Park Springs to Expand Health Care Center at Retirement Community

Cobblestone to add two memory care rooms, 18 skilled nursing rooms, two prep kitchens

Park Springs, the Southeast’s premier continuing care retirement community announces that it is renovating Cobblestone, the community’s health care center, expanding the facility by 12 rooms. The expansion will include two phases of construction. Phase one is slated to begin in early January, while phase two is scheduled to begin in mid-February.

Renovations during phase one construction will include adjusting eight assisted living suites into 14 memory care suites. A new memory care dining area with a new warming and preparation kitchen will also be added. A new wandering control system is also planned to increase Members safety. Updated finishes in the new common area will also occur at this time.

Phase two will consist of renovating 12 memory suites into 18 skilled nursing rooms. Construction will also include the addition of a new preparation kitchen as well as upgrades to the existing skilled nursing preparation kitchen. Renovations to the common areas, a new skilled family area, and offices for the community’s physician and assistant director of nursing will also be added at this time.

“We are excited about expanding Cobblestone,” said Joan Carlson, Park Springs’ vice president of quality, innovation and culture. “We currently offer the highest quality services, medical care, nursing and rehabilitative care in a residential environment in the Southeast and our expansion will allow us to increase the level of care we provide. It will also allow us to provide outside short term admission to our Medicare skilled unit.”

Cobblestone’s Resident Centered model provides Members flexibility in their daily activities embracing individuality while focusing on all aspects of wellness. Staffing ratios are approximately two times greater than the state average. A full time doctor trained as a geriatrician whose sole responsibility is the health of our Members is employed on site. A clinic staffed by a full time Licensed Nurse Practitioner performs routine check ups, tests and lab work. The community doctor, clinic and skilled care are all Medicare certified. Home care services are provided by trained staff employed directly by the Park Springs and are licensed by the state, bonded and insured only after undergoing a strict screening process.

About Park Springs
The Southeast's premier CCRC, Park Springs enhances life for active seniors by providing independent residences alongside extensive amenities and on-site wellness and private health care facilities. The 398-home campus-style community is situated on 54 acres surrounded by Stone Mountain Park. A 64-suite health center provides assisted living, skilled nursing and dementia/Alzheimer's care. The campus style community boasts a 50,000 square foot Clubhouse serving meals in four themed dining rooms daily and a 12,000 square foot fitness center with an indoor swimming pool. The Seniors Housing Council of the National Association of Home Builders named Park Springs a Platinum winner. Park Springs is developed by Isakson Living and managed by Life Care Services LLC (LCS), a leader in senior living communities. LCS today serves more than 23,000 residents daily in over 80 communities nationwide. For more information on Park Springs, call 678-684-3300 or visit www.parkspringscommunities.com.
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Maternity Center at Piedmont Fayette Hospital Offers Classes for Expecting Parents

Parents and expectant parents are invited to attend several informative classes offered by the Maternity Center at Piedmont Fayette Hospital (PFH). For more information on the Maternity Center at PFH, visit fayettehospital.org. Community members are invited to take part in the following classes:

Prepared Childbirth Class - This course, recommended for women 20 to 28 weeks into pregnancy, provides an eight hour childbirth education class that teaches mom and her partner about what to expect during labor and delivery. The instructor will discuss the stages of labor, relaxation, breathing techniques, common concerns, comfort measures and much more. Participants will need to bring two pillows and a blanket or towel. The fee for the course is $85 and includes light refreshments. The class will be held Saturday, Nov. 21, from 9 a.m. to 5 p.m. in the Dietary Conference Room on the ground floor of the hospital. To register, call Link2Health toll-free at 1-866-900-4321. For more information call 770-719-6005.

Breastfeeding Basics - The Maternity Center at Piedmont Fayette Hospital offers a three-hour group participation discussion on the benefits and how-to's of breastfeeding. This class includes preparing for breastfeeding and getting started in the hospital and at home, special situations and growing a breastfeeding family. The class is best if done prior to delivery, but participants are welcome at any time. Fathers or support person are welcomed and encouraged to attend also. This class is now offered every month, and the next class is Saturday, Nov. 14, from 9 a.m. to noon in the conference room on the third floor of the hospitals 1279 building. For more information or to register, call 770-719-6005.

Moms in Motion - “Moms in Motion” is a fitness program designed to prepare women for the physiological changes that occur during pregnancy and postpartum. The class combines low impact aerobics, toning exercises, relaxation and breathing techniques and appropriate warm-ups/cool-downs perfect for both pregnant and postpartum women. The program provides not only a safe and effective exercise regime, but also provides valuable information on pregnancy, postpartum and child safety. Participants may register for this ongoing program at any time during or after pregnancy. Classes are held every Tuesday and Thursday from 5:15 to 6:15 p.m. in Suite 200 of the Piedmont Fayette Hospital Fitness Center at 1250 Hwy 54 West. Space is limited. The classes are FREE to fitness center members and $25 per month for non-members. Written approval from a physician is required. For more information or to register, call 770-719-7290.

Maternity Center Tours - The Maternity Center at Piedmont Fayette Hospital welcomes expectant mothers and their support partners to take a tour of the facility. The tour will be offered on Saturday, Nov. 14, at 12:30 p.m.; and Saturday, Nov. 21, at 6 p.m. The tour will provide information on the hospital's approach to maternity care and how physicians and staff help new mothers and their babies before and after delivery. Expectant mothers and their support partners are welcome. Please meet in the Maternity Center lobby (third floor, enter through the West Entrance). For more information call 770-719-6005.

Fayette County Safe Kids Child Passenger Safety Training Class - Fayette County Safe Kids will offer a car seat safety class to teach parents how to keep children safe, especially while traveling by car. The course will be offered Monday, Nov. 9, from 2 to 3:30 p.m. in Conference Room A on the third floor of the hospital's 1279 Building. This class is offered the second Monday of each month. For additional information contact Debbie Straight, 770-305-5148.

Sibling Class - Sibling classes are not being offered at the present time. For more information call 770-719-6005.
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Physician Coalition: "No Place for Big Government in Exam Room"

The Medical Association of Georgia (MAG) joined more than 100 doctors from across the country in Washington, D.C., today to offer legislators a “second opinion” on the best way to reform the nation’s health care system at a press conference that was sponsored by the Coalition to Protect Patients’ Rights.

“We need to reform our broken medical payment system, but a hurried approach that fails to protect the patient-physician relationship isn’t the answer,” said M. Todd Williamson, M.D., MAG’s immediate past president and spokesman for a coalition of state and national specialty societies that represents nearly 50,000 physicians. “There is no place for big government in our exam rooms.”

Of S.B. 1776 – which would have eliminated the Medicare Sustainable Growth Rate (SGR) payment cuts that are scheduled to go into effect on January 1, 2010 and that would have indefinitely frozen Medicare payment rates – Dr. Williamson said, “MAG supported the provisions that were included in Senate Bill 1776 that were designed to address the flawed SGR on an unconditional basis.”

Dr. Williamson added that tort reform represents a reasonable and proven way to reform the nation’s unsustainable medical payment system.

Dr. Williamson said that, “Our physician coalition group is encouraging Senate leaders to produce legislation that addresses the flawed medical payment system in a way that ensures that individual patients can control their own health care dollars and can consult with the physician of their choice as a trusted advisor in making the medical decisions that are best for them and their families.”

The Coalition to Protect Patients’ Rights is a non-partisan, grassroots coalition made of more than 10,000 doctors, health care providers, advocacy groups, and concerned citizens who are dedicated to the implementation of patient-centered health care reform that will improve patient care. It’s headed up by former American Medical Association President Donald J. Palmisano, M.D. Go to www.protectpatientsrights.org for additional information on the Coalition to Protect Patients’ Rights.

With more than 6,000 members, MAG is the leading voice for physicians in Georgia. Go to www.mag.org/nationalhealthcarereform/ for more information.
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Russian Health Care Delegation Hosted by Emory

A delegation of Russian healthcare workers are in Atlanta to learn about improving the outcomes of pregnancy through the Perinatal Health Care Delivery System, initiated in the State of Georgia by former President Jimmy Carter when he was Governor.

The arrival of the delegation to Emory University comes at a critical time as strategies for bilateral cooperation between the United States and Russia make headlines.

Recently, Emory Professor of Pediatrics Alfred W. Brann Jr. attended the Civil Society Summit in Moscow as a representative of the public health working group and helped draft the recommended areas for joint United States and Russian cooperation in the field of public health and medical science in the broad area of maternal and child health.

As director of the Atlanta-based World Health Organization/Collaborating Center in Reproductive Health (WHO/CC/RH), Brann has worked tirelessly to reduce infant and maternal mortality and improve perinatal care in some 30 countries over the last 25 years.

The visit of Russian healthcare delegation to Emory is co-sponsored by The Future of Russia Foundation, Emory University (Claus Halle Institute of Global Learning, the Center for Russian and East European Studies, Emory’s Center for Ethics and the World Health Organization Collaborating Centre for Reproductive Health) and the Rotary Club of Atlanta.

The collaborative educational program between Russian and American perinatal health care professionals will review previous mutual concerns in reproductive health; discuss the present status of these concerns; and determine the next steps in putting into action the Obama/Medvedev memorandum of understanding (MOU) in the field of maternal and infant healthcare.

Brann serves as medical director of the Future of Russia Foundation (FOR) - the only U.S. charitable foundation created for and solely committed to the mission of modernizing the Russian system for delivery of health care to women of reproductive age and infants, addressing Russia’s declining population, identified in then-President Putin’s inaugural address as Russia’s “greatest crisis.” Brann served in both capacities to lead the development of The Balashikha Project - a comprehensive model for modernizing perinatal care throughout Russia.

“The Russian population is declining some 700 000 people per year. We feel that the Balashikha Project and its potential for improving the outcomes of pregnancy will significantly improve the Russian population by creating new healthy births,” says Brann.

Over the past nine years through the Balashikha project, Russian health care providers have participated in four bi-lateral exchanges with Brann and his Atlanta based colleagues to share ideas and experiences with neonatalogists, pediatricians, obstetricians, nurses, midwives and public health professionals.

This collaborative effort enabled health experts to create a successful perinatal center within a hospital in Balashikha, made it a referral center for high-risk mothers and babies in the Moscow Oblast, and created a postgraduate education for perinatal health professions in that region. A perinatal surveillance system is currently being developed.

“We are trying to create a system of compassionate and evidenced care practices to improve every family’s chances for a healthy pregnancy outcome where the mother and infant are alive and normal following childbirth,” says Brann.
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Mayo Clinic Offers Perspective on Health Care Reform in New England Journal of Medicine

Mayo Clinic's perspective about how to get high-value health care is the focus of a Perspectives article in the New England Journal of Medicine, published online on Sept. 23, 2009, and in the print issue on Oct. 1, 2009.

"We must hold physicians and other providers accountable for providing high-value health care, defined in terms of both quality and cost," say Denis Cortese, M.D., president and CEO of Mayo Clinic and Jeff Korsmo, executive director of the Mayo Clinic Health Policy Center. To help achieve this goal, Cortese and Korsmo recommend basing a portion of Medicare payments to physicians and hospitals on value scores (measurable good outcomes, safety and service delivered at a lower cost), rewarding those providers who deliver high-value care and providing an incentive for others to improve.

In their essay, Dr. Cortese and Korsmo emphasize other key points to achieve true patient-centered health care reform including:

•Coordinating patient care services across people, functions, activities, sites, and time

•Reducing conflict of interest so physicians have less of a personal financial incentive to order unnecessary tests or procedures

"It should also be noted that researchers from the Dartmouth Institute for Health Policy and Clinical Practice have studied regional variation in health care quality and spending," says Korsmo. "They have documented that more care does not necessarily translate into better care. The research suggests that the United States could reduce health care costs by 30 percent or more if all regions practiced to the standard of the best-performing medical centers." The article can be viewed online.

Note: The New England Journal of Medicine also published a Mayo Clinic survey on physicians' beliefs and health care reform in the Sept. 14 issue. It can be viewed online.
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Mayo Clinic Proceedings: Common Blood Disorder May Not be Linked to as Many Serious Diseases, as Previously Thought

A symptomless blood disorder, monoclonal gammopathy of undetermined significance, known as MGUS, is not linked to as many serious diseases as previously thought. This finding may save patients from undergoing unnecessary workup and treatment according to a study published in the August 2009 issue of Mayo Clinic Proceedings.

MGUS has long been thought to be a precursor of serious disease, such as multiple myeloma, primary amyloidosis and Waldenström macroglobulinemia. However, for years physicians have reported possible association of MGUS with many more diseases. As a result, some patients with MGUS who had these disorders were subjected to investigations and sometimes additional treatments as a precaution.

MGUS is a fairly common disorder, affecting roughly 3 percent of the U.S. population. This study was supported in part by grants from the National Institutes of Health and the U.S. Public Health Service.

In this study, researchers looked at the records of 17,398 patients, all of whom were uniformly tested for the presence or absence of MGUS. Among the 17,398 samples tested, 605 cases of MGUS were identified. The researchers then looked at the incidence of over 16,000 different diagnosis codes in those with MGUS and those without. They identified 14 real disease associations, while 61 disease associations with MGUS were determined to be likely coincidental.

In addition to multiple myeloma, the associations deemed real include vertebral and hip fractures and osteoporosis. "In addition to the article, we have made available on the journal Web site an appendix that has the raw data on all 16,062 hospital diagnosis codes which we think will be valuable to other researchers in the field," says S. Vincent Rajkumar, M.D., of Mayo Clinic's Department of Hematology and senior author on the study.

A peer-review journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 nationally and internationally. Articles are available online at www.mayoclinicproceedings.com.
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Operating Cells Via Joystick

Moving cells around by joystick without causing any damage helps doctors study live samples.

Biomedical research could someday look a lot like playing video games thanks to a new device that allows users to manipulate cells with the swerve of a joystick.

A team of physicists and engineers at Ohio State University in Columbus, Ohio developed the device from a tiny piece of square-centimeter silicon inlaid with rows of zigzagging magnetic wires. At each corner, the wire behaves like two magnets pointed north to north or south to south. The fields of the two magnets create a point of strong attraction just above them. A nearby magnetic object, such as a magnetically-tagged cell is attracted to the corner and gets stuck there

To get the particles moving, the researchers then place two magnetic fields around the chip one in the plane of the chip and the other perpendicular to it. By flipping the direction of these fields, the researchers can guide tagged cells along the zigzagging wire and even make them jump from one wire to the next. The researchers computerized the magnetic field switching so that a user steered the cells by simply handling a joystick.

The team at OSU put the device through its paces with magnetically-tagged T-cells, the body's guardians against infection. They snapped the cells to attention at one end of the chip, marched them down to the other end, and made them hop from one wire to another, reaching speeds of about 20 micron, or about a one-fifth the width of a human hair, per second.

Jeffrey Chalmers, the chemical engineer who tagged the T-cells for the experiment, said that the device would be ideal for examining tumor cells. To study biopsied tumors, researchers often treat them with enzymes, which break them down into their constituent cells. Researchers then separate cancerous cells they want to study from healthy cells like fat and blood.

By Lauren Schenkman
Inside Science News Service
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MHA Director McIlwain Prepared for the Challenges of the Health Care System

As health care remains on the front burner of political debate, the Master of Health Administration (MHA) program at Clayton State University is prepared to continue its mission of developing well-rounded competent individuals for administrative positions in varying types of health care organizations. The new director of the MHA program, Dr. Thomas F. McIlwain, is prepared for the challenges in a changing health care system.

“Change is inevitable, and the health care system is no exception,” he says. “In my 25 or so years of working and teaching in health services administration, I have seen the problems, issues, health policies, and health policy outcomes debated. Each new policy change is a tweak of the existing system, but each has been designed to make it better. I have no doubt of the outcome of the current debate. The system will get a little better.”

McIlwain comes to Clayton State with a wealth of prior industry and teaching experience. In the 80s, he served as an administrative associate at University Hospitals of Alabama while teaching in the MSHA program at the University of Alabama at Birmingham, where he received his Ph.D. in Health Services Administration. His administrative residency was with a for-profit system, American Medical International, which eventually merged with National Medical Enterprises to form what is now know as Tenet Health Care.

His immediate teaching position after UAB was at Appalachian State University in the Walker College of Business’ Department of Management. He served as director of the undergraduate health care management program for eight of the 10 years he was in Boone, N.C. He then moved to Mount Pleasant, S.C., where he served as MHA program director for three of the 10 years he was on faculty at the Medical University of South Carolina.

For the past four years he was associate professor of Public Health and vice-chair in the Department of Community Health Sciences in the College of Health at the University of Southern Mississippi in Hattiesburg. While there, he developed the graduate emphasis in health administration in the CEPH-accredited Master of Public Health program. He was also involved in the development of the cohort-based Executive Master of Public Health in Health Services Administration program.

McIlwain has consulted with health care organizations in the area of strategic planning including medical group practices, nursing homes, and hospitals. His research interests are in health care marketing, including direct-to-the-consumer pharmaceutical advertising, and health care strategic management.

“The main goal of the MHA program at Clayton State is to become CAHME (the Commission on Accreditation of Health Management Education) accredited. CAHME is dedicated to promoting, evaluating, and improving graduate healthcare management education. I was responsible for the re-accreditation of the MHA program at MUSC where the program received the highest awarded number for seven years,” McIlwain says. “My goal is to move this program to that level of quality education. This process will involve making sure that we have quality admissions, support, and outcomes in teaching, service, and research. We are moving the program to competency based outcome measurement also.

“I was attracted to Clayton State because of its proximity to the health care industrial complex of the Metro Atlanta area. This program is poised to become a premier provider of graduate health care management education in the Atlanta and Georgia region. My experience with accreditation and program management provides me with a perspective of what this University can accomplish in this type of program”McIlwain is looking forward to accomplishing many goals within MHA program.

“The goals of the program are to prepare students for positions of increased responsibility within healthcare organizations. It also provides individuals with clinical backgrounds the management skills needed to assume leadership positions,” he says. “We are also interested in attracting individuals who have experience in other industries but want to begin careers in health care management.

“Of course the goal of all health administration programs is to improve the quality of care and resource use in health organizations by graduating individuals with the skills and competencies to achieve this goal.”
McIlwain is married to Margaret, a family nurse practitioner, and is the father of two sons.

A unit of the University System of Georgia, Clayton State University is an outstanding comprehensive metropolitan university located 15 miles southeast of downtown Atlanta.
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Piedmont Fayette Hospital Hosts Prostate Cancer “Ask the Doc” Session in Recognition of Prostate Cancer Awareness Month

PFH is Proud to Now Offer Brachytherapy for Prostate Cancer Patients

According to the American Cancer Society, prostate cancer is the most common form of cancer found in American men. September is Prostate Cancer Awareness Month, and Piedmont Fayette Hospital (PFH) and the American Cancer Society want to help educate men about this disease which will affect one in six men in their lifetime.

Man to Man, the prostate cancer support group held monthly at PFH, will hold a special “Ask the Doc” session at its next meeting on Tuesday, Sept. 22, at 7 p.m. at Piedmont Fayette Hospital’s 1279 Building, in the 3rd floor conference rooms. Medical oncologist Jonathan Bender, M.D., and urologist Scott Shelfo, M.D., will lead the discussion and answer questions concerning prostate cancer.

This free and informative session will feature a variety of topics including risk factors, diagnosis, treatment options, and ways to control recurrent cancer. Participants will also learn more about the plans for the new cancer center at Piedmont Fayette Hospital, as well as new cancer treatments available at PFH, including brachytherapy, a cutting-edge treatment for prostate cancer.

Brachytherapy allows radiation to concentrate more on cancerous cells, therefore inflicting less damage on normal cells. This unique type of radiation therapy allows higher doses of radiation to be administered as close to the cancer as possible over a shorter period of time.

In brachytherapy, small radioactive isotopes are placed in seeds, wires and rods called implants and then placed in the body. There are two types of brachytherapy placement: temporary and permanent. Temporary brachytherapy uses higher doses of radiation in the implants, which are removed after treatment. Permanent therapy uses small implants, which are inserted directly into the tumor, with smaller doses of radiation that remain in place after radiation is complete.

Man to Man support group is held on the 4th Tuesday of each month from 7 to 9 p.m., and provides a forum for men and their partners to discuss diagnosis, treatment options, and quality-of-life issues surrounding prostate cancer. This program will be followed by a period of questions as well as a time for sharing experiences.

The presentation is open to the public. For more information on the event, please call Man to Man coordinator Jim O'Hara at 770-632-2898, or Lisa Cockerham of the American Cancer Society in Peachtree City at 770-631-0625. For more information on cancer services at Piedmont Fayette Hospital, visit fayettehospital.org.

About Piedmont Fayette Hospital
Named one of the nation’s Most Wired hospitals for five consecutive years in the 100 Most Wired Survey and Benchmarking Study, Piedmont Fayette Hospital (PFH), ranked third in patient satisfaction among metro Atlanta hospitals according to the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey released in March 2009. One of the nation’s 100 Top Hospitals® four years in a row (2004-2007) according to Thomson Reuters (formerly Solucient), Piedmont Fayette Hospital is a 143-bed, acute-care community hospital located on Highway 54 in Fayetteville, offering 24-hour emergency services, medical and surgical services, as well as obstetrics, diagnostic cardiac catheterization and rehabilitation services. With over1,100 employees and a medical staff of over 500 physicians, PFH is a member of Piedmont Healthcare (PHC), a not-for-profit organization that also includes Piedmont Hospital, a 481-bed acute tertiary care facility offering all major medical, surgical and diagnostic services located on 26 acres in the north Atlanta community of Buckhead; Piedmont Mountainside Hospital, a 42-bed community hospital in Jasper; and Piedmont Newnan Hospital, a 143-bed, acute-care community hospital in Newnan. Piedmont Healthcare also is the parent company of the Piedmont Heart Institute (PHI), which combines over 60 renowned cardiologists in the Piedmont Heart Institute Physicians with over 30 offices across north Georgia, and the 162-bed Fuqua Heart Center of Atlanta; Piedmont Philanthropy, the philanthropic entity for private fundraising initiatives; the Piedmont Physicians Group, with over 100 primary care physicians in 30 offices throughout metro Atlanta; and the Piedmont Clinic, a 600-member physician network. For more information, visit fayettehospital.org.
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Piedmont Fayette Hospital Celebrates Its Neonatal Nurses

September 15 is National Neonatal Nurses Day

In recognition of National Neonatal Nurses Day on Tuesday, Sept. 15, Piedmont Fayette Hospital would like to shine the spotlight on its neonatal nurses for the outstanding care they provide to patients.

“Sometimes we don’t say ‘thank you’ enough to our employees,” said Darrell Cutts, president and CEO of Piedmont Fayette Hospital. “This day is a chance for us to tell them how much we appreciate the top service they give to some of the smallest patients in our community.”

The Neonatal nursing team at Piedmont Fayette Hospital specialize in comprehensive care for premature and compromised infants from gestation of 28 weeks and greater. These nurses are charged with monitoring ventilators and incubators, making sure the baby is responding and checking for complications. Often nurses must be available to check on an infant every 15 minutes to record health parameters.

“Neonatal nurses are the ones we trust to take care of our most sensitive newborns and help prepare them to go home,” said Cutts. “Piedmont Fayette Hospital is proud to celebrate these nurses who so carefully and professionally look after our precious new loved ones.”

Take the time on Tuesday, Sept. 15, to thank and honor any neonatal nurses you know. For more information on Piedmont Fayette Hospital’s neonatal services, visit fayettehospital.org.
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Mayo Clinic Identifies Two Genes as Potential Therapeutic Targets for Multiple Sclerosis

Early research holds promise for new therapies and better prediction of patient outcomes

A Mayo Clinic study has found that two genes in mice were associated with good central nervous system repair in multiple sclerosis (MS). These findings give researchers new hope for developing more effective therapies for patients with MS and for predicting MS patients' outcomes. This study will be presented at the Congress of the European Committee for Treatment and Research in Multiple Sclerosis in Dusseldorf, Germany, on Sept. 11, 2009.

"Most MS genetic studies have looked at disease susceptibility — or why some people get MS and others do not," says Allan Bieber, Ph.D., a Mayo Clinic neuroscientist and author of this study. "This study asked, among those who have MS, why do some do well with the disease while others do poorly, and what might be the genetic determinants of this difference in outcome."

Mayo Clinic provides care for nearly 2,500 patients with MS each year. MS is a disease of the central nervous system that includes the brain, spinal cord and nerves. MS is called a demyelinating disease because it results from damage to myelin, the insulating covering of nerves. It occurs most commonly in those between the ages of 20 and 40, and is the most frequent neurological disorder in young adults in North America and Europe. Approximately 330,000 people in the United States have MS. Symptoms include loss of muscle coordination, strength, vision, balance and cognition.

Dr. Bieber and a team of Mayo Clinic researchers used two different strains of mice with a chronic, progressive MS-like disease. One strain progressed to paralysis and death. The other underwent the initial damage induction phase of the disease and then spontaneously repaired the damage to the central nervous system and retained most neurologic function. Using the powerful genetic mapping techniques that are available for mice, the team mapped two strong genetic determinants of good disease outcome.

"It's possible that the identification of these genes may provide the first important clue as to why some patients with MS do well, while others do not," says Dr. Bieber. "The genetic data indicates that good central nervous system repair results from stimulation of one genetic pathway and inhibition of another genetic pathway. While we're still in the early stages of this research, it could eventually lead to the development of useful therapies that stimulate or inhibit these genetic pathways in patients with MS."

According to Dr. Bieber, the research suggests that there may be a small number of strong genetic determinants for central nervous system repair following demyelinating disease, rather than a larger number of weak determinants.

"If that's true, it may be possible to map the most important genetic determinants of central nervous system repair in patients with MS and define a reparative genotype that could predict patients' outcomes," says Moses Rodriguez, M.D., a Mayo Clinic neurologist and director of Mayo Clinic's Center for Multiple Sclerosis and Central Nervous System Demyelinating Diseases Research and Therapeutics. "Such a diagnostic tool would be a great benefit to patients with MS and is consistent with the concepts of 'individualized medicine.'"

Also on the Mayo Clinic research team was Kanitta Suwansrinon, M.D.
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CDC Awards $22 Million for Colorectal Cancer Screening Program

The Centers for Disease Control and Prevention (CDC) has awarded a total of $22 million to 26 states and tribal organizations to provide colorectal cancer screening services for low-income people aged 50-64 years, who are underinsured or uninsured. Colorectal cancer is the second leading cause of cancer deaths among men and women aged 50 and older in the United States.

The awards range from $358,283 to $1.1 million. The awardees are expected to begin screening patients for colorectal cancer within six months.

The states receiving five-year awards are: Alabama, Arizona, California, Colorado, Connecticut, Delaware, Florida, Iowa, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, New York, Oregon, Pennsylvania, South Dakota, Utah, and Washington. The tribal organizations receiving awards are: Alaska Native Tribal Health Consortium, Arctic Slope Native Association, South Puget Intertribal Planning Agency, and Southcentral Foundation.

The funding will support screening and diagnostic follow-up care, data collection and tracking, public education and outreach, provider education, and an evaluation to measure the clinical outcomes, costs, and effectiveness of the program. The awardees can choose from among any of the recommended screenings for colorectal cancer - colonoscopy, sigmoidoscopy and stool testing.

"Colorectal cancer kills more people than any other cancer except lung cancer," said CDC Director Thomas Frieden, M.D., M.P.H. "These colorectal cancer screening awards will save lives. We need to reach more adults aged 50 and over and others at high risk to prevent colorectal cancer."

In 2005, more than 141,000 new cases of colorectal cancer were diagnosed and 53,000 people died from this disease. The number of new colorectal cancer cases could be reduced by as much as 90 percent if all precancerous polyps (abnormal growths in the colon or rectum), were identified using screening tests and removed before they become cancerous. However, only half of all U.S. adults aged 50 or older have been screened appropriately for colorectal cancer, and while screening rates are slowly increasing, disparities still exist. Screening rates remain higher for whites compared to all other races, for non-Hispanics compared to Hispanics, and for people with health insurance compared to those with no health insurance.

"Screening tests can detect colorectal cancer at its earliest stages, when it is most treatable," said Laura Seeff, M.D., medical director of CDC's colorectal cancer screening program. "This screening program has tremendous potential to address the disparities that exist in colorectal cancer screening and to save lives."

The goals of CDC's colorectal cancer screening program are to increase population-level screening among all persons aged 50 and older in the participating states and tribes, and to reduce health disparities in colorectal cancer screening, incidence and mortality.
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CDC to Distribute $40 Million in Recovery Act Funding to Help States Fight Healthcare-Associated Infections

Money marks first time Congress appropriates HAI prevention funds specifically to states

The Centers for Disease Control and Prevention today announced plans to distribute $40 million to state health departments to help prevent healthcare-associated infections (HAIs). Funded by the American Recovery and Reinvestment Act, the money will be distributed through cooperative agreements to 49 states, Washington, D.C., and Puerto Rico to maximize prevention efforts such as:

* Creating or expanding state and local efforts to implement recommendations in the U.S. Department of Health and Human Services HAI Action Plan

* Increasing health care facilities' and health departments' use of CDC's National Healthcare Safety Network, a surveillance system that allows HAI data to be tracked, analyzed and compared for prevention efforts

* Hiring and training public health staff to promote and lead HAI prevention initiatives

* Complementing HAI investments from other HHS agencies

"Americans expect to get better when they go to the hospital, not worse" said HHS Secretary Kathleen Sebelius. "Unfortunately, every year, thousands of Americans die from illness they contract after they enter the hospital. Thanks to Chairman David Obey's leadership, the Recovery Act includes critical resources that will help fight these infections and keep patients safe."

Efforts will focus on HHS priority targets such as bloodstream infections, surgical site infections and catheter-associated urinary tract infections, and will address pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. diff). The investment represents the first time Congress has appropriated HAI prevention funds specifically to states.

"We expect these programs to strengthen tracking and prevention of healthcare-associated infections, enhance facility accountability, provide data for informed policy, and ultimately save lives," said CDC Director Thomas R. Frieden, M.D., M.P.H. "Funding critical prevention efforts at state and local levels represents a significant investment toward elimination of HAIs and improved patient safety."

CDC estimates that every year, Americans contract 1.7 million infections while being treated in hospitals. These infections are associated with approximately 99,000 deaths annually. In addition to the significant toll on patients' lives, HAIs represent an estimated $30 billion in added healthcare costs.

HHS has addressed HAIs by coordinating efforts across the Department and creating the HHS action plan which includes five-year national prevention targets to reduce and prevent much of the significant burden to our nation. One of the goals of the HHS Action Plan is to collaborate effectively with public and private sector partners to accomplish the large-scale prevention of HAIs.

For instance, CDC is collaborating with several states that have demonstrated that implementing CDC's HAI prevention guidelines and using NHSN to monitor progress can achieve major decreases in HAIs.

Prevention success can be characterized in a number of ways. Some states have shown quick reductions after implementing prevention efforts, and others have sustained low infection rates over an extended period of time. For example, in the first six months of 2009, compared to 2008, hospitals in Tennessee achieved a 30 percent reduction of bloodstream infections associated with central lines (a catheter, or tube, that is inserted into a major vein or artery, and that ends up close to or in the heart). In another instance, intensive care units in a New York state hospital group achieved a 70 percent reduction of central line-associated bloodstream infections and sustained these rates for a three-year period.

"Many states and localities have lacked the resources and personnel needed to appropriately address the HAI burden," said Marion Kainer, M.D., M.P.H., director of the Tennessee Department of Health Hospital Infection and Antimicrobial Resistance Program, and HAI prevention lead for the Council of State and Territorial Epidemiologists. "This investment will provide a unique opportunity to make prevention of HAIs a national accomplishment."

Background on HAI Investments in the Recovery Act

The American Recovery and Reinvestment Act of 2009, Public Law 111-5 (ARRA) was signed into law on February 17, 2009. Within the Recovery Act, $50 million was appropriated to support states in the prevention and reduction of healthcare associated infections (HAI). The Centers for Medicare & Medicaid Services (CMS) will use $10 million to improvethe process and frequency of inspections for ambulatory surgical centers, while CDC will allocate $40 million to states to create or expand state-based HAI prevention collaboration efforts, enhance state abilities to monitor and track HAIs, and build within health departments a workforce trained in HAI prevention. For more information on the Recovery Act: www.recovery.gov. For more information about CDC's HAI Recovery Act funding: www.cdc.gov/hai/recoveryact.
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Emory Eye Center Doctor Provides Retina Expertise at Emory Clark-Holder Clinic

Emory Eye Center physician Jiong Yan, MD, assistant professor of ophthalmology at Emory School of Medicine and retina specialist within Emory Eye Center, now sees patients at Emory Clark-Holder Clinic in LaGrange, Ga., in addition to her roles at Emory Eye Center and the Veterans Administration Medical Center. Yan will see patients in LaGrange every other Thursday of the month.

Yan’s expertise will enable the residents of Troup County to have access to an Emory Eye Center ophthalmologist who can provide the highest level of care for retinal disorders. Emory Eye Center is a top-ranked academic eye institution with a three-fold mission of quality patient care, innovative research, and ongoing education, training future ophthalmologists from around the world.

Yan’s interests include diabetic retinopathy, macular disease, retinal detachment and age-related macular degeneration. Additionally, she directs the inherited retinal disease unit at Emory Eye Center. In her position at Emory, she has been involved in eight clinical trials, serving as either principal investigator or co-investigator. She has published nearly 20 papers.

“We are pleased to be able to serve patients in the LaGrange community,” says Yan. “Our retina patients must often have a family member drive them to their clinic appointment. The Emory Clark-Holder Clinic location will help those in the immediate area have closer access to advanced ophthalmic care. Because many our of retina patients need treatments every two months, a more convenient clinic will allow them to make their appointments with more ease. We are excited to work with these patients and provide the care they need, near their homes.”

Timothy W. Olsen, director of the Emory Eye Center, says “Emory Eye Center is excited to have an opportunity to work with our neighbors to bring subspecialty care to West Georgia. I’m certain that the talent and compassion of Dr. Yan will benefit her patients as well as the community. We look forward to our ongoing collaborations at Emory Clark-Holder Clinic.”

Anna Kao, MD, an ophthalmologist serving at Emory Clark-Holder says, “Ophthalmology has been a long-standing tradition with Clark-Holder Clinic. It is very exciting to see the expansion of our service with Dr. Yan’s experience. With the advancement of new technology and medicine, we are able to make a significant difference in saving sight for retinal disorders such as age-related macular degeneration. Dr. Yan’s presence in LaGrange will allow our local and surrounding residents to be part of modern medical advances.”

Yan attended medical school at Louisiana State University (1998). She completed an internship at UMDNJ-Robert Wood Johnson Hospital in New Brunswick, N.J. (1999). She finished a residency in ophthalmology at Emory University (2002), a vitreo-retina fellowship at the Jules Stein Eye Institute, University of California (2004), and an honorary fellowship in retinal dystrophy and degeneration at Moorfields Hospital, London. She joined Emory Eye Center in fall 2004. Yan also serves as chief of the Retina Service in the department of ophthalmology at the Veterans Administration Medical Center, Atlanta.

Yan is board-certified in ophthalmology and is a fellow with the American Board of Ophthalmology. Memberships include the American Academy of Ophthalmology, the Association for Research in Vision and Ophthalmology, the American Society of Cataract and Refractive Surgery, and the Georgia Society of Ophthalmology.

Background
Emory Eye Center has a mission to conduct pioneering research into blinding eye diseases, to educate and train eye professionals, and to provide excellent patient care. The Department includes 35 ophthalmologists, eight optometrists, ten basic scientists, 11 post-doctoral fellows, and nine researchers in other Emory departments who hold joint appointments in the Emory University School of medicine’s Department of Ophthalmology. Ophthalmology research is supported by current NIH funding - $20 million through 2010. The Department remains in the top rankings (#9 – 2009) by U.S. News & World Report for the 13 years the magazine has held a ranking for Ophthalmology. It also ranks in the Top Ten in all four categories surveyed by Ophthalmology Times annual report. http://eyecenter.emory.edu

Established in 1936, Clark-Holder Clinic is the largest multi-specialty group practice in West Georgia employing more than 30 doctors and other healthcare providers with a staff of 170. Key facilities are located in LaGrange, West Point and Newnan. Clark-Holder Clinic has provided medical services to the citizens of west Georgia and east Alabama for nearly 70 years. The partnership with Emory Healthcare physicians in January 2008 provided access to the highest level of care for the residents of Troup County and the surrounding areas.
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Improvements in Sexual and Reproductive Health of Teens and Young Adults

After a period of improvement, trends in the sexual and reproductive health of U.S. teens and young adults have flattened, or in some instances may be worsening, according to a new report from the Centers for Disease Control and Prevention.

CDC analyzed data from 2002-2007 from the National Vital Statistics System and numerous CDC reports and surveys including the Youth Risk Behavior Survey of high school students, the National Health and Nutrition Examination Survey (NHANES), the National Survey of Family Growth, the HIV/AIDS Reporting System, and the National Electronic Injury Surveillance System.

The data are reported in a Morbidity and Mortality Weekly Report Surveillance Summary, "Sexual and Reproductive Health of Persons Aged 10-24 Years - United States, 2002-2007." All the data are not new, but the goal of this report is to present data from multiple sources in order to summarize trends in the sexual and reproductive health of America's young people.

Findings include:
* There were approximately 745,000 pregnancies among U.S. females under age 20 in 2004.

* In 2006, the majority of new diagnoses of HIV infection among adolescents and young adults between the ages of 10 and 24 occurred among those aged 20-24 years and among males.

* About 1 million adolescents and young adults aged 10-24 years were reported to have chlamydia, gonorrhea, or syphilis in 2006. Nearly a quarter of females aged 15-19 years, and 45 percent of those aged 20-24 years, had a human papillomavirus (HPV) infection during 2003-2004.

* Approximately 100,000 females aged 10-24 years visited a hospital emergency department for a nonfatal sexual assault injury during 2004-2006.

Although the sexual risk behaviors and negative health outcomes tended to increase with age, the youngest age group - youth 10-14 years of age - were also affected:

* An estimated 16,000 pregnancies were reported among females in this age group in 2004.

* Approximately 17,000 young people in this age group were reported to have a sexually transmitted infection in 2006.

* During 2004-2006, 30,000 females in this age group visited a hospital emergency department because of a nonfatal sexual assault injury.

* Approximately one third of adolescents had not received instruction on methods of birth control before age 18.

"This report identifies a number of concerns regarding the sexual and reproductive health of our nation's young people. It is disheartening that after years of improvement with respect to teen pregnancy and sexually transmitted diseases, we now see signs that progress is stalling and many of these trends are going in the wrong direction," said Janet Collins, Ph.D., director of CDC's National Center for Chronic Disease Prevention and Health Promotion.

Among the signs that progress has halted in some areas:

* Teen birth rates increased in 2006 and 2007, following large declines from 1991-2005.

* Rates of AIDS cases among males aged 15-24 years increased during 1997-2006 (AIDS data reflects people with HIV who have already progressed to AIDS.)

* Syphilis cases among teens and young adults aged 15-19 and 20-24 years have increased in both males and females in recent years.

The report also identifies a number of racial/ethnic disparities.

Hispanic teens aged 15-19 are much more likely to become pregnant (132.8 births per 1,000 females) compared to their non-Hispanic black (128 per 1,000) and non-Hispanic white (45.2 per 1,000) peers. Additionally, rates of new HIV and AIDS diagnoses among young adults were highest among non-Hispanic black youth across all age groups.

"This report serves as a reminder that adolescents and young adults in this country continue to be impacted by STDs, including HIV," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "It is imperative that all of us at the national and community level work together to ensure STD and HIV prevention programs are reaching young people, particularly in communities with the greatest burden of disease."

The full report is available at www.cdc.gov/mmwr.

(Note: this came out in July, but we missed it, thought you may have also... )

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Dental Hygiene Holds Second Annual White Coat Ceremony

The Clayton State University Department of Dental Hygiene held its second annual “White Coat” ceremony on Aug. 17 in the Harry S. Downs Center. A total of 55 junior and senior students took the dental hygiene oath.

“The Dental Hygiene program’s White Coat Ceremony is a great day of recognition for our current students. The day welcomes the junior students into the program and introduces them to the responsibilities associated with patient care while in the dental hygiene program. The ceremony also reminds the senior students of their responsibilities associated with patient care in the program and also promotes the principles of professionalism they will need to embrace in their future practice of dental hygiene,” says Dr. Susan Duley, head of the Department of Dental Hygiene.

Dr. Karl Haden, founder and president of the Academy for Academic Leadership, was the keynote speaker at the ceremony. Tianddria Walton (Newnan), president of the Student American Dental Hygienists’ Association at Clayton State, led in reciting the oath along with her fellow classmates.

Haden was also guest speaker for the first White Coat ceremony at Clayton State in fall 2008. For more than 15 years, Haden has consulted with colleges and associations in academic healthcare. Haden’s areas of expertise include leadership development, organizational change, ethics, team building, negotiation and conflict management, strategic planning, curriculum development, and the scholarship of teaching and learning.

A unit of the University System of Georgia, Clayton State University is an outstanding comprehensive metropolitan university located 15 miles southeast of downtown Atlanta.
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Life Expectancy at All Time High; Death Rates Reach New Low, New Report Shows

U.S. life expectancy reached nearly 78 years (77.9), and the age-adjusted death rate dropped to 760.3 deaths per 100,000 population, both records, according to the latest mortality statistics from the Centers for Disease Control and Prevention (CDC).

The report, "Deaths: Preliminary Data for 2007," was issued today by CDC's National Center for Health Statistics. The data are based on nearly 90 percent of death certificates in the United States.

The 2007 increase in life expectancy - up from 77.7 in 2006 -- represents a continuation of a trend. Over a decade, life expectancy has increased 1.4 years from 76.5 years in 1997 to 77.9 in 2007.

Other findings:

* Record high life expectancy was recorded for both males and females (75.3 years and 80.4 years, respectively). While the gap between male and female life expectancy has narrowed since the peak gap of 7.8 years in 1979, the 5.1 year difference in 2007 is the same as in 2006.

* For the first time, life expectancy for black males reached 70 years.

* The U.S. mortality rate fell for the eighth straight year to an all-time low of 760.3 deaths per 100,000 population in 2007 -- 2.1 percent lower than the 2006 rate of 776.5. The 2007 mortality rate is half of what it was 60 years ago (1532 per 100,000 in 1947.)

* The preliminary number of deaths in the United States in 2007 was 2,423,995, a 2,269 decrease from the 2006 total.

* Heart disease and cancer, the two leading causes of death, accounted for nearly half (48.5 percent) of all deaths in 2007.

* Between 2006 and 2007, mortality rates declined significantly for eight of the 15 leading causes of death. Declines were observed for influenza and pneumonia (8.4 percent), homicide (6.5 percent), accidents (5 percent), heart disease (4.7 percent), stroke (4.6 percent), diabetes (3.9 percent), hypertension (2.7 percent), and cancer (1.8 percent).

* The death rate for the fourth leading cause of death, chronic lower respiratory diseases, increased by 1.7 percent. Preliminary death rates also increased for Parkinson's disease, chronic liver disease and cirrhosis, and Alzheimer's, but these gains are not statistically significant.

* There were an estimated 11,061 deaths from HIV/AIDS in 2007, and mortality rates from the disease declined 10 percent from 2006, the biggest one-year decline since 1998. HIV remains the sixth leading cause of death among 25-44 year-olds.

* The preliminary infant mortality rate for 2007 was 6.77 infant deaths per 1,000 live births, a 1.2 percent increase from the 2006 rate of 6.69, though not considered statistically significant. Birth defects were the leading cause of infant death in 2007, followed by disorders related to preterm birth and low birthweight. Sudden infant death syndrome (SIDS) was the third leading cause of infant death in the United States.

The full report is available at www.cdc.gov/nchs.
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Free Prostate Screening at North Fulton Regional Hospital

Tuesday, September 15 & Wednesday, September 16
5:15–7:30 p.m.

North Fulton Regional Hospital Outpatient Surgery (3000 Hospital Boulevard)
Glover Little, MD John Moseley, MD

The screening consists of a PSA blood test and a physical exam.Who should participate:
- Men age 50 or older with no prior history of prostate cancer
- Men age 40 or older with a family history of prostate cancer
- African-American men age 40 or older
- Men who have not been seen by a urologist or been tested for prostate cancer within the last 12 months
- Men who have not already been diagnosed with prostate cancer

Screenings are by appointment only, and space is limited. To schedule your FREE screening, call 770-751-2660.
www.northfultonregional.com
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Flu-Like Illness Being Reported in Communities District-Wide

District 4 Public Health wants parents and employers to know that flu-like illness is being reported in communities within the 12 county Region. Because only a small portion of persons with respiratory illness are tested for novel H1N1, confirmed and probable case counts represent a significant underestimation of the true number of novel H1N1 flu cases. Because of the low testing rate, we should not use these as indicators of the presence of H1N1 in our community.

We should be proactive and conduct ourselves as if this virus is already in our communities. Therefore, it is important for everyone to take steps to prevent contracting the flu and follow recommendations to prevent the further spread of illness.

Currently, the CDC is recommending that anyone with a flu-like illness stay at home for 24 hours after the last sign that fever is subsiding without the use of fever-reducing medicine. However, any ill persons who work in a health care setting are being asked to isolate themselves for up to seven days until feeling better.

“Public Health has been working closely with school systems and many other partners, some of these partners are also reporting incidents of flu-like illness,” said Michael Brackett, M.D., director of District 4 Health Services. “Novel H1N1 is confirmed in some parts of our District, so we are not surprised to see clusters popping up as schools reopen. This was predicted.”

The symptoms of novel H1N1 are similar to regular seasonal flu and include fever, lethargy, lack of appetite and coughing. Some infected people have also reported runny nose, sore throat, nausea, vomiting and diarrhea. Most people who get it recover at home in approximately a week, the same as with seasonal flu.

“There is no vaccine available yet to protect people from catching novel H1N1. Until a vaccine has been developed and proven safe, our best course of action is to take steps to prevent the spread of illness in our schools – not just novel H1N1 but any kind of virus,” said Brackett.
“Some of the medical recommendations will change as we learn more about this virus. These are everyday actions you and your children can take to stay healthy.”

• Do not send your child to school with a fever. Keep childrenwith flu-like illness at home so they don’t infect others.• Sick children should not return to school or participate in any activities putting them in contact with others until their fever has been gone for at least 24 hours without the use of fever-reducing medication.

• Cover your nose and mouth when you cough or sneeze (using your sleeve is good). If you use a tissue to cover coughs or sneezes, throw it in the trash after you use it. Teach your children to do the same.

• Avoid giving children aspirin and products that contain aspirin. Aspirin use with a virus has been associated with a rare medical problem called Reyes Syndrome.

• Wash your hands often with soap and water, especially after you cough or sneeze and before you eat. Alcohol-based hands cleaners are also effective if regular soap and water is not available. Be a good role model for your children.

• Avoid touching your eyes, nose or mouth. Germs spread that way.

• Try to avoid close contact with sick people.

• Have your family – including your children – vaccinated against regular seasonal flu.

People who develop severe illness should contact their local healthcare provider immediately. Most cases of novel H1N1 illness have been consistent with regular flu and should be treated similar to regular flu. People who have underlying at-risk medical conditions who develop flu-like symptoms or who think they were exposed but don’t have any symptoms should seek medical advice.

From what we know now, Public Health is NOT recommending schools close when novel H1N1 infections occur in students and/or faculty. However, we are working closely with Local, State and Federal Health experts and other partners to monitor the situation. Recommendations will change as the disease spreads and as we learn more about it or if the virus changes in severity.
For more information about novel H1N1, contact your local county health department or go online, www.cdc.gov or www.flu.gov.
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Clayton State Preparing Students and Faculty for Possible Swine Flu Outbreak

Clayton State University’s University Health Services is encouraging the Clayton State faculty and students to be prepared for flu season.

In an all-campus email communication, Dr. Julia Spinolo, director of University Health Services and assistant professor of Nursing, had a very basic message for the faculty…

“If a student has flu like symptoms (a fever of 100.5 or greater, sore throat, runny nose, and cough) please tell them to stay home!”

Spinolo also encourages faculty members to send students who appear to be ill to University Health Services (UHS) and to plan ahead.

“Develop a plan for notification of illness. Inform your students how you wish to be notified if they have the flu. Develop a contingency plan for how you will handle the continuation of instruction should you be ill and are unable to attend or conduct class for up to two weeks,” she said. “Review your attendance policies, penalties, and make up procedures for students work. Please consider that we WANT students to stay home if they are sick, so please be lenient regarding students missing class for illness.

“Consider needed changes in your syllabus and your attendance policies. Schedule make up days for tests and project/paper due dates. Consider alternative on line assignments that do not require class attendance as an option.”

Spinolo also reminds faculty about some of the basic prevention techniques, including using hand sanitizer and proper cough technique (coughing in the inner elbow instead of hands).

A similar message will be going out to the student body early next week, in conjunction with the start of fall semester classes.

A unit of the University System of Georgia, Clayton State University is an outstanding comprehensive metropolitan university located 15 miles southeast of downtown Atlanta.
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