Gail Henderson to Advise Federal Agencies on Human Genome Initiatives and to Present at HIV Conference in Thailand

Gail Henderson, PhD, is headed to Thailand where she will present at an HIV conference.

Gail Henderson, PhD, is headed to Thailand where she will present at an HIV conference.

The new year is proving fruitful for Gail Henderson, PhD. The professor of Social Medicine and Director of the Center for Genomics and Society at UNC has been confirmed for a four-year term as a member of the National Advisory Council for Human Genome Research, and asked to speak at the 19th Bangkok International Symposium on HIV Medicine.

“Serving on the Advisory Council is a distinct honor,” said Henderson.

In her new role, Henderson will work with other council members on advising the U.S. Department of Health and Human Services, the National Institutes of Health (NIH) and National Human Genome Research Institute (NHGRI) about genetics, genomic research, training, and programs related to the human genome initiative.

Since 1990, the National Human Genome Research Institute has supported research on ethical, legal, and social implications (ELSI) of genomics, and UNC has become a major center for this work. For Henderson, this began in 1999 with funding to study how researchers and study participants understood the possibilities of new, cutting-edge genetic technology—in gene therapy trials. Since then, UNC investigators from the Schools of Medicine, Public Health, Nursing, Law, and Arts and Sciences have pursued ELSI issues in genomics as investigator-initiated grants and larger consortia. And more than a decade ago, the Center for Genomics and Society at UNC was funded to support research and training on ELSI issues now and in the future.

Henderson has served as director and principal investigator of the interdisciplinary Center for Genomics and Society at UNC since 2007. In 2013, the Center was renewed for another five years, to conduct “GeneScreen” – a study of the harms and benefits of screening asymptomatic adults for rare, medically actionable mutations.

Research Focuses on Study Volunteer Behavior
In mid-January, Henderson will travel to Thailand to present during the 19th Bangkok International Symposium on HIV Medicine. Her talk is titled “Why Do People Join or Decline HIV Cure Research?” The talk is based on data from a recently awarded, four-year R01 from the National Institute of Allergy and Infectious Disease (NIAID) that explores decision making for HIV remission trials taking place in Bangkok.

This award is part of a special NIAID Program Announcement for research on ethical and social issues in HIV research. In this work, colleagues at UNC, RTI, the U.S. Military HIV Research Program/Henry Jackson Foundation, and the Thai Red Cross AIDS Research Centre are collaborating on a longitudinal study of HIV remission trial joiners and decliners.

“We are collecting empirical data on how people in actual, ongoing HIV remission trials come to these decisions and why,” Henderson said.

UNC Radiology Malawi Program Strengthens Local and International Ties

Malaria Parasite Evades Detection

Jonathan Parr, MD, MPH, stands on the banks of the Congo River in the Democratic Republic of the Congo.

Jonathan Parr, MD, MPH, stands on the banks of the Congo River in the Democratic Republic of the Congo.

The Democratic Republic of the Congo (DRC) has one of the highest rates of people living with malaria. Rapid diagnostic tests (RDTs) account for more than 70 percent of diagnostic testing for malaria in Africa. Most rapid test diagnostics rely on the detection of histidine-rich protein 2 (HRP2), an antigen specific to Plasmodium falciparum malaria. However, one of every 15 children infected with Plasmodium falciparum malaria parasites in the DRC is infected by a pfhrp2-deleted mutant, producing a false-negative result when an RDT is used, investigators from the University of North Carolina at Chapel Hill found. Their results were published in the Journal of Infectious Diseases and discussed during a recent World Health Organization meeting during the American Society of Tropical Medicine and Hygiene’s annual conference in Atlanta.

“This is the first nationwide study to demonstrate the presence and estimate the prevalence of malaria caused by pfhrp2-deleted P. falciparum in asymptomatic children,” said Jonathan Parr, M.D., M.P.H., the study’s lead author and a researcher within UNC’s Infectious Disease Epidemiology and Ecology Lab. “Because most rapid diagnostic tests in the DRC are HRP2-based, they will fail to detect these parasites. Their spread would represent a serious threat to malaria elimination efforts.”

Samples were collected from children under the age of 5 during the 2013-2014 Demographic and Health Survey in the DRC. The UNC team focused on 783 samples with opposing rapid test diagnostic test and polymerase chain reaction (PCR) results. PCR testing showed positive results for malaria where rapid diagnostic testing did not.

“We identified 149 P. falciparum isolates with a deletion of the pfhrp2 gene, representing a country-wide prevalence of 6.4 percent,” Parr said. “This proved that pfhrp2-deleted P. falciparum is a common cause of rapid diagnostic test negative, but PCR positive malaria test results among asymptomatic children in the Democratic Republic of the Congo. Surveillance for these deletions is needed and alternatives to HRP2-specific rapid diagnostic tests may be necessary.”

The WHO and UNC coordinated a meeting Tuesday morning in Atlanta to address these parasites. The meeting brought together leading researchers, policy makers, commercial diagnostic developers, and representatives from diverse national malaria control programs to review what’s known and to formulate a response. Alternate rapid diagnostic tests will be deployed in settings where they are found to be common, and further research into their clinical impact and distribution throughout Africa will be undertaken.

The DRC project resulted from an NIH-funded study of malaria transmission led by Steven Meshnick, M.D., Ph.D., professor and associate chair of epidemiology at the UNC Gillings School of Global Public Health. Meshnick emphasized the need for a measured response.

“It is important to note that these mutated parasites have only been found in a small number of places in the world,” Meshnick said. “HRP2-based rapid tests continue to play a key role in malaria control and elimination efforts.”

The team is actively investigating these parasites through applied genomics studies recently funded by the Thrasher Research Fund and the ASTMH/Burroughs Wellcome Fund and ongoing NIH-funded epidemiological studies in Kinshasa Province, DRC.

Currin Named Nurse of the Year

David Currin, RN, ACRN, CCRC, has worked as a nurse in UNC's Division of Infectious Diseases since 2001.

David Currin, RN, ACRN, CCRC, has worked as a nurse in UNC’s Division of Infectious Diseases since 2001.

This November David Currin, RN, ACRN, CCRC, will check two achievements off his bucket list. Currin will take a river boat cruise down the Danube in Europe. And he will also be honored as the HIV/AIDS Nursing Certification Board’s 2016 Certified Nurse of the Year.

“I was so surprised and excited when I received the letter that I would be receiving this year’s award,” says Currin, who serves as the Certified Clinical Research Coordinator and the Clinical Quality Program Manager for UNC’s Global HIV Prevention and Treatment Clinical Trials Unit. “Honors and awards are not why I do this work. I am going to dedicate this award to the memory of the friends I lost in the 1980s and 1990s to HIV.”

Certified as a research coordinator and an HIV nurse clinician, Currin has spent the past 15 years seeing patients on study at UNC and at affiliated site like the Wake County Health Department. At any given time, he sees participants from five to six studies, including those funded by the government and those trials funded by pharmaceutical companies. He splits his time between these duties and overseeing the team who manage the data collected by the unit’s many studies.

“My heart is really in seeing research patients,” Currin says. “I got my start after nursing school at the state’s mental health hospital. When I came to UNC in 2001, the first studies I saw patients on were treatment naïve trials. These were people who were being diagnosed with HIV and had never initiated therapy. Because of my psychiatry background, I felt I could help them identify ways to accept their diagnosis and the lifelong commitment of taking daily medications.”

Currin has watched as the research field has shifted from studies aimed at identifying the best treatment for HIV to those focused on prevention and a cure. He has also witnessed the demographic of those infected with the virus shift from an older population to youth.

“When I first started at UNC, I was seeing patients on study who were my age,” Currin says. “But now those newly diagnosed are in their teens and twenties. We are seeing the next generation living with or at risk for HIV. But what is exciting is that we have these important studies about pre-exposure prophylaxis, or PrEP, to prevent HIV now. HIV Prevention Trials Unit (HPTN) 073 was my first PrEP study. We also have a cure for another viral infection – hepatitis C virus. I was the study coordinator for that successful treatment trial at UNC. It gives me hope that maybe we will see a cure for HIV.”

CurrinPullQuoteCurrin was nominated for the award by colleague Cheryl Marcus, BSN, Clinical Director of the research unit, and Claire Farel, MD, MPH, Medical Director of UNC’s Infectious Diseases Clinic.

“David has worked in HIV/AIDS nursing for the last 15 years, initially as a study nurse, followed by years of progressively increased responsibility,” Marcus says. “He always brings the highest level of professionalism and commitment to everything he does, providing superb care, spotless data and personalized support to each study volunteer. He fosters collaboration and continuous learning among his peers, serving as a trainer, mentor, friendly advisor and role model. I am privileged to work with him and was pleased to nominate him for this well-deserved honor.”

Farel works with Currin to connect patients from the Wake County Health Department and the UNC ID Clinic with research studies.

“He does an incredible job of ensuring that patients have all of the information they need to make a good decision,” Farel says. “What’s so important and special is that he makes sure that staff are comfortable communicating this information – this ensures that all of our patients have a chance to be a part of the progress we are making in the fight against HIV and in improving the lives of people living with HIV. He is a patient teacher to staff and colleagues and is always happy to answer a question or explain a study.”

Robert Dodge, PhD, RN, ANP, AACRN, is president of the HIV/AIDS Nursing Certification Board that is presenting Currin with the award.

“David was selected for this commitment and compassion to the nursing field, particularly in the area of HIV,” says Dodge. “He has the ability and interest in teaching other health care professionals what it means to be compassionate, caring and supportive to patients with HIV.”

Currin jokes that he is also known in the research unit as “the hugging nurse.” He said it is a habit he started after noticing the power of touch when he was a nursing student treating his first patient with HIV. The patient had been attacked and stabbed in a phone booth because of his sexual orientation. Because he was living with HIV, he was put in a hospital room much further down the hall than the other patients. Currin noticed the man had a partial plate in his mouth and asked if the patient would like him to clean it.

“As a first semester nursing student, I was only allowed to take a patient’s vital signs, give baths, change their sheets and provide oral care,” Currin says. “When I noticed this patient had a partial plate in his mouth, I offered to take it out and clean it for him. He had been in the hospital several days by this point and had undergone two surgeries. I took it out and he sighed. I looked at the plate and it was so dirty. I realized no one had offered to clean it for him before me. He was my first patient and I will always remember how this small act really made a difference. That is why I offer a hug to my patients. Sometimes just listening and giving someone a hug can make all the difference.”

UNC Donates Lifesaving Equipment to Malawi

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UNC-Pembroke staff prepare the pathology equipment for shipment to UNC Project-Malawi.

A donation of pathology equipment between two schools in the University of North Carolina (UNC) system will save lives and improve lab operations in Malawi.

UNC-Pembroke sent a Leica Bond Max Machine for Immunohistochemistry (IHC) and In Situ Hybridization (ISH) to UNC-Chapel Hill’s site in Lilongwe, Malawi. These particular instruments will allow the laboratory at UNC Project-Malawi to get more detailed information about the tumors that are diagnosed in patients there. This information improves the accuracy of the diagnoses the pathologists make, which in turn helps to make certain that patients in Malawi are being treated appropriately.

“The impact the donated equipment will have in Malawi is significant,” says Nate Montgomery, MD, PhD, UNC-Chapel Hill Department of Pathology and Laboratory Medicine. “The stains performed on these instruments are part of the standard-of-care here in the United States, but there is only a very limited capacity to do them in Malawi. The instrument donated by UNC-Pembroke changes that. This gift will help bring an important tool to a place with far too few resources.”

The Leica machine provides automated staining, which will allow UNC Project-Malawi’s lab technicians to process more specimens.

The Leica machine arrived in Lilongwe and will aid staff with managing an increasing volume of clinical samples.

“Neither the pathology lab nor immunohistochemistry existed in Lilongwe until UNC Chapel Hill introduced them in 2012, and immunohistochemistry has now become a routine part of lab operations,” says Satish Gopal, MD, MPH, UNC Project-Malawi Cancer Program Director. “The automated stainer from UNC-Pembroke will allow us to process even more patient specimens with higher efficiency, while freeing up our technicians to do many other vital lab functions. This is essential in a setting where the per capita health care workforce is orders of magnitude smaller than the US. To handle the overwhelming clinical volume with limited trained staff requires high levels of efficiency, and the new instrument will be critical in this regard.”

The equipment donation was born out of a collaboration between Ben Bahr, PhD, William C. Friday Distinguished Professor of Molecular Biology and Biochemistry at UNC-Pembroke, and Stephanie Montgomery, DVM, PhD, Assistant Professor of Pathology and Laboratory Medicine at UNC-Chapel Hill. The pair was working together on the pathology of Alzheimer’s disease when Bahr mentioned his team did not use the Leica machine very often. Months later, Montgomery learned that UNC-Project-Malawi could benefit from this technology and she contacted Bahr.

“I think it is important that we want to make sure this machine is being utilized for the best operation to help people,” says Bahr. “It is very exciting to be part of this worldwide effort and help people on the other side of the planet.”

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Dental Students Treat Mexican Children

Dr. Angie Rhodes, left, in a picture from her Project Mexico trip. Twenty years later, her longtime patient Roxie Braxton, right, would go on the same trip.

Dr. Angie Rhodes, left, in a picture from her Project Mexico trip. Twenty years later, her longtime patient Roxie Braxton, right, would go on the same trip.

By Bradley Allf, Features Writer UNC Institute for Global Health & Infectious Diseases

In 1996, Angie Rhodes, DDS, spent her second summer of dental school providing health care and education to children living in an orphanage in Miacatlán, Mexico, as part of a program called the UNC Mexico Project. This summer her lifelong patient Roxie Braxton, now a third year dental student at UNC, went on the same trip.

Rhodes was thrilled when she learned that Braxton was going on the Mexico Project trip. “I knew that she would have an amazing experience and treasure her time there just as I still do,” says Rhodes. “The love and excitement hasn’t changed in 20 years!”

The UNC Mexico Project, which started in 1987, has a long history of service in Miacatlán. The project is a partnership between the UNC School of Dentistry and an international organization called “Nuestros Pequeños Hermanos” (NPH) that provides homes for orphaned and abandoned children in Latin America.

NPH was started back in 1954 by a priest named William Wasson who adopted a child convicted of stealing from his church in Mexico, rather than press charges. Over the course of that year, Wasson ended up adopting 31 more disadvantaged children and the program grew from there. NPH is now a multinational humanitarian organization, which has provided homes for thousands of children.

Sarah Wong, right, helps treat a patient at NPH.

Sarah Park, right, helps treat a patient at NPH.

UNC has sent dental students to the NPH home in Miacatlán since 1987. These students provide dental care and education to hundreds of the children that live and study in the home. The project itself is three weeks long and takes place each summer around August. This year five students attended, as well as Carolina Vera Resendiz, DDS, Clinical Assistant Professor in the UNC School of Dentistry’s Department of Prosthodontics and an advisor for the Project.

The students assist the community’s only local dentist Leticia Gomez, DDS, with fillings, sealants and cleanings for the kids as well as dental education. Braxton says one of her favorite parts of the trip was teaching some of the younger kids about oral hygiene.

“We were showing them how to floss; they were only 3 so it was hard for them to wrap the string around their fingers,” says Braxton. “But they were just so interactive in wanting to participate, and that connection you make with the kids—it’s so gratifying.”

All the dental students have clinical experience, but for many of them the trip provided a bigger exposure to dental pediatrics. This can bring with it certain challenges. “Sometimes you have to be a bit more persuasive,” says Sarah Park, another student who went on the trip.

Park had a moderate amount of Spanish training going into the trip, which she says was helpful. But fortunately there were also bilingual volunteers on hand to help translate for the students without a strong Spanish background.

In addition to the two weeks of living and working at NPH, the students had a “culture week,” where they were able to explore Mexico City, tour the Chapultepec Castle and expand their palates with food like toasted grasshopper. They were also shown around the National Autonomous University of Mexico’s state-of-the-art dental facilities. There, they had the opportunity to hear from dentists working in the region and get a broader perspective on how dental care is provided in a country with such a wide spectrum of healthcare access.

Roxie Braxton, left, giving oral hygiene instruction to some of the kids living at NPH.

Roxie Braxton, left, giving oral hygiene instruction to some of the kids living at NPH.

Park says her experience in Mexico certainly impacted how she thinks about practicing dentistry. “When you’re a provider you have the power to improve someone’s health and educate them and help them help themselves. [The trip] was a good reminder of that,” she says. Park’s experience also solidified her commitment to humanitarian outreach, and she wants to stay involved in the Project going forward.

Braxton says she thought the impact of the trip really hit home during the meals with the kids. “They really warm your heart and remind you why you’re in the field,” she says. Braxton also hopes to stay involved with UNC Mexico Project in the future.

“And who knows, maybe one day down the road one of my patients will go on the UNC Mexico Project service trip!” she says.

Student Targets Mental Health Stigma

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Nikhil Tomar, a doctoral student in UNC’s Department of Allied Health Sciences, is tackling the stigma surrounding mental health locally and globally.

By Elizabeth Poindexter, Communications Director of UNC’s Department of Allied Health Sciences

Nikhil Tomar, a doctoral student in occupational science in the Department of Allied Health Sciences, has worked for years to understand and reduce stigma surrounding mental health concerns around UNC’s campus, the Chapel Hill community and the world.

Through collaborations with the UNC School of Social Work, he has also conducted research at the intersection of mental illness and the criminal justice system in the state of North Carolina. This past summer, he participated in a Movement for Global Mental Health research project, being conducted via a collaboration between Public Health Foundation of India and King’s College London’s India Institute. As part of his dissertation, he hopes to expand upon research gathered during the summer and understand stigma toward mental illness in India.

Tomar, a Royster Fellow at UNC’s Graduate School, became interested in mental health after realizing the impact of negative and ill-informed perceptions about mental health on life experiences of individuals with mental illness. Tomar connected mental health issues with his studies in occupational science, which studies the science of everyday living, including productive physical and social activity.

“Removing stigma from a community can help people not feel embarrassed when accessing services or being diagnosed, which can have a significant impact on their future mental health. Research evidence suggests that stigma can have a more detrimental effect on individuals with mental illness than the symptomatology of the illness itself,” Tomar said.

This infographic from Stigma Free Carolina explains what CAPS - Counseling and Psychological Services at UNC.

This infographic from Stigma Free Carolina explains CAPS – Counseling and Psychological Services at UNC.

Starting Local with Club Nova
Research indicates that mortality rates are much higher among people with a mental illness when compared to the population at large. Additionally, people living with mental illness face an increased risk of social discrimination and chronic physical medical conditions.

Club Nova is trying to reduce these numbers. Since the spring of 2015, Tomar has volunteered with Carrboro-based nonprofit. Club Nova uses an international psychiatric recovery model called the clubhouse model, where people with mental illness work together to sustain the clubhouse.

“Nikhil came in to a brand new setting and was completely open. He went out of his way to build authentic relationships with members and staff and he blended right in with our way of working and was eager to absorb everything around him in a very positive way,” said Club Nova Executive Director Karen Kincaid Dunn. “Nikhil is committed to approaching the world from a place of non-judgment and it shows in his relationships with everyone he comes across. If we had a world of Nikhil’s, we would be truly stigma-free.”

On any given day, clubhouse members work in their area of interest or expertise to maintain the clubhouse – such as cooking daily meals, gardening, managing Club Nova’s thrift store, creating budgets and paying bills. The Clubhouse also helps members return to work or school, and live the life of their choice in the community.

“It has been an enriching experience for my own thinking about stigma,” Tomar said. “I thought to myself, ‘there is a need for more volunteers here. How can I, given my background as a student and on campus, assist them?’”

Specifically, Tomar, through a summer fellowship, assisted in streamlining the volunteer process at and strengthened ties between University resources and the Clubhouse.

“Nikhil came in at first with only the intention to observe and learn. He is tremendously devoted to learning a system before he attempts to work with it, which is rare. He was then able to identify a need—more structure around our volunteer program—and jumped right in,” said Kimberly Anderson, Club Nova Public Relations & Development Coordinator. “We now have many more volunteers working with us doing meaningful things and it enriches our program on all sides.”

As Club Nova enters a capital campaign, they hope to expand into a new facility to support the estimated 8,000 people in Orange County who live with serious mental illness.

Tackling Stigma on Campus
Tomar is also co-founder of Stigma Free Carolina, a campus organization aimed at reducing stigma toward mental health concerns and treatment on college campus. According to Stigma Free Carolina, more than 19 percent of UNC students felt receiving mental health treatment was a sign of personal failure. More than half of students surveyed agreed that most people would think less of someone who has received mental health treatment. Stigma Free Carolina also connects students to resources, both on and off campus, for those who need them.

While Tomar will likely finish his PhD work in 2017 or 2018, he hopes that other students will be motivated to volunteer at Stigma Free Carolina and at Club Nova.

“Students, from any walk of life, can learn so much by being at the clubhouse,” he said.