Clinical research nurses from more than 20 states and four countries discussed the "Road Ahead" this November at the Second Annual International Association of Clinical Research Nurses (IACRN) Conference co-hosted by Clinical Center Nursing and Patient Care.
Dr. Christine Grady, acting chief of the CC Bioethics Department, delivered the conference's keynote, "Clinical Research Nursing: Ethical Foundations and Challenges on the Road Ahead." Grady described some of the central ethical tensions experienced by nurses in a clinical research setting and encouraged nurses to be active, vocal members of the research team.
"Each of the diverse nursing roles has its own absolute critical function in the conduct of clinical research, and all of us are committed to quality research practices, high ethical standards, regulatory compliance, and human subjects protection," she said. "In order to accomplish those goals, we need to be familiar with the ethical challenges that we face—the principles, regulations, and other guidance for the ethical conduct of clinical research."
According to Grady, clinical research nurses or research nurse coordinators often find themselves in a position where they are advocates for three competing components of research: the individual as patient, the individual as study participant, and the research.
"All of us, I think, can recognize times when there is a tension between a data point that needs to be taken care of and a patient who might be upset or asleep," she said. "We wake them up, we calm them down, but the tension that we feel in that process is real. There are struggles between what we believe is important for the comfort and interest of the patient, and the need to collect and report accurate data."
The emphasis on ethics in this year's conference was offered in response to feedback received by conference coordinators from IACRN members who wanted to learn more about the ethical issues surrounding clinical research nursing.
Dr. Clare Hastings, CC chief nursing officer, was honored with the IACRN Distinguished Clinical Research Nurse Award at a dinner on November 18.
"Thank you for your leadership and vision," said past-president Margaret McCabe, director of Nursing Research/Medicine Patient Services at Children's Hospital Boston, during the award presentation. McCabe noted that the CC is the world's largest employer of clinical research nurses.
Hastings was moved by the gesture. "This is just fabulous. You guys are just—you're my people," she told the room of clinical research nurses.
A third speaker from the CC, nurse consultant Julie Kohn, shared the clinical research nurse competencies as determined by the CC Clinical Research Nursing 2010 initiative.
Governor O'Malley tours Clinical Center
Governor Martin O'Malley met with NIH leaders and toured the Clinical Center before addressing the Federal Facilities Advisory Board on November 18. The governor appointed the board last year to develop a comprehensive assessment of how Maryland can best support and leverage the vast potential of its more than 50 federal facilities and help connect Maryland companies with federal opportunities to create jobs.
Former CRTP fellow reflects on influence of program
The NIH Clinical Research Training Program (CRTP) aims to prepare the next generation of clinician-scientists through a year of immersion in the NIH intramural program. One alumna of the program recently returned to speak on her experience and to inspire her successors.
Karen Hoffman, assistant professor in the Department of Radiation Oncology at The University of Texas MD Anderson Cancer Center, spoke on a panel of graduates of the year-long research programs represented at the Clinical Investigator Student Trainee Forum which was held in the Clinical Center in November. She was part of the CRTP class of 2001-2002. The CRTP competitively selects participants, known as fellows, to spend a year engaged in a mentored clinical or translational research project in an area that matches their clinical research interests and goals.
Hoffman did her undergraduate work at the University of Virginia and earned her medical degree from Duke University. She also holds a Master of Public Health from the Harvard School of Public Health and Master of Health Science in Clinical Research from Duke University. While in the CRTP, Hoffman researched the late effects of treatment in long term survivors of pediatric sarcoma with Dr. Patrick Mansky, formerly of the National Center for Complementary and Alternative Medicine, and genetic and hormonal regulation of osteosarcoma metastasis with Drs. Lee Helman and Chand Khanna of the National Cancer Institute Center for Cancer Research.
"My experience here in the CRTP helped launch my career," she said. "It really helped me develop the thought process to formulate research questions and provided the skills to pursue my independent work."
At MD Anderson, Hoffman conducts prostate and breast cancer clinical research. Her time is split with 75 percent devoted to clinical practice and 25 percent to research. She enjoys the interaction with patients this balance allows her, Hoffman said.
Astute Clinician examines genes' role in liver and heart disease
The 13th Annual Astute Clinician Lecture brought a crowd to Masur Auditorium on November 17 with a popular topic—"Genes Versus Fast Foods: Eat, Drink & Be Wary."
Dr. Helen H. Hobbs delivered the lecture established through a gift from the late Dr. Robert W. Miller and his wife Haruko. The Astute Clinician Lectureship honors a US scientist who has observed an unusual occurrence and, by investigating it, has opened an important new avenue of research.
Hobbs is a Howard Hughes Medical Institute investigator, director of the Eugene McDermott Center for Human Growth and Development, and professor of internal medicine and molecular genetics at the University of Texas Southwestern Medical Center. For the past 10 years she has spearheaded the Dallas Heart Study, a large population-based study of Dallas County.
In her lecture—part of the NIH Director's Wednesday Afternoon Lecture Series—Hobbs presented the case study of Morgan Spurlock, the star of the documentary "Supersize Me" that chronicled his experience with a McDonald's-only diet. Spurlock's elevated liver function tests and cholesterol levels after only 12 days of his experiment is indicative of the effect such diet has on many Americans, albeit at a slower rate, Hobbs said.
The elevated liver function tests are most likely due to the development of fatty liver disease, which is associated with both obesity and insulin resistance. However, some diabetics and obese people do not have fatty liver disease, Hobbs said.
"The question that we wanted to address was ‘Are there genetic factors that are responsible for individuals contributing to the propensity to deposit triglyceride in the liver?'" she said.
Hobbs' team also used genetics to examine the relationship between plasma levels of cholesterol and heart disease. Researchers know that high plasma levels of cholesterol promote atherosclerosis [plaque buildup in the arteries], Hobbs said. She presented evidence that low plasma levels of cholesterol, if maintained over a lifetime, provide protection from heart disease.
To hear more of Hobbs' lecture, watch the archived videocast at http://videocast.nih.gov/summary.asp?Live=9532.
Meeting supports advancement in critical care trials
By: Britt Ehrhardt
Clinical Center staff joined other NIH representatives and researchers from around the nation to encourage the best science and exchange ideas on clinical trials in critical care medicine on November 9 and 10.
Approximately 100 researchers attended the third meeting of the U.S. Critical Illness and Injury Trials Group, which vets study ideas, offers networking opportunities, and facilitates large, multi-center trials. This year's meeting at Natcher Conference Center focused on neurologic emergencies. Attendees discussed the key role played by emergency room and ICU staff in treating strokes and other neurologic emergencies, when quick response matters most.
"Meetings like this improve the efficiency of studies," said Dr. Anthony Suffredini, associate chief of the CC Critical Care Medicine Department and member of the meeting organizing committee. "There was a lot of synergy between different groups in the multidisciplinary critical care community who might not otherwise have the opportunity to communicate or collaborate."
Evidence-based changes to standard care—changes that improve the chances of thousands of patients—come from large studies aided by this group and similar networks overseas, Suffredini said. For example, trials supported by this group worked to determine factors that help predict which patients in the emergency room are at high risk for developing severe respiratory failure. This information will allow health care staff to target patients for preventive therapies.
Staff from multiple NIH institutes and centers attended this year's meeting, which was sponsored by the National Institute of General Medical Sciences and the NIH Critical Care and Injury Scientific Interest Group.
Take a bite into a healthy recipe from the Clinical Center executive chef
Clinical Center Executive Chef Robert Hedetniemi prepares fresh weekly specials for patients, including this salmon salad with healthy greens and sunflower seeds. See more of his creations at http://www.cc.nih.gov/scienceexpo/recipes.pdf (293 KB).
Method of Preparation:
Nursing research institute marks 25th year with Grand Rounds
The National Institute of Nursing Research celebrated its 25th anniversary with a special Grand Rounds lecture on November 3. Dr. Mary Kerr, deputy director of NINR introduced the two speakers, both special volunteers for NINR and former intramural research program scientists with the institute.
"NINR doesn't focus on the curing of any disease. We focus on symptom biology and building the scientific foundation for clinical practice, especially related to symptoms that occur with acute and chronic illness and with the end of life," said Kerr.
Dr. Jessica Gill, assistant professor at George Mason University, presented on her research into the resiliency and vulnerability factors for Post-Traumatic Stress Disorder. Her lecture, "Insights into the Role of Inflammation in Post-Traumatic Stress Disorder (PTSD) With and Without Depression," addressed the endocrine and immune function differences between PTSD with and without depression and the associated health risks.
"This program of research is deeply informed by NINR's focus on interdisciplinary research that links clinical and biological methods to look at common problems in a new and novel way," she said.
Dr. Taura Barr, assistant professor at the West Virginia University School of Nursing, presented on her work involving the use of technologies for genomic characterization and treatment of neurological diseases. She discussed the use of gene expression profiling to characterize ischemic stroke and neurological disease in her lecture, "An Inflammatory Profile for Stroke Diagnosis and Outcome Prediction."
CFC sweetens campaign with bake-off
The Clinical Center Combined Federal Campaign (CFC) committee hosted a fundraiser in early November—a bake-off that raised $1,687 for local food banks. The CFC is the annual philanthropy drive conducted by federal employees in the workplace each fall.
Clinical Center departments could submit more than one dessert to sell but enter only one sweet treat for judging. Representatives from the benefiting local food banks were also in attendance to speak with attendees about their services.
Deciding which of the cakes, cookies, pies, and such was the best was: Clinical Center Executive Chef Robert Hedetniemi; Pain and Palliative Care Chief Dr. Ann Berger (who judged aesthetics); Karen Baker, also from Pain and Palliative Care; and CFC keyworker Lakenya Crockett of the Social Work Department.
Taking home first prize was Rita Lapointe of Lab Medicine's white chocolate raspberry cheesecake. Second went to Janey Hoey of the Nutrition Department's carrot muffin, and in third was Bekah Geiger from the Office of the Director's Oreo truffles.
Lecture will examine promise of alternative remedies
The National Center for Complementary and Alternative Medicine presents the second annual Stephen E. Straus Distinguished Lecture in the Science of Complementary and Alternative Medicine on December 15 at 9 am in Lipsett Amphitheater. Dr. Vikas Sukhatme will speak on the "Promise for the Future in Yesterday's Remedies: Traditional Therapies to Modern Medicine."
Sukhatme is the Victor J. Aresty Professor of Medicine at Harvard Medical School and chief academic officer at Beth Israel Deaconess Medical Center. He is also chief of the Division of Interdisciplinary Medicine and Biotechnology in the Department of Medicine at Beth Israel and a member of both the nephrology and hematology-oncology divisions of that department.
Sukhatme's research interest is in tumor metabolism and tumor immunology and on "outside-the-box" approaches to therapies for advanced cancer. Among these is lifestyle manipulation—specifically dietary adjustments and stress reduction—that may show promise in treating certain forms of cancer or in alleviating some of the side effects of current cancer therapies. Similar opportunities lie in generic FDA-approved drugs and nutritional supplements. These therapies share one feature—because there is not enough money to be made on them, there is little incentive for industry to fund their development and to rigorously test them in human studies. Sukhatme will discuss the importance and benefits of studying such "fiscal orphans" and discuss challenges in trying to make these therapies more widely available and accepted.
South Drive entrance closed during construction
South Drive at Old Georgetown Road will be closed for more than a year as construction of the John Edward Porter Neuroscience Research Center (Building 35) is completed. The entrance will service construction vehicles only until completion of the major construction, when it will reopen for employee use.
The entrance at Center Drive at Old Georgetown Road will now be open until 9 pm on weekdays. Please be aware this is near the NIH Fire Department, and emergency vehicles are routinely entering and departing via Center Drive. Do not block the fire lane while waiting for the traffic light to change.
There is no change for employees entering campus as pedestrians or bicyclists on South Drive between Old Georgetown Road and Convent Drive. Hours of operation for visitors entering the West Gateway Center remain unchanged from the existing schedule: Monday to Friday, 6 am to noon.
For an updated map of the NIH campus and complete schedule of the hours of operation for entrances/exits, visit: http://parking.nih.gov/employee_access_map.htm.
Trials recruiting research volunteers
Clinical Center Grand Rounds
Lipsett Amphitheater, 12 noon
December 8, 2010
December 15, 2010
Applications of Pharmacogenomics in Drug Development and Regulatory Review: Recent Relabeling of Drug Products
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This page last reviewed on 04/3/14