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Sept. 4 issue of UW Medicine Insight
IN THIS ISSUE:
and much more...
A biweekly newsletter focused on issues related to
UW recieves $25m for trials on mental health and appendicitis care
I am very pleased to announce that UW Medicine researchers will receive a total of $25 million in the most recent contracts announced by the Patient-Centered Outcomes Research Institute (PCORI). Funding for research from PCORI, a nonprofit, independent institute authorized by Congress in 2010, is widely sought and highly valued nationally.
PCORI funds evidence-based research needed to make better informed healthcare decisions. The current round of national funding totals $60 million. There were 132 letters of interest and 24 applications for this highly competitive funding and only four new projects were selected nationally.
The two UW Medicine projects selected for funding represent areas of national significance: ways to improve behavioral and mental health care in rural areas and a patient-centered study of treatment options for appendicitis. The studies aim to produce results that are relevant to a broad range of patients and care settings and easier to adopt in routine clinical practice.
One trial, led by John Fortney, UW professor of psychiatry & behavioral sciences, and Jürgen Unützer, chair of the UW Department of Psychiatry & Behavioral Sciences, will compare use of an integrated care model in rural primary care clinics to use of telemedicine-facilitated referrals to offsite mental health specialists. This $11.7 million trial will be the largest study of rural Americans with a psychiatric disorder ever conducted. One thousand primary care patients screening positive for post-traumatic stress disorder (PTSD) or bipolar disorder will be recruited from 15 Community Health Centers in three states (Arkansas, Michigan, and Washington) and randomized to the integrated care model or the referral model.
The other trial, led by David Flum, UW professor of surgery, will compare surgery to antibiotics-first treatment for uncomplicated appendicitis. This $12.9 million project will recruit 1,552 patients and include physicians from 10 Washington state hospitals. This will be the largest randomized controlled trial of its kind and the first looking at both clinical outcomes and patient-reported outcomes that matter most to patients, such as time off work, anxiety associated with the risk of reoccurrence and quality of life.
Congratulations to Drs. Fortney, Flum and many others involved in this important work. These two major projects will provide important information to improve health.
Paul G. Ramsey, M.D.
Kristie Ebi, UW professor of global health and of environmental and occupational health sciences, is co-author of a study published in the International Journal of Environmental Research and Public Health that shows regional temperatures in the U.S. Southeast are projected to increase 4 to 8 degrees by the end of the century, while sea levels could rise 4 feet over the next 50 to 100 years and inundate 2,400 miles of major roads between Mobile and Houston.
“Climate change may amplify existing public health impacts, as well as introduce new health hazards to the Gulf Coast,” the authors wrote. These can include morbidity and mortality from heat waves, malnutrition from droughts, and injury and deaths from floods.”
The researchers stressed the importance of investments in new and existing programs to address public health threats. Among their proposed various adaptation measures are developing programs that would provide air conditioning to low-income households and improving infrastructure to withstand rises in sea levels. The study identified vulnerabilities and pulled together different dimensions, Ebi said, “so people can be better prepared, better able to cope and can recover more quickly." For more information, see the article on HSNewsBeat.
The Sightline Institute based in Seattle released a short video (2:40) on how scientists can talk to non-scientists about climate change; the guidelines are appropriate for any scientist talking about topics other than climate change. The rules, in brief: 1) Emphasize what is known. 2) Give conclusion before background. 3) Less is more. 4) Speak in plain language. View the video.
More research stories:
The UW Medicine Regional Heart Center is one of the first cardiology programs in the nation to deploy a lantern-shaped heart device intended to halt the formation of potentially blood clots.
The "Watchman" device is for people who live with atrial fibrillation, a common condition in which the heartbeat quickens and goes out of sync. The condition can lead to blood clots forming and traveling to the brain, causing a stroke. The device helps create a barrier to stop clots from forming.
“The FDA was finally given enough information to take action,” said Mark Reisman, section head of interventional cardiology, who, along with Liz Perpetua, associate director of the Center for Cardiovascular Emerging Therapies, helped conduct early trials of the Watchman up to a decade ago.
The device, which Perpetua said costs about $30,000, is inserted via a catheter pushed through a vein in the leg. The catheter advances through the bloodstream until it reaches the heart, where the doctor makes a small hole and positions it into the left atrial appendage, or LAA. The doctor pushes the Watchman device into place, where it opens like an umbrella, blocking the LAA. Once it’s in place, heart tissue grows over the device within six weeks, creating a permanent barrier to prevent blood clots from forming. For more on the story and the first patient to use the device, see article in The Seattle Times.
Two University of Washington faculty aim to develop an injectable HIV therapy that can be administered once a week, easing the regimen of daily pills that HIV-positive people must manage now. Rodney Ho, UW professor in pharmacy and director of DNA Sequence & Gene Analysis, and Ann Collier, UW professor of medicine in the Division of Allergy and Infectious Diseases and director of the UW AIDS Clinical Trials Unit, received funding from the NIH to develop antiretroviral treatments that overcome limitations of current oral drug therapies. “This was the only HIV treatment program to receive NIH funding for this specific purpose,” Ho said. For more on the story, see article on HSNewsBeat.
More clinical stories:
The nearly 250 first-year medical students starting in August are experiencing the first major change to the UW School of Medicine curriculum in the past 15 years.
“Turning traditional medical education on its head, incoming first-year medical students begin their schooling with an intensive clinical training in immersion,” said William G. Sayres, Jr., assistant dean for UW Spokane. After immersion, students are assigned to work with clinicians in the community with whom they anchor the basic science they learn in the Foundation curriculum. The new curriculum has three phases: Foundation, Patient Care, Explore and Focus.
The current curriculum change process began in 2010 and has involved more than 500 faculty, staff, students and alumni from across the WWAMI university sites (University of Wyoming, UW Seattle and Spokane, University of Alaska-Anchorage, Montana State University, University of Idaho) and from regional clinical settings across the WWAMI region. Developing this curriculum has been perhaps the most complex ever for any medical school, given the school’s five-state reach. While building a curriculum that serves all WWAMI states with common objectives and assessments is a challenge, it has resulted in a collaborative culture and regional ownership.
More education stories:
One thing was clear to Frank Batcha: He didn’t want to be a chemistry teacher anymore. This epiphany came into particular focus when Batcha was riding home from a particularly disappointing loss from a high school football game in Ohio, where he worked as an assistant coach, as well as teaching chemistry. “It was a pretty humiliating loss, and the bus was in a morose mood,” Batcha remembered. “The head coach turned to me. He was substantially into his teaching career. He told me that if there was anything I wanted to do more than teaching, that I should do it while I could.”
So, he thought, what did he want to be? What was he passionate about? The answer came, almost unbidden. He wanted to be a doctor, preferably, a doctor in the west. When he began searching for a residency program after graduating from Northeastern Ohio School of Medicine, his requirements were a bit unusual – there had to be a wilderness medicine component incorporated into the family practice training. And the only residency which had both was in Boise, Idaho.
Batcha now serves as the preceptor for the WWAMI’s RUOP (Rural Underserved Opportunities Program) and directs the UW’s TRUST (Targeted Rural Underserved Track) and WRITE (WWAMI Rural Integrated Training Experience) site in Hailey, Idaho. In 2014, he was awarded the Physician of the Year award by the Idaho Academy of Family Physicians. Aside from guiding students in the intricacies of country and backcountry medicine, part of Batcha’s job is to guide them into a residency that’s a good fit. “My advice is to simply pick a specialty they enjoy,” regardless of location and income, he said.
Batcha said that most students that come through his program are surprised by the diversity of the medical conditions they see in a rural areas. “I’ve never been bored a day in my medical career or dreaded the idea that I have to come to work,” he said.
Mary-Claire King,UW professor of medicine (medical genetics) and genome sciences, received one of the newly established Outstanding Investigator Awards from the National Cancer Institute (NCI). The $6.4 million award over seven years will allow her team to further their research into inherited breast and ovarian cancer.“This award makes it possible to think outside all the boxes. We can exploit genomics tools at a level not previously possible for a lab of our size,” said King.
King has spent 40 years studying inherited breast cancer and discovered the BRCA1 gene that predisposes women to breast and ovarian cancer. She has also characterized BRCA2 and other genes essential to DNA repair that when mutant predispose women to breast or ovarian cancer. However, mutations of the classes detectable with existing tools explain only about half of inherited breast cancer, she said. “For most families severely affected with breast and ovarian cancer, the genetic basis of cancer predisposition is still not known,” she said. “We hope to think about mechanisms of mutation that act in previously unexplored ways.
The objective of the NCI Outstanding Investigator Award is to provide long-term support to experienced investigators with outstanding records of productivity in cancer research. The award is intended to allow investigators the opportunity to take greater risks, be more adventurous in their lines of inquiry and take the time to develop new techniques. King said her team plans to sequence the entire genomes of breast and ovarian cancer patients from severely affected families in order to identify mutations at a great distance from the genes they regulate. She likens this approach to understanding how human evolution depended on regulation of timing of gene expression. “It’s an enormous endeavor,” she said. “We know the sequences of all genes but we don’t know all the regulatory elements – when and at what level that gene is expressed. We are trying to figure that out in the context of inherited breast and ovarian cancer.”
She said her team will begin by studying variation in the genomic regions harboring the 20 genes known to influence inherited breast or ovarian cancer. The team will examine the DNA sequences of women from large kindreds to learn what genomic variation is co-inherited with cancer in the family. Then they will explore what those individual mutations regulate. “Genetics is a way of thinking and genomics is a set of tools,” said King. “With modern genomics tools we are able to answer questions of genetics that humans have posed for as long as human have thought about health and disease. It’s a perfect marriage of medicine and technology.”
Her UW team includes Tomas Walsh, research associate professor in medical genetics; Silvia Casadei, research geneticist in medical genetics; Suleyman Gulsuner, senior fellow in medical genetics; Ming Lee, statistician and computer scientist in medical genetics; Elizabeth Swisher, professor in gynecologic oncology; and Barbara Norquist, assistant professor in gynecologic oncology
Wylie Burke, UW professor of bioethics and humanities, and Dawn Ehde, UW professor of rehabilitation medicine, are the 2015 recipients of the UW Medicine Excellence in Mentoring Award. This award recognizes the accomplishments of School of Medicine faculty in advancing excellence in mentorship of students and faculty, particularly women.
Wylie Burke holds adjunct appointments in the UW departments of medicine and epidemiology and served as chair of the UW Department of Bioethics & Humanities from 2000 to 2014. She is a successful clinician-scientist whose forward-looking academic research focuses on the social, ethical and policy implications of genetic information, including its uses in research, clinical care and public health.
“She guides her mentees toward greater self-understanding and a realistic assessment of their capabilities and energies, which in turn helps them find the best fit for them, whether within academia or in some other capacity. This isn’t just mentorship geared toward professional success; it’s mentorship for living a happy, fulfilled life, and it’s a gift to all of the fortunate people who have received it, myself included.” – Staff scientist
Dawn Ehde’s formal participation in mentoring began in 1998 when she became chair of the Professional Development Committee for the UW Department of Psychiatry & Behavioral Science’s clinical psychology internship program. She was chair for 12 years and was awarded the Mentor of the Year twice.
“One of the things that sets Dawn apart from other mentors is her realness, approachableness and candor. With Dawn, the mentor/mentee relationship is professional, productive and enjoyable without the burden and barriers of decorum or intimidation. Dawn sets a positive and constructive tone by being focused on her mentee’s goals and development and by being very frank and open about her own ongoing development, pursuit of professional goals and struggles along the way. Perhaps one of the greatest complements to Dawn is when my fellow early career psychologists say that they wish that they had her as a mentor.” – Former postdoctoral trainee
The American Board of Internal Medicine (ABIM) appointed Jeanne Marrazzo, UW professor of medicine in the Division of Allergy and Infectious Diseases and acting head of the division, as the new chair of the American Board of Internal Medicine Council. The council guides the policies and procedures for certification and maintenance of certification in all of the disciplines of internal medicine.
The ABIM also appointed Larry Dean, UW professor of medicine (cardiology), to the Cardiovascular Board. Members of the specialty boards provide valuable insights that enable them to define, refine and set performance standards for their specific certification program.
The Fourth Annual Pink Boat Regatta is a sailing fundraiser for breast cancer awareness with funds going to the labs of UW Medicine researchers Julie Gralow, professor of medicine (oncology) and Mary-Claire King, professor of medicine (medical genetics) and genome sciences. For more information, go to www.pinkboatregatta.org.
nanoDDS is the key annual event for researchers developing next-generation delivery vehicles – targeted, responsive, biodegradable nanomaterials – to make diagnostics more sensitive and drugs more effective. For more information, see the conference website.
The UW Faculty Wellness Program is sponsoring a day-long event on cooking, yoga and mindfulness at Bastyr. Cost: $50. Register by noon Sept. 11.
Mandy Morneault, Institute of Translational Health Sciences' (ITHS) manager of regulatory knowledge and training, will lead this program aimed for research coordinators and describe the goals and common triggers of creating quality systems to assure data integrity and regulatory compliance. This is part of ITHS' Clinical Research Education Series. For more information, see the ITHS website.
Speaker Susan Lindquist, Ph.D. will give the talk, "From yeast to human IPS cells: A chemical biology discovery platform for protein folding diseases." Lindquist is a pioneer in the study of protein folding. She has shown that changes in protein folding can have profound and unexpected influences in fields as wide-ranging as human disease, evolution and nanotechnology. Lindquist is a member and former director (2001-2004) of Whitehead Institute, a professor of biology at MIT and a Howard Hughes Medical Institute investigator. She received a Ph.D. in biology from Harvard University in 1976, and was elected to the American Academy of Arts and Sciences in 1997, the National Academy of Sciences in 1997 and the Institute of Medicine in 2006.
UW Medicine is a big supporter of the American Heart Association's Puget Sound Heart & Stroke Walk, and we expect 1,050 walkers to join us. While the percentage of deaths due to heart attack, stroke and other cardiovascular diseases has fallen by nearly one-third since 1999, cardiovascular disease is still the leading killer in the United States according to the American Heart Association. Every day, more than 2,000 Americans die of cardiovascular disease. Currently the American Heart Association is funding $5.78 million in active research grants in the state of Washington; $5.3 million is funded at UW. Last year, UW Medicine raised $192,801.50, making UW Medicine the top fundraiser. Please register online at the UW Medicine Company Heart & Stroke Walk page. You can sign up as a team captain or you can join an existing team. You can also make a donation at any time to help us reach our goal.
Continuing Medical Education
The local health effects of
Washington's wildfires, Crosscut, Aug. 27.
Men who admire their own
work, Inside Higher Ed,
5 mobile technologies help
level the playing field for people with disabilities, Scientific American, Aug. 25.
UW Health Sciences NewsBeat, a website featuring news from UW Medicine and Health Sciences.
UW Medicine magazine