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Talent behind the lab coats

“Ni hao.” “Namaste.” “As-Salaam-Alaikum.” “M’bolani.” “What’s up?”

At the recent Talent and Attire Show hosted by the Association of International Researchers (AIR), these were only a few of the responses to Ranjitha Dhanasekaran, PhD, president of AIR, who opened the show by directing the audience: “Say hello in your native tongue.”

The show in the Krugman Conference Hall, complete with international banquet catered by local restaurants, was the culmination of the nationwide International Education Week (IEW). “IEW is hosted by the State Department of the United States to recognize the importance of international education and cultural exchange,” said Michelle Larson-Krieg, JD, director of the International Student and Scholar Services (ISSS) with the Office of International Affairs at the CU Anschutz and CU Denver campuses.

One of the many volunteers who made the event possible, Daniela Santos, MD, said the annual event fosters both a sense of belonging and acceptance among international researchers on campus as well as an avenue to show pride in their heritage. “It’s a two-way exchange of ideas,” she said. For example, Santos elaborated, it changed her perspective seeing a Nigerian lab mate, who typically wears U.S. street clothes, donning traditional Nigerian apparel for the attire show. “It’s a way to learn about who he is and where he came from.”

Humor a theme of the night

Talent show Ironic
Jennifer Major, PhD, and her 6-year-old daughter Roxy perform a Canadian music tribute vis-à-vis Alanis Morissette’s “Ironic.”

Canada-born Jennifer Major, PhD, and Scotland-born John Peacock, PhD, postdoctoral fellows at the CU Anschutz Medical Campus, served as hosts and comedic relief for the event. “What’s the difference between the United States and Canada?” Peacock quipped to the audience. “The U.S. has a nice neighbor.” Off-stage, a more serious Peacock explained that as a scientist, it’s important to have interests other than science, and the event brings much-needed art and culture to the medical campus, which he feels can be a bit sterile at times. “There are many diversely talented people working here, and unless they have such a platform to show off these talents, few people will know this.”

In contrast to Peacock’s droll humor, Major, AIR’s vice president of communications, performed a Canadian music tribute while her 6-year-old daughter Roxy danced in accompaniment. While not intended as a comedy routine, Major’s rendition of Alanis Morissette’s “Ironic” was affected by a few sound glitches, causing her to improvise with an a cappella performance and lending some levity amidst the technical problems.

Global talent on a local stage

Talent show international
From left: Daniela Santos, 10-month-old Emmalina Sayem, Nabanita Mukherjee, PhD, and Ranjitha Dhanasekaran, PhD, president of the International Student and Scholar Services at the CU Anschutz Medical Campus. All women participated in the attire show.

The two-part talent show took a break for dinner, followed by the attire show. Over 100 international and domestic faculty, staff and students were in attendance, many with their children. Talents on display included singing, dancing, folklore and short comedy readings. “People embrace the opportunity to share their background, culture and talents,” said Larson-Krieg. “You can see the enthusiasm for the event in the volunteers, the people who participate, and the performers.”

Marveling at the diversity of the campus international community, director of the Postdoctoral Office and Career Development Office Bruce Mandt, PhD, joked, “Who knew there was so much talent hiding behind lab coats?” Mandt said events such as the talent show are important career-development opportunities. “Science is global,” Mandt insisted. “Our trainees need opportunities to understand that science transcends borders and at some point, regardless of whether they remain in academia or move into other industries, they will work with people from all over the world.”

Nabanita Mukherjee, PhD, wearing traditional ceremonial attire including a reed crown, performed Odissi, one of the oldest surviving Indian classical dance forms. Mukherjee explained that her performance began with a tribute to Mother Earth, then to the Almighty, to the Teacher/Guru and finally to the audience. In the past, Mukherjee frequently performed public dance routines; however, she took a break from dancing following the birth of her child. “It felt great to me personally to realize I can continue dancing,” she said.

One of the most striking performances of the night came when the song “The End of the World,” most notably performed by Skeeter Davis and featured in movies such as “Girl, Interrupted” and TV shows including “Mad Men” and “Lost,” was performed at the event by Yao Ke, PhD, who alternated singing in English and Mandarin Chinese. Given the familiarity of the tune, many in the audience sang in their native language, serving as a reminder that though songs may be translated into other languages, the melody remains the same. Likewise, at CU Anschutz, a community of researchers from diverse cultures and backgrounds are united by their passion for science.

Dhanasekaran added, “The Association for International Researchers is here to promote inclusivity and diversity.” Further elaborating, she quoted thought leader Verna Myers: “Diversity is being invited to the party. Inclusion is being asked to dance.”

Guest contributor: Story written by Shawna Matthews, a postdoc at CU Anschutz. Photos by Eseosa Enabulele, MPH

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Information on reproductive health outcomes lacking in Catholic hospitals

As Catholic health care systems expand nationwide, little is known about the reproductive outcomes of their patients compared to patients in other settings, according to researchers at the  University of Colorado Anschutz Medical Campus.

“What we were essentially looking at is how religious guidelines that restrict reproductive care at Catholic facilities impact patient care,” said the study’s senior author Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine.

The study was published today in the journal Obstetrics & Gynecology.

Catholic health care

Researchers identified only 27 studies that described the provision of reproductive health services at Catholic health care facilities and found just one with reported patient outcomes. At the same time, they discovered a number of restrictions to care compared to non-Catholic settings.

In 2016, 14.5 percent of U.S. hospitals were Catholic-owned, accounting for one in six acute hospital beds. And 349 of the 654 Catholic hospitals had obstetric services, accounting for more than 529,000 deliveries.

Yet providers at these facilities are expected to adhere to the Ethical and Religious Directives for Catholic Health Care Services. These directives stress the sanctity of marriage between a man and a woman, allude to the moral imperative that intercourse involves both `love-giving’ and `life-giving’ intentions while stating that human life begins at conception, the study said.

“So according to these tenets, family planning methods cannot inhibit the `life-giving’ aspect and infertility techniques cannot inhibit the `love-giving’ aspect of the marriage or sex act,” said Guiahi.

Contraception and sterilization

In analyzing the studies found in the review, Guiahi discovered differences in the way reproductive health services were provided in Catholic health care facilities. Often Catholic facilities limited common women’s health services like contraception and sterilization.

“Patients may not know that tubal ligations or IUDs (intrauterine devices) are often restricted,” she said. “When it comes to birth control, sometimes they are only offered pills, which have a 9 percent typical failure rate over a year and certain facilities may only offer natural family planning as a contraceptive method.”  She noted that in many of these facilities, reproductive health care is acceptable solely to treat other medical conditions.

The review found that in most studies participants were primarily physicians and emergency department staff. Some of them reported that Catholic facilities either don’t provide or are less likely to provide family-planning methods than non-Catholic facilities. One survey showed that 54.9 percent of Catholic hospitals do not dispense emergency contraception in any cases compared to 42.2 percent of non-Catholic hospitals.

Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the University of Colorado School of Medicine
Maryam Guiahi, MD, associate professor of Obstetrics and Gynecology at the CU School of Medicine

“Some Catholic institution representatives reported there were policies in place that prohibited discussion of emergency contraception with rape victims,” the study said. One national survey showed that less than 2 percent of Catholic-affiliated obstetrics and gynecology clinics offered abortion.

But some studies revealed that reproductive services were not completely prohibited in these settings. A 1975 study reported 60 percent of Catholic hospitals offered some form of contraception, most commonly instruction in the rhythm method. A study done between 2014-2016, found 95 percent of Catholic hospitals offered appointments for birth control and many were willing to provide IUDs or tubal ligation appointments.

Limited provision of reproductive health services

“As many facilities do not always adhere to the directives, it is unclear to health care consumers how Catholic affiliation might impact the reproductive services they are offered,” said Guiahi.

Overall, she said, most studies examined showed limited provision of reproductive health care services, reflecting adherence to the religious directives governing Catholic hospitals.

“We need to understand how institutional restrictions affect patient outcomes,” Guiahi said. “We need to know that when women are denied tubal ligation, what percent of them get pregnant again. How are minorities and transgender patients affected when religion plays a role in their health care? These are all questions that require further exploration.”

The study’s co-authors include: Nichole B. Thorne, BS; Taylor K. Soderborg, BA; Jacqueline J. Glover, PhD and Lilian Hoffecker, PhD, MLS.

 

 

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Hormone may preserve bone and muscle mass in older women

Women 55 and older have an increased risk of bone and muscle loss, but therapy with the hormone Dehydroepiandrosterone (DHEA) may help prevent bone loss and increase muscle mass in older women, according to a new study led by Catherine M. Jankowski, PhD, FACSM, an exercise physiologist and associate professor at the University of Colorado College of Nursing at the CU Anschutz Medical Campus.

The study was published online Nov. 27 in the journal Clinical Endocrinology and highlighted in Endocrinology Today.

Jankowski and colleagues analyzed data from four single-site, double-blinded, placebo-controlled, randomized clinical trials sponsored by the National Institute on Aging designed to assess the effects of oral DHEA therapy on bone mineral density (BMD) and body composition in women and men between the ages of 55 to 85 who were not using sex hormone therapy.

The dose of DHEA used in the studies increased circulating DHEA sulfate levels to that of young adults.

“Because age-related decreases in androgen and estrogen production contribute to the loss of bone and muscle mass in older adults, restoring DHEAS to youthful levels may be an effective strategy for maintaining bone and muscle,” said Jankowski.

In all four studies, dual-energy X-ray absorptiometry (DXA) was used to measure total body fat and lean (muscle) mass, and bone mineral density of the proximal femur, total hip, and lumbar spine at baseline and after 12 months of DHEA or placebo administration. Serum DHEA sulfate, estradiol, testosterone, sex hormone-binding globulin and insulin-like growth factor I concentrations were also measured at baseline and at 12 months. Researchers merged data from the four studies into a central database and compared the 12-month changes in BMD, body composition, circulating hormones, and growth factors in response to oral DHEA therapy versus placebo.

Of the 486 cases, 138 women and 98 men had low bone mass, and 29 women and 11 men had osteoporosis. The researchers found that DHEA therapy was associated with increased BMD of the lumbar spine, total hip and trochanter in women, but not in men. The increases in BMD in women were not as large as seen with other treatments such as bisphosphonates.

“Unlike some pharmaceutical trials targeting BMD, the DHEA trials we conducted did not target women with osteoporosis, which may have contributed to the modest increases in BMD,” said the researchers.

“It is possible that DHEA therapy could be a strategy to mitigate the decline in BMD in postmenopausal women who do not tolerate other treatments,” according to Jankowski. However, the authors also concluded that the safety of long-term DHEA therapy (more than one year) needs further research.

The investigators also found sex-specific results effects on fat-free mass (which includes muscle mass) in women and a decrease of 0.4 kg fat mass in men. None of the four trials controlled for exercise behaviors, which could have contributed to the increase in fat-mass of women taking DHEA.

“Combining DHEA therapy with resistance exercise that imparts mechanical strain to bone may promote greater increases in muscle mass and BMD compared to either intervention alone,” stated Jankowski. “The beneficial effects of DHEA replacement on body composition are to modestly increase fat-free mass in women and decrease fat mass in older men, a reversal of the usual age-related trends in muscle and fat.”

Jankowski and colleagues are currently conducting a randomized placebo-controlled trial to determine the independent and combined effects of bone-loading exercise and DHEA on BMD and muscle mass in postmenopausal women with low bone mass or moderate osteoporosis (NCT# 03227458).

Co-authors of the pooled analysis include: Wendy Kohrt, Pamela Wolfe, and Sarah J. Schmiege of the University of Colorado Anschutz Medical Campus, Aurora; K. Sreekumaran Nair, Sundeep Khosla, and Michael Jensen of the Mayo Clinic, Rochester, Minn.; Denise von Muhlen, Gail A. Laughlin, Donna Kritz-Silverstein, Jaclyn Bergstrom, and Richele Bettencourt of the University of California, San Diego; Edward P. Weiss currently of St. Louis University, St. Louis; and Dennis T. Villareal, currently of Baylor University and the Michael E. DeBakey Veterans Administration Medical Center in Houston.

Guest contributor: Dana Brandorff, director of Marketing & Communications, CU College of Nursing

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CU Anschutz on forefront of reimagining health care

Amid spiraling costs, complexity and inefficiencies, the health care industry has reached an inflection point. It’s ripe for massive disruption.

Fortunately, the digital technology revolution is also on the rise, and it offers cutting-edge solutions to the problem. Digital health, remote monitoring systems and prescriptive analytics are just a few ways technology is intersecting with health care. Painting this picture were Richard Zane, MD, professor and chair of the Department of Emergency Medicine in the University of Colorado School of Medicine, and Kimberly Muller, managing director of CU Innovations. They presented the many ways the CU Anschutz Medical Campus is at the forefront of innovation and reimagined health care to about 50 members of the Metro Denver Executive Club at the Denver Country Club on Wednesday.

“What’s going to happen in the next two years, or 10 years, will fundamentally alter the way in which we deliver care, the way in which you get care, and the relationship of industry to health care,” Zane said.

Sobering statistics

After running through sobering statistics — health care costs the average American $10,000 per year (a total of $3.5 trillion), and medical error is the nation’s No. 3 cause of death — Zane showed the arc of technological advancement and noted that leading companies — Google and Amazon among them — are now putting health care in the crosshairs. By aggregating the barriers to care, wastefulness in the system and care outcomes, they are beginning to deliver solutions.

Richard Zane, MD, speaks at country club
Richard Zane, MD, delivers a talk titled, “Can Innovation and the Digital Revolution Save Healthcare?” at the Denver Country Club.

Zane, who is also Chief Innovation Officer at UCHealth, noted that Google’s Verily has launched Project Baseline, which monitors everything about a person — respiration, heartbeat, reactions to environmental conditions, etc. Project Baseline collects so much data that it will create a new definition of a healthy human, he said.

But can the human brain interpret all of this data? “I don’t think so,” Zane said. “By 2025 knowledge is expected to double every 12 to 14 hours. The only way we’re going to deal with this is by partnering with machines. We have to figure that out: How we use data science, and how we can allow electronic medical records to help us.”

Information at fingertips

For example, technology offers promising solutions to the prescription-drug conundrum. Currently, a couple variables mainly factor into the drug a physician prescribes a patient, Zane said. They are: was this medicine effective in another patient I treated with a similar condition, and can I properly spell the drug’s name? Imagine, he said, if doctors instead could use a tool that easily culls prescriptive analytics from a patient’s electronic medical record. It would scour each person’s medical record, learn everything about the patient and match a drug to the diagnosis. “With the click of a button, we know the medicine that I just prescribed is not only the right one, but your insurance will cover it and the pharmacy has it,” he said.

As another example, he noted that UCHealth has implemented successful remote care through technology. Using video uplink, sub-specialists based on the CU Anschutz Medical Campus deliver care to patients with tertiary illness in UCHealth’s Longs Peak Hospital in Longmont. “But what’s to prevent Amazon from having all the sub-specialists, or Google or anyone?” he said.

And what about soon-to-come 5G digital connectivity, which will further revolutionize the many wearable biometric-monitoring devices on the market? “It’s a game-changer,” Zane said. “Maybe we can develop a patch that costs $30 to make and lasts for three months. You put it on, collect all your biometric data. Then all of the sudden, like air traffic control, doctors will be able to see all their patients and figure out who does and doesn’t need care.”

Turning game-changers into reality

Muller said the goal of CU Innovations is to take these game-changing visions and turn them into reality. She noted that venture capital is growing exponentially in health care, but a problem remains: Many of the advancements are occurring in silos, separate from the point of care within health systems.

Kimberly Muller, CU Innovations
Kimberly Muller, managing director of CU Innovations, explained the importance of technology companies and clinicians working side by side, as they do at the CU Anschutz Medical Campus, to forge innovations.

Some research shows that as many as 95 percent of new health care technologies are never adopted in a clinical setting, she said. That’s where CU Innovations and the CU Anschutz Medical Campus comes in.

“We have the entire continuum — pediatrics all the way to geriatrics — and that broad system represents every setting in health care. We have an academic medical center, community hospitals, urgent care, clinics and at-home settings,” Muller said. “Imagine if we use this large system as a Clinical Validation Laboratory to test all of the technologies that Dr. Zane talked about. In fact, that’s what we’ve been building.”

The Clinical Validation Lab has received interest from hundreds of companies and is regarded as a national model for accelerating the transfer of world-class research and ideas to the marketplace.

Side-by-side collaboration

“Now you truly have the convergence of technology companies coming together, working side by side with clinicians, to figure out how we get those adoptions (by physicians and patients) and turn that technology failure rate on its head,” Muller said.

She added that by studying every major vertical within health care — payers, device manufacturers, pharmaceuticals, etc. — CU Innovations has a holistic vision of the industry and understands how technologies can be best advanced.

“We continue to form partnerships with health systems around the country, so we can take the work happening here and scale it quickly, instead of the 20-year cycle that we’ve traditionally seen in health care,” Muller said.

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Terrific Tuesday is all about doughnuts for students

Mark your calendar: another Terrific Tuesday is around the corner!

University Police and Student Services will pass out doughnuts and fruit to students as they enter Education 2 North from 7:15 – 8 a.m. on Tuesday, Dec. 11. They also offered the goodies on Dec. 4, and it proved extremely popular with CU Anschutz students.

It’s just a little extra support for our students during final exams.

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CU Faculty and Staff Invest in Future Health Care Leaders

Scholarships support students’ dreams, advance their careers

Faculty and staff are a vital part of our philanthropic community at the CU Anschutz Medical Campus. They have the foresight to invest in our students and our future success at CU. One way that faculty and staff support our students is by directing a portion of their clinical revenues to the CU Medicine Scholarship Program. The program recognizes outstanding academic and extracurricular achievement among those students pursuing degrees in medicine, physical therapy, the physician assistant program or anesthesiology.

In 2018, the CU Medicine Scholarship Program provided nearly $1 million to more than 50 students from diverse backgrounds. The scholarship recipients are those who have demonstrated a commitment to serving their communities as health care leaders, and intend to practice in rural communities.

The following students are just three of many outstanding scholarship recipients for the 2018-2019 academic year who were recognized among others at the 2018 CU Medicine Scholarship Reception.

Katherine “Kitty” Branche
Class year: 2021
Program: Doctor of Medicine

Why CU Anschutz?

I chose this campus for the people. I knew that wherever I went for medical school, I was going to have to work very hard. The difference, however, would be made by those who were part of my academic journey. The CU School of Medicine is filled with inspiring and incredible students and faculty that are passionate and thrive on collaboration. That’s an environment that I wanted to be immersed in.

When did you know you wanted to pursue a career in medicine?

I’ve wanted to be a doctor for as long as I can remember. I loved the idea of taking care of others and of following in the footsteps of four generations of doctors before me on my father’s side.

Outside of school, what do you enjoy doing?
I enjoy playing tennis, hanging out with friends, volunteering at my church, cooking, traveling and watching movies.

What does scholarship support mean to you?
My scholarship means so much to me. Tuition is a big investment for me, as an out-of-state student. The additional support enables me to take out less loans that need to be paid back in the future.

What would you say to someone interested in giving to scholarships or supporting educational programs at CU?
I would encourage making the investment. One day I hope to be able to give back through scholarships in the future. I truly believe in the concept of paying it forward, and I can’t think of a better way to empower students to pursue careers in medicine.

 

Kevin Earl Morris II
Class Year: 2018
Program: Doctor of Physical Therapy

Why CU Anschutz?

I decided to visit the campus during my junior year of undergraduate school. A student from the CU School of Medicine volunteered their time and spent an afternoon showing me around campus. It made me feel valued, respected and inspired. That simple gesture made CU Anschutz feel like home.

When did you know you wanted to pursue a career in medicine?
I shadowed a physical therapist in high school, and I observed the transformative effect that physical therapists have on a patient’s life. Many of these patients expressed gratitude for their care and their own ability to conquer chronic pain, injuries or movement disorders. The experience stuck with me. I hope to offer the same gift of health to the patients that I’ll one day have the privilege to serve.

Outside of school, what do you enjoy doing?
I enjoy playing video games, hiking, cross country skiing and reading about American politics.

What does scholarship support mean to you?
As a first-generation college student, I didn’t have easily accessible means to finance my education. Scholarship support afforded me the opportunity to chase my passion and follow my dreams.

What would you say to someone interested in giving to scholarships or supporting educational programs at CU?
By providing the gift of scholarships, you give students like me a chance – a chance to become eager learners, mentors and make a difference on the world. The effect of scholarships ultimately come back to the patients we serve with compassion and gratitude.

 

Brittney Poggiogalle
Class Year: 2021
Program: CHA/PA (Physician Assistant)

Why CU Anschutz?

One reason is because of the physician’s assistant program’s strong pediatric focus. I love working with children and have always known I wanted a career working with them. During my interview for the program, I was welcomed into a warm and supportive community. Every day I feel extremely lucky to be supported and included in such an incredible program and beautiful campus.

When did you know you wanted to pursue a career in medicine?
I’ve always known I wanted to pursue a career in medicine. From a young age, I saw the impact that clinicians have on patients’ lives, like my mom’s, as she received care for multiple sclerosis. I knew that I wanted to make the same impact on lives through a career in medicine.

Outside of school, what do you enjoy doing?
When I’m not studying, you can find me working out and spending time with friends and family. I love to do strength workouts as well as cycling classes. Since moving to Colorado, I’ve also been getting outside to hike around our beautiful state.

What does scholarship support mean to you?
Being awarded for my passion for primary care has only made me more excited and confident to make a difference in patients’ lives. I’m dedicated to educating, building relationships and delivering high-quality health care, and scholarship support helps me achieve these goals. For that, I’m beyond appreciative.

What would you say to someone interested in giving to scholarships or supporting educational programs at CU?
I highly encourage it. Scholarship support has brought me great financial relief as I continue through school, meaning that I can shift my focus to my studies, and serving others. Scholarships truly make a difference in the lives of students, no matter the amount. I couldn’t be more appreciative for those who have contributed to the scholarships at CU Anschutz.

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Looking ahead to Public Health 4.0

Faculty, students, staff and friends of the Colorado School of Public Health (ColoradoSPH) gathered Nov. 28 for an annual event with a special twist. The “State of the Sc­­hool” address, led by Dean Jonathan Samet, MD, MS, included an acknowledgement and celebration of the school’s 10th anniversary.

As Samet noted, a “free” gift was on hand for attendees in the Nighthorse Campbell Native Health Building’s Shore Auditorium: an 86-page 10th anniversary magazine, titled with the school’s anniversary tagline, “Charting New Paths for a Healthier Future.” The publication’s 28 pieces highlight the school’s wide range of education, practice and research at the University of Colorado, Colorado State University, and the University of Northern Colorado.

“It’s a 10-year panorama of what has happened at the school,” Samet said, joking that after 409 days on the job, “I can still call myself a new dean.”

Past, present, future

10th anniversary at ColoradoSPH
Attendees of the Colorado School of Public Health’s 10th anniversary snapped up editions of the school’s 10th anniversary magazine, “Charting New Paths for a Healthier Future.”

Samet used his presentation to engage his audience and to pivot between the past, the present and the future. A sheet of paper with three questions about what they would do to direct the future of the school awaited people at their seats, along with a decidedly old-school item.

Saying “I’ve given you a little bit of homework,” Samet held up a stubby pencil. “This is a pencil,” he jokingly said. “If you’re not sure how to use it, ask someone who is age-appropriate.”

With that, Samet briefly reviewed the history and progress of the public health field, noting that the number of public health degrees conferred in the United States has more than quadrupled over the last 25 years. Over the school’s first 10 years, ColoradoSPH has graduated a total of about 2,000 students, he added, with roughly 500 Master of Public Health (MPH) degree-seeking students currently enrolled.

Fast-growing field

“Public health has grown,” Samet said. “We’re part of that growth.”

He underscored the school’s commitment to its education mission with a quick review of a few of the many recent capstone projects and papers produced by students and graduates and a nod to new educations initiatives including a PhD program in Health Economics, an MPH concentration in Population Mental Health and Wellbeing, and several new public health certificate programs in Latino health, mental health and wellbeing, and applied biostatistics, as well as a developing certificate in American Indian and Alaska Native health.

‘We need to have extended interactions with communities in new ways, some of them data-driven.’ – Dean Jonathan Samet

Of course, a major goal of public health education is to get graduates into the field. Samet pointed out that 97 percent of the school’s graduates were employed or seeking further education within one year of receiving their degrees. He singled out the school’s Center for Public Health Practice, led by Cerise Hunt, PhD, for its initiatives in local, rural and regional public health workforce training programs – including 222 online and in-person trainings over the last year that have served more than 9,500 people.

A mix of funding from the National Institutes of Health (NIH) and other sources makes up $34.8 million to support research, another key component of the school’s mission. He also noted that private philanthropic support totaled more than $9 million in 2018, bolstering efforts in faculty recruitment, student scholarships and attention to public health policy.

Challenges ahead

Samet spent a good part of the session with an eye toward the next decade. Looking to the challenges facing public health professionals, Samet said that ongoing issues, including obesity, diabetes, mental health, substance use disorders and tobacco use, will continue to require close attention. But he added that “there are new things that are always emerging. That is the nature of public health.” He listed risks posed by oil and gas drilling, marijuana use, vaping and urbanization leading to the closing of rural hospitals as examples.

He also ticked off a number of “personal priorities,” including “advancing diversity” among the student body, increasing “synergies” across the three campuses and continuing to build close relationships with the people and public health officials across the state and region.

“We need to step back and say, ‘Does our university reflect the communities around us, the communities of need, the communities that we really want to focus on in advancing public health?’” Samet said.

Lively discussion

Through the talk, Samet encouraged back-and-forth discussions about the three questions he had posed for paper-and-pencil pondering. What would your highest priority be if you were Dean for the day? With a gift of $10 million to the school, what would be your priority areas for spending it? What are the two areas that need the most attention for strategic planning?

toasting the 10th anniversary of the ColoradoSPH
Attendees of the State of the School address enjoyed a non-alcoholic celebratory toast to mark the 10th anniversary of the Colorado School of Public Health.

The answers ranged widely: constructing a dedicated building for the school; increasing support for fellowships and scholarships; responding more aggressively to the social determinants of health; beefing up marijuana research; building relationships with incoming legislators; probing mental health issues; responding to the impacts of climate change – and more.

The conversation continued in this vein when Samet said he’d obtained an advance copy of the 20th anniversary magazine. “I’d like to show you a little bit of that,” he said, starting with an artist’s rendering of a brand-new ColoradoSPH building. “It might be a bit garish,” Samet conceded. But the publication-to-be also looked forward to what he called “Public Health 4.0,” the next generation of challenges for the field.

Public Health 4.0

“What will Public Health 4.0 be?” an audience member asked. Samet said he sees it resting on “two pedestals,” the first being the need to gather more and more data from increasingly sophisticated technology and figure out “the useful signals from that data.” Second, “We need to have extended interactions with communities in new ways, some of them data-driven. I think we will see that the public health community will recognize that a lot of the things we do are going to require greater engagement with communities.”

Before adjourning to the auditorium lobby for a non-alcoholic celebratory toast, Samet received a folded American flag, encased in glass, from Jamila Bryant, a 2017 graduate of the school’s MPH program at Colorado State University. Bryant, a Master Sergeant in the U.S. Air Force Reserves, recently served a six-month deployment to the Al Dhafra Air Base in the United Arab Emirates. The flag she presented to the ColoradoSPH was flown on Feb. 22, 2018, during a mission in support of Operation Inherent Resolve, a multinational coalition committed to the defeat of the Islamic State of Iraq and the Levant, a group designated as a terrorist organization by the United Nations.

Bryant presented the flag and a certificate to Dean Samet to spirited applause from the school’s audience in attendance.

Guest contributor: Story written by Tyler Smith. Photos by Brett McPherson.

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Can technology provide solutions to mental health crisis?

Speaking to a rapt audience of almost 5,000 in Denver, Matt Vogl covered more territory than what is usual in a brief TEDx talk. He went from an unflinching account of what led him to the brink of suicide 15 years ago to his desire to disrupt and innovate in the nation’s “snarled” mental health system to promising virtual-reality treatments for prisoners in Alaska and beyond.

Vogl, executive director of the National Mental Health Innovation Center (NMHIC) at the University of Colorado Anschutz Medical Campus, was among the featured speakers at TEDx Mile High “Reset” on Saturday at the Bellco Theater. Listed in the program as a “mental health technologist,” Vogl wowed the crowd, which frequently broke in with spirited applause and gave him a standing ovation after his 15-minute presentation.

Matt Vogl at TEDx Mile High
Matt Vogl, who once worked as a standup comedian, told the TEDx Mile High crowd, “The best part of the comedy life was it provided the perfect cover for my misery.”

Vogl recounted the highs of his standup comedian career, saying, “Even when it sucked, the comedy life was amazing: I was getting paid to make people laugh. And best of all, it provided the perfect cover for my misery. … I was really funny, and I was really miserable.”

‘My rock bottom’

He recalled a night of smash shows at the Comedy Works in Denver, then going home and researching ways to kill himself. “Eventually, it got so bad that I wrote a note and picked a date. And then I bought a gun.” He said a neighbor randomly intervened and saved his life that day.

“It’s crazy how close I came, but what’s even crazier is that almost dying by suicide wasn’t my rock bottom,” he said. “My rock bottom came when I tried to access care in our snarled mental health system.” He illustrated the U.S.’s broken care system by showing a photo of highway gridlock. Access to care is abysmal, misdiagnoses are common and medications often make the patient feel worse. Vogl said he bottomed out when a therapist fell asleep in the middle of a session — and had the nerve to ask for a copay.

Currently in the United States, 80 percent of people with a mental illness don’t receive adequate care, Vogl said. But building more clinics and hiring more providers won’t solve the crisis, he said. “We cannot clinic our way out of our mental health access problem.”

Access to mental health care

His goal as co-founder of the NMHIC, established 2-1/2 years ago, is to test news ways to make mental health services of all kinds more accessible to everyone — when they need it and even before they need it. The center brings together behavioral health experts and community resources to produce new strategies that advance care in Colorado and across the nation.

Vogl, who has type 2 bipolar disorder, is fueled by a passion for mental behavioral services, and he’s increasingly intrigued by ways technology can be part of the solution.

An example is a collaboration the NMHIC has forged with prisons in the northernmost state — at the request of the Alaska Department of Corrections. The department was struggling with mental health issues among many inmates, often exacerbated by Alaska’s extremely long and dark winters.

Demos of virtual reality
The National Mental Health Innovation Center’s booth in the lobby at Bellco Theater was popular with attendees who enjoyed demonstrations of the center’s virtual reality technology.

Vogl and a couple NMHIC colleagues introduced some of the inmates to VR technology. One inmate, behind bars for nearly 40 years, was transported to a sunny mountainside, leaving him in tears and saying, “I forgot what free felt like.”

Pilot program in Alaska prisons

The NMHIC launched a pilot program in three Alaska prisons to help inmates meditate. The plan is to integrate meaningful, personalized content for their virtual exposures. “A native inmate could meditate in the Inuit village where he grew up, or even participate in traditional ceremonies,” Vogl said. “We believe that over time this program can help us lower the use of sedating medications and solitary confinement.”

VR also shows promise in helping people overcome phobias, he said. For prisoners, this could help them transition to life on the outside — a prospect so frightening that it fuels a 70 percent recidivism rate.

VIRTUAL REALITY A HIT AT TEDx

The National Mental Health Innovation Center had a booth at the Bellco Theater lobby where the throngs of TEDx attendees could try virtual reality for themselves. More than 500 people participated in the demos, enjoying a relaxing tai chi experience, as well as being exposed to some of the meditation scenarios that are being piloted in Alaska prisons.

“We’re working with a New York-based startup firm to pilot test a series of VR experiences that enables inmates to learn critical skills to thrive on the outside. Things like resolving domestic conflict, or dealing with a job interview where the interviewer is grilling you about your time in prison,” he said. “Very often prisoners have some of the worst access to mental health services. So, if a solution works for them, there’s a good chance it will work for the rest of us — and it is.”

Technology isn’t the enemy

He showed a slide of his two sons, Mark and Sam, and said bipolar has a genetic component. He noted that people with untreated bipolar disorder have a 30 percent higher suicide rate than the general population, and “that scares me.” Prevention, early intervention and quick access to great care can lower those rates, Vogl said, motivating him to turn his fear into solutions.

“Technology isn’t the enemy of mental health. It’s a scalable solution,” he said. “I know because we’re seeing it work. In this life we can make life better — for me, for Mark and Sam, for inmates in Alaska and for everyone else caught in that bumper-to-bumper traffic.”

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Women in hospital medicine face major obstacles in pregnancy and returning to work

Women in hospital medicine face major obstacles during pregnancy, parental leave and returning to work, prompting a discussion about gender equity in medicine, according to a new study from researchers at the University of Colorado Anschutz Medical Campus.

Emily Gottenborg, MD, assistant professor in the division of Hospital Medicine at the University of Colorado School of Medicine
Emily Gottenborg, MD, assistant professor in the division of Hospital Medicine at the CU School of Medicine

The study, published recently in the Journal of Hospital Medicine, includes wide-ranging interviews with 10 female academic hospitalists from institutions around the country. They were asked about their experiences during pregnancy, parental leave and the challenges of returning to work including barriers to breastfeeding and diminished career opportunities.

“It is commonly thought that the medical profession is more enlightened around parental support than other professions, but it really isn’t,” said the study’s lead author Emily Gottenborg, MD, assistant professor in the division of Hospital Medicine at the University of Colorado School of Medicine. “We found a lack of paid leave policies in academic settings, difficulty in support for breastfeeding, and loss of career opportunities when new parents return to work.”

Gottenborg said hospital medicine is unique in that 47 percent of practitioners are women and 80 percent are under age 40, indicative of a large proportion of women entering the profession during a time in life when many want to start a family.

“The field poses known challenges to this population, including shift work, atypical schedules and unpredictable hours,” Gottenborg said. “Our goal was to both explore the challenges to undergoing this experience and discovering solutions to support female academic hospitalists.”

Most participants described inadequate paid parental leave that resulted in haggling with managers, human resources and administrative staff for time away from work with their newborns.

“All of my leave was unpaid…managed to finagle short-term disability into paying for it…the system was otherwise set up to screw me financially,” one research participant said.

All of the women described significant physical challenges when working during pregnancy.

“I used to lie on the floor of my office, take a little nap, wake up, write some notes, go home, take another nap, wake up, write some more notes,” a doctor reported.

Breastfeeding, extolled by the medical community for its long-term benefits to children, was an endless challenge, the study said. Privacy was often elusive.

“It’s two chairs that are behind a curtain in a women’s locker room in the basement of the hospital, that are tiny and gross,” said one physician.

Another said this:

“I would get to work, set up, and pump while chart reviewing. Then I would go and see people…and come back to my office and pump and write a few notes. And go out and see more patients, and then pump. I was like a cow.”

Some stopped breastfeeding early because of these difficulties.

Many of the physicians interviewed faced serious career challenges during this period. Sometimes they were left out of projects or not asked to participate.

“People feel they are missing out and their career suffers,” Gottenborg said. “One of the reasons women are not in more leadership positions in medicine is because of these big breaks in their lives.”

The study calls for a more generous paid leave policy that not only includes maternity leave but a flexible scheduling period before and after the leave to account for the challenges of pregnancy and new motherhood.

“Paid parental leave is rare in academic settings, but studies from other industries show that when women take paid leave, they are more likely to remain in the workforce 9-12 months afterward, work more weekly hours and feel more loyal to the organization,” the study said.

Ultimately, Gottenborg said, if academic medicine wants to continue to attract and retain women it needs to reexamine work-life policies that often feel antiquated.

“As medical professionals we should be in the forefront of this kind of change,” she said, “not lagging behind.”

The study co-authors include: Anna Maw, MD; Li-Kheng Ngov, MD; Marisha Burden, MD; Anastasiya Ponomaryova, BS and Christine Jones, MD, MS.

 

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