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December 12, 2014
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UW Medicine takes impressive role on Ebola, locally and globally
Like health organizations everywhere, UW Medicine has been preparing for the possibility of an Ebola diagnosis in a patient coming to one of our hospitals or neighborhood clinics for treatment.
Over the past weekend, that preparation was put to the test when a 52-year-old man who had traveled to Mali was taken to Harborview Medical Center with symptoms of possible Ebola infection. Fortunately, he was not infected with the deadly virus.
Jeff Duchin, chief of communicable disease and epidemiology for Public Health - Seattle and King County and UW professor of medicine, told media last weekend that 14 people in King County are now under Ebola surveillance.
As part of our regional Ebola planning, the Washington State Department of Health has designated Harborview Medical Center as one of our state’s Ebola Treatment Facilities prepared to care for a patient with confirmed Ebola virus disease for the duration of a patient’s illness. Harborview had an on-site assessment of our Ebola preparations by the Centers for Disease Control and Prevention (CDC), Washington Department of Health and Public Health on Dec. 8, leading to this state designation following the CDC guidelines for a tiered approach to acute healthcare facility preparations.
The UW campus as a whole, and UW Medicine as a healthcare system, have done extensive readiness preparation that aligns with national guidance from the CDC and with localized advisories from city, county and state health departments.
"Plans are constantly updated to stay abreast of the latest information and guidelines on Ebola, and to incorporate lessons learned from institutions and individuals who have managed cases," said John Lynch, who is working with Timothy Dellit, Harborview’s associate medical director, on overseeing UW Medicine’s Ebola preparedness. Both are UW associate professors of medicine in the Division of Allergy and Infectious Diseases.
UW Medicine physicians are also being deployed to the CDC in Atlanta for an up-close look at handling an outbreak. Christopher Sanford, UW associate professor of family medicine and global health who heads the UW’s Northgate Travel Clinic, is in Atlanta for two weeks this month. He relieved Stephen Morris, UW acting instructor in emergency medicine, on deployment. He said the CDC has a large team (over 500 in Atlanta and about 150 in West Africa) working on Ebola and they offer consultation 24 hours a day. Sanford is helping physicians and epidemiologists determine the risk of Ebola in their patients and giving advice regarding testing, quarantine and transportation.
I would like to thank all faculty and staff who have helped in this effort both here and in West Africa. These efforts highlight what an exceptional resource and leader UW Medicine is locally and worldwide.
Among UW colleagues serving in West Africa, Shevin Jacob, UW acting assistant professor of medicine in the Division of Allergy and Infectious Diseases is on his fourth deployment this year, consulting with the World Health Organization. His moving account on the front line was excerpted in the Nov. 21 Online News. Karin Huster, a former Harborview nurse who studied global health at UW, is on her second deployment, and has written op-eds in The New York Times and Seattle Times, among others. Jeri Sumitani, a physician working with UW’s International Training and Education Center for Health in South Africa, is blogging about her experience for WebMD.
For additional resources, please see the following Q&As:
Paul G. Ramsey, M.D.
Did you ever wonder why deer ticks don’t get infected with Lyme disease? Lyme disease is a debilitating illness that can lead to everything from headaches to neurological disorders if left untreated. It’s transmitted through the saliva of deer ticks.
A recent discovery, reported in the Nov. 24 issue of Nature could one day make deer ticks vulnerable to the disease they transmit. Researchers at UW found that the genes they thought were only present in bacteria were also inside ticks and mites. Deer ticks use these genes to produce a toxin that keeps Lyme from replicating to the point that it kills them.
"This result was particularly surprising because the only role so far attributed to these toxins involved competition between bacteria," Joseph D. Mougous, UW associate professor of microbiology, told The Washington Post.
The animal toxins were serendipitously discovered when the Mougous group was working with evolutionary biologist Harmit Malik at the Fred Hutchinson Cancer Research Center to find more bacterial competition toxins. Their analyses revealed that these genes had jumped from bacteria into animals and had become permanently incorporated into the genomes of these animals through a process known as horizontal gene transfer. While such transfer events are common between microbes, very few genes have been reported to jump from bacteria to more complex organisms.
Mougous, the lead author of the study, said inhibiting the tick's ability to regulate Lyme is a far-fetched hypothesis discussed by researchers as a possible medical benefit. Such a thing would probably require decades of study if it can ever be achieved. "I would say the real benefit to the medical community is that the basic biology of ticks and the tick immune system are quite understudied," Mougous told The Washington Post. "The more we understand how these organisms modulate the levels of bacteria (and other pathogens for that matter) in association with them, the closer we are to identifying creative ways to intervene in transmission."
The Nature paper is titled, “Transferred interbacterial antagonism genes augment eukaryotic innate immune function.” The research was funded by the National Institutes of Health, the Defense Threat Reduction Agency, and the Biotechnology and Biological Sciences Research Council, with additional support from the Howard Hughes Medical Institute.
The University of Washington School of Medicine's Palliative Care Center of Excellence, launched just two years ago, received a $10 million grant from the Cambia Health Foundation based in Portland, the largest grant ever from Cambia.
The interdisciplinary center, which will be renamed this month as the Cambia Palliative Care Center of Excellence, was launched in 2012 under the direction of Randy Curtis, UW professor of medicine in the Division of Pulmonary and Critical Care Medicine. The center, which involves health professionals in medicine, public health, nursing and social work, helps to manage the pain, stress and symptoms that come from serious chronic illnesses, not just end-of-life treatment.
"As our society ages and more people are living with chronic illness, we see that more and more people will need palliative care to deal with health problems and we believe this fund will continue to bolster the workforce and provide students with fellowships," Peggy Maguire, president of the Cambia Health Foundation, told The Puget Sound Business Journal.
The funding will be used to hire more people so that more health care professionals will have the chance to practice this type of care and integrate it into their work. The funding will also support palliative care research and education at UW Medicine.
Several events will be taking place around the world and at UW to mark the launch of a Dec. 18 special supplement to the Journal of Adolescent Health (JAH). The special supplement marks 20 years since the landmark International Conference on Population and Development took place in Cairo. The conference laid out a bold, clear and comprehensive definition of reproductive health and rights for all segments of the population, including adolescents. This plan was adopted by 179 countries.
Today, efforts to reach adolescents (10-19 years of age) with education and health services have often been too limited, too little and too late and with deleterious effects. For example, HIV-related deaths have declined worldwide, but increased by 50 percent from 2005 to 2012 among adolescents. In the United States, teen pregnancy rates are among the highest in industrialized countries and double that of Canada. And in Washington state, pharmacy access to emergency contraception can still be denied.
Donna Denno, UW associate professor of pediatrics and global health, is the lead author on the supplement article on sexual and reproductive health services. She said that evidence was strongest for multi-component packages that not only train and support health providers, but also make adolescent-friendly modifications to clinics (such as by improving privacy and confidentiality), engage adolescents to generate demand and work with communities to gain acceptance for these services. Denno emphasized that improving access to comprehensive sex education and adolescent-friendly health services are effective and do not lead to earlier, increased or unsafe sexual activity.
Denno spoke on Dec. 11 on campus as part of the series of launch events to bring greater attention to adolescent sexual and reproductive health and rights. She was joined by UW Department of Global Health Chair Judith Wasserheit; Clarissa Lord Brundage from the Bill & Melinda Gates Foundation; Marleen Temmerman, World Health Organization director of reproductive health and research (via recorded video); Rachel Katzenellenbogen, UW assistant professor of pediatrics; Andrea Hoopes, a UW fellow in adolescent medicine; and a panel of students from the Department of Global Health, who addressed realities from the field perspective.
By Doug Nadvornick
First-year students attending the UW School of Medicine at the Spokane WWAMI site have the option of completing the second year in Seattle or Spokane. In the last two years, 28 students have remained in Spokane to participate in a pilot study on a small group learning environment. In the small-group setting, students are expected to do more reading and review case studies before class to prepare for discussions.
"This method of teaching is much more holistic," said Bill Sayres, one of the clinician educators who teach in the pilot program. "We try to integrate the three traditional second-year subjects of physiology, pathology and pharmacology in our curriculum. These are normally taught as separate courses, often overlapping in some areas. This integration reflects how a clinician approaches a patient."
The move away from lectures and toward small-class discussions represents a new method of learning for many students as well as a new of teaching for clinician educators.
"Our 'process' is evolving," said Bruce Abbotts, one of the four clinician educators. "We've learned a lot about the details, assigning reading and organizing the information for the students in a meaningful way. We can direct changes to make individual sessions better and to make the overall course flow better," he said. "I also think I've become a better facilitator. I had to learn to step out of the role as an 'authority' and be quiet and let the students solve problems."
By Darryl Potyk
The primary work of a professor of medicine in a medical school is in the wards, teaching his pupils how to deal with patients and their diseases." - Sir William Osler
Osler's advice is clear: Integral to the role of the physician is teaching. There was ample evidence of this at the Faculty Development Seminar in Spokane September 23, sponsored by UW, WSU and Providence Sacred Heart Medical Center. The idea of clinicians as teachers is fully embraced but not all great clinicians are great teachers. Faculty development sessions are designed to help physicians hone their teaching skills for maximal effectiveness.
The collaborative Faculty Development Seminar featured two speakers from UW School of Medicine. Byron Joyner, vice dean for graduate medical education, discussed recognizing and appreciating the generation gap and accompanying traits often separating practicing physicians and millennial students. Christina Surawicz, assistant dean for faculty development, emphasized the art of ensuring that bedside teaching incorporates the needs of both the patient and the learner in a respectful manner. Surawicz's comments included input from "master clinicians" in the Spokane community.
More than 90 physicians from the Spokane community attended this event after a full day of seeing patients. Attendees included those already involved in teaching medical students and residents, as well as those who are not currently teaching but would like to be.
UW researchers Paul Lange, chair and professor emeritus of urology, and Robert Vessella, professor of urology and director of the UW Genitourinary Cancer Research Lab, received the prestigious Lifetime Achievement Award from the Prostate Cancer Foundation.
The Prostate Cancer Foundation, the leading philanthropic organization funding and accelerating prostate cancer research globally, was started by Michael Milken, a former American financier who funded medical research after getting the disease himself. His foundation has raised and distributed over one-half billion dollars in research monies and more than $12 million to researchers at UW and Fred Hutchinson Cancer Research Center (FHCRC), said Lange.
and Vessella received the award at the foundation’s annual meeting in October, the
largest and best-known prostate cancer research meeting in the world.
Every year, the UW Medicine Alumni Association recognizes exceptional alumni with a series of awards for professional achievement and community service. UW Medicine alumni, faculty, staff and other professionals are encouraged to nominate colleagues who received a degree from, or completed residency or fellowship training in, a program administered by the UW School of Medicine or one of its academic departments. The association will accept nominations for the 2015 awards through Thursday, Jan. 15, 2015. If you have questions, please visit www.uwmedalumni.org/awards or contact the Office of Alumni Relations at 206.685.1875 or firstname.lastname@example.org.
Rising Stars is a faculty career-development program that provides promising early-stage investigators from the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region with a high-quality, targeted and structured career development package for two years. The package includes components such as research funding up to $15,000, mentoring, peer-to-peer networking and review services. For more information about applying, see the Institute for Translational Health Services site.
Visit Continuing Medical Education for information on upcoming classes.