The National Institute of Nursing Research of the National Institutes of Health has awarded the School of Nursing a five-year, $585,000 institutional research training grant. The grant, titled "Reducing Health Disparities through Informatics," provides nurses with tuition and stipend support for pre- and post-doctoral training in informatics to improve healthcare for underserved populations using information technology.
The funding focuses on three areas: reduction of health disparities and facilitation of evidence-based practice; improvement of patient safety; and promotion of public safety.
Dr. Suzanne Bakken, Alumni Professor of Nursing in the School of Nursing and professor of medical informatics at P&S, and Dr. Edward H. Shortliffe, professor and chairman of medical informatics at P&S and professor of computer science, are directing the grant.
The new training grant supports informatics training for nurses who are either students at the School of Nursing pursuing a doctor of nursing science (D.N.Sc.) degree or a nurse earning a doctorate in medical informatics through the Department of Medical Informatics at P&S. Students in the new program are required to take courses and conduct research in both the School of Nursing and the Department of Medical Informatics, Dr. Bakken says. Examples of students' current research interests and activities include web-based interventions for underserved populations, decision-making and decision support systems, user interface design, and health care terminologies.
The grant is the third Dr. Bakken and her colleagues have received to bring principles of evidence-based practice and informatics to faculty research and nursing education. A $450,000 grant from the National Institute of Nursing Research in August 2001 provided resources to establish the Center for Evidence-based Practice in the School of Nursing. The other award, for $725,151, came from the U.S. Department of Health and Human Services' Health Resources and Services Administration in July 2001. The grant supports subspecialty education for nurse practitioner students in nursing informatics and integration of informatics competencies throughout the nurse practitioner curriculum.
Characterizing the structures and motions of proteins helps biologists understand how they function in response to the binding of drugs, hormones, and other proteins. For the past decade, Dr. Arthur Palmer, professor of biochemistry and molecular biophysics, and members of his laboratory have developed methods in nuclear magnetic resonance (NMR) spectroscopy for studying motions in proteins with the aim to understand energetics, ligand binding, and protein folding.
Last month, Dr. Palmer gave one of 10 plenary talks at the International Conference on Magnetic Resonance in Biology Systems, the leading conference in the field, summarizing the contributions of his laboratory to the study of proteins in aqueous solutions. Dr. Ann McDermott, professor of chemistry, biological sciences, and chemical engineering/applied chemistry at the Morningside Heights campus, also gave a plenary talk at the conference. She studies enzymes with NMR.
NMR spectroscopy entails putting proteins in a very strong magnetic field, which polarizes the atomic spins. Radiofrequency pulses perturb the state of the spins from equilibrium and the resulting NMR spectra, recorded as the different atomic spins return to equilibrium, contain information on dynamic processes over time scales from picoseconds to milliseconds.
Dr. Palmer presented results from his recent work with the enzyme ribonuclease H derived from organisms that live at normal and high temperatures. Scientists have been interested in understanding how the enzyme functions at higher temperatures without falling apart. Preliminary findings show that the motions in both proteins at room temperature are surprisingly similar. Work at elevated temperature is ongoing. Dr. Palmer also described novel radiofrequency pulse sequences developed by his laboratory for use in these analyses to improve the information available from NMR spectroscopy. As emphasized during the talk, a key component of the research relies on the use of NMR magnets of several different frequencies, ranging from 500 MHz to 800 MHz.
The New York Structural Biology Center provides access to 800 MHz NMR spectrometers for Dr. Palmer and other Columbia University scientists. The new center is located at the City University of New York and was developed by a group of 10 universities, including Columbia, in the metropolitan area.
When sinusitis, an inflammation or infection of the mucous membranes inside the nose and sinuses, becomes resistant to medical treatment, doctors often perform surgery to alleviate the condition. More than 200,000 procedures to enlarge the sinus openings and correct nasal passage defects are done each year in the United States. After the operation, doctors place gauze or a sponge-like packing in the nostrils to control bleeding. But the packing causes significant patient discomfort because it blocks the nasal passage and is painful to remove.
Columbia University Health Sciences researchers now have tested a nasal spraycalled CoStasis, made by Cohesion Technologies of Palo Altoand found it controls bleeding as well as packing and greatly reduces post-surgical pain because packing does not have to be extracted.
The spray solution contains collagen and thrombin, two proteins important for clotting, and the patient's plasma, drawn just before surgery. The thrombin reacts with the plasma to initiate and speed the conversion of fibrinogen to fibrin, another bleeding inhibitor, which mixes with the collagen to inhibit blood flow.
In a study led by Dr. Jeffrey Ahn, assistant professor of otolaryngology and head and neck surgery at P&S and director of facial plastic and reconstructive surgery at Columbia-Presbyterian Medical Center, researchers compared nasal packing with the topical spray in 30 patients after sinus surgery: 15 patients received nasal packing and 15 were given the spray.
One week after surgery all the patients in the nasal packing group reported significantly higher nasal congestion and headache. The mean pain score for the packing group was seven on a scale of zero to 10. But only eight of the spray patients experienced nasal congestion while six reported headache. The mean pain score for the spray group was one. No post-surgical bleeding complications were found in either group.
The researchers have since used the spray on 45 more peopleall of whom reported little or no discomfort. Dr. Ahn plans to evaluate the spray in other types of facial surgery.
The findings, presented at the Sept. 23 annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery, have been submitted for publication to the Otolaryngology-Head and Neck Surgery Journal.