As big changes continue to be made in the pharmacy profession, corresponding changes are taking place in the College of Pharmacy's professional program curriculum.
During the past five to 10 years, the profession has shifted focus from drug products to providing pharmaceutical care, which involves identifying, resolving, and preventing drug-related problems, as well as monitoring patients to ensure optimal outcomes are achieved. Pharmaceutical care's scope ranges from answering questions about over-the-counter medication to following a high-risk elderly patient with a dozen prescriptions for several diseases and related side effects. Except for quality control, product distribution can be separated from pharmaceutical care; robots and technicians are playing an ever-increasing role in filling prescriptions.
Adding patient-oriented skills to the curriculum as well as knowledge required to provide pharmaceutical care led to a change in the entry-level program. Pharmacy has gone from a three-year bachelor of science program to a four-year program leading to the Doctor of Pharmacy (Pharm.D.) degree.
We are now entering the third year of our new Pharm.D. program. Students still get a strong scientific grounding in drugs and diseases, but there is much more emphasis on patients and pharmaceutical care beginning in the first year. Students have early clerkship experiences, courses about the health system, and a three-year pharmaceutical care laboratory course. In the laboratory, they apply their knowledge in a variety of simulated pharmaceutical care experiences, as well as experiments that reinforce and apply what they have heard in class lectures. There are more problem-solving exercises, active learning experiences, and communication skill-developing opportunities built into the curriculum. The fourth year is spent in clerkship experiences. Students are encouraged to participate in team-care experiences, such as the Rural Health School rotations or the interdisciplinary geriatric training program.
There are curriculum refinements yet to be made. For example, giving students the experience of following patients and their families for a year or more would provide perspective about the long-term impact of their care, and help develop understanding of the social and cultural context of health care. Communication skills should be more systematically taught and outcomes measured. Team care needs to be incorporated earlier in the curriculum. However, we feel we have made a lot of progress in producing pharmacists who will provide high-quality pharmaceutical care to patients.
We have also learned that practicing pharmacists with B.S. degrees are eager to advance their skills. The College will offer a non-traditional Doctor of Pharmacy program for them starting in fall, 1998.
I encourage those of you who are members of other health professions to talk with our students, faculty, and practicing pharmacists. Learn how we are changing and how we can all work together as a health care team.
-Marilyn K. Speedie, Dean, College of Pharmacy
Doing industry-sponsored research at the Academic Health Center is about to get a lot easier-for both researchers and companies.
In September, the Research Services Offices (RSO), which will support research collaborations between University faculty and biomedical companies opens on the sixth floor of the Children's Rehabilitation Building.
For researchers, the office will offer one-stop shopping for a variety of services, including legal counsel, contracting, budget preparation, approvals, and animal and human subjects document preparation.
The RSO will provide companies with a single access point to the Academic Health Center to connect with faculty who have specialized expertise. Toward that end, the office will maintain a faculty expertise database that can also be accessed by faculty looking for internal collaborators. And clinical trials will be coordinated through the RSO to avoid duplication or conflicts and share information gained from research subjects.
"This office will position us to take advantage of the growing number of opportunities for industry collaborations," says Leo Furcht, who headed the task force that recommended creating the RSO. "For example, there's a trend among pharmaceutical companies to outsource business. We have a wealth of internal resources that could be matched with external sponsors."
Recruitment for a director is under way. The director will be responsible for planning and oversight and must have experience in both business administration and health care research. Applications should be directed to Susan Jackson, Human Resources, Box 23, 420 Delaware St. SE, Mnpls., MN 55455. The position is 50 to 100 percent time.
The health technologies team from the Office of Research and Technology Transfer Administration's Patents and Technology Marketing division will work out of the new office part time. Headed by Jim Severson, Ph.D., this group includes three licensing agents who work with faculty to identify, patent, and license marketable health and research products. Staff from ORTTA's Sponsored Projects Administra-tion, which handles budgeting and contracts, will also join the RSO part time.
The RSO was recommended by a faculty/staff task force formed to study research management at the AHC. In essence, the task force found that research services are fragmented, oversight is poor or lacking, and that paper work is often stalled at various stages of processing. To improve research support services and stimulate interation with industry, the group recommended integrating services through the RSO. They also recommended a business development division and a clinical trials unit. The clinical trials unit has been open since spring.
-Peggy Rinard
$5,750,000 for new programs
Plans are under way to decide how to use $4,250,000 from the legislature and $1.5 million in internal funds for new AHC programs in 1998-99. Broadly, the funds will be invested in three ways:
Intercollegiate initiatives
Faculty research development funds
Faculty seed grants
A faculty team is developing a request for proposals (RFP) and review process for the two faculty research funds. Request forms are expected to be available in early September; proposals will be due November 15.
For further information, refer to the AHC web site at www.ahc.umn.edu or call John Fetrow at 625-2176.
Graduate medical education (GME) costs will be carved out of the Medicare per capita rates over the next five years and redirected to teaching hospitals. And the Indirect Medical Education (IME) adjustment will be reduced from 7.7 percent to 5.5 percent over four years rather than two, as proposed by the House of Representatives, to soften the impact on teaching hospitals. Congress passed both measures as part of the budget agreement last week. Sr. Vice President Frank Cerra, Duluth School of Medicine Dean Ron Franks, and U Federal Relations Director Tom Etten visited with legislators on July 17 to promote the recommendations. Cerra plans to continue advocacy to separate GME funding from Medicare.
The federal government cannot sue the U under the False Claims Act, according to a July 23 U.S. District court ruling, which responded to two lawsuits filed by the U and the federal government in the case of alleged federal grant mismanagement in the surgery department. However, the court did not order the National Institutes of Health (NIH) to remove the U's "exceptional organization" status. The U is implementing a corrective action plan the NIH required to restore expanded authorities over grants management and remove the designation. The corrective action plan can be reviewed on the U Research Office's web site at www.research.umn. edu/research.html. According to a memo issued by Research Vice President Mark Brenner, most of the plan has been implemented. An NIH site visit is expected in the fall or winter.
Duluth School of Medicine Interim Dean is Rick Ziegler, UMD professor of medical microbiology and immunology. Zeigler, who will replace Ron Franks September 1, studies how HIV components affect the nervous system. He has been recognized by medical students as an outstanding basic science teacher and received the Minnesota Medical Foundation's Basic Science Teacher of the Year award in 1979. Ziegler has been a UMD faculty member since 1971.
A bioartificial liver designed by Sr. Vice President Frank Cerra has been licensed to Algenex, Inc., a company formed by a venture capital group specifically for the device. The technology, which could be used as a bridge to transplantation or to enable the liver to regenerate, uses pig liver cells in a bioreactor to filter out toxins in the blood of patients with liver failure, much like kidney dialysis. The company's first step will be to raise funds for clinical trials. The bioartifical liver was developed in the lab of Wei-Shou Hu, chemical engineering. A host of faculty, postdoctoral researchers, and students have contributed to its development over the past few years. The device has two patents with a third pending.
Women students from Central High School visited the AHC July 21-25 for an annual summer research camp to learn about science career options. Activities included a tour of the Biomedical Image Processing Laboratory, a lesson in computer-assisted drug design, a visit to the Raptor Center, a demonstration of echocardiography, and observation of a behavioral pharmacology experiment. The students also visited chemistry and physics laboratories. Organizers were Wenda Carlyle, medicine/cardiology; Laura Mauro, biochemistry; and Sylvie Lac, psychiatry.
The Cancer Center's Tissue Procurement Facility provides tissue samples to all University research studies. The facility is authorized by the Institutional Review Board to obtain tissue that has been resected and would otherwise be discarded. Technologists obtain consent forms from patients prior to surgery and work with surgeons, pathologists, and investigators to maximize scientific value of tissue used in diagnosis. Tissues may be obtained fresh, frozen in liquid nitrogen, embedded in a cryopreservative, or fixed. There is a minimal charge for this service. For further information and application forms, call Diane Trussoni, technologist, at 624-6682. Amy Skubitz is medical director.
A new twist on giving up tobacco is offered by the School of Dentistry. Intended for both smokers and chewers, the program arose from observations made by dentists and hygienists about the effects of tobacco on teeth and gums. "Many studies have shown that tobacco use is a major risk factor for periodontal disease," says clinical dental specialist Eric Stafne, D.D.S., M.S.D., adding that gums of people who smoke or chew tobacco don't heal very well after treatment." The program combines a variety of approaches, including behavior modification and nicotine replacement using gum or a transdermal patch. Participants also fill out questionnaires to identify why and when they smoke. "It helps to know the reasons people smoke as well as their smoking rituals and routines in order help them stop," Stafne says. Data from participants will be used to learn more about periodontal disease and tobacco, and students will observe counseling techniques and follow-up. Cost is $85 for the initial visit and $25 for follow-up visits. For information, call 626-0440.
Complementary and alternative care options for health care will be explored at a day-long conference Sept. 16 at the Radisson Metrodome. Topics include herbal medicine, nutritional therapies, acupuncture for chemical dependency, menopause management, therapeutic touch for arthritis, and pain control through hypnosis. Sponsors are the University of Minnesota Center for Spirituality and Healing, directed by Mary Jo Kreitzer, and regional managed care organizations. To register, call 626-7600. Continuing Medical Education credit is offered.
The AHC goes to the State Fair. The AHC will be represented at the U's booth in the Education Building at the State Fair from August 21 through September 1. All schools, as well as the Cancer Center, will take turns hosting the booth. Health professionals will be available each day to talk to visitors, and students will do health screening tests. Visitors will also be able to access health information using a CD ROM. And the AHC program "Health Talk and You" will be televised before a live audience on August 28 in the KMSP building. Call Amy Olson at 624-5100 for further information or to volunteer.
The Center for Bioethics has moved to Suite N504 Boynton, 410 Church Street, SE. Phone number is 624-9440, fax 624-9108; e-mail, bioethx@tc.umn.edu.
The Aquatennial JELL-O slide raised about $15,000 for the University Children's Foundation (UCF) in the Department of Pediatrics. Participants who plunged into an 800-gallon pool of chilled JELL-O included interim Pediatrics Department Head James Moller; UCF director Alfred Fish, a pediatric nephrologist; and Andrew Laskey, pediatric rheumatologist. The pediatrics department raised $1,500 in pledges to support them. The event was covered by three television stations, the Star Tribune and the Pioneer Press. A group of 20 enthusiastic student and staff volunteers mixed up the red JELL-O. Co-sponsors were Kraft, Cub Foods, and KOOL 108-FM.
Special note: The university's Health Sciences Orchestra will appear on "Ordinary Extraordinary," on CBS (WCCO-TV 4) August 29 at 9 p.m. Sam Levine,
associate professor of otolaryngology, was interviewed about a new ear implant that allows deaf children to hear for a feature that aired on KARE-TV on July 30. John Wagner, associate professor of pediatrics, appeared on KSTP-TV on July 25 for a feature piece on a young boy with a rare anemia who needs a blood and marrow transplant. Rick Wagner, associate professor of medicinal chemistry, discussed his recent finding that the AIDS drug AZT was effective in limiting the growth of breast cancer cells. Kristine Ensrud, assistant professor of medicine and epidemiology, was quoted in a July 22 Washington Post debate on preventing hip fractures. Eli Coleman, professor of family practice and director of the program in human sexuality, appeared on KSTP-TV July 22 for a story on sex after pregnancy. He was also quoted in the June 30 San Diego Business Journal for a story examining the effect impotence has on a couples' lives. News that Jesse Edwards' heart collection could find a new home in the AHC made the pages of the Boston Sunday Globe on June 29. Richard Grimm, professor of medicine and epidemiology, was featured in the July 16 Pioneer Press for his research showing the use of a low-dose diuretic can reduce the risk of heart disease for people who have high blood pressure. Robert Maxwell, professor and head of neurosurgery, was interviewed by KSTP-TV for a piece on pallidal stimulation to treat Parkinson's Disease on July 16. Marshall Hoff, telemedicine coordinator, and Whitney Tope, assistant professor of dermatology, appeared on KMSP-TV on July 15 for a special feature on the University's telemedicine program. Dorothy Hatsukami, professor of psychiatry, discussed her tobacco cessation study July 14 on WCCO radio, MPR, WMNN and KSTP-TV. Roger Feldman, professor in the Institute for Health Services Research, was cited in the July 14 Star Tribune editorial examining proposed changes in how Medicare reimburses health-care providers. Les Robison, professor of pediatrics, was named in the July 3 edition of the Wall Street Journal regarding his finding that electromagnetic fields generated by power lines and household appliances do not increase a child's risk of developing leukemia. Dana Johnson, professor of pediatrics, appeared in the June 16 issue of Newsweek for a story about the health of children adopted internationally.
-Teri Charest
Dick Bianco has a nice view of trees along the Mississippi River from his office. But there's another view that he finds at least as interesting, one that most visitors don't see. It's a look into the past.
Transformed by a coat of white paint, neutral carpet, and formica-topped office furniture, his office was once the surgical laboratory where C. Walton Lillihei and Richard Varco, among others, "practically invented cardiovascular surgery," Bianco says. During the 1950s, medical history was made here as medical researchers helped develop the heart valve, the pacemaker, the oxygenator, and numerous surgical techniques.
As director of experimental surgery and a steward of the University's tradition of surgical innovations, Bianco thinks that's "pretty cool." From this historic spot, he coordinates experimental surgery services for the Department of Surgery, which include testing new surgical procedures on research animals; evaluating new implanted devices for biomedical companies; and providing training programs for a broad range of students. And he also plans the program's future.
It's evident from a look at recent research projects that the work of past Department of Surgery members is still thriving. Recent achievements include bowel transplantation, lung reduction surgery, pancreas and islet cell transplantation, and new pediatric heart valves. Bianco and his staff are also helping surgery faculty answer questions about xenotransplantation (use of animal organs in humans) by doing animal-to-animal transplants. And they work at the cellular level as well, for example providing pig liver cells for a bioartificial liver developed by Health Sciences Senior Vice President Frank Cerra, former head of surgery.
Evaluating devices for industry grew out of relationships with companies that spun off the surgery department. The program has continued to attract other clients by word of mouth. A current list ranges from small, start-up companies to Medtronic and St. Jude as well as companies in other parts of the country and around the world. Most testing is for cardiovascular devices, such as valves, vascular grafts, defibrillators and stents (short tubes that hold arteries open), although the program also gets requests to test neurological devices and other types of implants. Virtually all of the data generated is submitted to regulatory agencies to demonstrate safety and efficacy of devices prior to clinical use.
As exciting as this work is, Bianco takes a special interest in the educational component of the program. Students represent a broad range of ages, socioeconomic backgrounds, and educational preparation. Minority teenagers from Minneapolis work with St. Paul Academy students. The American Heart Association (AHA) funds summer scholarships for promising high school and college students. Other undergraduates come from colleges statewide as well as the U to learn more about medical, veterinary, and biomedical engineering careers. And residents and fellows come to refine their skills. A few have even made the complete journey from high school through residency.
"The beauty of this program is that funds generated from evaluating devices for industry support the students and residents, and the students and residents help with the testing for industry," Bianco says. The relationship exemplifies how research, education, and outreach can work together, he adds.
Learning the ethics of animal research is a critical part of each student's training. No animal is used without a good reason, Bianco stresses. And every study is carefully reviewed by the Animal Care Committee before being approved. "If we do our job right, we don't have to use as many animals and people will benefit from our research sooner," he says. Besides preaching ethics internally, Bianco is active in national organizations that promote quality care of research animals. He is director of the National Association for Biomedical Research and a member of the International Standards Organization. He's also the Institutional Official for the University's animal care program.
Bianco can often be found working with students in the program's busy surgical laboratories, watching the future of medicine unfold. "The excitement of this work is that you get to see everything first, from the next generation of medical devices to the next generation of surgeons and researchers," he says. On a given day, there are at least 15 to 25 faculty, staff, and students involved in several surgical procedures and providing care for animals, plus a parade of visitors from local high schools, colleges, and companies.
"Everyone is welcome here," says lab manager Lynne Hartman, who handles scheduling for procedures, staff, and visitors. "I think people feel that when we walk through the door. That's why we get so many groups." There's also a strong sense of camaraderie among faculty, staff, and student interns, Hartman says. "People are eager to teach, to help each other out. The kids really learn a lot. And at the end of the day, the staff thanks everyone for their help as they leave. It's a simple thing, but it really makes people feel appreciated."
Hartman is a part of the administrative structure that keeps things running smoothly. Others are Eric Solien, associate director, and Megan O'Farrell, administrative aide. There are also 15-25 staff technicians and full-time student workers.
If the laboratories seem a little crowded, it's because they are. In addition to the increasing number of visitors and student trainees, the program is also doing more projects for industry.
"Industry business has doubled over the past year," Bianco says. That's partly because he makes lots of visits to biomedical companies and goes to national meetings to attract new clients. But even Bianco is surprised by the dramatic increase.
"I think it's an indication that there is a real need for this service" he says. "And as federal grants become scarce we must identify additional sources of revenue like this to support basic research programs and the education of our residents."
-Peggy Rinard
The Minnesota Medical Foundation, which provides support for research and education at the University's medical schools in the Twin Cities and Duluth and the School of Public Health, has reported significant growth in gifts received and the endowment for fiscal year 1997, ended June 30. The growth resulted in support of a record number of student scholarships, research projects, and other efforts to advance health-related education, research, and service at the University of Minnesota.
"It's been an excellent year," says Barbara Forster, chair of the Minnesota Medical Foundation Board of Trustees. "Our continued growth has enabled the Foundation to substantially increase our support of health education and research at the University. We are very grateful to our generous benefactors who embrace the importance of our mission."
More than 14,500 donors contributed nearly $17 million during the past year. Gift production figures for the year, including future gift commitments, totaled $31 million. The Minnesota Medical Foundation endowment grew from $107 million on July 1, 1996, to approximately $145 million on June 30, 1997. Future philanthropy through planned gifts totals more than $60 million.
"Private support is critical to the advancement of health-related research and education at the University," says President Mark Yudof. "The impact of philanthropy is substantial. We are very grateful for the generous spirit of giving in this community."
A record 299 Medical School students received Minnesota Medical Foundation scholarships, and an additional 800 students and former students benefited from emergency and long-term, low-interest loans. More than 400 research projects -- seeking to solve the mysteries of cancer, heart disease, diabetes, Parkinson's disease, Alzheimer's disease, and many others -- were funded with the assistance of private contributions.
"We try to help people understand how they can have a significant impact on some of the most serious health issues of our time," says Foundation President and CEO Brad Choate. "These gifts mean improved health for citizens of our state, our country, and beyond."
For more information about the Minnesota Medical Foundation, call (612) 625-1440 or visit the web site at http://www.med.umn.edu/mmf.
-Jean Murray
You probably read about information-seeking skills, lifelong learning, evidence-based medicine, and outcome-based research in current journals and textbooks. These are not new ideas in health care education or in clinical practice. However, the information technologies and resources available today offer us new tools to teach these concepts and to use them in our research and clinical activities. The Bio-Medical Library is positioned to provide the resources and expertise to help the Academic Health Center in this endeavor.
The library has created an "Infrastructure for the Internet Generation," a new learning environment comprised of enhanced computer facilities, specialized classes, upgraded networks, and a multitude of electronic materials. The Bio-Medical Library's home page (www.biomed.lib.umn.edu) brings you desktop access to resources and provides electronic forms for you to request reference help, photocopy/delivery, recalls and renewals of library materials, inter-library loans, searches, and registration for library classes. Via this site you can link to "Health and Medicine in the News" a database created by Bio-Med staff, which provides substantive, verified information about health-related newspaper reports. This unique resource is regularly used around the world. You can also connect to HealthWeb, a collaborative project we have developed with colleagues from the Big Ten health sciences libraries. HealthWeb is a meta-list of current, authoritative web sites in more than 70 subject areas in the health sciences. Subjects include health administration, nursing, radiology, substance abuse, primary care, and telemedicine; links are made to sites for clinical information, organizations, resources, research and funding, electronic publications, conferences and events, and patient information.
To help patrons benefit fully from the new environment, the Bio-Medical Library has expanded instruction, offering a series of nineteen library-sponsored courses on the use of Internet and multimedia materials. These range from "Internet Basics," "Hands on Practice on the Internet," and "Basics of Database Searching" to more advanced topics including "Creating a World Wide Web Home Page," "Finding Health and Vital Statistics" and "Introduction to Molecular Biology Databases." Librarians also teach course-integrated classes to students upon request by instructors, and have co-sponsored classes with faculty. We are happy to provide classes on information and research sources tailored to your curricular objectives, and to help you design assignments to reinforce instruction.
Two years ago the library implemented BioMedSearch, a new user-friendly, server-based bibliographic search system. BioMedSearch provides on-site and remote access to such databases as MEDLINE, CINAHL (nursing and allied health), all sections of Current Contents, International Pharmaceutical Abstracts, Healthstar (health care policy/delivery; health services research), as well as cancer and bioethics files. In September, we will offer Web-based access to BioMedSearch. A new collection of fifteen high interest full-text journals is now available on BioMedSearch, encompassing JAMA, New England Journal of Medicine, Lancet, Science and others; fifteen additional titles including American Journal of Public Health and Nature will be added in the fall quarter. These journals are all hypertext linked from MEDLINE. Fourteen full-text nursing journals linked to CINAHL will also be available. University Libraries also offers free access to more than 100 electronic full text journals in the health sciences (www.lib.umn.edu/ej/j-health.html). This page links to the journals and also indicates access information such as passwords and format. Some titles included are: Journal of Biological Chemistry, Nucleic Acids Research, and Cancer.
Educational technology materials are available in the library in a variety of formats (CD-ROM, videodisc, software, and Internet-accessible). A sampler of titles follows. The Cochrane Library provides a critical summary of randomized controlled trials in health care; it is a key source for evidence-based practice. USP DI; Merck Manual; Scientific American Medicine and Stein's Internal Medicine are examples of several core reference and textbooks available in interactive electronic format. We also have a large collection of software titles in anatomy including ADAM Interactive Anatomy, Netter's Human Anatomy, and Visible Human.
The Bio-Medical Library has embarked on a number of collaborative initiatives with AHC programs. With the School of Nursing we have received funding from the National Library of Medicine to support health information access for rural nurse practitioner students. We are working with the Medical School to support faculty integration of information technology into the curriculum, as well as to link the new student computer lab to library resources and services. We recently completed a four-year project funded by the U.S. Department of Education to apply knowledge management concepts to biotechnology.
As you prepare for the new academic year, we invite you to visit us to sample the vast array of resources available in the Bio-Medical Library and to avail yourself of one-on-one consultation and help from our information experts. Or, visit us "virtually" from your desktop, laboratory or home, to obtain access to a wealth of electronic resources and assistance.
-Ellen Nagle Director, Bio-Medical Library
Russell Luepker, professor and head of epidemiology, received the American Heart Association Award for meritorious achievement at the annual delegate assembly, held in Dallas, Texas. Luepker was honored for his contributions to the association's scientific and community programs. Ernest Ruiz, professor of emergency medicine, was honored with a resolution from the Hennepin Country Board of Commissioners for founding the emergency medicine department at Hennepin County Medical Center and developing emergency medical services. Don Amren and Paul Singh received gold-headed cane awards at the Department of Pediatrics annual Education, Research, and Service Banquet in June. The department's highest honor, the awards recognize lifetime achievement. Julie Johnson, assistant professor of pharmacy, has been elected to the board of the Minnesota Chapter of the Arthritis Foundation. She is the first pharmacist to serve on the board. Eli Coleman, professor and director of the Program in Human Sexuality in the Department of Family Practice and Community Health, was elected president of the World Association for Sexology. Coleman also recently received the 1997 annual award from the National Men's Studies Association. Cheryl L. Perry, professor of epidemiology, received a Bush Sabbatical Supplement Program Award to support her 1998 sabbatical. Ellen Bellairs, chief resident in the Department of Therapeutic Radiology - Radiation Oncology, was honored by the American Society for Therapeutic Radiology and Oncology for her clinical research.
Letters, opinions, and news items should be sent to: this thursday, Academic Health Center Office of Communications, Box 735, 420 Delaware Street S.E., or e-mailed to ahcweb@gold.tc.umn.edu. Tel: 624-5100.
Letters may be edited for length and do not necessarily reflect the opinions of this thursday staff.
Publisher: Academic Health Center Office of Communications
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Research Services Office opens in September
AHC news in brief
(Proposals are not being requested for these funds, which were appropriated by the legislature in response to proposals submitted last winter.)
Media Watch
Experimental surgery carries on tradition of innovation
Private support advances medical research and education
Information Technology
Health sciences education in the information age
Kudos
this thursday is published biweekly for the University of Minnesota Academic Health Center community.
Director: Christine Roberts
Editor: Peggy Rinard
Writers: Gayle Bonneville, Teri Charest
Design: Ted Crandall, University Printing Services