Impact August 2016 by UTMB Health

UTMB Newsletter â&#x20AC;˘ AUGUST 2016

The sound of survival: Victory Bell celebrates end of cancer treatment Holistic care for a gender-diverse population Spotlight on Rex McCallum, chief physician executive

Sterile Processing: Keeping patients safe one tray at a time

Maureen Wilder, DNP, RN, ANP-BC, associate professor and Master’s Program director in the School of Nursing, was recently awarded a grant from the U.S. Department of Health and Human Services’ Health Resources and Services Administration entitled, “Adding Practice Partnerships for Learning to Advance Underserved Service Efficiency.” The grant will address the necessary culture, language-appropriate and advanced skills of adult-gerontology primary care nurse practitioner and family nurse practitioner graduates from the SON. The program prepares graduates to competently work with underserved populations in the greater eastern Gulf coast area of Texas, providing much-needed primary care services. Dana Jones, a senior medical records technician in Health Information Management, and Melissa Clary, a nurse at the League City Campus Hospital’s Emergency Department, received President David Callender’s Way to Go Award during the July Town Hall meeting. Jones was recognized for going the extra mile while helping a patient get the records he needed. She was nominated by a UTMB retiree, who said Jones was “kind, caring, took her time, answered questions and was extremely professional. She deserves to be recognized.” Clary was recognized for providing exceptional care to a 12-year-old who arrived at the ED after a bike accident. The patient’s mother, a fellow UTMB employee, said, “It is always scary to be on the other side of patient care, especially as the mom of the patient, but I have never had a better experience than Melissa provided. She put my child at ease and I can never thank her enough. I left the ED around midnight and was so proud to work for an organization that has people like Melissa Clary.” The Provost Pacers, consisting of a team of employees from the Provost’s office, recently completed a 100-mile virtual race for charity. Between May 15 and July 15, each team member logged more than 100 miles by running outside, jogging, bicycling and walking. The race helped raise money for Helen Keller International, a nonprofit organization dedicated to saving the sight and lives of the most vulnerable and disadvantaged. The Provost Pacers team included: Dr. Danny Jacobs, Dr. Michael Ainsworth, Dr. David Niesel, Toni D’Agostino, Michelle Moreno, Victor Moreno, Lori DeWillis, Chasity Burris, Claudia Young, Diane Chide, Dena Bannan, Karen Little, Alexis Loyd, Jami Goodsell, Sheryl Lashway and Mary Schlobohm.

Nisha Jain Garg, PhD, MBA, was recently appointed chair of UTMB’s Academy of Research Mentors. She will lead a multidisciplinary team of more than 30 NIH-funded, experienced mentors in enhancing the culture of mentoring at our institution. Garg is professor in the departments of Microbiology and Immunology and of Pathology, associate research officer in Basic Sciences and associate director of the Institute for Human Infections and Immunity. Congratulations to the latest winners of the Always Award, given quarterly to recognize units and clinics that have moved their teams closer to always doing the right thing for our patients. The Ambulatory Always Award, presented by Ann O’Connell, vice president of ambulatory operations, was awarded to Texas City Pediatrics and accepted by Michelle Basci, senior practice manager. The Inpatient Always Award, presented by David Marshall, chief nursing and patient care services officer, was awarded to the Transplant Unit (9D) and accepted by Dr. Muhammad Mujtaba and Jason Ziegler, assistant nurse manager. The UTMB Blood Bank Laboratory was recently reaccredited by the American Association of Blood Banks and the College of American Pathologists. As part of the accreditation process, the Blood Bank received a joint inspection from the AABB and the CAP and passed with flying colors. The accreditation survey takes place every two years and is designed to ensure labs meet Clinical Laboratory Improvement Amendments requirements and promote the highest standards of care for patients and donors in all aspects of blood banking, transfusion medicine, testing and other cellular therapies. Special thanks to Dr. Barbara Bryant and Craig Maschmann for their leadership.

AUGUST 2016

impact

From the President We are nearing the end of another fiscal year and what a year it has been. From the opening of Jennie Sealy Hospital in Galveston in April to the first patient at our new League City Campus Hospital in June, there has been much to celebrate. I’d like to thank you for making this 125th year a remarkable one at UTMB as we’ve continued to build on our legacy of excellence in education, research and patient care.

A UGUS T 2 0 1 6

Inspired patient gives back with Victory Bell necklaces

Speaking of research, our team of world-renowned scientists continues to be on the leading edge in helping the global community find treatments for Zika, the mosquito-borne virus that has spread quickly through Latin America and has arrived in the U.S. Their work is improving health and saving lives throughout the world thanks to their unending efforts to combat infectious disease.

Page 5

You can learn more about their most recent research findings in this latest issue of Impact, along with stories about our people. Among them: • A day in the life of Lori Martin, a sterile processing technician in UTMB’s Sterile Processing Department

A day in the life of a sterile processing technician

• A profile of Rex McCallum, vice president and chief executive physician • A closer look at a new service offered at UTMB for runners to help prevent injuries and improve efficiency • An overview of the newly released economic impact report that shows the broad and significant reach of UTMB in the local community, the region and the state • One incoming medical student’s mission to provide holistic health care for the transgender population • Tips on beating the heat by Dr. Patricia Beach, professor of Pediatrics and director of the Division of General Academic Pediatrics • And many other accomplishments and kudos in the Working Wonders column and throughout the newsletter

Page 8

Building a culture of inclusion Page 12

I hope you enjoy reading this latest issue, and please let the Impact team know if you have story suggestions for future editions. Thank you!

Spotlight on Rex McCallum, chief physician executive

Dr. David L. Callender UTMB President

Page 13

Impact is for and about the people who fulfill UTMB’s mission to improve health in Texas and around the world. We hope you enjoy reading this issue. Let us know what you think! ON THE COVER: Lori Martin, a sterile processing technician, holds a tray of surgical instruments inside UTMB’s Sterile Processing Department in the Clinical Services Wing. Martin and her team run a 24/7 operation and are responsible for washing, sterilizing, cooling, assembling, packaging and storing all medical devices and instruments for UTMB, from Galveston to Huntsville. P rinted by U T MB graphic design & P rinting S ervices

Vice President Marketing & Communications Steve Campbell

Associate Vice President Marketing & Communications Mary Havard

Campus mail route: 0144 U.S. Postal address: UTMB Marketing & Communications 301 University Boulevard Galveston, TX 77555-0144

Editors KirstiAnn Clifford Stephen Hadley Art Director Mark Navarro

PAT I E NT C A RE

B y K irsti A nn C lifford

hen Dr. Gwyn Richardson hears a bell ring at UTMB’s Cancer Center in Galveston or League City, it’s music to her ears.

liked the idea of the bell being made from a knife, which symbolizes “cutting cancer away.” She started raising funds to buy the necklaces in bulk so that all UTMB patients who finish their “It’s a happy, happy sound,” said Richardson, a gynecologic oncol- cancer treatment or reach a certain milestone can be given one. ogist and assistant professor of Obstetrics and Gynecology. “It Richardson said she loves working in gynecological oncology signifies the end of cancer treatment and has been a UTMB because of patients like Domingue. She’s been honored to help tradition for many years. Patients also ring a bell when they guide her as a patient, but also counts her as a friend. reach certain milestones, such as “I became a gynecologic oncoloone-year or five-year anniversaries gist because I appreciate caring for being cancer-free.” women at this unique time in their lives. Cancer is, necessarily, a scary word. I treasure the relationships that form over years with patients and their families,” said Richardson, pointing to a wall in her office brimming with pictures of her patients. “At UTMB, we offer a personalized approach while caring for cancer patients. We don’t always beat cancer but treatment becomes more about She’s still fighting, but she’s still here. the journey for each person, and And for that, Domingue is grateful. helping them set and meet their “I’ve been blessed to have beaten individual goals—whether it’s trying the odds with great physicians and to get to a wedding at a certain time prayers from family and friends in or being there when a grandchild the past, so why can’t I do it again?” arrives. Some of the women will (L-R) Jessica Haven, Jody Domingue, Dr. Gwyn Richardson and said Domingue, who travels from send me pictures of themselves Orange to Galveston with her sup- Patrick Wroblewski. standing on different beaches portive husband, Butch, for cancer around the world and say, ‘I’m here care. “And Dr. Richardson is one of the best decisions I’ve ever today—and that’s enough.’ That’s really the reaffirming part.” made. She’s incredibly warm and personable, but also aggressive Domingue has now raised enough money for 150 necklaces— when it comes to making sure we kill every possible cancer cell. enough to provide to all League City and Galveston Cancer It’s a perfect combination.” Center patients for the next year. Each person will also receive Reflecting on her journey and the relationships she’s built at a blessing adapted from a poem by Domingue’s mother, who UTMB, Domingue was inspired to give back. She met with was also a cancer survivor. Domingue wears her own necklace Richardson to brainstorm ideas, and the “UTMB Victory Bell” proudly every day, and hopes to ring the bell a fourth and final necklace was born. time later this year. “When patients ring the bell, that’s usually it. You take a photo and “When I finish treatment, I’m going to continue my efforts to go home,” said Domingue. “But I wanted the bell to ring always— provide victory bell necklaces to as many patients as I can,” she loud and clear—for patients to remember their courageous fight.” said. “Every time you hear the bell ring close to your heart, it’s Jody Domingue, a patient of Richardson’s, has experience ringing the bell. When she was 26, Domingue overcame stage 4 breast cancer after undergoing experimental chemotherapy. Now, 42 years later, she has rung the bell two more times at UTMB, following treatment for advanced-stage endometrial cancer.

She found an artist online who made bell pendant necklaces from antique butter knives, complete with a fork tine clapper. Domingue

like someone is saying a prayer for you and you aren’t alone. That means a lot.” impact

AUGUST 2016

Pati ent Care

B y K irsti A nn C lifford

Are you a serious runner who always gets aches and pains at mile 14 of a marathon? Are you looking to improve your form and shed a few seconds off your 10K personal record? If so, a video running analysis could help. The analysis is a new service now offered by UTMB’s Occupational and Physical Therapy Clinic in Galveston. “So many things come into play when you are running, from your stride to your foot strike,” said Tyler Morrison, a rehabilitation aide and certified strength and conditioning specialist. “People think running is simple, but It’s actually a highly complex motion involving the entire body. Our goals are to help identify ‘bad habits’ that could lead to injuries and to improve overall efficiency.” As part of the analysis, Morrison records video of the patient running on a treadmill from several angles. He also performs a Functional Movement Screen that assesses seven basic movement patterns for functional limitations and asymmetries. Morrison works alongside Jeanne Smith, a sports and orthopedic certified physical therapist specialist, who analyzes the video with state-of-the-art software to identify movement impairments that are impeding efficiency and potentially leading to overuse injury. “I have software that slows the video down to 60 frames per second, so I can really see things like foot and ankle position when they hit the ground,” said Smith, who was a sprinter Sarah Jones talks to Tyler and hurdler in college. “From that, we can help Morrison as she gets people understand foot strike and what it means warmed up on the treadmill for the body and the amount of stress and wear and tear it places on us. Depending on where the weaknesses are, I can suggest exercises to improve form and prevent injuries.”

impact

AUGUST 2016

Sarah Jones, a business operations manager with Perioperative Services, said the video analysis was helpful to her in preparing for the Chicago Marathon in October. She runs about 35 miles a week and wants to improve her form and stay injury-free throughout training. “They broke down my whole stride and provided some helpful Jeanne Smith uses video analysis software critiques,” said Jones. “Now when to get a closer look at Jones’ running form I’m running, I implement their suggestions, such as extending my legs back further and keeping my arms at my side, especially when I’m tired. It is the small adjustments that can make a big difference. If it helps shave off a few seconds per mile, that would be an added bonus.” Smith hopes to get more runners like Jones into the clinic before an injury occurs. “I want to help keep the running community happy and healthy; preventing injuries is the main focus,” said Smith. “For runners to take part in this analysis, they have to be pain-free. We can give tips for form and improving their efficiency, but can’t treat someone with injuries unless a doctor refers them to PT. I can help point out where the main issues are that may be causing them to lose speed and give them exercises to target that. If I can help runners be more proactive instead of reactive—and enjoy the sport even more—I’d like to do that.” The video analysis costs $100 and is ideal for healthy runners looking to improve form and efficiency, not for the injured individual requiring rehabilitation. If you are injured, a running analysis can be conducted once you are pain-free and cleared to return to running by your physician. For more information, contact Tyler Morrison or Jeanne Smith at 409-772-8834.

RESE A R C H

Nicholas Barrows, first author of a study that tested potential therapeutics for Zika virus, demonstrates preparing media in the lab.

B y C hristopher S mith G onzalez

he latest research from UTMB scientists found that a drug to treat Zika virus infections could already exist and be available on the market.

A team of researchers, led by Dr. Mariano A. Garcia-Blanco, a professor and chair of the biochemistry and molecular biology

department at UTMB, and Shelton S. Bradrick, an assistant professor in the department, tested more than 770 different U.S. Food and Drug Administration-approved therapeutics and found that more than 20 of those decreased Zika virus. Their findings were published in the August edition of Cell Host & Microbe.

RESEAR C H B R I E F S Compiled from press releases written by Donna Ramirez and Christopher Smith Gonzalez. Find out more at www.utmb.edu/newsroom. Rakez Kayed, PhD, was recently awarded $1.9 million from the NIH’s National Institute on Aging to study the formation and propagation of tau oligomeric strains in Alzheimer’s disease. Brain cells depend on tau protein to form highways for the cells to receive nutrients and get rid of waste. In Alzheimer’s and other neurodegenerative diseases, the tau protein changes into a toxic tau oligomer. When this happens, molecular nutrients can no longer move to where they are needed and the brain cells eventually die. Tau oligomers are an important drug target because of their toxicity, seeding potency and the ability to propagate a specific abnormal tau conformation and initiate widespread tau pathology. The funding will be used to further explore how tau oligomers form and move throughout the brain. The results of these studies will yield useful results with great potential to advance the development of diagnostic and therapeutic applications to target toxic tau oligomers in Alzheimer’s and identification of useful approaches for screening the best drug candidates.

In collaboration with colleagues from Mexico, UTMB researchers were the first to directly connect the Aedes aegypti mosquito with Zika transmission in the Americas, during an outbreak in southern Mexico. The findings are available in the Journal of Infectious Diseases. Scott Weaver, PhD, director of UTMB’s Institute for Human Infections and Immunity, said the researchers completed a house-to-house survey to identify patients who met the World Health Organization case definition of Zika virus infection in several locations in the state of Chiapas. One hundred nineteen blood samples were collected with permission from people suspected of Zika virus infection. Zika virus was confirmed in 21 percent of the blood samples using a PCRbased test. The researchers also gathered adult mosquitoes in and around 69 homes of suspected Zika patients using backpack aspirators, and identified Zika virus in several samples of A. aegypti but not in other mosquito species. Weaver said that the study indicates that A. aegypti was the principal carrier of Zika virus in the Tapachula area of Chiapas State, based on the detection of virus in several mosquito pools and the prior demonstrated transmission competence of this species of mosquito. He also stressed that it’s important to note that Zika was not found in Culex quinquefasciatus, another common urban tropical mosquito discussed as a potential Zika vector.

AUGUST 2016

impact

RESEARCH

“We were driven by the lack of any available treatment options when confronted with severe Zika infections, specifically in pregnancy,” Garcia-Blanco said. “We decided to look for treatment opportunities among FDA-approved drugs.” The team is recommending that some of the drugs found to be effective against Zika virus be considered for testing in clinical studies. Among the effective therapeutics in the study were drugs used to treat a wide range of ailments and diseases, including bacterial and parasitic infections, cancers and depression. “Given that viruses highjack many of our own cellular processes, and these are targets of known drugs, this approach seemed reasonable,” said Nicholas Barrows, the first author of the study.

There are no approved vaccines or specific therapies available yet. Researchers, including some at UTMB, are working on possible vaccines, but it could still take some time before they are ready for clinical trials. Meanwhile, many of the drugs shown to be effective in the study have already been tested and approved for human use. “Multiple drugs that inhibit Zika virus in our studies have been used previously during pregnancy to treat other diseases and have been used safely in the U.S. and abroad,” Bradrick said. To find the effective drugs, the researchers tested 774 FDA-approved drugs using a variety of human cell types, including human neural stem cells and primary amnion epithelial cells.

“Although it can be difficult to extrapolate from in vitro experFirst isolated in 1947 in Uganda, Zika virus emerged as a global iments to efficacy on people, it is promising that our testing in concern in 2007 with a primary human cells disseries of outbreaks across covered several drugs with the Pacific followed by a anti-Zika virus activity,” Gardramatic spread in the cia-Blanco said. Americas in 2014 and Other authors of this study 2015. Declared a global include Rafael K. Campos, health emergency by the Steven Powell, K. ReddiWorld Health Organizasiva Prasanth, Geraldine tion, researchers are now Schott-Lerner, Ruben working to understand Soto-Acosta, Gaddiel Galarmany facets of the virus, za-Muñoz, Erica L. McGrath, including the potential Rheanna Urrabaz-Garza, neurological complications Junling Gao, Ping Wu, Ramthose infected could suffer kumar Menon, George Saade, and the microcephaly- Jipru Fane (L), Andrew Routh, Reddisiva Kambham, Steven Powell, Nicholas Barrows, Ildefonso Fernandez-Salas, related birth defects some Roben Soto-Acosta, Shelton Bradrick, Géraldine Lerner and Dr. Mariano A. Garcia-Blanco, Shannan L. Rossi, Nikos babies have experienced. stand in the lab where the team tested potential therapeutics for Zika virus. Vasilakis and Andrew Routh.

Following certain injuries, illnesses or surgeries, patients are often sent to an inpatient rehabilitation facility (IRF) before they return home. Zakkoyya Lewis, a doctoral student in UTMB’s Department of Rehabilitation Services, has found that patients with strong social support from family and friends recover more quickly and spend less time in an IRF. This study is currently available in the Archives of Physical Medicine and Rehabilitation. Lewis said that the social support of family and friends is associated with likelihood of returning to a community rather than being alone. People seem to recover better and have a better quality of life when they know that they have loved ones to depend on. This study was the first to look at how level of social support impacts how long patients need to spend in a rehab facility. For 119,439 Medicare beneficiaries who spent time in an IRF in 2012, the researchers compared the amount of time that Medicare determined patients would need to spend in rehab with the actual length of their stay. They also analyzed social support based on information that the patients provided. The study showed that having strong social support influences how long patients need to spend in rehab when leaving the hospital. Compared with patients that have strong support from family or friends, those with little social support were more likely to need extra time than predicted by Medicare.

impact

AUGUST 2016

Gabrielle Rudenko, Ph.D. and Jia Zhou, Ph.D., in the Department of Pharmacology and Toxicology and the Sealy Center for Structural Biology and Molecular Biophysics, together with Eric J. Nestler at Mt. Sinai Medical School, received a five-year R01 grant of $3 million from the National Institutes of Health to develop and optimize new chemical probes that target deltaFosB, a substance which Gabrielle Rudenko accumulates in highly specific regions of the brain in response to cocaine or other drugs of abuse. The new probes will enable researchers to test the functions and therapeutic potential of deltaFosB as a viable drug target for treating drug addiction. The researchers hope to exploit the structures and functions of deltaFosB to strategically regulate key genes and overcome harmful brain and behavioral adaptations induced Jia Zhou by repeated drug use.

8 8

AA UU G G UU SS TT 22 00 11 66

impact impact

If you point at any one of the surgical instruments in UTMBâ&#x20AC;&#x2122;s Sterile Processing Department, bets are Lori Martin knows its name and purpose. No, sheâ&#x20AC;&#x2122;s not a surgeon, but she plays a vital role in patient care.

B y K irsti A nn C lifford

impact impact

AA UU G G UU SS TT 22 00 11 66

9 9

As a sterile processing technician, Martin handles thousands of reusable surgical instruments and devices—from scalpel handles to fiber-optic endoscopes—every week. Her team runs a 24/7 operation and is responsible for washing, sterilizing, cooling, assembling, packaging and storing all medical devices and instruments used by UTMB, from Galveston to Huntsville. “Making sure everything is clean, sterile and safe is work that is done behind- “The tape plays an important role,” says Martin. “It changes color from white the-scenes, but it feels good to know that we are protecting the welfare and to black to indicate that the sterilization cycle ran at the proper temperature for the right amount of time. To be properly sterilized, temperatures have to safety of patients,” said Martin, who starts her day at 6:45 a.m. reach at least 270 degrees Fahrenheit. We also include a biological indicator I meet up with her on a Tuesday morning on the fourth floor of the Clinical [BI] in each load. It uses microbes that are highly resistant to sterilization. When Services Wing. After getting suited up in a protective hair net and white the highly resistant bugs contained inside the BI are killed during sterilization, coverall that resembles an oversized bunny costume, I’m ready to enter the we can be confident that all the instruments are sterile and safe.” Sterile Processing Department. While Martin helps out in all areas of the department, she can usually be “There are 70 surgeries scheduled today in the Jennie Sealy Hospital OR, found in the stock area, among seemingly endless aisles of sterilized trays so we’re busy getting instrument trays sterilized and prepped for the next that are ready for use. She sorts and restocks trays according to their service, procedure,” she says as she leads me into the decontamination room. such as cardiovascular or urology. The “decon” room is where carts holding dirty instrument trays come immediately following a surgery. It’s loud and lively, with techs taking apart, rinsing and soaking equipment before loading it onto industrial-sized automated washers. They look like my dishwasher at home on steroids—there’s even a giant washer for dirty carts. All employees wear protective gear, including face masks, gloves and gowns. “We have to be careful to protect ourselves, too, from bioburden [bacteria living on a surface that has not been sterilized] and harsh cleaning chemicals,” says Martin. “Safety is a top priority in the decontamination room.” Once dirty carts and instruments run through a wash cycle, they exit on the other side, which is sterile. Martin walks me out of the decon room and into the sterile room, where packing and sterilization begins. Here, the washed instruments are sorted, inspected and counted at eight computerized workstations with bar code technology to track their location. Martin pulls up a “count sheet” at a computer workstation to assemble a retina instrument tray, used for eye surgeries. “The count sheet tells us how many of each instrument is supposed to be in the tray,” she says. “Depending on the service, the trays contain different items. With this eye tray, you’ll notice all the instruments are much smaller than a tray for an orthopedic surgery, for example.” Martin picks up the completed tray and wraps it in a blue medical grade paper that acts as a barrier to air and waterborne contamination. She adds a piece of tape to the outside of the package before adding it to a load that is ready to go into an autoclave.

AUGUST 2016

impact

Lori Martin and Raoul Simmons team up to get the job done fast and efficiently.

“Every day, people come to UTMB for life-changing surgeries. I’m proud to be a part of the overall mission and, ultimately, help deliver positive patient outcomes.”

She introduces me to Raoul Simmons, a sterile processing tech who helped train Martin when she started four years ago. The two have forged a great working relationship and are known for teaming up to get the job done fast and efficiently. “When things get chaotic, we don’t even have to talk to each other; we just know how the other person operates and what needs to get done,” said Martin. “I really like the people I work with. Everyone is great and has a wealth of knowledge. If you need anything, they are there for you.”

case cart and give it to the surgery that is happening right now and then turn it over quickly so it’s ready to be used again a few hours later. I try to keep everyone happy and make sure they have all the instruments they need.” We enter the centerwell area, which is in the middle of all the operating rooms and holds supplies and instruments that can be grabbed quickly during surgery. Martin knocks on the door of one of the ORs and hands the tray over to a nurse, who is grateful for the fast service.

Just as she finishes that thought, the phone starts ringing and the pace picks up. A nurse is on the line, and she needs a specific instrument delivered to the OR quickly, as the surgeon is in the midst of a pediatric surgery.

I say goodbye to Martin as she heads back to prep case carts for the next day’s surgeries. She sorts out preference cards for each case, which includes the surgeon’s name, instruments requested, procedure, location and other information.

“Want to see the OR?” Martin asks as she heads for the door. As we walk briskly toward the Jennie Sealy Hospital OR, she tells me she can take about 20,000 steps a day, delivering items to the OR at a moment’s notice.

Martin may not have direct contact with patients, but she is truly one of the unsung heroes of patient care. Her attention to detail and commitment to best care is evident in all she does.

“If the surgeon wants a certain item that isn’t on the original case cart or if an instrument gets contaminated, we have to replace it quickly,” said Martin. “If we don’t have a particular instrument, we may have to take it off of another

“Every day, people come to UTMB for life-changing surgeries,” she says. “I’m proud to be a part of the overall mission and, ultimately, help deliver positive patient outcomes.”

impact

AUGUST 2016

e ducatio n

Building a culture of inclusion Incoming medical student aspires to provide holistic health care for transgender population

B y K irsti A nn C lifford

Colt Keo-Meier knows it can be a cruel world for people who don’t conform to societal norms. As a licensed psychologist and preeminent researcher on transgender health, he sees patients from early childhood to adulthood who struggle with not fitting into traditional gender roles. All too often, suicide seems like the only way out.

“female.” But growing up in Beaumont, Texas and attending Catholic school, he always felt a disconnect between what “the gender others told me I was and the gender I knew myself to be.” It wasn’t until his 20s that he told his parents how he felt. Keo-Meier’s mother, Dr. Pam St. Amand, knew exactly whom to contact.

Dr. Walter Meyer, a professor of Psychiatry “Living in a world that is and Pediatrics, came to so unwelcoming makes Colt and Becca Keo-Meier recently led a workshop on understanding transgender and UTMB in 1975 as the human sexuality issues in the workplace for UTMB employees and students. people not want to stay chief of Pediatric Endohere,” said Keo-Meier, crinology and has been who earned his doctorate in clinical psychology from the University of Houston. “I even the Gladys Kempner and R. Lee Kempner Professor of Child hear younger patients say, ‘Mommy, God made a mistake, I’m Psychiatry since 1992. Because of St. Amand’s residency decades earlier, she knew that Meyer helped run one of the first gender not a girl. Can I just go back to Jesus?’” clinics in the state at UTMB in the 1970s. He also served as an They’re heartbreaking words to hear from a child—and they’ve advisor to the Rosenberg Clinic in Galveston, which served the fueled Keo-Meier’s passion to save lives. When he starts medi- transgender community until its recent closure. cal school at UTMB in the fall, he will continue his mission to provide access to well-rounded, competent health care for all St. Amand arranged for Keo-Meier to talk with Meyer and ultipeople—regardless of whether their gender identity differs from mately travel from Houston to Galveston to receive therapy and hormone treatment at the Rosenberg Clinic. the sex the doctor marked on their birth certificate. “I want to help to keep this population alive, and in order to Keo-Meier says he has had many privileges that many other do that, they need access to good medical care in addition to transgender people don’t have: parental support and access to behavioral health care,” said Keo-Meier. “My end-goal is to even- resources. But those privileges have put him in a position to tually function as a psychologist as well as a family medicine help others and attend medical school at UTMB.

physician. During my time as a psychologist, my experience in research and clinical work with the transgender population has impressed upon me how important the medical side of things are. Once I am trained as a physician, I will be able to provide a much more holistic way of caring for transgender patients throughout their lifespan.”

“If you look at all the medical schools in Texas, UTMB was the first medical school to provide any transgender care, and they did so at a comprehensive level, so that’s really important to me,” said Keo-Meier. “If a university is willing to take care of these patients who have a lot of stigma associated with who they are, that’s really meaningful to me.”

Keo-Meier’s decision to attend UTMB is both personal and professional. Born at John Sealy Hospital while his mother was an OB–GYN resident at UTMB in 1983, his birth certificate said

Keo-Meier is excited to get started at his new school. He and his spouse, Becca Keo-Meier, recently led a workshop on understanding transgender and human sexuality issues in the workplace for

AUGUST 2016

impact

education

UTMB employees and students. As a co-founder of Gender Infinity—a network of providers and families that offers consultation, clinical services and conferences focused on gender affirmative care—Keo-Meier has been working with UTMB’s Diversity Council to further a culture of inclusion on campus. He hopes to get more health care providers interested in and educated on providing care for a gender-diverse population. “We need providers to identify themselves and say they are willing to see this population,” said Keo-Meier. “But just because one says that they don’t discriminate doesn’t mean they are equipped to provide competent care—it can be a steep learning curve to know all about hormone therapy, pubertal suppression, the standards of care, etc. But we have to start somewhere and we have to know who is at least willing to learn and to be kind. We can go from there.” Meyer, who still has patients who drive from all over the state to see him in Galveston, says he’s happy to have Keo-Meier join the UTMB family. Over the years, he’s seen trans care evolve, with more clinics and providers stepping up and making a difference. “Colt has already accomplished a lot. He’s a very smart person who has some national prominence in his research, so he’ll make a real positive contribution at UTMB and beyond,” said Meyer. “I have no doubt about that.”

CME-accredited online resources enhance patient-centered care and cultural competency The UTMB Diversity Council Health System sub-committee has been addressing disparities and inclusiveness with emerging patient populations. In fact, UTMB recently achieved “2016 Leader in LGBT Healthcare Equality” status from the Human Rights Campaign and will be featured as an Equality Leader in the Healthcare Equality Index 2016 report. The Healthcare Equality Index is the national LGBT benchmarking tool that evaluates health care facilities’ policies and practices related to the equity and inclusion of their LGBT patients, visitors and employees. As a participant in the annual index, more than 50 different online, on-demand CME-accredited LGBT training options are free to UTMB staff. The Center for Affiliated Learning will also provide certificate equivalency for CEUs and CNEs upon request. Visit www.hrc.org/hei-training-on-the-cal for course descrip-

tions and to register. Use Facility ID Number: 55863, Security Code: HRC Additional training is available at www.lgbthealtheducation. org/lgbt-education/learning-modules/ Email rfinkels@utmb.edu for more information.

White coats welcome new physician assistants B y K irsti A nn C lifford

Eighty-nine incoming Physician Assistant Studies students recently received their white coats in a ceremony to welcome them into their new program of professional study. During the July 1 rite of passage at Levin Hall on the Galveston Campus, the UTMB PA class of 2018 donned their white coats for the first time and took a professional oath, publicly acknowledging their new responsibilities and affirming their pledge to clinical excellence and health care. The ceremony has become a tradition in the UTMB PA program. It recognizes the transition of new PA students into the academic program, into the profession and into their future career as a physician assistant.

impact

AUGUST 2016

UTMB’s Physician Assistant Studies program offers a master’s degree that prepares professionals to practice medicine on health care teams with physicians and other providers. PAs are invaluable members of the health care team who conduct medical histories and physical examinations, order and interpret diagnostic tests, diagnose and treat health conditions, perform procedures and provide patient education and counseling services. All 50 states, the District of Columbia, the majority of U.S. territories and the uniformed services allow PAs to practice and prescribe medications.

lead e r s p ot l ight

Spotlight on Rex McCallum, vice president and chief physician executive Dr. Rex McCallum joined UTMB in 2010 as vice president, chief physician executive and professor of Internal Medicine. In 2014, he became associate dean for clinical affairs. He is a recognized leader and physician executive with expertise in strategic and operational development within a complex health care organization. Before coming to UTMB, McCallum served as associate medical director of the private diagnostic clinic and vice chair for faculty affairs in the Department of Medicine at the Duke University School of Medicine. He earned a bachelor’s degree in biology from Rice University and went to medical school at Vanderbilt University. McCallum completed his residency and fellowship training in medicine and rheumatology and immunology at Duke University Medical Center. He was a member of the Duke faculty from 1989–2010 and remains an adjunct professor there. His clinical interests include rheumatoid arthritis, vasculitis, inflammatory arthritis, inflammatory eye disease and Behcet’s disease. What does the Road Ahead look like for you?

What do you like to do outside of work?

On my road ahead, I’ll continue to work with the clinical chairs, my clinical colleagues and my Health System colleagues to grow the clinical enterprise at UTMB and improve our quality and costs for our patients, payers, the University of Texas System and the people of the state of Texas. These are very exciting times in health care with many changes occurring. I see numerous opportunities for UTMB in the future, if we stay committed and focused.

I love to travel, as does my wife, Jan. I love to experience new locations, people and cultures. I have been to every continent except Antarctica, and I hope to get there one day. Spending three weeks several years ago in Australia was the best trip ever. We went to four of the five major cities, climbed the Sydney Harbor Bridge, saw the Sydney Opera House, experienced the Outback, saw the wildflowers in Western Australia, took pictures of Brighton bathing boxes and stuck a toe in the Indian Ocean. We stayed with some of Jan’s electronic scrapbooking business partners and were privileged to catch a glimpse of their lives.

What are the biggest challenges you face as UTMB’s chief physician executive? My biggest challenges are addressing and managing needed change in our fluid health care environment. Outside the institution, forces are demanding greater quality and lower costs. For the Faculty Group Practice and Health System to continue to improve, our systems and processes must change. While change is an opportunity, it is disruptive in many ways. Managing the process and disruptions are my biggest challenges. What’s the best advice anyone has ever given you? My close colleagues have often heard me say, “Life is a relationship game.” I find this fabulous advice, as teamwork is required to accomplish almost any major task. Teamwork is about a common goal, vision and open relationships. What was your first job? My first job, other than family tasks and small jobs, was as a lifeguard on a lake that was part of a Tennessee state park. It was a fabulous job! I went to work every day at 10 a.m. and worked until 6 p.m. I was able to be outside and be around other young people (and girls) every day! My friends were lifeguards with me. We did our work from a dock in the middle of the swimming area. We canoed to the dock for our time on duty—standing up and paddling.

Rex McCallum and his wife, Jan, in front of the Cardiff Castle in Cardiff, Wales.

What is something people would be surprised to know about you? I grew up in a small town in West Tennessee called Henderson. My father was one of three physicians in the entire county. Everyone in my hometown knew me as “Doc’s Son.” This security and sense of belonging fostered my development. Given that everyone knew me, it was hard to get away with anything, as someone always told my father. What’s something you always wanted to do but have not done yet? I think it would be really fun to rent a mobile home and drive across the country for four to six weeks with no particular destination in mind. I believe that wandering around and being spontaneous would be a blast. If you could travel anywhere in the world, where would it be and why? I would like to go to a South Pacific Island and live in a cottage over the water for at least a week. I would love to wake up in the morning and dive off my balcony into the warm waters of the Pacific Ocean. I would sit and read, watch the fish and relax.

AUGUST 2016

impact

Ec onomic I mpact

Study: UTMB has significant impact in region, state By STEPHEN HADLEY

A study released in May shows UTMB has a broad and significant economic impact in our local communities, the region and throughout the state. The study, produced by Friendswood-based Quanticon LLC, looked at FY2015 and measured UTMB’s generation of business volume, personal income, durable goods purchased and job creation in the local communities where it has a presence, in the region and throughout the state of Texas. According to the study, UTMB operations throughout the state generated more than $3.3 billion in business volume, over $2 billion in personal income and created 46,242 jobs both directly and indirectly during FY2015. On Galveston Island alone, UTMB generated more than $300 million in business volume and accounted for approximately a quarter of the entire island workforce through the creation of 10,187 direct and indirect jobs. “This study is just another way to think about the impact of our institution,” UTMB President Dr. David L. Callender said during the July 11 Town Hall discussion about the report. “Of course, our principal impact is through our mission work: education, research and patient care. But it’s important to remember that we also generate great economic benefit for Galveston, Galveston County and the state of Texas.” “The numbers tell only part of the story. Quanticon also found that, despite its tax-exempt status, the university’s presence on Galveston Island contributes to local government through taxes paid by UTMB employees, students and local vendors, as well as through municipal-type services the UTMB provides for itself (for example, police). The result: UTMB activities contribute $1.58 to the city of Galveston for every dollar forgone through its tax-exempt status. “Certain aspects of UTMB’s activities are not easily quantifiable but may also be considered to have economic consequences,” the report stated. “For example, the health care provided by UTMB that mends the injured and aids the sick would be expected to increase the productivity of adults and children at work and school. “Also, the physicians, nurses, health professionals and scientists trained at UTMB, and the health and medical research performed by faculty and students, will contribute to the betterment of public health and, through alumni employment, generate further economic activity.” See the full report at www.utmb.edu/economic_impact. impact

AUGUST 2016

Top tips to beat the heat By Dr. Patricia Beach, professor of Pediatrics and director of the Division of General Academic Pediatrics brimmed hats that shade the neck. If shade is not an option, parents can apply a minimal amount of sunscreen with at least 15 SPF to small areas, such as the infant’s face and hands.

• Wear lightweight clothing. Lightweight, loose-fitting clothing will help sweat evaporate easily and keep you cooler in hot, humid climates. Look for shirts and pants with a tight weave and avoid dark colors, which can absorb heat. Top it off with a wide-brimmed hat and sunglasses that protect against UVA and UVB spectrum light.

• Know your limits. Signs of heat exhaustion include confusion, dizziness, fatigue, headache and fainting. If you start to feel under the weather, don’t ignore your body, and head indoors to cool off. If hydration and cooling do not work, seek medical attention immediately.

• Seek shade. Avoiding direct exposure to sun rays can prevent heat rash, heatstroke, sunburn and other heat-related illnesses. If you want to spend time outdoors but your patio or deck area is not covered, try using movable umbrellas or awnings to create shade. • Avoid peak heat. Whenever possible, avoid spending time outside during the hottest parts of the day, typically between 10 a.m. and 4 p.m. Choose outdoor activities that you can enjoy in the early morning or evening. • Got water? Don’t wait until you’re thirsty to drink. In hot and humid weather, it’s more important than ever to ensure everyone in the family—from children and pets to parents and grandparents—get enough water. When it is hot and you are active, the rate your body can absorb fluids is less than the rate it loses water due to perspiration. • Don’t overdo warm weather workouts. Reduce the intensity of activities that last 15 minutes or more. If you are just beginning an

exercise program, the intensity and duration of outdoor activities should start low and then gradually increase over a two-week period to acclimate to the heat and humidity. • Slather on the sunscreen. Apply a thick coating of broad-spectrum sunscreen with an SPF of at least 15 and use extra caution near water and sand as they reflect UV rays and may result in sunburn more quickly. Be sure to reapply every two hours, or after swimming or sweating. Dress infants under 6 months in lightweight, long pants, long-sleeved shirts and

• Look before you lock. Never leave your child alone in a car—not even for a minute. Heat stress in infants is serious—small children are not able to regulate their body temperature the same way that adults do. Every summer, an infant is inadvertently left in their car seat, usually by a loving parent who does not usually make the morning day care run and forgets to drop the baby off. Help avoid this senseless tragedy by: —— Putting the diaper bag in the front passenger seat of the car to remind you that the baby is in the back. —— Placing your purse or brief case, cell phone or anything else that you routinely take to work in the back seat so you have to get them out (and check for the baby!) when you arrive at work. —— Writing a note to yourself and hanging it on the rearview mirror. —— Setting a timed reminder on your cell phone.

Parting Sh ot

Just Beachy. From East Beach in Galveston, one can see how much UTMB’s Galveston Campus has grown over its 125-year history. What started as one medical school building in 1891 has developed into an academic health center featuring two on-site hospitals, four schools, a national biocontainment laboratory, a comprehensive medical library and numerous clinics and research facilities. As the newest addition to campus, the Jennie Sealy Hospital (behind the water tower), features 310 patient rooms with awe-inspiring views.

AUGUST 2016

impact