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Professor of anesthesiology appointed to the Colorado Medical Board

Roland Flores

The Governor of Colorado appointed Roland Flores, MD, FASA, an assistant professor of anesthesiology in the Department of Anesthesiology, CU School of Medicine, to serve a four year term as a board member on the Colorado Medical Board.

The board was instituted as part of the Medical Practice Act with the purpose of regulating and controlling the practice of medicine in the state of Colorado. The board governs the practice of physicians, physician assistants and anesthesiologist assistants.

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Alzheimer’s FAQ

Alzheimer’s disease is the sixth leading cause of death in the United States, impacting millions of Americans and their families.

Here at the CU Anschutz Medical Campus, The Rocky Mountain Alzheimer’s Disease Center is focused on ending Alzheimer’s disease and other causes of dementia.

The Center’s Director, Dr. Huntington Potter, PhD, has answers to some common questions they receive on Alzheimer’s disease.

Dr. Huntington Potter Kurt N. and Edith von Kaulla Memorial Professor of Neurology; Vice Chair of Basic Research; Director, Rocky Mountain Alzheimer’s Disease Center

What causes Alzheimer’s disease?

Alzheimer’s is a complex disease caused by the accumulation of harmful proteins both inside and outside brain cells. These clumps, called plaques and tangles, kill healthy neurons and eventually lead to memory loss and other cognitive problems. What causes the beginnings of Alzheimer’s disease remains a mystery.

What are the first warning signs and early symptoms?

We want to stress, Alzheimer’s disease is not normal aging, but the very earliest symptoms are often misread as simply getting older: having less energy and drive, some forgetfulness or confusion, and mood changes. The name for the condition that precedes Alzheimer’s disease is called Mild Cognitive Impairment. Many people ignore the early signs when they should be seeing their doctors, asking for an evaluation.

How is someone diagnosed?

Historically, a diagnosis of Alzheimer’s was 100% accurate only after death and a brain autopsy. But more recently, physicians are able to make probable diagnoses while people are living, using brain imaging technology, multiple questions and answers, and an analysis of blood proteins.

Is Alzheimer’s hereditary?

Yes and no. Heredity often plays a role but it is not a guarantee. Many people with a family history of Alzheimer’s do not get the disease, and likewise, many with no family history can still develop Alzheimer’s. Alzheimer’s disease is the most common form of dementia, and the greatest risk for everyone is simply living longer.

What about prevention? Are there ways to keep the brain healthy as we age?

A healthy brain is often part of good overall physical health. Although there is no cure, there is research that says health-conscious living can delay the onset of dementing diseases, including Alzheimer’s. We sometimes say, “what’s good for the heart is good for the brain,” meaning a heart-healthy lifestyle is also a brain-healthy lifestyle. Getting lots of exercise, the right amount of sleep, a good diet, and staying engaged with people and creativity all make life more enjoyable with healthy brain benefits.

How can someone best help a loved one diagnosed with Alzheimer’s?

Continue to love and support the person and be mindful that the disease is no one’s fault. Beyond having a supportive attitude, families and individuals should get their affairs in order while they have the presence of mind to do so. Determine how care in both the short and long term can be provided. Don’t expect one person to have the capacity, know-how or interest to provide all the care. Build a network of care partners and get trained on how to properly manage the changes that are coming.

What are researchers at the Rocky Mountain Alzheimer’s Disease Center focused on? Are there any promising studies?

We have a large, dedicated team of scientists and clinicians at the University of Colorado Anschutz Medical Campus working together, studying how the disease develops and how it can be better diagnosed. We’re also developing new treatments in the laboratory that will be next tested in mice and, if successful, ultimately in humans.

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Help is only a phone call away with Real Help hotline

In life, there are highs and lows. Some are big and small. If you reach a point where you’re feeling overwhelmed by the stress in your life – whether it’s related to finances, relationships or any other issue – there’s help through the Real Help hotline.

The Real Help hotline provides all CU employees with access to professional counselors, who offer assistance finding wellness and behavioral health resources or immediate counseling over the phone. Whether callers are experiencing a serious crisis or just need recommendations for when life gets too stressful, Real Help is here. Due to the hotline’s extensive footprint, counselors can assist callers with safety, emergency financial and legal resources. It’s free, confidential and available 24/7.

The best part: The CU Health Plan’s hotline affiliation means counselors can direct callers to services and behavioral health providers covered by CU’s health plans. They can recommend CU Health Plan wellness programs that may help employees deal with situations including the Employee Assistance Programs (EAP), Move, Silver Sneakers and many others. Any CU employee, regardless of health coverage, can receive assistance and referrals to the appropriate care.

“The Real Help hotline is an initial step toward providing members of the CU community with integrated resources and access to multi-level mental health care,” said Gena Trujillo, Assistant Vice President and Operations Officer at CU Health Plan Administration.

 

Not sure when to call? Here are the top five reasons people called in April 2019:

1. Anxiety
2. “Major Life Stressors”
3. Mood Concern(s)
4. Safety concerns/ suicidal ideation
5. Family Issues

 

Calls are not limited to your personal needs. If you have concerns about others, Real Help is there – 8% of calls are people calling in concern about others, most often a dependent. Dependents of CU Health Plan members can also use the service.

“Everything with this service was designed from the start to be convenient and accessible for every employee. While our crisis clinicians and triage specialists are not benefits counselors, they can direct employees to local resources and referrals, and provide in-the-month, crisis-focused mental health support 24-7,” said Josh Larson, MA, LPC, Rocky Mountain Crisis Partner’s Clinical Operations and Quality Assurance Specialist.

If you, a co-worker or a family member needs assistance, the number to call is (833) 533-CHAT (2428).

 

Guest contributor: Kayle Lingo, University of Colorado.

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Study finds FDA dermatology advisors receive payments following drug approvals

Tablets

A team of researchers led by a member of the University of Colorado School of Medicine faculty at the Anschutz Medical Campus examined post-advisory financial relationships between U.S. physicians who advised FDA committees during dermatological drug approval processes. Critics of these industry-physician relationships claim these types of payments could incentivize advisors to alter their voting habits.

The findings are published in a research letter in the Journal of the American Academy of Dermatology. 

Robert Dellavalle, MD, PhD, professor of dermatology and public health at the University of Colorado School of Medicine
Robert Dellavalle, MD, PhD, professor of dermatology and public health at the University of Colorado School of Medicine

“It’s known from previous studies that financial payments to FDA advisors can take place after a drug is approved but this is the first time we’ve researched and seen that this trend spans to the dermatology field,” said Robert Dellavalle, MD, PhD, professor of dermatology and public health at the University of Colorado School of Medicine.

Dellavalle adds, “It’s hard to control post-advisory financial relationships since it’s not on the record going into the committee and top doctors can be paid as ongoing academic advisors for a variety of reasons. Regardless, financial conflicts of interest in medical research are important to discuss and monitor.”

Physician advisors serve as external experts in determining whether a new medical therapy is fit for the U.S. market. Of the advisors analyzed, 54 percent received at least one payment from pharmaceutical companies.  Twenty-seven percent accepted more than $1,000, 15 percent accepted more than $50,000 and nine percent took more than a $100,000. The advisors received a mean of more than $47,000. For the majority of the drugs examined, payments from competitors outnumbered payments from manufacturers.

The study analyzed Open Payment data, a national transparency program that collects and publishes information about financial relationships between the health care industry (i.e., drug and device companies) and providers (i.e., physicians and teaching hospitals). The study focused on payments made by U.S. physicians who advised FDA committees during the approval of ten dermatologic therapies.

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Heart of the matter: Doctors and designers collaborate to improve patient care

Model of young heart

Among the projects of Inworks, a joint innovation initiative of the University of Colorado Denver and the Anschutz Medical Campus, one remains close to the heart. That is, the literal hearts from Inworks’ high-end polyjet printer, which produces 3D model organs for surgical planning. For a young patient of Max Mitchell, MD, the model hearts served as illustrative surgical tools and a showcase of the collaboration between doctors and designers.

Associate Director Monika Wittig describes Inworks as the pre-pipeline to CU Innovations’ ecosystem. Where doctors and clinicians work with CU Innovations to refine and hone their ideas for commercialization, Inworks is where those ideas first come to life. Budding inventors can collaborate with Inworks designers to create animations, 3D models, virtual reality simulations, and other prototypes.

That dedication to cutting-edge technology and collaboration drew Dr. Mitchell to proposition Inworks for a customized approach to his patient’s dilemma.

Model of a patient’s heart

As a pediatric congenital cardiac surgeon, Dr. Mitchell is well-versed in difficult cases but wanted to take extra precautions for a patient with Wolff-Parkinson-White syndrome. Cardiac ablation would correct the patient’s tachycardia, but prior procedures found that traditional catheterization was ineffective. Further surgery would be necessary, and, based on the patient’s organ structure, incisions would be difficult to predict and hard to place.

Dr. Mitchell approached Inworks to print a model of the patient’s heart so that he and the team — cardiologists Dr. Kathryn Collins, Dr. Johannes Von Albensleben, Dr. Martin Ruciman, Dr. Dale Burkett, Dr. Michael DiMaria, and radiologist Dr. Lorna Browne — might have a better idea of what to expect during surgery.

The request for a custom model didn’t spring up overnight. For several months, Inworks designers Nick Jacobson and Hayden McClain, a CU Denver graduate student in mechanical engineering, collaborated with surgical teams at Children’s Hospital Colorado. What began as an invitation to observe Dr. Mitchell, Dr. DiMaria, Dr. Browne, and other surgeons, evolved into sessions where Jacobson and McClain brought in models and discussed with doctors how to refine and improve them to better serve as surgical tools.

When Dr. Mitchell made his patient-specific request, about a week before the scheduled surgery, McClain was so experienced in the anatomy and process that he transformed the CT scans and patient data into models within 72 hours. After a design session where the doctors practiced and planned their surgery with the models, Jacobson and McClain delivered a second set, customized for view planes, cross sections, and access points based on the doctors’ feedback. The designers also used their first hand knowledge of the surgeons, like Dr. Mitchell’s position at the right side of the patient’s chest, to tailor their models to mimic the surgical experience as closely as possible.

Fast, inexpensive prototyping

In preparing for the operation, the model was used with the echo probe and the intracardiac navigation system and overlaid on the MRI study. Combining these techniques, Dr. Mitchell recalled the team was able “to pinpoint within millimeters where they were in the heart.” In the next day’s surgery, Dr. Mitchell found he needed to be exactly where the model had predicted, which eliminated a certain amount of risk for the patient during the procedure.

According to Nick Jacobson, “the magic of 3D printing is that ideas can be prototyped quickly and inexpensively, making it easier to test out new concepts and ideas,” which “puts the power of innovation directly in the hands of those who have the best understanding of the problems that need to be solved.” In this case, both surgeon and patient benefited from the customizable nature of 3D printing and how it fits hand-in-hand with treating congenital diseases. The outcome epitomizes Inworks’ emphasis on human-centered design — improving patient care and outcome and developing tools tailored for the end user — as the designers continually push the limits of what is possible.

In addition to patient-specific cases, Inworks is also a maker workshop where physicians can prototype their ideas and, when suitable, gain traction toward commercialization. To do so, Inworks continues to grow its working relationship with CU Innovations to create the most successful outcome by collaborating from the start and merging Inworks’ design expertise with CU Innovations’ administrative and operational resources.

Guest contributor: Stephanie So

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Tornado time: How to stay safe on campus in severe weather

Colorado doesn’t fall into the nation’s notorious “twister alley,” but severe thunderstorms occasionally spawn funnel clouds or tornados. Some have even churned in the vicinity the CU Anschutz Medical Campus.

So it’s worth taking note of safety precautions in the event the campus – a veritable small city of about 50,000 people daily – falls within the area of a tornado watch or tornado warning. Both are issued by the National Weather Service. The “watch” is an alert to the possibility of a tornado over the next several hours, while the “warning” means a tornado has been spotted or one is suspected to be in the area.

An easy way to stay apprised of local weather events is to sign up for emergency alerts by the Aurora Office of Emergency Management. Also, sign up for emergency alerts through the CU Anschutz Medical Campus website.

Academic, research and administrative buildings at CU Anschutz don’t have designated tornado shelters, so in the event of a tornado warning, Cory Garcia, emergency preparedness coordinator for University Police, said people should seek the lowest accessible floor in a building. You should move to interior rooms, including inner hallways, restrooms or stairwells, away from windows.

“Getting to the lowest, safe place indoors is the message we push out,” Garcia said.

Stay away from windows

While the impulse might be to watch the skies from windows in the towers on campus, that’s a patently unsafe place during severe weather. People who stand by windows or go higher in buildings to gawk and take pictures are “not only putting your own life at risk, but the responding officers would probably prefer to be sheltering at that point,” Garcia said.

Stu Pike, interim director of emergency management for University Police, said tornados cause pressure to build inside buildings, so structures are prone, in severe climatic events, to explode outward. This makes it all the more imperative to stay away from glass.

Avoid getting in vehicles

Going outside to vehicles is likewise not advisable. Pike recalls a microburst that hit campus about 10 years ago. “It knocked over a tree in a parking lot – killed a Prius.”

Aurora’s safety sirens blare when a tornado warning is issued. The city does not issue all-clear sirens, so the campus community should immediately heed the major siren sound at the start of a warning. The city typically performs a warning siren test early in the season: call 303-739-7636 or email afd_oem@aurora.org for information.

For the hospitals, severe-weather safety precautions are similar, and specific precautions are in place for patient-care areas. Employees should consult emergency preparedness procedures and team members at their location for more information.

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Research projects emphasize improved outcomes in pediatrics

Leah Webb, MD

An array of innovative ideas – from devising a way to speed medications to sepsis patients to creating a standardized process that better secures epidural catheters to children – were on display at the Colorado Clinical and Translational Sciences Institute (CCTSI) biannual pediatric poster session.

The CCTSI collaborated with the Research Institute of Children’s Hospital Colorado and the Department of Pediatrics in the CU School of Medicine on the May 17 event. The informal session highlighted current pediatric research of fellows and faculty.

With over 100 posters prepared, many different pediatric topics were covered, including basic sciences, psychiatry and patient education. There were two groups of presenters, fellows and faculty, and the fellows were judged by a panel and had the opportunity to win recognition and a gift card.

Sharing research

“The poster session is a great opportunity for fellows, faculty, residents and nurses to share their scientific ideas and strengthen our community of pediatric researchers,” said Ronald Sokol, MD, CCTSI director. “It is also an important aspect of the CCTSI’s mission to foster the next generation of biomedical research leaders.”

Emily Greenwald, MD
Emily Greenwald, MD, received an honorable mention for first-year fellows for her study into pediatric sepsis.

“This event is a wonderful opportunity for researchers to see their peers’ incredible work,” said Janine Higgins, PhD, professor of pediatrics-endocrinology. “It is also a great chance for fellows to practice explaining their research to judges, as they will certainly do much more of this in the future.”

Improving outcomes in pediatric sepsis

Emily Greenwald, MD, a pediatric emergency medicine fellow, studies pediatric sepsis. She won honorable mention for first-year fellows.

“When it comes to sepsis, we can really affect mortality,” she said. “The goal of our study was to improve the amount of time it takes to get medication to sepsis patients, which has been shown to improve patient outcomes.”

Greenwald and her team followed sepsis patients from start to finish, looking for problems in the process. They found a subset of the patients who challenge routine methods to obtain vascular access. So a quality improvement initiative took place to develop an algorithm that can help care teams obtain vascular access in alternative ways to give medications more promptly.

“After rolling out the urgent access algorithm across several Children’s campuses, we’ve seen improvements in the amount of time it takes to get vascular access,” she said. “These improvements allow us to deliver the best care to children with suspected sepsis who also happen to have very difficult vascular access.”

Lowering pediatric epidural dislodging rates

Leah Webb, MD, a fellow in pediatric anesthesiology, shared her research on pediatric epidural catheter dislodging rates.

“Epidurals are frequently used for anesthesia,” said Webb. “It is administered through the placement of a catheter, which is susceptible to falling out. We really have one shot to place it correctly in a child. If it dislodges, it’s considered a failure.”

There are many different techniques to placing an epidural catheter. Webb designed a study to standardize the securement method. Through education and simplification, she found that the failure rate decreased by 43 percent.

“I’m excited to see this success and share it with other people,” she said. “This competition is a great opportunity to do just that.”

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Save on summer CU tuition for employees or dependents

CU faculty and staff can now apply for Tuition Assistance for the summer 2019 semester.

CU employees often take advantage of the Tuition Assistance Benefit by taking a summer class to expand their learning. Dependents who are looking to get ahead in the school year also cover their classes with this benefit through the Intercampus Dependent Tuition Assistance Benefit Pilot Program.

Qualified employees can save on up to nine credits, and their children, spouses and other dependents have several options to save on tuition costs.

Employees must submit the application on behalf of their dependent. Submit the Tuition Assistance Benefit application by the deadline for the campus they will attend classes at:

CU Boulder – Thursday, Aug. 22, 2019

CU Colorado Springs – Tuesday, June 18, 2019

CU Denver/Anschutz – Summer deadline: Tuesday, June 18, 2019

Get started:

  1. Log into the employee portal.
  2. Open the CU Resources dropdown menu at the top center of the page and select
  3. Click the Career Advancement tile, then click the Tuition Assistance Application

See full policies, deadlines and instructions on the Tuition Assistance Benefit.

Taxation

By law, some uses of the Tuition Assistance Benefit are taxed. Taxable tuition assistance will be subject to federal, state, and FICA (Social Security and Medicare) taxes. Taxable employees can expect these taxes to be deducted from their paychecks one to two months after their CU campus of registration’s census deadline.

Employee Services will notify taxable employees via email each semester. Learn more about the general taxation process by viewing our webinar on the Tuition Assistance Benefit Taxes website.

Guest contributor: Kayle Lingo, University of Colorado.

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How can you avoid losing excess vacation hours?

Employees with excess vacation hours should use them or donate them to leave banks before they are removed from their accounts during leave sweeps.

What are leave sweeps?

Leave sweeps remove University and Classified Staff excess vacation and/or sick leave hours, as required by state and university policies. The process helps to ensure employees use their hard-earned vacation hours, and allows them to confirm no errors occurred with their leave throughout the year.

Extra leave should be used by June 30

Excess hours will be removed from employees’ accounts after the July monthly payroll, so they should be used by June 30. Employees who are unable to use their leave by this deadline may donate their vacation time to a leave bank.

Each campus has its own leave sharing policy:

Vacation and sick leave limits

Leave limits vary based on whether an employee is University Staff, 12-Month Faculty or Classified Staff. They may maintain hours up to their limit but anything over is considered excess.

University Staff

University Staff and 12-Month Faculty have a limit of 352 vacation hours with no sick leave limit.

Classified Staff

Vacation hours

Maximum vacation hours are determined by length of service:

  • 1-5 years of service: 192 hours
  • 6-10 years of service: 240 hours
  • 11-15 years of service: 288 hours
  • 16+ years of service: 336 hours

Sick hours

Maximum sick leave is 360 hours and does not vary by length of service. However, if employees have 80 or fewer excess hours, 20% of them can be converted to vacation hours.

For example, 40 excess sick hours could be converted to 8 hours of vacation leave.

Learn more about leave policies

Please review University Staff leave policies or Classified Staff leave policies, and direct any questions to your campus Human Resources office.

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Cochrane US Network opens affiliate at CU Anschutz

The Cochrane US Network, made up of some of the country’s leading institutions in the research and practice of evidence-based medicine, announced Tuesday the opening of 11 new affiliates across the country including one at the University of Colorado Anschutz Medical Campus.

These new affiliates will join Cochrane’s 70 other groups around the world to promote evidence-informed decision making in health care by supporting and training systematic review authors and users of Cochrane Reviews, as well as working with clinicians, professional associations, policymakers, patients, health care provider organizations and the media to encourage the dissemination and use of Cochrane evidence.

Robert Dellavalle, MD, PhD, MSPH, professor of dermatology at the CU School of Medicine
Robert Dellavalle, MD, PhD, MSPH, professor of dermatology at the CU School of Medicine

“Cochrane is a leading evidence-based medicine organization, so it’s a very big deal to be a site that is tied to that effort,” said Robert Dellavalle, MD, PhD, MSPH, a professor of dermatology at the University of Colorado School of Medicine, who will lead the CU Anschutz affiliate. “Cochrane is known for having some of the best methodology for doing systematic review of evidence and they are highly cited in the field.”

The Cochrane US Network is made up of the existing Cochrane US West Associate Center based at Oregon Health & Science University; three Cochrane Review Groups producing systematic reviews in neonatal health, fertility regulation and urological conditions; three US satellites of Cochrane Review Groups focusing on eyes and vision, pregnancy and childbirth and musculoskeletal disease; one field specializing in complementary medicine. The 11 new affiliate institutions include:

  • AcademyHealth
  • American College of Physicians
  • Central Michigan University
  • Cornell University
  • Mayo Clinic Evidence-based Practice Center
  • Penn Medicine Center for Evidence-based Practice
  • RTI International – University of North Carolina Evidence-based Practice Center
  • Texas Christian University
  • University of Chicago Medicine
  • University of Colorado Anschutz Medical Campus
  • University of Maryland School of Medicine

Mark Wilson, Cochrane CEO, said: “I am delighted to see such a prestigious and committed group of US institutions and leaders in evidence-informed health care join Cochrane’s global family of collaborators.”

“Many of these researchers and clinicians are leaders in the field, and I am excited by the expertise, innovation and knowledge they will bring to our mission of delivering trusted evidence into health policy and clinical decision-making,” Wilson said. “The US health system is the largest and most sophisticated in the world, yet suffers from huge inequalities in health outcomes and tremendous wastefulness.”

Wilson believes a vibrant Cochrane Network promoting greater use of evidence showing what health interventions work and what don’t can make a real difference.

“I hope that this new – already extensive – network will grow further and welcome many more partners in the years to come,” he said.

These new Cochrane affiliates each have their own specific areas of expertise and focus. Collectively, the Network will focus on producing high quality evidence on priority topics for the US; providing training to systematic review authors and health care practitioners, policymakers and others in the interpretation of Cochrane Reviews. It will also raise the general awareness around Cochrane evidence to make well-informed health and health care decisions.  The new Network will build on the work of the former US Cochrane Center based at Johns Hopkins University.

“The establishment of the US Network is an important development for Cochrane as well as the health care community in the U.S.,” said Marguerite Koster, co-chair of the Cochrane Governing Board. “Coordination and collaboration are core values of the Network because we strongly believe we can add value by working together as a consortium. I very much look forward to the start of the network and to seeing it develop and grow as a platform for anyone interested in evidence-informed health and health care in the US.”

A formal launch of the new ‘Cochrane US Network’ was held today in Washington DC. During the launch meeting Cochrane CEO, Mark Wilson, and Governing Board co-chair, Marguerite Koster, introduced the US Network. Additionally, representatives from the Network will introduce their institutions and planned work, and speak to the value of being part of the Network.

The Cochrane US Network is part of Cochrane, a global independent network of researchers, professionals, patients, careers and people interested in health. Cochrane produces reviews which study all of the best available evidence generated through research and make it easier to inform decisions about health. Cochrane is a not-for profit organization with over 65,000 members and supporters from more than 130 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Cochrane’s work is recognized as representing an international gold standard for high quality, trusted information.

 

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