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May 16, 2013

Research Notes

Feds fund study of USAID programs in West Africa

A faculty group has joined an evaluation and training project, supported by a $2.6 million contract from the United States Agency for International Development (USAID), to examine West African communities where crime, unemployment and religious extremism are high and government effectiveness is low.

The governance group in the University’s Ford Institute for Human Security has partnered with The Mitchell Group, a Washington, D.C.-based research firm. The team also will help teach program-evaluation skills to West African professionals working in civic and humanitarian organizations.

The Pitt-Mitchell Group will analyze USAID’s Peace through Development program in Niger, Burkina Faso and Chad, which is working to help communities threatened by violent extremist groups. In addition, the team will assess USAID programs aiming to improve post-conflict social cohesion in Cote d’Ivoire, early warning signs of regional conflict throughout West Africa and natural resources transparency in Niger. They will carry out research projects on political violence, party development and other regional matters and manage a fellowship program for citizens of Burkina Faso, Chad and Niger to develop their own research projects.

Principal investigators are governance group coordinator Louis A. Picard, director of the Ford Institute and a Graduate School of Public and International Affairs (GSPIA) faculty member,  and lead methodologist Steven E. Finkel, Daniel H. Wallace Professor of Political Science.

The group will oversee the conduct of surveys, interviews and focus-group discussions in each of the countries where Peace through Development operates. The Pitt group also will conduct cross-national statistical comparisons in order to monitor the program’s overall effectiveness.

The project is expected to be a significant resource for faculty and students.

“We may want to use this material in other parts of the world, in other programs,” said Picard, adding that the methodological work completed during this project could be valuable to students and other researchers.

CPR choice influenced by doctors’ words

A physician’s choice of words when talking with family members about whether to try cardiopulmonary resuscitation (CPR) if a critically ill patient’s heart stops may influence the decision, according to a study led by Amber E. Barnato, a faculty member in clinical and translational science at the School of Medicine.

Barnato and her team recruited more than 250 adult children or spouses in eight cities: Boston, Atlanta, New York, Los Angeles, San Francisco, Dallas, Denver and Pittsburgh. The participants took part in a web-based survey involving a hypothetical situation in which a loved one was in the intensive care unit with a 40 percent chance of dying from sepsis, a bacterial infection. Some subjects were shown a photo of their loved ones to help them imagine the situation and heighten the emotional response. An actor portrayed a physician who held a virtual, interactive meeting with the family member. The “doctor’s” responses varied, using different words for the same scenarios. Additionally, some people were offered emotional support and others were offered only clinical information.

A key finding was that when participants were asked to choose between having their loved ones receive CPR if their hearts should stop — a treatment with a 10 percent chance of successfully reviving them — or the alternative, a “Do Not Resuscitate” (DNR) order, 60 percent chose CPR. When the alternative was described as to “allow natural death” instead of a DNR order, the number choosing CPR dropped to 49 percent.

When the “doctor” cited “his own experience” about how most others handled such a situation, family members were more likely to choose what they believed was the common approach.

Using more empathic language did not influence CPR choice.

“Simple changes of words and perceptions about social norms resulted in large differences in CPR choices,” said Barnato. “The change in terminology from ‘DNR’ to ‘allow natural death’ already has been implemented in a health system in Texas. This study suggests that the change isn’t just window dressing  —  it makes a real difference in the choices that people make. We expect that it also may reduce feelings of guilt for choosing against CPR by making family members feel like they are doing something positive to honor their loved one’s wishes at the end of life, rather than taking something away from them.”

Robert M. Arnold, faculty member in palliative care and medical ethics at the School of Medicine, coauthored the study, which was funded by the National Institute of Nursing Research and appears in the June edition of Critical Care Medicine.

Consumers less worried about being stranded electronically

For consumers of electronic products, the risk of being “stranded” by choosing a losing, incompatible format — buying a Betamax videocassette player and seeing the VHS format attain market dominance, for example — is lessening, according to an article coauthored by Chris F. Kemerer, David M. Roderick Professor of Information Systems in the Katz Graduate School of Business and College of Business Administration.

It draws on research demonstrating that in many corners of the business world, competition among digital products is no longer ending with a single clear winner, marking a move away from business environments distinguished by “standards wars” between similar but incompatible technologies.

Kemerer, along with co-authors at Carnegie Mellon and the University of Texas-San Antonio, explained that the new business trend is creating a market for digital goods in which “winners take some” instead of “winner takes all.” Basic economic theory, the authors wrote, traditionally has predicted that markets for technologies will tip toward a single dominant standard, with competing technologies falling away. However, many technologies with multiple formats now are succeeding alongside one other.

The primary sources of this shift are digital converters — devices that accept multiple formats, thus resolving incompatibility issues. Said Kemerer: “The digital medium allows you to make conversions easily, yielding near-perfect copies. Converters are the game changer.”

Kemerer and his colleagues cited the example of Amazon, which allows users to read Amazon’s Kindle book titles both on Amazon’s Kindle digital reader and on other portable devices, including iPads and iPhones. They also point to the market for flash memory cards — storage sources that can be used interchangeably between digital cameras, mobile phones and audio players — as an example of how digital converters have changed the marketplace.

The researchers determined that the “winners-take-some” marketplace provides reasons for optimism among consumers, who increasingly are able to value product features, functionality and design features over mere platform compatibility as they did during the Betamax-versus-VHS era. There are potential advantages for firm managers, too, if they can adapt to the changing environment. Instead of pouring money into encouraging customers to choose a particular technology, anticipating a jackpot payment when the standards war has been won, firm managers should cross-license their products to increase total market size, the researchers said.

The article was published in the May issue of Communications of the ACM (Association for Computing Machinery).

HIV research could lead to treatment for bacterial infection

Researchers led by senior author Ronald Montelaro, faculty member in microbiology and molecular genetics in the Graduate School of Public Health, have discovered a potential treatment for deadly, drug-resistant bacterial infections that uses the same approach that HIV uses to infect cells. It is especially promising in the development of a potential treatment for lung infections in people with cystic fibrosis.

Montelaro, who also is co-director of the Center for Vaccine Research (CVR), said: “The discovery of this new antibiotic was an unexpected result of basic research on HIV proteins. As a result of studying these proteins, we discovered novel structures that turn out to work very well against bacterial infections, including the complicated bacterial populations in lung infections in cystic fibrosis patients.”

Joseph M. Pilewski, faculty member in medicine, cell biology, physiology and pediatrics in the School of Medicine and co-director of the Adult Cystic Fibrosis Center at UPMC, said: “Infections with progressively resistant bacteria in the lung shorten the lives of people with cystic fibrosis. What happens is the genetic defect predisposes patients to infections that drive the production of mucus that then blocks the airways and makes it difficult to breath.”

Montelaro and his colleagues found that a particular sequence of amino acids on the tail end of HIV allows the virus to penetrate and infect cells. The team manufactured a synthetic and more efficient version of this sequence — called engineered cationic antimicrobial peptides, or “eCAPs” — that laboratory tests have shown to rapidly destroy bacteria that otherwise are resistant to most standard antibiotics.

The eCAPs can be assembled in a laboratory from the amino acids arginine and tryptophan and manufactured to the shortest effective length, giving the resulting antibiotic treatment maximum potency while reducing costs.

Pitt has taken out several U.S. and international patents on this discovery.

Co-author Yohei Doi, medicine faculty member in the School of Medicine, said: “We have an unmet clinical need for treatment of hospital-acquired infections where the bacteria are extremely resistant to antibiotics. We have patients with no treatment options left. The fact that these eCAPs are completely engineered puts them at an advantage because they can be manufactured easily, and they give us some hope for a quick-acting treatment in these dire circumstances.”

Traditional antibiotics typically work by poisoning important metabolic processes after being taken up by the target bacteria, a process that may take days, to clear a bacterial infection. In contrast, the eCAPs are specifically attracted to the surface of target bacteria where they disrupt the bacterial membrane, causing the bacteria’s death within minutes.

Tests indicate that the eCAPs work well against biofilms, which are bacterial communities that develop very high levels of resistance to antibiotics by working together to protect the film’s inner bacteria from traditional treatments. The eCAPs seem to push through the outer layers of biofilms to destroy the entire bacterial community.

Montelaro said: “While cystic fibrosis patients are our initial target and a very high-priority target, we also could look at infections associated with burns or indwelling medical devices, such as venous catheters. We could even look to the biodefense realm, in terms of a rapid, handheld nebulizer treatment that soldiers could use in the case of exposure to a bioterrorism agent.”

Other co-authors were Berthony Deslouches and Jodi Craigo of CVR and a researcher from the Lake Erie College of Osteopathic Medicine at Seton Hill.

The research was funded by the National Institutes of Health (NIH) and will be published in the June issue of Antimicrobial Agents and Chemotherapy.

Breast milk ingredient may help preemies

An ingredient that occurs naturally in breast milk might be used to prevent premature babies from developing a deadly intestinal condition that currently is largely incurable, according to researchers led by senior author David Hackam, Watson Family Professor of Surgery in the School of Medicine and co-director of the Fetal Diagnosis and Treatment Center at Children’s Hospital.

Once babies who are born before 36 weeks gestation are stable, they typically are fed with formula, because breast milk often is not readily available.

Some of these preemies develop necrotizing enterocolitis, or NEC, in which the intestinal tissue is dying. Hackam said: “We have no choice but to remove the dead parts of the intestine, but despite surgery, half of these preemie babies still die from the condition.”

Hackam and his team noted NEC occurs when the intestines begin being colonized with bacteria, a process that occurs normally after birth. They focused on toll-like receptor 4 (TLR4), an immune protein that is involved in recognizing microbes and which they recently discovered plays a role in gut development. TLR4 is present in higher amounts in the blood vessel lining in preemies than in full-term babies, the researchers found.

Using a mouse model designed to induce NEC, the study showed that, unlike normal mice, those bred to lack TLR4 in their blood vessels did not develop NEC. The findings indicate that bacteria in the blood activate TLR4, leading to a reduction in nitric oxide, which in turn narrows blood vessels and decreases blood flow, Hackam said.

“This pathway can be dangerous when the preemie’s immature gut becomes inflamed from exposure to the bacteria normally present in the intestine,” Hackam said. “Abundant TLR4 triggers a shutdown of the blood supply to the intestine, leading to tissue death or necrosis.”

According to co-author and nitric-oxide expert Mark Gladwin, chief of the Division of Pulmonary, Allergy and Critical Care Medicine at the School of Medicine, because premature babies who are nursed rather than formula-fed are more likely to survive NEC, the team took a closer look at the components of breast milk.

They found that breast milk contains high levels of sodium nitrate, which is converted to nitrite by gut bacteria. Nitrite can be directly converted to the vasodilator nitric oxide, which can both protect the intestinal lining and improve blood flow.

Said Gladwin: “The additional nitrite appears to overcome the effects of TLR4 activation and corrects the blood flow problem. When we gave formula supplemented with a sodium nitrate and nitrite analog to the premature mice, we saw improved blood flow in the intestine, and NEC did not develop.”

Hackam and Gladwin are testing the compound, which is FDA-approved for other uses, in other models of NEC with the hope that it could be added routinely to formula fed to premature infants to prevent NEC.

Co-authors of the paper included researchers from the Division of Gastroenterology and the pediatrics, pathology and surgery departments at the School of Medicine and from Children’s Hospital.

The project was funded by NIH, the Hartwell Foundation, the Institute for Transfusion Medicine and the Hemophilia Center of Western Pennsylvania.

Results appear in the current online early edition of the Proceedings of the National Academy of Sciences.

Children with disabilities growing fastest among higher-income families

More children have disabilities now than a decade ago, and the greatest increase is among children of higher-income families, according to a study led by Amy Houtrow, a faculty member in physical medicine and rehabilitation and in pediatrics at the School of Medicine.

The study also showed that while disabilities due to neurodevelopmental and mental health problems have increased sharply, disabilities related to physical health conditions have decreased. This trend was most noteworthy among children under 6 years of age whose rate of neurodevelopmental disabilities nearly doubled during the study, from 19 cases to 36 cases per 1,000 children.

Said Houtrow: “A century of health-care improvements and social changes have altered the face of childhood chronic disease and disability. Nearly six million kids were considered disabled in 2009 and 2010, almost one million more than in 2001 and 2002.”

While previous studies have found an increase in the prevalence of childhood disability, Houtrow and her research team wanted to look more closely at the specific conditions and socio-demographic factors associated with disabilities.

The researchers studied data from the National Health Interview Survey conducted by the U.S. Centers for Disease Control and Prevention (CDC) from 2001 to 2002 and from 2009 to 2010. Participants included more than 102,000 parents of children up to age 17.

The research team assembled a composite of disability indicators to identify children with disabilities and their associated underlying chronic conditions. Conditions were categorized into three groups: physical; neurodevelopmental/mental health, and other.

The overall rate of disability for children under age 18 increased 16.3 percent between the 2001-02 period and the 2009-10 period.

Children living in poverty represented the largest numbers of overall children with disability in both time periods, but not the highest growth rates. The largest increase in growth rates of disabilities was seen among children living in households with incomes at or above 300 percent of the federal poverty level, about $66,000 a year for a family of four in 2010.

“We are worried that children living in lower-income families may be having problems accessing diagnostic and treatment services,” Houtrow said.

Co-investigators were from the American Academy of Pediatrics, the University of California-San Francisco and UCLA.

Results were presented at the Pediatric Academic Societies’ annual meeting.

Plasma given  on choppers may reduce deaths

Trauma experts working under principal investigator Jason Sperry, faculty member in surgery and critical care medicine at the School of Medicine, are launching a multi-center trial to see if they can improve survival of patients who have suffered traumatic injuries with uncontrolled bleeding. Paramedics will administer plasma to these patients while they are being transported by helicopter to the hospital.

Uncontrolled bleeding is one of the leading causes of death following a traumatic injury because it can lead to multiple organ failure. The pre-hospital air medical plasma trial (PAMPer) will build on research findings that early transfusions can lower mortality and reduce the total number of blood transfusions required.

Said Sperry: “If plasma treatment proves beneficial, this study could provide a new standard of care for emergency services nationwide.”

During the four-year study, STAT MedEvac will enroll patients with blunt or penetrating trauma and hemorrhagic shock resulting from significant blood loss who are being transported to a trauma center participating in the trial. STAT MedEvac already carries red blood cells for transfusion in these patients but not plasma because of logistical issues related to coordination between helicopters and the blood bank. Plasma will be added to the helicopters in this study in one-month, randomized intervals.

“A quarter of patients with these types of traumatic injuries present with a tendency toward bleeding, which is associated with death occurring in a relatively short time,” said Sperry. “Plasma reduces bleeding. By bringing the plasma to patients before they even get to the hospital, we may reduce the potential for death.”

Because patients who have suffered these kinds of injuries are unlikely to be able to give consent to participate in the trial, the PAMPer study will be conducted under a federally authorized exception from informed consent process that includes a means to opt out of inclusion. Community members who do not wish to participate in this research study can obtain a bracelet to opt out by contacting Meghan Buck at

The research, sponsored by the U.S. Department of Defense, Pitt and UPMC, will be performed at UPMC Presbyterian and five other medical centers.

Amphibians gain insecticide resistance

Amphibian populations living close to agricultural fields have become more resistant to a common insecticide and actually are resistant to multiple common insecticides, according to two studies by principal investigator Rick Relyea, faculty member in biological sciences in the Dietrich School of Arts and Sciences and director of the University’s Pymatuning Laboratory of Ecology.

In the most recent study, published this month in Evolutionary Applications, the researchers demonstrated, for the first time, that tadpoles from populations close to farm fields are more resistant to chlorpyrifos, one of the most commonly applied insecticides, often sold as “Dursban” or “Lorsban.” In addition, a related study published in February showed that tadpoles resistant to chlorpyrifos also are resistant to other insecticides.

Said Relyea: “While we’ve made a lot of progress in understanding the ecological consequences to animals that are unintentionally exposed to insecticides, the evolutionary consequences are poorly understood.”

The researchers used newly hatched tadpoles collected from nine populations of wood frogs living at different distances from agricultural fields. They tested the frogs’ resistance when exposed to chlorpyrifos, which is used against insects, and Roundup Original MAX, which is a common herbicide used against weeds.

Relyea and his Pitt collaborators exposed the tadpoles to environments containing either no pesticides, chlorpyrifos or Roundup. After 48 hours, they measured how well the populations survived.

Said Rickey Cothran, lead author of the study and a postdoctoral researcher in Relyea’s lab: “Wood frogs living close to agricultural land were more likely to have been exposed to pesticides for many generations compared to those living far from agriculture; the latter frog populations likely experienced little or no exposure to pesticides. Although populations differed in their resistance to Roundup, populations closer to fields were not more resistant to the herbicide.”

“Because chlorpyrifos kills in a way that is similar to many other insecticides, higher resistance may have been favored each time any insecticide was sprayed,” said Jenise Brown, a co-author of the study and a former undergraduate researcher in Relyea’s lab. “In contrast, herbicides have a variety of ways that they kill organisms, which may make it harder for animals to be resistant when exposed to different herbicides over many years.”

In the earlier study, published online Feb. 21 in Environmental Toxicology and Chemistry, Relyea’s research team examined whether wood frog populations that were resistant to chlorpyrifos might be resistant to other insecticides. This phenomenon, said Relyea, happens commonly in pest species when farmers switch pesticides from year to year, but little is known about how this switching of pesticides affects amphibians.

Using three commonly applied pesticides that have similar chemical properties — chlorpyrifos, carbaryl and malathion — the researchers exposed 15 populations of wood frog tadpoles to high concentrations of each insecticide. They found that wood frog populations with resistance to one insecticide also had resistance to the other insecticides.

Said Jessica Hua, the lead author of the earlier study and a graduate student in Relyea’s lab: “This has a beneficial outcome. While it doesn’t mean that pesticides are beneficial to amphibians, our work does suggest that amphibians can evolve to resist a variety of pesticides and therefore improve their survival.”

As they hypothesized in the more recent study, the researchers suspect that the reason for this cross-resistance is that chlorpyrifos kills in a way that is similar to many other insecticides. Thus, evolving higher resistance to one insecticide may provide higher resistance to others.

Funding for both studies was provided by the National Science Foundation.

Depression in late-lifeshows higher dementia risk

Late-life depression is associated with an increased risk for all-cause dementia, Alzheimer’s disease and, most predominantly, vascular dementia, according to the results of a new meta-analysis led by Meryl Butters, psychiatry faculty member in the School of Medicine and corresponding author of the study.

Previous studies have shown an association between depression and Alzheimer’s disease, but this is the first meta-analysis that specifically addresses the risk of Alzheimer’s disease and vascular dementia in older adults with late-life depression. The study, conducted with other medicine researchers at the Federal University of Minas Gerais, also is the first to show that late-life depression increases the risk of vascular dementia and that the risk of vascular dementia is greater than the risk of Alzheimer’s disease for older adults with depression.

“All-cause dementia” refers to all dementia syndromes; the most common is Alzheimer’s disease, accounting for 60-80 percent of dementia cases. Alzheimer’s disease is associated with memory problems and apathy in early stages, and impaired judgment, confusion, disorientation, behavior changes and difficulty speaking in later stages. Vascular dementia is the second most common cause of dementia, and is associated with impaired judgment or ability to plan and complete tasks.

Said Butters: “An understanding of how late-life depression increases the risk of dementia could lead to better prediction and prevention mechanisms. Early diagnosis and prevention of depression could have a major dual public-health impact as they could also potentially prevent or delay cognitive decline and dementia in older adults.”

Late-life depression is one of the most common psychiatric illnesses in older adults, affecting 15 percent of adults aged 65+ in the United States, or approximately 6 million people.

Although the symptoms of depression vary, clinical depression is characterized by an inability to function normally or complete daily tasks over a prolonged period of time.

The research evaluated 23 community-based cohort studies as part of a meta-analysis to calculate the pooled risk of all-cause dementia, Alzheimer’s disease and vascular dementia in older adults with late-life depression. The findings concluded those with late-life depression are:

• 1.85 times more likely to develop all-cause dementia;

• 1.65 times more likely to develop Alzheimer’s disease;

• 2.52 times more likely to develop vascular dementia.

The authors note that preventing depression and improving general health, including cardiovascular health, should be considered in public-health policies associated with preventing and/or delaying the onset of dementia.

The research was sponsored by the National Institute of Mental Health and the John A. Hartford Foundation Center of Excellence in Geriatric Psychiatry at UPMC. It was published in the British Journal of Psychiatry.

Computer paper tops

A paper coauthored by Alex Jones, faculty member in electrical and computer engineering and director of the computer engineering program at the Swanson School of Engineering, was named one of the top 25 most influential papers from the IEEE Field Programmable and Custom Computing Machines Conference (FCCM).

“A MATLAB compiler for distributed, heterogeneous, reconfigurable computing systems” (2000) was recognized in part for providing “a first step in the development of the MATLAB compilation tools in Xilinx System Generator that are used by thousands of engineers annually.”

FCCM is the premiere IEEE conference on field programmable computer hardware. The paper, which had 12 other co-authors, was in the top 5 percent of all papers presented at the conference over its 20-year duration.

Grants fund skin cancer research

Two University of Pittsburgh Cancer Institute researchers have been awarded grants by the Melanoma Research Alliance (MRA).

Hussein Tawbi and Hassane M. Zarour, both faculty members in the Department of Medicine,  are among 49 researchers worldwide who will share over $9.6 million in MRA grants to develop improved means to prevent, detect and treat melanoma, one of the fastest growing cancers.

Tawbi is one of three principal investigators awarded the Team Science Award to continue study of the safety and efficacy of the selective BRAF inhibitor drabafenib in melanoma patients with brain metastases. Tawbi and researchers from the University of Texas M.D. Anderson Cancer Center and Melanoma Institute Australia will receive $900,000 over three years.

Zarour received an Academic Industry Award for his study looking at therapy with anti-PD-1 antibody and Peginterferon alpha-2b for melanoma. He will receive $786,000 over three years from both Merck and MRA.

Program prevents teen dating violence

Coaching Boys Into Men (CBIM), a program that seeks to reduce dating violence and sexual assault, is effective in reducing abusive behaviors among male athletes toward their female partners, according to a year-long evaluation study led by Elizabeth Miller, faculty member in  pediatrics in the School of Medicine, which examined the long-term effectiveness of the program.

The study looked at more than 2,000 male athletes in 16 California high schools who participated in the coach-led program to prevent abuse toward women. Results demonstrated that participants were less likely to support peers’ abusive behaviors and showed a significant relative reduction in abuse perpetration.

Said Miller: “Boys who participated in the program were significantly more likely to stop abusive behaviors among their peers. Now, one year later, we find that the rates of abuse perpetration actually increased among youth who didn’t participate, whereas perpetration did not increase among the male athletes whose coaches delivered the program.”

Created by the national nonprofit Futures Without Violence in collaboration with Miller, the CBIM program works with coaches to teach their male athletes about building healthy relationships and how to intervene when witnessing disrespectful and abusive behaviors among their peers.

The program combines discussions of personal responsibility, being a positive bystander (stopping disrespectful behaviors among peers), respectful relationships and preventing technology-based bullying, and leverages the influence of athletic coaches as powerful messengers for violence prevention and male athletes as leaders in their community. Lessons focus on respect, non-violence, integrity and leadership.

The study was funded by the CDC.

Collaborators with Miller on the study were researchers from Children’s Hospital, University of California-Davis, Futures Without Violence, Johns Hopkins, University of California-San Diego and WEAVE.

Results appeared in the online version of the American Journal of Preventive Medicine.

Fracking’s perceived effects still stressors

Pennsylvania residents living near unconventional natural gas developments using hydraulic fracturing, or “fracking,” attribute several dozen health concerns and stressors to the Marcellus Shale developments in their area, according to a long-term analysis by public health researchers.

Reported health impacts persist and increase over time, even after the initial drilling activity subsides, they noted. The study did not include clinical examinations of the participants’ physical health or any environmental tests. Researchers surveyed those who believe their health has been affected by hydraulic fracturing activities for self-reported symptoms and stressors. The most commonly cited concern was stress, which 76 percent of participants said they’d experienced. Among the leading causes of stress reported by the participants were feelings of being taken advantage of, having their concerns and complaints ignored, and being denied information or misled.

Senior author Bernard Goldstein, faculty member and former dean, said: “Many of these stressors can be addressed immediately by the gas drilling industry and by government. Scientific literature shows that if people do not trust companies doing work in their communities, or believe that the government is misleading them, there is a heightened perception of risk.

“Community disruption and psychosocial stress have been well-documented as a result of environmental issues like oil spills and Superfund sites,” said Goldstein, who is a member of the National Academies’ committees to investigate shale gas drilling in the United States and Canada. “A strong response by the Pennsylvania Department of Health to address concerns about health impacts of hydrofracturing could reduce observed stress and resulting symptoms.”

From May through October 2010, members of public health’s Center for Healthy Environments and Communities conducted in-depth interviews with 33 people concerned about fracking in their communities. Three-quarters of the residents resided in five of the seven most heavily drilled counties in Pennsylvania.

Follow-up interviews were conducted January-April 2012 and included 20 of the initial 33 participants. The remainder could not be reached or declined to participate.

Said lead author and doctoral student Kyle Ferrar: “Comprehensive epidemiological studies of all potential adverse consequences of fracking need to be performed, and they should include a close look at psychosocial symptoms, including stress, which cause very real health complications.”

Participants attributed 59 unique health issues to Marcellus Shale development. In addition to stress, these perceived health issues included rashes, headaches, shortness of breath, nausea and sore throats.

Public health co-authors included Jill Kriesky, Charles Christen, Lynne Marshall, Samantha Malone, Ravi Sharma and Drew Michanowicz.

The work was funded by the Department of Environmental and Occupational Health. It appears in the May issue of the International Journal of Occupational and Environmental Health.

Grant awarded to study meds at discharge

A team from UPMC, including Amy Calabrese Donihi and Kim C. Coley, faculty in the School of Pharmacy, were awarded funding by the American Society of Health-System Pharmacists Research and Education Foundation for research on the implementation of a program that enables the dispensing of multi-dose medications to patients when they are discharged from the hospital.

After patient discharge, most hospitals discard partially used multi-dose medications, such as insulin pens and inhalers, even if the patient will be continuing the same medication at home. This practice is costly from a waste disposal perspective and it is both costly and inconvenient for the patient, who must immediately go to a pharmacy after discharge to obtain the same medication.

Hospitals typically do not send medications home with patients because it is difficult to meet the regulatory requirements of an outpatient pharmacy, such as offering pharmacist counseling. The primary goals of this project are to develop a process to overcome these barriers, implement a program to dispense partially used multi-dose medications to patients at the time of hospital discharge and demonstrate that providing this type of program improves medication access, patient satisfaction and patient outcomes.


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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