findings, the current standard method of measuring the enzyme isn’t accurate. The results showed the antibody typically used now isn’t as well suited to gauging enzyme levels in tissue samples as are other available antibodies.

“Through the methods we developed in this study, we determined first that ERCC1-XPF protein levels vary from tumor to tumor. We also created the first rigorous approach for identifying biomarkers that could help determine which patients might benefit from certain chemotherapies, and which patients might not,” said Niedernhofer.

Co-authors of the paper included Nikhil R. Bhagwat, a graduate student in the Graduate School of Public Health, Vera Y. Roginskaya of molecular oncology, Rajiv Dhir of pathology and Rick Wood, now of MD Anderson Cancer Center.

The study was funded by the UPCI SPORE grant for lung cancer research.

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The University Times Research Notes column reports on funding awarded to Pitt researchers as well as findings arising from University research.

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