August 4, 2014
Host: Ted Simons
Arizona’s Future: The Future of Medicine
- Much of the future of medicine is in determining how our genes contribute to sickness and how they can be used for wellness. Cutting-edge genomics research is being conducted on a daily basis in downtown Phoenix at the Translational Genomics Research Institute, or TGen. Dr. Michael Berens, TGen's deputy director for research resources, will discuss the myriad of research going on at the facility.
- Dr. Michael Berens - Deputy Director for Research Resources, Translational Genomics Research Institute
| Keywords: medical
Ted Simons: Tonight's edition of Arizona's future looks at how cutting-edge genomics research is being conducted on a daily basis in downtown Phoenix at the Translational Genomics Research Institute or TGen. Dr. Michael Berens, TGen’s deputy director for research resources is joining us now. It's good to have you here. There's so much to get to, but let's start with the definition. What is the human genome?
Michael Berens: Well, we all have one. We're humans. It's really our code of instructions of how we move from being a single cell at conception to becoming a complicated self-renewing human being. It's our genetic instruction. We believe it's the medical textbook of the future as we've learned how to read it in the last years or so.
Ted Simons: Is it pretty much like digitalizing, digitize, whatever the word is, the human body? It sounds like that's what it involves.
Michael Berens: Well, it's the code behind what we see in the human body. A digital code, for the computer people in the audience, there's a zero and a one. The genetic code has instead of just two components, it has four. There's four building blocks to make up the genetic code, and it's very similar to that. It's very easy to read now that we've sequenced it, and it's exciting. It gives us a way to look at human disease.
Ted Simons: The high school biology, it's starting to rear its ugly head. The impacts of genomics research on neurological disorders, neurological diseases, what's happening downtown?
Michael Berens: It's an exciting time. I think one of the most exciting things that we've seen in the last maybe two to three years to come out of TGen has been a strategy to better understand people who let us look at their genetic code in the context of how their memory works. TGen has a website that's called mindcrowd.org, and we've had over 30,000 people come onto that website, and they take a memory test, very simple. And then we can follow up and ask them for a cheek swab where we can get DNA and we can start to look for events that would correlate with memory behavior and there have been some amazingly exciting things. We're very interested in the healthy aging brain as well as the brain that doesn't age well. We all know people with dementia, Parkinson’s, Alzheimer's looking at the extremes, we get great insight into the genetic basis of those disorders.
Ted Simons: And I would also imagine things like autism, bipolar involves kids, as well.
Michael Berens: It does. Understanding how the brain develops has a lot to do with how it functions. I'm very proud, and I think the whole Arizona community should be proud of TGen's center for rare childhood disorders. These are families with children that have been on medical legacies, looking for some diagnosis, and now TGen's able to sequence the genetics of the kids and the family and start to identify events that could account for those problems, many, many times diseases that we don't even have a name for because of their rarity and we can find guidance on how to better care for those little ones. So that is a huge blessing for this state.
Ted Simons: Also, I understand looking for biomarkers as far as concussion-related injuries are concerned to athletes and those who wind up with head-related injuries.
Michael Berens: Well, athletes, but just humans on the planet that get bumps, fall off a bicycle or have some kind of altercation, we're very interested to know how severe was the event? Right now, it's very descriptive, and the neurologist and the E.R. staff have to work with soft metrics, but we're looking for biomarkers that might even be a saliva test to determine how severe a head injury, should an athlete not reenter a game? Take some time off? So we think we’re going to have healthier people as we understand these markers.
Ted Simons: In coming years, athlete gets injured, goes to the sidelines, do a little swab activity, and you might be able to, in the coming years, try to figure out if that athlete should be back on the field or not?
Michael Berens: Correct. We want to keep athletes healthy and strong and if there's been a severe event, we want to let them know and get them back in the game when they're fully recovered from those.
Ted Simons: The pathogen genomics studies in Flagstaff, what’s that all about? That sounds like it's everything from valley fever to HIV, to the plague, all points in between.
Michael Berens: Well, it's a phenomenal, focused, but very diverse team that works with us as part of TGen’s program at TGen North, our pathogen genomics division. We work with the Flagstaff community and with Northern Arizona University on these pathogens. Actually in our body, Ted, there are more microbes than there are cells that are me. It's a little bit of a bizarre thought, but there are lots of microorganisms, some of them are critical for the health of my body. We tend to think if it’s a bug it’s bad, they won't let it in, but having healthy microorganisms can have huge influences on gastrointestinal health and we want to learn better about how these things work so that's a fantastic resource that leverages the genomic strength of TGen.
Ted Simons: That’s the whole probiotic thing there, right?
Michael Berens: Correct. Well, that’s the strategy. If you have a healthy gut, you're going to have a much healthier body.
Ted Simons: And again, as far as the genomic impact and things like kidney disease and diabetes, the genomic impact specifically on those. What are you seeing out there?
Michael Berens: Well, we're better understanding subgroupings of a disease. So diabetes affects 26 million people in the United States. That's massive. If we could understand subgroupings and patients who respond to behavioral modification or behavioral input versus those who need real restrictive dietary regimens, those would be very helpful and give us more success in helping people get through that lifestyle kind of disease that that can represent.
Ted Simons: Kind of understanding why some people who are diagnosed with diabetes, they go on a diet, everything kind of gets back to normal or at least is treated, and some folks, you just can't seem to treat them.
Michael Berens: That’s correct. That's the whole range of who's most vulnerable, and then there's grades of that and so we want to better understand how we can better bring the right medicine to the right patient based on genomics.
Ted Simons: Let's talk about cancer research. How is TGen approaching cancer research? Is it with an elephant gun, are you starting to narrow things down there?
Michael Berens: I really hope that when people look at what TGen's doing in 2014 and we look in the rearview mirror down the road, they'll go wow, they got out their lasers and we took a very fine look at what makes a tumor vulnerable to the therapies we have today and how do you get the right chemotherapy or the right targeted therapeutic to the specific individual patients so that you are most likely to hurt the tumor without hurting the patient. And that's a fantastically exciting opportunity.
Ted Simons: Does that opportunity change when you deal with kids as opposed to the folks in middle age, as opposed to folks in later age?
Michael Berens: It actually does. The genetic noise in a cancer, in an older person, is large. There are an enormous number of genetic events in cancers from older people. We've been around a longer time. We've been exposed to more environmental agents, cosmic rays, various things, so those genomes of those cancers are very complicated. It’s tough to say who's the driver event and what do we design the therapy around? Tumors in children tend to be what we call quiet. There's very little noise. It's hard to decide how is that even a cancer? So it's an amazing contrast between pediatric cancers and adult cancers, but every time we study the whole genome of a cancer we learn about the disease and we learn about things that can affect the next patient. So it's so important that these patients who to me are the heroes, they help us understand the disease.
Ted Simons: Well, that's interesting. I think most people would think when you're born, you got your genomic makeup, and your human genome is set in stone and never changes. Are you saying it does change?
Michael Berens: Well, it does. Our genome, it's affected by environmental agents, by our diet. It's not necessarily the sequence of the genome, but they modify how the genes can get informed or unpacked to be used by cells. In the case of cancers, there are frank mutations and rearrangements and restructuring that takes place, just terribly damaging events in a very complicated system and those changes point us in the directions of how to treat the disease.
Ted Simons: This is fascinating stuff. So when you consider the future, our series looking at the future of a variety of things. When you look at the future of medicine, what do you see?
Michael Berens: Well, I hope that my kids have physicians that are trained in the practice of precision medicine, that they understand that you get a histological or the tissue diagnosis of the disease, but also, a genomic fingerprint of the disease. Did it come from my mom and dad so we have certain insights, but also if there's changes in the disease tissue, what can be done specifically to match a therapy to that event? And so I'm excited. Our Arizona medical schools are training physicians of tomorrow who are going to be groomed for this kind of practice.
Ted Simons: Well, it indeed is exciting. Great information, good to have you here, thanks for joining us.
Michael Berens: Wonderful to be here.
AZ Giving and Leading: Pet Connections
- When Hospice of the Valley patients need a little lift, they can turn to four-legged friends. Therapy teams make weekly or bi-weekly visits to homes and professional care settings. We’re not talking just dogs and cats. We’ll introduce you to Lilly, a 30-inch tall, 250-pound miniature horse, and Myrtle, the 107-year old patient who looks forward to her visits.
| Keywords: giving
Ted Simons: In tonight’s focus on “Arizona Giving and Leading,” producer Christina Estes and photographer E.J. Hernandez show us how a Phoenix-based program is creating unique friendships.
(Sound on tape)
Christina Estes: Inside the chapel at the Good Samaritan Society’s Peoria campus, Myrtle Clark is preparing for a special visitor.
Myrtle Clark: This is the only second time I saw her.
Christina Estes: Meet Myrtle's newest friend. At four years old, Lilly is much younger than Myrtle. At inches 30 inches tall, she's also much shorter, but the differences don't matter much.
Myrtle Clark: Yes! You're a sweet little thing!
Christina Estes: Lilly is part of “Pet Connection,” a Hospice of the Valley program where teams visit nursing facilities and patients' homes.
Myrtle Clark: She's used to being around people.
Christina Estes: Burt Mortensen is Lilly's partner.
People ask me all the time did I train Lilly to do this? And, no, I didn't train her to do this. I think it's her calling in life, and I think she enjoys it.
Myrtle Clark: Yes, you are so -- oh! [ Laughter ]
Christina Estes: It's not just Lilly's personality that generates smiles. It's also what she wears.
Myrtle Clark: Those shoes, I can't get over! I love horses. I always did from little on. My dad had two horses always going around. And they were regular pets.
Ann Roseman: This brings them all the benefits and joys of pet companionship without the burdens of ownership.
Christina Estes: Ann Roseman plays matchmaker for patients and pets.
Ann Roseman: We want to make sure that all the animals visiting for us have lovely, even and predictable temperaments, even in unpredictable and random circumstances.
You are so soft! You're like a kitty! Look at that baby dance!
Christina Estes: Employees at Hospice of the Valley's Phoenix office also enjoy the benefits of pet therapy. Every month, pets like Snickers show up to spread joy and collect treats.
Let's go visit.
Christina Estes: Snickers and his partner, Ann Kendall, are among nearly therapy teams. They've been making weekly visits for a couple of years.
Ann Kendall: You go in to a group home or a palliative care setting and maybe someone's not having a very good day and once they see Snickers and you see that big grin or smile on their face of their reaction, they've forgotten their troubles for that few minutes that you're there with them. And that's what we're all about.
Ann Roseman: These are people sometimes that don't recognize their families anymore, but they'll know oh, it's Snickers day today. They'll know what that means.
Thanks for coming by. Made my day!
Christina Estes: Lilly will make about 100 visits this year. Each one touching more than the patient.
She teaches me compassion and service and she just has unconditional love for anybody that she meets.
Ted Simons: The pet connection program also includes cats and rabbits. Find out more at hov.org. That is it for now. I'm Ted Simons. Thanks for joining us, you have a great evening.
Vote 2014: Early Voting
- Early voting is already underway, with the primary election set for August 26. Find out all you need to know to cast your ballot properly, whether you vote by mail, vote on Election Day or are registered as an independent. Maricopa County Recorder Helen Purcell will give us all the details.
Category: Vote 2014
- Helen Purcell - Recorder, Maricopa County
| Keywords: vote2014
Ted Simons: Early voting started last week and although casting a ballot may seem like a simple thing, there are lots of factors that come into play. Joining us now is Maricopa County recorder Helen Purcell. It is that time of year. Good to see you again. Are you busy? You must be just crazy busy.
Helen Purcell: Just a little bit.
Ted Simons: Just a little. Let's get to early ballots. I'm going to ask you a lot of questions here, just basic stuff. How do you request an early ballot?
Helen Purcell: You can do it a couple of ways. First of all, if you were on the permanent early voting list, you do not have to request. We would just automatically send you a ballot. If you happen to be not registered in a major party, then you have to tell us, even though you're on that permanent early voting list, you have to tell us which ballot you want. Do you want Republican, Democrat, Libertarian, Americans Elect or maybe you just want to do a city election, you can just ask us for a city ballot.
Ted Simons: Interesting because, again, independents can choose wherever they go, but they've got to choose one place.
Helen Purcell: That's right. But they can vote in the primary and that's the point that we've gotten across this year.
Ted Simons: Yes, yes. We'll see about that. Who, who can request an early ballot?
Helen Purcell: Anyone that's a registered voter can request an early ballot and you can do it if you're not on the early voting list, you can do it on our website, you can call our office at 506-1511 and request it that way. Anyone can request, up until the 15th of this month.
Ted Simons: So that's the deadline, right?
Helen Purcell: The deadline to request.
Ted Simons: What if you miss that deadline?
Helen Purcell: Then you can always go to the polls. You can go to an early voting site and we have a number of those around the country that you can go to one of those until the Friday before the election. So you still have a few days and if you miss all that, you can go to the polls on Election Day.
Ted Simons: I think people forget sometimes. They say, oh I missed the deadline; I can’t vote. Of course you can vote, just go to the polls.
Helen Purcell: Absolutely.
Ted Simons: Alright so, what if you've just moved here, maybe you've got a forwarding order for your address. How does that come into play?
Helen Purcell: I'm missing what you're saying.
Ted Simons: Well, let's say that you've moved and you've got a forwarding order with the post office. Is that enough to get everything election-related and registration-related sent --
Helen Purcell: Not your ballot. A ballot is not forwarded. It will come back to us. If you're not at that address any longer, it will come back to us. So if you didn't get your ballot, then you need to contact us.
Ted Simons: So if you've moved and you haven't updated your registration?
Helen Purcell: That's right.
Ted Simons: So basically a post office, all that kind of change, not good enough.
Helen Purcell: Not good enough. If you haven't updated that registration, not good enough.
Ted Simons: So let's say you've requested the early ballot, can you learn if you're registered on the website?
Helen Purcell: Absolutely, you can go to our website, you can go to the Secretary of State’s website and find out if you're registered.
Ted Simons: Okay. How do you cast an early ballot?
Helen Purcell: Well, we sent them out this year in bright yellow envelopes, so you take that ballot out of the envelope and you vote the ballot, you can look at the sample ballot online if you want to ‘cause there’s sample ballots is online, but you take that ballot out, we want you to study it. You've gotten a lot of information in the mail and so forth, vote that ballot, put it back in another yellow envelope and send it back to us. Be sure you sign and date the outside of that envelope.
Ted Simons: Now, am I correct in assuming that you can't just use any old pen? You can’t use like a red ink or a permanent ink on these?
Helen Purcell: Red ink will not show up on our computers so you need to use -- we suggest a black pen. It doesn't have to be a felt tip like we use at polling places, but just a regular black pen.
Ted Simons: And the idea is to connect those two sides.
Helen Purcell: Just connect them. You don't have to scrub it or anything like that. Just connect them.
Ted Simons: You don’t have to make artwork out of it. Just connect them. What if you make a mistake? You’re sitting there at home and oh, my goodness I just voted for the wrong person.
Helen Purcell: You let us know and if you send it back to us and say I need a duplicate ballot or give us a call and we will make sure that that first ballot does not count and we'll reissue you a ballot.
Ted Simons: Okay. That bright yellow envelope, what if the dog eats it or what if you lose it? What happens if you lose the envelope?
Helen Purcell: There again, you have to let us know. Because we have to have an envelope coming back that's got your signature and the date on it. So we can replace that if we need to.
Ted Simons: And as far as, again, early ballots having to be received. That date is?
Helen Purcell: They have to be received by Election Day.
Ted Simons: By Election Day.
Helen Purcell: Seven o’clock on election night. If you have not dropped your early ballot in the mail and I wouldn't put it in the mail after the 20th of August. If you haven't done it by then, you can drop it off at any polling place and that will be received in our office that night.
And you say the 20th. That would be six days before the election. Is that because postmarks don't count?
Helen Purcell: No, postmarks do not count in Arizona.
Ted Simons: Interesting. Can you check the status of your ballot? If you’ve gone ahead and mailed it in, could you say did you get it, did you get it?
Helen Purcell: Absolutely.
Ted Simons: You can?
Helen Purcell: You can check online.
Ted Simons: Wow, alright. Casting early ballots on Election Day. How does that work?
Helen Purcell: As I said, you can drop them off at any polling place on Election Day. Those are the first ballots that we take care of, are those early ballots that have been turned in on Election Day either in the mail or at a polling place and those have to be processed. And then we get to the provisional ballots. If for some reason you had to vote a provisional ballot, we want to make sure first that you haven't voted that early ballot if you ordered it. And then we will process your provisional after we process the early ballot.
Ted Simons: And, as you said, signed and sealed in that envelope.
Helen Purcell: That's right.
Ted Simons: Now, if you haven't cast a ballot, you requested the early ballot, you got the early ballot, you haven't cast a ballot, do you still go to the polls. You got to do the provisional thing again, don’t you?
Helen Purcell: That’s right. If you don't have that ballot with you, you have to vote a provisional ballot.
Ted Simons: What does that entail?
Ted Simons: It's just we have provisional ballots tables that you can go to. And this year there’s going to be a change at the polling place because we have electronic poll books. So you’ll walk into a polling place with your identification, let's say your driver's license or your voter registration card, you swipe it through the reader and your name will automatically pop up. If you're in the wrong place, as we have had people do before and you want to get to your right voting place, the electronic poll book will print out a receipt for you that will tell you where your polling place is and give you cross streets to get there.
Ted Simons: Oh my goodness, that is quite an improvement, isn’t it? It's Brave New World out there at the polling place. As far as this permanent early voting list, how do you get on it again, I need better information on that. That one seems like it's kind of controversial. How do you get on it and is it still okay if you missed a few? Because I thought the law -- they were trying to push that through, but I don't think that made it through, did it?
Ted Simons: It's still okay if you missed a few. We do not change your status for the fact that you haven't participated in an election. We'll change it if you've moved because then we can't deal with you anymore. But anybody can call us, anybody can re-up, go to Service Arizona and say I want an early ballot. Go to our recorder's website and say I want an early ballot. There are any number of ways you can do that.
Ted Simons: The question you get most often regarding early voting, what do you hear most often?
Helen Purcell: I think –- I didn’t get my early ballot. We've had already at our call center people, my husband got his and I didn't get mine. Well, you're not on the permanent early voting list and your husband was. So now, you can order it, and we'll send it to you. Why haven't I gotten a ballot? My neighbor got a ballot. Why didn’t I get one? You haven't signed up for one. Those are the kinds of questions.
Ted Simons: And as far as -- and as far as again, independent voters because that's such an interesting aspect of the election. What do they need to know?
Helen Purcell: We've concentrated on that this year, let them know that they can vote, let them know that they have to let us know. So we sent them a 90-day notice telling them they need to tell us which ballot they want and then we again send them the 33-day notice, again telling them we haven't heard from you yet, we would like to hear from you. Now, we've had almost 60,000 of those people that have requested a ballot for the particular party they want, which is a lot more than we even had participate in the 2012 election. We only had about 43,000 participate in the whole 2012 election.
Ted Simons: And you, of course, are hoping that they return the envelope in the mail and don't come in there with those provisionals. Because that makes for late counting, doesn’t it?
Helen Purcell: That's the one problem that we have and that's what we're trying to alleviate with the work that we've done up to now.
Ted Simons: Well alright, it sounds like all systems are a go as they say. We'll see how far they go. Always a pleasure, good to have you here.