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February 15, 2013

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Message from Paul Ramsey

Paul G. Ramsey

UW Medicine at the forefront of rapidly changing healthcare landscape 

Dear Colleagues:

Last Thursday in my annual address to the UW Medicine community titled Rapid Changes, Enduring Values, I reviewed progress at UW Medicine in 2012 and discussed directions for the future. As I said in my remarks, change in healthcare has never been so rapid. Change is the new norm, and we are likely to experience an accelerated pace of change over the coming years. Many UW Medicine faculty, staff and students are leading rapid changes in research, education and clinical programs, and your work is making very important contributions to advance our mission of improving the health of the public.

The faculty, staff and students of UW Medicine are world leaders in healthcare. In science and medicine, you lead the world in innovative work at both the micro and macro levels, from the ENCODE project—the “operating system for the human genome”—to the Global Burden of Disease project, a comprehensive understanding of changes in health burden patterns worldwide with dramatic policy implications for how we address health. As the largest and most comprehensive healthcare system in King County, our strategic plan is designed to position UW Medicine as one of the leading accountable care organizations in the nation. We meet the needs of our communities in vital areas and continue to serve those in greatest need. In medical education, our continuous curriculum renewal is focused on innovation that will build on the history of excellence and cost effectiveness of the WWAMI Program. Our clinical programs are based on the principle that “patients are first,” and our education programs focus on active, integrated learning that will support the interprofessional competencies required to improve healthcare for individual patients, improve the health of the population, and control costs.

At the same time that we innovate and embrace change, a defining characteristic of UW Medicine is that we maintain enduring values—excellence, innovation, collaboration, community, service—that position us as leaders and sustain us as a community.

If you were not able to attend my address, it is available for you to view online. I would very much appreciate hearing from you about what you believe has worked well at UW Medicine and where we can improve. Your thoughts and opinions matter a great deal. I would like to take this opportunity to thank each and every member of the UW Medicine community. We are fortunate to have an exceptional community of individuals with diverse and complementary talents. With your talent and commitment, we are advancing our mission of improving the health of the public. Thank you for all that you do on behalf of this meaningful mission.


PGRamsey Signature2


Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington



UW scientists probe a key to healthy aging 

Matt KaeberleinEvidence is accumulating that it not only possible to slow the aging process, but that by doing so, the onset and progression of multiple age-related diseases can be delayed, according to a review by University of Washington scientists in the journal Nature.

“Slowing aging should increase both lifespan and healthspan—the period of life spent in relatively good health, free from chronic disease or disability,” the authors write.

“A shared feature of most medically relevant diseases is that your risk of dying from them increases dramatically as you get older”, said Matt Kaeberlein, senior author of the paper. “Unlike traditional approaches, which tend to focus on a specific disease, targeting the aging process itself has a much greater potential to improve human health.

UW scientists examine how the inhibition of the protein mTOR, which stands for “mechanistic target of rapamycin”, may modulate aging and age-related disease. The review was written by Simon Johnson, a graduate student in pathology; Peter Rabinovitch, professor of pathology; and Matt Kaeberlein, associate professor of pathology.

Many experts in the biology of aging believe that pharmacological interventions to slow aging are a matter of 'when' rather than 'if'. A leading target for such interventions is the nutrient response pathway defined by mTOR, a protein that controls cell growth.

“Inhibition of this pathway extends lifespan in model organisms and confers protection against a growing list of age-related pathologies. Characterized inhibitors of this pathway are already clinically approved, and others are under development. Although adverse side effects currently preclude use in otherwise healthy individuals, drugs that target the mTOR pathway could one day become widely used to slow aging and reduce age-related pathologies in humans,” said the authors.

The authors compare the effects of mTOR inhibition to the positive effects in rodents of dietary restriction in extending the lifespan and delaying the incidence of age-related decline and disease, including cancer, cognitive decline and neurodegeneration.

“Emerging evidence suggests that, like dietary restriction, mTORC1 inhibition may have similar positive effects on multiple age-related pathologies in rodents and, in some cases, humans,” according to the scientists.

The UW is an internationally recognized leader in aging research. It has NIH-funded Centers of Excellence in the basic biology of aging (Nathan Shock Center), Alzheimer’s Disease (Alzheimer’s Disease Research Center), and Parkinson’s Disease (Morris K. Udall Center), and is working with Kaeberlein to establish the UW Healthy Aging and Longevity (HALO) Research Institute.

“It may sound a bit like science fiction,” said Kaeberlein, “but there is growing confidence in the field that we really can develop drugs that slow human aging and extend the period of healthy life for most people. Imagine what you could do with an extra 10 or 20 years of youthfulness.”

Read more in Nature.

Russ Van Gelder receives prize for 'audacious' vision research idea

Russ Van GelderRussell Van Gelder, UW professor and chair of the Department of Ophthalmology, is one of 10 recipients of the National Eye Institute’s  (NEI) Audacious Goals Challenge prize, a nationwide competition for “compelling, one-page ideas to advance vision science.”

The NEI Challenge to Identify Audacious Goals in Vision Research and Blindness Rehabilitation is part of a federal effort to bring the best ideas and top talent to bear on the nation’s most pressing challenges through the awarding of prize money, among other types of awards. The challenge sought ideas that support the NEI mission to conduct and support research and other programs aimed at reducing the burden of vision disorders and disease worldwide.

Prize competition entries were solicited not only from experts in vision research, but also from anyone in the private, government, and nonprofit sectors, including scientists, engineers, healthcare providers, inventors, and entrepreneurs, as well as the general public. Entries were reviewed by experts on the basis of relevance to the NEI mission and whether the idea is bold, daring, unconventional, or exceptionally innovative; broad in scope; and potentially attainable in about 10 years.

More than 80 experts in the vision community helped narrow the field of nearly 500 to 81 final candidates. A federal panel consisting of 13 clinicians and scientists then selected the winning ideas.

Van Gelder’s idea, Reversing Retinal Blindness Using Small Molecules, seeks to restore vision to patients with retinal diseases through the use of a photo switch, a small molecule that is chemically modified to become active or inactive after exposure to certain wavelengths of light.

Other winning ideas included restoring light sensitivity to the blind, precision correction of defective genes, and growing healthy tissue from stem cells for ocular tissue transplants.

Each winner will receive a $3,000 prize plus travel expenses to attend and present their ideas at the NEI Audacious Goals Development Meeting, Feb. 24-26, at the Bolger Conference Center in Potomac, Md. The meeting will include 200 vision researchers, patient advocates, ophthalmologists, and optometrists from the U.S. and abroad. Following the meeting, NEI staff and members of the National Advisory Eye Council will finalize and publish a set of the most compelling audacious goals for the institute and the broader vision research community to pursue over the next decade.

For more information, visit the Audacious Goals website.   



Clinical Care  

A healthy body image reduces risk of eating disorders 

The following was adapted from an article by Suzanne El-Attar, family medicine physician at UW Neighborhood Shoreline Clinic. The article was published by Journal Magazine.

Suzanne El-AttarAccording to the National Eating Disorders Association, about 20 million women and 10 million men in the United States suffer from an eating disorder during their lifetime. The most common problems are anorexia nervosa, bulimia nervosa and binge-eating disorder. Although teenage girls and young women are most at risk, eating disorders affect people of all ages.

Anorexia is characterized by extreme thinness. Because anorexics have an intense fear of gaining weight, they eat very small quantities of food. They may also see themselves as being overweight, even when they are very thin. For women, one risk is lack of menstruation and infertility. Severe weight loss can also cause life-threatening damage to the heart, liver, kidneys, bones, muscles and intestines.

Bulimia involves episodes of binge-eating followed by purging. To compensate for overeating, bulimics engage in behaviors such as forced vomiting, excessive use of laxatives or diuretics, fasting, and excessive exercise. Like anorexics, bulimics want to lose weight and are unhappy with their body size and shape. Symptoms of regular purging include chronic sore throat, swollen salivary glands, dental problems, intestinal distress, severe dehydration, and electrolyte imbalances.

Binge-eating differs from bulimia in that purging is absent, but it often results in the same distress about overeating. Many people with binge-eating disorder are overweight or obese, which increases their risk of developing high blood pressure, diabetes and cardiovascular disease.

Eating disorders are treated with counseling and by relearning eating habits. With anorexia, the focus is on gaining weight. Bulimic patients may benefit from certain medications. People with eating disorders commonly hide their behaviors and often do not seek treatment.

The National Eating Disorders Association will observe its Awareness Week from February 24 to March 2.

Read more in the Journal Magazine.  

UW Medicine Cares Award first-round nominations deadline, Feb. 15

UW Medicine established the UW Medicine Cares Award in 2013, a program to formally recognize and celebrate the accomplishments and excellence of those in the UW Medicine community who consistently exemplify the UW Medicine Service Culture Guidelines. (Requires a UW NetID.) The guidelines are professional standards that ensure that anyone who encounters UW Medicine receives the same great care and service throughout the system.

Each UW Medicine clinical entity—Harborview Medical Center, Northwest Medical Center, Valley Medical Center, UW Medical Center, UW Neighborhood Clinics, UW Physicians and Airlift Northwest—participates in the awards program.

Awards will be presented biannually, in the spring and fall. The deadline for nominations for the first round of awards is end of day, Friday, Feb. 15.

Learn more about the UW Medicine Cares Award  in the Jan. 4 issue of Online News.


Education and Training 

Douglas Wood elected president of The Society of Thoracic Surgeons 

Douglas WoodDouglas E. Wood, professor and chief of the Division of Cardiothoracic Surgery, has been elected as the 2013 president of The Society of Thoracic Surgeons (STS). Wood is also vice-chair of the Department of Surgery, where he also holds the Endowed Chair in Lung Cancer Research.

STS is a not-for-profit organization representing more than 6,600 cardiothoracic surgeons, researchers, and allied health professionals worldwide dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest.

An STS member since 1995, Wood has broad experience as a volunteer leader on the STS Board of Directors, Executive Committee, Finance Committee, Council on Health Policy and Relationships Operating Board, and the Workforce on Critical Care. He has represented the Society on the Board of Directors for the Joint Council on Thoracic Surgery Education and on the Lung Cancer Guidelines panel of the American College of Chest Physicians.

Wood also has held leadership positions at several other organizations, including president of the Seattle Surgical Society, president of the Western Thoracic Surgical Association, councilor for the European Association for Cardio-Thoracic Surgery, chair of the Guidelines Panel for Lung Cancer Screening for the National Comprehensive Cancer Network, and on the Board of Directors for the United Network of Organ Sharing.

Wood has dedicated a major part of his career to resident education. He is the program director of thoracic surgery at UW Medical Center, chair of the Thoracic Residency Review Committee for the Accreditation Council for Graduate Medical Education, recent director of the American Board of Thoracic Surgery, and has served on the educational program committees of many cardiothoracic societies in the United States.

Wood specializes in lung and esophageal cancer. He is a leader in the management of complex airway disease and the surgical management of end-stage lung disease. 

UW students garner Western Student Medical Research Forum awards

Seventy-one UW School of Medicine students were among 258 presenters at the annual meeting of the Western Student Medical Research Forum (WSMRF) in Carmel, Calif., Jan. 24-26.

The annual conference is held in conjunction with the Western Section American Federation for Medical Research (WAFMR), Western Society for Pediatric Research (WSPR), Western Association of Physicians (WAP), and the Western Society for Clinical Investigation (WSCI).

The medical students showed posters and gave oral presentations to students and faculty from 21 western medical schools and programs from across the United States and Canada. The presentations were on projects the students designed and implemented as part of their Independent Investigative Inquiry (III) research requirement. 

UW students who received subspecialty awards are second-year medical students.

WAFMR/WSCI Subspecialty Award Winners: Rebecca Abbey, Cost-Benefit Analysis of Indirect Antiglobulin Screening in RH (D) Negative Women at 28 Weeks Gestation, and  Daniel Julien, Small Interfering RNA to Treat Pancreatic Cancer.

WAFMR/WSPR Subspecialty Award Winners: David Roach, Analysis of the PRDM9 Gene Shows Large Amounts of Diversity and Points Toward Potential Speciation Mechanism in Ancestral Primates, and  Sara Weller, A High-Throughput, Mechanism-Based, Whole-Cell Screen Using Escherichia Coli to Identify Inhibitors of the SEC Pathway of Bacterial Protein Export.

Best oral presentations: Rebecca Abbey received the Dionesia P. Bertakis Award for Cost-Benefit Analysis of Indirect Antiglobulin Screening in RH(D) Negative Women at 28 Weeks Gestation, and  Huat Lim received the Gale Hansen Starich Award for Sydecan-1 Attenuates the Lung Cancer Malignant Phenotype, Potentially via RhoA Activation.


Yakima MEDEX trainees honored for 'quick action'

Yakima PAsFirst-year MEDEX Northwest physician assistant trainees Christopher Varady, Dustin Golding, Luke Lenehan, and Ryan Frost were awarded certificates of recognition Jan. 8 at the Yakima City Council meeting.

The four, who are based at the Yakima MEDEX site, were out walking Oct. 20 when they noticed smoke coming from a ground-level unit in their apartment complex. They called 911, pulled building fire alarms, went door to door to ensure everyone was evacuated, and entered the unit. They went in armed with fire extinguishers to attempt to control the fire before it spread.

At the city council meeting, Yakima fire chief and assistant fire chief were on hand to speak about the students’ efforts and to award the certificates. The certificates stated, "For your quick actions at an apartment fire on Oct. 20, 2012 at 5200 W. Nob Hill Blvd., Yakima, WA. Your actions provided an early alert to occupants and helped to minimize property damage.”

(Photo, left to right: Luke Lenahan, Chris Varady, Ryan Frost and Dustin Golding.)



WWAMI Regional News  

WWAMI legislative update

WWAMI MapThe WWAMI states represent a strong collaboration to advance regional excellence in medical education and to meet physician workforce needs in rural and underserved areas. In addition to working on WWAMI common goals, each WWAMI partner state has unique needs, challenges and opportunities. These are reflected in the legislative sessions in each state and impact future funding for WWAMI education positions. This update provides a glimpse of what and when legislative sessions are held each year, what is happening in each WWAMI state legislature, and the status of each state in forming Health Insurance Exchanges—the new entities provided for under the Affordable Care Act that will function as marketplaces for purchasers of health insurance—and accepting the Medicaid expansion option for states that would give more poor adults access to government care.

Washington holds a legislative session every year, adopting a 2-year budget in a long session that lasts 105 days and holding a shorter session in alternate years, which lasts 60 days. The 2013 legislative session is a 105-day session. For the 2013-2015 biennium, the budget has a projected two billion dollar deficit. The state of Washington has received federal approval for a public-private state-based health insurance exchange and is also planning to expand Medicaid; both will begin in January 2014.

Wyoming holds a regular legislative session every other year and a shorter, budget-only session in alternate years. The current 2013 legislative session is a budget-only or short session. The state of Wyoming projects a slight decrease in revenues due to the decreasing price of the state’s common natural resources. Wyoming is not expected to expand Medicaid or have a state-based health insurance exchange.  

Alaska holds a regular legislative session each year. The 2013 legislature is projecting a decrease in revenues due to a decrease in the price of Alaska’s natural resources. Alaska is undecided on expansion of Medicaid or whether to have a state-based health insurance exchange.

Montana holds a regular session every other year. The current year is a regular session. The state of Montana has a projected revenue increase for the next biennium. The state is undecided on Medicaid expansion and whether to have a state-based health insurance exchange. A request is before the 2013 legislature to increase the number of WWAMI students and to help with funds for the new ACGME-accredited family medicine residency program in Missoula.

Idaho has a regular session every year. The 2013 legislature projects a slight increase in revenues. Idaho is undecided on Medicaid expansion and the Governor has recommended adopting a state-based health insurance exchange. A request is before the legislature to increase the number of WWAMI students as well as to help with funds for the Boise Internal Medicine Residency program and increase funding for the family medicine residency programs and the Psychiatry Residency Track.

For more information about the state-based health insurance exchanges in states across the country, visit the National Conference of State Legislatures website. For more information about Medicaid expansion in each state, visit the Kaiser Family Foundation website.


Why early clinical experience works: Meet John Bragg from Laramie, Wyo. 

John BraggThe Wyoming WWAMI medical education program salutes the outstanding accomplishments of John Bragg who serves as a physician preceptor for first-year WWAMI students in Laramie, Wyo. Bragg completed his medical education at Creighton University School of Medicine in Omaha, Neb. In 2001, he completed residency training in obstetrics and gynecology at Creighton University Medical Center and joined Laramie Physicians for Women and Children.

The first-year preceptor program offers medical students invaluable knowledge and clinical experience by allowing them to receive training from working clinicians.  According to Bragg, “Students are given an opportunity to see the many facets of a medical practice and life as a doctor as opposed to picking everything up from a book…it adds to the depth of their medical school experience.” Bragg has been working with first-year medical students in the WWAMI program since he joined Laramie Physicians for Women and Children. He formally  became a preceptor with the program in 2010.

When asked how the preceptor program specifically enhances the first-year medical school experience, Bragg replied, “I remember when I was a medical student and being so busy with study…it would have been a nice break to see where all the hard work was leading. Additionally, it is beneficial for students to see the principles they are learning being used in practice and hopefully, at times, having the opportunity to see interesting cases and the process required to care for a patient.”

With his generous participation, Bragg offers first-year students unique insight into practicing medicine. Remarking on the preceptor program overall he said, “Medical school and residency are such a long process. It’s nice to have students in the actual professional setting seeing and experiencing what will hopefully be the end result of 7 to 8 years of education. We have had the opportunity to have some of the students that have spent time with us return to work as part of our group. It is exciting to see them grow and become very effective clinicians.”




Upcoming Events  

The following events may be of interest to the UW Medicine community:  

Medical Genetics Seminar, Feb. 15

Investigators’ First Amendment Right to Return Results to Research Participants, 12:30 p.m., Friday, Feb. 15, UW Health Sciences Building, Room K-069. Presenter will be Barbara Evans, professor of law and co-director of the Health Law & Policy Institute, University of Houston Law Center. The seminar is presented by the UW Division of Medical Genetics. For more information, call 206.616.4521 or send an email to medgen@u.washington.edu.

Bioengineering Seminar, Feb. 15

Restoring Standing and Walking after Spinal Cord Injury using Intraspinal Microstimulation, 1 p.m. to 2 p.m., Friday, Feb. 15, UW Center for Sensorimotor Neural Engineering, 1414 NE 42nd St., Seattle. Vivian Mushahwar, associate professor in the Division of Physical Medicine & Rehabilitation and Centre for Neuroscience, University of Alberta and the leader of the Alberta Innovates-Health Solutions Interdisciplinary Team in Smart Neural Prostheses (Project SMART), will speak. A reception follows. Contact Shirley Nollette at 206.685.2002 or nollettes@uw.edu for more information.

Microbiology Lecture, Feb. 19

Influenza Pandemics, 9 a.m., Tuesday, Feb. 19, UW Health Sciences Building, Hogness Auditorium, A-420. Yoshihiro Kawaoka, professor of virology at the Influenza Research Institute, Department of Pathobiological Sciences at the School of Veterinary Medicine, University of Wisconsin-Madison. Kawaoka is a leading scientist in the field of influenza and other infectious diseases. Contact Elonna Marci-Salmon at 206.543.5824 or elonna@uw.edu  

2013 Mini-Medical School, Feb. 19 – March 12

Medical Illnesses of Famous Impressionist Artists, 7 p.m., Tuesday, Feb. 19, with Teresa Brentnall, professor and Walters Endowed Chair in the Division of Gastroenterology. Multiple Sclerosis and Palliative Care: Improving Quality of Life for People with Chronic Diseases, follows with Annette Wundes, assistant professor of neurology and co-director of UW Medicine’s Multiple Sclerosis Center, and J. Randall Curtis, professor of pulmonary and critical care medicine and director of UW Palliative Care Center of Excellence. The free Mini-Medical School lectures take place in the UW  Health Sciences Building, Hogness Auditorium, A-420, each Tuesday through March 12. For a complete listing of sessions and presenters, visit the UW Mini-Medical School website.

Genome Sciences 11th Annual Symposium, Feb. 20

Primate Genomics, all day event, Wednesday, Feb. 20, Foege Auditorium. Speakers are Svante Paabo, director, Department of Genetics, Max Planck Institute for Evolutionary Anthropology, Leipzig; Anne Yoder, professor of biology, Duke University; Katy Gonder, assistant professor of biological sciences, University at Albany, State University of New York, Jeff Rogers, associate professor, Human Genome Sequencing Center, Baylor College of Medicine; and Yoave Gilad, associate professor, Department of Human Genetics, University of Chicago. Svante Paabo presents the Laurence Sandler Public Lecture, Archaic Genomics, at 7 p.m. in Kane Hall, Room 120. No registration necessary. For more information, visit the symposium website or contact Carlene Cross at cross2@uw.edu.

19th Helen & John Schilling Lecture, Feb. 22

Regenerative Medicine: New Approaches to Healthcare, 4 p.m., UW Health Sciences Building, Hogness Auditorium, A-420. Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine, will discuss the science, clinical outcomes and ethics of organ and tissue engineering. Atala, who is also the W.H. Boyce Professor and Chair of the Department of Urology at Wake Forest University, Winston-Salem, N.C., will describe his journey in the field and his patients’ successes with lab-created urinary bladders, tracheas and other organs. A reception follows in the Health Sciences lobby. For more information, contact the Department of Surgery at dosadmin@uw.edu.

Graduate Medical Education Grand Rounds, March 6

Recharge Your Training Experience: How to Continue to Make the Most of It, 5:30 to 7 p.m., UW Health Sciences Building, Turner Auditorium, Room D-209. A panel of residents and fellows will share with their peers ideas and suggestions to revitalize and boost energy and enthusiasm at the mid-point of their training. Panelists are Shana Elman, chief resident in nuclear medicine; Cody Gillenwater, post-doctorate in physical medicine and rehabilitation; Christopher Johnson, a fellow in nephrology; and William Van Cleve, post-doctorate in anesthesiology. Register online. Contact Shawn Banta at sbanta@uw.edu or 206.616.8286 for more information.

Continuing Medical Education
Visit Continuing Medical Education for information on upcoming classes.


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