Black History Month 2014
Feb. 19, 2014 College News - In honor of Black History Month, the Medical College of Wisconsin has created a series of video vignettes and stories that will be posted online during the month of February. The vignettes highlight some of our African-American and Black faculty, staff and students and the contributions they have made. The stories highlight MCW programs that improve the health of underserved populations (including African-American and Black), offer these populations improved access to health care and education, and reduce health disparities.
All of the vignettes and stories will be added to the College’s Black History Month 2014 Web page as they are published.
This story highlights a few of the programs within our research, educational, and patient care missions.
Sickle Cell Disease Research Programs
Faculty and staff at the Medical College of Wisconsin (MCW) and the BloodCenter of Wisconsin (BCW) are conducting basic, translational and outcomes research on sickle cell disease (SCD), which affects one in 400 African American and Black newborns in the United States. It is a genetic disorder affecting hemoglobin, which are the protein molecules in red blood cells that carry oxygen through the bloodstream, and patients with it can experience numerous symptoms including bouts of extreme pain and shortness of breath.
These sickle cell clinical and research faculty have been significant contributors to the study of hydroxyurea (a drug used to treat SCD) in children, participated in numerous multicenter SCD clinical trials, laid the ground work for understanding patient-reported SCD outcomes, and developed the only health-related quality of life tool specific to children with SCD. The group has also been instrumental in expanding the knowledge of health care utilization for children and adults with SCD, including re-hospitalizations and emergency department use at a population level.
The sickle cell faculty and staff work with partners in the community, including the Milwaukee Public School system, to provide outreach communication and education to the public. These faculty and staff have a national presence in the sickle cell community. Faculty members participate in standing and ad hoc NIH study sections, strategic planning groups, and data safety monitoring boards. They are also active members of the American Society of Hematology.
Ongoing patient-centered research currently being conducted include patient-reported outcomes and quality of life in children with SCD; improvement of communication process and outcomes after newborn genetic screening; reducing hospital readmissions for children with SCD; and Emergency Department utilization.
Areas of ongoing basic research at MCW and BCW include cell free hemoglobin, lipid oxidation and nitric oxide in SCD; role of coagulation and inflammatory pathways in SCD vaso-occlusion; red blood cell adhesion and vascular injury in SCD; HDL dysfunction and vascular inflammation in SCD; and oxidative stress in murine heritable hemolytic anemia.
Areas of ongoing clinical and translational research include asthma and nocturnal hypoxemia in SCD; cysteinyl leukotrienes receptor inhibitors: a target for decreasing SCD-related morbidity; pain in mouse models of SCD and hemolytic anemia; neurobiology of pain in patients with SCD; pain outcomes in individuals with SCD; psychosocial factors (sleep, mood) impacting pain in SCD; and neuropsychological complications of SCD; multicenter clinical trial using Intravenous magnesium for acute painful crisis; pulmonary complications of SCD; Dr. Joshua Field has pioneered Phase I clinical trials in SCD on our campus (regadenoson) and is exploring novel techniques to measure blood flow in individuals with SCD.
As a result of all of the above efforts, this is one of only a few sickle cell clinical and research groups in the country able to translate basic science discovery in SCD into clinical protocols aimed to benefit patients, exemplifying bench to bedside research.
Faculty currently involved in sickle cell research include: Amanda M. Brandow, DO, MS, Assistant Professor of Pediatrics (Hematology/Oncology); David C. Brousseau, MD, MS, Professor of Pediatrics (Emergency Medicine); Michael Farrell, MD, Assistant Professor of Medicine (General Internal Medicine); Joshua Field, MD, Assistant Professor of Medicine and Associate Investigator at the BloodCenter of Wisconsin; Cheryl A. Hillery, MD, Professor of Pediatrics (Hematology/Oncology); Neil Hogg, PhD, Professor of Biophysics; Matthew Myrvik, PhD, Assistant Professor of Pediatrics (Hematology/Oncology); Robert F. Newby, PhD, Associate Professor of Neurology; Julie A. Panepinto, MD, MSPH, Professor of Pediatrics, (Hematology/Oncology); Kirkwood A. Pritchard, PhD, Professor of Surgery (Pediatric Surgery); J. Paul Scott, MD, Professor of Pediatrics (Hematology/Oncology); Cheryl L. Stucky, PhD, Professor of Cell Biology, Neurobiology and Anatomy; and Nancy Wandersee, PhD, Assistant Professor of Pediatrics (Hematology/Oncology).
Sickle Cell Disease Patient Care Programs
Through MCW’s partnerships with Children’s Hospital of Wisconsin and Froedtert Hospital, Medical College of Wisconsin faculty and staff in the pediatric and adult sickle cell disease clinics annually provide comprehensive care to roughly 500 children and adults with sickle cell disease.
The Wisconsin Sickle Center at Children’s Hospital is a nationally-recognized comprehensive sickle cell program that incorporates both clinical care and research into the disease. It is one of only 11 sickle cell sites nationwide to be considered a National Institutes of Health-funded Basic and Translational Research Program
Opened in 2011, the Adult Sickle Cell Clinic at Froedtert Hospital cares for over 300 adults with sickle cell disease. The Adult Clinic provides comprehensive and integrated specialty disease and pain management services including inpatient and outpatient acute care management, hydroxyurea and transfusion therapy services as well as access to single and multi-institution clinical studies. Through the efforts of the Adult Clinic over the past 2 ½ years, the majority of care for adults with sickle cell disease has shifted from the inpatient to outpatient setting, resulting in a significant reduction in rate of emergency department and hospital admissions. More important than the cost savings to the hospital, the reduction in admission rate reflects better disease management and healthier patients.
Urban and Community Health Pathway
Created in 2010, the Urban and Community Health Pathway links training with community needs and assets to prepare students to care for patients in urban, underserved settings, promote community health and reduce health disparities. Using a service learning model, students partner with communities of color to address high-priority health needs. Examples of some of the partnerships in place (and the partners involved) include:
Health careers education at James Madison High School (AHEC Youth Health Service Corps) and Pearls for Teen Girls.
Girls on the Run fitness education (Neu-Life Community Center)
Health programming at three homeless shelters (Guesthouse, Family Support Center and Walkers Point)
Asthma Smarts - self-care education to kids with asthma (Fight Asthma Milwaukee Allies and Milwaukee Public Schools)
Childhood Obesity Prevention Project (United Neighborhood Centers of Milwaukee)
Youth health programming (Journey House, Holton Youth Center)
Elder Health Education in public housing (SET Ministry)
Global Health Pathway
The Global Health Pathway prepares students to address the special health care needs of patients from areas of the world with diverse resources. Many of the World Health Organization’s targeted Neglected Tropical Diseases preferentially affect minority populations around the world where health care needs are great but resources are limited. Structured MCW-linked international experiences in developing countries are strongly encouraged as summer research and or M-4 options. Locally, students in the Global Health Pathway have the opportunity to participate in “local/global opportunities” by working with community-based agencies that serve refugees and immigrants.
Diversity education pipeline programs
MCW has several diversity education pipeline programs designed to encourage students from diverse backgrounds to consider careers in medicine and the biomedical sciences. Two of the summer programs are offered to undergraduate students interested in medicine or biomedical research, and three of the programs are geared toward local high school students. Seventy percent of high school participants in the pipeline programs go on to college/university and some continue to medical school or graduate studies in research fields.
AIM participant Ronisha Howard in the STAR Center. Person in the background is Gabrielle Ferguson.
The high school programs include the Apprenticeship in Medicine (AIM) program, the Research Opportunity for Academic Development in Science (ROADS) program, and the ACS Project SEED summer research program.
The Apprenticeship in Medicine Program (AIM) was launched in 1989 to provide academically talented students from diverse backgrounds with the opportunity to learn more about careers in medicine and allied health. Since 1996, 171 students have graduated from AIM with a substantial portion of these students continuing their education in college.
The program is designed to educate students about common medical problems in their communities, provide them with hands-on opportunities in medicine, and encourage them to attend college or university and pursue a career in medicine. Students spend most of their time in an instructional environment but also attend area clinics one full day per week to maximize learning opportunities and time with positive role models.
The Research Opportunity for Academic Development in Science (ROADS) program was launched in 1990 and is intended to motivate high school students from diverse backgrounds to consider careers as physicians and scientists. More than 100 students have participated in the ROADS program since it was first implemented, and a study of the program’s 86 enrollees from 1996 to 2011 found that 66% graduated from high school and 65% attended college.
As part of the ROADS program, each student completes a bench or community research project guided by his or her faculty preceptor. Students also are required to attend scheduled lecture sessions on types of research, research analysis, ethics, and the use of simulations in medicine. During the final week of the program, an informal research symposium is held to allow students to share the results of their work with faculty, members of their labs and their peers.
The ACS Project SEED summer research program offers economically disadvantaged students entering their junior or senior year in high school the chance to experience what it’s like to be a chemist. For 8 to 10 weeks, SEED students work with faculty researchers who help them develop laboratory, written and oral skills. In addition to hands-on research, Project SEED students receive guidance on their career and personal development.
The Diversity Summer Health-Related Research Education Program (DSHREP) allows undergraduate students to explore their interests in science and technology through a summer research training experience supervised by full-time Medical College faculty.
Qualified students who are accepted into the 10-week program are “matched” with a full-time faculty investigator to participate in a research project(s) addressing the causes, prevention, and treatment of cardiovascular, pulmonary and hematological diseases. Each student researcher is required to provide an abstract of their research and present a brief presentation of their project at the conclusion of the summer experience. Our outcome tracking found that approximately 30% of undergraduate students have pursued medicine as a career, with a small number still in medical school.
Asthma Patient Care Programs
MCW physicians provide comprehensive care for adult and pediatric patients with asthma, another chronic disease that affects African Americans and blacks disproportionately.
Adults and children with severe, difficult-to-control asthma receive specialized care through the Asthma Plus program. As part of this program, doctors from many different specialties help patients focus on education, identify short- and long-term health goals, develop an asthma action plan, and review the avoidance of triggers and stressors. The patients also better understand when to contact a physician, learn the importance of nutrition and exercise, and learn the importance of an annual flu vaccine and having regular follow-up visits with a medical professional.
Medical College of Wisconsin physicians are an essential part of Fight Asthma Milwaukee Allies, an organization that educates children and families about asthma and seeks to improve asthma control. Their efforts are paying off. Between 1999 and 2008, Children’s Hospital of Wisconsin had a 38% reduction in asthma hospitalizations for children living in the central city of Milwaukee. Fight Asthma Milwaukee Allies was selected by the U.S. Environmental Protection Agency for a National Exemplary Award for outstanding contributions to help people with asthma live active, healthy lives. MCW physicians, along with the American Lung Association, help lead Milwaukee’s only Asthma Camp. This week-long day camp is for kids with asthma, and helps them to better understand asthma, their triggers, and their medications.
MCW, in collaboration with Froedtert Hospital, has a comprehensive Asthma, Chronic Obstructive Lung Disease, and Smoking Cessation Continuity Clinic Program that provides guidelines-directed medical care, patient education and counseling, and medication and lung function testing resources. Over the past nine years, more than 1,300 patients have been cared for through clinics at Froedtert Hospital, the Lisbon Ave. Clinic, Clinica Latina, and Columbia St Mary's Family Practice Center.
Patients who become part of this program show marked decreases in symptoms and use of the emergency department and hospital for exacerbations, and marked increases in lung function, quality of life, and the ability to stop smoking.
Community Engagement Programs
Project Ujima, created in 1995, is a violence intervention and prevention program committed to stopping the cycle of violent injuries to our youth. A partnership between Children's Hospital of Wisconsin clinical and community services and the Medical College of Wisconsin, the program annually serves more than 380 youth ages 7-18 who suffer assaults, stabbings and firearm injuries as well as more than 500 adult victims of homicide, intimate partner violence, robbery and assault.
Many of the children who are cared for through the program come from underserved populations, including the African American community. Since it was launched, more than 4,000 adolescents with injuries due to interpersonal violence have been treated in the Emergency Department/Trauma Center at Children’s Hospital. Violent injuries are associated with psychological trauma, poor school performance and repeat incidents of violence. Project Ujima uses a network of services that assist with physical, psychological and social recovery using the arts, education, career development, sports and faith-based communities.
A national model, Project Ujima received the Award for Professional Innovation in Victim Services from the Department of Justice in 2004. Project Ujima is a founding member of the National Network of Hospital-Based Violence Intervention Programs and helps other hospitals start similar services within their communities.
Center for Healthy Communities and Research
MCW formed the Center for Healthy Communities (CHC) in 1997 to develop community-academic partnerships that improve health in Wisconsin urban and rural communities. In 2010, CHC converted to the Center for Healthy Communities and Research (CHCR) to combine both the center and the research divisions.
The goals of the CHCR are to develop, implement and sustain community-academic partnerships that promote health, conduct and disseminate research to address community-identified health needs, and collaborate to expand community-academic partnerships. CHCR partners include the Housing Authority of the City of Milwaukee, S.E.T. Ministry, Inc. (Serve, Empower, and Transform), the Milwaukee County Department on Aging, the Veteran’s Administration Medical Center and the Rural Wisconsin Health Cooperative.
Many of the CHCR urban partnerships are with organizations that address the health needs of underserved populations including the African-American and Black communities. An example of one such partnership is the Elder Community Health Upholders (ECHU) and its current project titled, One-Hundred Healthy, At-Risk Families. This project is designed to improve the health of seniors with multiple chronic diseases by working through ten Milwaukee church communities. Along with project churches, this collaborative includes the Arthritis Foundation, Columbia College of Nursing, the Alzheimer’s Association, the Center for Urban Population Health, Wisdom, Inc., and the St Joseph Family Care Center. ECHU has developed nurse-directed education modules for seniors, a health risk monitoring tool, and a pastoral leaders’ fellowship to advocate for healthy homes and communities.
Created in 2006, ECHU has been the recipient of the Department of Family and Community Medicine’s Community Partnership Award, recognizing outstanding engagement and influence on community health.