Unraveling the Genetic Mystery of Pneumocystis

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Researchers examine a genome of Pneumocystis to better understand its metabolic pathways for treatment.

NIH researchers have sequenced nearly the entire genome of Pneumocystis—the cause a deadly infection that helped identify the HIV/AIDS epidemic. Pneumocystis is still a significant risk for those patients as well as for transplant recipients and other immunosuppressed patients.

Pneumocystis has puzzled researchers for years—especially how it developed its “unique” mechanisms of adaptation to life in mammals. “Having the genome information helped us recognize the unusual biology of Pneumocystis and how it co-exists with its mammalian hosts,” said Liang Ma, MD, first author of the paper on the study. Through analysis, the researchers now better understand where the organism lives—it’s “highly adapted to existence in the host lung with strict dependence on the mammalian host for nutrients and a stable environment.” They can also get a better idea of how it avoids elimination by the host’s immune system.

The researchers say their study helps map out a clearer picture of the genomes, compared with prior studies, with high-quality, near chromosomal draft genomes—the “highest level of genomic mapping.” That high quality helped them identify metabolic pathways critical to the growth and survival of the organism, as well as pathways in other closely related fungi that Pneumocystis does not have. The pathways likely disappeared as Pneumocystis evolved to become highly dependent on its host to stay alive, the researchers say.

 

Their detailed description of genes that are present or missing should facilitate attempts to culture the organism, they note. Culturing could help speed drug development and allow for genetic manipulation to modify the genes involved.

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Researchers examine a genome of Pneumocystis to better understand its metabolic pathways for treatment.
Researchers examine a genome of Pneumocystis to better understand its metabolic pathways for treatment.

NIH researchers have sequenced nearly the entire genome of Pneumocystis—the cause a deadly infection that helped identify the HIV/AIDS epidemic. Pneumocystis is still a significant risk for those patients as well as for transplant recipients and other immunosuppressed patients.

Pneumocystis has puzzled researchers for years—especially how it developed its “unique” mechanisms of adaptation to life in mammals. “Having the genome information helped us recognize the unusual biology of Pneumocystis and how it co-exists with its mammalian hosts,” said Liang Ma, MD, first author of the paper on the study. Through analysis, the researchers now better understand where the organism lives—it’s “highly adapted to existence in the host lung with strict dependence on the mammalian host for nutrients and a stable environment.” They can also get a better idea of how it avoids elimination by the host’s immune system.

The researchers say their study helps map out a clearer picture of the genomes, compared with prior studies, with high-quality, near chromosomal draft genomes—the “highest level of genomic mapping.” That high quality helped them identify metabolic pathways critical to the growth and survival of the organism, as well as pathways in other closely related fungi that Pneumocystis does not have. The pathways likely disappeared as Pneumocystis evolved to become highly dependent on its host to stay alive, the researchers say.

 

Their detailed description of genes that are present or missing should facilitate attempts to culture the organism, they note. Culturing could help speed drug development and allow for genetic manipulation to modify the genes involved.

NIH researchers have sequenced nearly the entire genome of Pneumocystis—the cause a deadly infection that helped identify the HIV/AIDS epidemic. Pneumocystis is still a significant risk for those patients as well as for transplant recipients and other immunosuppressed patients.

Pneumocystis has puzzled researchers for years—especially how it developed its “unique” mechanisms of adaptation to life in mammals. “Having the genome information helped us recognize the unusual biology of Pneumocystis and how it co-exists with its mammalian hosts,” said Liang Ma, MD, first author of the paper on the study. Through analysis, the researchers now better understand where the organism lives—it’s “highly adapted to existence in the host lung with strict dependence on the mammalian host for nutrients and a stable environment.” They can also get a better idea of how it avoids elimination by the host’s immune system.

The researchers say their study helps map out a clearer picture of the genomes, compared with prior studies, with high-quality, near chromosomal draft genomes—the “highest level of genomic mapping.” That high quality helped them identify metabolic pathways critical to the growth and survival of the organism, as well as pathways in other closely related fungi that Pneumocystis does not have. The pathways likely disappeared as Pneumocystis evolved to become highly dependent on its host to stay alive, the researchers say.

 

Their detailed description of genes that are present or missing should facilitate attempts to culture the organism, they note. Culturing could help speed drug development and allow for genetic manipulation to modify the genes involved.

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Winning Ideas for Preventing and Reducing VTE

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CDC recognizes 8 hospitals for innovative strategies of treating health care associated venous thromboembolism.

Inventive ways of identifying and treating patients with health care associated venous thromboembolism (HA-VTE) have garnered awards for 8 hospitals and health care systems in the HA-VTE Prevention Challenge, sponsored by the CDC.

The winners range from small community hospitals to large health care systems: Mayo Clinic, University of California Health, Center for Health Quality and Innovation; University of Wisconsin Health (Madison); Intermountain Healthcare (Murray, UT); Northwestern Memorial Hospital (Chicago); Johns Hopkins Hospital (Baltimore); Harborview Medical Center (Seattle); and Hutchinson (KS) Regional Medical Center.

All improved VTE prevention with innovative, effective, and sustainable initiatives and strategies.

Harborview Medical Center (HMC) developed an electronic tool for efficient, standardized review of HA-VTE. The tool uses natural language processing, allowing the HMC VTE Task Force to quickly gauge the accuracy of risk assessment and appropriateness of prophylaxis. It also developed tools to provide real-time, actionable information at the bedside, including lists that highlight patients who have not received chemical or mechanical prophylaxis in 24 hours. Those who have received vitamin K antagonists are identified to ensure patient/family education and appropriate follow-up. Treatment data “snapshots” are embedded in resident physician and nursing handoff tools to enhance multidisciplinary communication. All process and outcome measures are displayed on an internal web-based dashboard, with improvement opportunities highlighted.

As a result, HMC has had zero potentially preventable VTE events since the measure was implemented in January 2013—a national best practice. Improved VTE prophylaxis contributed to a 15% reduction in HA-VTE between 2011 and 2015. Among postoperative patients, the rate of VTE dropped 21%. Diagnosis, treatment, patient education, and outpatient follow-up have all improved. Moreover, HMC says, the lessons learned have formed the basis of ongoing improvement initiatives.

Four entrants (“Unique Populations and Interventions”) received honorable mentions: Michigan Hospital Medicine Safety Consortium, Ann Arbor; Sheppard Pratt Health System, Baltimore; Rotunda Hospital, Dublin, Ireland; and University of Cincinnati Medical Center.

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CDC recognizes 8 hospitals for innovative strategies of treating health care associated venous thromboembolism.
CDC recognizes 8 hospitals for innovative strategies of treating health care associated venous thromboembolism.

Inventive ways of identifying and treating patients with health care associated venous thromboembolism (HA-VTE) have garnered awards for 8 hospitals and health care systems in the HA-VTE Prevention Challenge, sponsored by the CDC.

The winners range from small community hospitals to large health care systems: Mayo Clinic, University of California Health, Center for Health Quality and Innovation; University of Wisconsin Health (Madison); Intermountain Healthcare (Murray, UT); Northwestern Memorial Hospital (Chicago); Johns Hopkins Hospital (Baltimore); Harborview Medical Center (Seattle); and Hutchinson (KS) Regional Medical Center.

All improved VTE prevention with innovative, effective, and sustainable initiatives and strategies.

Harborview Medical Center (HMC) developed an electronic tool for efficient, standardized review of HA-VTE. The tool uses natural language processing, allowing the HMC VTE Task Force to quickly gauge the accuracy of risk assessment and appropriateness of prophylaxis. It also developed tools to provide real-time, actionable information at the bedside, including lists that highlight patients who have not received chemical or mechanical prophylaxis in 24 hours. Those who have received vitamin K antagonists are identified to ensure patient/family education and appropriate follow-up. Treatment data “snapshots” are embedded in resident physician and nursing handoff tools to enhance multidisciplinary communication. All process and outcome measures are displayed on an internal web-based dashboard, with improvement opportunities highlighted.

As a result, HMC has had zero potentially preventable VTE events since the measure was implemented in January 2013—a national best practice. Improved VTE prophylaxis contributed to a 15% reduction in HA-VTE between 2011 and 2015. Among postoperative patients, the rate of VTE dropped 21%. Diagnosis, treatment, patient education, and outpatient follow-up have all improved. Moreover, HMC says, the lessons learned have formed the basis of ongoing improvement initiatives.

Four entrants (“Unique Populations and Interventions”) received honorable mentions: Michigan Hospital Medicine Safety Consortium, Ann Arbor; Sheppard Pratt Health System, Baltimore; Rotunda Hospital, Dublin, Ireland; and University of Cincinnati Medical Center.

Inventive ways of identifying and treating patients with health care associated venous thromboembolism (HA-VTE) have garnered awards for 8 hospitals and health care systems in the HA-VTE Prevention Challenge, sponsored by the CDC.

The winners range from small community hospitals to large health care systems: Mayo Clinic, University of California Health, Center for Health Quality and Innovation; University of Wisconsin Health (Madison); Intermountain Healthcare (Murray, UT); Northwestern Memorial Hospital (Chicago); Johns Hopkins Hospital (Baltimore); Harborview Medical Center (Seattle); and Hutchinson (KS) Regional Medical Center.

All improved VTE prevention with innovative, effective, and sustainable initiatives and strategies.

Harborview Medical Center (HMC) developed an electronic tool for efficient, standardized review of HA-VTE. The tool uses natural language processing, allowing the HMC VTE Task Force to quickly gauge the accuracy of risk assessment and appropriateness of prophylaxis. It also developed tools to provide real-time, actionable information at the bedside, including lists that highlight patients who have not received chemical or mechanical prophylaxis in 24 hours. Those who have received vitamin K antagonists are identified to ensure patient/family education and appropriate follow-up. Treatment data “snapshots” are embedded in resident physician and nursing handoff tools to enhance multidisciplinary communication. All process and outcome measures are displayed on an internal web-based dashboard, with improvement opportunities highlighted.

As a result, HMC has had zero potentially preventable VTE events since the measure was implemented in January 2013—a national best practice. Improved VTE prophylaxis contributed to a 15% reduction in HA-VTE between 2011 and 2015. Among postoperative patients, the rate of VTE dropped 21%. Diagnosis, treatment, patient education, and outpatient follow-up have all improved. Moreover, HMC says, the lessons learned have formed the basis of ongoing improvement initiatives.

Four entrants (“Unique Populations and Interventions”) received honorable mentions: Michigan Hospital Medicine Safety Consortium, Ann Arbor; Sheppard Pratt Health System, Baltimore; Rotunda Hospital, Dublin, Ireland; and University of Cincinnati Medical Center.

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Grants Available for Native American Mental Health Programs

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SAMHSA offers grants up to $20,000 a year to AI/AN organizations that address mental health needs.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is providing support to Native American tribes and organizations with great ideas for improving mental and physical health. The Tribal Behavioral Health cooperative agreements (short title: Native Connections) offers grants to programs aimed at preventing and reducing suicidal behavior and substance use, addressing trauma, and promoting mental health among American Indian/Alaska Native (AI/AN) young people.

SAMHSA is now accepting applications for the cooperative-agreement grants. Grants total up to $94.8 million over 5 years. SAMHSA says it expects to fund as many as 94 grant recipients with up to $200,000 each per year for up to 5 years. Currently, Native Connections serves 20 grantees.

Native Connections also provides webinars to guide grantees in developing plans for such programs. One series, for instance, provides cultural considerations in screening and treating young people at risk.

Federally recognized AI/AN tribes, tribal organizations, and consortia of tribes or tribal organizations are eligible to apply for the grants. Applications are available at www.grants.gov and www.samhsa.gov/grants/applying. Applicants must download the required documents from both sites. The due date to receive applications is June 2, by 11:59 pm (ET).

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SAMHSA offers grants up to $20,000 a year to AI/AN organizations that address mental health needs.
SAMHSA offers grants up to $20,000 a year to AI/AN organizations that address mental health needs.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is providing support to Native American tribes and organizations with great ideas for improving mental and physical health. The Tribal Behavioral Health cooperative agreements (short title: Native Connections) offers grants to programs aimed at preventing and reducing suicidal behavior and substance use, addressing trauma, and promoting mental health among American Indian/Alaska Native (AI/AN) young people.

SAMHSA is now accepting applications for the cooperative-agreement grants. Grants total up to $94.8 million over 5 years. SAMHSA says it expects to fund as many as 94 grant recipients with up to $200,000 each per year for up to 5 years. Currently, Native Connections serves 20 grantees.

Native Connections also provides webinars to guide grantees in developing plans for such programs. One series, for instance, provides cultural considerations in screening and treating young people at risk.

Federally recognized AI/AN tribes, tribal organizations, and consortia of tribes or tribal organizations are eligible to apply for the grants. Applications are available at www.grants.gov and www.samhsa.gov/grants/applying. Applicants must download the required documents from both sites. The due date to receive applications is June 2, by 11:59 pm (ET).

The Substance Abuse and Mental Health Services Administration (SAMHSA) is providing support to Native American tribes and organizations with great ideas for improving mental and physical health. The Tribal Behavioral Health cooperative agreements (short title: Native Connections) offers grants to programs aimed at preventing and reducing suicidal behavior and substance use, addressing trauma, and promoting mental health among American Indian/Alaska Native (AI/AN) young people.

SAMHSA is now accepting applications for the cooperative-agreement grants. Grants total up to $94.8 million over 5 years. SAMHSA says it expects to fund as many as 94 grant recipients with up to $200,000 each per year for up to 5 years. Currently, Native Connections serves 20 grantees.

Native Connections also provides webinars to guide grantees in developing plans for such programs. One series, for instance, provides cultural considerations in screening and treating young people at risk.

Federally recognized AI/AN tribes, tribal organizations, and consortia of tribes or tribal organizations are eligible to apply for the grants. Applications are available at www.grants.gov and www.samhsa.gov/grants/applying. Applicants must download the required documents from both sites. The due date to receive applications is June 2, by 11:59 pm (ET).

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SAMHSA Reports Track Behavioral Health in U.S.

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The 2015 and 2016 SAMHSA short reports highlight federal, state, and community records.

From 2005 to 2011, emergency department visits related to nonmedical use of narcotic pain relievers rose in all age groups (except for adolescents aged 12 to 17 years).  For “detailed insight on the nature and scope of behavioral health issues” in the U.S., The Substance Abuse and Mental Health Services Administration (SAMHSA) posted its 2015 and 2016 short reports on the National Library of Medicine’s website. The specialized reports, prepared by SAMHSA’s Center for Behavioral Health Statistics and Quality, cover a range of information at the federal, state, and community levels, from state estimates of marijuana use to heroin use in the U.S., and more.

The short reports are available at www.ncbi.nlm.nih.gov/books/NBK343537/. The full range of SAMHSA statistical studies and reports is available at www.samhsa.gov/data/.

 

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The 2015 and 2016 SAMHSA short reports highlight federal, state, and community records.
The 2015 and 2016 SAMHSA short reports highlight federal, state, and community records.

From 2005 to 2011, emergency department visits related to nonmedical use of narcotic pain relievers rose in all age groups (except for adolescents aged 12 to 17 years).  For “detailed insight on the nature and scope of behavioral health issues” in the U.S., The Substance Abuse and Mental Health Services Administration (SAMHSA) posted its 2015 and 2016 short reports on the National Library of Medicine’s website. The specialized reports, prepared by SAMHSA’s Center for Behavioral Health Statistics and Quality, cover a range of information at the federal, state, and community levels, from state estimates of marijuana use to heroin use in the U.S., and more.

The short reports are available at www.ncbi.nlm.nih.gov/books/NBK343537/. The full range of SAMHSA statistical studies and reports is available at www.samhsa.gov/data/.

 

From 2005 to 2011, emergency department visits related to nonmedical use of narcotic pain relievers rose in all age groups (except for adolescents aged 12 to 17 years).  For “detailed insight on the nature and scope of behavioral health issues” in the U.S., The Substance Abuse and Mental Health Services Administration (SAMHSA) posted its 2015 and 2016 short reports on the National Library of Medicine’s website. The specialized reports, prepared by SAMHSA’s Center for Behavioral Health Statistics and Quality, cover a range of information at the federal, state, and community levels, from state estimates of marijuana use to heroin use in the U.S., and more.

The short reports are available at www.ncbi.nlm.nih.gov/books/NBK343537/. The full range of SAMHSA statistical studies and reports is available at www.samhsa.gov/data/.

 

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Aprepitant Protects Against Chemo-Induced Nausea and Vomiting

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Researchers reveal the addition of aprepitant to cisplastin reduced or eliminated patient nausea and vomiting.

According to international guidelines, > 90% of patients on a cisplatin regimen experience chemotherapy-induced nausea and vomiting (CINV). Antiemetic prophylaxis with a 5 hydroxytryptamine receptor-3 antagonist (5-HT3RA) plus dexamethasone still leaves about 20% of patients with acute or delayed vomiting and nausea during the first cycle of chemotherapy. However, researchers from Chang Gung University in Taiwan found that adding aprepitant provided about 70% complete protection against emesis when the primary prophylaxis did not work. Those findings led them to conduct a study that evaluated the antiemetic efficacy of a combination of 3 drugs: palonosetron (a long-acting second-generation 5-HT3RA), 3-day oral aprepitant (a neurokinin-1 receptor antagonist), and dexamethasone.

Related: Delayed Adjuvant Chemotherapy Significantly Affects Breast Cancer Recovery

Patients in the study were scheduled to receive at least 50 mg/m2 cisplatin followed by a continuous infusion of 5-fluorouracil (5-FU) with or without other chemotherapeutic agents. Cisplatin was given on day 1; the other drugs were given on day 1 and subsequent days. All 69 patients who received palonosetron, aprepitant, and dexamethasone were evaluated in the first cycle of chemotherapy.

No patients experienced acute vomiting; nearly all (98.6%) were protected against nausea. Moreover, 97.1% had no delayed vomiting, and 87% had no delayed nausea. Most episodes of delayed nausea were rated as mild. Overall, 97.1% of patients had no vomiting, and 85.5% of patients had no nausea.

Related: FDA Approves Rescue Drug for Chemotherapy Overdose

The effects were sustained. In the second cycle of chemotherapy, again, none of 61 evaluated patients experienced acute vomiting, and 96.7% were free of nausea. Most patients also were protected against delayed vomiting or nausea (96.7% and 83.6%, respectively). Of patients who underwent 2 cycles, 45 did not experience nausea or vomiting in either cycle.

The combination of drugs was generally well tolerated; most adverse events were mild.

Yang C-K, Wu C-E, Liaw C-C. Biomed J. 2016;39(1):60-66.
doi: 10.1016/j.bj.2015.08.006.

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Researchers reveal the addition of aprepitant to cisplastin reduced or eliminated patient nausea and vomiting.
Researchers reveal the addition of aprepitant to cisplastin reduced or eliminated patient nausea and vomiting.

According to international guidelines, > 90% of patients on a cisplatin regimen experience chemotherapy-induced nausea and vomiting (CINV). Antiemetic prophylaxis with a 5 hydroxytryptamine receptor-3 antagonist (5-HT3RA) plus dexamethasone still leaves about 20% of patients with acute or delayed vomiting and nausea during the first cycle of chemotherapy. However, researchers from Chang Gung University in Taiwan found that adding aprepitant provided about 70% complete protection against emesis when the primary prophylaxis did not work. Those findings led them to conduct a study that evaluated the antiemetic efficacy of a combination of 3 drugs: palonosetron (a long-acting second-generation 5-HT3RA), 3-day oral aprepitant (a neurokinin-1 receptor antagonist), and dexamethasone.

Related: Delayed Adjuvant Chemotherapy Significantly Affects Breast Cancer Recovery

Patients in the study were scheduled to receive at least 50 mg/m2 cisplatin followed by a continuous infusion of 5-fluorouracil (5-FU) with or without other chemotherapeutic agents. Cisplatin was given on day 1; the other drugs were given on day 1 and subsequent days. All 69 patients who received palonosetron, aprepitant, and dexamethasone were evaluated in the first cycle of chemotherapy.

No patients experienced acute vomiting; nearly all (98.6%) were protected against nausea. Moreover, 97.1% had no delayed vomiting, and 87% had no delayed nausea. Most episodes of delayed nausea were rated as mild. Overall, 97.1% of patients had no vomiting, and 85.5% of patients had no nausea.

Related: FDA Approves Rescue Drug for Chemotherapy Overdose

The effects were sustained. In the second cycle of chemotherapy, again, none of 61 evaluated patients experienced acute vomiting, and 96.7% were free of nausea. Most patients also were protected against delayed vomiting or nausea (96.7% and 83.6%, respectively). Of patients who underwent 2 cycles, 45 did not experience nausea or vomiting in either cycle.

The combination of drugs was generally well tolerated; most adverse events were mild.

Yang C-K, Wu C-E, Liaw C-C. Biomed J. 2016;39(1):60-66.
doi: 10.1016/j.bj.2015.08.006.

According to international guidelines, > 90% of patients on a cisplatin regimen experience chemotherapy-induced nausea and vomiting (CINV). Antiemetic prophylaxis with a 5 hydroxytryptamine receptor-3 antagonist (5-HT3RA) plus dexamethasone still leaves about 20% of patients with acute or delayed vomiting and nausea during the first cycle of chemotherapy. However, researchers from Chang Gung University in Taiwan found that adding aprepitant provided about 70% complete protection against emesis when the primary prophylaxis did not work. Those findings led them to conduct a study that evaluated the antiemetic efficacy of a combination of 3 drugs: palonosetron (a long-acting second-generation 5-HT3RA), 3-day oral aprepitant (a neurokinin-1 receptor antagonist), and dexamethasone.

Related: Delayed Adjuvant Chemotherapy Significantly Affects Breast Cancer Recovery

Patients in the study were scheduled to receive at least 50 mg/m2 cisplatin followed by a continuous infusion of 5-fluorouracil (5-FU) with or without other chemotherapeutic agents. Cisplatin was given on day 1; the other drugs were given on day 1 and subsequent days. All 69 patients who received palonosetron, aprepitant, and dexamethasone were evaluated in the first cycle of chemotherapy.

No patients experienced acute vomiting; nearly all (98.6%) were protected against nausea. Moreover, 97.1% had no delayed vomiting, and 87% had no delayed nausea. Most episodes of delayed nausea were rated as mild. Overall, 97.1% of patients had no vomiting, and 85.5% of patients had no nausea.

Related: FDA Approves Rescue Drug for Chemotherapy Overdose

The effects were sustained. In the second cycle of chemotherapy, again, none of 61 evaluated patients experienced acute vomiting, and 96.7% were free of nausea. Most patients also were protected against delayed vomiting or nausea (96.7% and 83.6%, respectively). Of patients who underwent 2 cycles, 45 did not experience nausea or vomiting in either cycle.

The combination of drugs was generally well tolerated; most adverse events were mild.

Yang C-K, Wu C-E, Liaw C-C. Biomed J. 2016;39(1):60-66.
doi: 10.1016/j.bj.2015.08.006.

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Assistive Technology for Veterans’ Homes

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VA grants awarded to 4 institutions for their housing assistive technology innovations.

The VA awarded 4 grants totaling nearly $800,000 to veterans with service-connected disabilities to adapt their homes with assistive technology .

The Specially Adapted Housing Assistive Technology (SAHAT) grants go to individuals, researchers, and organizations that develop assistive technology. The 4 grants awarded are going to Auburn University in Alabama for touch-voice-eye-controlled assistive technology; Philips Research of North America in Massachusetts for personalized location-aware assisted technology for individuals with mild cognitive impairment; Simply Home of Asheville, North Carolina, for an assistive technology link platform that interfaces the Firefly Platform with the Amazon Echo Device; and St. Ambrose University in Iowa for its virtual demonstration and training site for home independence.

Typical home adaptations include ramps, wider halls and doors, and wheelchair-accessible bathrooms. New technology from the SAHAT Grant program will be added to the list of home modification options as they become available.

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VA grants awarded to 4 institutions for their housing assistive technology innovations.

The VA awarded 4 grants totaling nearly $800,000 to veterans with service-connected disabilities to adapt their homes with assistive technology .

The Specially Adapted Housing Assistive Technology (SAHAT) grants go to individuals, researchers, and organizations that develop assistive technology. The 4 grants awarded are going to Auburn University in Alabama for touch-voice-eye-controlled assistive technology; Philips Research of North America in Massachusetts for personalized location-aware assisted technology for individuals with mild cognitive impairment; Simply Home of Asheville, North Carolina, for an assistive technology link platform that interfaces the Firefly Platform with the Amazon Echo Device; and St. Ambrose University in Iowa for its virtual demonstration and training site for home independence.

Typical home adaptations include ramps, wider halls and doors, and wheelchair-accessible bathrooms. New technology from the SAHAT Grant program will be added to the list of home modification options as they become available.

The VA awarded 4 grants totaling nearly $800,000 to veterans with service-connected disabilities to adapt their homes with assistive technology .

The Specially Adapted Housing Assistive Technology (SAHAT) grants go to individuals, researchers, and organizations that develop assistive technology. The 4 grants awarded are going to Auburn University in Alabama for touch-voice-eye-controlled assistive technology; Philips Research of North America in Massachusetts for personalized location-aware assisted technology for individuals with mild cognitive impairment; Simply Home of Asheville, North Carolina, for an assistive technology link platform that interfaces the Firefly Platform with the Amazon Echo Device; and St. Ambrose University in Iowa for its virtual demonstration and training site for home independence.

Typical home adaptations include ramps, wider halls and doors, and wheelchair-accessible bathrooms. New technology from the SAHAT Grant program will be added to the list of home modification options as they become available.

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Sexual Orientation and Cancer Risk

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Sexual minorities, relative to heterosexuals, may be at higher risk of cancer, according to data from the Growing Up Today study of children.

Young people in sexual minorities are at higher risk of cancer because they engage in risky behavior more often, say researchers from City University of New York, Harvard, Boston’s Children’s Hospital, and San Diego State University.

The researchers analyzed data from 9,958 participants in the national Growing Up Today Study (1999-2010). The study participants were the children of the women in the Nurses’ Health Study II; those women were invited in 1996 to enroll their 9- to 14-year-old children. Of the participants, 84.5% reported being “completely” heterosexual, 12.1% were “mostly” heterosexual, 1.8% were lesbian or gay, and 1.6% were bisexual.

Related: Native Americans Address LGBT Health Issues

The researchers measured responses about tobacco and alcohol, diet and physical activity, exposure to ultraviolet radiation, and sexually transmitted infections.

Compared with completely heterosexual women, lesbian, bisexual, and mostly heterosexual women more frequently engaged in multiple cancer-related risk behaviors. For instance, they were more likely to have smoked, to be overweight, and to have been physically inactive in the previous year. Bisexual and mostly heterosexual women were more likely to have had a sexually transmitted infection. Interestingly, heterosexual women were more likely to have used a tanning booth ≥ 10 times in the previous year.

Compared with heterosexual men, sexual-minority women were also more often engaged in risky behaviors. The differences between gay/bisexual men and heterosexual men were less marked, although gay men more often vomited to control their weight, compared with heterosexual men, and had a higher prevalence of STIs.

Related: Treating LGBTQ Youth

The literature, the researchers note, tends to focus on “ever or never” behavior. They were mindful, they say, that exposure to a potential carcinogen usually must occur over time, and that the likelihood of cancer increases with exposure, which is why they focused on assessing frequent engagement in each cancer-related risk behavior, long term. Their findings indicated that sexual minorities, relative to heterosexuals, are at risk for cancer through multiple risk behaviors—“concerning,” they add, because the “additive or synergistic effect of another cancer-related risk behavior may provoke or exacerbate a determinant of cancer: chronic inflammation.”

Source:
Rosario M, Li F, Wypij D, et al.  Am J Public Health. 2016;106(4):698-706.
doi: 10.2105/AJPH.2015.302977.

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Sexual minorities, relative to heterosexuals, may be at higher risk of cancer, according to data from the Growing Up Today study of children.
Sexual minorities, relative to heterosexuals, may be at higher risk of cancer, according to data from the Growing Up Today study of children.

Young people in sexual minorities are at higher risk of cancer because they engage in risky behavior more often, say researchers from City University of New York, Harvard, Boston’s Children’s Hospital, and San Diego State University.

The researchers analyzed data from 9,958 participants in the national Growing Up Today Study (1999-2010). The study participants were the children of the women in the Nurses’ Health Study II; those women were invited in 1996 to enroll their 9- to 14-year-old children. Of the participants, 84.5% reported being “completely” heterosexual, 12.1% were “mostly” heterosexual, 1.8% were lesbian or gay, and 1.6% were bisexual.

Related: Native Americans Address LGBT Health Issues

The researchers measured responses about tobacco and alcohol, diet and physical activity, exposure to ultraviolet radiation, and sexually transmitted infections.

Compared with completely heterosexual women, lesbian, bisexual, and mostly heterosexual women more frequently engaged in multiple cancer-related risk behaviors. For instance, they were more likely to have smoked, to be overweight, and to have been physically inactive in the previous year. Bisexual and mostly heterosexual women were more likely to have had a sexually transmitted infection. Interestingly, heterosexual women were more likely to have used a tanning booth ≥ 10 times in the previous year.

Compared with heterosexual men, sexual-minority women were also more often engaged in risky behaviors. The differences between gay/bisexual men and heterosexual men were less marked, although gay men more often vomited to control their weight, compared with heterosexual men, and had a higher prevalence of STIs.

Related: Treating LGBTQ Youth

The literature, the researchers note, tends to focus on “ever or never” behavior. They were mindful, they say, that exposure to a potential carcinogen usually must occur over time, and that the likelihood of cancer increases with exposure, which is why they focused on assessing frequent engagement in each cancer-related risk behavior, long term. Their findings indicated that sexual minorities, relative to heterosexuals, are at risk for cancer through multiple risk behaviors—“concerning,” they add, because the “additive or synergistic effect of another cancer-related risk behavior may provoke or exacerbate a determinant of cancer: chronic inflammation.”

Source:
Rosario M, Li F, Wypij D, et al.  Am J Public Health. 2016;106(4):698-706.
doi: 10.2105/AJPH.2015.302977.

Young people in sexual minorities are at higher risk of cancer because they engage in risky behavior more often, say researchers from City University of New York, Harvard, Boston’s Children’s Hospital, and San Diego State University.

The researchers analyzed data from 9,958 participants in the national Growing Up Today Study (1999-2010). The study participants were the children of the women in the Nurses’ Health Study II; those women were invited in 1996 to enroll their 9- to 14-year-old children. Of the participants, 84.5% reported being “completely” heterosexual, 12.1% were “mostly” heterosexual, 1.8% were lesbian or gay, and 1.6% were bisexual.

Related: Native Americans Address LGBT Health Issues

The researchers measured responses about tobacco and alcohol, diet and physical activity, exposure to ultraviolet radiation, and sexually transmitted infections.

Compared with completely heterosexual women, lesbian, bisexual, and mostly heterosexual women more frequently engaged in multiple cancer-related risk behaviors. For instance, they were more likely to have smoked, to be overweight, and to have been physically inactive in the previous year. Bisexual and mostly heterosexual women were more likely to have had a sexually transmitted infection. Interestingly, heterosexual women were more likely to have used a tanning booth ≥ 10 times in the previous year.

Compared with heterosexual men, sexual-minority women were also more often engaged in risky behaviors. The differences between gay/bisexual men and heterosexual men were less marked, although gay men more often vomited to control their weight, compared with heterosexual men, and had a higher prevalence of STIs.

Related: Treating LGBTQ Youth

The literature, the researchers note, tends to focus on “ever or never” behavior. They were mindful, they say, that exposure to a potential carcinogen usually must occur over time, and that the likelihood of cancer increases with exposure, which is why they focused on assessing frequent engagement in each cancer-related risk behavior, long term. Their findings indicated that sexual minorities, relative to heterosexuals, are at risk for cancer through multiple risk behaviors—“concerning,” they add, because the “additive or synergistic effect of another cancer-related risk behavior may provoke or exacerbate a determinant of cancer: chronic inflammation.”

Source:
Rosario M, Li F, Wypij D, et al.  Am J Public Health. 2016;106(4):698-706.
doi: 10.2105/AJPH.2015.302977.

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Golfing for Rehabilitation

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VA teams up with PGA of America to help disabled veterans golf.

Golf can be a bridge back into the community for disabled veterans. That’s the rationale behind a specialized golf program launched by the VA in partnership with PGA Reach, the philanthropic arm of PGA of America. PGA HOPE (Helping Our Patriots Everywhere) is a therapeutic program led by PGA professionals certified in golf instruction for veterans with disabilities. The two-step program begins with an introductory clinic.

“When you think of rehabilitation, golf is not always the first thing you think of,” admits VA Secretary Robert McDonald, “but it can play an integral role in the healing process through social interaction, mental stimulation and exercise.”

 

More than 2,000 veterans have already participated in the 50 programs available. For more information, visit www.pgareach.com

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VA teams up with PGA of America to help disabled veterans golf.
VA teams up with PGA of America to help disabled veterans golf.

Golf can be a bridge back into the community for disabled veterans. That’s the rationale behind a specialized golf program launched by the VA in partnership with PGA Reach, the philanthropic arm of PGA of America. PGA HOPE (Helping Our Patriots Everywhere) is a therapeutic program led by PGA professionals certified in golf instruction for veterans with disabilities. The two-step program begins with an introductory clinic.

“When you think of rehabilitation, golf is not always the first thing you think of,” admits VA Secretary Robert McDonald, “but it can play an integral role in the healing process through social interaction, mental stimulation and exercise.”

 

More than 2,000 veterans have already participated in the 50 programs available. For more information, visit www.pgareach.com

Golf can be a bridge back into the community for disabled veterans. That’s the rationale behind a specialized golf program launched by the VA in partnership with PGA Reach, the philanthropic arm of PGA of America. PGA HOPE (Helping Our Patriots Everywhere) is a therapeutic program led by PGA professionals certified in golf instruction for veterans with disabilities. The two-step program begins with an introductory clinic.

“When you think of rehabilitation, golf is not always the first thing you think of,” admits VA Secretary Robert McDonald, “but it can play an integral role in the healing process through social interaction, mental stimulation and exercise.”

 

More than 2,000 veterans have already participated in the 50 programs available. For more information, visit www.pgareach.com

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Vaginal Ring May Protect Against HIV

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Clinical trial shows that vaginal rings that release dalpivirine provide modest protection against HIV infection.

A vaginal ring that continuously releases dapivirine, an experimental antiretroviral drug, provided a “modest” level of protection against HIV infection in a multisite clinical trial that involved more than 2,600 African women.

The ASPIRE study, also known as MTN-020, funded in part by the National Institute of Allergy and Infectious Diseases, began in 2012. Women received either the ring containing dapivirine or a placebo ring. The rings were replaced every 4 weeks.

The antiretroviral ring reduced the risk of HIV infection by 27% overall and by 61% among those who used the ring most consistently, women aged ≥ 25 years. When the researchers excluded data from 2 sites where many women did not return for study visits or use the ring consistently, the dapivirine ring reduced risk by 37%.

When the researchers performed further analyses, they found that the ring reduced the risk of infection by 56% in women older than 21 years but provided no significant protection for women aged 18 to 21. Younger women appeared to use the ring less consistently, based on the blood levels of dapivirine measured during study visits.

The rate of adverse events was similar among women in both groups, as was the frequency of antiretroviral resistance in women who acquired HIV.

In another ongoing large trial, which tested the dapivirine ring for safety and efficacy, researchers found an overall effectiveness of 31%, with a slightly greater reduction of risk in women older than 21.

The ASPIRE study is the first to demonstrate that a product that slowly releases the antiretroviral over time can offer partial protection from HIV.

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Clinical trial shows that vaginal rings that release dalpivirine provide modest protection against HIV infection.
Clinical trial shows that vaginal rings that release dalpivirine provide modest protection against HIV infection.

A vaginal ring that continuously releases dapivirine, an experimental antiretroviral drug, provided a “modest” level of protection against HIV infection in a multisite clinical trial that involved more than 2,600 African women.

The ASPIRE study, also known as MTN-020, funded in part by the National Institute of Allergy and Infectious Diseases, began in 2012. Women received either the ring containing dapivirine or a placebo ring. The rings were replaced every 4 weeks.

The antiretroviral ring reduced the risk of HIV infection by 27% overall and by 61% among those who used the ring most consistently, women aged ≥ 25 years. When the researchers excluded data from 2 sites where many women did not return for study visits or use the ring consistently, the dapivirine ring reduced risk by 37%.

When the researchers performed further analyses, they found that the ring reduced the risk of infection by 56% in women older than 21 years but provided no significant protection for women aged 18 to 21. Younger women appeared to use the ring less consistently, based on the blood levels of dapivirine measured during study visits.

The rate of adverse events was similar among women in both groups, as was the frequency of antiretroviral resistance in women who acquired HIV.

In another ongoing large trial, which tested the dapivirine ring for safety and efficacy, researchers found an overall effectiveness of 31%, with a slightly greater reduction of risk in women older than 21.

The ASPIRE study is the first to demonstrate that a product that slowly releases the antiretroviral over time can offer partial protection from HIV.

A vaginal ring that continuously releases dapivirine, an experimental antiretroviral drug, provided a “modest” level of protection against HIV infection in a multisite clinical trial that involved more than 2,600 African women.

The ASPIRE study, also known as MTN-020, funded in part by the National Institute of Allergy and Infectious Diseases, began in 2012. Women received either the ring containing dapivirine or a placebo ring. The rings were replaced every 4 weeks.

The antiretroviral ring reduced the risk of HIV infection by 27% overall and by 61% among those who used the ring most consistently, women aged ≥ 25 years. When the researchers excluded data from 2 sites where many women did not return for study visits or use the ring consistently, the dapivirine ring reduced risk by 37%.

When the researchers performed further analyses, they found that the ring reduced the risk of infection by 56% in women older than 21 years but provided no significant protection for women aged 18 to 21. Younger women appeared to use the ring less consistently, based on the blood levels of dapivirine measured during study visits.

The rate of adverse events was similar among women in both groups, as was the frequency of antiretroviral resistance in women who acquired HIV.

In another ongoing large trial, which tested the dapivirine ring for safety and efficacy, researchers found an overall effectiveness of 31%, with a slightly greater reduction of risk in women older than 21.

The ASPIRE study is the first to demonstrate that a product that slowly releases the antiretroviral over time can offer partial protection from HIV.

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Hunting Down a C difficile Vaccine

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Researchers test a potential vaccine that may help prevent thousands of deaths per year related to C difficile infection.

Could a vaccine help prevent infection with Clostridium difficile (C difficile), which causes thousands of deaths every year? In a first-in-human phase 1 study, researchers compared 3 doses of an investigational vaccine with placebo. The vaccine consisted of toxoids A and B (the principle virulence factors of C difficile-associated disease), and given with or without aluminum hydroxide in doses of 50, 100, or 200 μg at 0, 1, and 6 months.

Related: Antimicrobial Stewardship in an Outpatient Parenteral Antibiotic Therapy Program

The vaccine was well tolerated and effective. Local reactions and systemic events—mostly injection site pain, headache, and fatigue—were predominantly mild to moderate. Increasing the dosage or number of doses did not affect the frequency and severity of adverse effects, as reported by the participants in e-diaries.

Both the toxin A- and toxin B-specific neutralizing antibody levels increased from baseline. The first dose produced “modest” increases, but the second dose produced “marked” increases and the third dose had a “substantial” booster response, the researchers say. The booster response against toxin A was similar in both age groups tested (50-64 years and 65-85 years); the response against toxin B was the same or slightly higher in the older group.

Related:Hospital-Acquired Infections on the Decline

Overall, antibody responses were higher in the toxoid-only groups. The researchers note that aluminum salts have been used to enhance vaccine responses for decades and it was somewhat unexpected in this study that the toxoid-only vaccine led to better antibody responses.

While the study was limited by the small number of participants, the researchers say, the robust response and persistence of immune response to 12 months support further investigation.

Source:
Sheldon E, Kitchin N, Peng Y, et al. Vaccine. 2016;34(18):2082-2091
doi: 10.1016/j.vaccine.2016.03.010

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Researchers test a potential vaccine that may help prevent thousands of deaths per year related to C difficile infection.
Researchers test a potential vaccine that may help prevent thousands of deaths per year related to C difficile infection.

Could a vaccine help prevent infection with Clostridium difficile (C difficile), which causes thousands of deaths every year? In a first-in-human phase 1 study, researchers compared 3 doses of an investigational vaccine with placebo. The vaccine consisted of toxoids A and B (the principle virulence factors of C difficile-associated disease), and given with or without aluminum hydroxide in doses of 50, 100, or 200 μg at 0, 1, and 6 months.

Related: Antimicrobial Stewardship in an Outpatient Parenteral Antibiotic Therapy Program

The vaccine was well tolerated and effective. Local reactions and systemic events—mostly injection site pain, headache, and fatigue—were predominantly mild to moderate. Increasing the dosage or number of doses did not affect the frequency and severity of adverse effects, as reported by the participants in e-diaries.

Both the toxin A- and toxin B-specific neutralizing antibody levels increased from baseline. The first dose produced “modest” increases, but the second dose produced “marked” increases and the third dose had a “substantial” booster response, the researchers say. The booster response against toxin A was similar in both age groups tested (50-64 years and 65-85 years); the response against toxin B was the same or slightly higher in the older group.

Related:Hospital-Acquired Infections on the Decline

Overall, antibody responses were higher in the toxoid-only groups. The researchers note that aluminum salts have been used to enhance vaccine responses for decades and it was somewhat unexpected in this study that the toxoid-only vaccine led to better antibody responses.

While the study was limited by the small number of participants, the researchers say, the robust response and persistence of immune response to 12 months support further investigation.

Source:
Sheldon E, Kitchin N, Peng Y, et al. Vaccine. 2016;34(18):2082-2091
doi: 10.1016/j.vaccine.2016.03.010

Could a vaccine help prevent infection with Clostridium difficile (C difficile), which causes thousands of deaths every year? In a first-in-human phase 1 study, researchers compared 3 doses of an investigational vaccine with placebo. The vaccine consisted of toxoids A and B (the principle virulence factors of C difficile-associated disease), and given with or without aluminum hydroxide in doses of 50, 100, or 200 μg at 0, 1, and 6 months.

Related: Antimicrobial Stewardship in an Outpatient Parenteral Antibiotic Therapy Program

The vaccine was well tolerated and effective. Local reactions and systemic events—mostly injection site pain, headache, and fatigue—were predominantly mild to moderate. Increasing the dosage or number of doses did not affect the frequency and severity of adverse effects, as reported by the participants in e-diaries.

Both the toxin A- and toxin B-specific neutralizing antibody levels increased from baseline. The first dose produced “modest” increases, but the second dose produced “marked” increases and the third dose had a “substantial” booster response, the researchers say. The booster response against toxin A was similar in both age groups tested (50-64 years and 65-85 years); the response against toxin B was the same or slightly higher in the older group.

Related:Hospital-Acquired Infections on the Decline

Overall, antibody responses were higher in the toxoid-only groups. The researchers note that aluminum salts have been used to enhance vaccine responses for decades and it was somewhat unexpected in this study that the toxoid-only vaccine led to better antibody responses.

While the study was limited by the small number of participants, the researchers say, the robust response and persistence of immune response to 12 months support further investigation.

Source:
Sheldon E, Kitchin N, Peng Y, et al. Vaccine. 2016;34(18):2082-2091
doi: 10.1016/j.vaccine.2016.03.010

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