Health Sciences Report (2002)

UNIVERSITY OF UTAH HEALTH SCIENCES REPORT Health Sciences Center Helps _ Utah Pr< in » r Bit PWilSMl irism iJ f fcarai^," iigfe W S U M M E Hot breezes carried the scent of honeysuckle; sunshades slumped against car windshields in the lots behind the health sciences center when I began working on this issue's cover story. Runners traversed the Bonneville Shoreline Trail, where, just a handful of months ago, deer cautiously made their way down through the snow. When temperatures flirted with triple- digits, it was hard to remember just how cold the winter landscape had felt on my skin: blowing wind, chapped lips- and the chill of fear. Far from the buildings of downtown Salt Lake City, draped with banners supersized to match the Olympic spirit; behind the rise of the flame at Rice- Eccles Stadium had been the security tents. Small armies of guards with guns slung around their waists and over their shoulders swept the undersides of cars and trucks entering the health sciences center. Ten- foot electrified barbed- wire fences surrounded the Athletes Village. Guards were stationed every 25 feet, their black and yellow parkas ubiquitous. Cement barricades emblazoned with red and yellow slashes defined the boundaries of our lives. Then, literally within hours, they were gone with the Games, and with them, our anxiety. Finally, we could count medals, not worries, and stash the " what if" disaster scenarios rehearsed for months in the back of our memories. Until July, when new warnings shot through the nation's independence celebrations. We were on alert once again. News magazines diagnosed an epidemic of anxiety. When I interviewed David Tomb about the psychiatric repercussions to bioterrorism, the conversation turned to mass hysteria and the role of memory. " It's one of the most fallible mechanisms we have," said the psychiatrist. " There's very little we remember accurately, even the most important things that have happened to us." Yet, as he gazed out his office window, feet propped up on his desk, he wondered aloud: " Is there anything more us than our memories? Your life is your memory. You are obligated, as a human being, to believe your memory." As I walk out to my car at summer's end, I pass radiology suites where patients, conscious and unconscious, undergo tests; past the ER where gurneys hold bodies battered by accidents and disease. We don't need 9/ 11 to remind us just how faint the lifelines etched deep into our palms really are. Perhaps that's why I've noticed a door in a back hallway of the hospital. The sign outside reads: " Emergency Preparedness Supplies." It's always closed. But inside I imagine row after row of shelves, stacked with boxes three, four deep, like memories: images of comfort, of reassurance, of that uniquely human quality of hope enabling us to believe like Caryn Summers that we, too, can meet the challenge. " I'm prepared in my professional life and my personal life," the clinical nurse coordinator for the emergency department told me. " I'm prepared in my heart." w\ JMiljll^ U Susan Sample 2 0 0 2 Published by the Office of Public Affairs, University of Utah Health Sciences Center, 50 North Medical Drive, Salt Lake City, Utah 84132. Telephone 801- 581- 7387. Articles may be reprinted with permission. University of Utah Health Sciences School of Medicine College of Pharmacy College of Nursing College of Health University Hospitals & Clinics University of Utah Medical Group Eccles Institute of Human Genetics Huntsman Cancer Institute John A. Moran Eye Center Spencer S. Eccles Health Sciences Library Editor: Susan Sample Editorial Consultant: Anne Brillinger Contributing Writers: Mary Chachas, Phil Sahm Photographers: Brad Nelson and Steve Leitch, Medical Graphics and Photography Visit the University of Utah Health Sciences Center Web site at: uuhsc. utah. edu. Cover: Suited up in their personal protective gear are members of University Hospital's Emergency Department: from left, Caryn Summers, R. N., B. S. N.; Stan Renshaw, E. M. T.; Seari Nordgran, R. N.; and Deborah Kim, A. P. R. N., M. S. N. Photo by Brad Nelson. HEALTH SCIENCES REPORT F E A T U R E S Learning to Tell Time 12 Lynn Jorde, Ph. D., studies genetic mutations to learn when and how modern humans originated. Scenario for Security 16 While others are just beginning, the University of Utah already has revised scripts for bioterrorism preparedness that draw on all areas of the health sciences center. Are Americans Really Living in Fear and Trembling? 20 The psychiatric repercussions of 9/ 11 aren't as surprising, or as new, as we're being led to believe. Surveillance Systems Give First Alert 23 Hosting the 2002 Winter Olympics gave the University an opportunity to develop and test several electronic disease surveillance systems. Nursing's a Profession with Potential 26 Completing her first year as dean, Maureen Keefe, R. N., Ph. D., reflects on the future of the College of Nursing, as well as her own professional past. Out of Africa 28 Ten medical students who volunteered in Ghana last summer returned with lessons about life and medicine. D E P A R T M E N T S Headlines 2 People 10 In Memoriam 11 Research in Brief 32 Gift of Health 34 Contributions fund College of Health scholarships, renovation at the College of Nursing and the Moran Eye Center's Campaign for Vision. Opinion 37 A School of Medicine faculty member who serves on the Indian Health Service Research IRB discusses the ethical concerns of conducting research in different cultures. HEALTH SCIENCES REPORT UNIVERSITY OF UTAH Vol. 26, No. 2r U Geneticist Wins Top U. S. Science Award ario R. Capecchi, Ph. D., distinguished professor of human genetics id biology, received a 2001 National Medal of Science from President George W. Bush in a ceremony at the White House June 12. Thirteen other scientists and one engineer also received the nation's highest award for lifetime achievement in fields of scientific research. Capecchi was honored for his work using gene targeting methods in mice to study and change, or " knock out," genes in a living organism. The National Science Foundation said the U geneticist's tools " revolution-ized the study of mammalian genetics and provided important new models for human genetic diseases." Using knockout technology, researchers have produced animal models for hundreds of human diseases, from atherosclerosis to Alzheimer's disease, enabling academic scientists to test new ideas and the pharmaceutical industry to test new drugs. Knockout mice also are providing Capecchi and other researchers with insights into understanding fundamental biological questions, including development of the brain in the embryo. Last September, Capecchi received the 2001 Albert Lasker Award for Basic Medical Research for pioneering knockout technology. He shared the award, often called " America's Nobel," with Martin Evans of Cardiff University, Wales, and Oliver Smithies, University of North Carolina, Chapel Hill. At the U, Capecchi holds the Helen Lowe Bamberger Colby and John E. Bamberger Presidential Endowed Chair in the Health Sciences. He also is an investigator for the Howard Hughes Medical Institute and a member of the National Academy of Sciences. A U faculty member since 1973, Capecchi was named co- chair of the Department of Human Genetics last July ( see pg. 4). h Health Sciences Finance VP Comes to Utah from RWJMS ames R. Bardsley, Ph. D., chief administrator and director of planning for the Robert Wood Johnson School of Medicine ( RWJMS), assumed the position of associate vice president for finance and planning at the U health sciences center last July. He oversees finance in all areas, strategic planning, and critical resource management for the health sciences center, which includes the medical school, three other academic colleges, two hospitals and additional clinical facilities under construction, and on- site and community clinics. The ninth U4 President George W. Bush presents Mario R. Capecchi, Ph. D., with the National Medal of Science during a White House ceremony June 12. James R. Bardsley, Ph. D. largest employer in Utah, the health sciences center had a budget of $ 822 million in fiscal year 2000- 2001. Bardsley was associate dean for planning and administration, and associate professor of clinical environ-mental and community medicine at RWJMS of the University of Medicine and Dentistry of New Jersey, New Brunswick and Piscataway. " Dr. Bardsley has wide- ranging skills and experience in many aspects of medical school administration and in strategic planning and institutional evaluation," said A. Lorris Betz, M. D., Ph. D., senior vice president for health sciences and medical school dean. " His expertise will be invaluable at a time when our health sciences center is challenged by the need for growth and expansion in a time of increasing economic pressure." Before joining RWJMS, Bardsley was an administrator and faculty member at the Louisiana State University Medical Center, Shreveport. He served as executive management consultant with Louisiana's Department of Health and Human Services, Baton Rouge, for five years and has consulted with other state programs, n AAMC Selects Bjorkman for Leadership Program David J. Bjorkman, M. D., M. S. P. H., senior associate dean of the School of Medicine, was selected last summer to participate in a new national leader-ship development program for current and future medical school deans. He was one of three selected from among 16 applicants for the 2002- 03 Council of Deans Fellowship Program,' sponsored by the Association of American Medical Colleges ( AAMC). David J. Bjorkman, M. D., M. S. P. H. 2 Health Sciences Report Smmer 2002 As a fellow, Bjorkman will choose a " dean mentor" and visit his mentor's school several times during the year to gain insight into the leadership, organizational style, and workings of his mentor's office. For the research component of the program, which must address a question of national interest to medical schools, he will develop multidisciplinary clinical and research programs. Fellows also participate in meetings of the 125- member Council of Deans to learn about strategic goals and activities. Since he joined the U medical school in 1985, Bjorkman has held various medical and administrative posts. He is professor of internal medicine in the Division of Gastroenterology and executive medical director of the University of Utah Medical Group, the organization of U physicians, c U Physician to Oversee Campus Research Ethics Jeffrey R. Botkin, M. D., M. P. H., professor of pediatrics and adjunct professor of human genetics and internal medicine at the U School of Medicine, was named last July as the University's associate vice presi-dent for research integrity. A nationally known bioethicist, Botkin was appointed to the new posi-tion by Raymond F. Gesteland, Ph. D., U of U vice president for research and distinguished professor of human genetics and biology. " Over the last couple of years, the federal regulations on research ethics have been rapidly evolving, and there has been much focus on their implementation," said Gesteland. " We want to help our faculty by educating them about the rules and making it easier for them to abide by federal regulations." Botkin will oversee the University's Institutional Review Board, which protects human research subjects by approving procedures and consent forms. He also will direct the Resource for Genetic and Epidemiologic Research, the campus organization that ensures the University adheres to its agreement with the state and The Church of Jesus Christ of Latter- day Saints regarding the use of church genealogical records in its genetics research. Botkin's responsibilities also will include overseeing the University's conflict- of- interest policy, receiving and evaluating allegations of research misconduct, and supervising adherence to biosafety regulations involving research with microorganisms and toxins, E Team Awarded NIH Grant for Group A Strep Study Utah researchers are part of a team that is studying several types of streptococcal infections with a seven- year, $ 4.2 million grant from the National Institute of Allergy and Infectious Diseases ( NIAID), National Institutes of Health ( NIH). Harry R. Hill, M. D., professor of pathology and pediatrics, and adjunct professor of internal medicine, is principal investigator. L. George Veasy, M. D., professor of pediatrics and adjunct professor of internal medicine, is senior co- investigator. They are joined by other researchers from the U medical school and Primary Children's Medical Center ( PCMC), and scientists from the NIAID Rocky Mountain Laboratories in Hamilton, Mont. They are examining the microbio-logic, immunologic, and genetic factors contributing to the pathogenesis of fulminant streptococcal infections, such as necrotizing fasciitis, associated with what has been described as " flesh- eat-ing bacteria," and the frequently fatal toxic shock syndrome. The investiga-tion will include an examination of the virulence factors of the organisms, the body's immune response to them, and the role of toxins and cytokines in the pathogenesis of these disorders. The study also will investigate the mechanisms by which group A streptococcal infection can lead to acute rheumatic fever, cardiac valve damage, and rheumatic heart disease, one of the top two leading causes of acquired heart disease among young people worldwide. Some 30 patients with acute rheumatic fever, 80 with uncomplicated group A streptococcal pharyngitis, and 20 with invasive streptococcal infections seen at University Hospitals & Clinics and PCMC will be enrolled each year of the study. Co- investigators from the U include: Lloyd Y. Tani, M. D., associate professor of pediatrics; James F. Bale, M. D., professor of pediatrics and neurology; Judy A. Daly, Ph. D., professor of pathology; Karen C. Carroll, M. D., associate professor of pathology and internal medicine; John F. Bohnsack, M. D., professor of pediatrics and adjunct professor of pathology; Andrew T. Pavia, M. D., professor of pediatrics and chief of the Division of Pediatric Infectious Diseases; Harry Rosado- Santos, M. D., assistant professor of internal medicine in the infectious diseases division, and Edward B. Clark, M. D., professor and chair of the Department of Pediatrics, b Pincetl Named Asst. VP for Info Technology Services Pierre S. Pincetl, M. D., was appointed U assistant vice president for health sciences information technology services ( ITS) last June. Since he joined the U in 1996, Pincetl has served as chief information officer and director of the Office of Informa-tion Resources for University Hospitals & Clinics. He has increasingly assumed responsibility for health sciences ITS and its integration with the University. In his new role, Pincetl will continue to expand and coordinate ITS throughout the health sciences center and with the main campus. Pincetl, associate professor of internal medicine and medical infor-matics at the School of Medicine, also continues as an associate administrator at University Hospitals & Clinics. Prior to joining the U of U, Pincetl served as chief information officer and associate professor of internal medicine at George Washington University, c Jeffrey R. Botkin, M. D., M. P. H. Pierre S. Pincetl, M. D. Health Sciences Report Smmer 2002 Mario R. Capecchi, Ph. D. Mark F. Leppert, Ph. D. Capecchi, Leppert Named Human Genetics Co- chairs Mario R. Capecchi, Ph. D., distin-guished professor of human genetics and biology, and Mark F. Leppert, Ph. D., professor of human genetics who has been serving as interim department chair for the past 20 months, have been named co- chairs of the Department of Human Genetics at the School of Medicine, pending approval by the U of U Board of Trustees. Both appointees are prominent sci-entists. Capecchi pioneered " knockout mouse" technology that has allowed the creation of animal models of hun-dreds of human diseases. Last June, he received the National Medal of Science, the country's highest award for lifetime achievement in scientific research ( see pg. 2). Last year, he was presented with the Albert Lasker Award for Basic Medical Research. Leppert is credited for mapping numerous new genetic markers in human linkage- reference families. He has been working in the field of human genome science for more than 16 years and has more than $ 6.5 million in grant support for research to localize and identify disease genes related to epilep-sies, retinal disorders, colon and other cancers, as well as common diseases such as heart disease and hypertension. " I am confident that, under the direction of Mario Capecchi and Mark Leppert, the department will provide leadership for disease and develop-mental genetics research at our university and become one of the pre-eminent departments of human genetics in the world," said A. Lorris Betz, M. D., Ph. D., senior vice president for health sciences and dean of the medical school, E Jodie Barrie, R. N., M. S. N. Barrie Joins U Hospital Administrative Team J f adie Barrie, R. N., M. S. N., was I named interim associate adminis-rator of patient care services for inpatient services and chief nursing officer ( CNO) at University Hospitals & Clinics last May. She succeeded Madeline C. Buelt, R. N., M. S. N., who accepted a position with the Seattle Cancer Care Alliance. Barrie is responsible for University Hospital patient services areas, includ-ing outpatient services, Huntsman Cancer Institute, and the Moran Eye Center. Since 1999, Barrie had been the service director for emer-gency and trauma services at the U. Prior to that, she was CNO/ vice president of clinical services and interim CEO at Pioneer Valley Hospital in West Valley City, Utah. She also held administrative and management positions at medical centers in St. Peterburg, Fla., and Shreveport, La., and at University of Alabama Hospitals and Clinics in Birmingham, and at the University of South Alabama in Mobile. In 1994, she was named Nurse Manager of the Year by the Utah Emergency Nurses Association, c Occupational Health Center Receives $ 1.03 Million Grant The U Rocky Mountain Center for Occupational and Environmental Health ( RMCOEH) was approved for five years of support with a first- year award of $ 1.03 million from the National Institute for Occupational Safety and Health ( NIOSH). The RMCOEH is a component of the public health programs in the U medical school's Department of Family and Preventive Medicine. Established in 1977, the center is one of only 16 national educational and research sites supported by NIOSH. It offers graduate and continuing education programs in occupational medicine, industrial hygiene, ergonomics and safety, occupational injury prevention and hazardous-substances control. It also conducts research and furnishes services in these areas, providing support to more than 270 Utah businesses, government agencies, and other organizations. Crabtree Serves Hospital as Interim Financial Chief Gordon L. Crabtree began a term as interim associate administrator for financial services at University Hospitals & Clinics last July. He replaces Keri Anderson, who is on a leave of absence. Crabtree is responsible for all hospital finances, including account-ing, patient financial services, budget office, program review, contracting, patient access services, third- party reimbursement, medical records, payroll, accounts payable, and decision support. Gordon L. Crabtree Before joining University Hospital, Crabtree was managing director of finance for the Salt Lake Olympic Committee. He also served as director of finance for the State of Utah from 1985- 95. E Lloyd Named New Director of U Community Clinics Robin Lloyd, M. P. A., was named executive director of University of Utah Hospital's Community Clinics/ Community Physician Group ( CC/ CPG) last April. As a member of the U Hospital administrative team, Lloyd is responsible for CC/ CPG's relationship with University Hospitals & Clinics, School of Medicine departments, the colleges of Nursing, Pharmacy and Health, and health plans. The Community Clinics serve Robin Lloyd, M. P. A. 4 Health Sciences Report Smmer 2002 more than 100,000 patients each year at seven neighborhood locations, from Tooele to Park City and Orem to Layton. A U graduate, Lloyd worked with the Holy Cross Health Services primary care network in Salt Lake City from 1992- 96. He then was a consultant with Ambulatory Management Services, Inc., in Columbus, Ohio, a Alumna Returns to Chair Pharmacy Practice Dept. Diana I. Brixner, Ph. D., R. Ph., a U of U graduate in medicinal chemistry, returned to the College of Pharmacy in June to chair the Department of Pharmacy Practice. Brixner, who holds a bachelor of science degree in pharmacy, received her doctorate from the U in 1987. She worked for SmithKline Beecham and Novartis, where she served in many positions including executive director of national managed care accounts and vice president of health- care management. She has extensive experience in technical marketing and patient- related outcomes research. Brixner also served on the adjunct faculty of Philadelphia College of Pharmacy since 1994. At the U pharmacy college, Brixner leads 15 core and more than 100 adjunct faculty members. She plans to develop an Outcomes Research Center to conduct collabora-tive research between the college and community practices, E U Hospital, Physicians on Nation's " Best" Lists University Hospitals & Clinics and physicians from the School of Medicine have earned spots on three recently released lists of the nation's top health- care systems and health- care professionals. For the ninth year, the hospital is ranked amo