DiversityNursing Blog

By Sara Cheshire

Can we predict the future of medicine? Although designer babies and a disease-free world may or may not come to pass, you can get a glimpse of the most promising and upcoming medical innovations each year, via the Cleveland Clinic.

The clinic's Top 10 Medical Innovations list, which has been an annual undertaking since 2007, contains treatments and technologies that are expected to significantly change patient care and save lives.

To be considered, each innovation must have a good chance of being available to the public in the upcoming year, says Dr. Michael Roizen, chief wellness officer at the Cleveland Clinic and chairman of the committee that decides the list. The committee must also expect it to have a significant impact on a large part of the population.

The process starts with a panel of Cleveland Clinic physicians and scientists who submit their ideas. These suggestions, which Roizen said totaled about 700 for the 2015 list, are then narrowed down and voted on by 40 physicians in a variety of health fields.

Here's what they selected for 2015:

1. Mobile stroke unit

Videoconferencing has made its way into ambulances, specifically for treating stroke victims on the go. Hospital stroke neurologists can interpret symptoms via a broadband video link and instruct an onboard paramedic, critical care nurse and CT technologist on treatment. This new technology should improve the speed of medical care, which is important as strokes quickly damage and kill brain cells.

2. Dengue fever vaccine

The World Health Organization reports that about half of the world's population is now at risk for dengue fever, which up until now was preventable only by avoiding mosquito bites. The disease is a leading cause of death and illness in children in some countries. A new vaccine has been developed and tested, and is expected to be available in 2015.

3. Painless blood testing

For those who hate large needles, a nearly painless way to sample blood will be a welcome relief. Plus, it will be cheaper and provide faster results than today's blood test. The new technology takes blood from your fingertip, and the Cleveland Clinic reports that over 100 tests can be performed on just one drop of blood.

4. New way to lower cholesterol

New self-injectable drugs called PCSK9 inhibitors have shown to be very effective in lowering cholesterol. These drugs may prove to be helpful for people with high LDL cholesterol who don't have good results with statins. The FDA is expected to approve the first PCSK9 in 2015.

5 ways to lower cholesterol

5. Cancer drug that doesn't harm healthy tissue

Although chemotherapy can save lives, it can be hard on the body and attack healthy cells as well as cancerous ones. A welcome breakthrough in the world of cancer treatment, antibody-drug conjugates can deliver targeted treatment without damaging healthy tissue.

6. Immune booster for cancer patients

Immune checkpoint inhibitors have been shown to prevent cancer cells from "hiding" from the immune system, allowing the body to more effectively fight these abnormal cells. Combined with chemotherapy and radiation treatment, the drugs have shown significant, long-term cancer remissions for patients with metastatic melanoma, one of the most deadly forms of cancer.

7. Wireless cardiac pacemaker

Until this point, wires have been a necessary component in pacemakers. A new wireless pacemaker about the size of a vitamin can now be implanted in the heart without surgery. Its lithium-ion battery is estimated to last about seven years.

8. New medications for idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis is a life-threatening disease that causes scarring in the lungs, leading to breathing difficulties and a shortage of oxygen in the brain and other organs. Life expectancy is only three to five years after diagnosis, but those numbers may change now that the FDA has approved two experimental drugs that slow the disease: pirfenidone and nintedanib.

9. Single-dose radiation therapy for breast cancer

The National Cancer Institute estimates that 40,000 women in the United States will die from breast cancer in 2014. The Cleveland Clinic cites multiple chemotherapy appointments, sometimes requiring the patient to travel long distances, as a hindrance to successful treatment. Intraoperative radiation therapy is a new solution. It treats a breast cancer tumor during surgery in a single dose, reducing time and cost spent on treatment.

10. New drug for heart failure

About 5.1 million people in the United States suffer from heart failure, according to the National Heart, Lung and Blood Institute. It is managed with a combination of drugs, but a new drug, angiotensin-receptor neprilysin inhibitor, has been granted fast-track status by the FDA because of its ability to cut the risk of dying from heart failure more effectively than current treatments.

For more information on the annual medical innovations list, including descriptions and videos, download the "Innovations" app or visit the website. A "where is it now" feature also includes updates on innovations that made the top 10 list in prior years.

"We look in past to see what we voted on to improve the process," Roizen said. "With one exception, we've been pretty good."

Source: www.cnn.com

By Brittany Maynard

Editor's note: Brittany Maynard is a volunteer advocate for the nation's leading end-of-life choice organization, Compassion and Choices. She lives in Portland, Oregon, with her husband, Dan Diaz, and mother, Debbie Ziegler. Watch Brittany and her family tell her story at www.thebrittanyfund.org. The opinions expressed in this commentary are solely those of the author.

(CNN) -- On New Year's Day, after months of suffering from debilitating headaches, I learned that I had brain cancer.

I was 29 years old. I'd been married for just over a year. My husband and I were trying for a family.

Our lives devolved into hospital stays, doctor consultations and medical research. Nine days after my initial diagnoses, I had a partial craniotomy and a partial resection of my temporal lobe. Both surgeries were an effort to stop the growth of my tumor.

In April, I learned that not only had my tumor come back, but it was more aggressive. Doctors gave me a prognosis of six months to live.

Because my tumor is so large, doctors prescribed full brain radiation. I read about the side effects: The hair on my scalp would have been singed off. My scalp would be left covered with first-degree burns. My quality of life, as I knew it, would be gone.

After months of research, my family and I reached a heartbreaking conclusion: There is no treatment that would save my life, and the recommended treatments would have destroyed the time I had left.

I considered passing away in hospice care at my San Francisco Bay-area home. But even with palliative medication, I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind.

Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind. I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that.

I did not want this nightmare scenario for my family, so I started researching death with dignity. It is an end-of-life option for mentally competent, terminally ill patients with a prognosis of six months or less to live. It would enable me to use the medical practice of aid in dying: I could request and receive a prescription from a physician for medication that I could self-ingest to end my dying process if it becomes unbearable.

I quickly decided that death with dignity was the best option for me and my family.

We had to uproot from California to Oregon, because Oregon is one of only five states where death with dignity is authorized.

I met the criteria for death with dignity in Oregon, but establishing residency in the state to make use of the law required a monumental number of changes. I had to find new physicians, establish residency in Portland, search for a new home, obtain a new driver's license, change my voter registration and enlist people to take care of our animals, and my husband, Dan, had to take a leave of absence from his job. The vast majority of families do not have the flexibility, resources and time to make all these changes.

I've had the medication for weeks. I am not suicidal. If I were, I would have consumed that medication long ago. I do not want to die. But I am dying. And I want to die on my own terms.

I would not tell anyone else that he or she should choose death with dignity. My question is: Who has the right to tell me that I don't deserve this choice? That I deserve to suffer for weeks or months in tremendous amounts of physical and emotional pain? Why should anyone have the right to make that choice for me?

Now that I've had the prescription filled and it's in my possession, I have experienced a tremendous sense of relief. And if I decide to change my mind about taking the medication, I will not take it.

Having this choice at the end of my life has become incredibly important. It has given me a sense of peace during a tumultuous time that otherwise would be dominated by fear, uncertainty and pain.

Now, I'm able to move forward in my remaining days or weeks I have on this beautiful Earth, to seek joy and love and to spend time traveling to outdoor wonders of nature with those I love. And I know that I have a safety net.

I hope for the sake of my fellow American citizens that I'll never meet that this option is available to you. If you ever find yourself walking a mile in my shoes, I hope that you would at least be given the same choice and that no one tries to take it from you.

When my suffering becomes too great, I can say to all those I love, "I love you; come be by my side, and come say goodbye as I pass into whatever's next." I will die upstairs in my bedroom with my husband, mother, stepfather and best friend by my side and pass peacefully. I can't imagine trying to rob anyone else of that choice.

What are your thoughts about "death with dignity"?

Source: CNN

By Marie Ellis

Imagine swallowing a pill with tiny needles instead of getting an injection. Then again, imagine swallowing a pill with tiny needles. It may sound painful, but according to the researchers who developed the novel capsule - which could replace painful injections - there are no harmful side effects.

The researchers, from the Massachusetts Institute of Technology (MIT) and Massachusetts General Hospital (MGH), have published the results of their study - which tested the microneedle pill in the gastrointestinal (GI) tracts of pigs - in the Journal of Pharmaceutical Sciences.

Though most of us would probably prefer swallowing a pill over having an injection, many drugs cannot be given in pill form because they are broken down in the stomach before being absorbed.

Biopharmaceuticals made from large proteins, such as antibodies - known as "biologics" - are used to treat cancer, arthritis and Crohn's disease, and also include vaccines, recombinant DNA and RNA.

"The large size of these biologic drugs makes them nonabsorbable," explains lead author MIT graduate student Carl Schoellhammer. "And before they even would be absorbed, they're degraded in your GI tract by acids and enzymes that just eat up the molecules and make them inactive."

In an effort to design a capsule that is capable of delivering a wide range of drugs - while preventing degradation and effectively injecting the medicine into the GI tract - Schoellhammer and colleagues constructed the capsule from acrylic, including a reservoir for the drug that is coated with hollow, 5 mm long needles made of stainless steel.

The capsule measures 2 cm long and 1 cm in diameter.

Needle capsule worked safely and effectively in pigs

The team notes that previous studies involving humans who have accidentally swallowed sharp objects have suggested swallowing a capsule coated with short needles could be safe. They explain that there are no pain receptors in the GI tract and that, as a result, patients would not feel any pain.

But to assess whether their capsule could safely and effectively deliver the drugs, the researchers tested the pill in pigs, using insulin in the drug reservoir.

The capsules took more than a week to move through the whole digestive tract, and there were no traces of tissue damage, the researchers say. Additionally, the microneedles effectively injected insulin into the lining of the pigs' stomachs, small intestines and colons, which resulted in their blood glucose levels dropping.

Co-lead author Giovanni Traverso, a research fellow at MIT's Koch Institute for Integrative Cancer Research and gastroenterologist at MGH, notes that the pigs' reduction in blood glucose was faster and larger than the drop observed from insulin injection.

"The kinetics are much better and much faster-onset than those seen with traditional under-the-skin administration," he says. "For molecules that are particularly difficult to absorb, this would be a way of actually administering them at much higher efficiency."

'Oral delivery of drugs is a major challenge'

Though they used insulin for their tests in pigs, the researchers say they envision their capsule being used to deliver biologics to humans.

"This could be a way that the patient can circumvent the need to have an infusion or subcutaneous administration of a drug," says Traverso.

Prof. Samir Mitragotri, a professor at the University of California-Santa Barbara - who was not involved in the research - says:


"This is a very interesting approach. Oral delivery of drugs is a major challenge, especially for protein drugs. There is tremendous motivation on various fronts for finding other ways to deliver drugs without using the standard needle and syringe."

In terms of future modifications, the team plans to alter the capsule so that contractions of the digestive tract slowly squeeze the drug out of the capsule as it travels through the body, and they also want to make the needles out of degradable polymers and sugar that break off, becoming embedded in the gut lining and slowly disintegrating.

Source: http://www.medicalnewstoday.com

By LAWRENCE K. ALTMAN

A British-American scientist and a pair of Norwegian researchers were awarded this year’s Nobel Prize in Physiology or Medicine on Monday for discovering “an inner GPS, in the brain,” that makes navigation possible for virtually all creatures.

John O’Keefe, 75, a British-American scientist, will share half of the prize of 8 million kronor, or $1.1 million, in what is considered the most prestigious scientific award. May-Britt Moser, 51, and Edvard I. Moser, 52, who are married, will share the other half, said the Karolinska Institute in Sweden, which chooses the laureates.

The three scientists’ discoveries “have solved a problem that has occupied philosophers and scientists for centuries — how does the brain create a map of the space surrounding us and how can we navigate our way through a complex environment,” the institute said in a news release.

The positioning system in the brain that they discovered helps us know where we are, find our way from place to place and store the information for the next time, said Goran K. Hansson, secretary of the Karolinska’s Nobel Committee, in announcing the laureates.

The researchers documented that certain cells are responsible for higher cognitive function that steers the navigational system, the committee said.

Dr. O’Keefe began using neurophysiological methods in the late 1960s to study how the brain controls behavior. In 1971 he discovered the first component of the inner navigational system in rats. He identified nerve cells in the hippocampus region of the brain that were always activated when a rat was at a certain location. He called them “place cells” and showed that the cells registered not only what they saw, but also what they did not see, by building up inner maps in different environments.

Dr. O’Keefe was born in New York City and graduated from the City College of New York. He earned a Ph.D. in physiological psychology at McGill University in Montreal, in 1967, and moved for postdoctoral training to University College London, where he remains. He is a professor of cognitive neuroscience.

In 2005, the Mosers discovered a second crucial component of the brain’s positioning system by identifying another type of nerve cell that permits coordination and positioning. The scientists, who work at the Norwegian University of Science and Technology in Trondheim, called the cells grid cells. While mapping connections to the hippocampus in rats moving about a room in a laboratory, “they discovered an astonishing pattern of activity in a nearby part of the brain called the entorhinal cortex,” the Nobel committee said.

When the rat passed multiple locations, the cells formed a hexagonal grid. Each cell activated in unique spatial patterns. Their research showed “how both ‘place’ and ‘grid’ cells make it possible to determine position and to navigate,” the committee said.

The Mosers grew up in rural Norway and came from nonacademic families. May-Britt was born in Fosnavag and Edvard in Alesund. Although they went to the same high school, they did not know each other well until they were undergraduates at the University of Oslo. They married while they were college students and have two daughters. Both are professors at the university in Trondheim.

At one point they were visiting scientists at University College London, studying under Dr. O’Keefe.

The three also won Columbia University’s Louisa Gross Horwitz Prize last year for their discoveries.

Only a handful of married couples have shared a Nobel Prize, and the Mosers are only the second in the medicine category, which has been awarded since 1901. Fewer than a dozen women have been named laureates in medicine.

Evidence that place and grid cells exist in humans comes from recent studies using brain imaging techniques and from patients who have undergone neurosurgery.

The laureates’ findings may eventually lead to a better understanding of the spatial losses that occur in Alzheimer’s and other neurological diseases. The hippocampus and entorhinal cortex are often damaged in early stages of Alzheimer’s, with affected individuals’ losing their way and failing to recognize the environment. The findings also open new avenues for understanding cognitive processes like memory, thinking and planning, the Nobel Committee said.

According to The Associated Press, May-Britt Moser said the couple was elated. “This is such a great honor for all of us and all the people who have worked with us and supported us,” she said in a telephone interview with The A.P. “We are going to continue and hopefully do even more groundbreaking work in the future.”

Her husband was flying when the prize was announced, she said, and he later told the Norwegian news agency NTB that he learned about it when he landed and turned on his cellphone, to a barrage of messages and calls. “I didn’t know anything. When I got off the plane there was a representative there with a bouquet of flowers who said ‘congratulations on the prize,’   ” The Associated Press reported.

The laureates traditionally receive their awards at a banquet in Stockholm on Dec. 10, the anniversary of the death in 1896 of the prize’s creator, Alfred Nobel, an industrialist and inventor of dynamite.

Source: http://www.nytimes.com

With the generous support of the Robert Wood Johnson Foundation and guided by a national advisory committee, a multidisciplinary team based at the University of Pennsylvania seeks to learn from clinicians or clinical leaders who are primarily responsible for transitional care services in health systems and communities throughout the United States.  Specifically, the team is conducting a research study designed to better understand how transitional care services are being delivered in diverse organizations.  Participation in this research survey is voluntary.

If you are a clinician or clinical leader responsible for transitional care service delivery in your organization, I encourage you to learn more about this study.  To access the survey and more information on the study, please visit:

Transitional Care Survey

NAHN is happy to assist Dr. Mary Naylor and the University of Pennsylvania in this 2 year project.  Dr. Mary Naylor will be providing NAHN with feedback on the survey results. If you know of others who have such responsibility within your association or work environment, please forward this email to them.

Thank you in advance for your consideration of this request.

Source: http://www.nahnnet.org/

By Caleb Hellerman

Earlier this week, Brian Shepherd sat down in a small doctor's office in Bethesda, Maryland. A technician swabbed his arm and gave him a quick jab with a needle.

With that, Shepherd became subject No. 13 in the experiment testing a potential Ebola vaccine.

The trial was launched on an emergency basis earlier this month by the National Institute on Allergy and Infectious Disease. It's the first to test this kind of Ebola vaccine in humans.

"It's not just for the money," Shepherd wrote in a Reddit AMA. "I'm very interested in translational research and experiencing it from the guinea pig side is very rewarding. But yeah, the money helps. This one study will fund most of my grad school application costs, though not in time for application season."

The vaccine doesn't use live virus and can't infect volunteers with Ebola. Instead it uses specific Ebola proteins to trigger an immune response. They're delivered through the body on a modified version of an adenovirus, a type of cold virus.

In the initial phase, 10 healthy volunteers were given a low dose of vaccine. They were monitored for side effects and tested to see if their bodies are producing antibodies. In the second phase, of which Brian is a part, an additional 10 volunteers are being given a higher dose.

All participants will be followed for nearly a year and tested at regular intervals.

Shepherd, who has volunteered for several prior research studies at NIH, spoke with CNN about his experience.

The following is a condensed version of that conversation:

CNN: How did you come to join the study?

Brian Shepherd: I actually work at NIH; I'm a post-doc researcher in a developmental biology lab. Most trials I learn about from reading a ListServ (email list).

I heard about the vaccine study from going to preliminary meetings for a different study.

CNN: When was this?

Shepherd: Less than a month ago. I had my first appointment on August 26. It was just a sit-down, to talk about the trial, go through paperwork and consent forms, explaining what the trial was for. Then they did an initial run-through of my health history.

CNN: What was next?

Shepherd: The next week I had my second appointment. They did a full physical, blood work, health history, breathing checks. A lot of poking and prodding. My third visit was Wednesday. They drew blood, then gave me a shot. Now, my next appointment is Sunday.

CNN: What was it like? You wrote that pulling off the Band-aid was the worst of the pain.

Shepherd: I'm supposed to keep a daily diary for the first seven days, logging my temperature and any symptoms. The next morning, I woke up with a slight fever, 100.5. I took some Tylenol and it went away.

Other than that I feel fine. In fact, I ran a half-mile in a relay race at lunchtime with some people from work.

CNN: You wrote that for each of these regular visits, you're paid $175. How many times have you been a human guinea pig?

Shepherd: This is my second drug trial. Before that, I did mostly MRI studies.

The first one I did, I was in the MRI machine and had three tasks. They gave me two buttons and showed pictures. If it was Spiderman, I'd hit one button; if it was the Green Goblin, I'd hit the other. So I spent 15 minutes playing Spiderman vs. Green Goblin.

CNN: Did you have any reservation at all, taking part in this Ebola vaccine trial?

Shepherd: None at all.

Source: http://www.cnn.com

By JOSHUA A. KRISCH

McBaine, a bouncy black and white springer spaniel, perks up and begins his hunt at the Penn Vet Working Dog Center. His nose skims 12 tiny arms that protrude from the edges of a table-size wheel, each holding samples of blood plasma, only one of which is spiked with a drop of cancerous tissue.

The dog makes one focused revolution around the wheel before halting, steely-eyed and confident, in front of sample No. 11. A trainer tosses him his reward, a tennis ball, which he giddily chases around the room, sliding across the floor and bumping into walls like a clumsy puppy.

McBaine is one of four highly trained cancer detection dogs at the center, which trains purebreds to put their superior sense of smell to work in search of the early signs of ovarian cancer. Now, Penn Vet, part of the University of Pennsylvania’s School of Veterinary Medicine, is teaming with chemists and physicists to isolate cancer chemicals that only dogs can smell. They hope this will lead to the manufacture of nanotechnology sensors that are capable of detecting bits of cancerous tissue 1/100,000th the thickness of a sheet of paper.

“We don’t ever anticipate our dogs walking through a clinic,” said the veterinarian Dr. Cindy Otto, the founder and executive director of the Working Dog Center. “But we do hope that they will help refine chemical and nanosensing techniques for cancer detection.”

Since 2004, research has begun to accumulate suggesting that dogs may be able to smell the subtle chemical differences between healthy and cancerous tissue, including bladder cancer, melanomaand cancers of the lung, breast and prostate. But scientists debate whether the research will result in useful medical applications.

Dogs have already been trained to respond to diabetic emergencies, or alert passers-by if an owner is about to have a seizure. And on the cancer front, nonprofit organizations like the In Situ Foundation, based in California, and the Medical Detection Dogs charity in Britain are among a growing number of independent groups sponsoring research into the area.

A study presented at the American Urological Association’s annual meeting in May reported that two German shepherds trained at the Italian Ministry of Defense’s Military Veterinary Center in Grosseto were able to detect prostate cancer in urine with about 98 percent accuracy, far better than the prostate-specific antigen (PSA) test. But in another recent study of prostate-cancer-sniffing dogs, British researchers reported that promising initial results did not hold up in rigorous double-blind follow-up trials.

Dr. Otto first conceived of a center to train and study working dogs when, as a member of the Federal Emergency Management Agency’s Urban Search and Rescue Team, she was deployed to ground zero in the hours after the Sept. 11 attacks.

“I remember walking past three firemen sitting on an I-beam, stone-faced, dejected,” she says. “But when a handler walked by with one of the rescue dogs, they lit up. There was hope.”

Today, the Working Dog Center trains dogs for police work, search and rescue and bomb detection. Their newest canine curriculum, started last summer after the center received a grant from the Kaleidoscope of Hope Foundation, focuses on sniffing out a different kind of threat: ovarian cancer.

“Ovarian cancer is a silent killer,” Dr. Otto said. “But if we can help detect it early, that would save lives like nothing else.”

Dr. Otto’s dogs are descended from illustrious lines of hunting hounds and police dogs, with noses and instincts that have been refined by generations of selective breeding. Labradors and German shepherds dominate the center, but the occasional golden retriever or springer spaniel — like McBaine — manages to make the cut.

The dogs, raised in the homes of volunteer foster families, start with basic obedience classes when they are eight weeks old. They then begin their training in earnest, with the goal of teaching them that sniffing everything — from ticking bombs to malignant tumors — is rewarding.

“Everything we do is about positive reinforcement,” Dr. Otto said. “Sniff the right odor, earn a toy or treat. It’s all one big game.”

Trainers from the center typically notice early on that certain dogs have natural talents that make them better suited for specific kinds of work. Search and rescue dogs must be tireless hunters, unperturbed by distracting environments and unwilling to give up on a scent – the equivalent of high-energy athletes. The best cancer-detection dogs, on the other hand, tend to be precise, methodical, quiet and even a bit aloof — more the introverted scientists.

“Some dogs declare early, but our late bloomers frequently switch majors,” Dr. Otto said.

Handlers begin training dogs selected for cancer detection by holding two vials of fluid in front of each dog, one cancerous and one benign. The dogs initially sniff both but are rewarded only when they sniff the one containing cancer tissue. In time, the dogs learn to recognize a unique “cancer smell” before moving on to more complex tests.

What exactly are the dogs sensing? George Preti, a chemist at the Monell Chemical Senses Center in Philadelphia, has spent much of his career trying to isolate the volatile chemicals behind cancer’s unique odor. “We have known for a long time that dogs are very sensitive detectors,” Dr. Preti says. “When the opportunity arose to collaborate with Dr. Otto at the Working Dog Center, I jumped on it.”

Dr. Preti is working to isolate unique chemical biomarkers responsible for ovarian cancer’s subtle smell using high-tech spectrometers and chromatographs. Once he identifies a promising compound, he tests whether the dogs respond to that chemical in the same way that they respond to actual ovarian cancer tissue.

“I’m not embarrassed to say that a dog is better than my instruments,” Dr. Preti says.

The next step will be to build a mechanical, hand-held sensor that can detect that cancer chemical in the clinic. That’s where Charlie Johnson a professor at Penn who specializes in experimental nanophysics, the study of molecular interactions between microscopic materials, comes in.

He is developing what he calls Cyborg sensors, which include biological and mechanical components – a combination of carbon nanotubes and single-stranded DNA that preferentially bond with one specific chemical compound. These precise sensors, in theory, could be programmed to bind to, and detect, the isolated compounds that Dr. Otto’s dogs are singling out.

“We are effectively building an electronic nose,” said Dr. Johnson, who added that a prototype for his ovarian cancer sensor will probably be ready in the next five years.

Some experts remain skeptical.

“While I applaud any effort to detect ovarian cancer, I’m uncertain that this research will have any value,” said Dr. David Fishman, a gynecologic oncologist at Mount Sinai Hospital in New York City. One challenge, he notes, is that any cancer sensor would need to be able to detect volatile chemicals that are specific to one particular type of cancer.

“Nonspecificity is where a lot of these sort of tests fail,” Dr. Fishman said. “If there is an overlap in volatile chemicals — between colon, breast, pancreatic, ovarian cancer — we’ll have to ask, ‘What does this mean?’ ”

And even if sensors could be developed that detect ovarian cancer in the clinic, Dr. Fishman says, he doubts that they would be able to catch ovarian cancer in its earliest, potentially more treatable, stages.

“The lesions that we are discussing are only millimeters in size, and almost imperceptible on imaging studies,” Dr. Fishman says. “I don’t believe that the resolution of the canine ability will translate into value for these lesions.”

McBaine remains unaware of the debate. After correctly identifying yet another cancerous plasma sample, he pranced around the Working Dog Center with regal flair, showing off his tennis ball to anyone who would pay attention. In an industry saturated with hundreds of corporations and thousands of scientists all hunting for the earliest clues to cancer, working dogs are just another set of (slightly furrier) researchers.

Source: http://well.blogs.nytimes.com

By GILLIAN MOHNEY

For all the impressive advancements in medical technology, researchers and scientists still face a daunting challenge when they study the habits of the adorable but uncommunicative subjects called human infants.

In order to study infants without overwhelming them, scientists often try to mask the massive machines needed to view brain activity either by having the child sleep through it or by covering it in kid-friendly decorations. Other researchers have devised decidedly low-tech ways of reading an infant’s interest in a subject, even when they can’t say a single word.

In a study released Monday in the Proceedings of National Academy of Sciences, doctors used a special machine to examine infant brain activity as they start to learn language skills.

Patricia Kuhl, a professor of speech and hearing sciences at University of Washington and the lead author of the study, said the research indicated the area of the infants’ brain that controlled motor skills lit up when they heard certain words. The activity indicated that the infants are trying to mimic adults and speak much earlier before they say their first word.

However, Kuhl said, the study was important because of both the surprising findings and the way researchers were able to get them. To “read” the infant’s brain activity, they used the cutting-edge device called a magnetoencephalograph, that was quiet and nimble enough to read the chaotic world of infants’ brain activity.

Kuhl said unlike an MRI machine, which is extremely loud and requires a patient to be totally still, the magnetoencephalograph is nearly silent. However the infants still had to be strapped into a chair, so to keep them entertained the researchers were tasked with making silly faces and holding up toys all in the name of science.

“You want them to like the lab,” said Kuhl. “It’s decorated with fish and it’s got little stickies [on it.] It’s ... very baby friendly. We wave toys and we’re very aware and of their curiosity and of their desire to play. We do everything to make them comfortable.”

In a 2013 study published in Psychological Science, researchers used MRI machines to examine baby’s brain activity in response to different stimuli. However, to get the infants into a machine where they could not move, the researchers had the babies go in after they fell asleep naturally. They also used ear coverings so the loud MRI machine didn’t wake the infants.

MRI machines can be so distressing for patients because of claustrophobia or other fears about being in the hospital that a New York Hospital installed a pirate-themed scanner to put children (and some parents) more at ease.

“The genius is in this machine. ... There’s no noise and the baby can listen and can move,” said Kuhl of the magnetoencephalograph. “The ability for the first time to do this kind of recording in this kind of technical advanced machine ... [it’s like] we’re putting [on] a stethoscope.”

Aside from technological advancements, researchers rely on some decidedly low-tech approaches when studying infants.

Fei Xue, a professor of psychology at the University of California Berkeley, has done numerous studies examining how infants learn and react to new toys or information. She said researchers have plenty of tricks to keep babies focused on the tasks at hand.

Xue said most studies only last between 5-10 minutes because the infants will get bored if they're longer. If they want a baby to focus on an object, they darken the room and light up the object to draw the baby's attention.

“In a way, it’s easy to work with infants,” said Xue. “They’re very curious and they’re interested in the world.”

To measure if babies are interested in an object or scene without getting verbal confirmation, Xue and her fellow researchers simply follow the infant’s eye movement. While there are special computer programs, Xue said often it just comes down to a researcher holding a stopwatch and watching the infant through a monitor.

In spite of the infants’ inability to speak, Xue said, understanding their thought process can reveal how they learn, which could eventually help shape education programs.

“When they go to preschool and elementary school ... they will help us to know how to structure the school system,” said Xue of her young subjects. “Understanding these really young humans is important.”

Source: http://abcnews.go.com

By Cornell University

In a forthcoming Cornell study published in the journal Health Environments Research and Design, Rana Zadeh, assistant professor of design and environmental analysis, discovered nurses who had access to natural light enjoyed significantly lower blood pressure, communicated more often with their colleagues, laughed more and served their patients in better moods than nurses who settled for large doses of artificial light.

Letting natural light into the nurses’ workstations offered improved alertness and mood restoration effects. “The increase in positive sociability, as measured by the occurrence of frequent laughter, was … significant,” noted Zadeh in the paper.

Nurses work long shifts, during non-standardized hours. They work on demanding and sensitive tasks and their alertness is connected to both staff and patient safety. Past evidence indicates natural light and views have restorative effects on people both physiologically and psychologically. Maximizing access to natural daylight and providing quality lighting design in nursing areas may be an opportunity to improve safety though environmental design and enable staff to manage sleepiness, work in a better mood and stay alert, according to Zadeh.

“Nurses save lives and deal with complications every day. It can be a very intense and stressful work environment, which is why humor and a good mood are integral to the nursing profession,” Zadeh said. “As a nurse, it’s an art to keep your smile – which helps ensure an excellent connection to patients. A smart and affordable way to bring positive mood – and laughter – into the workplace, is designing the right workspace for it.”

Access to natural daylight, and a nice view to outside, should be provided for clinical workspace design, said Zadeh. In situations where natural light is not possible, she suggests optimizing electric lighting in terms of spectrum, intensity and variability to support circadian rhythms and work performance.

“The physical environment in which the caregivers work on critical tasks should be designed to support a high-performing and healthy clinical staff,” she said “ improving the physiological and psychological wellbeing of healthcare staff, by designing the right workspace, can directly benefit the organization’s outcomes”.

In addition to Zadeh, this study, “The Impact of Windows and Daylight on Acute-Care Nurses’ Physiological, Psychological, and Behavioral Health,” was authored by Mardelle Shepley, Texas A&M University; Cornell doctoral candidate Susan Sung Eun Chung; and Gary Williams, MSN, RN. The research was supported by the Center for Health Design Research Coalition’s New Investigator Award.

Source: www.sciencedaily.com