Boston Magazine has released its annual Top Docs issue. Sixty-two BUSM faculty and...
By Lisa Brown
BUSM researcher Dr. Jeffrey Samet and Dr. Carlos Del Rio from Emory University were recently awarded a five year, $5 million grant from the National Institute of Drug Abuse for their project titled: Improving Physician Opioid Prescribing for Chronic Pain in HIV-infected Persons.
Prescription opioids are the second most commonly abused substances in the U.S. (after marijuana), and overdose deaths related to prescription opioids now exceed deaths from motor vehicle crashes. Prescription opioid abuse appears to be even more common among HIV-infected patients, presumably a consequence of the known co-morbidity between HIV and substance use.
The grant will fund the “Targeting Effective Analgesia in Clinics for HIV” (TEACH) Study. TEACH will test the effectiveness of a collaborative care intervention to improve the management of chronic opioid therapy and reduce the misuse of prescription opioids among HIV-infected persons.
“This is a novel randomized controlled trial of a chronic disease management intervention to improve the delivery of chronic opioid therapy and reduce prescription opioid misuse among HIV-infected persons. If demonstrated to be effective, this model could be adopted by clinics nationwide, may improve physician satisfaction and confidence with this challenging aspect of patient care, and has the potential to improve the health and well-being of persons with HIV,” explained Samet, principal investigator of the grant.
The study will be conducted within the BMC HIV clinic (CID) with Dr. Meg Sullivan, as a co-investigator.
CME-Accredited Course Advances Teaching Skills of Health Care Professionals
Medical educators have an opportunity to participate in a new, first-of-its kind online medical education badge program at Boston University School of Medicine (BUSM). The BUSM+ Medical Education Badge Program (BUSM+Program) allows access to online faculty development in medical education and allows course graduates to display and share earned digital competency badges on social media, CVs and portfolio websites. The program is considered to be a form of digital micro-credentialing.
“The BUSM+ Program takes the concept of digital badging and applies it for an audience of health care providers (practicing and retired physicians, fellows, residents, medical students and healthcare teams) who may have missed educational courses in their professional career and are now teaching, or those healthcare providers who want to enhance their existing teaching skills,” explained Gail March, PhD, Assistant Professor of Medical Sciences & Education as well as Director of Instructional Design and Faculty Development at BUSM who founded the program.
According to March, the BUSM+ digital badge program is unique in that it is the first one for medical education faculty development. “There are faculty development programs available, but they are often very expensive and demand the health care provider leave their practice to attend. BUSM+ is available as an open (no application process), online, asynchronous program available 24/7 for a low cost,” she added.
This program is designed for practicing and retired health care professionals who educate other professionals, students and patients. Enrollees in the initial BUSM+Program course will review the fundamentals of teaching and learning. Three additional offerings are planned to follow the Teaching and Learning course including Curriculum Design, Academic Leadership and Medical Education Research.
BUSM+Program was funded earlier this year by an inaugural seed grant for online innovation from the Digital Learning Initiative at Boston University.
The American Society of Tropical Medicine and Hygiene (ASTMH) announced the 2014 recipients of the Benjamin H. Kean Travel Fellowship in Tropical Medicine. Through a highly competitive process, 22 Fellows from 18 medical schools were selected including two from Boston University School of Medicine Katrina Ciraldo and Daniel Silva.
This Fellowship is the only medical student award dedicated to nurturing a career path for physician-scientists in tropical medicine. It is awarded annually to full-time medical students at accredited medical schools in North America. Fellows receive airfare and up to $1,000 in living expenses for a clinical training or research project that takes place in an area where tropical diseases are endemic. ASTMH, founded in 1903, is a worldwide organization of scientists, clinicians and program professionals whose mission is to promote global health through the prevention and control of infectious and other diseases that disproportionately afflict the global poor.
“The future of global health and tropical medicine is in great hands with a group as dynamic and committed as this class of Fellows,” said Kean Fellowship Committee Chair, Chandy John, MD, MS, University of Minnesota. “Headlines and news reports remind us that diseases that affect people in the tropics can have worldwide consequences. These fellows will be part of the next generation working to alleviate the suffering and long-term disability caused by these diseases.”
“This premier award is both honorific and substantive. It makes overseas training experiences for students interested in tropical disease possible, and works to build the ranks of physician-scientists focused on diseases in low-income countries,” said ASTMH President Alan Magill, MD, FASTMH. “The Fellowship enables these future leaders to expand their scientific networks, which in turn advances their professional contributions. As a Society, our goal is guide them towards fulfilling career options allowing them to do the work that helps improve the lives of so many who suffer needlessly from tropical disease.”
The Fellowship is named to honor Benjamin H. Kean, MD, (1912-1993), an internationally acclaimed tropical medicine expert and personal mentor to many of today’s world-renowned tropical medicine experts who were inspired by him as his students in medical school. Kean is also credited with discovering the causes of several diseases, including turista or travelers’ diarrhea.
A recently completed renovation on the 11th floor of the Alumni Medical Library now provides a state-of-the-art, 220 seat testing center. The testing center is among the first of its kind, and will serve to both facilitate the administration of exams while at the same time enhancing the quality of study space for BUMC students.
Renovations include a new ceiling with improved sound-proofing qualities, energy-efficient lighting, new carpeting and flooring, newly painted walls, new chairs and tables with power outlets at every seat, and club seating and cube tables in the hallway outside the floor-to-ceiling glass walls of the testing center. The heating and air conditioning system was upgraded, and a more powerful wireless system is provided throughout the testing center, as well as some wired network connections.
The testing center is equipped with a video monitoring system and an audio system for proctor announcements. During exams, proctors will have video monitoring controls to observe activity throughout the space via iPad. The testing center serves a dual-purpose as student study space when not reserved for exams.
Medical Library Computing & Systems offices are located on L-11, and staff will provide on-site technical support for student laptops and laptop loaners during exams. A new state-of-the-art computer classroom with 26 PCs will also serve as a public computing lab when classes and exams are not scheduled. A coffee/vending lounge includes additional club seating, group study tables, PCs, a scanner and print release station. The elevator lobby was renovated and a new LCD monitor and signage have been installed throughout the floor.
On Monday, Aug. 4, members of the BUSM Class of 2018 received their white coats on Talbot Green. View the pics on Facebook.
Boston University School of Medicine (BUSM) received major funding from the National Institute on Aging (NIA) as part of a national effort to identify rare genetic variants that may protect against and contribute to Alzheimer’s disease risk.
The four-year, $3 million grant, “Identifying Risk and Protective Variants for AD Exploring their Significance and Biology” is led by Sudha Seshadri, MD, professor of neurology at BUSM and a Senior Investigator at the Framingham Heart Study and for the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium. This project is linked to CHARGE projects at two other universities which all together received grants totaling more than $10 million. Other BU investigators who are part of the CHARGE project are Anita DeStefano, PhD, Adrienne Cupples, PhD, and Josee Dupuis, PhD, who are professors of biostatistics, and Honghuang Lin, PhD, assistant professor of medicine.
“As a neurologist treating patients with Alzheimer’s disease, it is very exciting to see the increased recognition, at a national level, of the need to find more effective preventive and therapeutic measures,” said Seshadri.
Alzheimer’s disease, a progressive neurodegenerative disorder, has become an epidemic that currently affects 5.2 million people in the United States with economic costs that are higher than those of heart disease or cancer. Available drugs only marginally affect disease severity and progression. While there is no way to prevent this devastating disease, the discovery of genetic risk factors for Alzheimer’s is bringing researchers closer to learning how the genes work together and to identifying the most effective intervention for the disease.
Genetics is a cornerstone of identifying targets for Alzheimer’s disease therapies. This movement began in 2011, when President Barack Obama signed into law the National Alzheimer’s Project Act (NAPA), mandating support for Alzheimer’s research and health and long-term care services for affected individuals across all federal agencies. One of the first projects mandated by NAPA was the Alzheimer’s Disease Sequencing Project (ADSP). With this funding, CHARGE becomes a member of the National Institute of Aging-mandated Sequence Analysis Consortium, which also includes three National Human Genome Research Institute (NHGRI) Large-Scale Sequencing Centers.
CHARGE investigators will analyze whole exome and whole genome sequence data generated from 6,000 subjects with Alzheimer’s disease and 5,000 elderly individuals who do not have Alzheimer’s disease. They also will study data from approximately 100 large families, mostly of Caribbean and Hispanic descent, that include multiple individuals with Alzheimer’s disease to identify rare genetic variants that either protect against or cause Alzheimer’s disease. They will also be contributing additional CHARGE data from over 11,000 subjects with information on genetic sequence and AD-related traits.
“AD currently has no effective treatment thus prevention is the primary strategy to combat this disease,” said Boston University School of Medicine Dean Karen Antman, MD. “This is an exciting opportunity for our faculty to develop novel approaches that might ultimately delay or prevent AD.”
CHARGE is a collaboration of an international group of investigators. Eric Boerwinkle, PhD at the University of Texas, Houston and Baylor College of Medicine and Ellen Wijsman, PhD at the University of Washington will lead other funded CHARGE projects. Cornelia van Duijn, PhD who is a consultant on behalf of Erasmus University in the Netherlands.
This research at Boston University is supported by the National Institute on Aging grants U01-AG049505.
Robert Stern, PhD, professor of neurology, neurosurgery, and anatomy & neurobiology at BU School of Medicine as well as co-founder of BU’s Center for the Study of Traumatic Encephalopathy, testified before the U.S. Senate’s Special Committee on Aging at the June 25 hearing, “State of Play: Brain Injuries and Diseases of Aging.”
Stern, who is also Director of the Clinical Core of the BU Alzheimer’s Disease Center, gave an overview of the long-term consequences of repetitive brain trauma in athletes, in particular, chronic traumatic encephalopathy or CTE. CTE has been found in individuals, including youth, college, and professional contact sport athletes (including football, hockey, soccer, and rugby players), military service members exposed to blast trauma and other brain injuries, and others with a history of repetitive brain trauma.
He explained that although little is known about CTE what studies have shown thus far is that, in some individuals, early repetitive brain trauma triggers events in the brain leading to progressive destruction of the brain tissue including the build-up of an abnormal protein called tau, one of the abnormal proteins also seen in Alzheimer’s disease.
According to Stern, the ability to diagnose CTE during life is the next critical step in the study of CTE. He believes it will lead to the ability to answer important questions about this disease, such as: How common is CTE? What are the risk factors for CTE? Can it be prevented? How can we treat it? “At this point, we actually know very little about this disease, however one thing we do know about CTE is that every case of post-mortem diagnosed CTE has had one thing in common: a history of repetitive brain trauma,” Stern testified.
BU School of Medicine is participating in the American Association of Medical Colleges (AAMC) Faculty Forward Engagement Survey to benchmark our faculty members’ engagement levels with peer institutions, and to provide data for us to enhance our efforts to attract, retain, support and advance our faculty.
Who is eligible: All full time and part time faculty members at BUSM
When: June 24 launch
How: You will receive an email from the AAMC with a personalized link to the Survey
Confidentiality assured: The AAMC’s staff administers all aspects of the Survey
Please share your views candidly to help us understand how you view specific BUSM institutional policies and practices and prioritize key workplace issues that are important to our faculty.
For questions or concerns, contact Robina Bhasin.
Please participate in this important initiative!
Many patients require medication to thin blood, and some of these patients also have liver disease. Often warfarin is prescribed for this condition. This presents a challenge for physicians and patients, as the risk of bleeding in patients with liver disease taking warfarin is unknown and has not been studied.
BUSM Associate Professor of Medicine Adam Rose, MD, who is also affiliated with the VA of Bedford, Mass., Lydia Efird, MD, a former BMC resident (2013) in internal medicine and first author, and others have found that patients with liver disease taking warfarin have more bleeding events, and that certain lab values are most predictive of bleeds. Using these findings, they created a simple predictive scoring tool to assist clinicians. In a retrospective cohort study of more than 100,000 VA patients taking warfarin the researchers identified outcomes in more than 1700 patients with liver disease. Findings include:
- Patients with liver disease taking warfarin have poorer anticoagulation control and more major bleeds.
- Low albumin levels and poor renal function, as measured by creatinine, are most predictive of these poor outcomes.
The researchers created a 4-point clinical predictive tool to help identify and individualize the risks of treatment and direct future interventions. The system uses albumin and creatinine which help predict patients that are at risk of a major bleed while taking warfarin. “Prescribing blood thinners to patients with liver disease is challenging. This simple tool allows a quick calculation, in the office or bedside, to help clinicians predict which patients may safely receive warfarin and in which patients it is best avoided,” said Efird.
This article was published in Circulation Cardiovascular Quality Outcomes, May 20 2014. Epub May 13, 2014, 4 p.m. (Circ Cardiovasc Qual Outcomes. 2014;7:461-467) http://circoutcomes.ahajournals.org/