The grant, part of the AMA initiative Accelerating Change in Medical Education, makes Vanderbilt the recipient of $1 million over the next five years to take part in a consortium created to rapidly disseminate best practices in medical education across the country.

Bonnie Miller, M.D., senior associate dean for Health Sciences Education, said the announcement is evidence the innovations brought about by VUSM’s new educational curriculum, Curriculum 2.0, are among the nation’s most advanced.

For VUSM, Curriculum 2.0 represents the departure from a highly regarded, but traditional medical school curriculum to a complex, integrated, collaborative and flexible course schedule that includes less traditional lecture and more clinical and case-based experience.

“This is a validation that Curriculum 2.0 represents some of the most exciting and innovative ideas for medical education,” Miller said. “It is just what the AMA is looking for. Through this grant, the AMA hopes to disseminate best practice to medical educators throughout the nation. We believe this funding and collaboration will allow us to accelerate the changes we hope to bring about with Curriculum 2.0, and to rigorously evaluate the curriculum’s effectiveness.”

Vanderbilt’s grant submission outlined major changes included through Curriculum 2.0, such as embedding students at a single clinical site for the duration of their undergraduate medical education and competency-based assessments along with individualized learning goals and objectives. As a result of Curriculum 2.0’s competency-based progression, some students will be able to complete medical school in fewer than four years.

The AMA grant will also accelerate enhancements in VUSM’s informatics infrastructure supporting student learning.

The AMA said the grants are to support educational innovations envisioned by each institution.

“We are thrilled to award funding to 11 medical schools for their bold, transformative proposals designed to close the gaps between how medical students are trained and how health care is delivered,” said AMA President Jeremy Lazarus, M.D. “This AMA initiative will identify specific changes in medical education that can be applied in medical schools throughout the nation to enable students to thrive in a changing health care environment and improve the health of our nation’s patients.”

Miller said she is particularly excited to be working with other schools such as the University of California, San Francisco (UCSF), the Mayo Clinic and the University of Michigan, among others.

“Over the next five years we will have the incredible honor of sharing a curriculum we have worked on so hard for the last several years, and will have the opportunity to learn more about what works for other programs. It will be fun, helpful and interesting, but most of all it establishes Vanderbilt as a leader in transformational change in health care education,” Miller said.

The AMA said submissions for the grant were quite competitive, with more than 80 percent of the nation’s medical schools providing proposals. According to the AMA’s website, the purpose is to “alter undergraduate medical education significantly through bold, rigorously evaluated innovations that align medical student training with the evolving needs of patients, communities and the rapidly changing health environment.”

Robert Dittus, M.D., MPH, associate vice chancellor for Public Health and Health Care and senior associate dean for Population Health Sciences, co-authored Vanderbilt’s submission with Miller. Kim Lomis, M.D., associate dean for Undergraduate Medical Education, and other critical managers of Curriculum 2.0 will direct the grant work and will serve in the national consortium.

Katherine Dobie, M.D.

The Division of Ambulatory Anesthesiology at Vanderbilt was formed in 2008 to provide services for a growing number of Vanderbilt University Medical Center satellite locations, including the Nashville Surgery Center (NSC), Vanderbilt Outpatient Surgery Center (VOS), Cool Springs Surgery Center (CSSC), and Vanderbilt Bone & Joint Surgery Center in Franklin, Tenn.

Outpatient surgical services offered at Vanderbilt’s surgery centers include orthopaedic, gynecological, ophthalmologic, pediatric, plastic, spine, gastroenterology, urologic, and ear, nose and throat procedures. The Division of Ambulatory Anesthesiology provides services for more than 60 community surgeons and is on track to care for approximately 12,000 patients at Vanderbilt’s four outpatient centers in 2013.

Dobie received her medical degree from the James Quillen College of Medicine of East Tennessee State University in 2003. She completed two years of residency in general surgery at University of North Carolina at Chapel Hill and then joined Vanderbilt University School of Medicine in 2006 to complete her residency in Anesthesiology. In 2009, Dobie became a member of the Anesthesiology faculty as assistant professor of Clinical Anesthesiology. She then worked in private practice before returning to Vanderbilt in 2011 to serve as medical director of Vanderbilt Bone & Joint Surgery Center when the facility became a Vanderbilt satellite location.

“Dr. Dobie has proven to be a leader at Vanderbilt in the field of ambulatory anesthesia,” said Warren Sandberg, M.D., Ph.D., chair of the Department of Anesthesiology. “When we took over anesthesia services at Vanderbilt Bone & Joint Surgery Center, we knew we would face unique challenges by coming into such a high-volume, well-established practice. In her role there, Dr. Dobie was able to forge partnerships with surgeons, while quickly improving the efficiency and quality of patient care. At the same time, she initiated a comparative effectiveness and clinical research program. She was a logical choice for division chief.”

Dobie also established the Regional Anesthesia program at Vanderbilt Bone and Joint Surgery Center. That program delivers more than 1,200 regional anesthetics yearly, including a successful At-Home Peripheral Nerve Catheter program. Under Dobie’s leadership, the Vanderbilt Bone and Joint Surgery Center has become one of the leaders among Vanderbilt providers in patient satisfaction measures.

William Schaffner, M.D.

NMA is a nonprofit organization dedicated to educating families, medical professionals and others about meningitis. Schaffner, an expert in vaccine-preventable diseases and vaccine-related public policy, got involved in public health in the 1960s when he worked on a campaign to ensure all children received the “new” measles vaccine.

The measles vaccine campaign inspired Schaffner to play a critical role in educating the public by translating the science of immunization into passionate messages that help people of all ages understand why vaccines matter.

The NMA noted that Schaffner’s work “has elevated awareness about the importance of vaccines across the lifespan among both professional and public audiences, and these efforts have been invaluable in helping to protect adolescents from meningococcal disease.”

Schaffner also recently received the Nashville Business Journal’s 2013 Health Care Hero Award for Lifetime Achievement.

Here is the link to a video played at the award’s ceremony: http://www.bizjournals.com/nashville/news/2013/05/23/lifetime-achievement-award-hch-2013.html.

“There are few divisions that have the breadth and depth of science that is shared here in Clinical Pharmacology,” said the division’s sixth, and current, director, David Harrison, M.D.

“You can go to virtually any meeting in the nation and not learn as much science as you do during our Tuesday morning symposia,” said Harrison, the Betty and Jack Bailey Professor of Cardiology, and professor of Medicine and Pharmacology.

John Oates, M.D., the division’s founding director, credited its success to several Vanderbilt “visionaries,” among them Alan Bass, M.D., former chair of Pharmacology, Elliott Newman, M.D., who established one of the nation’s first Clinical Research Centers, and former chair of Medicine Grant Liddle, M.D.

Liddle’s stellar accomplishments in endocrinology “gave me the sense that things were possible at Vanderbilt,” said Oates, the Thomas F. Frist Sr. Professor of Medicine, professor of Pharmacology, and former chair of Medicine.

Nancy Brown, M.D., chair of Medicine and the fifth director of Clinical Pharmacology, credited the division for encouraging Vanderbilt’s “tremendous investment in mentorship and career development,” and for nurturing a culture of collaboration exemplified by establishing the first mass spectrometry core.

“Today, as we recruit investigators from other institutions, they’re amazed at what they can accomplish using shared resources,” she said.

Brown, the Hugh J. Morgan Professor of Medicine and professor of Pharmacology, described research on bradykinin, a natural vasodilator that plays a role in antihypertensive treatment by ACE inhibitors, but which also can cause inflammation and angioedema.

“Understanding the mechanisms of drugs really leads to understanding the pathophysiology and molecular biology,” she said.

In the division, individual patient cases often spark questions that lead to significant discoveries, Oates added.

For example, a careful history of a woman whose blood pressure was not controlled by a commonly used antihypertensive drug revealed she was also taking a tricyclic antidepressant, and led to the discovery that tricyclics block the antihypertensive effects of guanethidine.

Dan Roden, M.D., assistant vice chancellor for Personalized Medicine, who directed the division from 1992 to 2004, agreed — vociferously.

“’Idiosyncratic’ drug response … I despise this word,” said Roden, who has pioneered the pharmacogenomics of arrhythmia. “This word is a way of saying that something happened to this patient that you don’t understand.”

“Don’t use that word because it just means that you’re ignoring some giant clue that nature is giving you,” said Roden, the William Stokes Professor of Experimental Therapeutics, and professor of Medicine and Pharmacology.

Oates recalled the early days in the division, when its energy, sense of purpose and esprit de corps resembled that of “a big and boisterous family.”

“It’s clear that a prime source of scientific vitality in the division has stemmed from our graduate students and post-doctorate fellows,” he added. “Their enthusiasm, accomplishments and creativity, coupled with an extraordinary faculty, have driven discovery, and they continue to do so.”

Ronald Walker, M.D.

Recognition as a fellow is one of the highest honors the ACR can bestow on a radiologist, radiation oncologist or medical physicist. ACR Fellows demonstrate a history of service to the college, organized radiology, teaching or research. Approximately 10 percent of ACR members achieve this distinction.

Walker, also a Vanderbilt-Ingram Cancer Center investigator, is a staff radiologist and nuclear medicine physician for the Tennessee Valley VA Healthcare System.

The ACR is a national nonprofit association serving more than 34,000 radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists with programs focusing on the practice of radiology and the delivery of comprehensive health care services.

The Monroe Carell Jr. Children’s Hospital at Vanderbilt is piloting a new protocol to make minor outpatient procedures less painful for younger patients. Here, Dara Macer, R.N., works with 2-year-old Madelyn Turner. (photo by John Russell)

A patient comfort protocol is rendering minor procedures less painful for younger outpatients of the Monroe Carell Jr. Children’s Hospital at Vanderbilt.

The protocol allows nurses to use pain-preventing sprays and ointments prior to blood draws, intramuscular injections, IV insertions and venous catheter access. Children younger than 6 months old may also receive small amounts of a sweet solution by mouth, which helps increase pain tolerance.

The protocol is being piloted in the Pediatric Endocrinology and Pediatric Rheumatology clinics. Similar comfort measures have long been standard practice in the Pediatric Hematology and Oncology Clinic.

Outpatient procedure rooms have also been enhanced as part of a broader patient comfort initiative in Children’s Hospital. HGTV sponsored the nature-themed decoration of a procedure room in the Hematology and Oncology Clinic. In the Medical Specialties phlebotomy room, where patients go to have samples of their blood drawn for lab tests, younger patients are distracted from their procedure not only by their phlebotomist but also by colorful decorations and by a TV running children’s programs.

“One of our best opportunities to improve the patient experience and cement Vanderbilt’s position as the premier site for children’s care is to make the experience pain-free for the child,” said the leader for development and adoption of the protocol, Suz Kaprich, R.N., MHA, administrative director for Children’s Hospital outpatient nursing.

“When health care providers use the drugs and techniques recommended by the protocol, children will have an overall positive experience, which improves their compliance with health care when they become adults,”

A clinic-by-clinic rollout of the protocol has begun. Given that the ointments take 30 minutes to become active, implementation of the protocol involves some clinic workflow alteration.

According to Kaprich, before development of the protocol, pain prevention for minor procedures was occurring in Children’s Hospital outpatient areas on a sporadic basis.

“We look forward to the protocol becoming part of our culture, something we practice on every patient at every encounter, every time,” Kaprich said.

Kaprich convened physicians, pharmacists, nurses and Child Life specialists who spent a year developing the protocol. Key contributors include pediatric rheumatologist Brent Graham, M.D., M.S., general pediatrician Barron Patterson, M.D., child development specialist Nirupama Madduri, M.D., and Child Life specialists Katherine Bennett and Erin Munn.

Fred Ochieng’, M.D., a third-year resident in Internal Medicine-Pediatrics at Vanderbilt, will lead the briefing, which begins at noon in the Eskind Biomedical Library Executive Board Room. His older brother, Milton, is in his third year of a gastroenterology fellowship at Brown University.

In 2002, the Ochieng’ brothers’ idea of opening a medical clinic in Lwala was a pipedream consisting of lines drawn on scraps of paper.

While they worked on their Vanderbilt medical degrees, they spent their spare time raising funds for the newly formed alliance and flying home to help build a clinic from the ground up.

From left, Milton Ochieng, co-founder of the Lwala Community Alliance, Reeta Roy, president and CEO of the MasterCard Foundation, and President Bill Clinton at the Clinton Global Initiative 2011 Annual Meeting in New York City.

With grit, determination and some helping hands, their dream became a reality when the first wing of the clinic opened six years ago. Fast-forward to the present, and those line drawings have blossomed into a full-blown community hospital that has exceeded everyone’s expectations.

With the help of the Vanderbilt community, Lwala opened a new maternal health wing in 2011, tripling the infrastructure of the original clinic footprint with dedicated space for labor, delivery, postnatal care, 12 inpatient beds and four private consultation rooms.

“Patient traffic has increased by 137 percent, from an average of 1,200 patients per month to an average of 2,843,” Ochieng’ noted. About 1,000 people are being treated for HIV/AIDS.

In addition to health care, the Lwala Community Alliance has developed effective education, economic development and public health outreach programs.

Through the clinic’s Safe Babies maternal and child health outreach program, teams of Community Health Workers enroll pregnant women into the entire continuum of maternal, neonatal, and child health care. So far the program has reached more than 900 expectant and new mothers.

Aided by a new ambulance and two outreach motorcycles, the program has increased the percentage of area women delivering their babies in a health facility from 26 percent to 95 percent in the year since it was established.

“The Alliance is still growing,” Ochieng’ said. “The biggest needs right now include a new hospital wing to house pediatric inpatient beds, a new laboratory and a records department.”

To RSVP or for more information, contact Katherine Falk, development and communications coordinator of the Lwala Community Alliance, at katherine@lwalacommunityalliance.org.

— by Stephen Doster and Katherine Falk

Jackie Harris, medical assistant in the Neurology Clinic, left, reviews information with patient Sharon Miller using the new Krames Staywell standardized resource. (photo by Joe Howell)

When patients first come to the Vanderbilt Neurology Clinic, they often have alarming or painful symptoms.

There is a lot to take in, especially if they receive a new diagnosis, medication or plan of care. As is typical in nearly every clinical setting, patients can leave appointments feeling overwhelmed or confused about what to do next to take care of themselves.

Now, a new resource called Krames Staywell has begun to roll out across the Medical Center to help patients better understand and become more engaged in their own care. Jackie Harris, a medical assistant in the Neurology Clinic, is one of the early adopters of Krames. Harris makes sure patients see information about their conditions during appointments, and gives them a packet of information when they leave.

“The big difference is the Krames information is standardized. What we had in the past were pamphlets from drug companies, which were fine, but even if they tried not to brand the pamphlets, it was not as generalizable as we would like,” said Harris.

Krames Staywell is the nation’s largest patient education vendor. The company has licensed high quality educational information written in simple terminology and in multiple languages for Vanderbilt’s use. As part of a long-term plan for patient education, all acute and outpatient clinicians have access to teaching sheets, videos, graphics and animations on hundreds of medical conditions, procedures, tests and types of treatment.

Clinical and informatics experts from across the system selected Krames Staywell as the vendor for patient education. Lane Stiles, director of Patient Education for VUMC, says one of the key benefits of Krames is that it is fully customizable.

“We can add, delete or edit content as we see fit,” Stiles said. “So it’s important that users contact us at patient.education@vanderbilt.edu if they don’t find exactly what they want.”

Harris said there is a need in her clinic for information that covers even more conditions. She is already working with administrators to enhance content for the Neurology clinic, but she is generally pleased with Krames.

“One of our doctors used to spend 20 minutes with every stroke patient, going over what stroke is, the signs and symptoms, etc. Now we can pull a packet together electronically and print it ahead of time. When patients take it home, they can share with family, or put it on the refrigerator, and we can add personalized information right at the top. It really helps,” Harris said.

Krames will help Vanderbilt meet new federal requirements for “meaningful use.” The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act set “meaningful use” objectives to improve the quality of health care through electronic health records, including engaging and improving communications with patients and families.

The Krames Staywell content will roll out in several stages. Currently staff have access to information hosted on the Krames website. There will be deeper integration into clinical applications and workflows in the months ahead. The content will also be integrated into the public websites and MyHealth at Vanderbilt so that patients can directly access information on their own.

“We have promised our patients that we will treat them as the most important member of the health care team. This is especially important as we move into an era of outcomes-based reimbursement,” said Stiles. “This is one step toward fulfilling that promise.”

More information can be found through secure sign-on at https://www.mc.vanderbilt.edu/root/vumc.php?site=patienteducation, or staff and faculty can search for “Krames Staywell” at Vanderbilt Eskind’s Library site at www.mc.vanderbilt.edu/diglib/.

Materials available through the Krames Staywell license include:

• Krames On-Demand — 3,000 health sheets and 2,000 medication information sheets, all in English and Spanish and some in up to nine additional languages.

• Krames streamed — 500 videos and animations, some in up to nine languages.

• Exit-Writer — 1,500 Emergency Department discharge sheets and 200 lab test sheets, all in English and Spanish and some in three additional languages.

• Krames Go-to-Guides — Six interactive, multimedia electronic books for managing chronic disease, in English and Spanish.

• Staywell Solutions — Online consumer health content that includes wellness articles, news, multimedia, interactive tools, symptom checkers and more, all in English and Spanish.

And she is proud to admit, she is one too.

As the director of the Smoking Cessation Institute at Vanderbilt University Medical Centerand a former smoker, Forbes, MSN, APN, GNP, has spent the last 25 years helping thousands of smokers kick the habit.

Among the many tools Barbara Forbes, MSN, uses to help people kick the habit is a large jar of tar, foreground, that represents the amount of tar a smoker will ingest in a year. (photo by Joe Howell)

“We have had some longtime success stories,” said Forbes, a nurse practitioner. “We also have a lot of people who make multiple attempts to quit. It is OK to continue to try. There are no failures in the quest to end addiction to nicotine; rather we see it as moving another step closer to closing the learning gap on being a nonsmoker.

“Quitting smoking is a tough, tough task that requires support from many sources. What we do know is this – an individual has a greater chance of following through with the effort when someone from their medical team makes the suggestion to quit.”

That is why Forbes and her colleagues at Vanderbilt are excited about the Center for Disease Control and Prevention’s (CDC) campaign, “Talk With Your Doctor.”

The initiative encourages smokers to talk with their doctors, nurses and other health care providers about quitting smoking. The effort, being promoted by the Tennessee Department of Health, is part of a national tobacco education campaign to raise awareness about the effects of smoking and secondhand smoke exposure.

“Our message is simple: if you’re a smoker, quitting is one of the best things you can do for your health and the health, peace of mind and pocketbooks of the people you love,” said John Dreyzehner, M.D., MPH, commissioner of the Tennessee Department of Health.

Smoking is the leading cause of preventable death and disease in the United States, according to the CDC. More than 1,200 people die every day in the U.S. while 9,700 Tennesseans die every year from smoking – more than 26 a day.

State statistics show that 1.2 million adults are current cigarette smokers with 70 percent reporting a desire to quit. About 50 percent actually try to quit.

“Smoking cessation efforts are essential,” said Pierre Massion, M.D., director of the Thoracic Program at Vanderbilt-Ingram Cancer Center. “I see the folks who are at high risk of developing lung cancer in my practice. It is imperative that all primary care providers not only convey the message that smoking is bad, but also offer patients solutions and resources to become smoke free. It is no longer an option – it must become part of our clinical practice.”

Massion, professor of Medicine and Cancer Biology, is passionate about revving up support to help stop the smoking epidemic.

“This program is all about empowering the patient,” he said. “This needs to be a priority. Smoking cessation is the most important step in making a difference. I applaud this campaign.”

At Vanderbilt patients and employees have several options if they are interested in quitting smoking:

• The Kim Dayani Center Smoking Cessation Program offers an eight-week session that includes counseling and medication (when necessary) that is covered by most insurance plans. It is open to the community. Call 322-4751 for more information.

• The Occupational Health Clinic Quit RX Smoking Cessation Program offers counseling and treatment services and is available to employees. For more information call 936-0955.

• Health Plus Wellness offers one-on-one coaching to provide individualized support and encouragement by phone or in person for employees. Contact a wellness coach at 343-8943.

• Tennessee Tobacco QuitLine is available to anyone at 1-800-QUIT-NOW or 1-800-784-8669.

Forbes said the “Talk With Your Doctor” program, which launched in late May, will provide a much needed boost in the efforts to motivate smokers to quit as well as provide additional support to health care providers to encourage their patients to attempt to end the habit.

Vanderbilt’s Jonathan Forbes, M.D., left, is congratulated by David Connor, D.O., for earning the ‘Top Gun’ award at the annual meeting of the American Association of Neurological Surgeons.

Jonathan Forbes, M.D., a seventh-year resident in the Department Neurological Surgery, showed his skills in the “Neurosurgery Top Gun Competition,” earning a $1,000 prize, plus $1,500 for the residency program.

Open to all U.S. and international residents and fellows at the meeting, the Top Gun skills competition tests the participant’s ability in four simulated tasks: lumbar pedicle screw placement; external ventricular drain placement; endovascular catheter navigation; and thoracic deformity pedicle screw placement. The best combined score gets the Top Gun award.

This the second national award won by Forbes, who also received the AANS Synthes Craniofacial Award for research in Neurotrauma in 2011.

With temperatures rising in Middle Tennessee, health care professionals at Monroe Carell Jr. Children’s Hospital at Vanderbilt are stressing the danger of leaving children unattended in vehicles. This year in the United States, there have already been 11 deaths of children due to hyperthermia or heatstroke from being left unattended in a vehicle.

According to physicians at Children’s Hospital, a child’s body heats up three to five times faster than an adult’s, and when the body’s temperature reaches 104 degrees, the internal organs begin to shut down. Children are placed at extreme risk for severe hyperthermia and heat stroke in just minutes.

Each summer, the emergency department treats several children who are left alone in hot cars, which is illegal in Tennessee.

“Unfortunately, vehicle-related heat deaths continue to happen every year, and they can happen to anyone,” said Sarah Haverstick, Safe Children program manager for Children’s Hospital. “Caregivers often experience a break in their everyday routine and simply forget that the child is in the car. It is extremely important, especially for new parents, to make a habit of checking the entire car before walking away and locking the doors.”

Aaron and Stephanie Gray know all too well the devastating consequences of leaving a child in a hot car. Their 5-month-old son, Joel, died 10 months ago from heat stroke after accidentally being left in a hot car for hours.

A hectic schedule coupled with a last-minute change in the school drop-off routine was enough to make Stephanie think she had dropped Joel off at day care when he actually was sleeping quietly in his rear-facing car seat. Stephanie went about her routine, thinking nothing was amiss, and realized that she hadn’t dropped him off in the morning when she returned to the day care later that day. By the time Joel was found, still strapped into his car seat, it was too late to save him.

Now, the Grays are dedicated to raising awareness of the danger of leaving your child in an unattended vehicle. They want to stress that the most important piece of preventing these deaths is awareness.

“If people are simply aware that this could happen to them, and have a system in place to double check on a child in the back seat, these unnecessary deaths can be prevented,” said Stephanie Gray.

Haverstick said community members who see a child left alone in a hot vehicle should call 911 immediately.

Children’s Hospital offers the following tips to avoid vehicle-related heat injuries or death:

• Use cell phone or computer reminders to make sure children have been dropped off at the desired location.
• Place an item that you always take from the car into your destination in the backseat with your child.
• Teach your children never to play in vehicles in order to prevent them from accidentally locking themselves inside one. Be sure to lock all doors and windows to vehicles on your property.
• If your child is missing, check vehicles and trunks first.

For more information, please visit Children’s Hospital’s website for detailed safety information http://www.childrenshospital.vanderbilt.org/heatsafety.

(iStock)

Persistent patency of the ductus arteriosus (PDA) (a fetal vascular conduit that fails to close after birth) is a common cardiac problem in preterm infants.

In an analysis of findings from a previous clinical trial, Robert Cotton, M.D., Jeff Reese, M.D., and colleagues discovered an association between treatment of premature infants with the antacid cimetidine and PDA. Cimetidine inhibits histamine H2 receptors and also blocks certain cytochrome P450 enzymes (CYPs), which may play a role in DA closure.

Using mouse models, the researchers found that CYP enzymes are expressed in DA smooth muscle and that cimetidine and ranitidine (a related antacid) cause relaxation of term and preterm DA. They showed that the antacids relaxed the mouse DA by inhibiting CYP, not by blocking H2 receptors.

The findings, reported in the June Journal of Molecular and Cellular Cardiology, demonstrate an important role for CYP enzymes in perinatal vascular regulation and reveal that certain antacids and other CYP-inhibiting medicines pose a risk for PDA in critically ill newborns.

This research was supported by grants from the National Institutes of Health (HD044741, HL077395, HL096967, HL109199).

Leon W. Cunningham, Ph.D.

Family and friends are invited to visitation before the service from 1-3 p.m. at the church.

Dr. Cunningham, 85, died Saturday, June 8, a day before his 86^th birthday. His wife of 59 years, Jean Roberta Swingle Cunningham, died in 2007.

Dr. Cunningham was well known for his contributions to the fields of enzyme chemistry, glycoproteins and connective tissue biochemistry, and for his commitment to the department and to the graduate students he mentored.

“Leon Cunningham and I were friends of very long standing,” said Jan van Eys, M.D., Ph.D., clinical professor of Pediatrics, emeritus. “He was a dedicated scientist … (and) was most proud of the Ph.D. students for whom he was the primary thesis supervisor.”

He “was a consummate scientist with impeccable standards,” added Samuel Santoro, M.D., Ph.D., one of Dr. Cunningham’s former graduate students who now chairs the Department of Pathology, Microbiology and Immunology.

“The lessons I learned from him about how to approach science and how to be a scientist have guided my own career and resonate to this day,” Santoro said.

“Leon was on my Ph.D. committee at Vanderbilt during the years 1964-1968,” recalled Jackie Corbin, Ph.D., professor of Molecular Physiology and Biophysics, emeritus. “He was stern and demanding, but with a great sense of humor.

“He was also one of my favorite lecturers,” Corbin said. “Vanderbilt owes him so much. I will miss him.”

A native of Columbus, Ga., Dr. Cunningham earned his bachelor’s degree in Chemistry from Auburn University and his master’s and doctoral degrees in Chemistry from the University of Illinois at Urbana-Champaign.

He was a postdoctoral research fellow at the University of Washington before joining the Vanderbilt faculty as assistant professor of Biochemistry in 1953. In 1961-62, he received a Special Fellowship from the National Institutes of Health (NIH) to pursue his research at the Netherlands National Defense laboratories in Rijswijk.

In 1965, Dr. Cunningham was promoted to professor of Biochemistry, and in 1967 became the medical school’s first associate dean for Biomedical Sciences. In 1973, he was named chairman of Biochemistry, a position he held until 1988.

During his tenure, the Department of Biochemistry became one of the leading departments in the country in NIH funding and its faculty received international recognition.

“I feel so lucky to have known and worked with him,” said Marlene Jayne, longtime administrator of the department. “He contributed so much to making Biochemistry a great department.”

Dr. Cunningham was a close personal friend of Stanley Cohen, Ph.D., Distinguished Professor of Biochemistry, emeritus, and in 1986 attended the awarding of Cohen’s Nobel Prize in Medicine or Physiology for his discovery of epidermal growth factor.

In 1988, Dr. Cunningham was named Harvie Branscomb Distinguished Professor, and returned to teaching and research until his retirement as professor emeritus in 1994.

Dr. Cunningham was a member of several scientific societies, including the American Society for Biochemistry and Molecular Biology, the American Chemical Society and the American Association for the Advancement of Science.

He contributed to more than 100 scientific papers and to several books. “He was also very interested in the intersection of science and religion,” noted van Eys. Dr. Cunningham’s book on the subject, entitled “Old Truths, New Light,” was published last year.

Dr. Cunningham is survived by three children, Hugh Alan Cunningham of Dalton, Ga.; and Pamela Cunningham Hawkins and Sue Ellen Cunningham Miller, both of Nashville; four grandchildren and one great-granddaughter.

In lieu of flowers, memorial donations may be made to Community Care Fellowship, 511 South 8th Street, Nashville, Tenn., 37206, or to the Jean S. Cunningham Prayer Room ministry at Calvary United Methodist Church.

Children’s Hospital is the only pediatric hospital in Middle Tennessee providing a comprehensive array of specialty and subspecialty services to receive this honor, achieving national rankings for 9 out of 10 of its pediatric specialty programs.

“We feel extremely privileged that Children’s Hospital is again being represented among the very best in the country,” said Luke Gregory, chief executive officer of Children’s Hospital. “This recognition validates the great work our physicians, nurses and staff are doing as they continue to work to improve the quality and broaden the scope of patient care for our youngest and most vulnerable patients.”

The U.S. News Best Children’s Hospitals rankings for 2013-2014 recognize top performers among the nation’s 179 designated pediatric hospitals. Children’s Hospital has been ranked every year by U.S. News since the inception of the publication’s pediatric rankings, now in its seventh year.

“Once again, we are extremely pleased and proud of our national rankings, reflective of the commitment to excellence in our clinical service lines,” said Meg Rush, M.D., chief of staff and executive medical director of Children’s Hospital. “We know that many factors go into how specialties are reviewed to determine ranking. This year’s rankings, particularly in pediatric urology, show our steadfast focus on quality, service and excellence in all that we do.”

Children’s Hospital continues to be a national leader in Urology, which moved up four spots to rank 4th this year.  Pulmonology improved its ranking, moving up two spots to 19th. Gastroenterology & GI Surgery also moved up this year, improving from 33rd to 32nd. Other specialties ranked this year include: Cancer (36), Cardiology and Heart Surgery (23), Neonatology (16), Neurology and Neurosurgery (43), Orthopaedics (34) and Pediatric Diabetes and Endocrinology (29).

“We are honored that the Division of Pediatric Urology has again been bestowed with the distinguished acknowledgement as a top program in the country,” said John W. Brock III, M.D., director of Pediatric Urology, surgeon-in-chief of Children’s Hospital and Monroe Carell Jr. Professor.

“This achievement speaks volumes for the teamwork, collaboration and comprehensive care we strive to deliver to give our patients the very best. I am so fortunate to work with such a qualified team of physicians, including Mark Adams, M.D., Douglass Clayton, M.D., Stacy Tanaka, M.D., John Pope IV, M.D., and John Thomas M.D., as well as a tremendously skilled staff in our clinic, hospital and operating rooms. It is their dedication and passionate care for children that drive our division’s success.”

The U.S. News and World Report Best Children’s Hospitals rankings recognize the top 50 children’s hospitals in 10 medical specialties and are calculated using clinical outcomes, reputation and other care-related data, including survival rates, nurse staffing, and subspecialist availability, among other factors. Eighty hospitals across the country ranked in one or more specialties.

In addition to the data, two surveys were conducted to help determine hospital reputation. In one, 150 pediatric specialists were surveyed and asked to recommend the hospitals they consider best for children with challenging problems. Also, 1,500 physicians were asked where they would send the sickest children in their specialty, setting aside location and expense.

“We are extremely proud to be recognized by our peers as a top children’s hospital in multiple specialties,” said Steven Webber, MBChB, MRCP, Pediatrician-in-chief, chair of the Department of Pediatrics and James C. Overall Professor. “This recognition acknowledges our commitment to providing world-class medical care to the children in our region and beyond. Whether it’s discovering a cure of a childhood disease or performing a highly skilled surgery, we continue to strive to be leaders in children’s health.”

For more information, including full rankings and methodology, check out usnews.com/childrenshospitals and the August print issue of U.S. News & World Report.

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Tumor necrosis factor-alpha (TNF-alpha) is produced by most malignant cells, but its role in cancer progression – pro- or anti-tumor – is conflicting.

Pampee Young, M.D., Ph.D., and colleagues including Pierre Massion, M.D., explored whether the two different forms of TNF-alpha – membrane-bound (mTNF-alpha) and soluble (sTNF-alpha) – have distinct actions that contribute to the varying findings. Using mouse lung and melanoma tumor cell lines, they demonstrated that sTNF-alpha (the more studied form) promotes cancer growth and mTNF-alpha inhibits tumor growth by reducing the number of tumor-associated myeloid cells. They also found that human non-small cell lung cancer tissues have differing expression of membrane versus soluble TNF-alpha, and that patients whose tumors had gene “signatures” consistent with higher levels of mTNF-alpha had improved survival compared to tumors with more sTNF-alpha.

The findings, reported in the journal Cancer Research, suggest that the two forms of TNF-alpha have opposing effects on tumor progression – an insight that is critical for the effective use of TNFa inhibitors, which can block both forms.

This research was supported by grants from the National Institutes of Health (HL088424, RR024975, CA090949, HL069765) and by a Veterans Affairs Merit Award.

Linda Norman, DSN, R.N.

Norman, the Valere Potter Menefee Professor of Nursing and senior associate dean for Academics, will replace Colleen Conway-Welch, Ph.D., CNM, who is retiring from her longtime role at the end of June.

Recognized as a national and international leader in nursing and health profession education, Norman has led curricular innovations in blended learning, interprofessional education, quality improvement and doctoral distance learning. She has been responsible for setting and implementing the strategic direction for all of the School of Nursing’s academic programs.

The appointment comes during a key transitional period in academic health care as the School of Nursing, which celebrated its 100th anniversary five years ago, continues its upward trajectory. U.S. News & World Report currently ranks the school 15th in the nation in the magazine’s Best Graduate Schools-Nursing.

Within the School of Nursing nearly 1,000 students are pursuing master’s and doctorate degrees across a diverse array of specialties, continuing a decades-long tradition for training nursing leaders.

“I am delighted Linda is assuming this highly visible and strategically significant role. Having worked closely with her for many years, I know she will be an outstanding dean, bringing to this new opportunity extensive experience along with the respect of the School of Nursing’s faculty and students,” said Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine.

“I want to again acknowledge Colleen’s many contributions. She steps down at a time when the School of Nursing is in an enviable position with a stable faculty and leading academic programs in practice, research and informatics. I also want to thank Dr. Dittus and the members of the interdisciplinary search committee for their outstanding work to identify Linda as the school’s new leader.”

During her time at VUSN, Norman has helped assure the academic programs are innovative, on the leading edge of advanced practice nursing, meeting the needs of the health care industry at large and achieving national recognition.

“I am tremendously honored to be chosen for this position and look forward to the future,” said Norman. “The school is strong and as part of Vanderbilt University and Vanderbilt University Medical Center, we are poised to become a national leader in interprofessional health care education.”

Some of the transformational initiatives Norman has led include:

• Transition of the Master of Science clinical majors from the clinical nurse specialist to nurse practitioner.

• Initiation of six new MSN specialties and three combined specialties.

• Development and implementation of the blended distance learning options.

• Implementation of the Ph.D. in Nursing Science and Doctor of Nursing Practice programs.

The School of Nursing is known for its innovative educational approaches, multiple entry options, flexible scheduling and distance learning options. It has one of the most extensive nurse faculty practice networks in the country and offers the latest informatics technology woven throughout all of its programs.

Robert Dittus, M.D., MPH, associate vice chancellor for Public Health and Health Care and senior associate dean for Population Health Sciences, led the interdisciplinary search committee. The search committee was supported by David Raiford, M.D., associate vice chancellor for Health Affairs and senior associate dean for Faculty Affairs, and staffed by Suzanne Alexander from the Office of Faculty Affairs.

Other members of the search committee included: Leanne Boehm, School of Nursing Ph.D. candidate; William Cooper, M.D., MPH, Cornelius Vanderbilt Chair and professor of Pediatrics; Marilyn Dubree, MSN, R.N., executive chief nursing officer; Thomas Elasy, M.D., MPH, Ann and Roscoe Robinson Chair and director of the Division of General Internal Medicine and Public Health; Kevin Johnson, M.D., M.S., Cornelius Vanderbilt Chair and chair of the Department of Biomedical Informatics; Joan King, Ph.D., MSN, professor of Nursing; Melanie Lutenbacher, Ph.D., MSN, associate professor of Nursing; Morgan McDowell, School of Nursing master’s candidate; Jonathan Metzl, M.D., Ph.D., Frederick B. Rentschler II Professor of Sociology and Medicine, Health and Society; Bonnie Miller, M.D., senior associate dean for Health Sciences Education; Lorraine Mion, Ph.D., MSN, Independence Foundation Professor of Nursing; Sandra Moutsios, M.D., assistant professor of Medicine; Warren Sandberg, M.D., Ph.D., professor and chair of the Department of Anesthesiology; Paul Sternberg Jr., M.D., assistant vice chancellor for Adult Health Affairs and chair of the Department of Ophthalmology and Visual Sciences; and Clare Thomson-Smith, J.D., MSN, assistant dean for Faculty Practice.

Dittus said Norman is ideal for the role.

“The search committee was flooded with a national outpouring of extraordinary support for Linda; she is held in extremely high regard among her peers. Nominators noted she is kind yet firm, fair and easy to work with, has a collaborative leadership style, is insightful and a visionary, and has a clear passion for developing the critical interprofessional solutions to today’s health care problems,” said Dittus.

Norman has been involved in establishing interprofessional academic programs since 1993 when she first served on the Institute for Health Care Improvement’s (IHI) national advisory team that coordinated a national multi-site project involving nursing, medicine and health administration programs to integrate quality improvement and patient safety into health professions education.

She is currently the co-leader of the Vanderbilt Program in Interprofessional Learning with Bonnie Miller, M.D., senior associate dean for Health Sciences Education at Vanderbilt University School of Medicine, and a member of the Southern Education Consortium for Interprofessional Education, both funded by the Josiah Macy Jr. Foundation.

Inducted as a fellow into the American Academy of Nursing in 2004, she currently serves as director of evaluation at the Robert Wood Johnson Foundation/Northwest Health Foundations Partners Investing in Nursing Initiative.

Norman has authored numerous peer-reviewed articles, books and book chapters. A popular presenter, she delivers speeches and academic presentations on far-ranging topics within the field of nursing across the country and around the globe.

“I am delighted to welcome Linda as a partner as she assumes the role of Dean for the School of Nursing. She is perfectly positioned to lead the School and collaborate with the Medical Center as we develop innovations in clinical practice, education and research,” said Marilyn Dubree, MSN, R.N, executive chief nursing Officer.

Norman earned her bachelor’s and master’s degrees from the University of Virginia and her DSN from the University of Alabama at Birmingham. She has received many national and local awards, and this year was named to the Nashville Business Journal’s Women of Influence list.
Her visiting professorships include those at Queens University Belfast in Northern Ireland and the University of Hong Kong.

Conway-Welch, the Nancy and Hilliard Travis Professor of Nursing, will continue to serve as a member of the faculty, working with Norman and Balser in support of the School of Nursing.

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Children with autism spectrum disorder (ASD) are “markedly better” at perceiving the motion of certain objects than are typically developing children their age, according to researchers at Vanderbilt University and the University of Rochester.

This finding, reported last month in the Journal of Neuroscience, supports the theory that an imbalance between excitatory and inhibitory neural mechanisms may explain the complex behavioral, social and cognitive deficits that define ASD.

Jennifer Foss-Feig, Carissa Cascio, Ph.D., assistant professor of Psychiatry, and colleagues studied the ability of children aged 8 to 17 with ASD to tell which direction briefly presented vertical lines moved across a computer screen. Children with ASD perceived the direction of motion of high-contrast gratings twice as fast as controls in the same age group. However, they were no faster in discriminating the motion of low-contrast gratings.

Further exploration of the sensory and perceptual differences that characterize ASD may help reveal its neural underpinnings, and could provide a platform for developing novel intervention strategies.

This research was supported by grants from the National Institutes of Health (EY001319, EY008126, EY001925, MH090232, RR024975). Foss-Feig was supported by an Autism Speaks Dennis Weatherstone Predoctoral Fellowship.

photo by Cathy Wilson/Vanderbilt

Vanderbilt’s Division of Trauma and Surgical Critical Care held the first in a series of free rural trauma courses May 23 at Riverview Regional Medical Center in Carthage, Tenn.

Typically, the rural trauma patient is remotely located from first responders and health care facilities, which can lead to untimely treatment of injuries. This course offers help with the initial evaluation and management of these complex cases.

Vanderbilt presenters included Oscar Guillamondegui, M.D., associate professor of Surgery and Medical Director for the Trauma Intensive Care Unit; Bradley Dennis, M.D., instructor in Surgery; Chris Brown, EMT-PCC; Melissa Smith, MSN, R.N.; and Cathy Wilson, MSN, R.N., Trauma Outreach and Injury Prevention Coordinator.

From left to right: Kevin Nooner, operations director; Brick Baker, pilot; Dylan Wilson, flight paramedic; Kirk Krokosky, flight nurse; Keith Evans, chief flight nurse; Mark Tankersly, flight nurse; Sheldon Dreaddy, flight nurse; Robert Brooks, flight communicator; Lis Henly, program director; and Jeanne Yeatman, administrative director of Emergency Services. Photo by Liz Reeves/Vanderbilt.

Vanderbilt LifeFlight, along with several other emergency agencies, received two Star of Life awards for their life-saving efforts at the annual Star of Life banquet, presented by Tennessee Emergency Medical Services for Children.

Receiving recognition for saving  the life of a pediatric patient was Macon County EMS, Lafayette Fire Department and Vanderbilt LifeFlight. The LifeFlight staff recognized included Kirk Krokosky, flight nurse; Mark Tankersley, flight nurse; Sheldon Dreaddy, flight nurse; Greg Stoddard, pilot; and Robert Brooks, flight communicator.

A man who had a stroke in a cave, resulting in a lengthy rescue, prompted the award for the LifeFlight team in Mt. Pleasant, Tenn.  Recognized for that heroic save were the Maury County Fire Department, Maury Regional EMS, and LifeFlight’s Keith Evans, chief flight nurse; Dylan Wilson, flight paramedic; Bric Baker, pilot; and Kelly Scott, flight communicator.

Also recognized were Maury Regional EMS and LifeFlight Event Medicine employees Doug Rutherford and Sean McGee.

by Jerry Jones

Melinda Buntin, Ph.D.

The new department represents a reorganized and growing version of the Department of Preventive Medicine, chaired for 31 years by William Schaffner, M.D., who will continue his teaching and research duties at Vanderbilt, including his work with the Emerging Infections Program (EIP), a population-based network including the Centers for Disease Control and Prevention and state health departments who work with collaborators (academic centers, local health departments, infection control practitioners, and other federal agencies) to assess the public health impact of emerging infections and to evaluate methods for their prevention and control.

“Dr. Buntin’s timely recruitment brings significant insights into current and future pressures facing our nation’s health care system while also creating an exciting opportunity for growth in Vanderbilt’s national leadership in health policy research and design, thus furthering our ability to bring a multi-disciplinary approach toward solving the many public health challenges we face,” said Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the Vanderbilt University School of Medicine. “Dr. Schaffner’s long-serving, forward-thinking approach to public health issues leaves a strong foundation for Dr. Buntin to build upon.”

At the CBO, Buntin has been responsible for managing and directing studies of health care and health care financing issues in the Health, Retirement and Long-Term Analysis Division. The CBO analyzes health issues and policies that affect the federal budget, including Medicare, Medicaid, subsidies for the purchase of private insurance, public health and private health insurance markets.

“This is a watershed moment for the Medical Center and the University,” said Robert Dittus, M.D., MPH, associate vice chancellor for Public Health and Health Care, senior associate dean for Population Health Sciences, director of the Institute for Medicine and Public Health and the Albert and Bernard Werthan Professor of Medicine. “Melinda has been sitting at the heart of health care reform, and has expertise in health care financing and the implications of different models of health care financing and delivery, as well as in role and value of informatics to improve the quality and value of health care.

“At few times in our nation’s history has there been more attention on health care policy than over the past two years. She has her finger on the pulse of American health care policy and financing reform. She knows the key leaders, who admire her and think highly of her. We are very fortunate to have been able to recruit her,” Dittus said.

The new department will be a multi-disciplinary base for health policy research and design. The current department’s strengths in population-based epidemiology and prevention blend with cross-campus disciplines critically important to the health policy debate, including economics, law and business. The mission of the new department is to provide rigorous evidence and help drive public health decisions at the very highest level.

Prior to joining the CBO, Buntin was deputy director of RAND Health’s Economics, Financing and Organization Program, director of Public Sector Initiatives for RAND Health, and co-director of the Bing Center for Health Economics. Her research at RAND focused on insurance benefit design, health insurance markets, provider payment and the care use and needs of the elderly.

She also worked with the Office of the National Coordinator for Health IT, where she established and directed the economic analysis, evaluation and modeling group.

Buntin has an A.B. from the Woodrow Wilson School at Princeton and a Ph.D. in Health Policy with a concentration in economics from Harvard.

“The faculty and I are delighted that Dr. Buntin will be joining us and extend her a very warm welcome,” Schaffner said. “We look forward to working with her on an array of research and teaching endeavors that will strengthen our current activities and expand them into new areas.”

Buntin said her role at the CBO has prepared her well to lead the new department.

“My group at CBO confronts the entire range of health issues of interest to Congress, so during my time here I was able to work on a very wide range of challenging — and real — health policy questions. That perspective will be very valuable to me.”

At Vanderbilt, she plans to build on the existing strengths of affiliated faculty in areas such as health insurance coverage, preventive medicine and systems of care for the elderly, but in the future will also focus on building expertise in additional areas and bringing together multi-disciplinary teams to do the best work in the field.

Buntin said that Vanderbilt’s atmosphere of enthusiasm, collegiality and commitment are ideal for her.

“Passion for my work, productive relationships with my colleagues and research that can point the way to real improvements in health and health care are the key ingredients in career satisfaction for me,” she said. “At Vanderbilt it was clear that I would not only step into an environment where those things were already present, but I’d have the privilege of being able to ‘bake’ those ingredients into the new Department of Health Policy.”

Joining Buntin in Nashville will be her husband, John Buntin, a writer, and sons Oliver, 8, and Tom, 5.