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CU Anschutz joins six-state collaboration to create Veterans’ Action Leagues

A pioneering community engagement project for veterans is set to begin this month, kick-starting an innovative campaign to include the input of veterans, researchers and community members in the evolving dialogue around ways to improve veteran health care.

CU Anschutz Medical Campus, Building 500
CU Anschutz Medical Campus, Building 500

Project lead Cheryl Krause-Parello, PhD, RN, FAAN, and co-lead Linda Flynn, PhD, of the College of Nursing at CU Anschutz, are leading the multistate project named Veterans’ Action League (VAL). VAL is responsible for leading a dynamic two-year conversation empowering veterans to have an active voice in guiding their own healthcare delivery.

This national project examines what information veterans need and want to make informed decisions about their health care. Krause-Parello is also the director of the military healthcare initiative Canines Providing Assistance to Wounded Warriors (C-P.A.W.W.).

“We know that veterans reintegrating back into civilian life can face enormous pressure and challenges,” said Krause-Parello. “Many veterans may feel disconnected from the myriad resources that exist to help them. If we take the time to listen to veterans, we can empower our veterans to make the best possible decisions for their own health.”

To improve the health outcomes of military veterans, Krause-Parello and Flynn are connecting with powerhouse teams of Collaborative Academic Research Members (CARMs) from the University of San Diego, University of Texas at San Antonio, Florida Atlantic University, Pennsylvania State University, the University of Rochester and The Ohio State University, as well as committed veteran unit leaders (VAL-ULs) in each state who will play integral leadership roles in engaging the veteran community over the course of the project. VAL-ULs and CARMs from each state will join forces and resources to facilitate stakeholder-centered dialogues concerning veteran health and wellness.

The ultimate goal of this collaboration is the development of an interactive toolkit for use by veterans, community organizations and healthcare providers to connect veterans with available resources, presented in a straightforward, user-friendly format.

Using a blend of in-person meetings and digital conferencing among a geographically diverse team, this project advances a robust, veteran-driven model of patient-centered care and patient engagement, recognizing the discrete health care needs of armed forces members.

This project is partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (3302-UCD).

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University of Colorado Anschutz Joins Six-State Collaboration to Create Veterans’ Action Leagues

A pioneering community engagement project for veterans is set to begin this month, kick-starting an innovative campaign to include the input of veterans, researchers and community members in the evolving dialogue around ways to improve veteran health care.

CU Anschutz
CU Anschutz Medical Campus

Project lead Cheryl Krause-Parello, PhD, RN, FAAN, and co-lead Linda Flynn, PhD, of the College of Nursing at CU Anschutz, are leading the multistate project named Veterans’ Action League (VAL). VAL is responsible for leading a dynamic two-year conversation empowering veterans to have an active voice in guiding their own healthcare delivery.

This national project examines what information veterans need and want to make informed decisions about their health care. Krause-Parello is also the director of the military healthcare initiative Canines Providing Assistance to Wounded Warriors (C-P.A.W.W.).

“We know that veterans reintegrating back into civilian life can face enormous pressure and challenges,” said Krause-Parello. “Many veterans may feel disconnected from the myriad resources that exist to help them. If we take the time to listen to veterans, we can empower our veterans to make the best possible decisions for their own health.”

To improve the health outcomes of military veterans, Krause-Parello and Flynn are connecting with powerhouse teams of Collaborative Academic Research Members (CARMs) from the University of San Diego, University of Texas at San Antonio, Florida Atlantic University, Pennsylvania State University, the University of Rochester and The Ohio State University, as well as committed veteran unit leaders (VAL-ULs) in each state who will play integral leadership roles in engaging the veteran community over the course of the project. VAL-ULs and CARMs from each state will join forces and resources to facilitate stakeholder-centered dialogues concerning veteran health and wellness.

The ultimate goal of this collaboration is the development of an interactive toolkit for use by veterans, community organizations and healthcare providers to connect veterans with available resources, presented in a straightforward, user-friendly format.

Using a blend of in-person meetings and digital conferencing among a geographically diverse team, this project advances a robust, veteran-driven model of patient-centered care and patient engagement, recognizing the discrete health care needs of armed forces members.

This project is partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (3302-UCD).

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Bioengineering student overcomes learning disability to thrive academically

A simple goal motivates Kyle Adrian Kenyon: make his community healthier, smarter and more engaged. Kenyon, a bioengineering student, is a dynamo of academic and athletic activism – he mentors fellow students as well as youth soccer players – all while dealing with a host of personal challenges.

Kenyon struggled with test-taking anxiety while he earned bachelor’s degrees in biomedical engineering and molecular & cellular biology at the University of Arizona. However, it wasn’t until he arrived at the CU Anschutz Medical Campus as a bioengineering graduate student that he discovered he had a significant learning disability.

“I came here without knowing anyone and, working with Sherry (Holden) and Selim (Ozi) in Disability Resources and Services, I found out I’m dyslexic; I have a reading and writing learning disability,” Kenyon said. “Once diagnosed, I received accommodations and was able to demonstrate my knowledge.” Holden also referred Kenyon to Dominic Martinez, senior director of the CU Anschutz Office of Inclusion and Outreach, to assist him in the application process to the CU School of Medicine (SOM).

‘Finally know what a 4.0 feels like’

The diagnosis gave Kenyon a new perspective on some of his past challenges while opening the door to greater academic success. “I finally know what it feels like to get a 4.0 (GPA),” he said with a smile.

Kenyon is quick to credit others, specifically campus support services, for his achievements. With Martinez’s help, Kenyon, who expects to graduate with a master’s in bioengineering in spring 2017, is applying for the Medical Scientist Training Program in the SOM. “I’d like to combine the clinical, engineering and scientific research fields to be essentially a translational physician, doing bench-to-bedside work.”

Colorado Rapids youth outreach
Bioengineering student Kyle Adrian Kenyon is a youth coach and an organizer of Colorado Rapids outreach programs at schools in Denver and Aurora.

Performing a broad assortment of work suits Kenyon well. Besides being a full-time student, he works part-time as both a youth coach and organizer of Colorado Rapids outreach programs at schools in Aurora and Denver. Just as the Rapids professional club is on a roll this season – the team has advanced in the Major League Soccer playoffs – the club’s nonprofit youth-program arm provides after-school exercise for thousands of kids.

“We’re discussing the possibility of doing a public health study, related to the potential benefits of after-school exercise for kids, in collaboration with Elaine Belansky, PhD,” Kenyon said. Belansky is an associate professor in the Colorado School of Public Health (ColoradoSPH).

Also, the after-school programs, called Soccer for Success, have shown to help keep kids engaged in school, Kenyon said.

“What I like about the Rapids is the element of trying to make the community better,” he said. He’d like to expand his youth soccer work, as he sees “really big potential” in the development of a relationship with the ColoradoSPH at CU Anschutz.

Kenyon played soccer throughout his childhood and at the intramural level in college. He can be seen wearing his Colorado Rapids training jacket around campus.

Kyle Kenyon at CU Anschutz
Kyle Adrian Kenyon is active in both sports — he works part time for the Rapids youth division — and academics. He serves as vice president of the Biomedical Engineering Society, which encompasses students at CU Anschutz and CU Denver.

On the academic front, Kenyon is vice president of the Biomedical Engineering Society, which encompasses students at CU Anschutz and CU Denver. The group holds “pitch nights” where faculty from both campuses explain research projects with the hope of engaging student workers in their labs.

‘Like to build relationships’

In the future, Kenyon would like to hold “Engineering Clinics” where students in the Bioengineering Department (College of Engineering and Applied Science) offer basic engineering tutorials at area middle and high schools. “I like to build relationships and create things that help a great many people, all the while using my skills and knowledge in the most effective manner,” he said.

In just his second semester in the bioengineering graduate program, Kenyon saw his GPA vault to 3.9 (from 3.3). “There’s tangible improvement,” he said. “It’s been helped by those offices (Disability Resources and Inclusion and Outreach), and my new understanding of where my strengths and weaknesses are.”

Martinez said Kenyon has been an impressive mentor to undergraduate pre-health students on both campuses. For example, Kenyon used Microsoft Excel software to develop a GPA calculator that helps students track their progress while preparing for medical school and other graduate-level programs.

Martinez has been able to relate to Kenyon on many levels, including the dyslexia. “I had the same issue; I didn’t find out until graduate school that I was dyslexic,” he said. “The thing about Kyle is he’s risen to the occasion, and he doesn’t make excuses about it. He continues to move forward to be a better student and just to be a better person.”

Kenyon’s strong sense of empathy, balanced with a curious and analytic mind, is a prized characteristic in today’s sometimes impersonal world. His outgoing personality allows him to pivot with ease between a scientific environment – doing research in a lab – and various “soft skill” settings, such as communicating on the soccer field, in the classroom and in the lab.

“I feel I’ve been on a long, meaningful road,” he said. “It’s made me very flexible. Because of the struggles in my life, I feel I can understand and relate to people in many meaningful ways.”

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Brains of those with anorexia and bulimia can override urge to eat

Scientists at the University of Colorado Anschutz Medical Campus have discovered the neurological reasons why those with anorexia and bulimia nervosa are able to override the urge to eat.

In a study published last week in the journal Translational Psychiatry, the researchers showed that normal patterns of appetite stimulation in the brain are effectively reversed in those with eating disorders.

Rather than the hypothalamus, a brain region that regulates appetite, driving motivation to eat, signals from other parts of the brain can override the hypothalamus in eating disorders.

Guido Frank, MD
Dr. Guido Frank, associate professor of psychiatry and neuroscience at the University of Colorado School of Medicine.

“In the clinical world we call this `mind over matter,’’’ said Guido Frank, MD, lead author of the study and associate professor of psychiatry and neuroscience at the University of Colorado School of Medicine. “Now we have physiological evidence to back up that idea.”

Dr. Frank, an expert on eating disorders, set out to discover the hierarchies of the brain that govern appetite and food intake. He wanted to understand the neurological reasons behind why some people eat when they were hungry and others don’t.

Using brain scans, the researchers examined how 26 healthy women and 26 women with anorexia or bulimia nervosa reacted to tasting a sugary solution.

They discovered that those with eating disorders had widespread alterations in the structure of brain pathways governing taste-reward and appetite regulation. The alterations were found in the white matter, which coordinates communication between different parts of the brain.

There were also major differences in the role the hypothalamus played in each group.

Among those without an eating disorder, brain regions that drive eating took their cues from the hypothalamus.

In the groups with an eating disorder, the pathways to the hypothalamus were significantly weaker and the direction of information went in the opposite direction.  As a result, their brain may be able to override the hypothalamus and fend off the signals to eat.

“The appetite region of the brain should drive you off your chair to get something to eat,” said Frank. “But in patients with anorexia or bulimia nervosa that is not the case.”

According to the study, humans are programmed at birth to like sweet tastes. But those with eating disorders begin to avoid eating sweets for fear of gaining weight.

“One could see such avoidance as a form of learned behavior and more specifically operant conditioning, with weight gain as the feared `punishment,’’’ the study said.

This behavior could eventually alter the brain circuits governing appetite and food intake. Researchers now suggest that being afraid to eat certain foods could impact the taste-reward processing mechanisms in the brain which could then reduce the influence of the hypothalamus.

“We now understand better on the biological level how those with an eating disorder may be able to override the drive to eat,” said Frank. “Next we need to begin looking at children to see when all of this starts to come into play.”

Frank is the author of a new book entitled “WHAT CAUSES EATING DISORDERS – AND WHAT DO THEY CAUSE?” available on Amazon and other outlets.

 

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State of the Campus: ‘We seek to be the best’

In his “State of the Campus” address, Chancellor Don Elliman challenged CU Anschutz Medical Campus leaders to think big and be nimble, to both create another leading “headline” healthcare service as well as “continue to reinvent ourselves” amid a changing marketplace. He emphasized that now is the time to build on unprecedented momentum in the campus’s tri-fold mission of healthcare education, clinical care and research.

Elliman delivered his remarks to an audience in Hensel-Phelps West Auditorium on Tuesday. His presentation touched on where CU Anschutz has been – just Building 500 and some barren ground not many years ago – to where it is now – a thriving academic medical center of over 4,000 students, some 2 million patient visits and a research portfolio of over $420 million each year. He laid out a vision of where the campus should go, distilling the strategies into a singular ambition: “We are very good; we seek to be the best.”

Crowd at State of the Campus address
A full house in the Hensel-Phelps West Auditorium attended Chancellor Elliman’s State of the Campus address on Nov. 1.

Elliman’s roadmap for reaching that pinnacle includes nine potential strategies, which were developed through conversations with faculty and staff. After explaining the plan’s elements, he said, “Now it’s your turn,” inviting the campus community to offer feedback. The complete “State of the Campus” text can be found at  www.ucdenver.edu/AnschutzStrategies, which includes a link for posting ideas and suggestions.

‘Our next horizons’ 

After detailing CU Anschutz’s momentum over just the past two years – including the School of Medicine’s (SOM) $80 million investment in five new transformational research projects; unprecedented efforts to build the faculty base in quality and quantity; national rankings of both clinical affiliates, UCHealth and Children’s Hospital Colorado; new leadership at both hospitals on campus and at the SOM; and major financial backing to develop the Colorado Center for Personalized Medicine and the data warehouse COMPASS – the chancellor posed the question: “So where do we look for our next horizons?”

CU Anschutz Chancellor Don Elliman
CU Anschutz Chancellor Don Elliman delivers his State of the Campus address on Nov. 1.

New horizons, both aspirational and marketplace-oriented, are necessary because the landscape is shifting, he said. Most analysts expect a consolidation in research funding in upcoming years, meaning fewer academic medical centers are likely to be serious players. CU Anschutz must be one of those players, Elliman said, both in terms of basic and translational science.

‘Finest care in the world’

“We seek to be a medical destination of such breadth and quality,” he said, “that no one from the Rocky Mountain region should ever have to travel beyond this campus to receive the finest care in the world.”

Elliman noted that clinical revenues for both faculty and affiliates will be impacted by a changing environment for reimbursement rates and policies. Likewise, the future of federal research funding is unpredictable, and we live in a highly competitive clinical environment.

On the plus side, he said, CU Anschutz is in a fast-growing market and enjoys the distinction of being the only academic medical center over a very wide geographic territory. CU Anschutz is also extremely robust in that it is one of very few academic medical centers in the nation with all five major health science schools and colleges on a contiguous campus. Overall, he said, “we face a fluid future, but with at least as much potential for wind in our face as we have out our backs.”

Nine potential strategies

With that, Elliman unfurled nine suggested strategies for the campus:

  • Invest in becoming a “top 5” in a major service line. CU Anschutz is already there with Pulmonology – a shared distinction with National Jewish. “This isn’t to suggest we ignore the pursuit of excellence in other areas; it is to say we need another ‘headline.’” He said the SOM’s transformational research grants provide a leg up to specific areas of research in this process, and it’s critical that both affiliate clinical partners agree on the selection.
  • Move from the mid-20s in ranking for NIH research funding to the mid-teens, headed to the top 10. “Our role in helping to redefine the future of healthcare is at the core of who we are and represents our single biggest brand differentiator … Again, the transformational research grants should provide significant seed funding.”
  • Diversify our research portfolio. The campus has made recent strides – including a revamping of tech transfer into CU Anschutz Innovations and a more customer-focused Grants and Contracts organization – but more can be done to grow support for internal entrepreneurship and infrastructure, as well as accelerate connections to industry. On the big-data front, CU Anschutz has created data resources with the Colorado Center for Personalized Medicine and COMPASS. But the major players in healthcare data are the Googles, Amazons, Apples and the like, Elliman said. “We have to think about how we interface with that reality.”
  • Go big in mental health, which the chancellor calls the most unmet need in American healthcare. CU Anschutz has expanded its footprint here – notably with the creation of the National Behavioral Health Innovation Center and the expansion of the Helen and Arthur E. Johnson Depression Center – but the efforts have tended to be independent of one another. “We need to bring them together into a common strategy,” he said, “and we need to match our clinical expansion with renewed emphasis on research and education.”
  • Expand our ability and capacity to train the healthcare workforce. The campus needs to expand educational opportunities and output for physician assistants, advanced practice nurses and mental health professionals, to name a few. Funding will be a challenge, he said, “but if our workforce provider role in the region is to be fulfilled, we need to find a way.”
  • Tell the world who we are and what we do. The campus remains an unknown entity to too many residents in Colorado, the Rocky Mountain region and globally, the chancellor said. “We have a wonderful story to tell, and it gets better every day.”
  • Take more advantage of our co-location on campus. More than ever, healthcare is becoming a “team sport.” Elliman said that CU Anschutz, with its five health-related schools and major hospital affiliates, should better leverage this proximity to build more bridges between faculties, and create more multidisciplinary teams in research and education.
  • Become more risk-tolerant. Obviously, we should not take risks with regard to patient care, government compliance and other critical areas. Rather, “we have to get comfortable in dialing up our willingness to take calculated chances” that will help the campus grow in expertise and prestige, he said. The transformational research grants and a proposed new building on CU Anschutz’s horizon are examples of bets that will provide even greater returns to the campus.
  • Set priorities and allocate resources accordingly. No matter how the plans turn out, he said, campus leaders must be ready to make difficult choices to focus resources on top priorities.

Expand revenues, clinical footprints

Elliman said the rate of progress on these objectives will depend on critical factors. They include clinical revenue growth, fostering and improving relations with hospital affiliates, embracing technology, campus infrastructure, space, talent and philanthropic growth (which has more than doubled from just five years ago).

Chancellor Elliman talks with attendee at State of the Campus address
Chancellor Don Elliman chats with Patrick Gaines, executive director of the Gates Center for Regenerative Medicine, after the State of the Campus address on Nov. 1.

The chancellor said the SOM has seen its clinical revenues grow at over 10 percent a year for more than a decade. “We need to do everything we can to continue that trend … Further, I’d suggest all our other schools, many of which already have a clinical presence, need to look for ways to expand their clinical footprint.”

With regard to space, he said, the campus desperately needs another building to meet existing demands for clinical, laboratory and office space. Elliman expects that after construction of the next building – which could be 300,000 to 400,000 square feet in size, with a groundbreaking next year – the campus will need to plan the next one.

On the subject of talent, Elliman quoted former Apple CEO Steve Jobs: “Hiring the best is our most important task.” The chancellor said, “Our faculty – your talent – make this place what it is. If the talent base is getting better, we will get better with it.”

‘An amazing place’

He concluded by saying “this is an amazing place; together, we can make it even better” and reiterating that campus leadership will use plan feedback to guide the next steps.

CU Anschutz State of the Campus event
Richard Traystman, vice chancellor for research, chats with Ravinder Singh, chair of the CU Faculty Council, before the State of the Campus address.

A question was asked about the CU Cancer Center. If only 14 percent of people in Colorado with cancer come to the Cancer Center for treatment, an audience member asked, where do the remainder of patients go and what would happen if “suddenly they all decided to come here?”

The chancellor acknowledged that it would be a challenge if all of those patients currently going elsewhere came to our Cancer Center for treatment. But in general, the Cancer Center – one of only 47 NIH/NCI-designated comprehensive cancer centers in the U.S. – has the capacity to treat many more Colorado-based patients, he said.

Elliman added that campus leadership is close to finalizing a branding platform specifically for CU Anschutz, a task complicated because the affiliated hospitals on campus have individual brands that also need to be recognized.

“We’ve never done a particularly aggressive job at telling people what we have on this campus. That’s got to change, and the Cancer Center is one example,” Elliman said. “We have phenomenal resources in this very, very broad group of skill sets and we don’t get enough recognition for the work we do.”

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CU Anschutz team receives National MS Society grant to speed research

John Corboy, MD
John Corboy, MD

John Corboy, MD, professor of neurology at the University of Colorado School of Medicine and co-director of the Rocky Mountain MS Center at CU Anschutz, was awarded $6.7 million from the Patient-Centered Outcomes Research Institute (PCORI) in 2015 to determine the length of time someone living with multiple sclerosis should be on a disease modifying therapy. Now, the National MS Society is supporting this study with a $326,000 grant to expedite research.

The study seeks to answer whether a population of MS patients exists in whom it is safe to discontinue their disease modifying therapy as they age. Disease modifying therapies are used to reduce the number of relapses in people living with MS, slowing down the progression of the disease. Currently, these therapies are used chronically, with no clear knowledge of when these therapies should be discontinued for best results.

“It’s fairly clear that these medicines give the greatest benefit to people when they are younger,” Corboy said. “Then the question becomes: As people age, is there a point when the risk of new inflammatory disease activity becomes so low that any benefit achieved by therapy is outweighed by the cost, risk, side effects and hassle involved with taking medication on a regular basis?”

This study will collect data from 300 participants, age 55 and older, randomly chosen to continue or discontinue their therapy. Researchers will then examine how this affects the risk of new relapses, disease activity on MRI scans, disability progression and quality of life. It will provide the rigorous data necessary to allow medical professionals to determine when it may be appropriate to stop a MS therapy.

The $326,000 commitment by the MS Society allows the study to be expanded to 15 sites, decreasing the number of participants each site needs to recruit, thus expediting the research. Corboy’s team expects to start participant enrollment in early 2017.

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS.

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