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February 21, 2014
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UW Medicine Memory and Brain Wellness Clinic advances standard of care
In October 2013, the UW Medicine Memory and Brain Wellness Clinic opened at Harborview Medical Center. This new multidisciplinary initiative of the UW Medicine Neuroscience Institute links the evaluation and care of patients with memory impairment to research programs in Alzheimer’s disease and related disorders. The clinic’s goal is to move toward the day when threats to memory and brain health are detected and prevented as standard of care.
The new clinic utilizes a highly collaborative and multidisciplinary approach. Through the UW Medicine Neuroscience Institute directed by Tony Avellino, UW professor of neurological surgery, the clinic incorporates team members from the UW School of Medicine departments of Neurology, Psychiatry & Behavioral Sciences, Radiology, and Medicine (Division of Geriatric Medicine). This excellent team draws on UW Medicine’s expertise in neuroimaging and biomarker translational research. UW Medicine is one of only two sites in the nation with a National Institutes of Health-funded Alzheimer’s Disease Research Center, and a Morris K. Udall Center of Excellence in Parkinson’s Disease Research focused on cognitive aspects of Parkinson’s disease.
Each patient at the clinic is treated by a team of healthcare professionals consisting of a nurse practitioner, physician, social worker and neuropsychologist. Each care team has access to state-of-the-art imaging, biomarkers, and genetic diagnostics. The team provides a diagnosis and tailors, recommends and supports best care management options. The clinic anticipates developing community educational services and active rehabilitation services to promote wellbeing and prolong functional independence of patients with memory disorders.
Thomas J. Grabowski, UW professor of radiology and neurology, is the clinic director. The multidisciplinary nature of the team is key to its success. In addition to Drs. Avellino and Grabowski, I would like to acknowledge and thank team members Ruth Kohen and Shaune DeMers, geriatric psychiatrists; Angela Hanson, geriatrician; Elisabeth Lindley, nurse practitioner; Andrew McCormick, social worker; Vaishali Phatak, Michelle Kim and Brenna Cholerton, neuropsychologists; Jim MacKenzie, clinic manager; Julie Sniadoski, business operations manager; Carrie Barbee, patient care coordinator; and Marisa Areola, charge nurse.
The UW Medicine Memory and Brain Wellness Clinic is a superb example of a multidisciplinary team working together toward a common goal. I look forward to the advances this team will make in reducing the burden of Alzheimer’s disease and related disorders.
Paul G. Ramsey, M.D.
The hepatitis C virus has a previously unrecognized tactic to outwit antiviral responses and sustain a long-term infection. It also turns out that some people are genetically equipped with a strong countermeasure to the virus’ attempt to weaken the attack on it.
The details of these findings suggest potential targets for treating HCV, according to a research team led by Ram Savan, UW assistant professor of immunology. The study was published in Nature Immunology.
HCV infects more than 150 million of the world’s people. The virus is notorious for evading the body’s immune system and establishing an infection that can continue for decades, despite treatment. A lasting infection can damage the liver, and in some cases produce liver cancer. HCV infection is a major cause of liver failure requiring an organ transplant.
The virus, hiding in other tissues, can return in the transplanted liver. HCV and the human immune system are engaged in a seemingly never-ending duel, each trying to overcome the other's latest move. Several HCV mechanisms for defying the body’s immune system have already been uncovered.
Present treatments are about 70 percent effective in curing the infection, Savan said. The triple combination treatments consist of interferon, ribavirin and direct-acting antiviral agents.
He added, however, that resistant strains of HCV are emerging in antiviral treated patients. Also troubling, he said, is that certain patients can undergo almost a year of treatment and still be infected. They’ve endured the unpleasant, flu-like side effects of the regimen with little benefit.
After observing that patients of Asian descent reacted better to HCV treatment than did those of African descent, other research teams searched entire human genomes to identify gene clusters associated with response to therapy.
On chromosome 19, the scientists found different, single-letter DNA code changes linked to treatment response and the natural ability to clear HCV infection.
These tiny genetic variations are located near an area that encodes for interferon-lamda3 (IFNL3), also called interleukin-28B. Viruses can trigger blood cells and other cells to produce this potent substance, which is released to protect against virus invasion.
The mechanism aligning this genetic finding with clearance of HCV had been elusive, Savan’s group noted in their paper. His team discovered how the single-letter variation in the IFNL3 gene was responsible for the differences between those who could and those who could not effectively clear HCV.
Individuals who carry the T (for thymidine) variant have an unfavorable outcome in fighting HCV, while those who carry the G (for guanosine) variant have a favorable outcome.
When it comes to life’s stressors, most people would put caregiving at the top of the list.
But according to Peter Vitaliano, UW professor of psychiatry and behavioral sciences and psychology, there never have been data actually showing that caregiving causes psychological distress. So he, and other researchers at the UW conducted a study of about 1,228 female twins, some were caregivers, and some were not. The results were somewhat surprising.
The study, “Does caregiving cause psychological distress? The case for familial and genetic vulnerabilities in female twins,” was published in the Annals of Behavioral Medicine in January 2014. The findings showed that the associations between caregiving and different types of psychological distress (depression, anxiety, perceived stress and perceived mental health) depend largely on a person’s genes and upbringing and less on the difficulty of caregiving.
Did the person have a history of depression before being a caregiver? If so, “caregiving may be like putting salt on the wound,” said Vitaliano. If there’s no depression in the past, caregivers don’t seem more affected by depression than noncaregivers.
Depression and perceived mental health are most influenced by genes, said Vitaliano. Anxiety is most related to caregiving, and people who don’t get relief from anxiety are more likely to become depressed, he noted.
Perceived stress, meanwhile, is almost exclusively related to the kind of environment a person was raised in, not genetics or caregiver status, he said. If a person grows up in a home where one’s parents show lots of avoidance and fear in response to a lost job or sickness, then he or she will likely model that behavior.
Vitaliano said these results break the long-held belief that caregiving directly causes distress. He noted that since 1953 there have been more than a thousand papers on distress among caregivers without any data showing causality.
The UW Human Subjects Division has updated and streamlined many of its policies. All Institutional Review Board forms—initial applications, consent forms, modification forms, annual status reports, and more—have been updated to reflect the new policies.
The university has about 6,000 active studies with human subjects. The new approach is expected to relieve some of the administrative burden on researchers. A video explains the changes that went into effect Jan. 31.
Katy Sharrock, a training and education specialist with UW Human Subjects Division, recommends that UW researchers always download the latest version of forms for use.
Researchers can learn more by subscribing to the Human Subjects Division’s monthly newsletter.
Paul Ramsey, CEO of UW Medicine and dean of the UW School of Medicine, talked with members of the UW Medicine community about the transformation taking place in all aspects of healthcare in his annual address, Feb. 6. UW Medicine has prepared for and kept pace with the critical shifts in healthcare and will continue to do so across its clinical, education and research activities. Ramsey attributed UW Medicine’s success at keeping pace with healthcare’s rapid transformation to its ethic of continuous improvement in all activities, an ethic that characterizes the talented and committed UW Medicine community. He acknowledged and thanked the thousands of faculty, staff, students and trainees who make UW Medicine the extraordinary institution it is today.
Ramsey discussed how UW Medicine’s institutional value of continuous improvement—sustained, progressive work—supports and guides transformations in research, education and clinical settings. He cited numerous examples from research, education and clinical care throughout UW Medicine.
Take a look at HSNewsBeat, a website spotlighting news from UW Medicine and Health Sciences for employees, journalists and the general public. Our homepage and category pages allow for easy scanning and give prominence to great photos. At the story level, photos expand with a click and videos open in a window that hovers above the page.
HSNewsBeat will raise awareness of our impact on health research, care and education. We explore topics in narratives, Q&A’s and multimedia. Recent topics include Neanderthal genes, an altruistic-donor kidney transplant, new curriculum ideas for the medical school, and how high-tech seats ease long-haul truckers’ rides. We are also running a series about medical ethics.
UW Medicine’s media relations team, in consultation with the Health Science Schools, developed the site as a resource for journalists working in both traditional and social media. It provides easy access to press releases and advisories, story tips, a photo gallery and media relations liaisons. The site covers the UW Schools of Dentistry, Medicine, Nursing, Pharmacy, Public Health and Social Work, all entities of UW Medicine, and a variety of research institutes and service programs.
We welcome your story ideas about programs, people, research, therapies and techniques connected to UW’s mission of improving the health of the public. hsnewsbeat.uw.edu
John E. Olerud, UW professor and head of the Division of Dermatology, retired Jan. 31. Philip Fleckman, professor of dermatology, was named acting division head.
Olerud joined the UW faculty in 1977 and became division head in 1991. As division head, Olerud established the Dermatology Center at UW Medical Center Roosevelt, where evaluation and treatments are available for a wide variety of skin conditions. Under his direction, the division experienced markedly improved recruitment and retention of faculty, increased research interactions and new grant support, and increased funding of chairs and professorships for education and research.
An outstanding clinician and teacher, Olerud was responsible for the clinical clerkship in dermatology (Medicine 678), the most sought after medical school course elective in the Department of Medicine. He was also the inaugural recipient of the division’s John E. Olerud Resident Teaching Award.
In addition to his distinguished work in medicine, Olerud is well known for a parallel career in baseball. At Washington State University, he was team captain and catcher for the 1965 Cougars, who went to the College World Series, and was named All-American the same year. He was drafted to the majors and played on professional teams, including the Seattle Angels, throughout his medical training. Olerud currently plays for the Everest Tugs in the Puget Sound Senior Baseball League. He is the father of former Mariners first baseman John G. Olerud, also a star at WSU.
Fleckman joined the UW faculty in 1982 and is a recipient of the John E. Olerud Resident Teaching Award.
The Curriculum Renewal Steering Committee held an all-day retreat Friday, Feb. 14, to review and discuss recommendations received from committees working on developing the structure for the new curriculum. The steering committee will continue to work over the coming weeks to refine the recommendations and present them to the Medical School Executive Committee in early March.
After the MSEC meeting and while that group is considering the recommendations during the month of March, the steering committee plans to release the recommendations and hold a series of listening sessions open to all members of the UW Medicine community. The sessions will be an opportunity for community members—faculty, staff, students and trainees—to discuss and voice their thoughts, questions and reactions to the recommendations. Work to begin developing content and leadership for the new curriculum will start in April after further discussion of the recommendations at the UW Medicine Leadership Retreat in April.
Dates and times of the listening sessions are: Tuesday, March 11: 4:30-5:30 pm; Friday, March 14: noon-1 pm; Tuesday, March 18, 8-9 am; Thursday, March 27 noon-1 pm; Friday, March 28, noon-1 pm; and Monday, March 31 8-9 am. Some sessions will be available via video conference at WWAMI sites. Local locations and details of the sessions will be announced in the near future.
Please contact Sarah Shirley at email@example.com with questions.
The Alaska WWAMI program will present a faculty development conference for clinical teaching faculty from Alaska, March 8, at the Alyeska Princess Hotel in Eagle River, Alaska.
The conference will include small group workshops on evaluation, feedback and grading presented by UW School of Medicine faculty. In addition, there will be two panel sessions: senior Alaska clinical faculty will discuss their teaching experiences, including the successes and challenges of having clinical learners in their practice, and will provide practical advice; and a student panel of fourth-year Alaskan WWAMI students will review their experiences as learners and describe what has worked well for them and what they would like to see improved.
The Alaska WWAMI clinical faculty development conference is being incorporated into the Alaska Academy of Family Physician’s 16th annual mid-winter update, which is open to clinical faculty across the WWAMI region. Register for the Alaska AAFP mid-winter update online.
For the second year in a row, the Alaska WWAMI first-year students will attend the AAFP event to experience a medical society meeting and meet primary care physicians from all over Alaska.
The Alaska WWAMI faculty development conference is made possible by a generous gift from Premera Alaska.
Alaska Admissions for 2014
Alaska WWAMI has been admitting applicants to the WWAMI program since at least 1975. This year, Alaska received its highest number of applicants to the WWAMI program with 84 applications and 46 students interviewed for the first-year Alaska WWAMI class. Alaska has seen the quality and number of applicants increase for the past several years which the program attributes to the emphasis on Alaska pipeline programs for K-12 and undergraduate students.
The following events may be of interest to the UW Medicine community:
UW School of Medicine alumni awards nominations close Feb. 21
UW School of Medicine alumni, faculty, staff and other professional colleagues are invited to nominate alumni for a series of awards, including the Distinguished Alumnus Award, to be presented at the Reunion Weekend, June 6-7. Anyone who has received an M.D. from or completed a residency program or fellowship at the UW School of Medicine is eligible. Nominations are due by the end of day Friday, Feb. 21. Nominations can be submitted online or by email at firstname.lastname@example.org. For more information, please call 206.685.1875.
Science in Medicine Lecture, Feb. 24
More Than Meets the Eye: New Retinal Photoreceptors, and the Promise of Vision Restoration, noon to 1 p.m., Monday, Feb. 24, Health Sciences Bldg., K-069 (Fialkow Biomedical Sciences Research Pavilion). Russell Van Gelder, the Boyd K. Bucey Memorial Chair, and professor and chair of Department of Ophthalmology, will give the lecture. Van Gelder has been at the forefront of research in non-visual ocular photoreception and molecular diagnostics of ocular inflammatory disease. He is president-elect of the American Academy of Ophthalmology, associate editor of Investigative Ophthalmology and Visual Sciences, and a member of the editorial board of the journal Ophthalmology. Science in Medicine lectures are open to all faculty, staff and students. No registration is required.
Microsoft-UW Workshop on Technology Enriched Instruction offered Feb. 25
Learn to Use Technology in Teaching: A Microsoft-UW Workshop on Technology Enriched Instruction, 8 a.m. to 5 p.m., Tuesday, Feb. 25, in the Husky Union Building (HUB), Room 250, UW Seattle campus. The session incorporates participatory and inquiry-based learning, allowing faculty to actively experience a range of technology tools and resources and research-based approaches to use in teaching. This activity has been approved for AMA PRA Category 1 Credit™. Contact Stephanie Habben at email@example.com for information.
Fred Hutch Science for Life, Feb. 27
A Scientific Crystal Ball: Using Cancer’s Genetic Signature to Predict and Prevent Relapse, 7 to 8:30 p.m., Thursday, Feb. 27, Fred Hutchinson Cancer Research Center, Thomas Building, Pelton Auditorium, 1100 Fairview Ave. N., Seattle. This “Science for Life” lecture offers the public a chance to interact with world-class researchers in a fun, informal atmosphere. To find out more or to register, visit the Science for Life website or contact Mary Hazen at firstname.lastname@example.org or 206.667.1226 for more information.
11th Annual Western Regional International Health Conference, April 4-6
Uncensored: Gender, Sexuality & Social Movements in Global Health, April 4-6, 2014, University of Washington, Seattle. Conference will cover social and political movements, diverse sexualities and sexual health, gender-based violence, reproductive rights, global discrimination against LGBTQ community, income inequality, and universal access to healthcare. Keynote speaker will be Stella Nyanzi, Ph.D., of the Makerere Institute of Social Research at Makerere University in Kampala, Uganda. Her research covers the politicization of sexuality in contemporary Uganda. The conference is sponsored by the UW, the WRIHC, UW chapter of GlobeMed and the UW Department of Global Health. Register here. For more information, visit the Western Regional International Health Conference website or contact email@example.com
Paws-on Science recruiting researchers for April 4-6 Husky Weekend event
Paws-on Science: Husky Weekend at the Pacific Science Center is recruiting researchers to take part in its annual community outreach event, April 4-6. Paws-on Science, a partnership between the UW and Pacific Science Center, introduces families and the community to innovative research underway at the UW in a fun and accessible way. During the past four years, more than 1,100 UW scientists have shared their work through hands-on activities with nearly 47,000 adults and children. For more information, contact McCayla Butler at firstname.lastname@example.org or 206.543.1867.
Continuing Medical Education
Visit Continuing Medical Education for information on upcoming classes.
New ITHS newsletter highlights resources, studies and people of interest to researchers
The ITHS Research Connector, a newsletter of the Institute of Translational Health Sciences, highlights resources and tools available to scientists. The Winter 2014 issue also features researchers who are successfully using the REDCap survey and database tool, research coordinator core, Latino outreach program, and research bioethics consultation service. Researchers can contact Research Navigator Beth Hacker at email@example.com for more information about available resources.
UW Medicine magazine
UW Medicine 2012 Report to the Community