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UNC Study: More Than Half Of Seniors In ERs Poorly Nourished

UNC researchers have discovered that more than half of UNC’s emergency-room patients that are 65 or older suffer from poor nutrition.

“We know from other work that the emergency department is a unique environment which takes care of patients with a higher prevalence of limited access to routine care, and also financial limitations, said UNC Assistant Professor Tim Platts-Mill of the Department of Emergency Medicine. “So we thought the emergency department would be an important place to look at malnutrition.”

Platts-Mills is the senior author of a study by researchers at the University of North Carolina published online in the Annals of Emergency Medicine this past Tuesday.

It shows that more than half of 138 patients 65 or older who showed up in emergency rooms in UNC Hospitals over an eight-week period were either malnourished, or at risk for malnutrition.

Platts-Mills said that while there is no data that shows how much of a role malnutrition plays in the reasons for those emergency room visits, he said it’s likely significant.

He said it could often be a factor, for instance, when seniors get dizzy, or fall down. And it can be linked to poor bone health.

“There are lots of sort of downstream effects of not getting appropriate nutrition,” he said.

There can also be some downstream effects of chronic health problems that can prevent seniors from eating as well as they should. One of these is poor dental health, which can make eating difficult.

“Medicare does not pay for dental care,” said Platts-Mills. “So, if older adults get dental care, they have to have some sort of supplemental insurance specific to dental care in order to get it, or they have to pay out-of-pocket.”

Platts-Mills said it may help emergency physicians to explore some of the underlying factors that may be contributing to medical emergencies of seniors.

He also said he’d like to see more social-work personnel in emergency departments to identify malnourished senior patients and link them with resources that can help.

Executive Director Stacey Yusko of the Chapel Hill-Carrboro Meals on Wheels said that a lot of the seniors visited by her chapter struggle with depression, isolation, and loss of appetite. Many are not able to get out to stores to buy food.

And preparing food can be another difficult task.

“They might be able to pour a bowl of cereal in the morning, and get a meal from us at lunch, and then maybe have a little something for dinner” said Yusko. “But that’s a lot of work when you get older.”

She added that some older folks with memory issues can’t remember whether they’ve skipped an essential meal on some days. That’s what makes that lunchtime visit from Meals in Wheels so important.

Yusko said she’s not surprised that the study found a high percentage of malnutrition.

“We’re delivering to about 150 clients daily,” said Yusko. “And most of them, I would say, are on the normal-to-slender side. And when you look at the national weight picture in America, it’s not slender.”

Yusko said that her chapter of Meals on Wheels received some interesting evidence from CATCH of Central North Carolina last year.

CATCH stands for Care Transition to the Community and Home. It’s a program that strives to prevent re-admissions of seniors to emergency rooms within a month or so after the initial visit.

“And they said one of the things they found was that if there were guaranteed sources of food – of they knew someone was getting a meal everyday – that supported their health well enough until they recovered that they didn’t relapse.”

Meals on Wheels is not government-funded. It relies on fundraising. Yusko said her group is now working on its first-ever strategic plan, due to the rapidly increasing number of people it serves. The number has more than doubled from 65 to 150 over the past five years.

Yusko said she could use some volunteer drivers to help deliver meals to seniors, so if you’re interested, please call 919-942-2948.

http://chapelboro.com/news/health/unc-study-half-seniors-emergency-rooms-poorly-nourished/

UNC International Study Makes Breakthrough in Schizophrenia

The UNC School of Medicine has worked with nations across the globe in the largest genomic study to be published on any psychiatric disorder in order to identify more than 100 locations within the human genome that could connect to the development of schizophrenia.

Schizophrenia is a psychiatric disorder that affects about 1 of every 100 individuals around the world. It typically manifests in the teens and early 20′s, and is diagnosed by paranoia, hallucinations, and altered thought processes. With that come heavy costs on individuals as well as society, financially and for quality of life. In the United States, more than $60 billion each year is spent on the treatment of schizophrenia.

UNC Distinguished Professor and the Director of the Center Psychiatric Genomics, Patrick Sullivan, told WCHL how he and his team developed the group that would go on to conduct this project.

“We began the Psychiatric Genomics Consortium about seven years ago, and the work that was presented in the paper of Nature represents at least seven years of work by over 300 people and incorporates information from over 15,000 people,” says Sullivan. “It’s been an enormous amount of work, a labor of love by dozens and dozens of individuals.”

As this was an international study, Sullivan says that there were a significant number of sources that worked to make this analysis such a success.

“The number of authors on the paper was 302,” says Sullivan. “These individuals come from at least 30 different countries, and over 100 different institutions. It is truly a worldwide operation.”

The discoveries made by the international team can be found through the online publication, Nature, and connect to several aspects in human biology that are common in the occurrence of schizophrenia. Though there has not been significant progress in drug development for it in over 60 years, these findings could mean new ways of treating this disorder.

“The advantage of this study is that it allows us an unprecedented and detailed look under the hood,” says Sullivan. “For the first time, we are starting to be able to dial into what schizophrenia is, from a fundamental and genetic basis. We’re very hopeful that the knowledge will be the kind of thing that leads to important breakthroughs and treatment for people with schizophrenia.”

Sullivan says that UNC played a vital role in how the study was conducting, analytically and in gathering volunteers to participate in the study.

“There were 10 plus investigators who were on that paper who the hard work of actually finding individuals who could be part of the study, individuals with schizophrenia as well as without,” says Sullivan. “Other people contributed to the analysis, and that’s a huge amount of work to actually get that done. We were fortunate to have a number of great people from UNC as part of that.”

As of now, Sullivan says there are medications available on the market for schizophrenia that help, but only manage the psychosis aspect of the disorder. This is partially due to the fact that not much has been uncovered yet about what biologically affects the disorder. From their previous study, Sullivan says that their group has found several new locations within human biological makeup for schizophrenia to exist, which will make it much easier to find how the disorder develops.

“The previous study pushed the number of confirmed loci for schizophrenia to 22, and this study obviously found a lot more,” says Sullivan. “It gives us a lot more detailed ideas of what’s really going wrong with schizophrenia. These are the things that with future work I think will get us dialed firmly into fundamental biology.”

Those involved in the published study analyzed 80,000 genetic samples from patients who had schizophrenia in addition to healthy volunteers. Through this, they found 108 places in the human genome connected to what could develop schizophrenia; 83 of said places had never been linked to the disorder before.

Sullivan says that this study is much better than the last because of the number of individuals involved and who specifically worked to make it happen.

“The first is the scale; it’s the largest study in the field,” says Sullivan. “The second thing is we’ve been extremely fortunate to be involved with and attracting recruits from absolutely top-notch analysts, statisticians, and computer scientists. To handle information of this scale requires similarly scaled efforts.”

Sullivan concludes that this study has opened whole new doors in not only treating schizophrenia more intelligently, but many other mental disorders that could have connections to schizophrenia.

“One of the things that we’re finding is some unexpected connections between schizophrenia and other disorders. “We have published work suggesting that there may be not a complete overlap, but certainly an important genetic overlap for schizophrenia, bipolar disorder, and probably autism. Our larger study is in progress, and we’re hoping that we’ll have more clarity over the next couple years.”

http://chapelboro.com/news/health/unc-international-study-makes-breakthrough-schizophrenia/

UNC Medical Student Creates Nutrition Project

A student at the UNC School of Medicine has created an award-winning faith-based obesity prevention program to provide exercise and diet modification to better improve the health standards of the Durham-Chapel Hill community.

As a third-year medical student, wife and mother of three, Milele Bynum created the nutrition and walking program, “Walking in Faith,” as a part of the Albert Schweitzer fellowship.

Bynum told WCHL she was inspired by the challenges of obesity in her own life to begin this project to help those in the African-American community dealing with weight and health issues.

“It’s a problem that is really in the African-American community,” Bynum said. “Obesity has so many other health consequences from diabetes to cancer and heart disease and I’ve seen so many people in my family affected by the consequences of obesity.”

Bynum will receive the Community Outreach Award from the American Academy of Family Physicians, which is granted to family medicine residents and students who serve in community roles or projects to improve health care of populations.

“Walking in Faith” was started in conjunction with First Calvary Baptist Church in Durham. Almost 30 members of the church signed up for the eight-week program, and began nutritional sessions coupled with a weekday walking program. Bynum says the project produced positive results, as almost 70 percent of the participants reached the 150 minute weekly physical activity recommendation as well as reduced BMI and blood pressures.

With all participants identifying at the program’s start as overweight or obese, they have now developed a Healthy Eating Policy through the church’s Health and Wellness Ministry. Bynum and First Calvary have plans to expand this program to other communities by creating a curriculum through the American Academy of Family Physicians.

Bynum has brought the fight against obesity into her own home, teaching her children the importance of physical activity and adequate water-intake.

“Being a mother of three, I saw the importance of getting my children involved,” Bynum said. “Sometimes they didn’t want to come (workout), but they would come and walk with us every time we went and I thought that was important because if they see you doing it as a parent, then they’ll see that it is important.”

When trying to losing weight, Bynum reminds those who dare to make the lifestyle change to “celebrate small gains as they lead to big rewards.”

“I’ve really gained that it’s not easy, it’s something I’ve been struggling with my entire life but understand you don’t have to go out and run five miles a day. Just do anything to increase physical activity 15 minutes a day whenever it can be.”

http://chapelboro.com/news/health/unc-medical-student-creates-nutrition-project/

Homeownership, Scholarship, Taxes And Snow Days

Are you thinking about buying a home? Wondering how you can afford it?

Chatham Habitat for Humanity and EmPOWERment are co-hosting a two-part Home Buyer’s Education Workshop in Pittsboro, on Thursday, March 6 and Thursday, March 13 from 5:30-8:30 p.m. You’ll learn tips for shopping for homes and mortgages, how to financially prepare, and how to maintain your home after you’ve bought it.

The workshop takes place at 467 West Street in Pittsboro. It’s free and open to the public; dinner, door prizes and child care will be provided. To RSVP, contact Amanda Stancil at EmPOWERment by calling 967-8779, or Anna Schmalz Rodriguez at Chatham Habitat by calling 542-0794.

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Congratulations to Casey Rimland, a medical and doctoral student in the UNC School of Medicine who was recently named as a Gates Cambridge Scholar.

Created with a donation from the Bill and Melinda Gates Foundation, the Gates Cambridge Scholarship provides students with a three-year full scholarship to study at Cambridge University in England. Between 80 and 100 Gates Scholarships are awarded annually; Rimland is the second honoree from UNC.

Casey Rimland is originally from Charlotte and graduated from UNC-Charlotte in 2011. She’s also a thyroid cancer survivor, having been diagnosed in her first year of medical school.

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To compensate for all the snow days, the Chapel Hill-Carrboro City School Board has updated the district’s class schedule for the rest of the school year.

There were three remaining days on the district’s calendar that were set aside as delayed-opening days, but all three have now been changed to regular school days. Those three days are March 13, April 10 and May 8 – all originally delayed opening, but now functioning as regular, full school days. Students should report to school at the regular time.

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Congratulations to the AVID students from Smith Middle School, winners of this year’s sixth annual Black History Knowledge Bowl!

The event is sponsored every year by the Mu Omicron Omega chapter of Alpha Kappa Alpha sorority. It’s a competition between students at Culbreth, McDougle and Smith Middle Schools who participate in the AVID program (Advancement Via Individual Determination). This year’s Knowledge Bowl took place at Culbreth Middle School on February 22; Smith took first and Culbreth took second.

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Results are in for the Town of Chapel Hill’s Community Survey, and the numbers indicate that—for the most part—residents are extremely happy with the town’s services.

More than 90 percent of residents who responded say they’re satisfied with the town’s fire department, library, and trash collection services; more than 80 percent say they’re satisfied with Chapel Hill’s park maintenance and police department. Those numbers are “well above regional and national benchmarks,” according to a release from the Town.

On the down side, residents said they were most concerned with traffic congestion and “how well the Town is preparing for the future,” and also said the Town could do a better job providing affordable housing and “access to quality shopping.”

You can check out the full results at TownOfChapelHill.org/survey.

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It’s tax season—and if you need tax forms, the Orange County Public Library is offering select forms for free. Those forms include the 1040, 1040A, 1040EZ, Schedule A, Schedule B and Schedule SE.

In addition, the Orange County Department on Aging is offering its Volunteer Income Tax Assistance program—VITA for short—which provides free income tax preparation for qualifying individuals with low- to middle-incomes, regardless of age or county of residence.

For more information or to find out if you qualify, visit OrangeCountyNC.gov/aging/VITA.asp.

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UNC has received a grant of more than $40 million from the National Institutes of Health, to fund a global clinical trials unit working to treat and prevent the spread of HIV.

The grant will fund five clinical research sites through the year 2021. Three of those sites are located in North Carolina; the other two are located in Africa, in Malawi and Zambia.

UNC received $430 million in external funding for HIV research between 2008 and 2012. The university is ranked as one of the top 10 programs in America for HIV/AIDS research.

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http://chapelboro.com/news/news-around-time/homeownership-scholarship-taxes-snow-days/

Anniversaries, Wellness, And “Coffee With A Cop!”

ORANGE COUNTY – The Carrboro Police Department is inviting you to come have “Coffee with a Cop!”

“Coffee with a Cop” is a chance for community members to connect with police officers, ask questions and learn more about the department. It’s part of a national initiative supported by the U.S. Department of Justice, to break down barriers between police departments and community members—“one cup of coffee at a time.”

“Coffee with a Cop” will take place on Friday, January 31, beginning at 8:00 a.m. at the Looking Glass Café on West Main Street. Everyone’s invited to attend.

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St. Thomas More School is celebrating its 50th anniversary in 2014 with a year of festivities—beginning with a Golden Jubilee Celebration on Friday, January 31. Habitat for Humanity International CEO Jonathan Reckford—a St. Thomas More alum—will serve as guest speaker at the event, which begins at 7:00 p.m. at St. Thomas More Catholic Church, just off Fordham Boulevard at 940 Carmichael Street.

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The Orange County Department on Aging is inviting you to help them celebrate the fifth anniversary of the Central Orange Senior Center, which opened five years ago on January 29, 2009.

The free event will take place on Friday, January 31, at 10:00 a.m. at the Central Orange Senior Center, located at 103 Meadowland Drive in Hillsborough. There will be food and music, plus a special performance by the Prime Time Players senior actors group.

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The Orange County Public Library is hosting a free wellness workshop called “Make It Stick!” on Wednesday, January 29. Local wellness coach Marit Weikel will talk about how to change your habits to live healthier—and how to make those changes last.

The class will run from 6:30-7:30 p.m. at the main library in Hillsborough. Everyone is welcome.

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The Friends of the Downtown is holding its monthly meeting on Thursday, January 30, at 9:00 a.m. on the second floor of the Franklin Hotel. It’s free and open to the public. Local architect Phil Szostak will be the featured speaker; he designed the DPAC in downtown Durham and he’s currently working on the Carrboro ArtsCenter.

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The Orange County 4-H is inviting everyone to a Community Forum on Thursday, January 30. The forum is designed to identify the needs of local kids and teens, and 4-H officials will use data from the forum to develop programs for kids ranging from 5-19 years old.

The Community Forum will take place at 6:00 p.m. in the Orange County Center, located at 306 E. Revere Road in Hillsborough. Dinner will be served.

To RSVP, visit this News Around Town page on our website, Chapelboro.com.

<…call Sheronda Witter at 919-245-2057.>

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A study out of the UNC School of Medicine last week is contributing to a greater understanding of schizophrenia. UNC genetics and psychiatry professor Dr. Patrick Sullivan co-authored the study, which uncovered evidence that schizophrenia arises from the combined effects of certain minute mutations distributed across many genes.

The study was published in this week’s issue of Nature.

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Blue Cross and Blue Shield of North Carolina Foundation is providing the North Carolina Partnership for Children with a three-year, $3 million grant to expand a program called Shape NC.

Shape NC is an early childhood initiative designed to increase the number of children who start kindergarten at a healthy weight, by promoting physical activity and good eating practices. Shape NC is already being implemented in 19 child care centers across the state; the grant will enable the program to expand to another 240.

http://chapelboro.com/news/news-around-time/anniversaries-wellness-coffee-cop/

UNC Prof. Awarded Highest State Civillian Honor

CHAPEL HILL – North Carolina Award recipient for science, Myron Cohen, says he’s spent the last 33 years trying to reduce new cases of HIV.

“I’ve been doing this since the very beginning,” Cohen says. “I came to Chapel Hill in 1980, and the first cases of HIV in Chapel Hill were in 1981. We had a fairly large epidemic of HIV in North Carolina that the health care providers and the University helped to manage.”

Cohen is UNC’s Associate Vice Chancellor for Global Health and director of the Center for Infectious Diseases.

The North Carolina Award is the state’s highest civilian award and was given to five other people along with Cohen. This came one day after Dean Smith was given the Presidential Medal of Freedom, which is the highest national civilian honor.

Cohen is an infectious disease specialist and says he works with a large group of people across the nation.

“Working to understand the transmission of the virus HIV, and, most importantly, developing strategies to prevent the transmission of HIV,” Cohen says.

Cohen says the study of HIV/AIDS has come a long way in his more than three decades of work on the disease.

“There’s no organism better studied than HIV, and there’s incredible discoveries along the way that have taken this once universally-fatal infection, and, now-a-days, this infection is detected early and (if) people receive the proper treatment, they live a normal, healthy lifespan,” Cohen says. “So it’s a quite remarkable journey over 33 years.”

Cohen was presented the North Carolina Award by Governor Pat McCrory Thursday in Durham. The N.C. Department of Cultural Resources administers the awards.

Cohen received the award in the science division. He was joined this year by Asheville’s John E. Cram in fine arts, Davidson College graduate John M. H. Hart, Jr. in literature, and legislator Phillip J. Kirk Jr., education administrator John Harding Lucas, and internationally acclaimed linguist Walt Wolfram in public service.

http://chapelboro.com/news/health/unc-professor-awarded-highest-state-civillian-honor/

Lungs’ Unique Viability: Transplant Procedure Seeks To Save Lives

CHAPEL HILL –  Lungs have the ability to live longer than other organs after a person dies. If the lungs are recovered from an organ donor in time, it may lead to transplant operations that could save thousands of lives.

With a $4.2 million National Institutes of Health grant, the UNC School of Medicine is breaking ground with a clinical trial that tests an innovative method of recovering healthy lungs from donors who suffer sudden death outside a hospital.

Dr. Thomas Egan, professor of cardiothoracic surgery at the UNC of Medicine, is leading the trial. Through research, he found the lungs’ unique ability to stay alive.

“The reason the lung lives for hours after people die is because the lung has a supply of oxygen in all of the tiny little air sacs in the airwaves,” Egan says. “The cell in those airwaves and air sacs live off oxygen in the lungs, and they don’t rely on blood flow in order to get oxygen.”

Other organs require oxygen to be present through blood circulation.

Only 1,800 lungs a year are transplanted from conventional, brain dead organ donors who have died in a hospital. And many of that number, only 25 percent are found to be suitable for transplant.

“There maybe upwards of 40,000 patients that might be candidates for lung transplants to help them breathe better and live longer in frankly a much more improved quality of life if there were enough lungs to transplant.”

Egan says there is a great need for healthy lungs.

“Lung disease is now the third-leading cause of deaths in the United States,” he says. “While it is far behind cancer and cardiovascular disease, there are close to 200,000 deaths every year from in-stage lung disease.”

The trial has two crucial parts. The first step is retrieving the lungs, departing from the normal donation process.

Currently, the organs of registered donors who die outside of hospitals are not used. This is where Egan says the difference can be made.

There is a one to two hour window for the lungs to be recovered after the donor has died.

If emergency workers determine that the patient cannot be resuscitated, the local organ recovery agency will step in to contact the next-of-kin for permission to participate in the clinical trial.

Once permission is granted, emergency workers will then pump a small amount of air into the lungs to preserve them during the transport to a hospital.

Part two of the trial begins once the lungs arrive at the hospital.

Inside a dome-shaped machine, Egan’s lab perfuses and ventilates the lungs with a special solution to determine suitability for transplantation. The liquid is met to flow like blood would inside the lungs.

When the lungs are found to be healthy, the organs will be transplanted to patients who have consented under FDA- and IRB-approved standards and practices.

The trial pools together the cooperation of organizations such as the emergency rooms of UNC and Duke Hospitals; Wake County EMS; and Carolina Donor Services, the regional organ procurement organization.

If the trial proves successful, Egan believes it could lead to revolutionizing the organ donation process in the United States.

“Other organs might be salvaged down the road if we can change the whole paradigm of what happens to individuals after death if they have indicated a desire to be an organ donor.”

Egan was recruited by the UNC School of Medicine to start the lung transplant program in 1989.

http://chapelboro.com/news/health/lungs-unique-viability-unc-transplant-procedure-seeks-save-lives/

UNC Budget Close To Completion

CHAPEL HILL – UNC Provost Jim Dean says University leaders are in the process of putting the final touches on this year’s budget.

“We’re on a fiscal year budget of July through June, but we can’t really do our budgeting until the legislature does their budgeting, and then the General Administration does their budget,” Dean says. “We’re downstream from that, so we’re getting close to the end of the budgeting.”

At its Aug. 9 meeting, the UNC System’s Board of Governors made it’s allocations for the 16 campuses, based on the North Carolina General Assembly’s two-year budget plan.

The legislature’s spending plan, which was approved in July, called for substantial cuts to the UNC System. The spending plan designated $115 million in permanent funding reductions to the System’s base operating budget.

State budget cuts also called for the elimination of all funding for the UNC School of Medicine.  Five years ago, appropriations for the School of Medicine were about $46 million.

“We did better than we might have done but not quite so well as we would have hoped in certain areas,” Dean says. “We did end up with some budget cuts again. They are not so bad as we feared at one point.”

During four consecutive years of state budget cuts since the economic downturn, UNC campuses including Chapel Hill have faced significant reductions in state funding. Carolina has taken approximately $235 million in total state cuts since 2008, according to UNC’s website.

http://chapelboro.com/news/unc/unc-budget-close-to-completion/