Clinical Research Oriented Workshop (CROW) Meeting: October 24, 2013

Present:  Marianne Burke, Kat Cheung, Abby Crocker, Kairn Kelley, Ben Littenberg, Connie van Eeghen

Guest:     Kathleen Bryant, NP from Associates in Pediatrics

Start Up: Welcome to Kathleen B., who is working on a poster presentation and interested in our research group. 

1.                  Discussion: Marianne – Literature review results based on a query re: adolescents and opioids/analgesic with 172 matched publications (PubMed), plus a GoogleScholar search, and an Ovid search with 19 matches. 

a.       The literature can be divided into 2 overlapping groups: prescribing of opioids and use/misuse of opioids (both related to adolescents).  NAMCS (National Ambulatory Medical Care Survey) includes prescribing data but might not include the reason for prescribing (e.g. “palpitations due to opioid use). Articles reviewed that were of future interest to the group:

                                                  i.      Han, H on the rate of dose escalation in long term opioid therapy

                                                ii.      Lankenau, 2012, on prescription opioids and their misuse

                                              iii.      McCabe, 2013, nonmedical users of prescription opioids who used leftover medications form their own previous prescriptions

                                              iv.      McCabe, 2011, Medical misuse of controlled medications (possibly used YRBS)

                                                v.      McCabe, 2012, medical and nonmedical use of prescription opioids among high school seniors (same study as before, different target populations)

                                              vi.      Meier, 2012, Extramedical use of prescription pain relievers (National Survey on Drug Use and Health) (Michigan State University)

                                            vii.      Osgood, 2012, Oxycodone abuse patterns in adolescents

                                          viii.      Platts-Mills, 2012, age discrimination and pain medication in emergency departments (National Hospital Ambulatory Medical Care Survey)

                                              ix.      Shield, 2013, Use of prescription opioid analgesic – prevalence study from pharmacy data set, Canadian data set

                                                x.      Sjogren, 2010, population-based cohort study on chronic pain: the role of opioids – Danish health interview survey

                                              xi.      Vogel, 2011, prolonged use of benzos associated with childhood trauma in opioid maintained patients

b.      Also, the Ovid search produced another 300 studies based on the criteria used for the above list

2.                  Discussion: Abby – NAMCS data exploration, supported by the CDC. 

a.       Abby briefly reported on what can be found in this data source:

                                                  i.      Focus on prescriptions, including new and continued prescriptions

                                                ii.      Proportion of visits that include a anew or continued prescription

                                              iii.      Three new years for analysis: 2008-2010; cross-sectional study only

                                              iv.      Use of drugs based on standard of care, e.g. long term use of Percocet

b.      Summary: characteristics of continued versus new prescriptions in adolescents with covariates

c.       Two strategies for moving forward:

                                                  i.      Brief descriptive statistics on the above characteristics (Abby).  Describe prescriptions in data base and the covariates in the data base (may want to learn more about what is available in the data set before deciding).  Consider reviewing covariates for further study at later CROW session.

                                                ii.      Follow up on literature search to condense and focus (Marianne)

d.      Also consider a comparison study of changes in prescription patterns; as well as changes in the environment of regulation and evidence that may have affected prescription patterns.

3.                  Next Workshop Meeting(s): Thursdays, 11:45 a.m. – 1:15 p.m., at Given Courtyard South Level 4.   

a.       October 24: Abby review of NAMCS data source and Marianne – results from literature review

b.      October 31: Kat Cheung  

c.       November 7: Rodger Kessler

d.      November 14: Abby: cracking open the prescribing data base

e.       Future agenda to consider:

                                                  i.      Peter Callas or other faculty on multi-level modeling

                                                ii.      Charlie MacLean: demonstration of Tableau; or Rodger’s examples of Prezi

                                              iii.      Journal article: Gomes, 2013, Opioid Dose and MVA in Canada (Charlie)

                                              iv.      Ben: Tukey chapter reading assignments, or other book of general interest

Recorder: Connie van Eeghen

Many congratulations to Ahmed Abdeen Hamed, PhD candidate in Computer Science and Research Assistant in General Internal Medicine Research, for his recognition at the College of Medicine's Graduate Student Research Day. His work on using social networks to recruit candidates for clinical research was awarded 3rd Place in the Best Oral Presentation category.

Cholera History and UVM Research Presented in Dana Library Exhibit through December

Cholera History and UVM Research Presented in Dana Library Exhibit through December

Cholera epidemics have scourged human kind for centuries of recorded history.   “Cholera: Man versus Microbe”, an exhibit currently on display in the Dana Library presents, the horror, the science, and the hope for eradication of this disease.
 The exhibit opens with bleak images depicting the emergence of cholera in 19^th century Europe. A chronology of the discovery of the causative agent, vibrio cholera, follows with the contributions of the major researchers including Pacini, Snow, and Koch described.  A diagram shows how the cholera bacterium and its deadly toxin affect its human hosts and the panel notes the proven public health, rehydration, and vaccine therapies that reduce mortality when applied. The exhibit's final panel with images of cholera in the 21^st century, and the contributions a group of UVM researchers in the Cholera Vaccine Study Group (Caroline Lyon and Beth Kirkpatrick are co-PIs )  are making to combat this devastating disease.

Bibliographies of historical and contemporary articles about cholera supplement the exhibit, as do relevant materials from the Dana Library collection. Of particular interest are reprints of original articles by John Snow.

The exhibit coincides with the 2013 UVM First Year required reading, the Ghost Map: the story of London's most terrifying epidemic--and how it changed science, cities, and the modern world by Steven Johnson. The epidemic described in the book is cholera; the impact is the advancement of urban public health through the research of John Snow.

Library Associate Professor Frances Delwiche MLIS of Dana Library is the exhibit curator. She was   assisted by members of the Vaccine Testing Center’s Cholera Vaccine Study group/Beth Kirkpatrick lab.

The exhibit will continue through December 20.  A reception to highlight the exhibit and UVM cholera research will be held in October 24, at 2:30 pm.

Research to discover cholera’s  microbial  cause,  how it is transmitted, and how to successfully treat it in individuals and populations has been a translational science journey which continues today. All CTS students and faculty are invited to visit the exhibit at Dana Library any day between now and Dec. 20, and  to come to the reception on October 24.