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Lipid testing underutilized in adults taking antipsychotic medications

Too few adults taking antipsychotic medications are being screened for abnormalities in lipids, which include cholesterol and triglycerides, new research from the University of Colorado Anschutz Medical Campus finds.

The biggest gap in screening is among adults age 40 and younger, the group for whom early detection and intervention has been shown to be effective when additional cardiovascular risk is present.

Adults with serious mental illness die 20 to 30 years earlier than their peers, largely due to increased risk for diabetes, high cholesterol, high blood pressure and heart disease. Taking antipsychotic medication increases that risk. The American Diabetes Association and American Psychiatric Association recommends more intensive diabetes and cholesterol lipid screening for patients receiving antipsychotics, but rates of screening have remained low.

“Antipsychotic medications are associated with substantial weight gain, as well as changes in insulin sensitivity and lipid metabolism, which increase the risk of diabetes and cardiovascular disease,” said lead author Elaine Morrato of the Colorado School of Public Health at CU Anschutz.

Compared with prior reports, progress has been made to improve diabetes screening, but lipid screening remains particularly underutilized. The study, published May 11 in the journal JAMA Psychiatry, included 9316 Missouri Medicaid patients to identify factors associated with failure to receive annual glucose and lipid testing during treatment with antipsychotics.

Another notable study finding is understanding who is prescribing antipsychotics. About 75 percent of patients initiated therapy with a prescriber not practicing in a Community Mental Health Center and about half initiated therapy with a non-behavioral health care professional. Federal and state investment to prevent and reduce cardiovascular disease among those with mental illness has focused on psychiatrists practicing in community mental health settings.

Failure to receive testing was most strongly associated with patient characteristics and factors affecting frequency of health care utilization. Lack of testing was highest among adults 40 and younger, who have fewer chronic conditions.

One possible reason for low rates of testing may be the result of conflicting messages on whether younger adults should be tested. Some guidelines call for the use of screening tests in all patients receiving antipsychotics regardless of mental health diagnosis, while others prioritize screening only in adults with schizophrenia or bipolar disorder and other guidelines have prioritized screening based on age, ethnicity and other risk factors.

Better integration of behavioral health and primary care services is a public health priority. More research on the effectiveness of metabolic screening for younger adults receiving antipsychotics is needed to resolve the ambiguity in screening guidelines. Clarity is important for health system directors and policy makers who must decide on the most efficient use of limited resources for improving screening rates and achieving public health goals to reduce cardiovascular disease.

The University of Colorado Anschutz Medical Campus

The University of Colorado Anschutz Medical Campus is the only comprehensive academic health sciences center in Colorado, the largest academic health center in the Rocky Mountain region and one of the newest education, research and patient care facilities in the world. Home to 21,000 employees, more than 4,000 degree-seeking students and two nationally recognized hospitals that handle 1.7 million patient visits each year, CU Anschutz trains the health sciences workforce of the future and fuels the economy. CU Anschutz features schools of medicine, pharmacy, dental medicine and public health, a college of nursing and a graduate school. All interconnected, these organizations collaboratively improve the quality of patient care they deliver, research they conduct, and health professionals they train.

 

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Funding Nursing Research and Evidence-Based Practice

College of Nursing Announces the Dr. Colleen Goode Fund for Nursing Research & Evidence-Based Practice Projects

Goode
In recognition of a career dedicated to innovative patient care and world-class nursing education, the Dr. Colleen Goode Fund for Nursing Research & Evidence-Based Practice Projects will carry on the legacy of Dr. Collene Goode.

Colleen J. Goode’s, PhD, RN, FAAN, NEA-BC, distinguished 40+ year career has impacted thousands of patients, students and colleagues. You can see her research and inspirational work today in the thousands of former students caring for patients that she mentored, as well as her work refining the work environment for nurses and improving patient care.

Dr. Goode is widely recognized for enhancing the quality of care at University of Colorado Hospital, transforming it into a world renowned evidence-based institution. As a young nursing executive and director of nursing she designed and led the adoption of an evidence-based practice using the Iowa Model.  Over 1,000 hospitals and colleges use this innovative care delivery model infusing best evidence into nursing practice. Dr. Goode was subsequently presented with the prestigious American Organization of Nurse Executives Nurse Researcher Award in 2003 and is recognized as one of the 2014 Living Legends from the American Academy of Nursing for her contributions to the profession.

Dr. Goode is also known for her dedication to education and was one of the leaders in founding the first post-baccalaureate national nurse residency program that has graduated thousands of students nationally.

The Dr. Colleen Goode Fund for Nursing Research & Evidence-Based Practice Projects will continue this forward-thinking work long beyond her retirement. It will provide research funding for graduate students with a similar passion and curiosity for improving health care.

For information on how to donate to the Dr. Colleen Goode Fund for Nursing Research & Evidence-Based Practice Projects, please go to: www.giving.cu.edu/goode or call Ashley Miltgen at 303-724-1699.

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Hyatt Regency announces foundation to benefit CU Anschutz

William Butler

William Butler, chairman and CEO of Corporex, announces the creation of the Fitzsimons Aurora Medical Campus Foundation, Inc. alongside Lilly Marks, vice president for health affairs for the University of Colorado and Anschutz Medical Campus.

Hyatt Regency Aurora-Denver Conference Center has opened across the street from the CU Anschutz campus, and the university will be benefiting from more than new spaces for accommodations and events. Corporex Companies, LLC, which owns the conference center, has formed the Fitzsimons Aurora Medical Campus Foundation, Inc. to support programs related to patient care, research and education for areas on campus that do not have consistent sources of funding.

The establishment of the foundation was announced by William Butler, chairman and CEO of Corporex, in conjunction with the grand opening of the new conference center. Corporex contributed $25,000 to the foundation and plans to provide additional funds through a portion of the hotel’s revenue, which is projected to collect up to $1.5 million over the next 10 years.

Hyatt Regency Aurora-Denver Conference Center features 249 non-smoking guestrooms and suite accommodations, as well as 15 meeting rooms, which include 20,000 square feet of traditional meeting space, an 11,750-square-foot Grand Ballroom and 8,100 square feet of meeting space that holds the elite accreditation from the International Association of Conference Centers (IACC).

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Research supports global switch to new polio vaccine strategy

A groundbreaking study released today shows that a single injectable dose of inactivated polio vaccine (IPV) along with bivalent oral polio vaccine could protect up to 90 percent of children from polio and strengthen community protection against the disease. The research, published in the latest edition of The Lancet, provides the evidence behind the worldwide switch to a new polio vaccine strategy by demonstrating that new schedules of the injectable vaccine with the bivalent oral vaccine protects kids much faster and is safer than oral vaccine alone.

“Although we are closer than ever in our fight to eradicate polio from the globe, there are still challenges in Pakistan and Afghanistan, especially in the war-torn or politically unstable areas of these countries,” said Dr. Edwin Asturias, lead researcher of the study at the Center for Global Health at the Colorado School of Public Health, and pediatric infectious disease physician at Children’s Hospital Colorado. “The study provides the scientific evidence for the recent switch to using a two-component (bivalent) oral polio vaccine and IPV in the worldwide effort to eradicate polio within the next year.”

This video of Dr. Asturias details the study’s findings.

Up until now, most low- and middle-income countries used only three-component (trivalent) oral polio vaccines given over multiple months and years. While extremely effective, poor health and sanitation have meant that many children needed multiple doses to achieve the necessary protection. The type 2 component in the trivalent oral vaccine has also been the source of most of the rare outbreaks of vaccine-derived polio, particularly in areas of poor immunization coverage.

Since the type 2 wild polio hasn’t been reported anywhere since 1999, all OPV-using countries switched to the bivalent oral polio vaccine, which doesn’t include the type 2 component, in April 2016. The bivalent form will be coupled with at least one dose of IPV in the primary immunization series, providing stronger and faster protection to children.

As long as polio remains endemic in any part of the world, the risk of importing the virus continues, particularly in countries with weak or inconsistent immunization programs and/or travel and trade connections to these countries,” added Dr. Asturias. “Making a single injectable vaccine available especially in these countries will accelerate the worldwide eradication of the crippling disease.”

The study, sponsored by FIDEC (Fighting Infectious Disease in Emerging Countries), and conducted over 12 months on more than 1,400 subjects in Guatemala, Colombia, Panama and the Dominican Republic, was funded by the Bill & Melinda Gates Foundation, and was a collaboration among key stakeholders of the Global Polio Eradication Initiative, including the CDC and several other globally-renowned public health experts. “The data from this study will strengthen the clinical evidence base on polio eradication endgame vaccination strategies,” said Dr. Ananda S. Bandyopadhyay, Senior Program Officer at the Gates Foundation and a co-author of The Lancet article.

The study has implications for routine immunization today, as well as polio outbreak response strategies in the future. It also confirms the importance of the polio vaccine switch strategy and the feasibility of achieving and sustaining a polio-free world.

 

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De Santis named director of Health Sciences Library

Melissa De Santis has been named Director of the Health Sciences Library at the University of Colorado Anschutz Medical Campus.

Melissa De Santis

Melissa De Santis

De Santis has more than two decades of library service, including seven years as Deputy Director and one year as Interim Director at the Health Sciences Library. De Santis holds a Master of Library and Information Science (MLIS) from UCLA.  She also has a dozen years of experience at San Antonio’s Briscoe Library, part of the University of Texas Health Science Center at San Antonio.

Regina Kilkenny, PhD, Associate Vice Chancellor of Academic Resources and Services, said De Santis “has a solid track record of success” and has provided excellent leadership at the Health Sciences Library over the past year while retaining her role in operational support.

“I have been very impressed with Melissa’s passion for the library and its mission-critical work,” Kilkenny said. “She is a recognized leader in the national academic health sciences library community and is a trusted and valued colleague.”

Kilkenny said De Santis has also demonstrated her role as a collaborator in creating and sustaining relationships with other University of Colorado and academic research libraries in the region. She is knowledgeable about the major issues facing health sciences libraries and cares deeply about improving library resources and services.

Those qualities, as well as De Santis’s strategic and effective approaches to supporting students, faculty and staff, will serve her well as she collaboratively shapes plans to ensure the library remains relevant to campus needs, Kilkenny said.

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10 can’t-miss hikes for summer

Colorado is a boundless wonderland for hikers, offering mountains, valleys, forests and aspen-rimmed meadows to lace up and explore – all in the backyard of our thriving Mile High City.

Trails of all varieties weave past red rock spires, plunge into granite canyons and cut through verdant glades all along the Front Range. Now that summer’s here (almost), what better way to enjoy our state’s stunning natural beauty than to fill a water bottle, pack the gorp and sunscreen and set out on a trail?

Bernard Wolf at Matthew/Winters Park near Morrison

This group of avid trail hikers recently enjoyed a late-afternoon hike on the Morrison Slide Trail at Matthews/Winters Park just north of Morrison.

We consulted local trailblazer and CU Denver alumnus Bernard Wolf (geology, ‘85) for some of his favorite – and convenient – hikes in the foothills and beyond. He came up with a list of 10 go-to hikes that never fail to satisfy. Many of these trails are also mountain bike-friendly, so be sure to check the web links for more information.

Bernard Wolf CU Denver graduate

Bernard Wolf graduated from CU Denver in 1985 with a bachelor’s degree in geology.

No matter your ability level, you’re sure to find a hike – or several – on this list that will have you breathing deeply of soul-freshening mountain air.

Hike: Matthews/Winters Park. Jefferson County Open Space Park.

Distance: 4.2-mile loop – Morrison Slide Trail, looping back on Red Rocks Trail.

Where: Trails on both sides of Colorado Highway 93, just south of Interstate 70

Difficulty: Moderate

Web: Matthews/Winters

Matthew/Winters Park hike near Morrison

Red rock formations are a common sight on the Matthews/Winters Park trail near Morrison.

You’ll hike past red rock formations, sage brush and spring wildflowers. Enjoy a view of downtown Denver when you crest the hogback. Deer are frequently seen grazing on the foothill grasses. The Morrison Slide Trail is pretty steep, gaining more than 400 feet in about a half-mile. The route mellows on the Red Rocks Trail on the way back to the parking lot.

Wolf’s take: “The scenery over the hogback is great. Last summer the wildflowers were off the hook with all the rain we had.”

Hike: North Table Mountain Park. Jefferson County Open Space Park.

Distance: 7-mile loop on the North Table Loop.

Where: Just north of Golden on Colorado Highway 93, east side of highway.

Difficulty: Mostly easy

Web: North Table Mountain Park

View from atop North Table Mountain trail

North Table Mountain trail offers panoramic views of Golden and the Denver area.

You’ll enjoy panoramic views of the Denver area atop this mesa that rises just north of Golden. The plateau is home to deer and prairie dogs, and in the sky you might see red-tailed hawks and golden eagles that nest in the mesa cliffs. Also, keep your eyes on the trail, because the arid landscape is prime habitat for rattlesnakes. The park offers 15-plus miles of trails; the North Table Loop which encircles the mesa is a seven-miler.

Wolf’s take: “You start with a lung-burner incline, and then the loop is very nice. There are actually a few trees on top. Once you’re on top of the mesa, you feel like you’re on this island of wilderness surrounded by urban areas.”

Hike: Frazer Meadow via Horseshoe Trail. Golden Gate Canyon Sate Park.

Distance: 4.5 miles, out-and-back trail

Where: Golden Gate Canyon State Park. Take Highway 93 north out of Golden, turn left (west) on onto the park access road and follow 13 miles. Turn right on Crawford Gulch Road and look for Frazer Meadow parking lot on the left.

Difficulty: Moderate

Web: Golden Gate Canyon State Park

Homestead cabin in Golden Gate Canyon State Park

A deserted homestead cabin stands along the trail to Frazer Meadow in Golden Gate Canyon State Park.

The Outdoor Adventure Center on the Auraria Campus is an excellent resource for students looking for adventure in the Colorado outdoors. The center, located in the PE/Events Center Room 001, offers hiking, cycling, rock climbing, canoeing, snowshoeing and other excursions. The center also offers gear rentals for all of your outdoor needs. For information, call 303-556-2391 or visit the Campus Recreation at Auraria website and click on “Outdoor Adventure Schedule” in the menu.

The 14,000-acre park has a total of 12 trails, each named for an animal and marked with critter footprints. The Horseshoe Trail follows along Ralston Creek, crossing it several times via footbridges. At a clearing surrounded by aspens, you’ll come upon a deserted cabin with a historic marker about the homesteader. It’s an out-and-back trail that climbs about 1,000 feet. Enjoy conifer forests, views of peaks and aspen groves.

Wolf’s take: “The trail starts off kind of steep, but eventually it goes through nice aspen groves, so it’s especially nice in the fall. The trail goes up where the forest thins and opens into a couple nice meadows.”

Hike: Mount Falcon. Jefferson County Open Space Park.

Distance: A total of about 13 miles of trail in the park. Recommended: 2.1-mile loop and 3-mile loop.

Where: From U.S. 285, take the Indian Hills turnoff, follow Parmalee Gulch Road for five miles to Picutis Road, then straight to Mount Falcon Road. You can also access the park on the east side, via Colorado Highway 8 which runs south out of downtown Morrison.

Difficulty: Easy to moderate

Web: Mount Falcon Park

Shelter at Mount Falcon Park

Mount Falcon includes shelters, an old wooden tower and the remnants of a castle among its family-friendly features.

Mount Falcon is a family-friendly park with many trails to choose from, offering views of the Continental Divide to the west and panoramas of Denver and the plains to the east. Picnic tables and shelters are available. Kids enjoy an old wooden tower as well as the stone-wall remnants of a castle built by the visionary John Brisben Walker. For a 2.1-mile loop, take the Castle Trail to Tower Trail to Meadow Trail and back to Castle. For a slightly longer hike, giving you 1,000 feet of elevation gain, take Castle Trail to Tower Trail and return on Parmalee Trail.

Wolf’s take: “There’s a lot of interesting stuff to see at Mount Falcon. You can do multiple trails. I always cheat and do it from the west side, because it’s a brutal incline from Morrison (east side).”

Hike: Royal Arch Trail. Boulder Mountain Park.

Distance: 3.2 miles, out-and-back trail

Where: In Boulder, take Baseline Road west toward the foothills. Chautauqua Park will be on the left.

Difficulty: Moderate to strenuous

Web: Royal Arch Trail

Royal Arch in Boulder

The payoff for a challenging hike in the Boulder foothills is the Royal Arch.

This hike of 1,300 feet elevation gain gets your heart pumping and gives you an up-close look at Boulder’s majestic Flatirons – and you’ll walk under an impressive rock arch, to boot. Royal Arch is actually located in the red rock of the fifth Flatiron. The hike climbs rapidly, winding through about a dozen switchbacks. Sturdy hiking boots are a must as the trail gets quite rocky. It’s an up-and-back hike. Start on Bluebell Road Trail and connect to Royal Arch Trail to reach the end. Chautauqua Park offers more than a dozen trails to explore.

Wolf’s take: “Royal Arch is a butt-kicker for me. I’d call it a moderate to strenuous hike. You go up a ridge, then down and then back up.”

Hike: Woods Quarry. Boulder Mountain Parks

Distance: To the quarry is about a mile (Mesa Trail to Woods Quarry spur), so about 2 miles round trip. Hike can be extended to about six miles by taking side trips on Kohler Mesa, Enchanted Mesa and Skunk Canyon trails.

Where: Follow Broadway south from downtown Boulder and turn right (west) on Dartmouth. Turn left on Kohler Drive and right on Drake Street; at Vassar Drive turn right and follow west to Table Mesa Drive. Turn right and follow to the National Center for Atmospheric Research (NCAR) parking lot.

Difficulty: Moderate

Web: Woods Quarry

Woods Quarry near Boulder

Rock lovers will enjoy seeing the remnants of an abandoned quarry on the Woods Quarry hike near Boulder.

For geology and rock lovers, this hike is a must. From the NCAR lot, start out on the Mesa Trail and follow until you reach a water storage tank. Turn right (north) and follow the trail into a canyon. You’ll cross a steam then make a steep climb. Keep following Mesa until you see the Woods Quarry spur and follow the steep trail up to the abandoned quarry. Enjoy the view and the benches made of native rock. Be aware that black bears and mountain lions are known to inhabit this area.

Wolf’s take: “Woods Quarry is where the red rock (Lyons sandstone) was excavated that was used in the buildings on the CU-Boulder campus.”

Hike: Mason Creek to Old Mill to Staunton Ranch trails. Staunton State Park.

Distance: 7-mile loop

Where: Take U.S. Highway 285 south to Shaffers Crossing, about six miles west of Conifer. Turn north on Elk Creek Road and follow the signs 1.5 miles to the park.

Difficulty: Moderate

Web: Staunton State Park

Staunton Ranch Park.

Varied and tall rock formations are part of the scenery at Staunton Ranch Park west of Conifer.

Getting to this park takes a little longer, but it’s well worth the drive. The hike takes you through stands of ponderosa pine, aspen and meadows of wildflowers. Numerous interesting granite rock formations, which are popular among rock climbers, come into view along the way. This relatively new state park offers numerous other trails, including a 10-plus-mile trek to Elk Falls Overlook. Staunton Park features numerous shelters and picnic areas, as well as ponds and falls. It ranges in elevation from 8,100 feet to over 10,000 feet, so sunscreen and water is highly recommended.

Wolf’s take: “Staunton’s awesome. Great variety of terrain – there’s something for everyone.”

Hike: Alderfer/Three Sisters. Jefferson County Open Space Park.

Distance: 4-mile loop

Where: Turn west on Buffalo Park Road from County Highway 73, just south of downtown Evergreen, and travel about one mile.

Difficulty: Moderate

Web: Alderfer/Three Sisters

Alderfer/Three Sisters Park in Evergreen

Alderfer/Three Sisters offers the most trails per acre of any Jeffco foothills park.

Alderfer/Three Sisters Park sits in the heart of Evergreen and was once a working ranch for horses and cattle. The family homestead and barn still sit on the park, which offers a variety of terrain from rolling hills to the challenging climb of Evergreen Mountain to the south. Alderfer/Three Sisters features the most trails per acre of any Jeffco foothills park: nearly 15 miles on 770 acres.

For a nice four-mile hike that takes you past rock landmarks “Three Sisters” and “The Brother,” park in the east lot off Buffalo Park Road and follow Hidden Fawn Trail to Sisters Trail, where you’ll hike between North Sister and Middle Sister before reaching the Ponderosa junction. At Ponderosa Trail, head east a short distance to the Brother spur. Follow the spur up and back for a look at “The Brother.” Back on Ponderosa, head west for about a half mile to Silver Fox Trail. Follow Silver Fox east to the Ponderosa junction and continue east on Ponderosa to the parking lot.

Wolf’s take: “There are lots of interesting rock formations and a nice ponderosa pine forest with groves of aspen in between. I’ve hiked at Alderfer/Three Sisters in spring through fall and it’s always amazing.”

Hike: Creek Bottom to Rimrock Trail. Castlewood Canyon State Park

Distance: 4.5 mile-loop

Where: Take Interstate 25 south from Denver to exit 182 at Castle Rock. Turn east on Colorado Highway 86d and go six miles to Franktown. Turn south on Colorado Highway 83 (South Parker Road) and drive five miles to the park entrance on the right.

Difficulty: Easy to moderate

Web: Castlewood Canyon State Park

Ruins at Castlewood Canyon State Park

The ruins of an old dam one of the attractions on at Castlewood Canyon State Park near Castle Rock.

This hike is not in the foothills – it’s actually east of Castle Rock – but it’s still a scenic area of forest, sage brush and canyon. There are a total of 13 miles of trails, following along canyon walls carved by Cherry Creek, for exploring in the park. For the 4.5-mile loop, access from the West Side Trailhead Loop. Follow Creek Bottom Trail to Dam Ruins spur, to Rimrock Trail and back to Creek Bottom.

Wolf’s take: “It’s all forested, and you don’t expect it out in that neck of the woods. The trail has a pretty moderate elevation gain – about 200 feet. You start at the top of the canyon, work your way down and finish back at the top. The rocks at the top of the canyon are really cool.”

Hike: Apex Loop, Apex Park. Jefferson County Open Space Park

Distance: 5-mile loop

Where: Take Interstate 70 west to exit 259/Morrison. Turn right (north) onto U.S. Highway 40. Drive one mile to the entrance to Heritage Square on the left. Turn into the drive leading to the shopping mall, then turn right into the lower parking lot. Look for the trailhead sign.

Difficulty: Moderate to difficult.

Web: Apex Park

Apex Trail near Golden

A variety of scenery rewards the hiker on the Apex Trail near Golden.

From the trailhead, take the paved trail to where you cross a wooden bridge and start a pretty steep climb. For the five-mile loop, follow Apex Trail to the Sluicebox Trail turnoff. Follow Sluicebox to Pick-N-Sledge to Argos and back to Apex Trail. For a longer hike, stay on Apex and continue past the Sluicebox junction to the Enchanted Forest Trail. This will take you along a shaded stretch with mossy, fern-covered ground. Loop back the parking lot on the Apex Trail.

Wolf’s take: “This trail has some historic significance. It’s the old wagon road from Golden to Central City.”

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Writing Center goes 24/7

Magdelana Carr has a multitude of things to say but sometimes can’t find the words to express them. As a pre-engineering major, she doesn’t feel as confident with the written word. Thankfully for Carr and others, there is a growing center on campus that proves writing doesn’t need to be a looming, dark cloud.

The Writing Center at the University of Colorado Denver and Anschutz Medical Campus has expanded to offer support in academic, personal and professional writing at six locations and online. But until the beginning of Fall 2015, the center had difficulty meeting the demand of students.

“Across all locations, we run (on average) at 96 percent of capacity,” said Justin Bain, director of The Writing Center at CU Denver and CU Anschutz. “And on average, we turned away approximately 2,000 students per semester because we simply didn’t have the capacity to assist them.”

In response to the growing need, The Writing Center recently added three locations and offers around-the-clock online support. In addition to the locations at the North Classroom at CU Denver, the Health Sciences Library at CU Anschutz, and Campus Village at Auraria, the Writing Center offers in-person support at the following new locations:

Lobby of the CU Denver Business School on Lawrence Street

Professional Writing Consultants at this location are specially-trained in business writing. This is also a convenient location for students attending the College of Architecture and Planning and School of Public Affairs.

Lobby of the Liniger Building at CU South Denver

Writing consultants at this location are trained in business writing and science/medical writing. This location is convenient for students in the Business School and CU Anschutz students attending classes at CU South Denver.

The Auraria Library

This popular spot is a tri-institutional collaboration with the writing centers of CU Denver, the Community College of Denver and Metropolitan State University Denver.

For additional information on each location, along with an hourly schedule, visit the Writing Center website here.

Between the physical locations and the online chatroom support, students are able to get one-on-one help between 8 a.m. and midnight. Past midnight, students can send their writing (up to 10 pages) to the After Hours Drop Box and have it returned with a summary letter and in-text commentary within 24 hours.

“To my knowledge, no other writing center in the country offers the breadth of support that we do — specifically, some form of writing assistance available 24/7 and across so many physical locations and online platforms,” said Drew Bixby, assistant director of The Writing Center.

Since Fall 2015, The Writing Center has hired eight staff members to join their dynamic team of faculty with MAs, graduate students, and advanced undergraduates, all of which receive ongoing training. Student employees find the culture of mutual support and continual growth to be a cornerstone of the Writing Center.

“I get a lot of my education from working here,” said Chris Doxtator, master’s student of rhetoric in the English department. “Everything we are doing here is a lot of professional development. If you need to do writing for your degree, regardless of what your degree is, you learn a lot while you’re here. And convenience-wise, the location is hard to beat.”

Doxtator is one of the Professional Writing Consultants who works at the center. Additionally, he teaches a couple English courses, along with many workshops that are offered through the center.

For a list of workshops, click here.

In the future, The Writing Center will continue to develop its satellite locations and further integrate them into the respective academic programs they serve.

“I also have tentative plans to pilot some high school writing centers in Denver Public Schools in the coming year,” Bain said. “We see this as an opportunity to support our local students and school district while providing outreach to students who may want to attend CU Denver after high school.”

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CU Anschutz and Regis University academics behind new patient care law

A coalition of doctors and ethicists, including two from the University of Colorado Anschutz Medical Campus and another from Regis University, are behind a new law signed Wednesday allowing doctors to take better care of the most vulnerable patients in hospitals and emergency rooms.

The `Medical Decision Making for Unrepresented Patients’ law was signed by Gov. John Hickenlooper at a ceremony at the Northern Colorado Medical Center in Greeley. The measure will allow physicians to act as proxies for patients unable to provide consent or with no other proxy available.

Jackie Glover, PhD, professor of pediatrics at CU School of Medicine and Center for Bioethics and Humanities.

“This is a national problem that has been discussed for decades,” said Jackie Glover, PhD, professor of pediatrics who teaches ethics at the Center for Bioethics and Humanities at CU Anschutz. “If you are a patient without family or friends you are appointed a guardian but that’s an awful long process in Colorado.”

Glover along with CU Anschutz Professor of Medicine Jean Abbott, MD, MH and Debra Bennett-Woods, EdU, FACHE, and professor of health services education at Regis University, collaborated with a coalition of ethics committees under the umbrella of the Colorado Health Care Ethics Forum or CHEF to draft the legislation.

“This bill is a matter of social justice,” said Bennet-Woods, “HB16-11101 will enable the care team to provide the right treatment, at the right time and in the right setting.”

Glover said unrepresented patients in hospitals and long-term care facilities can’t speak for themselves and have no family or close friends to speak for them. By one estimate more than 16 percent of patients admitted to ICUs today are unrepresented and the number is growing. By 2020, more than 2 million Americans will have outlived friends and family.

Jean Abbott, MD, MH, professor emerita CU School of Medicine and Center for Bioethics and Humanities.

The group found willing partners in Rep. David Young and Sen. Kevin Lundberg who introduced the measure in the state Legislature.

The law will allow a second doctor, who is not the patient’s attending physician, to serve as a proxy of last resort when a patient is unable to provide consent and no proxy can be found. The hospital ethics committee must oversee this process, ensuring that all reasonable efforts to find a proxy have been made.

But the law will not require physicians to act as proxies. It also won’t replace volunteer guardianship programs, nor will it provide funding for a public guardianship program.

Glover said her group got together, examined what other states do and drafted the legislation. They were surprised at how quickly it advanced through the political process.

Bennet-Woods agreed.

“The process brought together a novel set of stakeholders and has the potential to keep them at the table as best practices are developed and rolled out,” she said.

But the law is only the beginning.

“The hard work is yet to come,” Glover said. “We now have to develop best practices going forward.”

 

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Cerebral palsy doesn’t stop her from dancing

Sarah Cauley

Sarah Cauley, a previous patient of the Gait Lab, is helping researchers understand how adults with cerebral palsy transition to adulthood. Sarah’s goal is to one day perform on Dancing with the Stars “to show anything is possible.”

Even though learning to waltz had been a lifelong dream for Sarah Cauley, she cancelled just one day before her first lesson. She was unable to open her hand enough for someone to hold it, and was afraid no one would want to try.

“The words ‘graceful’ and ‘cerebral palsy’ are two words that are not typically used in the same sentence,” explained Sarah, an individual with spastic cerebral palsy.

Watch Sarah dance today and you would describe her as graceful. Not only has Sarah become a competitive ballroom dancer, she is helping CU Anschutz researchers explore how cerebral palsy impacts health and mobility in adults.

Following a dream

Sarah was first inspired to follow her dream after seeing a news report about a blind individual who was able to learn ballroom dancing. She knew the challenges were different from her own, but thought there might be a way for her to learn. She called the dance studio, Colorado Dancesport, and explained her situation. They told her to come in for a lesson—the lesson that she ultimately cancelled.

Things were different six months later when she rescheduled for the eve of her 29th birthday. Despite still being nervous, she was resolved to pursue her dream.

“I stood across from my instructor, held out my hand, and I said, ‘Hello my name is Sarah, I’m 29 years old, and I would like to learn how to waltz.’”

Even though learning to dance proved more difficult than she first thought, Sarah eventually had the dance down. Five months later she and her instructor were performing a tango routine in front of a live audience. After that she entered her first ballroom dance competition.

“I dance because I love it,” said Sarah. “I hope when I dance people see that.”

People do see it. They see it when Sarah talks about dancing. They see it when she steps onto the dance floor. They see a lot that can be learned from Sarah’s determination, perseverance and courage.

Learning from Sarah

Jim Carollo, director of the Center for Gait and Movement Analysis at Children’s Hospital, also thinks much can be learned from Sarah’s active lifestyle, which is why he invited her to participate in the Cerebral Palsy Adult Transition (CPAT) study.

The CPAT study is designed to understand how the walking abilities of individuals with cerebral palsy changes during the transition from childhood to adulthood. Carollo, along with coinvestigator Amy Bodkin, are analyzing 70 former Gait Lab patients to see how their gait and other variables compare to data collected when they were children.

“Some people with cerebral palsy assume that they will have to stop walking at some point,” Carollo said. “However there’s no evidence to suggest that. What is important, is to avoid falling into a sedentary lifestyle, because there is evidence that that can lead to secondary health conditions, especially in patients with a pediatric condition.”

Sarah Cauley

A series of sensors track Sarah Cauley’s movements in the Gait Lab.

Carollo theorizes that maintaining an active lifestyle can help to maintain gait and walking ability—ultimately allowing individuals to stave off secondary conditions that accompany a sedentary lifestyle.

The hours Cauley spends practicing and performing her dance routines could also be helping her to maintain overall health. Cauley was eager to participate in the study since she knew there is little research on adults with cerebral palsy.

“I was excited to learn they were doing research to help people over 18 with cerebral palsy,” Sarah said. “There aren’t a lot of resources for that, and the condition doesn’t go away just because you’ve turned 18.”

This is a significant problem, according to Bodkin, who noted that the CPAT study is hoping to begin bridging the gap between patients lost during the transition from pediatric care to adult care.

Jim Carollo and Sarah Cauley

Jim Carollo chats with Sarah Cauley about the study. He will present her with a Health Passport at the end of the study outlining how her gait has changed over time and recommendations for the future.

“CP patients tend to get lost between 18-21 years old,” Bodkin said. “This happens to many adults with pediatric conditions. It is a combination of a lack of specialists and lack of insurance, as well as limited access to the healthcare system.”

Passport to health

Seeking to provide an additional resource for CPAT study participants, Carollo and Bodkin have created an individualized “health passport” for every participant. The health passport incorporates data collected from the gait analysis as well as lipid and insulin panels, quality of life assessments and other tests to give guidance on how they can live a healthy lifestyle. The passport is presented at a conference with the participant and their family.

“The health passport has been a strong motivator for patients to participate,” Carollo said. “The passport is valuable to them since it provides input on how they might maintain or improve movement going forward.”

Carollo and Bodkin plan to conclude the data collection phase of the study by the end of summer 2016. They hope that once analyzed, the data will shed light on adults with cerebral palsy and offer new ideas on how improve overall health and avoid secondary conditions.

“As a person who values measurements, I value being able to test previous patients not as an evaluation of the past, but as a roadmap for the future,” Carollo said.

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Doctors don’t die differently than anyone else

A new study from researchers at the University of Colorado Anschutz Medical Campus  appears to disprove the increasingly popular notion that doctors die differently than everyone else, using  fewer interventions that often have little value.

In fact, the researchers said, their national study found that physicians use more hospice care, spend more time in Intensive Care Units (ICUs) and just as much time in hospitals when compared to the rest of the population.

Stacy Fischer, MD, associate professor CU School of Medicine.

“The overall narrative that doctors die differently is false,” said the study’s senior author Stacy Fischer, MD, associate professor at the University of Colorado School of Medicine. “We found that doctors used more hospice care – about two days on average – but when you look at the length of stay in hospital in the last months of life, there is no difference between them and the rest of population.”

The study was published this week in the Journal of the American Geriatrics Society. In 2011, Ken Murray, a retired family physician, wrote an essay entitled `How Doctors Die’ saying doctors were more likely to die at home with fewer end-of-life medical interventions. The essay swiftly went viral and was supported by hypothetical surveys of physicians regarding their wishes for care at the end of life and later by smaller preliminary studies.

Fischer and her colleagues, including Daniel Matlock, MD, MPH of CU Anschutz, wanted to see if doctors with their knowledge of medical treatment and outcomes truly did die differently than others.

They examined data from 9,947 deceased physicians and a random sample of 192,006 non-physicians between 2008 and 2010. In the last six months and one month of life, the proportion of physicians and non-physicians having at least one ICU stay was essentially equivalent. The mean number of days spent in the ICU in the last six months and one month of life was slighter greater for doctors.

The study also showed that 46.4 percent of physicians and 43.2 percent of non-physicians had enrolled in hospice care for the last six months of life. Doctors used hospice an average of 2.4 days longer than others. And the proportion of doctors using hospice within seven days of death was slightly greater than non-physicians.

Daniel Matlock, MD, MPH. assistant professor CU School of Medicine.

“Based on prior survey research of physician attitudes toward end-of-life care, it was expected that physicians would have less use of high intensity hospital-based care at the end of life,” the authors wrote. “Why might the findings conflict with the prior evidence that demonstrates physician preferences for less aggressive care?”

The differences could be generational, they said, since the average age of the physicians studied was 83.

“Many of these physicians trained and practiced medicine at a time before hospice or palliative care and before many of the technological advances in intensive care,” Matlock said. “Second, fear and avoidance of dying are strong motivators of much of human behavior and perhaps physicians are not immune to these fears of dying.”

Yet the most troubling explanation, Fischer said, is that higher level health care system factors affect end-of-life care independent of patient or clinical factors.

“We need to take a critical look at our health care system and ask what is driving this low value care and by that I mean care that doesn’t offer any real quantity or quality of life,” she said. “And clearly, despite their medical knowledge, physicians are not immune. We hope our study will help spark a national conversation about this increasingly important issue.”

The co-authors include Traci E. Yamashita, MA, Min Sung-Joon, PhD, Alexander K. Smith, MD, MPH and Amy S. Kelley, MD, MSHS.

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