January 27, 2015

University of Missouri researchers’ discovery may aid Parkinson’s fight

University of Missouri researchers might have found a way to lessen the severity of Parkinson’s disease.

Department of Biochemistry Professor Mark Hannink

Department of Biochemistry Professor Mark Hannink

Researchers have discovered a molecule that could be key to developing drugs that will keep brain cells healthy in individuals with Parkinson’s.

Mitochondria generate the energy needed to keep brain cells alive.  When mitochondria become damaged and are no longer capable of making energy, they are sent to a part of the cell called a lysosome to be repaired.  For those suffering from Parkinson’s disease, mitochondria fail to move to lysosomes, causing buildups of damaged mitochondria that kill brain cells.

Department of Biochemistry professor Mark Hannink says the goal is to prevent the cells from dying.

“We think we know what causes the cells to die and that’s failure to recycle the mitochondria,” said Hannink.  “So, what we think we’ve found is an alternative way to promote the getting rid of damaged mitochondria.”

The alternative pathway for mitochondrial recycling uses a protein called phosphoglycerate mutase family member 5 (PGAM5).  Hannink’s study found a peptide which acts as a “switch” to cause the protein to generate an alternate pathway.  By regulating the protein with the peptide he discovered, it could be possible to restore mitochondrial recycling in neurons of patients with Parkinson’s.

Hannink says most of the published work has been test tube based.

“That’s really the foundation of drug development.  Drugs are small molecules, but are designed then to interact in very specific ways with particular regions on proteins and change their function,” said Hannink.

Hannink says after they characterize how the molecule behaves against purified protein and against mitochondria in cultured cells, they will begin testing on mice.

“There’s a couple of researchers in the school of medicine who have mouse models of Parkinson’s disease.  We’ll be collaborating with them to do those tests,” said Hannink.

With the hope of developing new treatments for Parkinson’s, University of Missouri officials may request authority from the federal government to conduct human clinical trials if these additional studies are proven to be successful.

Missouri ranks among lowest in US for tobacco prevention spending

The latest report on how well states are funding tobacco prevention and cessation efforts has Missouri ranked as one of the worst states in the nation.

Every year the Campaign for Tobacco-Free Kids issues an annual report on how well the states have kept their promise to use money from the $250 billion state tobacco settlement to protect kids from tobacco.  Missouri still collects money from the 16 year old legal settlement.

Missouri ranks 50th among the states and the District of Columbia.  New Jersey, which is spending zero dollars on prevention, is the only state that ranks below Missouri.

The CDC (Centers for Disease Control and Prevention) has a recommendation for what each state should spend on tobacco prevention.  The rankings are based on what the CDC recommends and what the state actually spends.

The CDC recommends an annual spending of 73 million dollars for Missouri, but the state is only spending 71,000 thousand dollars.  That’s one-tenth of one percent of the recommended amount by the CDC.

Director of Communications for the Campaign for Tobacco-Free Kids John Schachter says this year Missouri will receive 231 million dollars from tobacco taxes and the legal settlement with tobacco manufacturers.

“The state is literally sacrificing the health and lives of their children and the future of the state for no good reason.”

“Missouri has to pay nearly $3 billion in annual health care costs due to tobacco related illnesses,” said Schachter.  “If you look at the numbers, it’s probably too profitable for a state not to spend this on tobacco prevention.”

Schachter says prevention programs typically include aggressive media campaigns, TV commercials, social media outreach, partnerships with local organizations and student groups, and helplines.  The goal is to educate kids why they should not smoke and to help people who smoke quit.

The Campaign for Tobacco-Free Kids was established in the late 1990s around the time of the tobacco settlement.  Its goal is to decrease tobacco use among the population, especially among children.  The organization focuses on helping states pass more funding for tobacco prevention programs, raising a tobacco tax, and passing smoke-free policies.

Designer: new Fulton state hospital will be better, safer

Replacing the maximum security state mental hospital at Fulton means bringing the building itself in line with the modern mental health care philosophies and practices that its staff is using. The state has hired design firm Parsons Brinckerhoff to accomplish that.

This layout for the new Fulton State Hospital was presented to the Missouri Mental Health Commission in October.

This layout for the new Fulton State Hospital was presented to the Missouri Mental Health Commission in October.  It borrows a spoked wheel design used prisons for more than 100 years.

Vice President of Parsons Brinckerhoff, Tom Brooks-Pilling, told Missourinet the Biggs Forensic Center that mostly dates back to 1937 was built with confinement in mind more than rehabilitation.

“I’m not suggesting they didn’t have great programs back then. I don’t know what they had,” Brooks-Pilling said, “but when you look at the facility it’s really about warehousing and holding people.”

He said the new design will be radically different, adding, “It’s more of a hospital.”

“The present facility has been maligned for safety and security,” Brooks-Pilling said. “When we’re designing this new facility, safety is paramount, because without the staff and patients feeling safe … your mind is elsewhere. It’s hard for you to focus on treatment programs.”

He says the new hospital won’t look or feel like a prison but it will have security measures like those in a modern penal facility with three perimeter security fences, a closed-circuit television system, and alarms that go off any time a staff person gets into a horizontal position.

At the same time he said it will be, “a facility that brings in a lot of daylight, tries to create an uplifting and warm feeling – a therapeutic environment. We avoid anything that makes people feel incarcerated.”

One key improvement will be the lack of blind spots and hiding places.

“There’s all sorts of alcoves and places in existing Biggs where a patient, a client, could be hiding,” said Brooks-Pilling. “We don’t have any of those sort of spaces in the new hospital.”

“We set it up so that doors, if they’re intended to be open are locked open, so a client couldn’t intentionally use a door as a weapon to slam into an individual … the idea of having the building designed so people are watching other people’s backs, we’ve built that in throughout the facility.”

To accomplish the goal of increasing visibility, the new hospital borrows an element that has been built into prisons for more than 100 years. Living units will have a spoked wheel design, in which a staff person sitting at a central point can see what is happening in multiple units at the same time.

The Biggs Maximum Security Forensic Center is part of the Fulton State Hospital complex.

The Biggs Maximum Security Forensic Center is part of the Fulton State Hospital complex.

“From that position they can see everything that’s going on in that unit, and basically are watching the other staff’s back,” said Brooks-Pilling, “to make sure that they can focus on treatment and not necessarily worry about who might be sneaking up on them or what activities might be going on behind their backs.”

Brooks-Pilling said the staff has also been included in the design process.

“They ideas that they have, we vet and we incorporate into the process,” he said.

One example is what designers heard about how patients are brought into the current facility.

“When we got started on the project [a staff member] said, ‘When we have new clients come to Biggs Forensic now, they come in through a back door next to the dumpster. What does that make you feel like when your first experience going into this new facility is being brought in by the back door dumpster? Doesn’t give you a strong, dignified feeling, does it?’ We understood that.” Brooks-Pilling said the new hospital will have a “more dignified” and discrete patient entrance.

Brooks-Pilling says the new layout will be four hospitals in one. It will house 300 patients, or clients as they are called in modern mental health care circles, divided among four communities based on treatment programs and the severity of mental illness.

12 separate living units will have 25 persons each, grouped into communities of between 50 and 100 patients. Most treatment programs will take place in those communities.

All of those will share a common treatment mall being named The Hope Center. It will have a “town square” feel, according to Brooks-Pilling.

“It has your library, your place of worship, bank, hair salon, restaurant, shops, gymnasium/fitness center, classroom activities and such,” he said. Some patients will have free access to that, others will have restricted access based on condition.

A vocational enterprise area is also available where patients can do work and be paid for it.

“It really emulates life as we know it – a full day regime, from waking up, going through programming, doing some work, doing some activities, and then going back to bed. It’s a full cycle,” said Brooks-Pilling.

The projected cost of the project is $211-million dollars, that the legislature and the governor approved paying through a bond issuance. The first $92-million of bonds were issued in November. Later this year demolition of the current dietary, materials management, energy control center, and maintenance buildings will begin. Construction of the new hospital is scheduled to start in 2016 and be done by December, 2017, with the Biggs facility slated for demolition in 2018.

Earlier stories:

Legislature adopts Gov. Nixon’s plan to pay for new Fulton Mental Hospital

Mental Health Official pleased with Nixon plan to replace Fulton State Hospital

Administrators’ pitch: 211-million from bonds to improve Fulton State Mental Hospital

Proposed cuts to Missouri’s blind pension halted

The Nixon administration has backed away from cutting benefits to hundreds of Missouri’s blind pension recipients.

cane dayThe Department of Social Services had sent out notices several weeks ago that the benefits would be cut by $33 a month. The payments go to about 3,900 Missourians whose vision is no better than 5/200.  That’s well beyond “legally” blind, which is defined as 20/200.

A state three-cent property tax raises the money for the program.. But Department Finance Director  Patrick Luebbering told us last week that’s not enough to fund the payments. “We have available funds of 31.3 million. Last year on the blind pension program we spent a little bit over $32 million and again in this year we expect to expend around $32 million, which leaves us with a shortfall,” he says.

The department had estimated the department would save almost three-quarters of a million dollars with the cuts.  He had said the full monthly payment of $718 likely would be restored when the next fiscal year starts, July 1 although that determination would be made later after the department saw how much tax money had come in.

A St. Louis Post-Dispatch article had questioned the need for the cut hours before the Governor’s office put out a press release saying Nixon had ordered the department to reverse its plan. Nixon says he’ll ask the legislature next year to add enough money to the budget to keep the payments at current levels.


New effort for a Missouri Prescription Drug Monitoring Program (AUDIO)

A state representative has a personal reason to renew the effort to make Missouri the last state to adopt a prescription drug monitoring program. But she will still have to overcome a big obstacle.

Representative Holly Rehder talks about her plan to introduce a prescription drug program bill.

Representative Holly Rehder talks about her plan to introduce a prescription drug program bill.

Every other state has the system that lets doctors and pharmacies know if someone is getting or filling multiple prescriptions for pain killing drugs.   Supporters of the program say Missouri needs the database  that limits so=called doctor-shopping and minimizes the supply of prescription pain-killers that are being sold on the streets.

State Representative Holly Rehder of Sikeston has a personal reason for trying again. It began when her 17-year old daughter cut her finger at work and got a painkiller prescription.  She began buying the drug on the street when she finished the supply she got at a hospital.   “We’ve been twelve years down the road of ups and downs in rehab,” she says.  But Rehder said her daughter has been “clean” for the last six months.

The House has approved the program but the bill has run into St. Joseph Senator Rob Schaaf and a few allies who have blocked it. Schaaf claims the database cannot be sure, a claim that Rehder says it not supported by the experience in other states.  He wants a statewide vote, which Rehder says is just a stalling tactic, and a limit on the amount of time the information can be stored, which Rehder says is worth discussing although she thinks Schaaf’s demand for a six-month limit is not realistic.

AUDIO: News conference 35:53

(with Rehder, Dr. Bob Twillman (American Academy of Pain Management), Jeff Rowland (deputy police chief, Poplar Bluff), Stephen Keithahn, MD, University of Missouri Health System-School of Medicine, Columbia).