Tag Archives: University of Washington

UW President Young: WSU statement on the end of medical school partnership ‘misleading’ – Puget Sound Business Journal

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president-young-UW michale While Young said he is disappointed the partnership will not continue – especially if it results in an inability to grow the number of primary care physicians in rural and underserved parts of eastern Washington – he “can’t imagine” that the Legislature wouldn’t approve funding in 2015 for UW’s plans to expand WWAMI. He talked with the PSBJ about what this means for the future of the program.

via UW President Young: WSU statement on the end of medical school partnership ‘misleading’ – Puget Sound Business Journal.

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Making hard decisions: WSU President Elson Floyd on splitting up with UW – Puget Sound Business Journal

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elson-floyd-wsu-president*304xx2996-4494-299-0Q: What brought about the decision to split up?

A: It was the view of the UW that in order to continue our participation in the WWAMI program we had to be “100 percent in,” and that was the term that was used by UW. And by that they meant we could not continue in the WWAMI program while pursuing aspirations to have a second medical school in the state.

via Making hard decisions: WSU President Elson Floyd on splitting up with UW – Puget Sound Business Journal.

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Chain Saw

Sequester will force universities to scale back scientific research

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Chain SawBy Jim Malewitz
Stateline Staff Writer

Marian Alicea, an engineering student who is slated to graduate from college this spring, needs a doctorate degree to achieve her lofty career goal of becoming a White House environmental adviser with scientific expertise.

But the budget battle in Washington is complicating her plans for getting there.

In normal times Alicea, who attends Southern Polytechnic State University in Marietta, Ga., would likely be a shoo-in for a full research stipend. She is an honors student who has snagged several prestigious internships. And as a Latina she belongs to a minority group that is underrepresented among engineers.

But because of the sequester—the automatic federal budget cuts that went into effect March 1—some of the schools that want Alicea can’t offer her the financial aid she needs.

Federal agencies pour billions each year into university research, largely through grants that allow student researchers to pay their bills as they work.

With less federal money to spend, some Ph.D. programs are delaying admissions decisions, while others have already cut positions amid the uncertainty.

In 2011, federal money accounted for more than $40 billion of the $65 billion universities spent on research. At several large research universities, including Johns Hopkins, the University of Washington, the University of Pennsylvania and Harvard, federal dollars comprised 80 percent of research spending.

Research funding

Like most other federal agencies, the National Institutes of Health must cut 5 percent of its budget to comply with sequestration. Because NIH funnels about 85 percent of its budget to researchers, it is already scaling back some grants, according to director Francis Collins.

Meanwhile, the National Science Foundation, facing similar cuts, estimates it will give out about 1,000 fewer research grants and awards this year, affecting as many as 3,000 researchers.

Researchers and university officials worry the lost funding will slow or halt research on everything from cancer treatments to contaminated soil and water.

They also fear it will dissuade young scholars from pursuing scientific careers.

“It will be profoundly devastating for this generation of students,” said Michael Reid, head of the physiology department at the University of Kentucky’s College of Medicine.

Alicea was accepted into four of the dozen programs she applied to, but only two —Virginia Tech and Auburn — offered her financial help.

The other universities, Maryland and Illinois, said they could not guarantee her money because the sequester had muddled their budgets.

“Chilling effect”

Enrollment in graduate schools was already lagging amid growing concerns about student debt. Between 2010 and 2011, first-time U.S. enrollment across programs fell by 1.7 percent, following a decade of gains, according to a survey by the Council of Graduate Schools.

“This financial stress on institutions comes at a really tough time,” said Debra Stewart, the council’s president. “It has a chilling effect on what was already a chilly situation.”

For all university students, sequestration will mean higher fees on Stafford Loans and reduced payments from some grants, including federal work study.

Some educators worry that the prospect of amassing higher debt will scare students away, particularly as institutions hike tuition amid eroding state funding.

But the economic forecaster Moody’s expects universities as a whole to face only “minimal” immediate effects from sequestration as they turn to other revenues.

For graduate students in the sciences, the impact will be more dramatic. A lack of federal money prompted the University of Kentucky’s College of Medicine to admit about a third fewer students to its Ph.D. program in physiology, according to department head Reid.

“There were a number of qualified candidates we had to turn away,” he said.

Reid, who oversees a lab studying how chronic disease, such as cancer, speeds up muscle deterioration, said one of his lead doctoral students will lose his grant if sequestration continues, threatening to halt his education and dramatically slowing down the line of work.

If the politicians in Washington can craft a budget deal that replaces the sequester, Reid’s lab could immediately resume some of its stalled research, he said. But when it comes to genetically engineering mice, a process that can take years, it would likely have to start from scratch. When that type of research is halted, Reid said, “That’s it. You’re toast.”

A “grim fate”

Alicea has no qualms about taking the offer from Virginia Tech, but she is frustrated by her constricted choices and troubled by what it says about lawmakers’ support for the sciences.

Experts consider investment in those areas to be essential for the country’s economic competitiveness and ability to improve health and technology.

Consider Lucas Arzola, founder and head of Inserogen, a biotechnology startup that uses tobacco leaves to speed up the development of human and animal vaccines. He originally developed the technology as a Ph.D. student at the University of California-Davis, largely supported by federal grants.

If Congress doesn’t act, “how many graduate students will no longer have the support to make that next critical discovery?” Arzola said in a video testimony shortly before sequestration took effect.

Major drug, energy and engineering companies are increasingly relying on universities to build on their research and develop new products, said Robert Duncan, vice chancellor for research at the University of Missouri.

Duncan says sequestration “is terrible for U.S. competitiveness,” pointing to a 2010 National Academies of Sciences studythat showed the U.S. has begun to lag behind other countries in math and the sciences.

“In spite of the efforts of both those in government and the private sector, the outlook for America to compete for quality jobs has further deteriorated,” the authors concluded. They called for more spending on research and education.

Furthermore, many economists argue it is misguided to curb research spending to address the nation’s budget crisis, because several studies have shown such spending spurs economic activity far greater than what is invested.

Last fall, an analysis by the Information Technology and Innovation Foundation, a non-partisan think tank in Washington, estimated cuts to research and development funding under sequestration would reduce GDP by as much as $860 billion over nine years.

“If we want to see our still somewhat lagging economy pick up again, (investing in research) is one of the major ways to achieve it,” said Collins, the NIH head.

At NIH, the cuts follow a decade in which funding stayed static despite inflation, and could result in the elimination of as many as 20,500 U.S. research jobs, according to an analysis by United for Research, a coalition of research institutes and patient advocates.

“It is a paradoxical thing that we are both at a time of remarkable and almost unprecedented scientific opportunity,” Collins said, “and we‘re also at a time in the United States of unprecedented threat to the momentum of scientific progress.”

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Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.

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Teen Pregnancy, Part 5: Teens Raising Children

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By Jen Brown, RN
From Seattle Children’s Teenology 101 weblog

It’s hard to write a brief post on something as complicated on teens having and raising children! Your story will be different than anyone else’s, and your experience unique. However, I think the following 8 points are good ones to consider when your teen tells you they are thinking about becoming a parent.

1. Your teen needs to make this decision. Let your teen know what you think about them having and raising the child, and why. Make a pro-con list. Discuss your experience in parenting and give them a realistic view of what to expect. But even if you disagree with their decision, it’s important to respect it. This isn’t a decision you can make for them without the possibility of major repercussions down the road.

2. This is going to be a hard adjustment. Many parents of teens are looking forward to a time when the house will be theirs again, when they can retire and take trips and generally relax. Now there is the prospect of a new infant in the home. It’s completely normal to feel disappointed or angry, even while you know you’ll love your grandchild. If the feelings persist or are interfering with your ability to cope, seek help from a counselor. Likewise, if you feel like your teen is having trouble adjusting, have them see a counselor as well.

3. Your teen needs your help. Remember how lost you felt, the first time you were caring for a newborn? Hopefully, you had wise friends and family to help you with taking on the role of a new parent. Your teen needs that wise advice, and your experience is invaluable. Any teen can learn to feed, change, and clothe a baby. But they will need your ongoing support to interact with their baby, learn to play with them, differentiate normal behavior from worrisome signs, and adjust to their rhythms.

4. Make a plan. Any teen will appreciate help with babysitting, diaper changes, and driving to the doctor’s appointments, but some teens simply expect their parents to raise the baby. Even young teenagers can and should take on parenting responsibilities. Sit down with your teen before the baby is born and work through what your expectations are, including their responsibilities in getting prenatal care now and planning for the birth. Make sure they know that as they get older, more parental responsibility will shift to them. Conversely, some teens may expect to be able to take on all care immediately, with little to no parental help. Let them know that you are happy to assist, and they will usually take you up on it once the baby is born.

5. Don’t abandon educational and career goals. Your teen needs to attend school full-time after their time off to have the baby, making use of day care as needed. If your teen gets any pushback at school, this may be illegal; the ACLU has information about ways to respond effectively. If your teen was planning on college, having a child shouldn’t change that. Many campuses have family housing, day care facilities, and support for student parents. Further education or career training leads to better financial stability in the future, which will help both your teen and their child.

6. Let your teen have a life. Part of teen development is spending time with peers, and your teen is no different. They need to be able to go out with their friends, date, and have an active social life. While they should expect some nights in, it’s important that they spend time having fun outside the house. By offering to babysit and let your teen go be a typical teen for a while, you’re helping them mature into a socially healthy adult. In addition, find community programs (this one is a good example) where your teen can meet other teen parents.

7. Expect rough patches. Babies are adorable. Toddlers are adorable, too, but at around age 2 they become much less pliable. Your teen may have a lot of trouble with the “terrible twos”, when their baby is discovering its identity, being contradictory, and fighting parental authority. For a teen whose developmental tasks are discovering their identity, being contradictary, and fighting parental authority, this can be a lot to take. Know that there are times in the development of both your teen and your grandchild when a cooler head and more experienced hands may be called for.

8. You’re going to love your grandchild. Even if this wasn’t exactly when you planned on having a grandchild, you’ll still love this baby like crazy. Your family is growing, perhaps unexpectedly, but you will have a new love in your life along with all the chaos this situation brings!

What advice would you give to parents whose teens are planning to have and raise a child? What advice would you give to teens?

 

About Jen Brown, RN, BSN

Jen-Brown-RN-BSN_avatar-100x100Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington

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Teen Pregnancy, Part 4: Adoption

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By Jen Brown, RN
From Seattle Children’s Teenology 101 weblog

One option for pregnant teens is to bear the pregnancy to term, have the baby, and put it up for adoption. 2-3% of teens who are pregnant choose this route. However, the term “adoption” is not as simple as it used to be; there are different types of adoptions available. In this post, we’ll explore resources, basic information, and options for you and your teen to consider.

Many adoptions in the popular media are portrayed as unsatisfactory in some way, sometimes to the point of being ridiculous. The truth is that the majority of adoptions work out very well, enriching the life of the child being adopted as well as that of the adoptive family. They also allow the birth mother to continue her life without the unplanned impact of raising a child.

If your teen is considering continuing the pregnancy, and having the child adopted,  it may be hard for her to decide how she will feel after the adoption is through. Ask her to picture what it might be like. She might be able to see herself feeling relieved, deprived, proud, anxious, responsible, or miserable. It’s normal to be uncertain which emotion would predominate (especially as she will likely experience many.) Work through these emotions with her. What difference would it make in her life if she felt proud and responsible? What might she feel anxious about? What if she felt like she had made the wrong decision? What will it be like to get prenatal care and deliver the baby? How will this decision affect her life goals?

If your teen decides she wants to carry the pregnancy and adopt out the baby, the next decision is what kind of adoption she wants to have. The two broadest categories are “open” or “closed” adoptions. An “open” adoption means that she (and the baby’s father, if he wishes) will communicate with the adoptive family. This can range to everything from meeting them once during the pregnancy to regular, in-person visits with her child as he or she grows up.  Most people who choose open adoption end up somewhere in between those two ends of the spectrum. If your teen wants, she can select which family adopts the baby.

“Closed” adoptions mean that your teen will not meet the adoptive parents, and will be uninformed and uninvolved regarding the child’s placement, although she can make requests to a third party. Most closed adoptions do involve her releasing a medical history, since it is vital for someone to know what disease risks run in their biological family.

Research has shown that open adoption is, in general, better for the mother’s mental health than closed adoption. But your teen is a person, not a statistic. If she desires a closed adoption, that’s her choice. It’s best to allow some room for leeway, in case she decides she wants some basic information on the child down the road. It’s much easier to ask for less information and contact in an open adoption, than to try and get more in a closed one.

Adoptions can be performed through an adoption agency, through independent legal counsel, or by the your family independently. I would highly recommend at least having contact with a specialist, even if that person or agency does not end up handling the adoption.  This document has information about some local agencies and lawyers who are informed on the various issues around adoption, and can guide the process. Make sure your teen gets to research different choices and decide what works best for her. If the whole process is intimidating, partner with her to look at options.

These are the Washington state laws pertaining to adoption. It’s a dry read, and can be hard to understand, but I’d encourage you to go through them with your teen. If she asks, “What does that mean?” and you don’t know, contact a specialist and find out. (This is a short cheat sheet, if you’d rather start with something less technical before moving on to the laws themselves.) Your teen is about to make a big decision, and it’s important that she understand the adoption process thoroughly.

Many people have had their lives touched in some way by adoption. I’d love to hear your stories!

 

About Jen Brown, RN, BSN

Jen-Brown-RN-BSN_avatar-100x100Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington

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Teen Pregnancy, Part 3: Making the Decision

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By Jen Brown, RN
From Seattle Children’s Teenology 101 weblog

Pregnant teens have three options when they are pregnant: They can terminate the pregnancy, or they can carry the pregnancy to term and either raise the child or arrange for an adoption. No matter what happens, this is a decision and a time your teen will always remember. You’ll remember it, too.

It’s vital that you never coerce or force your teen into a choice about her pregnancy. Not only will she be left feeling powerless, but she may feel betrayed by you; that’s not something either of you should have to live with. However, your input and guidance may help her through a difficult time. If there is a choice you are hoping she will make, or one that falls in line with the values of your family, tell her, while making it clear that it’s her decision and you will respect the one she makes.

Adoption:

Your teen may want to bear the child, and have a family adopt the baby and raise it. There are many different types of adoption, and your teen will have a chance to choose what is right for her. It’s very common for a teen thinking about having her baby adopted to fear that she will change her mind. Make sure your teen knows that she can arrange for an adoption and have the child, and then decide to keep it at that point if she really cannot see things going any other way. This certainly isn’t the best or easiest way to go about it, and can be a hardship to a waiting adoptive family. But until she “signs the baby over” to that family, she has the chance to change her mind. This can be comforting for pregnant teens to know. We’ll talk more in upcoming posts about different methods and types of adoption.

Termination: 

A termination, or abortion, means that your teen will seek medical services in order to stop the pregnancy. This is a very emotional topic, and I am not going to address the morality of pregnancy termination. I would encourage you to discuss it with your teen, however, giving your opinion and seeking hers.

One important thing to consider about termination is that the decision to terminate a pregnancy should be made as quickly as possible. This is never a decision you want your teen to rush, but the earlier the termination, the easier it will be to find a provider and have the simplest procedure possible. If your teen cannot decide whether or not to terminate for months and months, she is in essence choosing to bear the child. There’s nothing necessarily wrong with this; this may be the way she ends up making the choice that’s right for her. But make sure she knows that if she is certain this is what she wants, it’s best to start seeking out a healthcare provider.

Raising the Child:

Your teen may decide that she wants to bear and raise the child. Depending on her age, this may involve a lot of you raising the child as well. She will most likely need financial support, not to mention help in learning to parent, fitting a child into her future plans, and dealing with negative reactions from those around her.

Most parents do not plan to raise another baby when they have teenagers. It’s important that your teen be involved in the work as well as the joy of raising a child, and it’s just as important that you’re there to help her. Once you have wrapped your mind around the fact that your kid is having a kid, offer as much support as you can while encouraging her to take responsibility for things like scheduling prenatal care appointments, seeking out a place to give birth, and deciding on how childcare will proceed after the baby is born. Teenage young woman who have children can and do finish  high school, go to college, and complete graduate and professional programs. Having a child might make her educational goals more difficult, but by no means impossible- especially if you commit to helping her reach them.

We will be talking about these three options in more detail over the weeks to come. Please feel free to chime in with any thoughts or questions!

 

About Jen Brown, RN, BSN

Jen-Brown-RN-BSN_avatar-100x100Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington

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Teen Pregnancy, Part 2: Young Men and Teen Pregnancy

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By Jen Brown, RN
From Seattle Children’s Teenology 101 weblog

Male teenagers who are involved in a teen pregnancy often don’t get much attention. And yet while the young woman bears the physical effects, a pregnancy takes two people. If your teen son is involved in a pregnancy, his reaction may surprise you. He may be expecting to do absolutely nothing regarding this pregnancy and “let her take care of it”, or he may be planning to get married and help raise the child. He may have no idea what he wants. He may feel angry, excited, miserable, joyful, apathetic, guilty, or a confusing combination of emotions. If this pregnancy is unwanted, as many teen pregnancies are, he may be having visions of a “worst case scenario”- whatever that means to him.

Barring a medical problem, there are basically three courses for a pregnancy to take, all of which we will discuss in further detail.

Adoption: If the young woman desires to continue the pregnancy and offer the baby for adoption, your son has a say in this. If he is strongly against it, seek legal help; it’s a complicated situation. Your son may be fine with the adoption, but want an active role in deciding on its aspects. He should communicate respectfully to the young woman and her family, expressing his desire to be involved. Encourage your son to become part of the adoption process if he wants to, and maybe even in the pregnancy itself.

Abortion: It is up to the young woman to decide if she wants to terminate the pregnancy. If this is her plan- or it has happened already- explore his reaction with him. He may be pleased at the decision and feel relief, or he may experience feelings of sadness, betrayal, or anger. Sometimes teens feel guilty for feeling relieved, or impatient if they cannot “get over it” as quickly as they feel they ought to. Oftentimes  feelings will be mixed, especially as the situation is unfolding. Some young men frustrate their parents by acting like it’s no big deal; in his mind, that may be true. Remember that even though your teen is faced with an adult situation, he’s not an adult. Help him learn how to prevent the situation from occurring again. Make sure he knows he can come to you for advice, support, or a sounding board whenever he wants.

Keeping the child: If the young woman is planning on having and raising the child, this is going to be life-changing for your teen. Here are several important issues you and your teen need to start thinking about immediately:

  • Is there any doubt about the paternity of the child? You do have the right to request a paternity test before your teen is named the child’s father. Teen fathers, like adult ones, take on a lot of responsibilities, and your teen may want to ensure that he is in fact the baby’s father. This document has some quick facts on paternity and child support. If you and your teen decide to request proof of paternity, make every effort to do so delicately and respectfully.
  • How involved does your teen want to be with the raising of his child? If your teen wants to be a father, he has every right to be. Since the young woman and your teen don’t live together, arranging this can be complicated. In a best case scenario, both families will come together and agree on a plan that works for everyone. If there are disagreements, seek legal advice before making any major decisions.
  • How closely can you work with the young woman’s family? Most families will be open to talking to you and your teen about what happens next. While both sets of parents may be surprised at being grandparents, remember that you have much-needed skills and wisdom. If you can all work cooperatively to ensure the well-being of both your teens and their baby, things will go much more smoothly.

No matter what happens, your teen may experience very strong feelings, and you need to encourage him to express them and offer emotional support. You need to do this even if you don’t think his feelings are wise or even valid. If your teen is having trouble coping with the situation, help him seek out a counselor to talk to. Remind him that you love him and are there for him no matter what happens, and mean it.

 

About Jen Brown, RN, BSN

Jen-Brown-RN-BSN_avatar-100x100Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington

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Teen Pregnancy, Part 1: Getting the News

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Seattle Children's LogoBy Jen Brown, RN
From Seattle Children’s Teenology 101 weblog

Finding out that your teen is pregnant, or has gotten somebody pregnant, is usually quite a shock. There are some situations and cultures in which you’re not shocked, and may be okay with the news, in which case your path will be easier. But many parents find themselves reeling at the news. You may feel angry, sad, hurt, astonished, betrayed, scared, confused, disappointed- or a mix of any of these emotions and more. Your kid pregnant- or fathering a child- and yet they are still a kid. You still pay their bills, and weather their bad moods, and sometimes are still driving them around. How did this happen?

If your teen is sexually active and you didn’t know about it, you are certainly not alone. It doesn’t mean you’re a bad parent, or you didn’t encourage them to communicate with you, or you didn’t discuss sex with them. It doesn’t mean they don’t love you and value your viewpoint. It means that they’re a teenager, and many teenagers like to keep secrets. When I was a teen I would hide from my parents that I was dating this or that person, not because they would have minded, but because I liked the kick of having to keep the secret and operate everything under the radar. Or perhaps they feared your reaction, or perhaps they themselves weren’t particularly proud of what they were doing. Perhaps they were coerced or even forced into sex (if not, I’d say that’s something to be thankful for.)

There are lots of possible reasons. But your kid getting pregnant, or getting someone pregnant, does not equal bad parenting. Teens with great parents can still be sexually active, can still take risks, can try to do everything right and end up with outcomes they didn’t expect. So if you’re feeling guilt, you can let go of it and focus on what’s going on.

It’s hard not to get emotional at the news. And it’s okay to get emotional at the news. But now that you know, you need to offer your teen support- even if you’re still really mad at them or are more scared than you’ve ever been in your life. I can guarantee you that your teen is mad and scared too. It’s okay to tell them you’re still mad, and it’s okay to still cry when you talk about it. But if you can’t talk without yelling, or sobbing, or biting your nails, you need to figure out how to get to a different emotional place. The emotions are certainly warranted, but your teen needs this issue approached with a cool head, and it’s unlikely to be theirs.

Now is a time when your teen has options to consider, and they’ll need your help considering them. I’m not saying they need you to make the decision for them; this is a really personal decision and in the end, they should have the final say. This may be the first adult decision they need to make. They can’t put it off. They can’t avoid it. They have to face up to the situation, and a parent who is there to support, guide, and love them throughout is invaluable.

Over the next few posts, we’re going to look at the issue more closely, and options available to pregnant teens. Keep in mind that if your teen fathered a child, their decision-making power in this situation may be limited. Nevertheless, they should be there for, or at least available to, whomever is pregnant. It’s common for teen boys who have fathered a baby to want to run away and hide, but they played a role in causing this situation and they need to deal with it. With you behind them, they can figure out the best way to do that.

Make sure you’ve got support too. Friends, family, or partners can help you. Your teen may beg you not to tell anyone, and with the possible exception of a co-parent, it’s best to respect their wishes. In that case, talk to a counselor, a pediatrician, or someone who doesn’t know your kid at all and you trust to keep things confidential. You need to be able to organize your thoughts and stay strong for whatever comes ahead.

 

About Jen Brown, RN, BSN

Jen-Brown-RN-BSN_avatar-100x100Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington

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Azita Emami named dean of UW School of Nursing

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Azita Emami, professor and dean of the College of Nursing at Seattle University, will become the new dean of the UW School of Nursing, effective July 1, 2013, subject to approval by the UW Board of Regents, the University of Washington has announced.

From the UW announcement:

Emami headshot 3 webEmami has been dean at Seattle University since 2008. Her career has included seven years at the Karolinska Institutet of Stockholm, Sweden, where she was an endowed professor in elderly care research and senior lecturer while also holding other administrative and research leadership positions.

Emami still holds positions at Karolinska as senior researcher and doctoral-candidate supervisor.

At Seattle University, Emami implemented a five-year strategic plan including major reorganizations that emphasized excellence in integrating teaching, research and clinical practice, as well as an expansive global-engagement program.

Her objectives were to develop a substantial professional development program for faculty and staff, greater accountability of faculty and staff members and better support for faculty collaboration.

She also placed a central focus on student experiences to prepare nurses to lead in an era of challenge and change by studying in a learner-centered environment.

In 2011-12 she implemented a curriculum transformation plan for a cutting-edge educational program. Under her leadership, Seattle University’s College of Nursing was successfully reaccredited and expanded its offerings with the launch of a nurse midwifery specialty and a doctoral degree in nursing practice. The college has begun offering online hybrid programs in the past year.

Emami has more than 60 published scientific articles in refereed international and Swedish journals, three book chapters and two scientific reports. She serves on the editorial boards or as a reviewer at six peer-reviewed journals.

She has participated in major international collaborations with institutions in the U.S., Great Britain, Australia and Iran. She recently became a fellow in the American Academy of Nursing.

Emami holds a bachelor’s degree in nursing from the Karolinska Institutet, a master’s degree in international health care from Karolinska and the Red Cross College of Nursing, a nursing education degree with a teaching certification and a doctorate in medical sciences from Karolinska. Her annual salary will be ­­­­­­­­­­­$320,000

 

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Seattle’s contribution to kidney-failure research reflected in one woman’s story

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NancySpaeth3

Nancy Spaeth at the Northwest Kidney Centers new museum explaining how this vintage dialysis machine worked when she used it in the 1960s / Photo Credit: Mali Main

By Mali Main

In 1959, Nancy Spaeth suddenly felt too tired to brush her own hair. The 12-year-old also noticed that her urine had turned a murky, mud color. Her doctor told her she had Bright’s disease, now called glomerulonephritis.

But no one told her that she had chronic kidney failure, that her kidneys were slowly deteriorating inside her, or that there was no known effective treatment.

“It was the custom in those days not to tell the patient what was going on,” recalls Spaeth, now a semi-retired nurse and teacher and grandmother of two.

It took seven years for her kidneys to completely shut down. “Kidney disease is insidious,” Spaeth says. By that time, Spaeth was a freshman at the University of Arizona. She lost her appetite, and the food she did eat would not stay down. She threw up her breakfast in the plants outside her early morning physics class. By the time the doctors sent her home to Seattle she weighed 88 pounds.

Fortunately, Spaeth returned home just when researchers in Seattle were making advances in kidney dialysis that would revolutionize the treatment of kidney failure. Many of those advances were made by researchers working at the Seattle Artificial Kidney Center, the world’s first artificial kidney clinic. The center, now known as the Northwest Kidney Centers, commemorates its 50th anniversary this year.

Spaeth would be among the first patients to be treated at the new center, and, today, she is one of the longest living chronic kidney failure patients in the world, says Christopher Blagg, former executive director of the Northwest Kidney Centers, a retired nephrologist who is writing a book on the history of the center. “She’s probably the only one who’s had every possible treatment during the course of their illness,” he adds.

Spaeth’s physician, Belding Scribner, wanted her on dialysis. Scribner had helped found the Seattle Artificial Kidney Center, but dialysis was an expensive, lifelong treatment and the Center could not accommodate more than a dozen or so patients at a time.

The Center set rigid medical guidelines for patient selection: well-adjusted adults between the ages of 18 and 45 whose kidney disease was uncomplicated by additional health problems.

But with more applicants to the Center than they could treat, anyone who wanted treatment also had to be approved by the anonymous seven-member Admissions and Policy Committee appointed by the King County Medical Society.

Spaeth, standing in the new dialysis museum at the Northwest Kidney Centers’ 700 Broadway, clinic points at a photograph on the wall. It’s a silhouette of a woman and six men sitting behind a long table, their faces obscured by shadow.

“We called them the Life & Death Committee,” Spaeth says. “They were supposed to be unbiased. But Dr. Scribner told me, years later, that he was sometimes able to get his two cents in.”

The Committee considered a variety of factors in making its life and death decision, including the applicant’s profession, whom they might leave behind and whether those left behind would be well-provided for or become a social burden.

Life Magazine and an NBC news documentary publicized their activities, inspiring the field of bioethics.

The committee sent a social worker to interview Spaeth’s family. Spaeth went through two days of psychological testing – during which she remembers they asked multiple variations of the question “Do you love your mother and father?” – before she was approved for dialysis treatment, which she began in 1966.

The Shunt

Spaeth pulls back her sleeve. Her arm is a tangle of scars from the wrist to the elbow. The divot on the inside of her left wrist is the 46-year old scar from the device that changed chronic kidney disease from a deadly illness to a treatable one: the Scribner shunt, an apparatus developed by her physician.

The scars on Nancy Spaeth’s forearm tell the evolution of dialysis technologies, how the techniques for coaxing blood from the arteries has changed over time / Photo Credit: Mali Main

The scars on Nancy Spaeth’s forearm tell the evolution of dialysis technologies, how the techniques for coaxing blood from the arteries has changed over time / Photo Credit: Mali Main

Blagg explains that before 1960 dialysis was only used to treat patients with acute, meaning temporary, kidney failure. Patients had to undergo surgery to be attached to the machine, a process that could only be done a few times. “If they had chronic kidney failure we would stop treatment there and the patient would go home and die,” Blagg says.

The shunt was a semi-permanent installation in the patient’s forearm made of three Teflon tubes.

One was inserted in an artery and the other into a vein, they were connected by a third u-shaped tube. During dialysis this u-shaped tube was removed so the arterial and venous tubes could connect to the artificial kidney.

“It didn’t hurt,” says Spaeth, “Not really. But it got infected a lot.” So she kept her shunt-embedded forearm wrapped in white gauze during the day while she studied for her BA in Education at Seattle University.

Then three nights a week she walked the three blocks to the Center, where the nurses unwrapped her shunt, unscrewed the u-shaped end piece, and connected her to the artificial kidney next to her bed.

While she slept, the device filtered excess salt and fluid from her blood and cleansed it of harmful wastes. In the morning, she would be disconnected and go back to school.

By 1968, Spaeth was able to have her dialysis done at home. She spent the summer of that year at the Coach House, an old motel near the campus where the University of Washington had set up a home-dialysis training program.

Nancy Spaeth on home dialysis, 1968 / Photo courtesy of Nancy Spaeth

Nancy Spaeth on home dialysis, 1968 / Photo courtesy of Nancy Spaeth

“I was always willing to try anything [the Center] was doing,” Spaeth says. “I learned how to run the machine, take it apart, clean it, and put it back together.”

Spaeth pulls back her sleeve further and slides her watch down to her palm. The scars tell the story of the changes in dialysis technology.

The different techniques for coaxing blood from her arteries is evident in the puffy overlapping grafts and the white sinusoidal scar near the soft bend in her elbow.

Transplantation:

In 1972, Spaeth had a renal transplant, a gift from her younger brother, Charlie. “He came home from Stanford on his spring break, gave me a kidney and went back to school.”

Charlie’s kidney lasted seven years. Enough time for Spaeth to get married and have two children, a boy and a girl.

Then in 1979, she contracted an infection that caused her to lose the transplant. Her next three transplants were from strangers: a young woman who fell from the ladder of a fishing barge in Alaska, a motorcyclist who died in an accident in Bellevue, and in 2000, she received the kidney she still has today. “It was from a man who was in a car accident near Spokane,” she says.

Peritoneal Dialysis

Sometime between her third and fourth kidney transplant, Spaeth was able to try another kind of dialysis, called peritoneal dialysis, that freed her from the machine. Instead the dialysis fluid, the dialysate, runs into the abdominal cavity through a catheter implanted in her abdominal wall.

To begin the process, she only had to have a place to hang the bag of dialysate. Once connected to the catheter, the fluid from the bag would flow into her abdomen, where the water, salts and wastes would be exchanged through a thin sheet of cells, called the peritoneal lining. When it was time to drain the dialysate, she set the bag on the floor and the fluid would run out.

She lifts her shirt and points to the pinch of flesh on her lower abdomen where the catheter was installed when she switched to peritoneal dialysis. “I liked it,” she says. “It gave me a huge amount of freedom.”

“I could travel, I could do it on the airplanes,” says Spaeth. “I would just find a restaurant in the airport and they would warm [the bag of dialysate] in the microwave for me.”

“I could do it in my brother’s kitchen,” she says with a laugh. “Just hang the bag from a knob on the cabinet and sit there and have a glass of wine.

Drug trials

In the late 1980s, after Spaeth lost her second transplant, she volunteered to be part of a clinical trial of a drug that changed the lives of kidney disease patients.

She and an architect friend had just finished building her new three-story house next to a gully on Mercer Island. “I was extremely anemic,” she says. “I was crawling on my hands and knees up the stairs in that house,” she explains.

Healthy kidneys, in addition to filtering waste from the blood, also secrete the hormone erythropoietin, EPO for short.

The Northwest Kidney Centers' new Haviland Pavilion clinic at 700 Broadway houses a museum and gallery that showcase advances in kidney disease treatment.

The Northwest Kidney Centers’ new Haviland Pavilion clinic at 700 Broadway houses a museum and gallery that showcase Seattle’s contributions to kidney disease research.

“It regulates how many red blood cells we have, and therefore, how much hemoglobin we have,” says Stuart Shankland, who heads the Division of Nephrology at the University of Washington. Hemoglobin colors blood red and infuses the organs with oxygen. “So when a kidney fails, it stops making EPO and you get anemic.”

Without hemoglobin, Spaeth’s cells and tissues were essentially being starved of oxygen.

The pharmaceutical company Amgen chose the late Joseph Eschbach, a senior research advisor at the Northwest Kidney Centers, to run the first human trials of their synthetic EPO.

“Dr. Eschbach had worked on anemia in patients with kidney failure since 1963,” says Blagg. “He was Mr. EPO at that time.”

The Food and Drug Administration approved EPOGEN in 1989. “It was a miracle,” says Spaeth. “After a few weeks, I could run up those stairs.”

Today

Today, Spaeth serves on the board of the Northwest Kidney Centers and travels around the country telling about her experience to the dialysis community. Lyle Smith, continuing education director at the Board of Nephrology Examiners Nursing and Technology, who has arranged for her to speak at professional conferences, says Spaeth is an inspiring speaker.

“In dialysis, we see so many patients who are devastated,” says Smith. “Nancy’s story gives staff hope that their patients can succeed.”

 Mali Main is studying Journalism and Quantitative Science at the University of Washington. She is the Newsletter Intern at the Division of Occupational Therapy in the UW Department of Rehabilitation Medicine and works as the Development Assistant at the St. James ESL Program. She has also covered art, astrophysics and healthcare reform.

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Silencing the science on gun research

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GunWhat regulations have best chance of reducing gun violence? Past research has shown background checks help. So does raising the age requirements for gun ownership.

And chances are that safe storage of guns and use of trigger lots will reduce the risk of family homicides.

But what does the latests research show? Well, not much.

Why?

In part, because in 1996 pro-gun members of Congress enacted legislation to block federal funding for gun-injury prevention research, argue Dr. Frederick P. Rivara, chief of General Pediatrics at the University of Washington, and and Dr. Arthur Kellerman, chair of policy analysis at the RAND corporation, in an viewpoint article posted on JAMA online this week.

After that legislation, the write. “Extramural support for firearm injury prevention research quickly dried up. Even today, 17 years after this legislative action, the CDC’s website lacks specific links to information about preventing firearm-related violence.”

Rivara and Kellerman go on to detail other successful legislative efforts to hamper research into gun-related violence

They write:

Health researchers are ethically bound to conduct, analyze, and report studies as objectively as possible and communicate the findings in a transparent manner. Policy makers, health care practitioners, and the public have the final decision regarding whether they will accept, much less act on, those data. Criticizing research is fair game; suppressing research by targeting its sources of funding is not.

Read the full article online for free: Silencing the Science on Gun Research.

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Chronic illness and disability becoming world’s leading health challenges – UW-led study finds

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Globe 125X125By Michael McCarthy

We’re living longer, but many of us are living with chronic illnesses that significantly lower the quality of our lives, according to a new study led by researchers at the University of Washington.

The survey, called the Global Burden of Disease Study, finds that there has been a major change in the causes and impact of poor health over the past decades, with a shift away from early death to chronic illnesses and disability.

The survey found that since 1970 life expectancy has increased by 11.1 years for men and 12.1 years for women and that deaths among children under age 5 have plummeted, except in subSaharan Africa where childhood mortality remains high.

In general, improvement in life expectancy has been steady, but it slowed in the 1990s largely due to deaths from HIV infection in sub-Saharan Africa and alcohol-related deaths in in easter Europe and central Asia.

With our longer life expectancy, the major burden caused by disease is no longer early death but instead chronic illnesses that cause pain and disability, such as arthritis, diabetes and dementia, and psychological disorders, the study concludes.

Change in the leading cause of deaths from 1990 to 2010

Change in the leading cause of deaths from 1990 to 2010 – Click on image for interactive display.

The study was led by University of Washington’s Institute for Health Metrics and Evaluation and funded by the Bill & Melinda Gates Foundation.

“We’re finding that very few people are walking around with perfect health and that, as people age, they accumulate health conditions,” said Dr. Christopher Murray, director of IHME and one of the founders of the Global Burden of Disease.

“At an individual level, this means we should recalibrate what life will be like for us in our 70s and 80s. It also has profound implications for health systems as they set priorities,” Murray said.

Dr. Paul Ramsey, chief executive officer of UW Medicine and dean of the University of Washington School of Medicine, said the study will serve as “a management tool for ministers of health and leaders of health systems to prepare for the specific health challenges coming their way.”

“At a time when world economies are struggling, it is crucial for health systems and global health funders to know where best to allocate resources,” Dr. Ramsey said.

The study found that while heart disease and stroke remained the two greatest causes of death between 1990 and 2010, all the other rankings in the top 10 causes changed.

Diseases such as diabetes, lung cancer, and chronic obstructive pulmonary disease moved up the list, and diarrhea, lower respiratory infections, and tuberculosis moved down, the researchers report.

Explore the changes with this interactive chart.

And while malnutrition used to be a major cause of illness and death, today poor diet and physical inactivity are to blame for soaring rates of obesity, diabetes, heart disease and stroke the study found.

“We have gone from a world 20 years ago where people weren’t getting enough to eat to a world now where too much food and unhealthy food – even in developing countries – is making us sick,” said Dr. Majid Ezzati, Chair in Global Environmental Health at Imperial College London and one of the study’s lead authors.

The study appears in this week’s issue of the medical journal The Lancet.

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Northwest Kidney Centers opens extensively remodeled facility at 700 Broadway

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Northwest Kidney Centers has completed an extensive remodel its facility at 700 Broadway.

The $8 million remodel of the building, known as Haviland Pavilion, includes:

  • An updated 15-station dialysis clinic.
  • Surge capacity for emergency dialysis in case a disaster makes services impossible at another dialysis facility in the region.
  • An expanded pharmacy that serves the special needs of people with chronic kidney disease, on dialysis or with a kidney transplant. Compared to the old pharmacy, capacity is now tripled.
  • A clinical research center to allow Kidney Research Institute investigators to work with Northwest Kidney Centers patients on studies and advance research.
  • New space and increased capacity for physician and clinical staff training and community and patient education, including a demonstration kitchen to show patients and their families to prepare tasty, healthy food.
  • A museum and gallery that showcase important artifacts of the medical history made at Northwest Kidney Centers.

Northwest Kidney Centers purchased the 40,000-square-foot building in 1978. The building is named for Dr. James Haviland, a founding father of Northwest Kidney Centers.

Dr. Haviland was president of the King County Medical Society in the early 1960s, at the time Dr. Belding Scribner at the University of Washington was developing technology to enable people to live indefinitely with kidney failure.

The two are credited with marshaling the community resources to create the world’s first dialysis organization 50 years ago.

The facility, which provides dialysis for some of Northwest Kidney Centers’ poorest and most at-risk patients, is one of three dialysis facilities on First Hill. The other two are located at 548 15th Ave. and at 600 Broadway.

$1.7 million of the $8 million construction cost was raised via Northwest Kidney Centers’ Transforming 700 Broadway capital campaign. More than 100 donors made gifts to the campaign

Northwest Kidney Centers provides 234,000 treatments per year to nearly 1,500 patients in its 14 dialysis centers, in 11 hospitals and in homes.

It is the largest provider of dialysis services in King and Clallam counties, and it offers one of the largest home hemodialysis programs in the United States.

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UW Medicine donors try their hand at protein folding

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UW Medicine’s donors gathered recently to be recognized for their contributions and to match wits on the University of Washington’s online game Foldit, a interactive protein-folding game developed by UW researchers that has drawn more than 200,000 Internet gamers.

The “Tomorrow. Today” event is held each year to honor members of the Turner Society, whose donations go to support research and scholarship at UW.

This year, attendees heard a talk on the promise and challenge of protein design by David Baker, Ph.D., the newly appointed director of the UW Medicine Institute of Protein Design.

After the talk, attendees played the Foldit game, competing to see which of them could use the program to design the best protein to block the “Swine Flu” influenza virus.

 

Screenshot of the Foldit game

 

Proteins are synthesized by our cells as long chains of amino acids, but they do not become biologically active until they fold into a precise shape.

How the chain folds is determined by a number of factors, including the sequence of the amino acids in the chain, the flexibility of the bonds between them, and the almost impossibly complex interactions between electrical charges on the amino acids and those of molecules in the surrounding fluid.

An amino acid chain folds into a functioning protein spontaneously

The result is highly convoluted structure in which the simple chain is twisted into spirals, bends, sheets and other complex structures.

The interactions that drive this process is so complex that it is beyond the calculating powers of even the most powerful super computers, but the human brain cam make intuitive leaps that computers can’t, Baker said.

So working with a team at the UW department of Computer Science and Engineering, led by Professor Zoran Popovic, director of the Center for Game Science, Baker’s team created a game that would allow individuals and groups to compete online bending and twisting computer models of proteins into their most efficient conformation.

“People are smart and groups of people working together are really, really smart and groups of people competing with each other are even more powerful,” Baker said.

UW student  and Foldit expert JSnyder explains how to play the game:

The gamers, many of whom have no background in biology, have proved to be adept at solving problems that often stump the experts.

In one case, Baker’s team designed a protein catalyst to accelerate chemical reactions, but it turned out to be very slow, Baker said.

“We couldn’t make it better so we sent it out as a challenge to Foldit players to improve it,” said Baker, and they came back with a design “that when we made it in the laboratory was much, much better that what we had made ourselves.”

Learning how proteins fold is crucial to understanding how they work and how they can be used to develop new drugs, Baker said.

Most current drugs are made of small molecules that interact with a protein to either block or promote the protein’s activity.

The problem with such small molecules is they may not “fit” their target site perfectly and often interact with other proteins causing unpleasant or even harmful side effects.

Another problem is that fewer and fewer small molecules are being found that can be turned into safe and effective drugs, Baker said.

Small proteins, however, can be designed to fit the target area so precisely that it is unlikely that they would affect other targets and cause side effects.

“Now we have the potential to take all the things we’ve learned about proteins from the human genome and all the other genomes we’ve learned about and come in and design new proteins for new therapeutics, new drugs, new diagnostics, new vaccines,” Baker said.

To learn more about Foldit:

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Institute of Medicine

Three UW faculty elected to the Institute of Medicine

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Three faculty members from the University of Washington School of Public Health have been elected to the Institute of Medicine, one of the highest honors in the fields of health and medicine.

The inductees are among 70 new members and 10 foreign associates announced Monday, Oct. 15, during the IOM’s 42nd annual meeting in Washington, D.C. The distinction recognizes outstanding professional achievement and commitment to service.

The School of Public Health inductees are:

  • Chris Elias, a clinical professor in the School’s Department of Global Health and president of global development for the Bill & Melinda Gates Foundation
  • Thomas Fleming, professor of Biostatistics and professor of Statistics
  • Andy Stergachis, professor of Epidemiology, professor of Global Health, adjunct professor of Health Services, and adjunct professor in the Department of Pharmacy

The Institute of Medicine, founded in 1970, is the health arm of the National Academy of Sciences and gathers experts to address issues from breast cancer and nutrition to patient safety and post-traumatic stress disorder. New members are elected by current members.

Profiles:

Chris Elias earned an MD from Creighton University in 1983 and received the School of Public Health’s Distinguished Alumnus Award in 2010. At the Gates Foundation, Elias leads the foundation’s efforts in integrated and innovative delivery, finding creative new ways to ensure solutions and products get into the hands of people in developing countries who need them most. Previously, he led Seattle-based PATH, an international non-profit working to improve health in more than 70 countries.

Tom Fleming is the former chairman of the School’s Department of Biostatistics, where he has worked since 1984. He earned a PhD in probability and statistics from the University of Maryland in 1976 and is also a member of the Fred Hutchinson Cancer Research Center in Seattle.

Andy Stergachis recently served on the IOM Committee on Strengthening Regulatory Systems in Developing Countries, and directs the UW’s Global Medicines Program. Through his affiliation with the School of Public Health’s Northwest Center for Public Health Practice, he works on emergency preparedness with the public health community. He is also affiliated with the UW Pharmaceutical Outcomes Research and Policy Program.

 

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