A student movement for health insurance outreach

RING executive board (from left to right): Anna Bausum, Dennis Valerstain, Rana Alsiro, Sehe Han, Nick Goodwin, Riana Kahlon, Dana Sand and Ijeoma Okafor. Photo by Stephanie Chan.

By Kimber Williams, Emory Report

The opening day of enrollment for the nation's new Affordable Care Act (ACA) was more harried than usual for Emory senior Nick Goodwin, who faced a personal checklist that seemed daunting, even to him:

Meet with Grady Memorial Hospital officials to discuss ACA launch logistics. Run back to campus for an exam in "Opium to Obamacare" anthropology class. Swing by apartment, change clothes. Race to Norcross to join regional U.S. Health and Human Services reps at a community forum to field questions about the new ACA.

What Goodwin didn't anticipate was the simultaneous launch of a government shutdown that day as Congress argued over appropriations, effectively furloughing some 800,000 federal employees. Instead of a supporting role, Goodwin was suddenly part of the forum's main event, helping lead the discussion on looming health insurance changes.

And so he did, fielding complicated questions from veterans and stay-at-home parents and full-time workers — the insured, the uninsured and the underinsured.

From the man who paid $500-a-month insurance premiums through his employer, yet still had no coverage for his children, to families denied insurance due to pre-existing diseases, that day, Goodwin stood and answered questions until the crowd was satisfied.

For Goodwin, it was a defining moment — the culmination of a journey kick-started by his own curiosity, a desire to reduce economic disparities among those seeking health care, and the need to make a difference.

But what began as a simple idea snowballed, remarkably, into something much bigger, resulting in the creation of RING (Resource and Insurance Navigator Group), a new organization founded by Goodwin and a team of Emory students to train college-aged volunteers in health care outreach that will include educating the public about new insurance options under the ACA. The goal: Create RING chapters on university campuses throughout Georgia, building a network of young advocates who can help link consumers with information about much-needed basic services — helping shape the changing face of health care, one unexpected step at a time.

Read the full story in Emory Report.

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Support mothers to curb the global rise in chronic diseases

By Carol Clark

After decades of studies showing that the chances of a person having a chronic disease in later life can be determined when they are in the womb, it is time to take stronger action, say researchers from Emory University and the University of Southampton in the current issue of Nature.

Rather than primarily focusing on people’s genes, or on their diets and lifestyles in adulthood, “we need a developmental approach to public health” that better supports girls and young women, they write.

The lead author of the commentary article is the late David Barker. He was a visiting professor at Emory’s Center for the Study of Human Health, a clinical epidemiologist at the University of Southampton in the UK, and a professor of cardiovascular medicine at the Oregon Health and Science University.

Barker, who co-taught undergraduate courses at Emory, including one on predicting lifespan health, and served as an adviser to graduate students, was widely considered to be one of the most important clinical epidemiologists of our time. He died of a cerebral hemorrhage last August at 75, after finishing the first draft of the Nature commentary. The article summarizes his life’s work, while also calling for action.

Barker essentially “invented” a new field of medicine, now known as Development Origins of Health and Disease, says Michelle Lampl, a co-author of the Nature article and director of Emory’s Center for the Study of Human Health.

“He’s responsible for a paradigm shift in medicine through his focus on the science of health in the womb and the early ages,” says Lampl, an anthropologist who focuses on human growth. “The idea that your first cell has a big influence on your later life sounds unbelievable, and he was criticized horribly when he came up with ‘the Barker hypothesis.’ But he opened the door and profoundly changed the way that we think about health and disease.”

The Nature article cites some staggering statistics: Globally, the prevalence of adult-onset diabetes is expected to double by 2030 and cardiovascular disease is expected to rise by about 35 percent.

“More than 30 years of epidemiological studies using data from several hundred thousand people around the world point to factors during prenatal and early childhood development that contribute to these statistics,” the researchers write.

The biology underlying the developmental origins of health and disease has begun to be better understood, and evidence suggests that women need to start eating healthily well before they become pregnant. Women who are obese, and those whose stores of nutrients mean the supply to their growing fetus is less than optimal, risk having babies with a greater likelihood of suffering diabetes, hypertension, cardiovascular disease or cancer in later life.

Watch a video of David Barker speaking to an Emory human health class last spring:


“People working in public health must support girls and young women with low incomes to feel more in control of their lives and so better able to prioritize healthy eating,” the researchers write. “At the same time, better access to quality food is necessary so that it is easier for people to make better choices. This would improve others’ nutrition and thereby the health of future generations.”

The researchers call for personal empowerment activities accompanied by environmental changes that make it easier for women to make better food choices.

They write: “So far, public health advocates have called for regulation and legislation as a means to improve diets — an increased tax on fatty and sugary foods, for instance. Yet this is unlikely to happen because raising the tax on soft drinks, say, is not in the interests of industry, or of politicians, who are sensitive to industry pressures and to a public who want cheap soft drinks.

“Instead of wagging fingers, we need to generate consensus. Empowering consumers to call for better access to better food will put pressure on both politicians to respond to voters, and on the food industry to please their customers.”

Additional co-authors on the paper are psychologist Mary Barker and developmental biologist Tom Fleming, both from the University of Southhampton.

Emory’s Center for the Study of Human Health was founded on Barker’s philosophy of predicting and supporting health, instead of just treating disease, Lampl says. “We will continue to build on this legacy, with our focus on empowering young people to make better personal health choices and preparing them to make the next generation of real breakthroughs in human health.”

Photos by iStockphoto.com.

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Multi-dog study points to canine brain's reward center

 Tigger, a Boston terrier that was one of 13 dogs in the study.

By Carol Clark

After capturing the first brain images of two alert, unrestrained dogs last year, researchers at Emory University have confirmed their methods and results by replicating them in an experiment involving 13 dogs.

The research, published by the Public Library of Science One (PLOS One), showed that most of the dogs had a positive response in the caudate region of the brain when given a hand signal indicating they would receive a food treat, as compared to a different hand signal for “no treat.”

“Our experiment last year was really a proof of concept, demonstrating that dogs could be trained to undergo successful functional Magnetic Resonance Imaging (fMRI),” says the lead researcher Gregory Berns, director of Emory’s Center for Neuropolicy. “Now we’ve shown that the initial study wasn’t a fluke: Canine fMRI is reliable and can be done with minimal stress to the dogs. We have laid the foundation for exploring the neural biology and cognitive processes of man’s best, and oldest, friend.”

Co-authors of the paper include Andrew Brooks, a post-doctoral fellow at the Center for Neuropolicy, and Mark Spivak, a dog trainer and the owner of Comprehensive Pet Therapy.

Both the initial experiment and the more recent one involved training the dogs to acclimatize to an fMRI machine. The task requires dogs to cooperatively enter the small enclosure of the fMRI scanner and remain completely motionless despite the noise and vibration of the machine.

Only those dogs that willingly cooperated were involved in the experiments. The canine subjects were given harmless fMRI brain scans while they watched a human giving hand signals that the dogs had been trained to understand. One signal indicated that the dog would receive a hot dog for a treat. The other hand signal meant that the dog would not receive a hot dog.

Pearl, a golden retriever that was in the recent study, was trained as a companion/assistance dog and is now registered as a therapy dog.

The most recent experiment involved the original two dogs, plus 11 additional ones, of varying breeds. Eight out of the 13 showed the positive caudate response for the hand signal indicating they were going to receive a hot dog.

The caudate sits above the brain stem in mammals and has the highest concentration of dopamine receptors, which are implicated in motivation and pleasure, among other neurological processes.

“We know that in humans, the caudate region is associated with decision-making, motivation and processing emotions,” Berns says.

As a point of reference, the researchers compared the results to a similar experiment Berns had led 10 years previously involving humans, in which the subjects pressed a button when a light appeared, to get a squirt of fruit juice.

Eleven of 17 humans involved in that experiment showed a positive response in the caudate region that was similar to the positive response of the dogs. “Our findings suggest that the caudate region of the canine brain behaves similarly to the caudate of the human brain, under similar circumstances,” Berns says.

Six of the dogs involved in the experiment had been specially bred and trained to assist disabled people as companion animals, and two of the dogs (including one of the service dogs) had worked as therapy dogs, used to help alleviate stress in people in hospitals or nursing homes. All of the service/therapy dogs showed a greater level of positive caudate activation for the hot dog signal, compared to the other dogs.

“We don’t know if the service dogs and therapy dogs showed this difference because of genetics, or because of the environment in which they were raised, but we hope to find out in future experiments,” Berns says. “This may be the first hint of how the brains of dogs with different temperaments and personalities differ.”

He adds: “I don’t think it was because they liked hot dogs more. I saw no evidence of that. None of the dogs turned down the hot dogs.”

One limitation of the experiments is the small number of subjects and the selectivity of the dogs involved, since only certain dogs can be trained to do the experiments, Berns says.

 Caylin, a border collie that was one of the study subjects.

“We’re expanding our cohort to include more dogs and more breeds,” Berns says. “As the dogs get more accustomed to the process, we can conduct more complicated experiments.”

Plans call for comparing how the canine brain responds to hand signals coming from the dog’s owner, a stranger and a computer. Another experiment already under way is looking at the neural response of dogs when they are exposed to scents of people and other dogs from their households, compared to the scents of unfamiliar people and dogs.

“Ultimately, our goal is to map out canine cognitive processes,” says Berns, who recently published a book entitled “How Dogs Love Us: A Neuroscientist and His Adopted Dog Decode the Canine Brain.”

Even in an increasingly technical era, the role of dogs has not diminished, Berns says. In addition to being popular pets, he notes that dogs are important in the U.S. military, in search-and-rescue missions, as assistants for the disabled and as therapeutic stress relievers for hospital patients and others.

“Dogs have been a part of human society for longer than any other animal,” Berns says. He cites a genetic analysis recently published in Science suggesting that the domestication of dogs goes back 18,000 to 32,000 years, preceding the development of agriculture some 10,000 years ago.

“Most neuroscience studies on animals are conducted to serve as models for human disease and brain functions,” Berns says. “We’re not studying canine cognition to serve as a model for humans, but what we learn about the dog brain may also help us understand more about how our own brains evolved.”

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What sea squirts can teach us about brains

Bluebell tunicates are bottle-shaped sea squirts. Photo by Nick Hobgood/Wikipedia Commons.

John Onians, a professor emeritus of art studies from the University of East Anglia in England, recently spoke at Emory about the links between neuroscience and art history. His eclectic talk also included a reference to sea squirts, which was highlighted in "ThoughtWork," the newsletter of the Academic Exchange:

"Why do we have a brain? I didn't know this previously: The reason we have a brain is because like all other organisms from amoebas to elephants, we need to move in order to reproduce and get food. A plant can reproduce and get food without moving. That's why plants don't have brains. This is illustrated by this marvelous creature the sea squirt. The sea squirt swims around the ocean until it's found a place where it can settle, and then when it settles it attaches itself and then it proceeds to consume its own brain because it no longer needs it, which is often unflatteringly compared to a professor that gets tenure. It is important to remember that the brain is there to help us move in order to get things which are of vital importance to us. The brain isn't primarily consumed with knowledge, the sort of things we were taught about. That was just an idea that the Greeks had because it was a good way of getting young men to forget their emotions. But really everything we do is driven by our emotional needs."

Click here to keep track of more interesting talks sponsored by the Center for Mind, Brain and Culture.

Environmental Sciences: A new name and master's program

Caroline Schwaner, a senior majoring in environmental sciences, tests the water quality of a stream in Madagascar, where she spent last summer conducting research. Photo by Carol Clark.

By Carol Clark

Emory’s Department of Environmental Studies has a new name, the Department of Environmental Sciences, and a new master’s level degree program through the Laney Graduate School, which will start in the fall of 2014.

“We’re not changing our direction with the new name. We’re reaffirming it,” says Uriel Kitron, who has chaired the department since he arrived at Emory in 2008.

“We felt that ‘Environmental Studies’ did not really convey our strong orientation toward research,” he explains. “The majority of our 11 faculty are focused on the natural and health sciences. We also have a few faculty involved in the social sciences, and we plan to increase their number. ‘Environmental Sciences’ encompasses the full range of what we do.”

The department’s emphasis on research gives students many chances to become involved in analysis, lab and field-work early on, Kitron says. The department has projects based in Atlanta and throughout the world.

Another hallmark of the department is extensive collaborations that cut across the University, from public health to business, law, anthropology, biology and other specialties throughout Emory College. The adjacent Centers for Disease Control and Prevention further raises the collaboration quotient and opportunities for research experience.

Caroline Schwaner uses rapid detection tests in the field in Madagascar to screen fecal samples for adenoviruses and rotavirus. Photo by Carol Clark.

The Environmental Sciences masters program (ENVS MS) is being launched due to student demand, Kitron says. Major challenges facing society, including a burgeoning human population, dwindling resources, the growing need for renewable energy and climate change, have heightened interest in the environmental sciences.

“Our masters program will train the next generation of professionals to address the complex interactions between people and their environment, with a goal of advancing ecosystem health, sustainable global development and conservation,” Kitron says.

The program will emphasize research experience and the development of quantitative skills, and will require a thesis. The curriculum will be grounded in the social-ecological systems framework created by Elinor Ostrom. In 2009, Ostrom became the first woman to win the Nobel Prize in Economics for her work “showing how common resources, such as forests, fisheries, oil fields or grazing lands, can be managed successfully by the people who use them, rather than by governments or private companies.”

In addition to drawing from resources of Emory College and Laney Graduate School, the ENVS MS will also tap the support of Emory Law, Rollins School of Public Health and Goizueta Business School.

The program will accept applications from environmental sciences majors in the spring of 2014, which will allow students to complete a BS in environmental sciences and an MS degree in five years, plus one summer to conduct research. By the fall of 2015, the ENVS MS program will open for students with a bachelor degree interested in a stand-alone, two-year ENVS MS degree.

The new program complements the existing programs of the ENVS BS/MPH and the joint ENVS/BBA Concentration in Environment and Sustainability Management.