News

April 4, 2013: Dr. Richardson Expands Her Work With Diabetes

Caroline R. Richardson, M.D., assistant professor, was elected chair of the Society of Behavioral Medicine’s special interest group on diabetes.  The group’s goals are to: 1) increase the presence of high-quality behavioral medicine research in diabetes at the SBM conference; 2) encourage interdisciplinary collaboration among researchers, clinicians, educators, and public health advocates that emphasizes the importance of the prevention and treatment of diabetes; and 3) support professional networking and the training of young investigators and students interested in diabetes research.

Dr. Richardson was also recently awarded two grants funded by Veterans Affairs.  The first project, Stay Strong, will look at ways to prevent weight gain in veterans newly returned from Iraq and Afghanistan.  In the second project, Online Diabetes Prevention Pilot Study, Dr. Richardson will study an innovative implementation of a group-based, fully internet-mediated diabetes prevention program in veterans.

 

April 1, 2013: Decision Aids in Cancer Screening

Masahito Jimbo, M.D., Ph.D., M.P.H., associate professor, completed a review of 73 cancer screening decision aids for breast, cervical, colorectal and prostate cancers.  The results will soon be published in CA: A Cancer Journal for Clinicians. The goal of this review was to assess the effectiveness of such decision aids, examine areas in need of more research, and determine how the decision aids can be currently applied in the real-world setting. In the review, Dr. Jimbo discusses the implications for future research and what clinicians can do now to incorporate decision aids into their practice.  Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Beuna Lichter Research Professor, was a co-author of this piece entitled, “What is lacking in current decision aids on cancer screening?”  See the abstract on PubMed.

 

March 29, 2013: Dr. Jimbo Shares His Research Expertise.

Masahito Jimbo, M.D., Ph.D., M.P.H., associate professor, was selected as a coach for the Mentored Research Academy: R01 Boot Camp. The boot camp is a new multi-tiered, mentoring program funded by UMMS Dean James O. Woolliscroft to support and increase the success rate of Medical School faculty applying for their first NIH Research Project Grant (R01). It is an eight-month program that is comprised of large group events and workshops, peer group activities, faculty coaches, and both internal and external subject matter experts.  Dr. Jimbo is currently coaching a team of physicians from internal medicine, radiation oncology, otolaryngology, and dermatology.  To learn more about this research program, please visit the Mentored Research Academy online.

 

March 29, 2013: Presenting Research From Ghana

Two students who worked with Katherine J. Gold, M.D., M.S.W., M.S., in Ghana presented work at the Consortium of Universities for Global Health’s annual conference this month.

Anna Meyer presented, “Speaking of Infant Loss: Societal Norms Among Bereaved Mothers in Ghana” and Aliisa Petrites presented “Physicians’ resilience in coping with high rates of perinatal death in a resource-poor setting.”

Dr. Gold noted, “This year our Ghana group was following up with mothers we had interviewed for post-partum depression the prior year.  Unfortunately, in almost 20% of cases, the babies had died since the first summer; Anna’s poster describes their experiences with infant death. We also talked to physicians and midwives to understand how they cope with recurrent stillbirth and infant mortality and yet continue to press on and care for patients.  Alissa found that there are many levels of coping.  At the highest levels, physicians reported feeling a duty to serve their country and help others—they kept going because they felt there was a larger reason for their work.  It was really quite inspiring and something which has not been previously researched in low-resource countries.”

 

March 25, 2013: Weight Gain in Pregnancy

Four family physicians, Tammy Chang, M.D., lecturer, Mikel Llanes, M.D., lecturer, Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, and Michael D. Fetters, M.D., M.P.H., M.A., professor, completed a study consisting of qualitative interviews of prenatal care providers and their approach to weight gain in pregnancy that was published in BMC Pregnancy and Childbirth.

In the publication "Perspectives about and approaches to weight gain in pregnancy: a qualitative study of physicians and nurse midwives" they state, "Both providers and patients may benefit from increased awareness of the morbidity of excess weight gain during pregnancy. Practice-level policies that support the monitoring and management of weight gain during pregnancy could also improve care. Research that further investigates the barriers to appropriate weight gain is warranted."

Read the publication on PubMed.

 

March 25, 2013: Published in Family Medicine

The March edition of Family Medicine features work by two Department faculty members.

In "Early Pregnancy Failure Management Among Family Physicians," co-authored by Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, researchers analyzed a survey women’s health providers and compared characteristics and practice patterns of family physicians who do and do not provide multiple options for early pregnancy failure (EPF). They found that family physicians are capable of providing a comprehensive range of options for EPF management in the outpatient setting, but few providers currently do so.  Read the complete publication (PDF).

Eric P. Skye, M.D., associate professor co-authored "Residency Program Solutions: Making a Difference in Quality Residency Education." The publications states that the Residency Program Solutions (RPS), consultants who assist family medicine residency programs in preparations for RRC site visits, have positively impacted iterations of Residency Review Committee-Family Medicine (RC-FM).  The researchers concur that Family medicine residency programs concerned about successful accreditation by the RC-FM will likely benefit from RPS Comprehensive Accreditation Program consultations by increased length of accreditation cycle and/or a decreased number of citations. Read the complete publication (PDF).

 

March 22, 2013: Statins Often Prescribed Without Good Evidence

Physicians may not fully consider cardiovascular risks when prescribing medications to lower patients’ cholesterol levels, according to a new University of Michigan Health System study that appears in the Journal of the American Medical Association: Internal Medicine this week.

Using a survey, the research team asked more than 200 physicians to make choices on the treatment of six different patients that they might consider treating for high cholesterol. Statins such as Lipitor, Crestor, and Zocor have become a widely-used method to lower cholesterol levels. In 2010 around 20 billion dollars was spent on statins.

“We found that physicians may be treating low-risk patients with statin medications that are unlikely to benefit,” says lead author Michael E. Johansen, M.D., clinical lecturer. Read more in the UMHS Headlines.

Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, Ananda Sen, Ph.D., associate professor, and Lee A. Green., M.D., M.P.H., professer emeritus were co-authors of the publication "A National Survey of the Treatment of Hyperlipidemia in Primary Prevention."

Dr. Johansen was also featured on Rueters and Fox News for this work.

 

March 8, 2013: Dr. Gold Continues Her Research in Ghana

Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, and Martha Boggs, B.S., clinical research coordinator, visited Kumasi, Ghana in January as part of a research grant from the University’s Institute for Research on Women and Gender.

The researchers presented the results of their baseline data on stillbirths at Komfo Anokye Teaching Hospital (KATH) where they were also able to meet with a senior obstetrician.  In addition to this, their main goals were to better understand the challenges for maternity care and contributors to stillbirth and other obstetrical complications within the community, to solidify relationships with current and future collaborators, and to double-check data which was collected for their pilot study.

They have plans for follow-up grant development in three main areas including: antenatal care outreach at Kumasi Central Market, tertiary hospital OB hotline for outside providers and referrals and training for community midwives.

 

March 8, 2013: Tools for Diabetes Self-Management

Caroline R. Richardson, M.D., associate professor, has recently become a member of the Diabetes HealthSense Task Group, part of the National Diabetes Education Program (NDEP).

The main objective of the Diabetes HealthSense Task Group is to update and review the resources of NDEP’s Diabetes HealthSense Tool. The task group will also identify and address resource gaps and explore ways in which NDEP can enhance promotion and evaluation efforts around this web resource.

“In order to successfully manage diabetes, patients need support in the form of information and behavioral skills building. The NDEP’s Diabetes HealthSense Task Group is leading a national effort to make available high quality tools to support self-management of diabetes and I’m looking forward to contributing to this effort,” says Dr. Richardson.

 

March 8, 2013: Looking at the Cost of Stillbirths

A study published in Maternal Child Health by Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, and Ananda Sen, Ph.D., associate professor, is one of the first to shed light on the unrecognized financial implications of stillbirth deliveries.

“There are more stillbirths every year in the United States than the number of deaths of all children ages 1-19 combined. Our findings suggest that increasing research on stillbirth prevention and bereavement support for families is not only compassionate care but also makes financial sense, noted Dr. Gold. 

Read more about "Hospital Costs Associated with Stillbirth Delivery" in the UMHS Headlines or see the complete publication at SpringerLink.

 

March 8, 2013: More Research from Dr. Richardson

In a recently published paper, Caroline R. Richardson, M.D., associate professor, and co-authors studied the association between sedentary behavior of overweight or obese adults with schizophrenia or schizoaffective disorders. The authors conclude, “From a clinical and public health perspective, the amount of time (approximately 13 hours) and percentage of time (81% excluding non-wear time associated with sleeping) engaged in sedentary behavior among overweight and obese adults in this population is alarming, and points to an urgent need for interventions to decrease sedentary behaviors.  The lack of associations between sedentary behavior and psychiatric symptoms may be due to a ceiling effect for sedentary behavior.”

Dr. Richardson also published a paper in BMC Public Health. In “A case-control study of physical activity patterns and risk of non-fatal myocardial infarction,” she and her co-authors examine how different types of exercise impacts myocardial infarction (heart attacks), and found that light indoor activity lowers the risk of heart attack.

 

March 8, 2013: Acupuncture Research Conference

Co-sponsored by the U-M Department of Anesthesiology and the Program in Integrative Medicine (UMIIM), the Society for Acupuncture Research (SAR) Annual Meeting will be held at the Michigan League in Ann Arbor, April 18-21, 2013.
The conference focuses on research advances and issues in acupuncture and Oriental medicine which includes acupuncture, herbal therapy, and other modalities, using quantitative and qualitative research addressing clinical efficacy, physiological mechanisms, patterns of use, and theoretical foundations. There will also be an oral presentation entitled, “Self-administered acupressure reduces chronic pain in breast cancer survivors.”

Suzanna M. Zick, N.D., M.P.H., associate research professor, will be giving a presentation, “Assessing objective outcomes for subjective symptoms in acupuncture research.”

Of the meeting, Dr. Zick says, “The SAR annual conference will be of import to primary care providers to become aware of the newest scientific evidence for translating acupuncture and other Traditional Chinese Medicine modalities into clinical practice.”

For more information, http://www.sar2013conference.org.

 

February 8, 2013: Fitness and Isulin Resistance

Caroline R. Richardson, M.D., association professor, co-authored “Daily physical activity predicts degree of insulin resistance: a cross-sectional observational study using the 2003--2004 National Health and Nutrition Examination Survey” which appeared in the January edition of the International Journal of Behavioral Nutrition and Physical Activity.  

The study examined the independent association of objectively measured physical activity on insulin resistance while controlling for confounding variables including: cardiorespiratory fitness, adiposity, sex, age, and smoking status.  Dr. Richardson and the research team found that the amount of time engaged in daily physical activity was associated with lower insulin resistance, whereas higher cardiorespiratory fitness was not. These results suggest that the amount of time engaged in physical activity may be an important determinant for improving glucose metabolism.

Read the complete publication at ijbnapa.org.

 

February 5, 2013: Deafness in the Medical Field

Are deaf and hard of hearing (DHoH) physicians getting the support they need? In a first of its kind study, Philip Zazove, M.D., the George A. Dean, M.D. Chair of Family Medicine, along with his co-authors, address the unique professional barriers faced by hearing-impaired physicians. The research team surveyed DHoH physicians and medical students to determine whether available accommodations enhance career satisfaction and DHoH providers’ ability to deliver care. The research has important implications for medical students, educators, employers and DHoH patients.

“This study highlights a little understood but clearly growing group of physicians who are demonstrating that hearing loss doesn't keep them from being a physician,” says senior author Dr. Zazove. “These doctors connect with DHoH patients in a way that hearing physicians can't.” 

The article, titled “Deafness Among Physicians and Trainees: A National Survey,” appears in the February 2013 issue of Academic Medicine(subscription required).

Learn more at uofmheath.org or U.C. Davis Health System.

 

January 25, 2013: Depression in Mothers in Ghana

Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, found that two-thirds of mothers of sick, hospitalized babies in Ghana showed high risk for symptoms of clinical depression – which puts their babies and young children at significant health risks.  She notes that postpartum depression in Africa appears to be at least as common and perhaps even more common than in high-income countries, yet very little research has looked at maternal mental health in developing nations.

Her paper, “Depression and risk factors for depression among mothers of sick infants in Kumasi, Ghana,” which was published in the International Journal of Gynecology & Obstetrics displays these findings.  Thomas L. Schwenk, M.D., emeritus professor, was a co-author of this paper.

 

January 25, 2013: Cancer Prevention Research

“Effects of Ginger Supplementation on Cell Cycle Biomarkers in the Normal-Appearing Colonic Mucosa: Results from a Pilot, Randomized, Controlled Trial,” co-authored by Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor, Zora Djuric, Ph.D., professor, Ananda Sen, Ph.D., associate professor and Suzanna M. Zick, N.D., M.P.H., was published in Cancer Prevention Research. The results of their pilot study suggest that ginger may reduce proliferation in the normal-appearing colorectal epithelium and increase apoptosis and differentiation relative to proliferation-especially in the differentiation zone of the crypts. 

 

January 25, 2013: Dr. Reed published in the Journal of Lower Genital Tract Disease

Little is known about patient satisfaction after having surgery to remove vulvovaginal lesions. Barbara D. Reed, M.D., M.S.P.H., professor, co-authored a paper that was recently published in the Journal of Lower Genital Tract Disease, “Postoperative sexual concerns and functioning in patients who underwent lysis of vulvovaginal adhesions.”

In this paper the co-authors found that “After surgery…women tend to be more likely to have intercourse, to have less urinary symptoms or infections, and to have fewer genital symptoms. However, for some, sexual difficulties persisted. It may be wise to consider sexual counseling for this population. Nevertheless, most of the patients stated that they were happy with the surgery and would recommend it to others.”

Full citation information: Suzuki V, Haefner HK, Piper CK, O’Gara C, Reed BD. Postoperative sexual concerns and functioning in patients who underwent lysis of vulvovaginal adhesions. J Low Genit Tract Dis. 2013 Jan;17(1):33-7.

 

January 25, 2013: Dr. Ruffin published in PLoS

“One out of six American men will be diagnosed with prostate cancer during their lifetime, and each year over 33,000 men die of this disease. The factors which separate indolent from aggressive disease remain unknown. Because prostate cancer is more prevalent in Western societies, it is hypothesized that both genetic and environmental factors play a prominent role in its etiology. Diet is considered one of the major modifiable environmental factors influencing disease course.”

Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor of Family Medicine, associate chair for research programs, co-authored a paper that was recently published in PLoS ONE, “Prostatic alpha-linolenic acid (ALA) is positively associated with aggressive prostate cancer: A relationship which may depend on genetic variation in ALA metabolism.”
Read the entire paper and learn more about their study on the PLoS website.

Full citation information: Azrad M, Zhang K, Vollmer RT, Madden J, Polascik TJ, Snyder DC, Ruffin MT IV, Moul JW, Brenner D, Hardy RW, Demark-Wahnefried W. Prostatic alpha-linolenic acid (ALA) is positively associated with aggressive prostate cancer: A relationship which may depend on genetic variation in ALA metabolism. PLoS ONE 7(12): e53104. doi:10.1371/journal.pone.0053104, Dec 2012.

 

January 21, 2013: Dr. Reed receives AMA-WPC Award

For excellence in mentorship, Barbara D. Reed, M.D., M.S.P.H., professor, hasreceived the Physician Mentorship Recognition award from the Women Physicians Congress of the American Medical Association.

Nominated by Carolyn Payne, who was an undergraduate at U-M at the time she worked with Dr. Reed, and who is now a medical student at another institution, says, “Dr. Reed’s mentorship in the field of clinical research provided me the highest quality introduction into the steps and processes behind conducting scientifically sound clinical investigation. Her instruction and guidance helped me to develop the skills and confidence necessary to become a contributor to the growing body of scientific literature on women’s health issues. I am happy to nominate Dr. Reed for recognition by the AMA-WPC as her mentorship and friendship, have been important components to my current success in medical school, and have influenced my desire to work further to expand our scientific understanding of women’s health issues.”

The study on which they worked together resulted in a paper that was published in the Journal of Women’s Health in November 2012, “Urogenital symptoms and pain history as precursors of vulvodynia—A longitudinal study.” (Full citation information: Reed BD, Payne CM, Harlow SD, Legocki LJ, Haefner HK, Sen A. Urogenital symptoms and pain history as precursors of vulvodynia—A longitudinal study. J Women’s Health, 2012 Nov;21(11):1139-43.)

“I was very honored to be nominated for this award. Working with committed, bright students, like Carolyn, has allowed me to share the joys and challenges of clinical research, as the students develop the skills needed to complete a project. When this results in publications for the students, their long hours, progress, and set-backs, are all put in perspective. The students come to appreciate the challenges of research—a challenge they may pursue in their careers, or one that will help them as they interpret research of others,” says Dr. Reed.

 

December 18, 2012: Dr. Reed to present at ISSWSH

The International Society for the Study of Women's Sexual Health (ISSWSH) fosters collaboration among clinicians, researchers, and academics to promote the good health of women.

Barbara D. Reed, M.D., M.S.P.H., professor, will be speaking at the 2013 ISSWSH annual meeting in February, in New Orleans, La. The talk, "Vulvodynia—does previous oral contraceptive use increase risk?", is based on a study that was coauthored with Laurie J. Legocki, Ph.D., lecturer, and Ananda Sen, Ph.D., research associate professor, from the Department of Family Medicine, and Sioban Harlow, M.D., professor of epidemiology; Margaret Helmuth, Ph.D., statistician from the Department of Epidemiology; Hope Haefner, M.D., professor of obstetrics and gynecology; and Brenda Gillespie, M.D., research associate professor of biostatistics.

"There has been ongoing controversy regarding the possible role of oral contraceptive use in vulvodynia risk. Our study indicates that oral contraceptives taken before the onset of vulvodynia do not increase risk—an important piece of information for physicians caring for these women. Further study on possible risk in specific subgroups will be ongoing," says Dr. Reed.

Learn more about the ISSWSH annual meeting, http://www.isswsh.org/meetings/2013/default.aspx.

 

December 11, 2012: Dr. Ruffin published in the American Journal of Health Behavior

Mack T. Ruffin IV, M.D., M.P.H., the Max and Buena Lichter Research Professor of Family Medicine, associate chair for research programs, was recently published in the American Journal of Health Behavior for a paper he co-authored, “Perceived risk of cervical cancer in Appalachian women.”

The authors interviewed nearly 600 women and found that those who have good or very good knowledge of cervical cancer, greater worry, and history of sexually transmitted infection had higher odds of rating their perceived risk as somewhat or much higher than did other women. Additionally, the authors found that former smokers had perceptions of lower risk.

From this information, Dr. Ruffin and his colleagues conclude that self-regulation model factors, or the way a patient understands the risk of illness and what she does to get better, are important to understanding cervical cancer risk in underserved women. They also note that smoking and worry to perceived risk may be a target for intervention.

“This study was led by Dr. Kimberly Kelly, a new investigator. Her work represents one of the first focusing on Appalachian women who still have higher rates of cervical cancer than other women in the United States even though they get checked regularly. The results will help us understand how we might eliminate the burden of cervical cancer for them,” says Dr. Ruffin.

Full citation information: Kelly KM, Ferketich AK, Ruffin MT IV, Tatum C, Paskett ED. Perceived risk of cervical cancer in Appalachian women. Am J Health Behav 36(6):849-59, Nov 2012.

 

December 6, 2012: Dr. Sen presents at U.S. Army Conference on Applied Statistics

Ananda Sen, Ph.D., research associate professor, was invited to give an oral presentation at the Army Conference on Applied Statistics (ACAS) held in Monterey, Calif., October 24-26, 2012.

ACAS is a conference of the Interface Foundation of North America and leading forum for the presentation and discussion of theoretical and applied papers relating to the use of probability and statistics for solving defense- and security-related problems.

Dr. Sen’s presentation, “Statistical inference for a parametric model for repairable systems under multiple failure modes,” focused on methodological advances in the field of recurrent events experienced by individuals or prototypes of a machine that are subject to multiple sources of recurrence.

“It has direct applications in industrial engineering and biomedical sciences,” says Dr. Sen.

To learn more, visit their website, http://www.armyconference.org.

 

December 4, 2012: A long-term study of vulvodynia symptoms

Lead author Barbara D. Reed, M.D., M.S.P.H., professor, and co-authors Laurie J. Legocki, Ph.D., lecturer, and Ananda Sen, Ph.D., research associate professor, were recently published in the Journal of Women's Health. Their article entitled, "Urogenital symptoms and pain history as precursors of vulvodynia: A longitudinal study" demonstrated that the incidence of vulvodynia was substantially increased among those with intermediate urogenital symptoms compared to those without any pain with intercourse or history of short-term vulvar pain.

"Our findings suggest that urogenital sensitivity may be very common long before patients present or are diagnosed with vulvodynia," says Dr. Reed.

Read the abstract online: http://www.ncbi.nlm.nih.gov/pubmed/23134279.

Full citation information: Reed BD, Payne CM, Harlow SD, Legocki LJ, Haefner HK, Sen A. Urogenital symptoms and pain history as precursors of vulvodynia: A longitudinal study. J Womens Health (Larchmt). Nov;21(11):1139-43, 2012.

 

November 29, 2012: Relief for cancer-related fatigue in breast cancer survivors

Breast cancer survivors often experience persistent fatigue after their treatment has ended.

Lead author Suzanna M. Zick, N.D., M.P.H., research associate professor, and co-author Ananda Sen, Ph.D., research associate professor, were recently published in BMC Complementary and Alternative Medicine. Their article entitled, “Acupressure for persistent cancer-related fatigue in breast cancer survivors (AcuCrft): A study protocol for a randomized controlled trial” compares two types of acupressure and their effectiveness to common or standard forms of treatment.

“Acupressure has been shown to decrease fatigue levels by as much as 70% while being inexpensive, non-toxic and easy to use. This study has the potential to develop a low-cost, self-care intervention for the most troubling of late-term effects in breast cancer populations, fatigue,” says Dr. Zick.

Read more about this study (http://www.biomedcentral.com/1472-6882/12/132).

Full citation information: Zick SM, Wyatt GK, Murphy SL, Arnedt JT, Sen A. Acupressure for persistent cancer-related fatigue in breast cancer survivors (AcuCrft): A study protocol for a randomized controlled trial. BMC Complementary and Alternative Medicine, 12:132, 2012.

 

November 12: Job stress and mental health problems contribute to higher rates of physician suicide, U-M study shows

Despite high access to health care, doctors are less likely to seek mental health treatment; trouble at work is associated with higher suicide risk for physicians

Doctors who commit suicide appear to be under-treated for mental health problems, despite their seemingly good access to health care, a new University of Michigan study shows. Read the rest of the press release featuring the study by Katherine J. Gold, M.D., M.S.W., M.S., assistant professor.

This was also featured on CBS Detroit, "Study: Physicians Have Higher Than Average Suicide Rates."

Read the article that appeared on PsychCentral, "Job Stress Linked to Higher Suicide Risks for Physicians."

Read the article that was featured on Science 2.0, "Health Care Access Doesn't Help Prevent Doctor Suicide."

MedPageToday featured the study as well, "Physician Suicide Linked to Work Stress."

This was also featured in UPI, "Doctors often don't get mental help."

From Life Matters Media: "Occupational stress: Doctors may suffer when unable to save lives."

From American Medical News, "Doctors shun the help that could cut suicide risk."

 

November 6, 2012: Dr. Richardson Has Been Invited to Speak at ACC.13

Caroline R. Richardson, M.D., associate professor, has been invited to speak at the ACC.13, the American College of Cardiology's 62nd Annual Scientific Session and Expo in March 2013 in San Francisco, Calif.

Her presentation is entitled, "Technology and informatics for lifestyle modification." For more information, visit their website.

 

 

 

October 25, 2012: Dr. Richardson Co-Authors Diabetes Clinical Care Guidelines

The U-M Health System recently published updated clinical care guidelines for diabetes. Co-authored by Caroline R. Richardson, M.D., associate professor, the guidelines are available to UMHS employees now, and will be available on the Agency for Healthcare Research and Quality website in January 2013.

The guidelines assist physicians in providing optimal care for patients in a cost effective manner, and focus on important clinical decisions and actions in the context of overall case management. They are based on empirical evidence, other evidence-based guidelines prepared by nationally recognized groups, and expert consensus about practical considerations in providing care.

Full citation information: Standiford CJ, Vijan S, Mi Choe, H, Harrison RV, Richardson CR, Wyckoff JA. Management of Type 2 Diabetes Mellitus (Update). Ann Arbor, Mich.: Office of Clinical Affairs, University of Michigan Health System, 2012.

 

October 23, 2012: Dr. Warber Receives Grant Award

Sara L. Warber, M.D., associate professor, received a $150,000 grant from the Health and Human Services, Department of Health Resources and Services Administration for the project, “Well-integrative medicine program in the University of Michigan School of Public Health Preventive Medicine Residency.” Dr. Warber is the co-principal investigator, and the grant runs now through 2014.

 

 

October 2, 2012: Dr. Aikens Receives Enhanced Grant Support

James E. Aikens, Ph.D., associate professor of family medicine, was recently awarded a $2.9 million grant from the National Institute of Mental Health (NIMH) for his research entitled, “Telemonitoring enhanced support for depression self-management.” It runs now through June 2017.

 

 

 

 

September 26, 2012: Dr. Warber Presents at WHO Symposium

Sara L. Warber, M.D., associate professor, Katherine Irvine, Ph.D., visiting professor from DeMontfort University, Leicester, United Kingdom, and Ph.D. student Melissa Marselle recently presented their work on the impact of different environments for an outdoor group walk on mental and emotional well-being at the World Health Organization (WHO) Europe Health Enhancing Physical Activity symposium in Cardiff, Wales. The focus of the symposium was "Physical Activity in the Natural Environment." More information can be found on the symposium's website.

 

June 19, 2012: Cultural Competence in Qatar

Michael D. Fetters, M.D., M.P.H., M.A., associate professor, is the co-author of "Cultural Competence Springs up in the Desert: The Story of the Center for Cultural Competence in Health Care at Weill Cornell Medical College in Qatar," which was published in the June edition of Academic Medicine. The paper discusses the efforts of Dr. Fetters and his co-authors in establishing the Center for Cultural Competence in Health Care, which educations students, faculty and health care providers about the cultural differences of nationalities and is the only one of it's kind in the Middle East. Find out more at Zawya or read the abstract at Academic Medicine (full article with subscription). The paper also received some press in Qatar. Please see the article in the Gulf Times.

 

June 18, 2012: Continued Research In Cervical Cancer Biomarkers

Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor, is the co-author of "Patterns of Cellular and HPV 16 Methylation as Biomarkers for Cervical Neoplasia" featured in the Journal of Virological Methods. The goal of this study was to determine if there was measurable methylation in cervical cancer screening samples, and if so, whether specific CpG sites in the selected candidate genes or HPV 16 genome were especially informative for differentiating cytology or HPV 16 status. To read the abstract, visit PubMed.

 

June 18, 2012: Research Presentation

Vijay Singh, M.D., lecturer, presented a poster at the Fathers & Fathering in Contemporary Contexts 2012 Annual Research Conference, on the NIH campus, Bethesda, Md. The poster is, "Moving up the magic moment: Engaging the expectant father at prenatal ultrasound," and co-presenters are Richard Tolman, LMSW, Ph.D., and Tova Neugut from the U-M School of Social Work. Future plans for their work include collecting more data. For more information, visit the conference website.

 

June 19, 2012: Further Research into Branding Excercise

A new study co-investigated by Caroline R. Richardson, M.D., associate professor, along with Michelle Segar, who is featured in the video, finds that overweight men and women responded differently to advertisements about the benefits from exercise. The researchers found that "daily well-being" motivates women to exercise, while "weight loss" and "health" are more motivational for men. Researchers investigated whether reading a one-page advertisement featuring one of those three reasons would influence intrinsic motivation for exercising, and whether men and women respond differently. Read more on theU-M News Service.

June 6, 2012: Michigan Family Medicine Research Day

The 35th Annual Michigan Family Medicine Research Day Conference was held on May 24. Once again, the Department had a great showing. Department award winners include:

• Best Oral Presentation by a Resident/Fellow – Patient Adherence and Knowledge
  • The Immediate effect of Third Trimester Group Education Classes on Maternal Knowledge by Puja Samudra
• Best Oral Presentation by a Resident/Fellow – Medical Education
  • Community Health Education in a Family Medicine Residency Curriculum: Educational Benefit for Resident Teachers and Community Learners by Elizabeth Nguyen and Nell Kirst
• Best Oral Presentation by a Resident/Fellow – Prevention
  Factors Associated with Shared Decision Making in Mammogram Screening by Jacob Bryan and Michelle Tortorello
• Best Poster by a Faculty Teacher
  • #1 – Experience Developing, Implementing and Evaluating a Family Medicine-Based Prenatal Group Visit Program for Japanese Women: Implications From a Mixed Methods Analysis for the Care of Patient Populations with Limited English Proficiency by Sahoko Little

June 4, 2012: Recruiting Research Subjects

Zora Djuric, Ph.D., professor, published "A Mediterranean dietary intervention in persons at high risk of colon cancer: Recruitment and retention to an intensive study requiring biopsies" in Contemporary Clinical Trials. The study recruited persons at increased risk of colon cancer to an intensive dietary intervention study that required biopsies of the colon by flexible sigmoidoscopy at baseline and after six months of intervention and found that flexible sigmoidoscopy does not appear to be a barrier for recruitment of high-risk individuals to an intensive dietary intervention trial, but that completing food records can be. Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor, and Ananda Sen, Ph.D., associate professor were among the paper's coc-authors. Read the abstract on PubMed.

June 4, 2012: Research Presentations

Sara L. Warber, M.D., associate professor, recently attended the International Research Congress in Integrative Medicine & Health. The following posters by Dr. Warber were featured at the conference.

• Addressing Nature Deficit Disorder: A Quantitative Survey Study of Multidimensional Aspects of Well-being among Young Adults at a Wilderness Camp
• Addressing Nature Deficit Disorder: A Mixed Methods Study of Social Well-being among Young Adults Attending a Wilderness Science Camp
• Prescribing Nature: A Content Analysis of Qualitative Responses among Park Users by Socio-demographics and Patterns of Use
• Natural Health Service: Enhancing Wellbeing with Group Walks in Green Spaces

Suzanna M. Zick, N.D., M.P.H., associate professor, also attended the conference and presented the following poster, which was co-authored by Ananda Sen, Ph.D., associate professor.

• Examination of the Association of Diet on Persistent Cancer Related Fatigue

May 15, 2012: Medical Students View of Future

Katherine J. Gold, M.D., assistant professor, co-authored a paper entitled "How Do Medical Students View the Work Life of Primary Care and Specialty Physicians," which was published in Family Medicine. The study found that as medical students prepare for residencies, many have negative views of their future work lives as physicians, especially if they have chosen a primary care specialty. Additional authors include Julie Philips, M.D., former resident, and Thomas L. Schwenk, M.D., emeritus professor. Read more in the UMHS Newsroom or the complete publication at STFM.org (PDF).

May 15, 2012: Tobacco Cessation

"Protocol of a randomized controlled trial of the Tobacco Tactics Website for operating engineers" co-authored by Caroline R. Richardson, M.D., associate professor, was published in BMC Public Health. The authors conducted a randomized control trial comparing the group's website to the state supported telephone hotline among blue collar workers, who are shown to have a higher rate of smoking. Read the complete publication at BioMed Central.

May 15, 2012: Reducing Diabetes Complications

Christine T. Cigolle, M.D., assistant professor, published a paper in the Journal of Gerontology. In "Clinical Complexity and Mortality in Middle-Aged and Older Adults with Diabetes," Dr. Cigolle found that both middle-aged and older adults may benefit from interventions that can prevent or delay the complications of diabetes, which include poor vision, nerve damage, heart disease and kidney failure. Read more in the UMHS Newsroom or see the complete paper at the National Center for Biotechnology Information.

March 29, 2012: Global Reach

Earlier this month, GlobalREACH sponsored a forum for the students who participated in the faculty mentored summer research projects in 2011 and for the students who will be participating in 2012. The Department featured posters by returning students and their mentors. Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, is a mentor for Ghana and David C. Serlin, M.D., assistant professor, for Ecuador. Several groups from both Ghana and Ecuador presented posters including:

• Peck D, Ligard S, Wong J, Rodriguez K, Serlin D, Heisler M. Barriers to Healthy Lifestyles: A Study of Diet and Exercise Among Chronic Disease Patients in Quito, Ecuador. (Poster) University of Michigan GlobalREACH Spring Meeting. March 6, 2012, Ann Arbor, MI.
• Rodriguez K, Peck D, Ligard S, Wong J, Serlin D, Heisler M. Improving Pre-Clinic Preparation for Patients with Chronic Conditions in Quito, Ecuador: A Randomized Controlled Trial. (Poster) University of Michigan GlobalREACH Spring Meeting. March 6, 2012, Ann Arbor, MI.
• Betts CL, Spangenberg K, Wobil P, Gold KJ. (Poster) Postpartum social support and interpersonal violence in Ghanaian women. University of Michigan GlobalREACH Spring Meeting. March 6, 2012, Ann Arbor, MI.
• Wiesner T, Spangenberg K, Wobil P, Gold KJ. (Poster) Correlation between interpersonal violence and pregnancy desire in Ghana. University of Michigan GlobalREACH Spring Meeting. March 6, 2012, Ann Arbor, MI.
• Jayasuriya T, Wobil P, Spangenberg K, Gold KJ. (Poster) Do mothers in Ghana understand why their baby is hospitalized? University of Michigan GlobalREACH Spring Meeting. March 6, 2012, Ann Arbor, MI.
  

The event was attended by Drs. Gold and Serlin, along with Kristi VanDerKolk, M.D., HOIII, who participated in the summer project in Quito and by Winnie Gossa, M.D., HOI, who will be working with the Uganda team. Both Drs. VanDerKolk and Gossa are using data collected on their trips for their original projects.

March 27, 2012: Asthma Treatment: A Team-Based Approach

Focusing on the best ways to help patients with asthma, Joyce E. Kaferle, M.D., assistant professor, and Leslie A. Wimsatt, Ph.D., educational planning and development administrator, conducted a study to see if a team-based approach of using a computer-based reminder system and nurse (RN) education would improve patient self-management of the disease would be effective.

They found that when doctors and nurses work together using the reminder system, the number of patients with asthma treatment plans increased.

"We have found that doctors are much more likely to recommend asthma action plans when they can just send the patient down the hall to an RN who has the time and skills to do a better job," says Dr. Kaferle. This study led to an article in the Journal of the American Board of Family Medicine.

March 27, 2012

Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor, is the co-author of two recent publications. In "Microsatellite Instability and DNA Mismatch Repair (MMR) Protein Deficiency in Lynch Syndrome Colorectal Polyps," published in Cancer Prevention Research, Dr. Ruffin and colleagues found that the prevalence of MMR deficiency increases with the size of adenomatous polyps suggests that loss of MMR function is a late event in Lynch syndrome-associated colorectal neoplasia. See the abstract at PubMed.

Another article, published in Human Vaccines & Immunotherapeutics, looked at disparities in HPV vaccine utilization rates and evaluated maternal correlates of HPV vaccination among their adolescent daughters. The article entitled, "National patterns in human papillomavirus vaccination: An analysis of the National survey of family growth" can be see online at Landes Bioscience.

March 27, 2012: Video Enhances Doctor/Patient Communication

An article co-authored by Michael D. Fetters, M.D., M.P.H., M.A., associate professor, presents health professionals with a how-to guide for using video-recorded doctor visits to help understand how patients and providers interact, enhance communication and ultimately improve patient care. The "video elicitation" technique described in the article published in the March/April edition of the Annals of Family Medicine, involves researchers interviewing patients or physicians about a recent clinical interaction while watching the session itself on video. Read more in UMHS' Health System Headlines. See the complete article in the Annals of Family Medicine.

March 19, 2012: Research Presentation

Caroline R. Richardson, M.D., associate professor, presented "The MOVE Program - Addressing Obesity in the Ambulatory Setting: A Team Approach" at the annual conference in Evidence Based Nursing Practice on March 16.

March 5, 2012: Utilizing Pedometers to Address Gestational Diabetes

Diabetic Medicine recently featured an article entitled, "A web-based pedometer programme in women with a recent history of gestational diabetes," by co-authors Michelle Draska, Research Area Specialist, Michael L. Hess, Director of Infrastructure ActiveStep, Elizabeth J. Wilson, Web Project Manager, and Caroline R. Richardson, M.D., associate professor. The group conducted a pilot study and found that structured web-based education utilizing pedometers is feasible although uptake may be low and to be successful similar programmes may need to be supplemented with additional measures in order to be effective for reduction of diabetes risk. Read the complete article in Diabetic Medicine (PDF).

March 5, 2012: Epidurals and Japanese Culture

Michael D. Fetters, M.D., M.P.H., M.A., associate professor, was the co-author of "Experiences with epidural anesthesia of Japanese women who had childbirth in the United States," which is featured in the Journal of Anesthesia. Dr. Fetters and colleagues examined the popular belief that cultural views are a critical barrier to the use of epidural anesthesia during childbirth in Japan, even though it is not routinely available. By studying Japanese women living in Michigan, where access to epidural anesthesia is routine, they found many chose to have it. Their findings indicate that limited access is a barrier at least as important as cultural barriers to epidural anesthesia use in Japan. Read the complete publication at SpringerLink.

March 5, 2012: Honorable Mention at STFM

The paper, "An Online Community Improves Adherence in an Internet-mediated Walking Program. Part 1: results of a randomized Controlled Trial" by Caroline R. Richardson, M.D., associate professor, was selected as Honorable Mention as part of the Society of Teachers of Family Medicine Best Research Paper Award. Her work will be recognized at the STFM Annual Spring Conference in April and will be on display during the poster sessions. Additional department authors include: Adrienne W. Janney, M.S.I., Ananda Sen, Ph.D., Michael L. Hess, M.S.I., Kathleen S. Mehair, B.A., and Laurie A. Fortlage, M.S. The article can be found in the Journal of Medical Internet Research.

February 13, 2012: Improving Diet During Chemotherapy

Zora Djuric, Ph.D., professor, published "A Diet and Exercise Intervention during Chemotherapy for Breast Cancer" in The Open Obesity Journal. Caroline R. Richardson, M.D., associate professor, and Ananda Sen, Ph.D., research associate professor, were co-authors of the publication. Knowing that weight gain can be a concern that impacts the outcomes and general health of breast cancer survivors, the researchers sought to evaluate women's compliance with a weight control program initiated at the beginning of their chemotherapy treatment. The pilot study indicated that women would comply with this type of program and that lifestyle counseling can be used to prevent a gain in body fat during treatment. They also noted, that without counseling, women who began treatment at lower BMIs saw the greatest body fat gain indicating that programs could improve well-being and health in all patients, not just those who are overweight or obese. Visit PubMed to read the complete publication.

February 13, 2012: Funding Mixed Methods Research

Michael D. Fetters, M.D., M.P.H. M.A., associate professor, published "RO1 Funding for Mixed Methods Research: Lessons Learned From the 'Mixed-Method Analysis of Japanese Depression' Project" in the Journal of Mixed Methods Research. The paper addresses the gap in the need for missed methods research of complex health-related phenomena and the lack of published articles addressing funding of such projects. In addition to looking at a National Institute of Mental Health project, the authors examined reviewers' comments and the authors' insights related to mixed methods proposals for successfully achieving RO1-level funding. Read the complete publication at Sage Journals.

February 13, 2012: A Further Look at Pedometer Use

Caroline R. Richardson, M.D., associate professor, wrote a commentary on "The Pre-diabetes Risk Education and Physical Activity Recommendation and Encouragement (PREPARE) programme study: are improvements in glucose regulation sustained at 2 years?" Dr. Richardson's commentary entitled, "Physical education combined with pedometer use is associated with better glucose tolerance among overweight/obese with impaired glucose tolerance; no benefit for education alone" appeared in Evidence-Based Medicine.

February 13, 2012: Health Beliefs

Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor, was co-author of a publication entitled, "Health beliefs among individuals at increased familial risk for type 2 diabetes: Implications for prevention," which was published in Diabetes Research and Clinical Practice. The study evaluate the perceived risk, control, worry and severity about diabetes, coronary heart disease and stroke among individuals who are a increased familial risk of diabetes. Read the abstract at PubMed.

February 13, 2012: Dr. Reed and Vuvlodynia Care In the News

For more than 100,000 Michigan women, chronic vulvar pain is so severe it makes intercourse, and sometimes sitting for long periods of time, painful, if not impossible. A study by Barbara D. Reed, M.D., M.S.P.H., professor, which surveyed 2,269 women in the metro Detroit area, found that more than 25 percent of women have experienced ongoing vulvar pain at some point in their lives. However, only two percent of women sought treatment for their pain. Additionally, the study, published in the American Journal of Obstetrics and Gynecology, found that 9.2 percent of women reported that they were currently experiencing pain consistent with vulvodynia, characterized by a burning, irritation, or sharp pain near the opening of the vagina that can vary greatly in women, and an additional 17.9 percent experienced symptoms in the past. Dr. Reed was featured in the most recent edition of U-M's Colleagues in Care. The publication was also discussed in the UMHS Newsroom after it was published online.

January 18, 2012: Research Presenation

Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor in Family Medicine, presented "The Role of Stress in HPV Infection Prevention in Women" at the Child Health Evaluation and Research Unit, Health Services Research Seminar on January 17, 2012.

January 16, 2012: Ginger Root as Cancer Prevention

"Phase II Study of the Effects of Ginger Root Extract on Eicosanoids in Colon Mucosa in People at Normal Risk for Colorectal Cancer," a publication by Suzanna M. Zick, N.D., M.P.H., assistant professor, was recently featured online on EmpowHer. "Ginger root may help some people prevent colon cancer, according to a new study published in the journal Cancer Prevention Research. Suzanna M. Zick, a naturopathic doctor at the University of Michigan Medical School, and colleagues found 2 grams of ginger root supplements taken daily, reduced markers of colon inflammation in a blind clinical study. Inflammation has been implicated in prior studies as a precursor to colon cancer." Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor, and Zora Djuric, Ph.D., professor, were co-authors of this publication.

January 16, 2012: Colon Cancer Risk Reduced by Diet

Zora Djuric, Ph.D., professor, was interviewed by Frontier Voice of Nutrition Remarks to discuss her research in the use of the Mediterranean diet to reduce the risk of colon cancer. "Unhealthy inflammation associated with unhealthy dietary patterns can increase colon cancer risk. Further, she added that the colon cancer risk is high for those who live in parts of the industrialized world such as the United States. Although in Greece, where people routinely consume a Mediterranean diet, the colon cancer rate is very low. However, the rate has increased among the people who migrated from Greece to industrialized countries. Using validated scientific information, Prof. Djuric clearly explained that the Mediterranean diet has multiple beneficial effects to lower colon cancer risk and improve colon health." Read the interview at Nutrition Remarks.

January 16, 2012: VA Research Network in Ann Arbor

VA Ann Arbor Healthcare System was selected as a VA Women's Health Practice-Based Research (PBRN) member site and Caroline R. Richardson, M.D., associate professor, was named the site lead. The Women's Health Research Network, composed of Consortium and Practice-Based Research Network (PBRN) components, focuses on VA investigators with demonstrated interests in women's health research and investigators interested in adding women to their research. Through the Consortium, VA develops education and training sessions in key content and methodological areas, provides technical consultations, enhances communication networks, develops a mentoring program, and fosters effective dissemination. Through the PBRN, VA has developed an infrastructure across partnered VA facilities to facilitate multi-site research.

December 12, 2011: Depression and Violence During Pregnancy

Increased screening of pregnant women and new mothers for major depression and conflicts with intimate partners may help identify women at risk for suicide, an analysis of federal data by Katherine J. Gold, M.D., M.P.H., M.S., assistant professor, concludes. Only a small percentage of women who take their own lives are pregnant or have recently become mothers, but their frequent interactions with the health care system may provide important opportunities for providers to intervene if risk factors are better understood, Dr. Gold says. The findings were published in General Hospital Psychiatry. Vijay Singh, M.D., lecturer, was also an author of this study. The study was featured in the UMHS Newsroom and has received wide promotion in U.S. News and World Report, NBC New York, Daily RX, Nurse.com, Doctors Lounge, UPI.com, and EurekAlert!, Additionally, the paper was featured within the health system on their homepage, in the Health System Headlines and on the Depression Center's website.

December 12, 2011: Dr. Ruffin Publishes Cancer Research

Mack T. Ruffin IV, M.D., M.P.H., the Dr. Max and Buena Lichter Research Professor in Family Medicine was co-author of a paper, "Clinical utility of family history for cancer screening and referral in primary care: A report from the Family Healthware Impact Trial," published in Genetics in Medicine. The study assessed the effectiveness of computerized familial risk assessment and tailored messages for identifying individuals for targeted cancer prevention strategies and motivating behavior change. Read the abstract on PubMed. Dr. Ruffin also co-authored a paper entitled, "Age-group Differences in Human Papillomavirus Types and Cofactors for Cervical Intraepithelial Neoplasia 3 Among Women Referred to Colposcopy" in Cancer Epidemiology Biomarkers & Prevention. Read the abstract on PubMed.

December 12, 2012: Research Presentation

Michael D. Fetters, M.D., M.P.H., M.A., associate professor, will present "Development and Experience with Virtual Human Patients in Health Communication Research" at the Center for Health Communications Research on December 15. See more at CHCR.

 

October 17, 2011: Family Medicine in the News

Michael D. Fetters, M.D., M.P.H., M.A., associate professor, and colleague published a comment entitled, "Education for health professionals in Japan—time to change" in The Lancet. The comment states, "Japan is known for its good health outcomes, which might indicate support from a strong primary health-care system; however, this is not the case. Most of the country's primary-care physicians are not primary-care physicians according to the standard definition. Furthermore, scarcity of gatekeepers—ie, primary-care physicians who are not well trained as generalists allow patients to self refer to secondary-care or tertiary-care hospitals even when their ailments could be treated just as well, if not better, at the primary-care level." This is key to what Dr. Fetters is working on with his Shizuoka-University of Michigan Advanced Residency Training and Exchange Research in Family Medicine (SMARTER Family Medicine) Project which aims to develop a Japan/US training exchange to provide advanced and clinical teaching skills to Japanese Family Physicians in both inpatient and outpatient community settings. Read the comment in The Lancet (subscription required).

October 17, 2011: Pregnancy Loss

Katherine J. Gold, M.D., M.S.W, M.S., assistant professor, published a moving and deeply personal essay in the most recent issue of the Journal of the American Medical Association. In the essay entitled, "In the Still of the Night," Dr. Gold discusses her experience with pregnancy loss and how she integrates her experience into her daily life as a physician. "Most of the time I can separate my own experience from that of my patients. I do not mention my loss to them. My career shifted to research, and I ended up examining the impact of perinatal death on families. How health care professionals deal with grief and bereavement. How we can improve care for families. My personal experiences help me understand the questions that need to be asked, but they do not give me the answers. After all, research involves data and statistical analysis. It is not hard to separate my emotions from epidemiology." Read the complete essay at JAMA (subscription required).

October 10, 2011: Research Grant Awarded

Sahoko H. Little, M.D., lecturer, was awarded a grant from the Center for Japanese Studies (CJS) to complete her project, "Stress and Expectations of Japanese Pregnant Women in the United States." Previously reported sources of stress were: language barriers, distance from family and friends, different culture, and health-care attitudes about childbirth. This project aims to identify sources of stress and expectations of pregnant Japanese women in the U.S. and assess how well the JFHP is addressing them. Read more on page 18 of the CJS newsletter.

October 10, 2011: Clinical Reminders in Prenatal Care

Margaret A. Riley, M.D., associate professor, Susan (Bettcher) Galang, M.D. (Residency 2008), and Lee A. Green, M.D., M.P.H., professor, recently published "The Impact of Clinical Reminders on Prenatal Care" in Family Medicine. Dr. Riley notes, "Prenatal care guidelines call for timed screening and diagnostic testing based on a patient's gestational age. We found that resident and faculty physicians were missing opportunities to provide recommended prenatal care services, and that point of care clinical reminders improved our compliance with prenatal care standards. Compliance decreased towards baseline levels when the clinical reminders were no longer active. Our study supports the use of clinical reminders as an effective way to aid family physicians follow prenatal care guidelines." Read the complete publication at STFM.org.

October 6, 2011: Doctor-Patient Communication

Subtle and unspoken clues exchanged by patients and doctors exert an influence on medical care, according to a new study by Michael D. Fetters, M.D., M.P.H., M.A., associate professor, and colleagues. Researchers analyzed video recordings of routine checkups and conducted follow-up interviews with participants to help elucidate signals sent and received on both sides of the examination table. The method shows promise for improving medical decision making by allowing doctors to better understand how they make judgments and what messages they may be unwittingly conveying to patients, the researchers explain. The study found that patients relied on non-verbal clues to evaluate the doctor-patient relationship, focusing on whether the doctor seemed hurried or put them at ease. Doctors, on the other hand, reported that patients' tacit clues influenced their medical judgments. The results were published in the Journal of Evaluation in Clinical Practice. Read more in the UMHS Newsroom. The study was also featured on examiner.com, DoctorsLounge, PsychCentral, Heritage Newspapers, Drugs.com, RWJF Alumni News, and NewsWise.

October 4, 2011: Re-branding Exercise

A new study by Caroline R. Richardson, M.D., associate professor, and colleagues in The International Journal of Behavioral Nutrition and Physical Activity finds that the most convincing exercise message emphasizes immediate benefits that enhance daily quality of life. Health care, business and public health have presumed that promoting health and longevity benefits from exercise will motivate people to exercise. The new findings, however, indicate that these individuals exercised less than those who aimed to enhance the quality of their daily lives. Read more in the UMHS Newsroom. The study was also featured on ABC 7 WXYZ, NewWise, BioScholar News, and Athletic Business.

October 4, 2011: Mixed Methods Health Research

Michael D. Fetters, M.D., M.P.H., M.A., associate professor, served on the NIH working group to establish the first-ever Best Practices in Mixed Methods Health Research Guidelines. Mixed methods research combines the strengths of quantitative research and qualitative research. Despite the increased interest in mixed methods research in health fields and at NIH, prior to this report, there was limited guidance to help scientists developing applications for NIH funding that featured mixed methods designs, nor was there guidance for the reviewers at NIH who assess the quality of these applications. Read the complete press release at NIH News and see the guidelines/best practices at the Office of Behavioral and Social Science Research.

September 30, 2011: Recent Faculty Presentations

Mack T. Ruffin IV, M.D., M.P.H., professor, and colleagues presented "Use of HPV testing in low risk women ages 30-35" and "HPV Papillomavirus vaccine knowledge and acceptance among women in Appalachia" at the 27th International Papillomavirus Conference in Berlin, Germany.

Barbara D. Reed, M.D., M.S.P.H., professor, presented "Vulvodynia & other co-morbid pain conditions" at the ISSVD World Congress in Paris, France.

Lee A. Green, M.D., M.P.H., professor, presented "Using Mixed Methods to Study Care Management in Primary Care Practice" at the Agency for Healthcare Research and Quality Annual Conference in Bethesda, Md.

September 30, 2011: More Insight Into Vulvodynia

For more than 100,000 Michigan women, chronic vulvar pain is so severe it makes intercourse, and sometimes sitting for long periods of time, painful, if not impossible. A study by Barbara D. Reed, M.D., M.S.P.H., professor, which surveyed 2,269 women in the metro Detroit area, found that more than 25 percent of women have experienced ongoing vulvar pain at some point in their lives. However, only two percent of women sought treatment for their pain. Additionally, the study, published in the American Journal of Obstetrics and Gynecology, found that 9.2 percent of women reported that they were currently experiencing pain consistent with vulvodynia, characterized by a burning, irritation, or sharp pain near the opening of the vagina that can vary greatly in women, and an additional 17.9 percent experienced symptoms in the past. Read more in the UMHS Newsroom. The study was also featured on Reuters, The Huffington Post, Live Science and HealBlog.net.

September 26, 2011: Research Subjects Needed

The Department, in conjunction with U-M Integrative Medicine, is looking for individuals to particpate in a research study about the effects of tart cherries.

Potential subjects must:

• Be 18 years or older
• Be able to provide their own transportation
• Be overweight or obese
• Have abnormal cholesterol levels
• Have high blood pressure
• Be willing to consume 45 tart cherries twice a day for 28 days

Participants will:

• Participate in two 5-hour stays at the Michigan Clinical Research Unit (MCRU)
• Have blood drawn on the first and last days of the 28-day study
• Be paid up to $250 for their participation

For more information, please contact the research team at (866) 219-9100 or umcherry2011@umich.edu.

Setember 8, 2011: Faculty Research
Barbara D. Reed, M.D., M.S.P.H., professor, was named co-chair of the Pathophysiology of Vulvodynia session of the ISSVD XXI World Congress that was held September 3-8, 2011 in Paris, France.

August 22, 2011: Healing Foods Pyramid

The Healing Foods Pyramid™, developed by Jenna Wunder, M.P.H., R.D., Program Coordinator and Registered Dietitian, was the sole featured food pyramid in the recently published book, "The Essential Guide to Healthy Healing Foods" by Victoria Shanta Retelny. The Healing Foods Pyramid encourages the consumption of foods known to contribute to health. Plant-based foods, whole grains, healthy fats, and a colorful array of fruits and vegetables create the variety and balance needed in a healthful diet. "This is an exciting book to be included in because it highlights what foods to eat and why. The Healing Foods Pyramid was created with this same premise in mind," said Jenna. Sara L. Warber, M.D., associate professor and director of U-M Integrative Medicine adds, "Inclusion of the HFP in this book highlights the lasting contribution made by this patient-centered tool." Read more about the Healing Foods Pyramid on the Integrative Medicine Website.

August 19, 2011: Movement and Kidneys

In a recent study, "Association between Physical Activity and Kidney Function: National Health and Nutrition Examination Survey," Caroline R. Richardson, M.D., associate professor, and colleagues determined the association between time spent at all levels of physical activity intensity and sedentary behavior and kidney function. The study was published in Medicine & Science in Sports & Exercise and reported that total and light physical activities were found to be positively associated with kidney function. Read the abstract on PubMed.

August 16, 2011: Retreat Inspires Hope in Heart Patients

Attending a non-denominational spiritual retreat can help patients with severe heart trouble feel less depressed and more hopeful about the future, Sara L. Warber, M.D., associate professor and director of U-M Integrative Medicine found in a study entitled, "Healing the Heart: A Randomized Pilot Study of a Spiritual Retreat for Depression in Acute Coronary Syndrome Patients." The study, which was published in Explore: the Journal of Science and Healing, was the first randomized clinical trial to demonstrate an intervention that raises hope in patients with acute coronary syndrome. "Our work adds an important spiritual voice to the current discussion of the importance of psychological well-being for patients facing serious medical issues, such as acute coronary artery disease," Dr. Warber says. The publication was featured in the UMHS Newsroom and has received wide media coverage including: Michigan Radio, Scope (Stanford Medicine), BeliefNet, Science Daily, Health 24, The Times of India, Barchester Healthcare News, Healthcare Today, Telecinco, EurekAlert, WPVI Philadelphia, KTLA Los Angeles, and WJW Cleveland – Akron.

August 9, 2011: Family Medicine in the News

The Journal of the American Medical Association recently reported on the depression tool developed by Family Medicine faculty, Michael S. Klinkman, M.D., M.S., professor, and James E. Aikens, Ph.D., associate professor, along with adjunct associate professor, Donald Nease, M.D. The Remission Evaluation and Mood Inventory Tool (REMIT) is designed to help primary care physicians determine whether their patients with depression are in remission. Read the complete article in JAMA.

The work of Drs. Klinkman, Aikens, and Nease was also featured prominently in the most recent edition of UMHS' Colleagues in Care. The article entitled, "New tool aims to improve measurement of primary care depression outcomes" can be found on page 10 of the newsletter (PDF).

August 9, 2011: Looking Closer at Gestational Diabetes

Caroline R. Richardson, M.D., associate professor, and colleagues examined the concurrent associations between postpartum sex hormone binding globulin (SHBG) and glucose measures from a 75-g oral glucose tolerance test (OGTT) among non-pregnant women with recent GDM. The study, recently published in Diabetes Research and Clinical Practice, was the first to look into this association. Read the abstract on Science Direct.

July 6, 2011: Depression and Pregnancy

Caroline R. Richardson, M.D., associate professor, and colleagues recently published "Lengthened Predelivery Stay and Antepartum Complications in Women with Depressive Symptoms During Pregnancy" in the Journal of Women's Health. The study found that that depressed women had significantly longer-than-average hospital stays: more than 24 hours prior to delivery. It also linked depression in pregnant women to an increased risk of complications like pre-term delivery, pre-eclampsia, premature membrane rupture and gestational diabetes. Read the abstract at PubMed and read a news release at Georgia Health and Science University News and Information.

July 6, 2011: Online Walking Programs

In an article entitled "Integrating an Internet-mediated Walking Program Into Family Medicine Clinical Practice: A Pilot Feasibility Study" published in BMC Medical Informatics and Decision Making, Christine W. Krause, M.D., instructor, Ananda Sen, Ph.D., associate professor, and Caroline R. Richardson, M.D., associate professor, sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH) and to monitor participant progress in the program. The study found that providers successfully referred patients to SUH, but were less willing to monitor their compliance. Additionally, the study showed that patients who completed the program significantly increased their step counts. Read the abstract at PubMed.

July 5, 2011: Looking at Family History

In an article entitled, "Clinical Use of the Surgeon General's 'My Family Health Portrait' (MFHP) Tool: Opinions of Future Health Care Providers" which was published in the Journal of Genetic Counseling, Mack T. Ruffin IV, M.D., M.P.H., professor, mentored Kailey M. Owens, a genetic counseling student in an examination the opinions of medical students and house officers as they used the MFHP tool. The study was designed in response to the 2009 NIH State-of-the-Science" Family History and Improving Health" conference which stated that more research is needed regarding health care providers' opinions of family history tools. This was the first study that sought the opinions of medical students and house officers. The study found that the majority of participants agreed that the MFHP tool is understandable, easy to use and suitable for general public use. The participants also felt that taking a family history is an important part of patient care, that medical geneticists and/or genetic counselors are not solely responsible for taking a family history, and that they would recommend their patients complete the MFHP tool prior to their appointment. To read the abstract, please visit SpringerLink.

June 24, 2011: Family Medicine Presentations

Caroline Richardson, M.D., associate professor, presented "Large scale implementation issues in automated internet-mediated walking interventions" at the Society for Ambulatory Assessment 2011 Conference in Ann Arbor.

June 13, 2011: Research in Statistics
Ananda Sen, Ph.D., associate professor, will speak at the The Seventh International Conference on Mathematical Methods in Reliability - Theory, Methods, and Applications, June 20-24 in Beijing, China. The title of his presentation is "Analysis of Repairable Systems Under Multiple Sources of Failure."

June 13, 2011: Further Developments in Vulvodynia
Barbara Reed, M.D., M.S.P.H., professor, will speak about vulvodynia at the Eunice Kennedy Shriver National Institute of Child Health and Human Development on July 11th and 12th in Washington, D.C. The goal of this workshop is to develop a National Institutes of Health (NIH) research plan for vulvodynia as a chronic pain condition.

June 8, 2011: Michigan Research Day XXXIV

Resident award winners: Alisa P. Young, M.D. (left), Thomas A. O’Neil, M.D., and Marisyl D. de la Cruz, M.D.

The Department of Family Medicine once again had a strong showing at the annual Family Medicine Research Day, in both oral and poster presentations. Residents and students achieved an impressive five out of twelve awards for their work. The event, sponsored by the Michigan Academy of Family Physicians, Michigan State University, University of Michigan, and Wayne State University, was held on May 26 at Cleary University in Howell, Mich.

Oral Presentations by Faculty:

Masahito Jimbo, M.D., Ph.D., M.P.H., associate professor of family medicine and urology, and inpatient service chief, “Decision aid to technologically enhance shared decision making.” There were many co-investigators; those from the Department were Ananda Sen, Ph.D., associate professor; Laurie A. Fortlage, M.S., R.D., project coordinator; and Nora Arato, Ph.D., data manager.

Oral Presentations by Residents:

Marisyl D. de la Cruz, M.D., house officer III and co-chief resident, won the award Best Oral Presentation by a Resident/Fellow (Clinical) for, “Use of HPV testing for cervical cancer screening in low risk women ages 30-65.” Co-investigators were Alisa P. Young, M.D., house officer III; and Mack T. Ruffin IV, M.D., M.P.H., professor and associate chair for research programs.

Jeffrey Kim, M.D., house officer III, “University of Michigan Department of Family Medicine inpatient teaching curriculum improvement.” Kei Miyazaki, M.D., house officer III, was the co-investigator on the project.

Kei Miyazaki, M.D., house officer III, “Cultural acceptability of group OB visits to Japanese women in the United States.” Co-investigators were Sahoko H. Little, M.D., Ph.D., lecturer; and Michael D. Fetters, M.D., M.P.H., M.A., associate professor and director of the Japanese Family Health Program.

Thomas A. O’Neil, M.D., house officer III and co-chief resident, won the award Best Oral Presentation by a Resident (Quality Improvement/Quality Assessment/Curriculum Development) for, “Virtual paychecks as a model to improve resident billing and coding.” Co-investigators were Margaret A. Riley, M.D., lecturer; Ananda Sen, Ph.D., associate professor; and Joel J. Heidelbaugh, M.D., associate professor of family medicine and urology, and clerkship medical director.

Suzanne V. Ross, M.D., house officer III, “Nutrition fundamentals for clinicians: An educational module.” Jamie Szelagowski, M.D., house officer III, was the co-investigator on the project.

Oral Presentations by Students:

Rayna M. Edwards, M.P.H., U-M School of Public Health student, won the award Best Oral Presentation by a Student (Clinical) for, “Compounded suffering: A population-based evaluation of the relationship between vulvodynia and interstitial cystitis.” Her faculty advisor and co-investigator on the project was Barbara D. Reed, M.D., M.S.P.H., professor.

Heather A. Elliot, M.P.H., U-M School of Public Health student, won the award Best Oral Presentation by a Student (Educational/Behavioral) for her work on, “How social relations contribute to patient assessments of healthcare quality in an extremely high-density multicultural setting in the Arabian Gulf region: Preliminary findings from a mixed methods project in Qatar.” There were many co-investigators; those from the Department were Sara Al-Rawi, N.D., M.P.H., clinical research coordinator; and Michael D. Fetters, M.D., M.P.H., M.A., associate professor and director of the Japanese Family Health Program, who also served as her faculty advisor.

Poster Presentations by Residents:

Marisyl D. de la Cruz, M.D., house officer III and co-chief resident, “Perceived barriers and potential solutions in the implementation of a residency-based peer evaluation system.” The co-investigators were Adaku B. Onyeji, M.D., house officer III; James E. Aikens, Ph.D., associate professor of family medicine and assistant professor of psychiatry; and Katherine J. Gold, M.D., M.S.W., M.S., assistant professor.

Elizabeth K. Jones, M.D., house officer III, “Clinical reminders for childhood immunizations.” The co-investigator was Donald E. Nease Jr., M.D., adjunct associate professor.

Alisa P. Young, M.D., house officer III, won the award Best Poster by a Resident (Clinical) for, “Comparison of HPV testing for cervical cancer screening in low risk women ages 30-65 among specialties.” The co-investigators on the project were Marisyl D. de la Cruz, M.D., house officer III and co-chief resident; and Mack T. Ruffin IV, M.D., M.P.H., professor and associate chair for research programs.

Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, who coordinated resident participation, says, “I was thrilled by the quality of the posters and the presentations. I know the residents put in hours and hours of work to develop and carry out their projects, and the level of scholarship and thoughtfulness in the presentations was remarkable. I’m also so appreciative of all the folks in our department who helped to mentor the residents and who have supported them in this work.”

May 26, 2011: New Tools in Depression Care

Primary care doctors have long been on the front lines of depression treatment. Depression is listed as a diagnosis for 1 in 10 office visits and primary care doctors prescribe more than half of all antidepressants. Michael S. Klinkman, M.D., M.S., professor, James E. Aikens, Ph.D., associate professor, Ananda Sen, Ph.D., associate professor, and Donald E. Nease Jr., M.D., adjunct associate professor, have developed a new tool that may help family physicians better evaluate the extent to which a patient’s depression has improved. The issue, the researchers explain, is that the official definition of when a patient’s symptoms are in remission doesn’t always match up with what doctors see in a real-world practice, especially for patients with mild to moderate symptoms. The study will be published in the upcoming May/June issue of General Hospital Psychiatry. Read more in the UMHS Newsroom.

The study has also been featured online at Eureka Alert and Science Daily.

May 12, 2011: Resident Original Research Projects

On May 11, 2011, the third-year residents presented their Original Projects as a part of the Department's Grand Rounds.

Original Projects Included:

• "Nutrition Fundamentals for Clinicians: An Education Module" by Suzanne Ross, M.D., and Jamie Szelagowski, M.D.
• "Clinical Reminder System for Childhood Immunizations" by Elizabeth Jones, M.D.
• "Perceived Barriers and Potential Solutions in the Implementation of a Residency-Based Peer Evaluation System" by Adaku Onyeji, M.D., and Marisyl de la Cruz, M.D.
• "The Use of HPV Testing for Cervical Cancer Screening in Low Risk Women and 30 - 65" by Marisyl de la Cruz, M.D., and Alisa Young, M.D.
• "Virtual Paychecks as a Model to Improve Resident Billing and Coding" by Thomas O'Neil, M.D.
• "University of Michigan Family Medicine Inpatient Teaching Curriculum Improvement" by Jeffrey Kim, M.D., and Kei Miyazaki, M.D.

In addition to the resident presentations, Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, the coordinator of the Original Projects, honored outstanding faculty mentors within the scholarly program. Faculty who have mentored five or more projects in the past 10 years were presented with a certificate and a "Family Medicine Rocks" journal.

Outstanding faculty mentors include: Lee A. Green, M.D., M.P.H., professor (10 projects), Michael D. Fetters, M.D., M.P.H., M.A., associate professor (7 projects), Barbara S. Apgar, M.D., professor (5 projects), Randall T. Forsch, M.D., M.P.H., assistant professor (5 projects), Donald E. Nease Jr., M.D., adjunct associate professor (5 projects), Mack T. Ruffin IV, M.D., M.P.H., professor (5 projects), and Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine, professor (5 projects).

To see pictures from this event please visit the Department's Facebook page.

May 12, 2011: Poster Presentations

Two posters by Caroline R. Richardson, M.D., associate professor, will be presented at upcoming conferences. "Associations between glucose tolerance and sex hormone binding globulin among women with recent gestational diabetes mellitus" will be presented at Diabetes and Pregnancy Study Group West Conference in May. Dr. Richardson will also present "Objective physical activity levels in adults with bipolar disorder" at the International Conference on Bipolar Disorder in June.

May 12, 2011: PPI Therapy

On May 7, 2011 at Digestive Diseases Week, the largest international gastroenterology research meeting, Joel J. Heidelbaugh, M.D., associate professor of family medicine and urology, gave a symposium entitled "Overuse of PPI Therapy in Clinical Practice". This was part of a 3-part symposium that also included "Potential Consequences of Achlorhydria/Hypochlorhydria" and "Safety Concerns of PPI Therapy."

May 5, 2011: Family Medicine in the News

Michael S. Klinkman, M.D., M.S., professor, was featured prominently on Physician's Weekly. The article entitled, "An Effective Intervention for Managing Depression in Primary Care" highlighted Dr. Klinkman's study on depression interventions in Primary Care from the Annals of Family Medicine.

"The primary aim of the study was to develop, implement, and evaluate the effectiveness and sustainability of a depression management program that could support how PCPs manage patients in both acute and chronic phases of treatment," says Dr. Klinkman.

Read more at Physician's Weekly.

May 2, 2011: Depression and Diabetes: Improving Overall Health

Caroline R. Richardson, M.D., associate professor, and a team of researchers from the VA Ann Arbor Healthcare System and UMHS recently published a study showing targeting depression can help diabetes patients improve their overall health. The study, "A Randomized Trial of Telephonic Counseling Plus Walking for Depressed Diabetes Patients," which was published in Medical Care, shows the intervention was successful in lowering patients' blood pressure, increasing their physical activity by about four miles of walking per week and easing their depressive symptoms. Read more in the UMHS Newsroom.

May 2, 2011: Developments in Vulvodynia Research

The Eunice Kennedy Shriver National Institute of Child Health and Human Development is working to develop a NIH research plan for vulvodynia as a chronic pain condition and Barbara D. Reed, M.D., M.S.P.H., professor, has been asked to speak about her research at the upcoming planning meeting in July. We hope to have more details about this development in the future.

April 28, 2011: Family Medicine in the News

A study, which originally appeared in the Journal of the American Medical Association by Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine, Leslie A. Wimsatt, Ph.D., educational planning and development administrator, and Lindsay Davis, medical student, was featured in the spring 2011 edition of Medicine at Michigan. Read the complete article, Secrets and Truth: When physicians - and students - are depressed.

 

And, see Dr. Schwenk talk about the results.

 

April 27, 2011: Integrative Medicine and Research Symposium

Suzanna M. Zick, N.D., M.P.H., assistant professor, and Richard E. Harris, Ph.D., Department of Anesthesiology and the Chronic Pain and Fatigue Research Center, recently teamed up to bring together researchers in integrative medicine and health care in the Great Lakes region.

With the help of Rita K. Benn, Ph.D., adjunct research investigator, and Laurie Lachance, Ph.D., M.P.H, Evaluation Director, Center for Managing Chronic Disease, School of Public Health, a full day symposium was held on April 6, 2011, at the Michigan League. Researchers from Wayne State University, Michigan State University, The Ohio State University and Henry Ford Health Systems joined a number of UM researchers to share their experience, frustration and solutions, as well as tap into the wisdom of other researchers in the field of integrative medicine and health care.

A number of collaborative efforts are already being discussed as a result of this symposium. The Great Lakes Integrative Medicine and Healthcare Research (GLIMHR) Symposium is expected to be an annual event.

April 19, 2011: The Risks of NSAIDs

In a response to "Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis," a meta-analysis that was featured in the British Medical Journal, Brian H. Bluhm, M.D., lecturer, and Lee A. Green, M.D., M.P.H., professor, supported the original authors findings that all NSAIDs are associated with an increased cardiovascular risk, with naproxen being the least harmful. The response, published in Evidence Based Medicine, stated, "This network meta-analysis provides further evidence that clinicians must assess cardiovascular risk, in addition to gastrointestinal and renal risk, in all patients who are being considered for NSAID therapy." Read the abstract at Evidence Based Medicine (full-text available with subscription).

April 19, 2011: Diagnosing Pancreatic Cancer

Pancreatic cancer is the fourth leading cause of cancer deaths in the United States with the worst prognosis among all cancers. One of the causes of poor prognosis is the lack of a reliable early-detection method of the disease. The current testing for pancreatic cancer utilizes a serum-based marker that has limited diagnostic value. Mack T. Ruffin IV, M.D., M.P.H., professor, and colleagues researched the use of unique fucosylation patterns of haptoglobin in serum as a means of early detection. Their results were published in an article entitled, "Mass Spectrometric Assay for Analysis of Haptoglobin Fucosylation in Pancreatic Cancer," in the Journal of Proteome Research. Read the abstract at ACS Publications (full-text available with purchase).

April 12, 2011: Family Medicine in the News

The paper, "Geriatric Conditions Develop in Middle-Aged Adults With Diabetes," by Christine T. Cigolle, M.D., assistant professor, and colleagues has been featured in the UMHS Newsroom and in multiple online sites including Science Magazine, UPI.com, and Slinking Towards Retirement.

March 31, 2011: NIH Grant Awarded to Study Colorectal Cancer Screening

Colorectal cancer has a major impact on Americans, yet not enough individuals follow through on screening. Masahito Jimbo, M.D., Ph.D., M.P.H., associate professor of family medicine and urology, was awarded a 4-year, $2.4 million grant from the National Institute of Health to study the use of an interactive decision aid to improve patient-physician communication and increase rates of colorectal cancer screening.

“I am really excited about this study for two reasons. First, we utilize a uniquely interactive decision aid that helps patients choose among colorectal cancer screening options. Second, our study will be among the first to examine the effect of a real-time preference assessment exercise on colorectal cancer screening and mediators, and, in doing so, will shed light on the patient-physician communication and shared decision making ‘black box’ that currently exists between the delivery of decision aids to patients and the subsequent patient behavior. The results will not only have important implications for improving shared decision making for colorectal cancer screening but can also be applied to other preference-sensitive care situations where underlying risk factors contribute to screening and/or treatment decisions,” said Dr. Jimbo.

The randomized controlled study will compare the use of Colorectal Web, an interactive decision aid, to facilitate Shared Decision Making for average and high risk adults needing colorectal cancer screening, to a non-interactive web-based colorectal cancer screening program.

March 31, 2011: Michael S. Klinkman M.D., M.S., professor, traveled to Geneva, Switzerland to meet with the World Health Organization Primary Care Consultation Working Group.

March 28, 2011: Diabetes and Geriatric Conditions

Christine T. Cigolle, M.D., assistant professor, and colleagues recently published "Geriatric Conditions Develop in Middle-Aged Adults With Diabetes" in the Journal of General Internal Medicine.  The study found that middle-aged, as well as older-aged, adults with diabetes are at increased risk for the development of geriatric conditions, which contribute substantially to their morbidity and functional impairment. The findings suggest that adults with diabetes should be monitored for the development of these conditions beginning at a younger age than previously thought. Read the article on SpringerLink.

March 28, 2011: Maternal Perceptions and the HPV Vaccine

As a part of a team, Mack T. Ruffin IV, M.D., M.P.H., professor and associate chair of research programs, published an article in Human Vaccines. The article entitled, “Maternal characteristics that predict a preference for mandatory adolescent HPV vaccination,” studied mothers already engaging in their own cancer screening, at a predominately black urban site and a predominately white suburban site and found that maternal perceptions of the HPV vaccine may hinder it’s use in children.  Read the abstract at Human Vaccines. (Full article available with subscription or purchase.)  

March 17, 2011: Student Research Reaches Terrific Outcomes

In the article “Hospital Do-Not-Resuscitate Orders: Why They Have Failed and How to Fix Them” featured in the Journal of General Internal Medicine, Jacqueline Yuen, M.D., states that overcoming the challenges of DNR orders is necessary to improve communications between physicians, patients and families near the end of life.

This article is the culmination of research that Dr. Yuen began as a medical student in a medical ethics elective with Michael D. Fetters, M.D., M.P.H., M.A., associate professor, who is also listed an author. Dr. Yuen graduated from U-M Medical School in 2008 and began an internal medicine residency at Cornell University.

Dr. Yuen became interested in DNR orders following her experience as a sub-I in the MICU within the U-M Health System. She saw many patients on life support who were of advanced age or with terminal illness and began to wonder if they were getting the type of care that they wanted. As a third-year medical student, she decided to research the topic after she learned how DNR orders were introduced to patient in a manner in which she found to be lacking. The patient whom she was observing was not informed of the benefits, risks and consequences of the procedure. 

Dr. Yuen said, “I found the research fascinating as I learned the history behind DNR orders, how inadequate many physicians are in discussing advance directives and code status with patients, the widespread misconceptions about CPR and DNR orders in the public and amongst health care professionals. As I started my residency, I continued to make observations about code status discussions in my hospital and to do additional research on the topic. Ultimately I learned that there is not one solution that can fix the problem but that several things would need to change including the hospital culture, the reimbursement framework, education of health care professionals, and institutional policies and laws.”

Dr. Yuen is not planning to stop now, this research set the stage for her current project - developing a communication skills workshop to teach residents to discuss goals of care and preferences for life sustaining treatments. 

The article was widely discussed on GeriPal, a geriatrics and palliative care blog. The original article can be found online at Springerlink.com. 

 

March 17, 2011: Statistician Joins Elite Research Panel

Ananda Sen, Ph.D., research associate professor, was invited by the Committee of National Statistics (CNSTAT) to serve on an expert panel on the Theory and Application of Reliability Growth Modeling to Defense Systems. CNSTAT is located within the National Research Council, the operating arm of the National Academy of Sciences. The first meeting of the panel was held in Washington, DC on March 4, 2011.

 

March 15, 2011: Defending Stance on Debt and Primary Care

In a letter to the editor of Family Medicine, Doug Campos-Outcalt, M.D., responds to "Medical student debt and primary care specialty intentions" authored by Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine, and Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, among others. Dr. Campos-Outcalt questioned their paper stating "High-quality studies have repeatedly shown that medical student debt levels are not related to specialty choice, in spite of what many believe." Read the entire letter to the editor and the author’s response in Family Medicine (PDF).