News

Schapmire receives national award for leadership in oncology social work

Tara Schapmire, Ph.D., M.S.S.W., of the University of Louisville’s Interdisciplinary Program for Palliative Care and Chronic Illness, today receives the Association of Oncology Social Work (AOSW)/American Cancer Society Leadership in Oncology Social Work Award for 2015. The national award recognizes an AOSW member for contributions to the field of oncology social work and leadership through administration, education, clinical practice or research.
Schapmire receives national award for leadership in oncology social work

Tara Schapmire, Ph.D., M.S.S.W.

 

Schapmire, an assistant professor at the University of Louisville School of Medicine and affiliated faculty member at the Kent School of Social Work, will receive the award and give remarks today at the AOSW Conference in Seattle.

Schapmire is co-investigator on a five-year, $1.5 million National Cancer Institute grant to create and evaluate an interdisciplinary oncology palliative care curriculum known as iCOPE (Interdisciplinary Curriculum in Oncology Palliative Care Education). The program is implemented across schools of social work, medicine, nursing and chaplaincy residency programs.

In addition to her work on iCOPE, Schapmire is a co-investigator on the $7.5 Million Kentucky LEADS Collaborative dedicated to reducing the burden of lung cancer in Kentucky through community-based interventions to educate providers and care for survivors, and the prevention and early detection of lung cancer.

As a practicing oncology social worker, Schapmire was responsible for securing grant funds to provide support for all aspects of psychosocial adjustment in all phases of the cancer experience by providing direct financial support, social support and teaching coping skills to patients and their families. She also created a palliative care program, support groups and provided continuing education for hospital employees in these areas.

“Dr. Schapmire’s work affirms UofL’s emphasis at addressing the comprehensive needs of cancer patients and their families through an interdisciplinary approach in treatment and education,” said Donald Miller, M.D., Ph.D., the director of the James Graham Brown Cancer Center.

“My nominators, and the committee who voted for me are all leaders in this field who equally deserve this award.  To be ‘lifted up’ and celebrated by these amazing people is especially meaningful,” Schapmire said.

Scientists meet in Louisville to share research that could lead to improved treatments for spinal cord and head injury

Scientists meet in Louisville to share research that could lead to improved treatments for spinal cord and head injury

The second participant to receive an epidural stimulator as part of the investigation of standing, stepping and voluntary control in individuals with complete spinal cord injury.

More than a dozen leading basic scientists from around the nation and the world studying neurological function will make presentations to 160 fellow researchers in Louisville Wednesday and Thursday. The goal is to facilitate collaborations that will advance science leading to improved spinal cord and head injury rehabilitation.

Scientists from Sweden, Canada and the United States will share their latest neurotrauma research at the 21st Annual Kentucky Spinal Cord & Head Injury Research Trust Symposium.

The symposium, sponsored by Kentucky Spinal Cord and Head Injury Research Trust, Kentucky Spinal Cord Injury Research Center, KentuckyOne Health, Craig H. Neilsen Foundation and University of Louisville School of Medicine, is organized to advance the study of neurotrauma and ultimately lead to methods of restoring function to those with spinal cord and head injuries.

Among those speaking are Abdel El Manira, Ph.D., and Tatiana Deliagina, Ph.D., of the Karolinska Institute in Sweden, and Paul Kubes, Ph.D. and Christopher Power, M.D., F.R.C.P.C. of Canada. El Manira will discuss his research into locomotor circuits in zebrafish. His research shows that neuron groups are selectively wired for slow, intermediate or fast movement, and the fish’s nervous system selects distinct motoneurons for different swimming speeds.

Deliagina will discuss her work studying feedback mode of postural control in quadrupeds. Loss of postural control is one of the major motor disorders following spinal cord injury. Marc Freeman, Ph.D. of the University of Massachusetts Medical School will present the keynote address on the cellular and molecular mechanisms of nerve degeneration.

This work is similar to basic science research that led to the groundbreaking clinical studies, done at the University of Louisville and Frazier Rehab Institute, in which stimulators were transplanted into spinal cord injured patients who subsequently gained the ability for volitional movement in their legs (see the patient photo below).

The event will be held May 20-21, 2015 at the Louisville Marriott Downtown, 280 W. Jefferson St. Hours are 8 a.m. - 5 p.m. Wednesday and 8 a.m. - 3:30 p.m. Thursday.

The UofL Kentucky Spinal Cord Injury Research Center is dedicated to developing successful spinal cord repair strategies in the laboratory that can be taken to the clinic in a timely and responsible fashion.

Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders created at UofL

Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders created at UofL

Dean Toni Ganzel, M.D.

Strengthening the provision of clinical care to patients and education and training to future physicians is an ongoing goal of the University of Louisville School of Medicine. The UofL Board of Trustees approved action in furthering that goal on Thursday (May 14) by establishing the Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, elevating the program from two divisions within the Department of Surgery.

Otolaryngology – also sometimes known as otorhinolaryngology – is the oldest medical specialty in the United States, according to the American Association of Otolaryngology-Head and Neck Surgery. Otolaryngologists are physicians trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT) and related structures of the head and neck. They are commonly referred to as ENT physicians.

The Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders is one of 23 departments – 18 clinical and five basic science – comprising the School of Medicine. At UofL, board-certified otolaryngologists practice with University of Louisville Physicians-Ear, Nose & Throat.

“Elevating the otolaryngology and communicative disorders divisions to departmental status puts UofL on par with other such programs at medical schools throughout the United States and reflects the growth of the UofL program,” said Toni Ganzel, M.D., dean of the UofL School of Medicine. “It further demonstrates the value of the program to the School of Medicine and the university.”

“Creation of this department will provide the opportunity for continued growth and expansion of the services provided in Otolaryngology and Communicative Disorders,” said Kelly McMasters, M.D., Ph.D., the Ben A. Reid, Sr., M.D. Professor and Chair, Department of Surgery. “By establishing autonomy for this department, UofL will be able to increase the focus on the specific needs of this subspecialty in education, research and clinical care.”

Diane Harper, M.D., M.P.H., M.S., chosen for executive program

UofL department chair and researcher is the 17th member of UofL faculty selected for ELAM
Diane Harper, M.D., M.P.H., M.S., chosen for executive program

Diane Harper, M.D., M.P.H., M.S.

University of Louisville Family and Geriatric Medicine Chair Diane M. Harper, M.D., M.P.H., M.S., has been selected as a member of the 2015-2016 class of the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program. Harper is one of only 54 women in the nation selected for the program.

ELAM is a year-long fellowship for women faculty in schools of medicine, dentistry and public health. The program develops professional and personal skills required for leadership and management in health care. More than 800 ELAM alumnae hold leadership positions in institutions around the world.

Harper was named the Rowntree Endowed Chair and professor in the Department of Family and Geriatric Medicine at the UofL School of Medicine in 2013. She is an award-winning clinician, educator and researcher with a background in family medicine, obstetrics and gynecology, epidemiology and biostatistics, as well as chemical engineering.

Harper was the U.S. principal investigator who designed the global trials to understand the efficacy of both of the prophylactic human papillomavirus (HPV) vaccines to control cervical cancer. She was a lead author in multiple Lancet publications,New England Journal of Medicine and JAMA, and co-author of more than 140 additional articles on cervical cancer prevention. She also has consulted for and published with the World Health Organization on the use of prophylactic HPV vaccines. Harper is a member of the NIH’s Population Sciences and Epidemiology Integrated Review Group of the Epidemiology of Cancer Study Section, as well as the Center for Disease Control and Prevention’s Special Emphasis Panel on HPV Vaccine Impact among Men who have Sex with Men (MSM) and Serosorting and Other Seroadaptive Behaviors Among Men Who Have Sex With Men (MSM) in the US.

In ELAM’s 20-year history, 16 faculty members from UofL have completed the fellowship, including UofL School of Medicine Dean, Toni M. Ganzel, M.D., M.B.A., who participated in 2003-2004.

For more information on the ELAM program, visit the program’s website. A complete list of UofL’s ELAM alumnae is included below.

 

The Hedwig van Ameringen Executive Leadership in Academic Medicine® (ELAM®) Program

University of Louisville Alumnae

 

Lourdes C. Corman, M.D. (1996-1997)

Professor and Vice Chair of Medicine

Chief, Division of Medical Education

University of Louisville School of Medicine

 

Laura F. Schweitzer, Ph.D. (1998-1999)

Professor, Department of Anatomical Sciences and Neurobiology

Associate Dean of Faculty Affairs

Associate Dean of Student Affairs

University of Louisville School of Medicine

 

Linda F. Lucas, M.D. (1999-2000)

Associate Professor of Anesthesiology

University of Louisville School of Medicine

Director, One Day Surgery

University of Louisville Hospital

 

Barbara J. McLaughlin, Ph.D. (2000-2001)

Professor of Ophthalmology

Associate Dean for Research

University of Louisville School of Medicine

 

Connie L. Drisko, DDS (2001-2002)

Professor of Periodontics

Assistant Dean for Research

University of Louisville School of Dentistry

 

Susan Galandiuk, M.D. (2001-2002)

Professor of Surgery

University of Louisville School of Medicine

 

Mary Thoesen Coleman, M.D., Ph.D. (2002-2003)

Associate Professor of Family and Community Medicine

Vice Chair for Clinical Affairs, Department of Family and Community Medicine

University of Louisville School of Medicine

 

Toni M. Ganzel, M.D., M.B.A. (2003-2004)

Interim Dean, School of Medicine

Professor of Surgery, and Otolaryngology

University of Louisville School of Medicine

 

V. Faye Jones, M.D., Ph.D., M.S.P.H. (2007-2008)

Associate Dean for Academic Affairs

Professor of Pediatrics

University of Louisville School of Medicine

 

Kathy B. Baumgartner, Ph.D. (2008-2009)

Associate Professor of Epidemiology and Population Health

University of Louisville School of Public Health and Information Sciences

 

Melanie R. Peterson, D.M.D., M.B.A. (2008-2009)

Associate Professor of Dentistry

University of Louisville School of Dentistry

 

Anees B. Chagpar, M.D., M.Sc., M.P.H. (2009-2010)

Academic Advisory Dean, School of Medicine

Director, Multidisciplinary Breast Program

Associate Professor of Surgery

University of Louisville School of Medicine

 

Jill Suttles, Ph.D. (2010-2011)

Professor of Microbiology and Immunology

University of Louisville School of Medicine

 

Kelli Bullard Dunn, M.D. (2012-2013)

Professor of Surgery

University of Louisville School of Medicine

 

Sharmila Makhija, M.D., M.B.A. (2012-2013)

Chair, Department of Obstetrics, Gynecology and Women's Health

Donald E. Baxter Endowed Chair in Obstetrics and Gynecology

Professor of Gynecologic Oncology

University of Louisville School of Medicine

 

M. Ann Shaw, M.D. (2013-2014)

Associate Dean for Medical Education

Academic Advisory Dean

Professor of Medicine

University of Louisville School of Medicine

UofL pediatrician part of national study reported in New England Journal of Medicine

Therapeutic hypothermia doesn’t improve results in children who suffer heart attacks
UofL pediatrician part of national study reported in New England Journal of Medicine

Melissa Porter, M.D.

Dropping a child’s body temperature following a heart attack does not appear to improve the child’s chance of surviving or their heart function one year after the heart attack, reports a team of physicians including Melissa B. Porter, M.D., an associate professor in the University of Louisville Department of Pediatrics.

The study is in tomorrow’s edition of the New England Journal of Medicine. Porter was the principal investigator for the Louisville portion of the national clinical trial. The two participants included in the local portion of the study were seen by Porter at Kosair Children’s Hospital, where she serves as a pediatric intensivist.

While therapeutic hypothermia is recommended for comatose adults after such events, there was limited data about this intervention in children. The study, funded by the National Institutes of Health, compared data for children who were treated with therapeutic hypothermia with those treated with the existing standard of care. The researchers concluded that therapeutic hypothermia did not offer significant benefit for the children’s survival and functional outcome at one year.

“It was a privilege to work with the team of physicians on this study,” Porter said. “It is gratifying to be a part of such wide-ranging research and to contribute to the improved standard of care for children with serious illnesses and speaks highly of the research practices here at UofL.”

This is the second large-scale, multi-center study involving UofL physicians published in the New England Journal of Medicine this spring, attesting to their increasing status among medical research centers nationwide.

In an earlier study, published March 5, 2015 in the journal, Charles R. Woods, M.D., a pediatric infectious disease specialist and acting chair of the UofL Department of Pediatrics, participated in a randomized, placebo-controlled trial of Valganciclovir therapy in newborns with symptomatic congenital cytomegalovirus (CMV) disease.

CMV is the leading nongenetic cause of sensorineural hearing loss. Woods tested patients at Kosair Children’s Hospital over a three-year period, comparing a six-week period of treatment with the drug to six-month treatment. The researchers concluded that treatment with the drug for six months provided modest long-term improvements in hearing and development over the six-week treatment.

“This study of Valganciclovir showed that the drug improves hearing in infants with symptomatic congenital cytomegalovirus (CMV) infection,” Woods said. “This also opens the door for more studies to see if this drug can help a broader group of infants with congenital CMV infection.”

University of Louisville physicians have long been at the forefront of pediatric medicine in Kentucky, providing state-of-the-art patient care at Kosair Children’s Hospital in addition to teaching and conducting research. Participation in studies such as these is an indication that their reputation for quality research is increasing among academic centers across the nation.

“Our contribution to these studies represents UofL’s growing connection and impact at the national level in research that improves health care for children,” Woods said. “UofL Pediatrics faculty members are becoming more widely recognized for quality research and contribution to medical knowledge.”

To read the NEJM articles, go to:

Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest in Children
http://www.nejm.org/doi/full/10.1056/NEJMoa1411480

Valganciclovir for Symptomatic Congenital Cytomegalovirus Disease
http://www.nejm.org/doi/full/10.1056/NEJMoa1404599

Symposium on heart disease in women to showcase healthy lifestyle and stress reduction programs

Symposium on heart disease in women to showcase healthy lifestyle and stress reduction programs

Kendra Grubb, M.D.

Cooking, exercise, acupuncture, yoga and tai chi demos, chair massages and more will help the community learn to reduce stress and improve heart health at the 2015 Louisville Symposium on Heart Disease in Women: Case Studies from the Heart of Louisville on Saturday, May 16.

The symposium is designed to provide the community, physicians, nurses and health professionals up-to-date information on the prevention, diagnosis and treatment of cardiovascular disease in women.

The event will be held from 8 a.m. until 5 p.m. at the Jewish Hospital Rudd Heart & Lung Center, part of KentuckyOne Health, in the Hank Wagner Conference Center, located on the top floor. Registration begins at 7 a.m.

In addition to presentations, case studies and panel discussions from leading experts, attendees can participate in a coping skills training session and learn about basic tenants and food prep for a heart-healthy Mediterranean diet used in the Ornish Program for Reducing Heart Disease.

The event is co-directed by Kendra Grubb, M.D., cardiovascular surgeon with University of Louisville Physicians, director of minimally invasive cardiac surgery for the University of Louisville at Jewish Hospital, and assistant professor at the University of Louisville School of Medicine, and Lorrel Brown, M.D., a cardiologist with University of Louisville Physicians, associate director of the Cardiovascular Medicine Fellowship and assistant professor at the University of Louisville School of Medicine.

“Heart disease can be prevented and, in some cases, even reversed through healthy lifestyle choices focusing on diet, exercise and stress reduction,” said Grubb. “In addition to case studies on treatment, the symposium will have a plethora of opportunities for learning about the latest recommendations and tools for heart disease prevention.”

Many of the wellness demos will be presented by staff from the KentuckyOne Health Healthy Lifestyle Centers, which offer cardiac rehab, medically supervised exercise, nutrition counseling, stress management and more to help individuals get healthy and stay well.

Admission is free to students, residents and fellows and $25 for community members. Continuing medical education credits are available for physicians ($100) and allied health professionals/nurses ($50). Registration is available at: louisvilleheartdiseasewomen.com or call 502.588.7600.


Twisted Pink donates $100,000 to UofL’s James Graham Brown Cancer Center

Twisted Pink donates $100,000 to UofL’s James Graham Brown Cancer Center

Twisted Pink presents check to James Graham Brown Cancer Center

Twisted Pink, a charitable foundation dedicated to funding research to prevent and cure metastatic breast cancer, presented a check for $100,000 to the University of Louisville’s James Graham Brown Cancer Center on May 7. The funds will be used to seek improved survival for those diagnosed with stage IV breast cancer. Metastatic breast cancer is cancer that has spread from the breast to another part of the body.

The presentation included, left to right, Haval Shirwan, Ph.D., Nicola Garbett, Ph.D. and Paula Bates, Ph.D. of UofL, Constanze Coon, Ph.D., Lara MacGregor and Caroline Johnson of Twisted Pink, and UofL’s Beth Riley, M.D., Yoannis Imbert-Fernandez, Ph.D., Jason Chesney, M.D., Ph.D. and Brian Clem, Ph.D.

University of Louisville, KentuckyOne Health become presenting partners of SOAR

University of Louisville, KentuckyOne Health become presenting partners of SOAR

The University of Louisville and KentuckyOne Health are delivering on their promise of working to make Kentucky a healthier place through a new partnership with Shaping Our Appalachian Region (SOAR).

UofL and KentuckyOne Health have agreed to become presenting partners of SOAR, providing more than $300,000 in support over the next three years.

SOAR was established in 2013 by Gov. Steve Beshear and Rep.  Hal Rogers and is designed to marshal the collective talents and energies of eastern Kentucky communities and citizens to address the most significant challenges confronting Appalachian Kentucky.

“At the University of Louisville, we have a public mandate to improve the lives of the people of Kentucky,” said UofL President James Ramsey. “Working with SOAR is a significant opportunity for us to partner with others throughout the state to achieve that mandate in a region of the Commonwealth that needs the most assistance.”

“We look forward to working with Gov. Beshear, Rep. Rogers and all who are associated with SOAR as we explore how best to meet the challenges of the region in terms of health, economics and general well-being,” said David L. Dunn, M.D., Ph.D., UofL executive vice president for health affairs. “We have worked with leaders in the region on individual projects to alleviate some of the immediate needs, especially in health care. But this is an opportunity to provide lasting solutions.”

“KentuckyOne Health facilities, physicians and care providers have a deep history serving the Appalachian region. Through our hospitals and clinics in Martin, Berea, Mount Sterling and London we are closely tied to the unique health challenges and barriers to care,” said Ruth Brinkley, president and CEO of KentuckyOne Health. “Through our relationship with UofL, now by partnering together with SOAR, we will expand our collaboration with Appalachian communities, utilizing the breadth of our patient services, wellness programs and community resources to truly make a difference.”

UofL and KentuckyOne Health entered into a partnership in 2012 with the mission of creating a healthier population and attacking some of the chronic health problems faced by the citizens of Kentucky. Together they are the largest health system in the Commonwealth of Kentucky.

“If we are to begin to resolve the health issues that the people of the Commonwealth face, everyone must work together,” Beshear said. “It is gratifying to see that two organizations with the stated purpose of improving the lives of people in Kentucky are taking leadership roles in the development of these critical partnerships.”

UofL and KentuckyOne Health already have significant efforts underway in the region. UofL for years has worked with Dataseam to utilize downtime on computers in schools in the region to create a supercomputer grid to speed the design process of potential anti-cancer drugs, while at the same time bringing those computers to the schools. Additionally, UofL has been very active in Remote Area Medicine programs in the region. These programs bring health care providers to underserved areas for large-scale clinics so people are able to receive care not otherwise available. Through the utilization of telemedicine, UofL neurologists have for years been assisting rural physicians with the diagnosis and treatment of strokes. UofL pediatricians are situated throughout the state, helping to fill the gaps in underserved areas.

For nearly 20 years, KentuckyOne Health facilities in Appalachia and surrounding communities have led a community-based program to provide home visits for patients following hospital discharge. Today, the Appalachian Outreach program covers 15 counties in eastern Kentucky, making contacts with more than 12,000 individuals each year. This regionally focused program provides a range of wellness support to help patients, caregivers and their families better understand their health and better manage their ongoing health and well-being.

Targeting health conditions with greatest prevalence in the region, KentuckyOne Health’s Saint Joseph Martin provides focused programs to fight prominent health conditions, notably cancer, diabetes and heart disease. Community programs include smoking prevention and cessation initiatives with local schools, a diabetes management program with Floyd County Health Department and community health fairs to check for heart disease risk factors.

“For years, both of these organizations have been supporting efforts to improve the lives of people in the region,” Rogers said. “Having them join with us so that we can hopefully multiply their individual efforts will only make the region stronger in the future.”

Get straight talk on climate change at the next Beer with a Scientist program

So, is it real or not?
Get straight talk on climate change at the next Beer with a Scientist program

Keith R. Mountain Ph.D.

The severity of climate change as a global issue and whether humans are causing climate shifts have been hotly debated among individuals and politicians in recent years. At the next Beer with a Scientist event, a UofL scientist will discuss the science behind the issue.

Keith R. Mountain, Ph.D., chair and associate professor of the University of Louisville Department of Geography and Geosciences, will address the question, "Climate change: What's the problem and is it even real?"

Mountain’s research interests and expertise center on climatology and climate change, radiative and surface energy balances, geomorphology – the study of the evolution and configuration of landforms – glaciology and Arctic and Alpine environments.

The program begins at 8 p.m. at Against the Grain Brewery, 401 E. Main St. on Wednesday, May 13. A 30-minute presentation will be followed by an informal Q&A session.

The Beer with a Scientist program began in 2014 and is the brainchild of UofL cancer researcher Levi Beverly, Ph.D. Once a month, the public is invited to enjoy exactly what the title promises: beer and science.

Admission is free. Purchase of beer, other beverages or menu items is not required but is encouraged.

Organizers add that they also encourage Beer with a Scientist patrons to drink responsibly.

For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook.

Medical students pound the pavement for pediatric patients

Runners presented Derby Festival Marathon and miniMarathon medals to young buddies
Medical students pound the pavement for pediatric patients

UofL Medical Student David Duncan, left, ran for Sebastian Edelen, center

For the past seven years, University of Louisville medical students have run in the Kentucky Derby Festival miniMarathon or Marathon in honor of patients with cancer and blood disorders in the university’s pediatric hematology/oncology division. This year’s runners presented their race medals to their young buddies in a special ceremony following the races on April 25 in the lobby of the Kosair Charities Clinical & Translational Research Building.

“It’s an opportunity to share yourself and your time. In doing so, you create a bond with a patient and gain a better understanding of what they go through,” said McKenzie Vater, a third-year medical student who has participated in the event for the past three years. “I train with them in mind to get through 13.1 miles of road knowing they are running a much more difficult race of their own.”

Medals4Mettle (M4M) distributes race medals earned by distance athletes to critically ill patients across the nation who are running a race of a different kind – a race for their lives. The UofL School of Medicine program is unique in that the students have the opportunity to meet with their buddies prior to the race and personally present their medals to them after running. The students often run for the same patient year after year, developing a special relationship between the students and the patients and their families.

Evan Hendricks was one of 71 UofL medical students matched with young patients for this year’s race. He ran for a little girl named Katie.

“We met three or four times and it was something I would look forward to and I hoped she would, too,” Hendricks said at the presentation ceremony. “I hope to give her some comfort and let her know that even people who don’t know you want you to do well.”

“I think this is important because it supports many of the children that are diagnosed with cancer,” said Chase Weaver, a young buddy who spoke at the presentation. “Instead of sitting in a hospital bed, they should be out playing. They should have the opportunity to get out and have fun instead of sitting in a hospital bed with IVs stuck in their arms and fingers.”

Gerard Rabalais, M.D., M.H.A., chair of the department of pediatrics at UofL, thanked the parents of the children for allowing them to participate with the medical students.

“There is far more to becoming a physician than learning from a book, studying and looking in a microscope. This is a chance for the students to see illness through a patient’s and family’s eyes. The availability of your children to partner with them, for them to get to know you and your family and to know that child, is such a special thing.”

 

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About Medals4Mettle

Medals4Mettle is an international public charity that arranges for medals donated by athletes completing distance events to be awarded to children and adults who are battling illness in hospitals around the world. Medals4Mettle has over 70 international chapters and has awarded over 40,000 medals since 2005.

Psychiatrist recognized for work on worldview in clinical psychiatry

Allan Josephson, M.D., to receive the Oskar Pfister Award from the American Psychiatric Association
Psychiatrist recognized for work on worldview in clinical psychiatry

Allan Josephson, M.D.

In recognition of his work on understanding the importance of both the patient’s and the clinician’s worldview in clinical psychiatry, Allan Josephson, M.D., chief of child and adolescent psychiatry and psychology in the University of Louisville Department of Pediatrics, will be the 2015 recipient of the Oskar Pfister Award from the American Psychiatric Association.

This award recognizes individuals who have made professional contributions to the interfaces of psychiatry, religion and spirituality in research and clinical practice.

"The Department of Pediatrics is honored to have Dr. Josephson leading our Division of Pediatric Psychiatry and Psychology,” said Charles Woods, M.D., interim chair of the UofL Department of Pediatrics. “This award recognizes his longstanding personal efforts and excellence in advancing the quality of mental health services for children and families both in the Louisville area and nationally."

For more than a decade, Josephson coordinated workshops, symposia and lectures on religion, spirituality and psychiatry at the annual meetings of the American Psychiatric Association. These events resulted in several publications, including the “Handbook of Spirituality and Worldview in Clinical Practice,” co-edited by Josephson and John Peteet, M.D., of Harvard Medical School. The work is now used in the teaching programs of many psychiatry residencies throughout the country.

“Are there people who come in to a psychiatrist’s office who really have spiritual issues, concerns about life in a broader context? We think there are,” Josephson said. “What we tried to do is bring these ideas in front of the psychiatric community. Some of my work and that of others has been directed toward helping psychiatrists say this may be an important part of your patient’s life.”

Josephson will receive the award at the annual meeting of the American Psychiatric Association in Toronto May 16-20, and will deliver the 33rd Oskar Pfister Lecture in New York in October at the American Psychiatric Association’s Institute of Psychiatric Services meeting.

 

About the award:

Oskar Pfister was a Protestant minister who regularly corresponded with Sigmund Freud on matters of psychiatry and religion. Award recipients are selected by representatives of the American Psychiatric Association, the Caucus on Religion and Psychiatry and the Association of Professional Chaplains.

Celebrating survivorship

Beshears and Luallen lead slate of speakers at April 30 Cancer Survivors Celebration
Celebrating survivorship

UofL President James R. Ramsey, second from right, is shown with survivors of cancer at the 2014 Cancer Survivors Celebration. The 2015 event will be April 30 at 3 p.m. at the Kosair Charities Clinical and Translational Research building.

People who have survived cancer and their loved ones and caregivers will again gather at the University of Louisville for celebration, inspiration and support at the annual Cancer Survivors Celebration. The event is set for 3 p.m., Thursday, April 30, at UofL’s Kosair Charities Clinical and Translational Research building, 505 S. Hancock St.

Traditionally held on the Thursday before the Kentucky Derby, it has become a highlight of the Derby Season, and attendees are invited to dress in their Derby finery. The event is sponsored by the Kentucky Cancer Program at UofL (KCP) and UofL’s James Graham Brown Cancer Center, a part of KentuckyOne Health.

Joining the event this year will be Gov. Steve Beshear, First Lady Jane Beshear and Lt. Gov. Crit Luallen. Also speaking will be UofL President James R. Ramsey and James Graham Brown Cancer Center Director Donald M. Miller, M.D., Ph.D.

“All Louisville comes together at this time of year to celebrate the traditions and pageantry of the Kentucky Derby with the world,” Ramsey said. “And we come together at the James Graham Brown Cancer Center to celebrate everyone who has faced cancer. This event is a celebration of every person who has walked through our doors.”

“This is our opportunity to celebrate the courage of our patients,” Miller said. “I am always so moved every year when see the growing number of survivors and their loved ones at this event. Their victories over cancer are why we come to work every day.”

“Each year, we dedicate time for cancer survivors to celebrate and enjoy a day of food, fun and fellowship,” said organizer Pam Temple-Jennings of the KCP. “This year, we will feature a raffle for tickets to the Kentucky Derby Festival’s Pegasus Parade and entertainment from Turner’s Circus. We also are so pleased that Gov. and Mrs. Beshear, Lt. Gov. Luallen, President Ramsey and Dr. Miller will be joining us once again.”

The Pegasus Parade will be held shortly after the survivor celebration, beginning at 5 p.m. The parade route traverses Broadway and is an easy two-block walk from the survivor celebration.

Turner’s Circus is an aerial, Cirque-du-Soleil-like troupe that incorporates gymnastics, dance and aerial acrobatics into performances set to music.

For additional information, contact the KCP at 502-852-6318 or pam.templejennings@louisville.edu.

 

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UofL awarded $3 million to speed technologies to market

NIH grant matched with another $3.1 million to commercialize research
UofL awarded $3 million to speed technologies to market

Paula Bates, Ph.D.

The University of Louisville announced April 22 that a grant from the National Institutes of Health will combine with matching funds from the university to create a new $6.1 million initiative to commercialize discoveries made by UofL researchers.

UofL is one of just three institutions in the United States selected as a Research Evaluation and Commercialization Hub (REACH) by the NIH. The REACH award consists of $3 million over three years matched by an additional $3.1 million from UofL.

“The funding from the REACH grant significantly advances UofL’s ability to bridge the gap between a great idea and the marketplace,” said UofL President James R. Ramsey in announcing the award. “The university will continue to supply a robust pipeline of diverse technologies and other discoveries along with the infrastructure and expertise required for translational research. The REACH grant will provide additional resources needed to bring that research to market.”

“This award illustrates the success UofL is witnessing in its mission to become a premiere metropolitan research university,” said William M. Pierce Jr., executive vice president for research and innovation. “We know it is not enough only to make great discoveries; we must find ways to bring those discoveries to the marketplace where they will benefit the people of our city, state and beyond. This grant provides significant support to do so.”

Executive Vice President for Health Affairs David L. Dunn, M.D., Ph.D., said the work that the grant supports is a natural outgrowth of UofL’s already demonstrated success in research. “UofL’s commitment to invest in talent and infrastructure already has paid dividends in translational research. UofL research that has led to new discoveries includes a first-in-class anticancer drug, a method to prevent organ transplant rejection, a treatment that can reverse damage caused by heart attack and a protocol that allows people with spinal cord injury to regain voluntary movement of their once paralyzed limbs. The REACH funding will enable us to translate even more of these types of new discoveries to the market.”

About the Research Evaluation and Commercialization Hub grant

The REACH grant will create UofL’s “ExCITE Hub” – reflecting its function to “Expedite Commercialization, Innovation, Translation and Entrepreneurship” to increase the success rate and speed at which biomedical research is translated into products that bring a positive impact on health.

The ExCITE Hub has three major aims:

  1. Identify the most promising technologies from UofL researchers and provide funding for product definition studies;
  2. Promote the commercialization of selected products; and,
  3. Expand education, experiential and networking opportunities for stakeholders such as researchers, other faculty, students and others within the university.

Paula J. Bates, Ph.D., is principal investigator on the grant and will direct the ExCITE Hub program. Bates is an associate professor in UofL’s Department of Medicine and a researcher with the James Graham Brown Cancer Center. Eugene Krentsel, Ph.D., acting director of UofL’s Office of Industry Engagement, and Donald Miller, M.D., Ph.D., director of the cancer center, will serve as co-principal investigators for the program. A team of faculty entrepreneurs and technology transfer professionals also will support the mission of the hub.

“We have given the ExCITE Hub a structure that will overcome the obstacles that can impede translating research from the research bench to the marketplace,” she said. “This structure comprises five innovative features, working in concert, that make the ExCITE Hub genuinely one-of-a-kind in the field of research commercialization.”

Those features are:

  • The ExCITE Hub is a geographically focused program to expedite operations and maximize the impact on the local ecosystem.
  • An innovative governance structure has been developed to integrate achievement of the three aims of the program and “avoid the creation of silos,” Bates said.
  • The program will proactively integrate education into the approach to continue to foster an entrepreneurial spirit in research.
  • A technology development grant program in the ExCITE Hub will provide mentored direction and provide for early and continued interaction among scientists, technology transfer staff and industry consultants.
  • Emphasis will be placed on consciously improving academia-industry relationships by increasing opportunities for mutual understanding, ensuring a robust technology pipeline and responding quickly to industry needs.

The NIH selected UofL along with the University of Minnesota, Minneapolis and the Long Island (N.Y.) Bioscience Hub, a consortium of Stony Brook University, Cold Spring Harbor Laboratory and Brookhaven National Laboratory, as the three recipients of REACH funding.

REACH is based on an initiative created by the NIH’s National Heart, Lung, and Blood Institute called the NIH Centers for Accelerated Innovations. The program is a public-private partnership whose objective is to change how to identify and develop innovations with scientific and commercial potential. The effort utilizes industry-style project management to determine technologies that are poised to have the greatest potential to launch into the marketplace.

University of Louisville physicians host symposium on heart disease in women

University of Louisville physicians host symposium on heart disease in women

Two of Louisville’s leading heart physicians will host a one-day symposium designed to provide the community, physicians, nurses and health professionals up-to-date information on the prevention, diagnosis and treatment of cardiovascular disease in women. The 2015 Louisville Symposium on Heart Disease in Women: Case Studies from the Heart of Louisville, will take place Saturday, May 16, 2015 and is open to the public.

The event, co-directed by Kendra Grubb, M.D., cardiovascular surgeon with University of Louisville Physicians, director of minimally invasive cardiac surgery for the University of Louisville at Jewish Hospital, and assistant professor at the University of Louisville School of Medicine, and Lorrel Brown, M.D., a cardiologist with University of Louisville Physicians, associate director of the Cardiovascular Medicine Fellowship and assistant professor at the University of Louisville School of Medicine,will feature presentations, case studies and panel discussions from leading experts.

“Cardiovascular disease is often viewed as a ‘man’s disease’ but the fact is, it kills more women than men each year,” Grubb said. “This symposium will offer case-based perspectives from top physicians on the best strategies for prevention and treatment of cardiovascular disease in women.”

The keynote address – “The One Minute Mindset” – will be given by Haley Perlus, Ph.D., peak performance consultant, author, international speaker, professor and industry leader in the psychology of helping people perform their best. Perlus is a known as a success coach with clients including members of the U.S., Canada and Australian national teams, NCAA athletes and more.

"We are excited to have Dr. Perlus as our keynote speaker,” Brown said. “Not only is she an expert in sport and exercise physiology, she also is a world-class Alpine skier. With her emphasis on translating the principles of top athletes into healthy living principles for everyday life, Dr. Perlus is a fantastic addition to our symposium this year."

The event will be held from 8 a.m. until 5 p.m. at the Jewish Hospital Rudd Heart & Lung Center, part of KentuckyOne Health, in the Hank Wagner Conference Center, located on the top floor.

Admission is free to students, residents and fellows and $25 for community members. Continuing medical education credits are available for physicians ($100) and allied health professionals/nurses ($50). Registration is available at: louisvilleheartdiseasewomen.com/.

Topics will include emerging controversies in cardiovascular disease and treatments; current guidelines in the medical management of heart disease in women; cardiac risk factors in women and opportunities for implementing new prevention strategies; trends, treatments and intervention strategies of cardiovascular disease in women; the differences in risk, presentation, diagnosis, and treatment for women with atrial fibrillation; emerging data in support of specific medical recommendations and surgical procedures in management of heart disease; emerging novel approaches and strategies to treating heart, vascular and valve conditions; and utilization of surgical techniques in the treatment of heart disease in women.

About KentuckyOne Health

KentuckyOne Health, the largest and most comprehensive health system in the Commonwealth, has more than 200 locations including, hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies in Kentucky and southern Indiana. KentuckyOne Health is dedicated to bringing wellness, healing and hope to all, including the underserved.  The system is made up of the former Jewish Hospital & St. Mary’s HealthCare and Saint Joseph Health System, along with the University of Louisville Hospital and James Graham Brown Cancer Center. KentuckyOne Health is proud of and strengthened by its Catholic, Jewish and academic heritages.

Children with neurological disorders need flu vaccine but don’t always get it

UofL-led article published April 9 shows vaccination rate on par with those without disorders despite high risk
Children with neurological disorders need flu vaccine but don’t always get it

Michael J. Smith, M.D.

Children who have neurological disorders such as cerebral palsy or epilepsy are no more likely to be vaccinated against influenza than youngsters without these conditions, despite the increased risk for complications from flu these children experience. Moreover, health care providers may not be familiar with the increased risk among these patients to effectively recommend influenza vaccine.

Those are the findings of a study by a research team from the University of Louisville and the Centers for Disease Control and Prevention published online April 9 in the journal Vaccine.

Michael J. Smith, M.D., is an associate professor in the UofL Department of Pediatrics and pediatric infectious disease specialist with University of Louisville Physicians. Smith is lead author of the study that is the first to estimate the rates of flu vaccination among children with neurological or neurodevelopmental disorders (NNDDs).

“Our research shows that influenza vaccination in children with NNDDs is comparable to vaccination in healthy children – but both rates are suboptimal,” Smith said. “More education about the need for annual influenza vaccination is needed, both for parents and health care providers.”

Overall, 2,138 surveys were completed by parents of children with at least one high-risk condition of any kind. Of these, 1,143 were completed by parents of children with at least one NNDD and 516 by parents of children with more than one NNDD. In the survey of providers, 412 physicians participated. The researchers worked with Family Voices, a national advocacy group for children with special health care needs, and the American Academy of Pediatrics to recruit survey participants in all 50 states and the District of Columbia.

Overall, 47 percent of parents reported that their children had received or were scheduled to receive seasonal flu vaccine; among the group of NNDD parents, the rate was only slightly higher at 50 percent.

The major driver to have a child vaccinated was not the presence of an NNDD, however, but the presence of a chronic respiratory condition, although several studies show that children with NNDDs are at increased risk of complications from flu. According to a 2013 study in the journal Pediatrics, one-third of reported pediatric influenza-related deaths between 2004 and 2012 in the United States occurred in children with NNDDs.

“The reasons for the increased severity of influenza among these children are uncertain,” Smith said. “We do know, however, that an NNDD, intellectual disability, was the most common NNDD associated with pediatric deaths during the 2009 H1N1 flu pandemic. A better understanding of the attitudes, beliefs and behaviors that influence flu vaccination of children with NNDDs such as intellectual disability is needed.”

Parents who did not vaccinate their children were asked why. More than one-third of the 1,140 respondents – 38 percent – said they had concerns about how the vaccine would affect their child. Another 32 percent expressed concerns about the safety of the vaccine.

Among the 412 physicians who participated, 74 percent recognized that children with another NNDD, cerebral palsy, were at higher risk from flu but other NNDDs were not so highly recognized as posing risk: epilepsy at 51 percent and intellectual disability at 46 percent.

Conducting the research with Smith were Georgina Peacock, M.D., and Cynthia Moore, M.D., Ph.D., of the CDC’s National Center on Birth Defects and Developmental Disabilities and Timothy Uyeki, M.D., of the Influenza Division of the CDC’s National Center for Immunization and Respiratory Diseases.

Updates in autism to be discussed April 16

UofL child psychiatrists will cover recent advances in understanding autism

Parents of children who are on the autism spectrum will have the opportunity to learn about recent advances in understanding the causes and detecting signs of the condition from a University of Louisville psychiatrist and a child psychiatry fellow on April 16. The physicians also will discuss updates in the treatment of autism.

“Autism 2015:  Updates and Roadmaps for Hope” will be presented by W. David Lohr, M.D. and Allison Yoder, M.D., on Thursday, April 16 at 7 p.m. at Second Presbyterian Church, 3701 Old Brownsboro Road. Admission is free and the public is invited.

Lohr and Yoder will discuss recent advances in understanding the causes and the ability to detect signs and symptoms of autism, as well as present updates in treatment. Families also may learn steps to maximize chances for success for their children with autism.

Lohr is an assistant professor of child psychiatry in UofL’s Department of Psychiatry and Behavioral Sciences and clinical co-director of the UofL Autism Center at Kosair Charities.

Yoder is a fifth-year fellow in child psychiatry in the UofL Department of Pediatrics.

The lecture is a part of the “Building Hope” public lecture series sponsored by the UofL Depression Center, Kentuckiana’s leading resource for depression and bipolar disorder treatment, research and education.

For more information, contact the UofL Depression Center at 502-588-4886.

Kentucky Cancer Program at UofL launches online guide to cancer resources

Program’s “Pathfinder” to be featured in April 1 KET call-in program
Kentucky Cancer Program at UofL launches online guide to cancer resources

The Kentucky Cancer Program at the University of Louisville has launched a new version of its cancer resource guide and moved it online.

Pathfinder, the KCP’s popular guide to cancer-related services and resources for 25 years, is now online and will be featured during a live KET call-in show on cancer at 8 p.m., Wednesday, April 1. The show will air at the culmination of the three-part series beginning March 30, “Cancer: The Emperor of All Maladies.”

About Pathfinder online

Pathfinder now provides an easy-to-use online tool to identify cancer resources in communities, counties, the state and across the nation, said Connie Sorrell, director of the Kentucky Cancer Program at UofL.

The opening page of Pathfinder features links for “Local Resources” and “National and State Resources” so users can go directly to the geographic area they want to investigate.

“People can easily search for resources in cancer prevention, screening, treatment, survivorship and caregiving through Pathfinder,” Sorrell said. “For example, in the ‘Local Resources’ section, you simply choose a topic, select your county and a list of resources in your area will be generated to view or print.”

For information about Pathfinder and the Kentucky Cancer Program, visit www.kycancerprogram.org or call 1-877-326-1134.

About the call-in program on April 1

Donald Miller, M.D., Ph.D., director of UofL’s James Graham Brown Cancer Center, a part of KentuckyOne Health, will join staff from the Kentucky Cancer Program and other health experts to provide information and answer questions from viewers at the conclusion of “Cancer: The Emperor of All Maladies.”

The three-part series based on the Pulitzer Prize-winning book by Siddhartha Mukherjee tells the complete story of cancer, from its first description in an ancient Egyptian scroll to the gleaming laboratories of modern research institutions.

At six hours, the film by Emmy and Peabody Award winner Ken Burns interweaves a sweeping historical narrative with intimate stories about contemporary patients and an investigation into the latest scientific breakthroughs that have brought the world to the brink of finding cures.

About the Kentucky Cancer Program

Established by the Kentucky Legislature in 1982, Kentucky Cancer Program is the state cancer control program with 13 regional offices located throughout the Commonwealth. The program is jointly administered by the University of Louisville and the University of Kentucky. The mission is to reduce cancer incidence and mortality through education, research and service.

UofL physicians, KentuckyOne heart team to live stream, tweet surgery April 2

UofL physicians, KentuckyOne heart team to live stream, tweet surgery April 2

Physicians with the University of Louisville and the KentuckyOne Health Heart Care team will live stream and tweet updates from the operating room as a heart valve procedure is being performed April 2 at Jewish Hospital.

The staff anticipates that the live stream will begin around 10 a.m. To participate, go to www.kentuckyonehealth.org/ky1heartcare for the live stream or follow the conversation on Twitter with the hashtag #KY1HeartCare.

The scheduled procedure will be a transcatheter aortic valve replacement (TAVR), a minimally invasive valve replacement for patients with severe aortic stenosis who are not well enough to undergo traditional open-heart surgery.

During the TAVR procedure, a cardiologist and cardiothoracic surgeon work together to implant a new heart valve, called the Edwards SAPIEN XT, through a small puncture in the groin. The procedure is performed in the hybrid operating room at Jewish Hospital.

Performing the TAVR procedure will be Assistant Professor of Cardiovascular and Thoracic Surgery Kendra Grubb, M.D. and Interventional Cardiologist and Assistant Professor of Medicine Michael Flaherty, M.D., along with the Jewish Hospital Heart Valve team. Both practice with University of Louisville Physicians.

ULP Cardiologist Lorrel Brown, M.D., also an experienced heart specialist, will be in the OR specifically to tweet during the procedure and answer questions posed on Twitter.

Students, faculty and staff are invited to take part as education, clinical care and new media come together in this unparalleled opportunity. For additional information, contact KentuckyOne Health at 502-562-7075.

 

Clinical “calculators” seriously overrate heart attack risk

Clinical “calculators” seriously overrate heart attack risk

Most “risk calculators” used by clinicians to gauge a patient’s chances of suffering a heart attack and guide treatment decisions markedly overestimate the likelihood of an attack, according to results of a study by investigators at Johns Hopkins, the University of Louisville and other institutions.

Physicians commonly use standardized risk-assessment systems, or algorithms, to decide whether someone needs care with daily aspirin and cholesterol-lowering drugs or just watchful waiting and follow-up exams. These algorithms calculate heart attack probability using a combination of factors such as gender, age, smoking history, cholesterol levels, blood pressure and diabetes, among others.

The new findings, reported in Annals of Internal Medicine, suggest four out of five widely used clinical calculators seriously overrate risk, including the most recent one unveiled in 2013 by the American Heart Association and the American College of Cardiology amid considerable controversy about its predictive accuracy.

The results of the study, the research team says, underscore the dangers of over-reliance on standardized algorithms, and highlight the importance of individualized risk assessment factoring additional variables into a patient’s score, such as other medical conditions, family history of early heart disease, level of physical activity and the presence and amount of calcium buildup in the heart’s vessels.

“Our results reveal a concerning lack of predictive accuracy in risk calculators, highlighting an urgent need to reexamine and fine-tune our existing risk assessment techniques,” says senior investigator Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

“The take-home message here is that as important as guidelines are, they are just a blueprint, a starting point for a conversation between patient and physician about the risks and benefits of different treatment or preventive strategies,” Blaha adds.

Those treatment and preventive strategies are impossible to develop without individualized consultation with patients, says Andrew DeFilippis, M.D., M.Sc., co-director of cardiovascular disease prevention and medical director of the Cardiovascular Intensive Care Unit at the University of Louisville, and a co-author of the study.  “What the data tell us is that current risk assessment algorithms provide the ‘jumping-off point’ for physicians to utilize in starting the process to determine a patient’s risk,” DeFilippis says. “Especially when these assessments indicate marginal or great risk, it is crucial for physicians to factor in other variables such as family medical history, calcium buildup in the vessels and lifestyle factors, among others, to obtain the truest picture of the patient’s condition. Only then can the physician develop prevention or treatment strategies that have the greatest chance of success.”

While prevention and treatment decisions are straightforward in some patients, many have borderline risk scores that leave them and their clinicians in a gray zone of uncertainty regarding therapy. Under the American Heart Association’s most recent guidelines, people who face a 7.5 percent risk of suffering a heart attack within 10 years are urged to consider preventive therapy with a cholesterol-lowering medication.

Risk overestimation could be particularly problematic for patients with marginal scores as it can artificially push a person with a relatively low risk profile into the “consider treatment” group. This is why patients with such borderline scores could benefit from further risk assessment including tests such as CT scans that visualize the degree of calcification in the arteries of the heart.

Additional testing could be a much-needed tie-breaker in all too common ‘to treat or not to treat’ dilemmas,” says study co-author Roger Blumenthal, M.D., professor of medicine and director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. “Such testing should be considered in all patients with marginal risk scores — those in whom the decision to treat with long-term statin and aspirin remains unclear.”

To check the accuracy of each one of five risk calculators, the investigators compared the number of predicted versus actual heart attacks and strokes among a group of more than 4,200 patients, ages 50 to 74, followed over a decade. None of the patients had evidence of atherosclerotic heart disease at the beginning of the study. Atherosclerotic heart disease or atherosclerosis — a condition marked by the buildup of fatty plaque and calcium deposits inside the major blood vessels — is the main cause of heart attacks and strokes, claiming the lives of some 380,000 people in the United States each year.

Four out of five risk scores analyzed in the study overestimated risk by anywhere from 37 percent to 154 percent in men and 8 percent to 67 percent in women. The fifth, and least flawed, risk-scoring tool overestimated risk among men by only 9 percent, but underestimated it by 21 percent among women.

The new American Heart Association calculator overestimated risk by 86 percent in men and by 67 percent in women. Thus, a man with projected risk score of 10 percent, had, in fact, a 6 percent risk of suffering a heart attack within 10 years. In the group with a risk score between 7.5 to 10 percent — the threshold at which initiation of stain is recommended — the actual risk was 3 percent, well beyond the level at which statin use should be considered.

The least flawed prediction of heart attack risk was generated by the so-called Reynolds risk score calculator, which underestimated overall risk by 3 percent. In addition to age, gender, smoking, diabetes, cholesterol and blood pressure, the Reynolds score factors in levels of C-reactive protein — a marker of systemic and blood-vessel inflammation — and family history of early heart disease.

While not the subject of the current study, the researchers say they believe the overestimation of risk stems from the fact that all calculators, including the newest one, use as risk reference data obtained decades ago when more people were having heart attacks and strokes.

“The less-than-ideal predictive accuracy of these calculators may be a manifestation of the changing face of heart disease,” Blaha says. “Cardiac risk profiles have evolved in recent years with fewer people smoking, more people having early preventive treatment and fewer people having heart attacks or having them at an older age. In essence, baseline risk in these algorithms may be inflated.”

The Reynolds risk equation, for example, was based on data from a more recent group of patients compared with other calculators, which may explain its superior accuracy, the researchers say.

Other institutions involved in the study included University of Washington, University of Colorado, the University of California-Los Angeles and Baptist Medical Group in Miami.

The research was funded by the National Heart, Lung, and Blood Institute under grant numbers N01-HC-95159 and N01-HC-95169 and by the National Center for Research Resources under grants UL1-TR-000040 and UL1-TR-001079.

UofL geriatricians join Beshear for bill signing

MOST legislation creates new guarantees for end-of-life decisions
UofL geriatricians join Beshear for bill signing

A faculty physician and a staff member with the University of Louisville will join Kentucky Gov. Steve Beshear as he signs Sentate Bill 77, legislation giving new guarantees to patients making end-of-life decisions.

The signing ceremony is set for 10:40 a.m. Tuesday, March 24, in Room 110 in the Kentucky Capitol in Frankfort. Participating from UofL will be Christian Furman, M.D., vice chair of geriatric medicine in the Department of Family and Geriatric Medicine and a geriatrician with University of Louisville Physicians-Geriatrics, and Mary Romelfanger, R.N., with UofL’s Institute for Sustainable Health Optimal Aging.

Under the new bill, an end-of-life order known as “medical order for scope of treatment,” or MOST, will be allowed in Kentucky. The legislation will create a form designed by the state Board of Medical Licensure to specifically direct the type of treatment a patient would like to have and how much medical intervention they want during end-of-life care. MOST forms are already in use in 32 other states.

Unlike advance directives, the orders are considered to be physician’s orders and are signed by both the patient or the patient’s legal surrogate as well as the physician.

Furman said that while many physicians discuss end-of-life care with their patients and families and document it, the information is often buried deep in the chart and is not easily accessible in an emergency situation.

"This issue comes to play on a daily basis," said Furman, who testified on behalf of the bill in February. “This legislation will ensure patients' wishes are honored when they have severe chronic illnesses. It will ensure patients have a voice."

 

Joining Furman and Romelfanger at the bill signing ceremony will be Joe Rotella, M.D., CMO of American Academy of Hospice and Palliative Care, Mary Ellen Green with Hosparus and Bonnie Lazor, M.D., with Vintage Care, all of Louisville.