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ADVANCE Discourse: Lab

Struck a Nerve
October 15, 2014 10:45 AM by Lynn

All of the phlebotomists are probably cringing at the term I used in the headline, but it seems germane considering the overwhelming number of comments the ADVANCE editorial staff has received since the launch of our 2014 Salary Survey.  (If you haven’t yet completed the survey, time is running out! Go to http://laboratory-manager.advanceweb.com/Web-Extras/Online-Extras/The-2014-Laboratory-Salary-Survey.aspx)

Although we haven’t yet tabulated or released results, I am saddened by many of the comments. In past surveys, many noted they felt the pay was not on par with the amount of responsibility and level of importance that clinical laboratory professionals of all levels have, and this year’s survey is no exception. What is different, however, is the number of individuals who noted they would not recommend the profession to others, or who wouldn’t have gone into the profession had they known what they know now.

“Techs are underpaid, overworked and underappreciated, and yet we are expected to be experts in all areas of lab medicine, serve as consultants, perform administrative work, train new hires, conduct competency assessment, etc. Although I love my work, if I had it to do all over again, I wouldn't choose laboratory technology. Unfortunately, for all of the above mentioned reasons I cannot recommend the profession to young people,” writes one person.

And another notes: “I enjoy my job as a medical technologist, but I am planning to leave the field within the next few years. This is due to the fact that I have a high level of responsibility (antibody ID and selecting compatible units for patients) but still make less than an RN with a A.S. degree. We are also understaffed at my facility, with me being the only Blood Bank technologist on the nightshift. The position has become highly stressful and completely underappreciated in the healthcare setting. I am finishing my Masters of Science, then moving to a job that is less stressful and better paid.”

There are still a handful of you who do enjoy the work you do (thank you for those comments, too!), but it seems you are in the minority. So how do we change this? How can this profession rally together to positively change the perception and financial compensation for the critical role you play in healthcare?

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Ebola at Home
October 1, 2014 4:26 PM by Michael Jones

Ebola is a subject that’s been on everyone’s minds for weeks and, as such, has received a lot of media attention. I’ve covered the Zaire Ebolavirus before and even discussed the heroism of those responsible for treating victims and disposing of the bodies, but the situation in West Africa has recently expanded to the US. An article from the New York Times detailed the journey of a man who took a trip to visit family and ended up in isolation at a Texas hospital, as well as the precautions being taken both by the facility and the US government. 

“We have had a plan in place for some time now for a patient presenting with possible Ebola,” explained Edward Goodman, MD, an epidemiologist at Texas Health Presbyterian Hospital in Dallas, Tx., where the unidentified patient is currently being treated. “Ironically, we had a meeting the week before of all the stakeholders who might be involved. We were well prepared to care for this patient. ”

Passengers attempting to board a plane out of areas of West Africa are being screened for Ebola symptoms prior to take off, but as his symptoms hadn’t yet presented, the infected passenger was able to board his flight to visit family in the US. After a few days, he started to get sick, sought medical attention and was treated. According to the NY Times article, however, the early symptoms of the disease like fever and nausea can be easily mistaken for any number of diseases – even despite the heightened alert concerning patients with recent travel histories in Guinea, Liberia or Sierra Leone.

After his symptoms started to worsen, the passenger went to the hospital and was put in isolation while they awaited his test results, which came back positive for Ebola. His family, as well as anyone he came into contact with during the infectious period of his stay, has also been brought into isolation. This is the first instance of Ebola in the US and the first time it’s been diagnosed outside of West Africa. Upon confirming the test, the CDC sent out a team to handle the situation in Texas while the Obama administration began a massive social media campaign to calm and educate the public.

“You cannot get Ebola through the air, water or food in the US,” said a post on the White House’s official Twitter account according to the NY Times article. “Ebola can only spread from contact with the blood or body of fluids of a person or animal who is sick with or has died from the disease.”

The appearance of the disease in the US is unprecedented, but healthcare facilities not unprepared. The NY Times article noted, “Many health experts said it would only be a matter of time before it reached the United States,” and there has been a lot of preparation across the country for such an event. Additionally, the isolation protocols established by the CDC were described in the article, in the words of Thomas R Frieden, MD, MPH, CDC director, as “tried and true.” He went on, commenting, “I have no doubt that we’ll stop this in its tracks in the [US].”

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The Big Squeeze
September 11, 2014 9:40 AM by Michael Jones

It’s no big secret that clinical laboratories have been subjected a series of strict budget and reimbursement cuts over the past few years. Rather than easing in the coming year, these cuts are predicted to remain equally rigid, if not more so. A recent news briefing from Dark Daily pointed out the unprecedented nature of cost-cutting measures in laboratories across the United States compared to any other time in recent history.

“Labs today face a stark reality: not only are they getting less money today from their parent organizations and health insurance plans, but they are entering a multi-year period that will see equally dramatic reductions in lab test reimbursement and lab revenue,” commented Robert Michel, editor-in-chief of the Dark Daily Report and Dark Daily.

Specifically, the release noted that the current fiscal situation in clinical laboratory is harsher than it has been in the last 25 years, and there’s no end in sight. For healthcare facilities facing reduced funding, the Dark Daily story also discussed the impact and importance of implementing methods like LEAN, Six Sigma and “process improvement methods with consistent success.” According to the article, laboratories that utilize these approaches tend to remain successful despite the new restrictions.

“Two big challenges confront the nation’s clinical laboratories and pathology groups,” continued Michel. “One is the need to cut costs aggressively in the face of shrinking lab budgets and failing lab revenue. The second is how to increase the value of lab testing services the lab delivers to physicians, patients, payers.”

These cuts are certainly not new and are predicted to continue. As healthcare facilities stretch both funds and personnel to cover for the increased financial pressure to continue providing the same level of care -- essentially doing more with less – managers and administrators who can roll with the punches on cost-cutting measures to adapt are going to be the most successful. Similarly, medical personnel are increasingly well-versed in multiple areas of the laboratory. 

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Unsung Heroes
August 29, 2014 1:53 PM by Michael Jones

I’ve discussed the spread of the Zaire ebolavirus before, but as it continues to overwhelm countries in West Africa, scientists have been able to track the virus in real time. A recent article from NPR followed a team of researchers as they collected and analyzed data on the genetic structure of the virus from its victims in Sierra Leone. As the researchers monitored the ebola spread, they noticed that it was rapidly mutating, “about twice as quickly as it did while circulating among animals in the past decade or so.”

The data was collected onsite as soon as possible and, according to the article, resulted in the death of five scientists who contracted the virus. Despite this, the tremendous effort led to the gathering of 99 ebola genomes for analysis. While the virus’ genome contains only seven genes (relatively small in comparison to the human genome’s 20,000), the article noted that the researchers have already, “found over 250 mutations that are changing in real time as we’re watching” -- a figure with significant implications for current treatments, which are experimental and rely on the known genetic makeup of the virus.

Meanwhile, men and women serving in healthcare facilities, clinics or in collaboration with Doctors Without Borders are consistently putting themselves at risk for the dangerous infection. These are nurses, doctors and laboratorians alike -- both local and international. One particularly brave group of workers heroes was highlighted in another NPR story, which followed the people responsible for collecting and disposing of the bodies of ebola victims in Liberia.

According to the story, the virus has already been responsible for 700 deaths and over 1,300 cases. The corpses remain highly contagious and can add to the already devastating rate of infection in Monrovia. These crews of “body collectors” must gather the bodies to dispose of them safely -- a task that carries unbelievable risks -- and prevent the further spread of the virus. In order to prepare, each collector wears protective gear, including surgical scrubs, rubber boots, white plastic jumpsuits, face masks and goggles -- and they all pray for luck together before getting started.

Whether it’s the scientists working to analyze the virus in the search for a cure or the hands-on professionals working with ebola on a day-to-day basis, their role is crucial. They are all unsung heroes. 

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Bears and 'Betes
August 14, 2014 3:47 PM by Michael Jones

Lately, I find myself becoming a little jealous of bears. That’s right, bears – but not for the reasons you might think. Sure, it’d be great to hang out in creeks during the summer months, eating nothing but fresh salmon and berries all day, every day. I guess it’d also be pretty fantastic to be able to hibernate and sleep away the winter too, but a recent blog post from NPR discussed some surprising physiological advantages of bears -- specifically in terms of their body’s response to their diet.

According to NPR blog, “Grizzly bears can easily double their body fat in the months leading up to hibernation.” This kind of rapid weight gain in humans can lead to any number of dangerous conditions, but the post highlighted the development of insulin resistance leading to the occurrence of type 2 diabetes. Insulin resistance occurs when the body is forced to “produce more and more insulin to control blood sugar,” turning it into fat. Eventually, the body becomes resistant. Type 2 diabetes is the result of the pancreas shutting down insulin production as a result.

So, why doesn’t this happen to grizzlies? In the blog post, a research team from Amgen Inc., led by Kevin Corbit, PhD, discovered that the bears become more and less sensitive to insulin before, during and after periods of hibernation. Kara Manke, the NPR blogger, wrote, “assuming that, like humans, bears became less sensitive to insulin when they gained weight,” the researchers subjected each of the six bears being monitored to a relatively small (human) dose of insulin just before they were supposed to enter hibernation. The results were almost catastrophic.

As it turns out, unlike humans, “the bears were actually most sensitive to insulin just before hibernation, when they were at their largest.” So, the insulin nearly killed them due to overdose. The researchers then hypothesized on the changing nature of the bears’ insulin resistance. In the article, Corbit noted that figuring out what allows the bears to regulate their insulin sensitivity could also benefit people. The impact of this could have enormous potential for patients with type 2 diabetes.

“I think giving insulin is making people much sicker,” said Corbit in the NPR blog. “I’m hoping that whatever we find is going to ramp up the insulin sensitivity enough that we don’t have to supplement with insulin at all.”

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The Zaire ebolavirus
August 6, 2014 2:54 PM by Michael Jones

The Zaire ebolavirus and the increasingly dire situation in West Africa have been all over the news in recent weeks. Airports and hospitals in the United States are on high alert for suspicious cases coming out of the region to prevent the potential spread into a new country. According to a recent Perspective article from the New England Journal of Medicine (NEJM), there are five known species of ebolavirus. Each of the African strains vary in severity, with the risk of fatality ranging from 40 percent to 70-90 percent (as is currently the case with the Zaire ebolavirus) in the African strains.

“There is currently no licensed prophylaxis or treatment for any ebolavirus or marburgvirus infection; therefore, treatment is merely supportive,” wrote Heinz Feldmann, MD, in the NEJM article.  

In discussing the treatment of the Zaire ebolavirus, Feldmann pointed out several promising options being considered, including antibody treatment, modulatory RNA, the introduction of a synthetic molecule called BCX4430 and recombinant technology-based vaccines. With no confirmed treatment available yet, however, the primary focus has been on diagnostics for surveillance and confirmatory testing. Antigen detection for more immediate diagnosis, antibody detection for confirmatory results and molecular techniques like reverse-transcriptase-PCR allow health and safety professionals to get control of a potentially dangerous situation quickly. Like many other outbreak scenarios, Feldmann also noted the importance of real-time information sharing for public health.   

 “The latest outbreak of Zaire ebolavirus in West Africa has shown the limited ability of our public health systems to respond to rare, highly virulent communicable diseases,” continued Feldmann in the article. “The medical and public health sectors urgently need to improve education and vigilance.”

The article went on to discuss the importance of rapid diagnostic capabilities, “so that local public health systems do not have to rely on distant reference laboratories.” In order to prepare before the occurrence of any future outbreaks, Feldmann concluded that the need to approve a treatment method is vital to “practice cutting-edge medicine, rather than simply outbreak control.” 

 

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Smart Contacts
July 24, 2014 5:04 PM by Michael Jones

We’ve discussed mobile medicine and hand-held technology before, but a recent partnership between drug manufacturer Novartis and internet juggernaut Google takes the theory to a whole new level. The two companies announced their collaboration to develop a smart contact lens to monitor blood sugar. Apart from the obvious implications of a “smart” piece of technology as small as a contact lens, the impact of results and information available “almost in real-time” could change the way diabetic patients monitor their blood sugar.

“It’s not going to happen overnight,” said Joe Jimenez, CEO at Novartis, in the New York Times article. “This will take a few years, as opposed to a few months.”

As a manufacturer, Novartis would understand the challenges of the development process better than most. The company had unsuccessfully attempted to produce glucose-monitoring contacts before. The new smart lens, based on Google’s prototype, utilizes “miniature sensors and a radio antenna thinner than a human hair to track glucose levels.” Additionally, Jimenez pointed out that the partnership with Google gave the project the technological step-ahead it needed in order to develop a more effective prototype.

“One of the biggest hurdles was miniaturization, and that’s one of the biggest benefits that Google X brings,” he continued. “This is a set of engineers that are really doing incredible things with technology.”

While the “smart” contact lenses remain in early stages of development, they represent a trend in healthcare towards personalized medicine and interactive testing. According to the NY Times story, as the general population continues to have a greater understand and, subsequently, take more control over their health, the healthcare and pharmaceutical industries are seeing an increased demand for improved medical technology. As of this year, both Apple and Samsung also offer individual health-monitoring technologies. 

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ACLA Comments to CMS
July 14, 2014 2:40 PM by Kerri Penno

In public comments presented to the CMS today, the American Clinical Laboratory Association (ACLA) provided input on various aspects of implementing relevant provisions of the Protecting Access to Medicare Act of 2014 ("PAMA"), which modifies the Medicare reimbursement rate methodology for lab services. 

"ACLA supports a measured and thoughtful analysis as well as robust stakeholder engagement in order to guarantee the new fee schedule continues to ensure adequate access to lab services for Medicare beneficiaries," said Alan Mertz, ACLA president.

ACLA's comments primarily focus on the need for CMS to develop or clarify definitions of several key terms, determine when private payor rates must be reported and for what timeframe, build a technology platform capable of accepting millions of discrete pieces of data, and establish coding processes for certain new tests.

A key definition identified by ACLA in its comments was "applicable laboratory" and ensuring that this encompasses the true private market. ACLA pointed out that the text of the statute, as well as Congress' intent, reflects that all major sectors of the laboratory market should be represented in reporting private payor rates, including independent laboratories and hospital outreach laboratories.

The way in which CMS defines the parameters, participants, methods, and timeframes for lab services payment rate and volume reporting, ACLA notes, will have a substantial impact on the rates that the Medicare program pays for clinical laboratory tests. It also has the potential to impact other payors' rates, as many private payors and state Medicaid programs base their reimbursement levels on Medicare rates. ACLA asserts that Medicare rates for lab services are best determined when payment and volume data reflect true market rates for clinical lab testing.

"Modifying the Medicare payment system for clinical laboratory services is a complex undertaking and ACLA is committed to ensuring the end result works for clinical labs, CMS, and Medicare beneficiaries," said Mertz. "Decisions made during this process will have a major impact on the clinical laboratory industry and the patients we serve, and it is important that those decisions work to promote ongoing diagnostic innovations and protect access to critical lab testing for Medicare beneficiaries."

To view ACLA's comments in their entirety, click here.

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A Pivotal First Step
July 10, 2014 3:01 PM by Michael Jones

Researchers from the Icahn School of Medicine at Mount Sinai and Harvard Medical School recently discovered a connection between a form of liver cancer and two mutations in the IDH gene. Intrahepatic cholangiocarinoma (iCCA) is the second most common form of liver cancer. Although there had previously been evidence of IDH mutations in patients with iCCA, this study marks the first time the exact genes, IDH1 and IDH2, have been targeted and identified specifically as a direct link. An story from Newswise detailed the study and subsequent findings.

“Our findings provide novel insights into the development of iCCA and offers a possible treatment option for patients suffering from this fatal disease,” said Josep Maria Llovet, MD, director of the liver cancer program at Mount Sinai’s Icahn School of Medicine, in the article.

The study demonstrated the effect of mutated IDH genes using mice, showing a decrease in the liver’s ability to health itself and an increase in “the number of cells to form a tumor. The gene mutations also resulted in a relationship with the KRAS gene, which is known to be linked to the development of cancer. The combination of these factors leads to formations of malignant legions in a liver with weakened defenses and, eventually, iCCA. According to the story, targeting IDH1 and IDH2 as pathways for iCCA has already resulted in new clinical trials to determine their impact on iCCA patients.

“iCCA is resistant to standard treatments like chemotherapy and radiation,” explained Llovet. “Understanding the molecular mechanism of the disease is the key to finding a treatment that works.”

Although the article pointed out, “there is no first-line, standard of care and no successful therapies” for patients with iCCA, the study has provided a necessary first step in the development of a treatment for the disease. The discovery has opened the door for further investigation into a relatively mysterious cancer and could potentially lead not only towards a broader understanding, but also a successful therapy. 

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Supercomputing and Big Data
June 18, 2014 11:30 AM by Michael Jones

The emergence of whole genome sequencing has certainly had an impact on both scientific research and clinical medicine, but there are still a few remaining hurdles preventing widespread use of the technology. While the ability to interpret the raw data provided by genetic testing relies on the computing power of laboratory instruments, few laboratories have the analytical equipment capable of that kind of speed. A recent news briefing from Dark Daily noted on recent study in which researchers at the University of Chicago, using software available to the public, successfully incorporated the “Beagle” Cray XE6 supercomputer in their genetic testing.

“Whole genome analysis requires the alignment and comparison of raw sequence data,” said Elizabeth McNally, MD, PHD, professor of medicine and human genetics and director of the cardiovascular genetics clinic at the University of Chicago’s School of Medicine, in the Dark Daily briefing. “[This] results in a computational bottleneck because of the limited ability to analyze multiple genomes simultaneously.”

According to the release, the research team was able to analyze 240 whole genomes simultaneously. Using the “Beagle,” for their study, titled “Supercomputing for the parallelization of whole genome analysis,” they looked at sequencing information from 61 patients -- which took less than 50 hours and only 25 percent of its total capacity. To put this into perspective, the Dark Daily briefing pointed out that, for a 2.1 GHz CPU, it would take “roughly 47 years to analyze the same data.” Because of this, most current laboratory practices simply analyze the human exome, which is comprised of only about 2 percent of the human genome responsible for protein coding. Although the briefing noted that this is considered to be the basis of 85 percent of “disease-causing mutations,” the ideal method for research would include the whole genome -- an approach that isn’t currently feasible for consistent use.

“By paying close attention to family members with genes that place then[m] at increased risk, but who do not yet show signs of disease, we can investigate early phases of the disorder,” continued McNally. “In this setting, each patient is a big-data problem.”

New screening technologies are continuing to improve the accuracy of testing technologies, but the laboratory’s ability to breakdown and investigate the results of those tests quickly and accurately is every bit as important. By successfully utilizing the “Beagle” supercomputer in the analysis of raw genetic data, the researchers at the University of Chicago have opened the door to improved options for understanding sequenced information. The potential of quicker interpretation capabilities in whole genome sequencing could lead to more standard genetic tests with faster turnaround times and, subsequently, a more cost-effective laboratory model. 

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"Neglected Variable"
June 11, 2014 10:47 AM by Michael Jones

A mouse is a mouse is a mouse is a mouse – or so the research community had thought. As it turns out, a major component has been missing from the majority of animal testing for clinical drug production: more female animals. In a recent article from the New York Times, experts in the field discussed the importance of incorporating more female subjects into clinical testing and the subsequent impacts of current, male-dominated models on women in terms of side-effects after production.

“One of the underlying assumptions has been that females are simply a variation on a theme, that it isn’t a fundamentally different mechanism, that if you’ve learned about the male you’ve learned enough to with both males and females,” said Jill Becker, PhD, a senior research scientist at the University of Michigan, in the article. “We’ve discovered that’s not always the case.”

The use of male animals as the primary subjects in clinical testing has resulted in some particularly harsh and often serious consequences for women once a drug has already been in production due to different physiological responses to a variety of treatments. An example of this is the FDA’s recent warning for women to cut Ambien pills in half because the female metabolic process in slower in processing the active ingredient. According to the NY Times Piece, the NIH has new policies regarding male and female testing scheduled to be introduced in October, with exceptions most likely to be made for gender-specific ailments like prostate and ovarian cancers.

“Every cell has a sex,” explained Janine A. Clayton, MD, director of the NIH office of research on women’s health, in the story. “Each cell is either male or female, and that genetic difference results in different biochemical processes within those cells.”

The article also predicted some resistance among scientists in the research community due to additional strains the new regulations might place on experiments as the inclusion of animals of both sexes could potentially double the number of subjects needed to deliver the necessary results. Additionally, the article noted scientists' concerns regarding the need for more extensive calculations made to factor in changes in hormones and the reproductive cycle. On the other hand, the long-term decrease in serious, potentially harmful side effects of drugs incorrectly calibrated for women stands to drastically improve the effectiveness of clinical medications.  

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The Genetic ABC’s
May 16, 2014 2:00 PM by Michael Jones

Imagine adding letters to the alphabet. Suddenly after centuries of working with 26 letters, there are just whole new possibilities for different words and phrases that had never been explored before. How would we use the new letters? As it turns out, research scientists at the Scripps Research institute in La Jolla, CA have been asking themselves the same question, but with a very different alphabet. According a recent article from NPR, Floyd Romesberg, PhD, along with the rest of the researchers in the department of chemistry, managed to introduce two new letters to the genetic alphabet.

“This is the first time that people have integrated a truly synthetic, manmade thing into the machinery -- in this case the most fundamental aspect of the machinery, the DNA -- and used it do something that system does, in this case store information,” said Romesberg in the NPR story. “And obviously we can now store more information than we could before

Romesberg and the research team created two synthetic letters in addition to A, C, T and G (adenine, cytosine, thymine, and guanine). Not only were the new codes successfully introduced into the DNA of a strain of E. coli, but they were duplicated as the cells multiplied, implying that the codes could be passed down. Of course, the findings remain in the preliminary stages of testing, but the prospect of new genetic combinations is especially exciting in terms of its impact down the road.

“Maybe you get three consonants and one vowel. Maybe there are some words you can write and you can string them together to make, sort of, primitive stories,” continued Romesberg. “But if you could have a couple extra letters, there’s more that you could write. Having the ability to store increased information would allow you to write more interesting words, bigger words, more complicated words, more nuanced words, better stories.”

While the team’s goal was simply to create fully integrated coding for the storage of genetic information, the new letters were intentionally left unreadable to the cells. According to the article, the next step for researchers will be to use the manmade letters to “use it to do something that a cell wouldn’t normally do -- like make a new kind of protein.” Along with the potential for a more advanced ability to engineer functions at the genetics level, the research could also provide additional insight on biology and even “how life got started in the first place.” 

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Crosstalk
May 2, 2014 1:13 PM by Michael Jones

It’s pretty widely agreed that stress can be unhealthy. Whether it comes down to high blood pressure, muscle tension or simply having trouble sleeping, the physical implications of stress can have physical implications on an otherwise healthy lifestyle. In a recent press release from Stem Cells Translational Magazine, researchers from both the UC-Davis Institute for Regenerative Cures and California State University examined the impact of stress in the healing process for chronic injuries and afflictions in a study led by Roslyn Isseroff, MD, and Mohan R. Dasu, PhD.

“The precise process that prevents their healing is unclear except for two constants: a prolonged inflammatory response and the bacterial colonization of the wound bed,” said Isseroff. “These two interrelated factors are thought to contribute to the wound’s chronic state.”

According to the release, the presence of a protein called epinephrine (adrenaline) functions to start the process of healing by increasing activity to TLR2. This allows inflation to occur and, as a result, promotes healing. The presence of bacteria, however, can cause “crosstalk,” disrupting the signals to epinephrine. In their study, the research team examined how increased epinephrine and TLR2 as a result of elevated stress levels could impact the stem cells and keratinocytes altered to help heal the wound, and found that the crosstalk produced by the increase led to the impaired healing of the injury.

“These findings have implications for understanding the mechanism controlling the differing susceptibility to infections and immune/inflammatory-related conditions in wounds,” commented Anthony Atala, MD, director of the Wake forest Institute for Regenerative Medicine and editor of Stem Cells Translational Medicine, in the release.

It’s important to remember to take a deep breath and relax sometimes, otherwise those annoying injuries that just won’t seem to go away might end up sticking around even longer. Not only is stress a mental strain, but the physiological impact can be detrimental to the healing process. The “crosstalk” seen in cell signals from increased stress can throw a wrench into the body’s natural ability to heal itself. 

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COLA Give Back Day
April 23, 2014 12:16 PM by Michael Jones

Not only does Medical Laboratory Professional’s Week (MLPW) celebrate the services provided by laboratorians throughout the year, but now it provides a platform from which to educate the public about the roles of these professionals and the potential for employment within the industry. Originally part of the “COLA Cares” initiative, “Give Back Days” began during MLPW 2011. In a recent interview with James Liggins, Chief Marketing Officer at COLA, he described the intended purpose of the “Give Back Days,” as well as the effect they have had on the industry overall.

“The reality is that, while job growth in this sector is faster than average, clinical laboratories across the nation have reported difficulties in recruiting new staff,” said Liggins. “This program is COLA’s way of helping to alleviate that worker shortage in the future.”

After the initial success of the MLPW 2011 Give Back Day in Baltimore, Md., COLA has continued the program annually, expanding to include local high schools, community colleges, universities and other venues. As the program has expanded, COLA staff members give presentations describing a day in the life of the typical medical laboratory professional, demonstrate simple laboratory tests and conduct fun experiments with participants.

“Our program now includes additional career presentations at schools, science expos and other venues; mentoring opportunities for interested students; and expanded scholarship support aid for students interested in medical laboratory careers,” explained Liggins. 

COLA’s Give Back Days feature a number of campaigns to increase awareness of the laboratory’s role in the healthcare industry and promote it as a viable career option. In addition to the outreach and continuing education programs offered during Give Back Day, COLA also offers scholarships to aspiring laboratorians and endowments to education programs catering towards future medical laboratory technologists.

 “We are also launching a course for allied health professionals, emphasizing the components of good clinical laboratory practices,” continued Liggins. “Designed for nurses and other healthcare personnel who work in hospitals, clinics and physician’s offices, the course will provide non-laboratorians with a basic knowledge of quality laboratory testing procedures in healthcare settings.”

The course, “Fundamentals of Clinical Laboratory Testing,” will be offered through Howard Community College’s continuing education program.  COLA hopes to expand the program elsewhere throughout the U.S. in the future.

MLPW is a time to celebrate the work of laboratories across the country, but why not use the spotlight to promote the profession among the rest of the industry and potential co-workers? In addition to their Give Back Days, COLA is also in the process of implementing “COLA Giving Back 365 Days a Year,” which will expand on areas already covered and include a new disaster relief program. AS Part of MLPW, COLA encourages laboratories everywhere to take part in COLA’s Give Back program with a free kit offered on their website (www.colacares.com/resources).

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"Missing Link"
April 7, 2014 1:36 PM by Michael Jones

Type 2 diabetes has been a growing concern in the United States for several years. While the established research has pointed to two specific hormones, glucagon and insulin, as the primary factors leading to the development of the disorder in patients, researchers have discovered a third key player in a recent news release from Johns Hopkins. The Johns Hopkins scientists discovered that Kisspeptin 1 (K1), a hormone typically associated with puberty and fertility, directly influences and interferes with the production of insulin in the pancreas.

“Glucagon and insulin alone never really made complete sense,” said Mehboob Hussain, MD, lead investigator, endocrinologist and metabolism expert at the Johns Hopkins Children’s Center. “There was always something missing and, we feel, kisspeptin 1 is a very good candidate to be that missing part. All of our findings point in this direction.”

According to the release, the general opinion prior to the discovered impact of K1 was that the slow build-up of blood sugar due to elevated levels of glucagon eventually tired out the pancreatic beta cells responsible for insulin secretion. Instead, it seems that, rather than the cells slowly wearing out, high glucagon triggers the production of K1, which targets the cells and suppresses the secretion of insulin, leading to the high blood sugar and low insulin levels associated with the disorder. In experiments with human blood and liver cells and eventually mice, once the Johns Hopkins researchers rendered their livers incapable of producing K1, the levels of insulin and blood sugar returned to normal.

“Our findings suggest that glucagon issues the command, but K1 carries out the orders,” explained Hussain. “And, in [doing so,] it appears to be the very cause of the declining insulin secretion seen in type 2 diabetes.

Additionally, Hussain and his colleagues speculated that the evolution of K1 arose from the need to prevent dramatic decreases in blood sugar during fight-or-flight situations. This research, while still in its preliminary stages, has offered a third key component in the assessment of type 2 diabetes and the possibility of a new method of treatment for the disorder. Rather than treating as needed with the injection of insulin, the disorder could potentially be cured by limiting and even eliminating the production of K1. 

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