About 180 staff members at the University of Colorado Denver | Anschutz Medical Campus were thanked for their years of service at a recent breakfast at CU South Denver.
Receiving invitations to the recognition event, organized by Human Resources, were all active CU Anschutz and CU Denver exempt professional and classified staff who achieved years-of-service milestones at five-year increments in calendar year 2018, beginning with 10 years and going up to 35 years.
Stephen Smidt, of University Police, was the longest-tenured staff member with 35 years of service.
CU Anschutz Chancellor Don Elliman was on hand to extend congratulations and thanks to the staff members for their contributions to the university.
10 YEARS OF SERVICE:
15 YEARS OF SERVICE:
20 YEARS OF SERVICE:
25 YEARS OF SERVICE:
30 YEARS OF SERVICE:
35 YEARS OF SERVICE:
Guest contributor: Photos supplied by Kaylene McCrum, Human Resources
Mark Kennedy, finalist for University of Colorado president, told an audience at the CU Anschutz Medical Campus Wednesday that his skills in running a large business, engaging stakeholders and his passion for academia make him the right candidate for the position.
The president of the University of North Dakota (UND) is spending the week holding open forums with faculty, staff and students across the four CU campuses. He was introduced to the nearly full auditorium by CU Anschutz Chancellor Don Elliman and Sue Sharkey, chair of the Board of Regents.
“In my 35 years in business and academia, I’ve always checked my values at the door,” said Kennedy, a former executive at major corporations and Republican member of Congress from 2001-07. He also held teaching and research posts at Johns Hopkins and George Washington University, where he directed the Graduate School of Political Management.
Kennedy, a first-generation college graduate, underscored themes of unity, collaboration and diversity, as well as his hopes that every CU student have the opportunity “for their personal moonshot, no matter what their dream might be.”
The audience questions, occasionally challenging, focused chiefly on his political views, especially his voting record as a Minnesota congressman and its impact were he chosen CU president (the Board of Regents will vote in May). He was asked about his stances on affirmative action, same-sex marriage, Deferred Action for Childhood Arrivals (DACA), stem cell research, gender inequity, gun violence research, reproductive rights and climate change.
Asked why he’s changed his views on same-sex marriage — he voted against it while in Congress – Kennedy said he’s had multiple experiences that “have shown me that I need to have a bigger, broader view … and I’m committed to it.”
Under his leadership since 2016, he noted, UND has made more progress instituting LBGTQ-plus community protections and other services geared toward diversity than in the previous decade.
Inclusivity as a competitive advantage
“I’m not neutral on this subject. I am an advocate for making sure we’re reaching out to all communities, making them feel welcome,” he said. “… Inclusivity is a competitive advantage for the university.”
When pressed further, Kennedy said presidents Barack Obama and Bill Clinton also took stances against same-sex marriage at various times.
He said he should be judged by his university leadership track record, where “this never became an issue,” rather than his congressional voting record. However, when it came to votes on education or National Institutes of Health (NIH) resources, he said he always voted in favor of additional funding, including a vote to double NIH funding.
On affirmative action, Kennedy said, “It’s a combination of affirmative action applied whenever it makes sense to achieve the diversity you need in a university environment … as well as the financing to make sure we have the scholarships and outreach, which is a recruiting policy.”
Supports academic freedom
An online question noted that Kennedy voted against stem cell research while in Congress. Kennedy responded that he is not a micromanager, and he will not impose his values on the university.
“My values will be what’s in the best interest of our faculty, staff, students and the state,” he said. “You have great academic communities that decide what type of research should go on or not. Academic freedom protects that.”
He was then asked how he would prevent his personal beliefs from interfering with life-saving research, training and medical care provided at CU Anschutz surrounding women’s reproductive rights and abortion.
Kennedy stressed that it would be faculty alone who decide what and how they research. His focus would be to help attract top medical professionals, professors, staff and students to CU.
“I will also say as it relates to reproductive rights or as it relates to LGBTQ, whatever the federal government does … we’re not going backwards in terms of the protections we have here at the University of Colorado,” he said. “We’re going to go forward in terms of the protections we provide, the benefits we provide.”
Gun violence research; gender inequity
He said he strongly supports CU’s ongoing research into gun violence. He also said he would support an examination of gender inequities, noting that it’s “a systematic thing that needs to be dealt with comprehensively.”
As for college affordability, Kennedy said he would strive to keep students on the path toward a degree to ensure a full return on their investment, work on improving efficiencies and look for alternative revenue sources, including through online education.
The American Civil Liberties Union gave Kennedy’s congressional record a low rating on civil rights, another audience member said.
Kennedy responded that he has “a very strong” civil rights record, noting his UND efforts toward unprecedented LGBTQ protections, a first-ever campus-wide survey on inclusivity, and launch of strong protections against sexual violence. At George Washington, he led the campaign to offer the school’s first Spanish language degree. Also, he said, he led the university’s effort to celebrate Martin Luther King Day. At UND, his eight-member executive committee includes four women – split evenly between women he promoted and hired.
Plans CU as career capstone
With Kennedy having a relatively short tenure at UND, another attendee noted, how would the CU community know he is committed for the long haul?
Attendees of this week’s forums are encouraged to submit feedback to the Board of Regents via this online form. Sue Sharkey, chair of the Board of Regents, said the CU community could learn more about the regents’ process in selecting Kennedy as the finalist in a statement released earlier this week.
Kennedy said he views the CU presidency as the capstone to his academic career.
“This is where I want to be for an extended period of time because many of the goals I have in terms of outreach, expanding research, expanding the impact of the institution on Colorado, won’t be done in a year or two, and I want to be here for the long term.”
Asked if he supports CU’s efforts to be a leader on climate change and climate change research, Kennedy cited legislation he co-authored to bolster alternative energy funding.
“I am strongly supportive of the research being conducted on climate change here at the University of Colorado,” he said, “as well as promoting investments in research that will make our economy ever more energy efficient.”
Photos by David Kelly and Julia Milzer, Office of Communications
The opioid epidemic is devastating communities, families and individuals across Colorado and the country. On average 130 Americans die every day from opioid overdose; it was responsible for 560 deaths in Colorado 2017. And for every death, there are many more people struggling with opioid addiction.
To address the expansive scale of the crisis, the CU Anschutz Medical Campus is marshaling its resources across the spectrum of health fields. Here are some examples.
Coordinating Colorado’s opioid response
CU Anschutz is the home of the Colorado Consortium for Prescription Drug Abuse Prevention, which coordinates Colorado’s statewide response to the opioid epidemic. Operated out of the Skaggs School of Pharmacy and Pharmaceutical Sciences under the direction of Professor Robert Valuck, the consortium’s members include faculty from each of our schools and colleges, in addition to representatives from state agencies, law enforcement and community coalitions. The consortium consults with state lawmakers about legislation, coordinates public awareness campaigns, and helps train doctors on safe prescribing practices and members of the community on how to reverse overdoses. It also supports public awareness campaigns and medicine takeback programs.
Educating health professionals To address the shortage of health professionals equipped to deal with the opioid epidemic, CU Anschutz offers a number of trainings, certificates and degrees. The Colorado School of Public Health launched both a certificate and an MPH concentration in Population Mental Health and Well-Being, addressing mental health and substance use from a population perspective. Both programs are set to begin in Fall 2019.
CU Anschutz physicians developed a one-click tool, launched at UCHealth University of Colorado Hospital in 2017, that allows busy emergency room staff to instantly see how many prescriptions a patient has filled at other locations.
Cognizant of the fact that dentists write about 12 percent of opioid prescriptions, the School of Dental Medicine offers continuing education programs to educate practicing dentists on newly developed guidelines for prescribing pain medications and best practices for discussing pain and opioids with patients.
Developing clinical solutions One way CU Anschutz is helping deliver quality care to address opioid addiction is illustrated in the story of Nicholas Antonio. Nicholas’s experience as a survivor of the Columbine school shooting 20 years ago led to significant post-traumatic stress disorder, and he turned to opioids to cope. After a downward spiral that included jail time, he finally found the help he needed at the Sheridan Health Services clinic, operated by the CU College of Nursing. There he received medication-assisted treatment (MAT), a whole-patient approach that combines FDA-approved medications with counseling and behavioral therapies. The approach not only worked for Nicholas; it has proven so effective in treating opioid addiction that governments at all levels are expanding access to it. State funding enabled CU Nursing to extend MAT training in Pueblo and Routt counties, and a federal grant to the School of Medicine expanded access across 24 additional rural Colorado counties.
Meanwhile, CU Anschutz physicians developed a one-click tool, launched at UCHealth University of Colorado Hospital in 2017, that allows busy emergency room staff to instantly see how many prescriptions a patient has filled at other locations. Should abuse be suspected, doctors can adjust their treatment plan accordingly. Then, depending on their addiction severity, patients can be referred for inpatient treatment at the Center for Dependency, Addiction and Rehabilitation (CeDAR) and/or to outpatient community programs such as the Sheridan Clinic’s MAT that combine medication-based approaches with behavioral treatments to help patients maintain sobriety.
Where to next? The epidemic continues to rage on, but there are some reasons for hope. Since 2014, the number of opioid prescriptions written by Colorado physicians has dropped by more than 200,000 (from 4 million to 3.8 million). And they’ve dropped even more dramatically at Colorado emergency rooms that participated in a pilot program to reduce opioid use – including University of Colorado Hospital’s ER, which has trimmed its opioid prescription from 20 percent to 8 percent of patients in the past three years.
Now the consortium and other state entities are devising a plan to take the opioid-reduction strategies from the ER program to the rest of the hospital. The idea is to bring together specialty doctors’ groups and get them working on guidelines tailored to the nuances of each specialty that will result in fewer opioid prescriptions.
These are just some of the broad-based efforts CU Anschutz is undertaking to combat the opioid epidemic. With a mission of improving the well-being of the communities it serves, CU Anschutz is responding to the seriousness and the complexity of the crisis broadly, and in concert with many other institutions. There is no single fix, but by attacking it from all sides we are making progress.
AURORA, Colo. (April 23, 2019) – A database of women scientists that was created a year ago by a team led by a CU School of Medicine postdoctoral fellow has grown to list more than 7,500 women and is featured in an article published today in PLOS Biology.
“The idea came from repeated experiences of seeing all men panels (‘manels’) and women’s scientific expertise often excluded in the public realm,” writes Elizabeth McCullagh, PhD, a postdoctoral fellow in the Department of Physiology and Biophysics on the Anschutz Medical Campus, and her co-authors.
The article, “Request a woman scientist: A database for diversifying the public face of science,” is published today in the peer-reviewed journal PLOS Biology.
According to a 2017 study that analyzed colloquium speakers at 50 prestigious universities, men were invited to give twice as many talks about their research as women. When asked why, the event organizes often repeated the same explanation: “We tried to find a women to speak on this panel, but we didn’t know any women who work on this topic.”
To combat the misperception that women are not engaged in a range of scientific activities, McCullagh and her colleagues created the Request a Woman Scientist database to connect educational institutions, policymakers, the media, the public, and others with women scientists across disciplines around the world.
Women listed in the database have indicated their willingness to speak with students or the media, consult on a project, sit on a panel or serve as a conference keynote speaker.
Between its launch in January 2018 to November 2018, when data was generated for the PLOS Biology article, more than 7,500 women from 133 countries have signed up and the platform has been accessed more than 100,000 times by journalists, conference organizers, school teachers, and other scientists. Already, journalists from The Atlantic, Grist, and online National Geographic have relied on the database for sources.
To be listed, women scientists fill out an online form and members of the group 500 Women Scientists vet the entries by verifying that the submitted information is accurate. The database lists women who are in a science, technology, engineering, math and medicine (STEMM) field.
500 Women Scientists is a grassroots organization started by four women who met in graduate school at CU Boulder and who maintained friendships and collaborations after jobs and life took them away from Boulder. The group’s mission is to make science open, inclusive, and accessible. When they published an open letter in November 2016, the group’s founders set an aspirational goal of collecting 500 signatures, which they surpassed within hours of posting the letter. More information about 500 Women Scientists is available at www.500womenscientists.org.
“Our goal is to increase representation of women scientists in society and change perceptions of what a scientist looks like,” said McCullagh. “As our database grows, we plan to make it easier to use so that women scientists are recognized for their significant contributions to science and our understanding of the world.”
Six authors, including McCullagh, are listed as authors of the article.
Guest contributor: Mark Couch, CU School of Medicine
Amid the pageantry of a holiday weekend at the Air Force Academy, a cadet suddenly feels fatigued and feverish. His condition quickly worsens until he starts having seizures.
An 11-year-old girl, shortly after a guest performance with the Boulder Symphony, develops a fever. Days later she becomes confused. Seizures follow.
Cases such as these illustrate the mystifying – even diabolical, as one parent describes it – nature of febrile infection-related epilepsy syndrome, or FIRES, a neurologic condition that can leave once-healthy young people with learning disabilities and chronic epilepsy.
The onset is so quick and severe that doctors are left to run a battery of tests for other types of epilepsy as well as encephalitis, meningitis and other neurologic conditions. FIRES becomes a diagnosis of exclusion, after every other possible condition has been ruled out.
What could cause a syndrome that can so quickly turn a life upside down? Nobody knows.
But physicians and researchers at the CU Anschutz Medical Campus and nationally are working to unravel its cause and possible treatments. Epilepsy experts at Children’s Hospital Colorado (CHCO) have seen some positive responses from a relatively new experimental treatment.
“To have this sudden explosive onset – someone who is previously healthy and then is having seizures – FIRES is pretty unique in that sense,” said Krista Eschbach, MD, a Children’s physician who is among the experts studying the syndrome.
‘Cared for by the best’
Nishanth Kalavakolanu, a second-year cadet at the Air Force Academy, was enjoying a visit from family last September when, on a sunny afternoon, he felt waves of fatigue. His parents were in town from Austin, Texas, for the academy’s annual parents weekend, and his sudden illness prompted a trip to a Colorado Springs hospital. That spurred a traumatic odyssey stretching into months as Nishanth found himself admitted to four different hospitals, the latter two being UCHealth University of Colorado Hospital in September and CHCO in November.
“We had faith that things would work out well in the end,” said his mother Lakshmi Damerla. “We knew he was being cared for by the best people, and that he had everything going for him in the hospital. It’s just a mystery what causes this.”
About two or three cases of FIRES are seen in Colorado each year. The average age of onset is 10 or 11, with other cases spanning the childhood spectrum, from toddlers up to teenagers.
In the 19-year-old Nishanth’s case, UCHealth providers consulted with Eschbach and Craig Press, MD, PhD, an assistant professor in pediatrics-neurology. Both CHCO epilepsy providers have experience with an experimental FIRES therapy. Nishanth arrived in a medically-induced coma due to constant seizures. It’s common for doctors to induce comas in these cases to quiet the brain while medications are given.
When he awoke on Nov. 7, Nishanth had been in a coma for 10 weeks, and Lakshmi and her husband, Anil, learned their son had FIRES. Doctors told the couple that some FIRES patients had experienced “remarkable effects” from Anakinra, a drug approved by the Food and Drug Administration to treat juvenile rheumatoid arthritis.
Since 2015, five FIRES patients have been treated with Anakinra at CHCO, all experiencing generally positive responses compared to historical outcomes, especially in terms of reduced frequency of seizures. Eschbach had heard about Anakinra being used in the treatment of a FIRES patient at the Mayo Clinic; Mayo’s 2016 study marked the first published literature citing the drug as a potential treatment for FIRES.
International case study
Eschbach is now working with an international group of physicians to improve the recognition, treatment and outcomes of children with FIRES. Through diagnosis protocol and treatment guidance, they hope to establish consistent approaches to patient care.
‘We knew he was being cared for by the best people, and that he had everything going for him in the hospital. It’s just a mystery what causes this.’ – Lakshmi Damerla, Nishanth’s mother
For instance, physicians hope to learn whether Anakinra is an effective treatment on its own, or combined with other medications. Doctors have also found that a ketogenic diet, high in fat and low in carbohydrates, is helpful for some patients. More study is also needed on that front.
Local physicians who treat the disease hope to get answers through collaborative research.
“It’s one of the strengths of having our hospitals so close together that we can do back-and-forth collaboration for the benefit of the patients,” Eschbach said.
‘Can’t wrap your head around’
For the families of FIRES patients the diagnosis can be devastating.
“It takes some time to absorb the shock,” said Natalee Gibson, whose daughter, Kailee, then 11, was treated for FIRES at CHCO four years ago. “It’s just something you can’t wrap your head around because there are no answers.”
Historically, about 77 percent of FIRES patients survive, but only 10 to 20 percent recover with normal cognitive abilities and almost all have learning disabilities and chronic seizures.
Not quite the same child
The Gibson family has noticed a distinct change in Kailee, who, among her many talents, performed with the Boulder Symphony just a few weeks before coming down with FIRES.
“She’s a fighter; she’s the strongest person I know; she’s definitely a very inspirational human being,” Natalee said. “But she’s not quite the same child she was.”
The family recently moved from the Front Range to Grand Junction, seeking a less-hectic atmosphere for Kailee. They installed a hyperbaric chamber in their home, after learning that some epilepsy patients benefited from hyperbaric oxygen treatment.
“It’s all trial and error,” said Natalee.
One thing they are sure of is the quality of care they have received on the CU Anschutz Medical Campus.
Providers haven’t just given outstanding treatment, they take an interest in their patients. They ask about the patients’ hobbies and passions, sit with families late at night while their children lay in comas, and even make time for special events, as was the case recently when the Air Force Academy hosted a temporary retirement for Nishanth.
Several members of his care team from both CHCO and UCHealth, including Press, Sunita Sharma, MD, and Brad Constant, MD, traveled to Colorado Springs for the ceremony, which was hosted by Brigadier General Kristin Goodwin. Not only was it a celebration of Nishanth and his many supporters, it signified something important to any cadet facing personal upheaval: he got to keep his full military benefits.
“It’s kind of like having another family,” Nishanth said. “It was a lot of support from these people who love me.”
Press connected Nishanth, who has played violin for 15 years, with his mother, who is an orchestra teacher and violinist. Her regular visits helped reconnect Nishanth to one of his passions as well as reestablish his neural pathways.
The hospital enhanced the violin lessons with a musical therapy program that brought a keyboard to his room.
Lakshmi said the rehabilitation team is exceptional.
“They were more like friends than people who worked with us. We now have a relationship that goes way beyond the hospital,” she said. “There were a lot of people who helped on Nishanth’s journey.”
Press said the year-old NeuroRecovery Program is a full-fledged team of specialists who care for patients from admittance to recovery to post-discharge therapy.
“Children’s is supporting us in a very forward-thinking way; it’s really an amazing investment,” said Press, who is director of CHCO’s Pediatric Neurocritical Care and the NeuroRecovery Program. “Ideally, we’ll be known, in the case of an acute brain injury, as the best place to go in the country for treatment and rehabilitation.”
‘Saved our daughter’s life’
Natalee Gibson, whose daughter was the first FIRES patient at CHCO treated with Anakinra, echoed the sentiments about the hospital’s care.
“It was very much a comforting place to be because of the staff and providers were so kind – it was like a bubble,” she said. “As terrible a time that was, I believe 100 percent that we needed to be at Children’s Hospital in Aurora. They saved our daughter’s life, quite frankly.”
Still, the devastating nature of the FIRES had its effect on Kailee, who before the syndrome struck was at the top of her sixth-grade class, a star soccer player and an accomplished musician.
“She was a rock star,” Natalee said.
Kailee spent six weeks in rehabilitation at CHCO, undergoing brain, speech and physical therapy. She responded well to the Anakinra treatment and the ketogenic diet, which were administered at the same time.
But due to the mysteries surrounding the syndrome, it remains unclear just what, specifically, helped Kailee.
“Was it one drug? The combination? The diet? Who can know?” Natalee said.
Brain: the last frontier
At the worst of her condition, which Natalee described as “diabolical,” Kailee suffered about 70 seizures a month. Now she has about 15 a month, and they aren’t as severe. Kailee can walk and dress herself, but she doesn’t have the same energy and stamina as before FIRES. Seizures can come any time: if she’s too tired, or experiences too much stimuli, a change in her schedule or diet.
“Our life with her is about maintaining the quality of life that we can give her while also giving her the best-possible control over her seizures,” she said.
Kailee, now 14, is homeschooled and requires all-day caretaking. She receives weekly visits from physical and speech therapists, and she continues playing piano and taking voice lessons.
The Gibsons have a strong religious faith, and they believe Kailee can continue to heal and regain normalcy in her life.
“Our role is to look at every option,” Natalee said. “I would like to see Western medicine join forces with other philosophies. I think if all these different medical approaches came together we might reach some better insights on how the brain works – it’s really the last frontier of healthcare.”
Nishanth: Hopes to serve country
Meanwhile, Nishanth’s family is gradually reintegrating the cadet into his Texas life.
“We knew the end would be OK; we just didn’t know how long it would take to get there,” Lakshmi said.
But the long journey for Nishanth, a straight-A cadet who received a U.S. flag from his Air Force family during the recent celebration, will continue.
Emotion welled up in Anil when he speculated as to whether his son would be able to resume his academy career and attain his dream of becoming a pilot.
“He wants to go back to serve the country he loves,” he said. “We hope he can do that.”
The CU Anschutz Medical Campus conducts cutting-edge research that is advancing personalized medicine and making other important discoveries. Typically, the work is done by scientists whose credentials include a PhD and often other advanced degrees.
Turner was selected as one of only 11 recipients of the prestigious Hertz Foundation Fellowship from a pool of more than 840 applicants. She is the first-ever CU Anschutz awardee; three students from CU Boulder have won Hertz Fellowships, with the last recipient being 15 years ago.
Highly prized award
“I honestly didn’t think it was going to happen,” said Turner, who received a bachelor’s degree in biochemistry and integrative physiology at CU Boulder in 2017. “Historically, they fund a lot of engineers and students in the physical sciences. I’m not an engineer. As I learned more about the fellowship, they are interested in people in a variety of disciplines – people who are very creative, curious and innovative.”
As part of the extremely prized award, Turner will receive about $250,000 in support toward her graduate-school ambitions, which include a PhD, with a particular interest in molecular oncology. Her program, the National Institutes of Health-funded MSTP, supports medical students seeking dual MD and PhD degrees.
Turner’s interest in research began in the cardiac laboratory of Russell Moore, PhD, in the Integrative Physiology Department at CU Boulder. As an undergraduate, she joined the Robinson Melanoma Research Laboratory at CU Anschutz, working alongside William Robinson, MD, PhD, a world-renowned melanoma expert, and Kasey Couts, PhD.
“They are pivotal mentors in my life, helping to teach me and spark my interest in science,” Turner said. “Most importantly, I saw how my work can be translated to benefit patients.”
Recently, the team of researchers published the first report of any kind of gene fusion responding to immunotherapy in any kind of cancer. “Our studies demonstrate kinase gene fusions have unique signaling mechanisms that can be targeted for treatment,” Turner said. “We show how understanding the physical properties of structural variation in the genome is important to identify and treat gene fusions.”
In essence, Turner and the team at the International Melanoma Biorepository and Research Laboratory at CU Anschutz has been working on gene rearrangement that translates into longer lives for cancer patients. “Having a stage IV melanoma patient survive for at least two more years based on our findings was really incredible,” she said. “That’s the kind of research I want to focus on.”
Clinically translational research
Along with Isabel Schlaepfer, PhD, assistant professor, Division of Medical Oncology, and Raul Torres, PhD, professor of immunology and microbiology, Turner is now working to integrate genetics, immunology and metabolism to construct a better understanding of cancer.
As part of the fellowship, Turner will attend workshops, retreats and seminars where she will meet and work with an even wider network of scientists. “You get a scientific community and network to tap into,” she said. “They also give you financial freedom to seek out the mentors you want to work with, which is really cool.”
These experiences continue to fuel Turner’s interest in clinically translational research. She is especially interested in developing cutting-edge therapies for patients with limited treatment options or a poor prognosis.
“Throughout my career, I hope to work with patients, identify novel therapeutic targets and develop new treatments for solid tumor malignancies,” Turner said.
Photos in lab by Matt Kaskavitch, Office of Communications.
For Frank DeAngelis, the “beloved 13” are never far away. They are with the retired Columbine High School principal when he speaks about school safety across the country, while he works as a consultant for safety and emergency management in Jefferson County, and the moment he wakes up in the morning.
“I refuse to become helpless and hopeless … each morning I recite the names of my beloved 13 and they give me the reason to do what I do,” DeAngelis said. “They gave me the reason to walk back into Columbine High School for 15 years after the tragedy.”
Although the Columbine shooting of 20 years ago represents one of the darkest days in Colorado history, a day-long symposium at the CU Anschutz Medical Campus on April 16 struck a hopeful and problem-solving tone. “Uniting to Prevent School Violence – 20 Years Since Columbine” drew more than 200 attendees and featured national experts on school violence, local politicians and leaders in law enforcement and mental and behavioral health.
In his introductory remarks, Matthew Wynia, MD, MPH, FACP, director of the Center for Bioethics and Humanities, said the tragedy of April 20, 1999, affected the entire country and rippled across the world. He said it forced Colorado to take a leadership role in helping others to learn how to prevent school violence.
‘Honor the legacy’
“Today our hope is to honor and respect the legacy of the tragedy at Columbine by coming together to learn and provide a forum for our state to help move forward the agenda to prevent such future incidents,” Wynia said.
The opening session featured keynote speaker Deborah Prothrow-Stith, MD, dean of the Charles Drew University of Medicine and Science and national expert on adolescent violence, and Colorado Lt. Gov. Dianne Primavera.
It was DeAngelis’ vivid recollections of that horrific day and its aftermath that evoked emotions from attendees.
The principal was in his office about to renew the contract of a first-year teacher when his secretary broke in with reports of gunfire. When he stepped into the hallway, “my worst nightmare became a reality because I encountered a gunman 75 yards away,” DeAngelis said.
The principal, the gunman and the key
He saw a group of girls walking into the same hallway, having just come from the locker rooms next to the gym. He ran toward the them and the gunman, urgently ushering the girls back down the hall toward the gym. “As the girls were screaming and the shots were ringing louder I reached in my pocket where I had a set of about 35 keys on a key ring,” he said. “The first key I pull out I stick in the door and it opens on the first try.”
The afternoon session began with a moving Art from Ashes poetry reading, an introduction from Attorney General of Colorado, Philip Weiser, JD, and former attorney general, Cynthia Coffman, JD, followed by a stakeholder discussion about the future direction for Colorado and our country.
In the panel discussion, Christine Harms, MS, director of Colorado School Safety Center, Department of Public Safety, highlighted the high teen suicide rate in Colorado and stated that it is a community issue, not just a school issue.
Susan Payne, founding director of Safe2Tell, stressed the importance of breaking down silos and creating a collaborative system of support at every school, including law enforcement and community members, as the majority of reports to Safe2Tell occur after school hours. All panelists agreed that the best way to put the research presented in the morning sessions into practice is to have young people be a part of the solution.
To this day, DeAngelis regularly receives photos from those girls – now women in their late 30s – showing off their growing families, their smiling children. “They say, ‘Mr. D, we’re so glad you found that key.’ … I’m not sure if I found that key. Someone found it for me.”
As mass shootings continue on a regular basis, DeAngelis and the thousands more who’ve been directly affected search for ways to prevent future senseless acts. The retired educator, who received a master’s degree from CU, noted that “so many lessons have been learned” over the 20 years, including improved response systems, crisis care and understanding of recovery for PTSD.
Back in 1999, he said, fire drills were the only emergency exercises held in school. “So that’s an important lesson learned – that we’re training for that day when something could happen at your school, at your church, at your mental facility.”
Much to learn from victims
Prothrow-Stith was among a group of leaders in the late 1970s who, alarmed by statistics that homicide was the leading cause of death for young black men and the second leading cause of death for all U.S. adolescents, set stage for addressing violence as a public health problem.
She said survivors of acts of mass violence are some of the best champions of solutions to the problem. “There’s a lot to learn from them, and the politicians listen to them when they don’t listen to the data.”
Prothrow-Stith offered several slides, including a study showing that states with stronger firearm laws have lower rates of suicide and homicide. Another study showed that motor vehicle fatalities have steadily dropped over the decades, corresponding to increased funding for automotive safety programs. Meanwhile, U.S. firearm fatalities continue to rise while safety-related funding remains low.
In 2015, for example, 33,800 Americans died in car accidents, and Congress approved $830 million for safety research. Meanwhile, 33,636 people died from gunshots that year while just $5 million was OK’d for gun safety research. “It seems we could have more of an impact if we had more collaborative, concerted funding focused on prevention (of firearm violence),” she said.
The matter of guns
Prothrow-Stith noted that there are almost twice as many suicides each year in the U.S. than homicides. “What we’re learning about guns and their participation in both homicide and suicide suggest that there are things we can do,” she said. “If I were to say where I’m probably the most frustrated it’s in our lack of ability … to address gun ownership in the U.S.”
She pointed out that New Zealand, where recent shootings at two mosques killed 50 people, has already banned semi-automatic weapons and assault rifles. In contrast, she noted, the U.S. has pro-violence cultural messaging that dates back centuries and it’s not changing. “I don’t know that we’ve released our children of the marketing of violence,” she said. “Now we’re marketing this thing called violence to girls as well.”
‘Colorado stands as a model for other states to look to when it comes to school safety.’ – Lt. Gov. Dianne Primavera
She admitted to reaching a point of being “almost withdrawn from this issue” when not even the devastating Sandy Hook Elementary School massacre in 2012 was enough to spur Congress to act. But the strong activist responses by students after last year’s Parkland, Fla., shooting, and the subsequent passage of a Florida gun bill, has renewed her optimism.
“When we think about hurt children hurting other children we really have to think about what we give as cultural messages, and of course we need to make the hurt go away,” Prothrow-Stith said. “But if we can share strategies for healing and handling the hurt better and healthier, rather than fighting or hurting oneself, I think we could make a dent in this.”
Primavera said Colorado has done much to improve school safety since Columbine, including:
Opening one of the largest School Safety Resource Centers in the nation, where more than 46,000 people have been trained on threat assessments, suicide prevention and child sexual abuse prevention.
Launch of the state’s Safe2Tell tip-line program, which has become a model for recognizing threats and responding quickly.
In 2013, the state passed universal background checks, resulting in “thousands” of people with criminal records being denied access to firearms.
In 2018, the Colorado Legislature approved $60 million in school safety grants.
Last week Gov. Jared Polis signed the Lifesaving Extreme Risk Protection Order into law. The legislation allows family members and law enforcement officers to request a court order to temporarily remove firearms from someone who is deemed a danger to themselves or others. Her mention about the new law drew a burst of applause from the audience.
“Colorado stands as a model for other states to look to when it comes to school safety,” Primavera said.
Emotions welled in the auditorium when DeAngelis read off the names of the 12 students and one teacher killed 20 years ago. He said his intent is to celebrate their lives. “As we go through the next four days, that’s what I want you to do. We’ll always remember the 13,” he said. “Columbine represents hope.”
Contributors: Sidebar story by Kiley Kudrna, photos by Matt Kaskavitch, Office of Communications
The University of Colorado Anschutz Medical Campus is part of a team of researchers that has received a grant of $3.6 million for the SPROUT-CTSA Collaborative Telehealth Research Network.
This five-year grant will support the development of telehealth research efforts, metric development, identification of best practices and the development of collaborative policy and advocacy materials across the country. It builds on work underway as part of the SPROUT (Supporting Pediatric Research on Outcomes and Utilization of Telehealth) collaborative, an established network of institutions and pediatric providers operating within the American Academy of Pediatrics (which is a sub awardee of the grant).
“At the national level, there is no academic authority currently spearheading multicenter telehealth research studies,” said Christina Olson, MD, assistant professor of pediatrics and site primary investigator at the University of Colorado Anschutz Medical Campus – Children’s Hospital Colorado. “We have piecemeal efforts happening in terms of research, national policy development and payer guidelines. This network will provide tools, resources and guidance to accelerate the development of telehealth studies across the country. We will support champions of telehealth to become champions of research as well.”
“This is a huge step forward in the development of safe and impactful telehealth programs across the country,” said primary investigator for the grant S. David McSwain, MD, MUSC Children’s Health physician and MUSC associate professor of pediatric critical care and chief medical information officer. “Academic research into the real impact of telehealth services is a critical component of developing and growing programs with the greatest potential to improve our health care system. Many physicians and other health care providers are hesitant about incorporating telehealth into their practices because it’s difficult to separate the theoretical benefits from the real value.”
In 2015, McSwain collaborated with a small group of pediatric physicians across the country to form SPROUT, which has since completed and published the nation’s first broad assessment of pediatric telehealth infrastructure across the country.
“That was a critical starting point,” said John Chuo, MD, associate professor of clinical pediatrics, co-chair of SPROUT and site primary investigator at CHOP. “When we started SPROUT, we realized that we couldn’t conduct studies on pediatric telehealth unless we actually knew which institutions were providing which types of services, and that information wasn’t available anywhere. So we made that our first investigation.”
While much anecdotal or small-scale evidence exists about the benefits of telehealth, including cost reduction, improved quality of care in some patient populations and improved access to care for some rural and underserved populations, barriers to fully demonstrating the gains made via telehealth care delivery persist. For example, there are few best practices in existence for conducting multisite telehealth research involving patient care outcomes, limited access to research trials for rural populations and limitations to care access for special populations such as children or the elderly.
The grant is funded by a Collaborative Innovation Award through the National Center for the Advancing Translational Science (NCATS), a branch of the National Institutes of Health. The program will operate in collaboration with CTSA (Clinical and Translational Science Award) sites across the country to facilitate research development and support current and future telehealth researchers to develop projects and apply for funding. CU’s Colorado Clinical and Translational Sciences Institute (CCTSI) and its partner, Children’s Hospital Colorado are one of these CTSA sites. As opposed to supporting a specific clinical research study, this grant seeks to establish an easily accessible support structure around telehealth research: tools, resources, guidance, collaboration, education and advocacy materials that will be valuable to anyone across the country who wants to study telehealth programs.
“We expect this network to become the preeminent source for evidence-based policy and outcomes data,” said Brooke Yeager McSwain, RRT, health policy consultant for the project and manager of the South Carolina Children’s Telehealth Collaborative. “Our national and state legislators have seen the benefits of telehealth for certain populations and regions. We have to demonstrate to them that this works across the country and has the potential to dramatically impact health care delivery models, particularly in value-based care.”
Alison Curfman, MD, medical director of Pediatrics at Mercy Virtual and a co-investigator of the grant, spends much of her time thinking about better ways to partner with children and their families for overall better health. “We have to ensure that children have access to every type of care that they need at the right time, no matter where they live. The technology is here. The commitment of the early-adopters is here. Our next frontier is proving to other pediatric providers across the health care spectrum that telehealth is about so much more than convenience.”
Guest contributor: Wendy Meyer, Colorado Clinical and Translational Sciences Institute.
This spring, fourth-year School of Medicine students were once again on the front lines of a pandemic.
Whoa, nothing to worry about! You don’t need to check Twitter, these are fictional pandemics. It’s an annual tabletop exercise designed to teach students preparedness and effective communication in emergency situations. Originally developed by internal medicine doctors Linda Overholser, MD, and Nichole Zehnder, MD, Associate Professor of Emergency Medicine Charles Little, DO, has run the exercise since 2012.
CU Anschutz Today sat down with Little to ask him about his perspective in organizing and running the event the past eight years.
What is the purpose of this exercise?
Medical students don’t really get any exposure to disaster or emergency management throughout their medical school curriculum, unless they show a special interest in doing an elective in some of that type of work. But almost all physicians at some point in their career will be involved in some emergency incident, and we want them to have at least some basic understanding of what the process is.
The exercise does several things:
First, it outlines what happens in pandemic influenza, which historically occurs every 10 to 20 years.
Second, it gives them an overview of what the health emergency response system looks like. It’s not just hospitals; it’s the entire community including clinics:
Public health has a very big role in infectious disease outbreaks.
Emergency management has an important role in any big event like that.
And then, EMS (emergency medical services) and transportation also play key roles.
We want them to have an understanding about all the players, other than just physicians, hospitals and clinics.
The third thing is to give them an opportunity to work in small groups on a “novel event” they really haven’t thought about before, and then do decision-making and generate a plan with limited background and limited understanding of what’s actually going on. They have to work a little bit through the fog of events.
How are students grouped together for this exercise?
We generate the number of spots we’re going to have, which this year was based on the number of community experts we had who were available to come help.
The one group that we let self-select is the ethics group, because we want people who actually have an interest in that who will participate in those discussions. Right before the exercise starts, we’ve got all the other groups assigned, and then we ask for a show of hands and pick approximately 10 people out of the audience to do ethics.
You break students into six different groups (public health agencies, cities, hospitals, clinics, ethics and the media). Do the students do better at specific “roles”?
I think it’s probably a little easier for them to grasp the clinics and the hospitals. They actually do very well in any of the groups, just because they’re overall pretty high performers, and they’ve worked in groups before. Things like the Office of Emergency Management are pretty far from their kind of previous training and understanding, so I think that and public health are a little harder. I think they all have some limited exposure to EMS, so I think they probably understand that a little better. But overall, they do well in all the groups.
Similarly, are there any roles students are challenged by more than others?
For all the groups, they actually really jump into it pretty well.
Even in things that [don’t] have anything to do with medicine, like the media group, they actually take to it pretty well. They’ll take out cell phones and they’ll start shooting videos of themselves as reporters. They figure out fairly early on in the process what the challenges are, and the goal of the media group is to get them to understand how the media can help you or hinder you, and you have to be forthcoming with reliable information, but not overshare things you’re speculating about.
What trends have you noticed year over year with this exercise? How has the simulation changed?
In terms of the exercise design, I refine it each year, and early on, what I did was I started to refine it to be more in the structure of the tabletop exercises that we do in the emergency management and disaster realm. And that helped to streamline it and make it somewhat easier to administer.
‘It’s a pretty huge undertaking … It’s pretty intense. I think the students understand a little bit about what it feels like to actually manage a real disaster.’ – Charles Little, DO, pandemic simulation organizer
This is actually, as these exercises go, a pretty huge undertaking. We’ve got 180 students, and we’ve usually got about 40 to 50 subject matter experts, and they all have to be coordinated. We’ve gotten better at that over the years.
From the student’s standpoint, it’s very interesting that different classes seem to have slightly different personalities, and some classes are a little more engaged, other classes are a little more reserved. But I think every year, they all get something out of it.
How would you describe the energy in the room during the simulation?
The students are actually very engaged in trying to work through problems, and it’s a pretty high-energy event. Usually they’re pretty tired by the end of two to three hours of doing this, because it’s a lot of decision-making, a lot of concentration, and a lot of active thinking, and responding to information they’re getting both by email from us, but also the requests they’re getting from other groups for support and information-sharing and things like that.
It’s pretty intense in that fashion. I think they understand a little bit about what it feels like to actually manage a real disaster.
What kind of feedback do you get from students afterward?
The vast majority of students find it very interesting and engaging. There are a couple people who clearly don’t like making decisions with no information that are high consequence, and that seems a little distressing to them. Overall, it’s generally a very engaging exercise with something they don’t do frequently. And they recognize that once they leave school, they may be involved in these type of events.
What do you hope the students take away from the simulation?
We want them to understand what any type of public health disaster kind of looks and feels like, and how you would go about managing it. And who your partners would be.
What is your favorite aspect of running the simulation?
It’s really fascinating to watch the students work through this with the subject matter experts. And that, I think, is the greatest thing.
And one other thing I’ll point out is we have about 45 subject matter experts who come year after year and help support this, and that goes from city emergency managers to county and state public health leadership, to people who do emergency management in clinics and hospitals. And I think they do it for a couple reasons.
One is they realize it’s important for the doctors who are generally leaders to have an appreciation of this, but they also have quite a bit of fun doing it. They’re willing to carve out an entire half-day once a year, year after year. That’s been tremendously helpful.
What have you learned personally by doing the simulation?
That’s a good question. I think I’m really impressed with how engaged the students will get with something when there’s a goal set in front of them that’s something they didn’t really consider was probably part of the responsibilities they would ever have, or something they would ever engage in.
I’m pretty impressed with how quickly they adapt, and move forward with that.
I’m also really impressed by the way the community has stepped forward to help support this exercise. I have to do some work to recruit people every year, but it’s been really rewarding to see how people come back and support this because they feel it’s a valuable event for the students.
Deputy Chief Mark had a distinguished 30-plus year career with APD, most recently serving as the electronic support section commanding officer for the past 10 years. In his role, Mark managed the body camera program, working with the Aurora City Council to provide body camera technology to officers across the City of Aurora. Mark held many other roles throughout his career, including investigations, the police area representative unit, SWAT negotiation team supervisor, recruitment and background investigations unit supervisor, patrol supervisor and public information officer.
“As a member of the Aurora Police Department for over 34 years, I’m familiar with the University community and history. I’m excited to be part of the University and look forward to the growth and challenges,” said Mark.
Mark will assist Police Chief Randy Repola in overseeing all CU Anschutz Medical Campus Police Department activities. Additionally, he will manage the Police Services division, which includes criminal investigations, traffic enforcement, special event staffing, security services and liaison with other law enforcement and security providers in the area. Police Services also collaborates with Student Affairs and the various schools and colleges on campus to address safety and security issues.
University Police is based on the CU Anschutz Medical Campus and houses four divisions, including Electronic Security, Emergency Management, Patrol and Emergency Communications. The Police Department is staffed by 60 employees and 28 full-time law enforcement officers who work directly with Deputy Mark to ensure the safety of the campus, including providing training sessions, using personal safety equipment and responding to accidents, injuries and unsafe situations.
“Thank you all for your patience as we have worked through the selection process. While the process was lengthy, it enabled us to identify and select a wonderful new team member,” said Police Chief Repola.
Guest contributor: Katherine Phillips is a contributor to CU Anschutz Today.