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Volume 4, Issue 1

UNT HEALTH SCIENCE CENTER APRIL 2019

Screen time: How much is too much?

POPULAR FIELD

Physician assistant studies, first created to address a shortage in primary care doctors, is one of the fastest growing fields in health care.

OPENING SOON

The TCU and UNTHSC School of Medicine begins classes in July, but it already has served as a catalyst to change health care in North Texas.

PHILANTHROPIC SUPPORT

2018 was a year of increasing momentum in philanthropic investments, which topped $21 million and touched every corner of campus.


OUR PROVIDERS CONTINUE TO TRANSFORM LIVES Top Docs Fort Worth Magazine Priya Bui, DO Pediatrics John Fling, MD Allergy/Immunology Toyya Goodrich, DO Pediatrics Raheela Hafeez, MD Pediatrics Nusrath Habiba, MD Pediatrics Geoffrey Kline, MD Cardiology Janice Knebl, DO Geriatrics Sarah Matches, DO Pediatrics

Health Care Heroes

Super Docs

Fort Worth Business Press

Texas Monthly Magazine

Alvin Mathé, DO Geriatrics/Hospice & Palliative Medicine

David Capper, MD TCU and UNTHSC School of Medicine

John Fling, MD Allergy/Immunology

John D. Orr, DO Neurology

Top Docs

Long Hoang, DO Gastroenterology

Sarah Ross, DO Geriatrics

Janice Knebl, DO Geriatrics

Monte Troutman, DO Gastroenterology

360 West Magazine Priya Bui, DO Pediatrics Toyya Goodrich, DO Pediatrics Lesca Hadley, MD Geriatrics Janice Knebl, DO Geriatrics Alvin Mathé, DO Geriatrics/Hospice & Palliative Medicine Monte Troutman, DO Gastroenterology

Alvin Mathé, DO Geriatrics/Hospice & Palliative Medicine Mary Ellen Quiceno, MD Neurology Sarah Ross, DO Geriatrics

Stephen Weis, DO Dermatology

Schedule an appointment with one of our health care providers by calling 817.735.DOCS unthsc.edu/patient-care

A. Scott Winter, MD Geriatric Psychiatry

PRACTICING WHAT WE TEACH


APRIL 2019, VOLUME 4, ISSUE 1

FROM PRESIDENT MICHAEL R. WILLIAMS

U

NTHSC has always had a mindset of entrepreneurship and innovation. Fifty years ago, we were a startup medical school called the Texas College of Osteopathic Medicine. The school had a crazy vision that we’ve since fulfilled: to become the top producer of primary care doctors in Texas. Today, our campus sits on 33 beautiful acres in the heart of Fort Worth’s Cultural District. We’ve added a Graduate School of Biomedical Sciences, a School of Public Health, a College of Pharmacy and graduate programs for physical therapists and physician assistants. We invest in innovative research projects. We invest in our students, educating and training them to become providers of the future. And we invest in our community, partnering on projects that create a healthier Fort Worth. We also invest in entrepreneurship, an increasingly necessary skillset for physicians in a changing health care environment and scientists in a changing environment of discovery. In this issue, you can read about our latest startup: the TCU and UNTHSC School of Medicine. The first classes don’t begin until July, but already the school is transforming health care in North Texas by serving as a catalyst for the creation of hundreds of new residency positions. In 2017, our economic impact on the Dallas-Fort Worth community measured at nearly $700 million. With that kind of footprint – and a mentality of innovation – we are living our purpose of transforming lives in order to improve the lives of others.

SOLUTIONS Solutions is a publication of the Office of Brand and Communication at UNT Health Science Center. Editor Kerry Gunnels Assistant Editor Jeff Carlton Art Director Marco Rosales  •  Designer Guillermo Gómez  •  Illustrator Rebekah Downing Writers Alex Branch, Jeff Carlton, Sally Crocker and Jan Jarvis Photographer Jill Johnson Senior Director, Office of Brand and Communication Amy Buresh

For more information about UNT Health Science Center and its educational, research and health care efforts, go to www.unthsc.edu. To find out how you can support Fort Worth’s Health Science Center, contact the Office of Institutional Advancement, 817-735-2018 or unthsc.edu/giving

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contents 05

Short Takes UNTHSC news in brief

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Physician assistants The profession has come a long way

FEATURES 24

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Screen time

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Impact Report Philanthropic investments top $21 million

56 62

44 50

At-home DNA tests

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The Migala Chronicles

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A transformation Dr. Jeff Beeson is leading changes to patient care

Dangers of vaping

Impact of MD school

For the young, how much is too much?

Generous gift Dr. Sid O’Bryant will hold endowed Schooler chair


short takes A quick look at how UNTHSC is creating solutions for healthier communities

Moderate exercise can help slow aging R

egular exercise slows the effects of aging. But the news is less positive for antioxidant supplements, another popular intervention often adopted by health conscious adults. The positive effects of vitamins E and C are not clear, said Nathalie Sumien, PhD, Associate Professor, Department of Pharmacology and Neuroscience, Institute for Healthy Aging. “If you’re going to pick one intervention, choose exercise,” she said. “And you don’t have to exercise like crazy or go to the gym every day to see some beneficial results.” Dr. Sumien spoke on the pros and cons of combining interventions to improve individuals’ health span at the 47th Annual American Aging Association meeting where she delivered the James A. Joseph Memorial Lecture. Dr. Sumien, who has studied aging for 22 years, said walking regularly at a moderate pace for three miles on the treadmill or outside is enough to make an impact.

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A lesson in living with HIV Such compassion is exactly what Patrick Clay, PharmD, hopes to inspire through his “Persons with HIV” panel for third-year pharmacy students. Now in its fourth year, the panel provides a way for students to learn real and meaningful information directly from individuals with HIV. “There is no more powerful way to accomplish this than sitting students down in front of patients who are living with the disease,” said Dr. Clay, Professor of Pharmacotherapy in the UNT System College of Pharmacy. “Using patients as teachers, especially in a stigmatized disease like AIDS, has revolutionized the value of the lesson to the students.”

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helia Neal can’t recall much of what happened on the day she learned she was HIV positive because of the sheer shock of it all. But one thing stands out. “Until then, I had never had a doctor bend down and look at me eye-to-eye,” she said. “But she did, and she held my hand, too.”

Making health care safer for patients

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omplicated medical literature, stacks of discharge orders and convoluted prescriptions can frustrate patients and lead to costly hospitalizations or even death. SaferCare Texas, a team of interprofessional patient safety experts, wants to change that landscape by giving patients information they understand, simplifying medical forms and teaching health care providers how to communicate more effectively, said Jessica Maack Rangel, RN, Nurse Executive and Director of SaferCare Texas.

Jessica Maack Rangel

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The team from SaferCare Texas, formerly known as the Institute for Patient Safety, includes experts in nursing, pharmacy, pathology, public health and other specialties who are dedicated to implementing innovative solutions and applying evidence-based strategies to make health care safer. “We are challenging traditional thinking to eliminate preventable harm to patients,” Maack Rangel said. “We are focusing on national, state-wide and local issues that impact all aspects of health care.”


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the

interview Meet Frank Ssentamu, a second-year pharmacy student who was the personal chef to Uganda’s president before coming to the United States to start life anew.

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As a boy growing up in rural Uganda, how did you get interested in health care?

When I was little, we had very limited access to modern medicine. All of our health problems were taken care of with herbs. I got interested in understanding the mystery behind the healing herbs that restored people’s lives. I also had a chance to assist my area herbalist and got to know those medicinal plants. I had hoped to grow up, become a health care professional, take advantage of our rich herbs, and help people in better ways.

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How did you become a chef?

After high school, I was fortunate to secure a spot at the nation’s best culinary arts program. Although it was not my first choice, it turned out to be very rewarding and interesting. While still in college, I was recruited as a trainee cook at the luxurious 4-star Nile Hotel International. I finished school and I was recommended to serve as the personal chef to the president of my country. I had a chance to travel to different parts of the world. I cooked for many distinguished people, including President Clinton and his family and the late President Nelson Mandela among others.

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What was your life like when you came to the United States?

Transitioning and assimilating into society here had some challenges, but many great Americans made it possible. However, working for Albertson’s became the “seminal” moment that resurrected my childhood dream of joining the care industry. My family joined me after two years, and we started all over with a new life.

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What led you to the pharmacy school?

One day I fell sick and went to Albertson’s Pharmacy to seek a remedy. The pharmacist, Robert Moulds, RPH, was gracious with his time. That initial interaction later translated into the start of my long journey to pharmacy school. He encouraged me to consider a pharmacy technician position, walked me through the process and gave me stacks of information study. He and other pharmacists encouraged me to forge ahead.

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What do you envision for the future?

I want to give back and make a difference in our community. I hope to do something with diet and nutrition and, if I am lucky, pursue a post-grad residency. Surely, I know how to make food look and taste good, but I also know that sometimes food is not safe for people. I hope to help people with better ways of preparing healthy meals.

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history lesson

The ‘Rattletrap’ F

or decades, UNT Health Science Center has been a leader in delivering highquality health care directly to underserved communities in Fort Worth. But 40 years ago, that care was delivered a little differently. “Sometimes I wonder if they’ve replaced all the street signs I knocked over yet,” joked Chuck O’Toole Jr., DO, a 1975 medical school graduate. In the 1970s, after the founding of the Texas College of Osteopathic Medicine, the school purchased a shaky old Winnebago and converted it into a mobile medical clinic. Students and a school pediatrician drove it into underserved communities to provide free screenings and care. The student with the highest grade point average got to drive. That was usually Dr. O’Toole.

“Even back in our day, the families we served were so thankful for the care we brought to them. They needed it. I don’t think that will ever change.” — Dr. Chuck O'Toole

“It had no power steering,” he recalled. “To stop you basically had to stand up on the brakes. We were all over the road.” However, the mobile clinic (nickname: Rattletrap) allowed students to provide care to low income families from Samson Park to Stop Six to Northside. A card tucked into the Winnebago’s sun visor mapped the pay phones in each neighborhood.

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“If I needed to consult with a doctor back on campus, I had to run down the street to the pay phone to call them,” Dr. O’Toole said. “We always made sure we had plenty of change in our pockets.” UNT Health Science Center still delivers health care to many of the same neighborhoods. Today, the medical team travels in the state-of-the-art Pediatric Mobile Clinic, launched in 2014. Dr. O’Toole, who still practices medicine in Parker County, said families were grateful for the care they received. “That will never change.”


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TCOM: T

he UNT Health Science Center’s osteopathic medical school was the only medical school in Texas to place at least 25 percent of 2018 graduates in family medicine. It’s the latest example of the program’s leadership in reducing the state’s shortage of primary care physicians. The Texas Academy of Family Physicians honored the Texas College of Osteopathic Medicine (TCOM) for the achievement at the organization’s annual meeting. It was the 20th year TCOM received the honor, which the

Texas’ top source for primary care doctors

academy created in 1993 to encourage medical schools to increase the number of graduates entering family medicine residencies. The shortage of primary care physicians is a growing problem in Texas. Earlier last year, TCOM was granted a 10-year Accreditation with Exceptional Outcome, the highest level of accreditation given by the American Osteopathic Association’s Commission on Osteopathic College Accreditation.

Dr. Robert Richard, ‘doing his job right’ R

A.J. Randolph, left, and Katy Kemp congratulate Dr. Robert Richard.

obert Richard, DO, told UNT Health Science Center medical student Sarah Hmaidan exactly what she should expect from him as her preceptor. “He told me if he wasn’t inspiring me to be the best doctor I could be or challenging me to see the whole patient, then he wasn’t doing his job right,” said Hmaidan, a member of the 2020 class. Dr. Richard always does his job right. That’s why medical students nominated him for the first Outstanding Preceptor Award from the UNTHSC Texas College of Osteopathic Medicine. Medical preceptors serve as mentors and teachers to medical students. They offer personal instruction, training and supervision and allow students to shadow them in clinical settings. “Dr. Richard is always patient and took his time explaining concepts or working through patient plans with me, even if this meant staying hours past our last patient of the day,” Hmaidan said.

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New leadership at UNTHSC J. Glenn Forister, PhD, PA-C Dean, School of Health Professions

J.

Glenn Forister, PhD, PA-C, believes in the value of high-performing teams, and that’s what he sees at UNT Health Science Center. The institution’s One University concept, values-based culture and focus on extraordinary teamwork are concepts that led Dr. Forister to accept the position of Health Professions Dean. “I have always worked on teams, and the idea of creating a sustainable people culture and transforming the Health Science Center into a destination workplace is very appealing to me,” said Dr. Forister, former Division Head of Physician Assistant Education in the School of Medicine at Oregon Health & Science University. “The President and Provost have energy and vision. I’m excited to join the team.”

Michael Mathis, PhD Dean, Graduate School of Biomedical Sciences

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ichael Mathis, PhD, sees plenty of similarities between his former job at Louisiana State University’s School of Veterinary Medicine, and his current one as GSBS dean. “A medical school and a vet school are really very similar,” said Dr. Mathis, former Department Head at LSU’s Veterinary Medicine school. “They both have clinical departments, basic sciences that support biomedical research and teaching, as well as graduate and professional students.” When he visited UNTHSC, he was immediately impressed by its commitment to core values. “They really resonated with me,” he said. “The elements represented by the core values have guided me throughout my career.”

Frank Filipetto, DO Dean, Texas College of Osteopathic Medicine

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s health care changes, so must medical schools, says Frank Filipetto, DO. Traditionally, the foundation of medical education in the United States has been a two-pillar approach focused on science and clinical care. Dr. Filipetto, named permanent dean after leading TCOM on an interim basis for 18 months, envisions the integration of a third pillar of Health Systems Science. It would prepare students to understand health care economics, data and new technologies, quality improvement, leadership, entrepreneurship and improved health care delivery models. “It’s not just about graduating the smartest students,” Dr. Filipetto said. “Twenty-first century medical education must be about providing students with marketable skills to lead the change in health care.”

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F

100%

or the fourth straight year, every graduate of the Physician Assistant Studies Program at UNT Health Science Center passed the national certification exam on the first attempt – the second-longest streak among the eight programs in the state of Texas. Since 2013, only one of about 450 total PA graduates from UNTHSC did not pass the exam on the first try. The Physician Assistant National Certifying Examination administrated by the National Commission on Certification of Physician Assistants assesses basic medical and surgical knowledge. “It all starts with exceptional students,” said Kirk Barron, PhD, PA-C, Chairman of the UNTHSC PA program. “We recruit intelligent, talented and determined students into our program, and that is reflected in our exam scores.” The flexibility to move between specialties, potential for a strong work-life balance and quality starting salary places the PA field on many national best jobs lists. The UNTHSC program receives more than 1,900 applications for just 75 spots each year.

PA students maintain perfect pass rate on national exam WWW.UNTHSC.EDU

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The evolution of the physician assistant By Alex Branch

PA profession has transformed health care and grown into one of America’s hottest careers

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PA Victoria Florez at the primary care clinic in Burleson where she sees patients

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o understand why physician assistant is one of the hottest jobs, meet Victoria Florez. She fielded four job offers before she even graduated in May from the UNT Health Science Center Physician Assistant (PA) Studies Program. Each offer was from a different specialty. Did she want to work in plastic surgery, wound care, critical care or primary care? The starting salaries were competitive – and the national median salary for a PA with zero to one year of professional experience in 2018 was more than $100,000. Florez eventually joined a primary care clinic in Burleson, working a 9 a.m. to 6 p.m. weekday schedule, with time for yoga, Pilates and evening dance lessons with her husband. “The relationships with our patients are fulfilling because as a PA you really get to

UNT HEALTH SCIENCE CENTER

know them and their families,” Florez said. “The quality of life is great. And most of my classmates found exactly what they wanted to do as well.” The physician assistant field is booming. Created in the 1960s, the profession today is one of the most desired jobs in the country, ranking third in the U.S. News and World Report list of the Best Jobs in 2018. Young people, attracted by the worklife balance, salary and flexibility to move between specialties, are flocking to nationally recognized PA programs like the one at UNTHSC. Instead of spending between seven to 10 years in medical school and residency training like physicians, PAs can be licensed to care for patients in less than 3 years. As the popularity surges, so does the competition. The number of applicants for the 75 first-year spots in UNTHSC’s program increased from 593 in 2011 to 1,919 in 2017. “Not terribly long ago, a good percentage of physician assistants were slightly older people who had previously held other jobs in medicine and did this as a second career,” said Kirk W. Barron, PhD, PA-C, Chairman of the Physician Assistant Studies Program. “Today, new college graduates are recognizing that physician assistant is a viable, very rewarding career. The profession has come a long way.” Origin of the specialty In 1965, U.S. Navy Hospital Corpsman Ken Ferrell, 21, stood aboard the USS Ashland warship in the Caribbean and studied a letter he had received from a friend. The friend had read a newspaper story about Dr. Eugene Stead Jr., who was recruiting students for a new educational program at Duke University. The program would train people for a new position in health care – the “physician assistant,” he called it. The physician assistant, or PA, was intended to combat a shortage of primary physicians. Dr. Stead described the physician assistant as “extending the arms and legs of the physician.” Dr. Stead had first imagined firefighters as candidates for the program but soon realized


physician assistants

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Navy corpsmen and U.S. Army medics were returning from the Vietnam War with valuable medical skills. “It seemed so practical,” Ferrell said. “I had been treating sailors for everything from sore throats to injuries from accidents on the ship. I was absolutely interested.” The first class of PA students – four Navy corpsmen, including Ferrell — started classes at Duke University in fall 1965. One would drop out. Two years later, Ferrell graduated and got hired by a busy internal medicine physician in Durham who saw 30 patients a day. Patients reacted to Ferrell with confusion. “You’re a what?” they asked. “Patients had never seen someone like me,” Ferrell said. “But they seemed to realize quickly that I could handle all of the things that didn’t require a doctor’s training to do. Soon the patients and nurses would call me instead of the doctor because they knew they could reach me faster.” Ferrell worked as a PA for 47 years. He is the only surviving member of the first class of PAs. One died of a heart attack at age 31 shortly after graduation. The other, Vic Germino, died last year after a long career as a PA. Ferrell and Germino stayed in touch, marveling that their experimental fourmember class had grown into more than 250 PA programs nationwide. “Did we think it would become this?” Ferrell said, laughing. “Not in our wildest dreams!” Freedom to change The first class of PAs at UNTHSC was bigger than Ferrell’s class, but not by much. In 1997, 12 students started the Fort Worth program, created under the supervision of founding director Hank Lemke, DHSc, PA-C. Today, the program accepts 75 students each year and has 765 graduates. The program emphasizes primary care and meeting the needs of underserved communities in Texas. More than 70 percent of PA graduates leave UNTHSC with an interest in primary care, according to surveys. PAs are increasingly found working in specialty fields. Among the many specialties

offered to UNTHSC students on clinical rotation are emergency medicine, pediatrics, psychiatry, surgery and women’s health. Tamara Willmoth, a 2012 PA program graduate, worked first in the gastrointestinal field and then emergency medicine before returning to UNTHSC as an Assistant Professor. “I was able to get four job offers just from places I spent time on rotation,” Willmoth said. “They had never had a physician assistant before

“The relationships with our patients are fulfilling because as a PA you really get to know them and their families.” — Victoria Florez and would say, ‘You did a good job. We’ll wait for you to graduate.’ “That’s why we tell students now to approach every rotation in every specialty like it’s a job interview.” If a physician wants to change specialties, he or she must go through an often time-consuming process to get certified in a different specialty. PAs simply get hired and train on the job. “A physician assistant can work in pediatrics for five years, work in surgery for five years and work in primary care for five years,” said Lauren Dobbs, MMS, PA-C, UNTHSC Associate Professor of Physician Assistant Studies. “The freedom to move swiftly between specialties is a big draw to the field.” Proven abilities Even though PAs have existed for a half century, their acceptance in the medical community has grown exponentially in the last 20 years. “I started as a PA in the early 2000s at a pediatric clinic for indigent patients in a South Texas community, and it wasn’t easy,” said Juliann Castillo, PhD, UNTHSC Associate Professor of Physician Assistant Studies. “I faced some skepticism from the medical community and had to prove my knowledge and abilities.”

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Assistant Professor Tamara Willmoth, left, speaks with PA students Julia Forsberg, Molly Berrier and Emily Lau.

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But skepticism has faded. Willmoth was the first PA hired to work in the emergency department at a hospital in Arlington. Four years later, 13 PAs work there. “At the Health Science Center, our student PAs train with our medical students,” Willmoth said. “They are comfortable working as a team, and our medical students recognize our PAs’ abilities. As our medical students go on to become doctors, they are eager to hire PAs.” Jenna Oropeza, MPAS, PA-C, a May 2018 graduate who now works in surgical oncology at Parkland Memorial Hospital in Dallas, said two fellow alumni also recently landed jobs in medical oncology and gastrointestinal surgery at the hospital. “The Health Science Center’s PA program is like a family,” she said. “It’s supportive, and the program’s training rotations are great

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experiences. I think employers know they are getting high-quality PAs.” Though the PA program is consistently ranked among the best in the country by U.S. News and World Report, program officials continue to refine it. The curriculum will shorten next year from 34 to 30 months to improve efficiency, and students now spend every Friday in a collaborative clinical setting instead of classroom lectures. Florez, the business major turned PA, said she had no regrets about turning down business job offers after undergraduate school to enter the UNTHSC program. “The PA program is intense; it is a few of the hardest years of your life,” she said. “But the opportunities waiting afterward are very much worth it.”


PAs by the numbers Where PAs work by specialty Family medicine

3.5%

2.8%

3.9%

Orthopedic surger y Emergency medicine Urgent care Internal medicine Hospital medicine Dermatology

17% 4.9% 6.6%

10.8% 9%

Cardiology

30

What can a PA do? Diagnose and treat illness

Percentage increase in PA employment expected between 2014 and 2024

76

Percentage of PAs who received multiple job of fers upon graduation

100

Percentage of UNTHSC PA graduates who passed the national certification test on the first tr y for four years straight

Prescribe medication

Perform procedures

Do clinical research

Order and interpret tests

Assist in surgery

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hey have been dubbed digital natives, and they are the first generation to cut their teeth on technology. Theirs is a world of tablets and texting; blogs, videos and all things digital. “These are the kids who have never even known a world without cell phones,” said Brandy Roane, PhD, Associate Professor of Physiology and Anatomy and a certified behavioral sleep medicine specialist. For all the good that technology has delivered, the digital age has brought with it some serious side effects for the nation’s youth.

When it comes to digital programming for kids, how much is too much? By Jan Jarvis

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Dr. Brandy Roane, with son Elijah, says children who spend too much time staring into computer screens can come away ill-equipped to handle social interactions.

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Excessive screen time Insomnia, behavioral issues, speech development delays, the inability to read social cues, obesity and vision problems have been linked to excessive screen time, said Christina Robinson, MD, Assistant Professor of Pediatrics. Preliminary results from an ongoing National Institutes of Health study involving 4,500 children found that the brain chemistry of kids who spent excessive amounts of time on screens was different from kids who did not. Some children are so hooked that taking away screen time can lead to severe withdrawal. “Most cases are not that extreme,” Dr. Robinson said. “But there are some children who can’t seem to function without media.” For most children, the impact is not so

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obvious, but no less disturbing. All those hours spent staring into a screen can eat away at fundamental social skills and contribute to the creation of a generation ill equipped to understand basic human emotion. “When you give kids a cell phone in place of face-to-face interaction, they never get what it means to look someone in the eye,” Dr. Roane said. “They don’t learn how to read facial expressions.” Fading face-to-face Among teens, face-to-face communication is fast fading in favor of texting or snapchatting. Even when they’re in the same room, kids frequently communicate through their phones, Dr. Roane said. Not so long ago, kids discovered who they were and where they fit in by hanging out


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To control screen time, Dr. Roane set up a token system for her children. By doing chores, they earn tokens that can be exchanged for screen time.

At a glance SCREEN TIME GUIDELINES • Children 18-24 months – Choose high-quality programming and watch it with your children. • Children 2 to 5 years – Limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children.

with their peers, typically a small group of neighborhood friends, said Witold Migala, PhD, Associate Professor of Biostatistics and Epidemiology. “Now that circle of friends is everyone online,” he said. And not everyone is so friendly. Cyberbullying is one of the biggest threats children face online. Stacey Vanvliet, MD, Physician Development Coach for the TCU and UNTHSC School of Medicine, said cyberbullying and the immense pressure that social media puts on teens are taking a terrible toll on their mental health. “It’s really tough for young minds to navigate this world where there is so much pressure from social media,” said Dr. Vanvliet, who is also a hospitalist at Cook Children’s Medical Center. “I see multiple patients a week in the hospital for suicide attempts,” she said.

screen use can lead to changes in the brain’s chemistry. Those changes are similar to those linked to addiction. It’s easy to see how kids slip into overuse. “They can learn about anything in just a few hours on the internet,” Dr. Migala said. “But it is knowledge without experience.” That lack of experience leaves adolescents especially vulnerable to the pressure of social media. Kids are used to posting about everything they do from the moment they get up until they go to sleep, Dr. Roane said. They worry about how many likes their breakfast photo got and wonder why their video did not go viral. “Kids are already very egocentric to start out with, and this just makes them super-egocentric,” she said. “Watching YouTube pranks just reinforces the idea that in order to get popular you have to do very weird things.”

Thoughts of suicide One study found that 48 percent of children who spent five or more hours a day on their phones had thought about suicide or made plans for it. There is growing evidence that heavy

Ways to differentiate For generations, kids have found ways to differentiate from their parents and develop their individual identity, but it is different for teens today, Dr. Migala said. “Once that meant growing your hair

• Children 6 and older – Place consistent limits on the time spent using media, and the types of media. Ensure media does not replace adequate sleep, physical activity and other behaviors essential to health. • Designate media-free times together, such as dinner or driving, as well as media free locations at home, such as bedrooms. • Have ongoing communication about online citizenship and safety, including treating others with respect online and offline. Source: The American Academy of Pediatrics

MORE INFO The Family Media Use planning tool can be found at HealthyChildren.org

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“Let’s face it, we live in a culture where everyone is always on, and the truth is people frown on just disconnecting.” — Dr. Brandi Roane ›

Dr. Roane and husband Arch work with their son, Joseph, to manage screen time.

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long, wearing outrageous outfits or listening to music that annoyed your parents,” he said. “Now the options are much more drastic, dramatic and available at their fingertips.” Parents alarmed by the proliferation of social media have tried to turn down the volume and set limits. But filters are only as good as the key words parents use to set them, Dr. Roane said. It is becoming increasingly tough to escape the impact of screens and just have a conversation, Dr. Migala said. “As a counselor, I used to advise patients to use time in the car to have quality conversations with their children,” he said. “But then, years

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ago, I noticed a SUV with a screen in it and realized that one of the last safe places for talking and sharing was gone.” Some schools have gotten involved by either requiring students to have a cell phone so they can look up information or banning cell phones in the classroom. But for parents who are also hooked on social media, it can be difficult to set a good example for their children. “Let’s face it, we live in a culture where everyone is always on,” Dr. Roane said. “And the truth is people frown on just disconnecting.”


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What the experts do in their own homes The Hospitalist Dr. Stacey Vanvliet Children: Jack, 2, and Ellie, newborn For the first 18 months of Jack’s life, all screens from tablets to TVs were off-limits. “We had absolutely no screen time with the exception of FaceTime with his grandparents a few times a week,” Dr. Vanvliet said. “Then between 18 and 24 months, we slowly introduced media, but focused on learning games.” Media time should always be shared. “I want to be able to interact with my son,” she said. Dr. Vanvliet prefers reading hardbacks to E-books, which can have distracting sounds and visual effects. “The back-and-forth that occurs when someone is reading to a child is so important and it really expands their knowledge,” she said. “If you have a computerized voice reading, you miss that conversational tone.”

The Pediatrician Dr. Christina Robinson Children: Kaitlin, 4, and Jonathan, 9 Dr. Christina Robinson’s believes in setting limits from the very start. “I’m not saying throw out technology altogether,” she said. “But we have to curtail it back.” She closely follows the American Academy of Pediatrics Screen Time Guidelines, which recommend no screen time for children younger than age 2 and limiting screen use to no more than an hour a day up to age 5. Now that her children are a little older, she limits media to 2 hours per day on weekends, special occasions or holidays. Since she limits screen time, Dr. Robinson makes a point of offering alternatives such as coloring, cooking or crafts. She also encourages her children to play outdoors and listen to music. “Music doesn’t have to involve a screen,” she said. “I encourage them to be creative by making their own music.”

The Sleep Researcher Dr. Brandy Roane Children: Joseph, 17, and Elijah, 14 In a family of gamers, negotiating screen time can be tricky. When her kids were 5, she set up a token economy to help them learn how to make good decisions about screen time. One token buys 30 minutes of screen time. They earn tokens by doing chores. There is a 90-minute daily cap on screen time. The exception: special splurge days when school is out. Enforcing such a program takes a backbone and a timer. “Very quickly my kids learned that if they spent all of their tokens in the morning, they would have no access to electronics in the afternoon,” Dr. Roane said. “Kids are good at finding loopholes and there’s always one parent who caves in.”

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short takes


short takes

SOLUTIONS

A growing number of experts agree that the dramatic rise of e-cigarette use among young Americans poses a significant health risk. By Sally Crocker

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vaping dangers

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Dr. Tracey Barnett stands in front of a vape shop located across the street from Paschal High School.

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A

Fort Worth mother of two discovered some unusual items while unpacking her family’s suitcases on vacation. Turns out, she had found her 15-yearold son’s JUUL pods. He had been secretly vaping, joining the tens of thousands of kids across the U.S. who have fallen prey to the latest hot – and dangerous – trend among adolescents and young adults. In recent years, more and more high school and college students, even middle schoolers, have been trying this form of electronic cigarettes, cleverly marketed to youth by tobacco and e-cig companies eager to attract a new generation of consumers. “Vaping has become the newest cool thing to do,” said Tracey Barnett, PhD, Associate Dean for Academic Affairs at the UNT Health Science Center School of Public Health. “The problem is, many people aren’t fully understanding the potential long-term effects and addictive qualities of these products, or how widespread the problem really is.” Data from the Office of the Surgeon General and a 2016 National Youth

Tobacco Survey reported a 900 percent increase in e-cigarette use by U.S. high school students during the years 2011-2015, with 1.7 million high school students and around 500,000 middle school students saying they had used e-cigarettes in the previous 30 days. The industry is huge and growing. E-cigarette advertising expenditures have increased dramatically in recent years, from $12 million in 2011 to $125 million in 2014, and it is estimated that more than 460 e-cig brands are currently on the market, with more than 7,700 vapor flavors to choose from. “With flavorings packaged like juice boxes and candy, and youth-oriented, fun names like gummy bear, cosmic cranberry and very berry blue, it’s clear who is being targeted,” Dr. Barnett said. “Many of these products are loaded with nicotine and contain other chemicals that may be dangerous.” Dr. Barnett’s research is focused on the health risks of nicotine, tobaccorelated products and now the youth vaping epidemic.


vaping dangers

SOLUTIONS

At a glance VAPING PROBLEMS AMONG THE YOUNG THE SCOPE From 2011 to 2015, e-cigarette use increased 900 percent among U.S. high school students.

THE DANGER Health experts warn that toxic chemicals in vaping products may cause more health problems than the nicotine in regular cigarettes.

Like others in public health, medicine, the research field, education and consumer safety, she has serious concerns and is working to address this problem. Dr. Barnett has published articles on the topic and is active with parent groups, educators, school staff and counselors, community organizations, legislators, the media and especially students, to share the facts about e-cigarette use.

Vaping is widely marketed through social media, gaming sites and youthoriented radio. The products can be purchased online or through vape shops. “Users must be over 18, but we all know there are ways around that,” Dr. Barnett said. Parents like the Fort Worth mother, who chooses to remain anonymous, often are caught unaware, with little knowledge of how their kids are getting the products. “My husband and I were shocked to find out that our son had been vaping for three or four months or maybe even longer,” she said. “We learned that the football field at his school was pretty much a lunchtime marketplace for obtaining JUULs. Older students were ordering the products online and selling them to younger kids.” Her family alerted their high school principal, and they have been monitoring their son in new ways since. “Trust has become a big issue. We changed to a non-cash system for his spending money,” she said. “There were times when we wouldn’t let my son close the door to his room, and I still check the nightstand drawers by his bed. But how can parents really fix the problem when practically anything can be found on the internet and there are vape shops on just about every corner?” Not all vape shops check IDs for age, and many internet sites only require a “yes, I’m over 18” click for access. “Sometimes it’s as simple as knowing a friend of a friend, or someone’s older relative who doesn’t mind making the purchase,” said a local high school administrator.

How does it work? “Electronic nicotine delivery systems go by different names,” Dr. Barnett said. “E-cigs, vapes, vape pens, e-pens, mods, e-hookahs and tanks are all common terms, and most recently, new names have popped up around specific brands like JUUL, which looks deceptively like a USB device or flash drive.” E-cigarettes have been marketed as a safer alternative to smoking, a way to reduce smoking and a tool to help users quit, although this has not been backed by the FDA. Rather than burning tobacco and producing smoke or odor, they release a vapor. The steam inhaled is made up of nicotine and liquid chemicals, which can include added scents and flavor juices. Early research has found that some of these smokeless tobacco products contain three to four times more nicotine than cigarettes. But because this trend is still relatively new to the United States, the industry remains largely unregulated, and little is yet known about the long-term health effects, Dr. Barnett said.

THE SOLUTION Education, parental involvement and new legislation are needed to control the dramatic rise in e-cigarette use among the young.

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SOLUTIONS

As e-cigarette use has increased, researchers, the medical and public health industries, and agencies like the CDC and World Health Organization have rejected the products as a safe alternative to smoking, warning the toxic chemicals may cause more health problems than the nicotine in regular cigarettes. In December 2018, the U.S. Surgeon General called the problem a serious epidemic among youth and stressed the importance of “protecting children from a lifetime of nicotine addiction and associated health risks.” “Here’s what we know. Nicotine is addictive,” Dr. Barnett said. “Nicotine can harm the developing brain, especially during adolescence. Teenagers are much more susceptible to addiction, and withdrawal can bring on anxiety, irritability, depression, physical symptoms and loss of concentration.” “Some vapes being marketed as having zero percent of nicotine have actually been found to contain nicotine,” she said. “But that’s not all. Particles of other dangerous substances have also been detected, such as metals like nickel, cadmium and lead, and carcinogens like formaldehyde.” Even the seemingly harmless flavor additives are suspect. “Very little is known yet about the long-term effects of inhaling flavor ingredients. While they might be approved for ingestion, that doesn’t necessarily mean they are safe to take into the lungs,” Dr. Barnett said.

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Getting hurt, getting high E-cigarette explosions are another increasing cause for concern, a fact emphasized locally in February when a man was killed after a device exploded in his face outside a Keller vape shop. In a recent Tobacco Control article published by UNTHSC-SPH alumnus Matthew Rossheim, PhD; SPH Dean Dennis Thombs, PhD; and colleagues, an estimated 2,035 e-cigarette explosions and burn injuries, close to three per day, were reported by hospital emergency departments between 2015 and 2017. “There is potential for the batteries in these devices to overheat, ignite or explode,” Dr. Thombs said. Drugs can present dangers of another kind that students and parents should be aware of, said Kathryn Everest, Director of Counseling Services for the Fort Worth Independent School District. “Marijuana users have found ways to mask the smell by mixing flavor juices with liquid marijuana compound, so they can smoke pot virtually undetected,” she said. “There have also been situations where other drugs were used to lace these products and kids have ended up in the emergency room. Students need to understand how serious this is.” Parents with questions can consult their school, their health care provider or reliable online resources like the Truth Initiative, the country’s largest non-profit public health organization dedicated to tobacco education. “Conversations around the dinner table are so important to talk openly about vaping, just like drugs and other situations that teens and young adults may face,” said Coby Bird, Principal at Southwest Christian School in Benbrook, whose high school is battling the problem through campus awareness programs, parent education and student counseling. “E-cigarettes are threatening to negate all of the progress made to reduce the damages and health risks from smoking in the U.S.,” Dr. Barnett said. “Future actions on this problem will be important to the safety of our children and generations to come.”


UNTHSC FOUNDATION

A YEAR OF ACCELERATING MOMENTUM IMPACT REPORT 2018 By Doug White Vice President, Institutional Advancement

M

omentum is a word used often at UNTHSC. It speaks to a desire to accelerate the pace and quality of education and research we conduct, and the patient care we deliver. And while this momentum may at first seem disconnected given the array of activities in play, a closer look proves otherwise. There is unity when understanding that the common goal at UNTHSC is to “transform lives in order to improve the lives of others.” That is our PURPOSE statement, and with every wave of momentum comes a transforming opportunity. 2018 was a year of increasing momentum, with much of the energy coming from alumni and community friends. Philanthropic investments topped $21 million and touched every corner of the campus. Likewise, our students and faculty spawned transformative change through their service. Whether through formal outreach and screening programs or through the 47,000+ hours of volunteer time logged, UNTHSC investments touched and improved the lives of neighbors young and old. The next pages feature just a few of the highlights from 2018. We share them out of gratitude to those who made them possible, and with the hope that you will remain on our team – or choose to join us – in 2019 and beyond. Our accelerating momentum depends on you! Learn more by visiting unthsc.edu/giving.

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UNTHSC FOUNDATION

Fiscal Year 2018 Giving Giving by source

$890,000

$21.4 million

total dolars invested

$4.2 million

Other

$10.5 million

Individuals

$5.8 million

Foundation Corporations

Giving by designation Research

$89,700 $556,400 $971,000 $1.1 million

Academics Other Outreach

$10.8 million

$3.7 million

Unrestricted Scholarships Capital

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$4.2 million


IMPACT REPORT 2018

4,800 230

Total students educated through the SAGE Program

Students awarded donor-sponsored stethoscopes

$572,800

Estimated labor savings through UNTHSC volunteerism

$52

million

UNTHSC research expenditures in 2018

3,700+

Children this school year given free vision screenings through the North Texas Eye Research Institute Mobile Vision Screening Program WWW.UNTHSC.EDU/GIVING

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SAGE W

ith America’s aging population increasing, our Seniors Assisting in Geriatric Education (SAGE) program was introduced in 2009 as an experiential education model helping prepare our medical-professions students to better meet the health care needs of older adults. The program partners 1st and 2nd year medical-professions students from across seven disciplines in teams of three to four students, and then pairs each team with a senior citizen volunteer for home visits. The interdisciplinary student teams make six home visits over a 1½ -year period during which they apply their classroom education and clinical skills to the same patients long term. Naturally, many of our students and senior volunteers develop long-lasting bonds that only amplify the core benefits of the program for both students and seniors. With its proven popularity among both students and senior volunteers, the SAGE program has seen tremendous growth in its first 10 years from just 189 student participants in 2009 to over 1,300 in 2017, and with over 440 enrolled active senior volunteers. The popularity and effectiveness of the program has garnered local and national recognition that resulted in a $1 million gift from an anonymous Fort Worth donor to place a permanent endowment behind the program. In total, the program to date has educated over 4,800 students, engaged over 1,700 senior volunteers, and accounted for over 7,700 home visits.

From the student perspective: “This experience has opened my eyes to the struggles and barriers, as well as the joys, of aging. It also has been helpful to really see older patients as real people that still want to live full lives – rather than just seeing them as patients who need their disease managed. I will see them as people who want to be able to get around, see family and friends, and live meaningful lives.” From the senior volunteer perspective: “I certainly enjoyed being in the SAGE program. The team who met with me proved to be very intelligent, responsible and energetic. Two things struck me: They all matured in the process over the two years, and they began to work together with trust in each other.” UNTHSC and TCU in the SAGE program: UNTHSC - medical, physician assistant, physical therapy, pharmacy students TCU - nursing, dietetics, social work students

$1,000,000 Invested to place a permanent endowment behind the program

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IMPACT REPORT 2018

Father to son gift E

ach of the six stethoscopes that William Thomas Jr., DO, has sponsored for first-year medical students at the Texas College of Osteopathic Medicine are special to him. But a stethoscope he funded this year has extra meaning to the 1982 TCOM graduate. His son, Andrew Thomas, was a recipient of the Littmann Cardiology IV stethoscope that Dr. Thomas sponsored through a gift to the UNTHSC Foundation. All 230 students in the Class of 2022 received stethoscopes thanks to the generosity of donors. “My father also was an osteopathic physician, and now my son is on a path to become the third generation of osteopathic physicians in our family,” Dr. Thomas said. “I’m very proud and excited for him to carry on the torch.” Alumni and community members can sponsor a stethoscope for a student through a gift of $250 — or make an even bigger impact by sponsoring more than one student with gifts of $500, $750, $1,000 or more. The stethoscopes’ tubing is inscribed with the student’s name and the bell can be inscribed with the sponsor’s name. Any extra funds support student scholarships. First stethoscopes are deeply meaningful to medical students. They use their stethoscopes throughout their medical education, and many continue to use them during their professional practice. Dr. Thomas has practiced family medicine in Burleson for 35 years. He not only supports the stethoscope sponsorship program but has also contributed to the renovation of Alumni Plaza, the Annual Alumni and Friends Crawfish Boil and student scholarships at UNTHSC. “Osteopathic medicine has given so much to me,” he said. “It’s very rewarding for me to be able to give back something to the future generation of osteopathic physicians.” Students who receive stethoscopes write thank you notes to their stethoscope sponsors. Reading them is one of the many things Dr. Thomas enjoys about the program. “These students are at the beginning of their medical journey,” Dr. Thomas said. “They are full of hope for the future and the stethoscope is something that they can carry throughout their career.”

My father also was an osteopathic physician, and now my son is on a path to become the third generation of osteopathic physicians in our family.” Dr. William Thomas Jr. TCOM, Class of 1982

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UNTHSC FOUNDATION

IREB opening

$8.5 million in community funding for capital or program needs

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W

hen the ribbon was cut last fall on UNTHSC’s Interdisciplinary Research and Education Building (IREB), a dream was realized for students and faculty alike. Yes, the desperate need for additional classroom and research space was addressed, but the magic of the IREB is in the way it delivers on that need. True to its “interdisciplinary” name, the facility is designed with teambased, collaborative learning and research in mind. The IREB features a totally different look for its classrooms, teaching labs, and research spaces. Traditional lectures will rarely take place, replaced with scores of collaboration spaces and with technology that allows reference materials and teaching aids to always be within easy reach via plug-ins and suspended monitors. As home to the UNT System College of Pharmacy and the TCU and UNTHSC School of Medicine, future physicians and pharmacists will more frequently interact, and with purpose. The spaces aren’t exclusive to those programs, however, as students from all six UNTHSC schools and colleges will be welcomed for activities planned and spontaneous. Community donors have provided more than $8.5 million in funding for capital or program needs associated with the IREB, with leadership commitments received from Quest Diagnostics, the Sid W. Richardson Foundation and the Amon G. Carter Foundation.


Philanthropy and research

T

he goal of research at the UNT Health Science Center is to translate discoveries made in the laboratory into diagnostic tools and medical therapies. Today, this bench-to-bedside approach means that scientific discoveries will provide patients with cutting-edge therapies quicker. The newly formed Institute of Translational Research is working to reduce the time between discovery and patient access beginning with Alzheimer’s disease. With the focus of research on precision medicine, researchers have a unique opportunity to quickly move discoveries to human trials that have the highest possible chance of success. But discovery requires investment. In 2018, UNTHSC received research awards of $52 million, with government grants comprising more than $48 million of that total. Generous support from individuals and private foundations also has helped to move the needle forward. With support from the Cure Glaucoma Foundation, the North Texas Eye Research Institute is getting closer to unlocking the secrets of glaucoma. Gifts from the Virginia M. Kincaid Foundation and the Rutledge Cancer Foundation continue to support the efforts of Andras Lacko, PhD, to treat cancer with targeting therapies that attack diseased cells without damaging the surrounding healthy cells. Pediatric cancer research also has been funded by Leukemia Texas and the TeamConnor Foundation. And Sid O’Bryant, PhD, continues to conduct ground-breaking Alzheimer’s research that will change how the world diagnoses and treats this debilitating disease. A One University strategy for translational medicine is moving the UNT Health Science Center closer to meaningful discoveries that will transform the lives of many in Fort Worth and beyond.

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Legends impact

$1.8 million Funds generated over the past six years

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S

ince the inaugural event in 2013, the Legends Concert Series continues to make a positive and powerful impact on UNT Health Science Center and the community we live in. The signature fundraiser has generated more than $1.8 million over the past six years while showcasing UNTHSC’s patient-centered education, groundbreaking research and outstanding clinical care. On November 5, 2018, the sixth annual Legends Concert featured Dwight Yoakam, who put on an incredible show in front of a packed house at iconic Bass Performance Hall. More importantly, significant funds were raised to support creation of the UNTHSC Legends Scholarship Fund. DID YOU KNOW? Many students arrive on the UNTHSC campus already carrying $100,000 or more in loan debt from their undergraduate education. For many, that debt will double as they train to become health care professionals. The Legends Scholarship Fund will greatly alleviate the financial burden for some of our talented health care and research leaders of tomorrow. Scholarships will be awarded to students from each UNTHSC college, supporting a medical student, a future pharmacist, an aspiring physical therapist or physician assistant, a research student pursuing the world’s next major discovery and a future leader in the field of public health. “Donors who graciously give allow my dream to become a reality,” one UNTHSC student scholarship recipient said. “Their gift makes a significant impact on our lives. I say ‘our’ because it not only affects me, but it also affects the future patients I’ll serve.”


IMPACT REPORT 2018

Continuous giving Q: What about UNTHSC motivates you to give year after year? A: Again, for us it is about supporting students or as the UNTHSC Purpose statement includes, "Transforming Lives." Furthermore, supporting students is critical as the cost of higher education continues to spiral upward. Q: What particular programs or areas at UNTHSC interest you the most? A: Scholarships, aging/geriatrics/population health education and clinical service programs. Q: What impact do you hope to make through your continued giving? A: Support of future osteopathic physicians with less debt who may then decide to enter primary care and/or geriatrics. Hopefully, by receiving this support, they in turn will support future generations of medical students.

F

or 21 consecutive years, Thomas Fairchild, PhD, and his wife, Janice Knebl, DO, loyal supporters of the UNT Health Science Center mission, have contributed to UNTHSC fundraising efforts that are most meaningful to them. Through their consistent support, they have directly impacted the lives of students, patients and our community. Learn more about what inspires them to support UNTHSC scholarships and programs year after year. Q: Why did you first give to UNTHSC? A: We both received several scholarships for our graduate degrees, and receiving these academic scholarships to assist in tuition inspired us to want to support Texas College of Osteopathic Medicine students with tuition scholarships. Also, having spent our careers at UNTHSC and UNT, we wanted to support the education/academic programs that directly impact students.

Q: How would you describe UNTHSC to others, including potential donors? A: UNTHSC is a valuable educational resource to the North Texas community that has developed a national reputation by the high quality of graduates that have gone on to significantly impact their respective fields. Supporting UNTHSC is a commitment to not only the future of the higher education, but also to the larger good of our community and nation. Q: Do you mind sharing anything from your personal background that shaped your attitude toward giving? A: Receiving scholarships during undergraduate college and medical school influenced our strong commitment toward giving. My attitude toward giving is rooted in what I learned from my parents. They always gave of their time, talent or financial resources to support our church and community. Their charitable behavior left a lasting impact on me that I attempt to stay true to today. UNT Health Science Center relies on generous consecutive supporters like Dr. Fairchild and Dr. Knebl to be the catalyst in helping us continue to transform lives. Join them and others in supporting our mission to create solutions for healthier communities.

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UNTHSC FOUNDATION

Making a difference V olunteerism provides people an opportunity to make a difference and connect, as well as serves as a valuable and renewable resource for communities. Since 1970, UNT Health Science Center students and employees have given back to the local community through service, education and philanthropy. Almost 50 years later, the spirit of volunteerism at UNTHSC is no different. UNTHSC students and employees embrace the value of serving others first through patient education at local non-profits or Fort Worth ISD schools, providing basic first aid and emergency medical services at local events such as Cowtown Marathon, Fortress Festival, and by administering hands-on screening services such as cholesterol, BMI and blood-glucose checks at various health fairs and community events. In 2017-2018, students, faculty and staff members volunteered a total of 47,736 hours, saving the community an estimated $572,800 in labor. UNTHSC is deeply invested in the growth and betterment of Fort Worth. By volunteering our time and talent, together, we are part of the solution to creating a healthier community.

47,736 Number of volunteer hours by students, faculty and staff in 2017-2018

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IMPACT REPORT 2018

Leaving a legacy

D

rs. Alan and Marianne Levine practiced medicine for a combined 54 years, and UNTHSC was fortunate to have both on faculty at one point or another over the course of these years. Following her beloved husband’s passing in 2012, Marianne had a big decision to make regarding the proceeds from her husband’s life insurance policy that were earmarked to support UNTHSC. After establishing The Alan and Marianne Rose Levine TCOM Pediatric Award to support senior students moving into pediatric residency, Marianne collaborated with UNTHSC President Michael Williams to decide how best to use the balance of the proceeds. They decided to establish the Alan and Marianne Levine Presidential Endowed Scholarship to annually award scholarships to four students in each of UNTHSC’s six colleges and programs, which include the Graduate School of Biomedical Sciences, Physician Assistant Studies, Physical Therapy, School of Public Health, the Texas College of Osteopathic Medicine, and the UNT System College of Pharmacy. Each of the 24 scholarships awards $1,000 and renews each year at this sustained level until the student recipient graduates. Dr. Alan Levine practiced medicine for 34 years and retired from UNTHSC in 2006 after teaching for 28 years. Dr. Marianne Levine, TCOM class of 1985, practiced as a pediatrician for 20 years.

$1,000 Scholarship awards and renews each year until graduation

FOR MORE INFORMATION: • Funding needs and opportunities 817-735-2254 unthsc.edu/giving • Other ways to partner with UNTHSC 817-735-2443 unthsc.edu/communityrelations

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SOLUTIONS

Dancer Celesta Gaiera outfitted with motion-capture reflectors 40

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The dancers and their doctors

By Jan Jarvis

Researchers use cutting-edge science to care for the ballerinas of the Texas Ballet Theater bout halfway through a ballet season filled with graceful leaps and pounding landings, dancer Celesta Gaiera had not suffered a single injury. Physical therapy, massage and compression boots helped keep the Texas Ballet Theatre dancer on her feet through “Cinderella,” “Cleopatra” and “The Nutcracker.” “As dancers, we are extremely in tune with our bodies and proactive when it comes to staying injury-free,” she said. “When I feel an ache or pain coming on, or even if something feels slightly out of place structurally, I immediately roll out, stretch, or utilize our preventative care in order to stay healthy.” To help dancers keep performing, UNT Health Science Center researchers are using motion capture technology to identify movements that over time can

lead to tendonitis, fractures and other injuries. A team that includes physicians, physical therapists and researchers are monitoring Texas Ballet Theater dancers throughout the season. The goal is to find ways to prevent injuries rather than rehabilitate them, said Sajid Surve, DO, Associate Professor of Family Medicine and Co-Director of the UNT Texas Center for Performing Arts Health. “If we can predict which ballet dancers are going to get hurt at the start of the season, we can perform interventions and prevent injuries, rather than waiting until they get hurt in the middle of the season,” Dr. Surve said. To capture data as dancers practice, researchers have taken a mobile version of UNTHSC’s Human Movement Performance Lab to the Texas Ballet Theater. Twice this season they have

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performance health

SOLUTIONS

Dr. Sajid Surve examines dancer Dara Oda.

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recorded dancers performing the same movements and then looked for changes, said Rita Patterson, PhD, Professor and Director of Research in the Department of Manipulative Medicine. In April, they will collect data for a third time. Five male and five female dancers are participating in the study that requires them to have reflectors attached to specific bony landmarks, said project lead Nathan Hershberger, DO, a former professional dancer and a Family Medicine/Osteopathic Neuromusculoskeletal Medicine resident with Medical City Fort Worth. “The dancers are recorded with 3D motion-capture technology, exactly the same as what was used in the movie ‘Avatar,’” Dr. Hershberger said. “The long-term goal is to use this technology

to recognize movement that would be considered pathological and find ways to intervene, which could, in theory, lengthen a dancer's already short career.” As Gaiera and other dancers moved through jetes and plies, an enormous volume of data was transferred to the computer where it appeared as stick figures on the screen. Each camera records 120 frames per second, collecting data that later will be analyzed by engineering students at the University of North Texas in Denton. By December, some dancers were feeling the strain of performing, with some developing minor injuries because of wear and tear. So far, researchers have focused on feet and stability.


performance health

SOLUTIONS

“Dancers are tough,” Dr. Surve said. “They will dance right through the pain with a smile on their face. Our job is to make sure that these minor problems don’t turn into major injuries down the road. “What we are seeing is there is a direct correlation between how much the supporting foot moves and how much training the dancer has. Less experienced dancers have a lot more movement, but the most experienced are like rocks.” The more stability someone has, the less likely they will be injured, Dr. Surve said. In the world of ballet, stability is everything. While the feet have been the focus so far, the research team plans to move to the knees and pelvis for the remainder of the season. “We want to see what joint gives us the best view in terms of predicting injury,” Dr. Surve said. Gaiera is grateful that an injury has not kept her away from dancing, and she hopes the data collected will provide even more insight into how to prevent injuries. “It has been such a thrill to be so dynamically challenged,” she said. “I feel grateful to be doing what I love every day!”

Dancer Celesta Gaiera demonstrates a dance move.

Dr. Rita Patterson adjusts a motion-sensor reflector on dancer Adeline Melcher.

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SOLUTIONS

short takes

The transforming power of medical education The TCU and UNTHSC School of Medicine doesn’t open until July. But it’s already changing the face of health care in North Texas. By Jeff Carlton

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SOLUTIONS

short takes

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medical education

SOLUTIONS

T

Dr. Linda Siy, born and raised in Missouri, performed her residency training in Fort Worth and stayed to practice medicine.

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here was a time when Linda Siy, MD, was a Missouri girl through and through. She was born and raised in Independence, Mo., famous as the home of President Harry Truman and the launching point for covered wagon journeys westward on the Oregon Trail. She later earned a biology degree and a medical degree from the University of Missouri-Kansas City School of Medicine. But when it was time for Dr. Siy to begin her promising medical career, she took her training and talents to Fort Worth, specifically to JPS Health Network’s familymedicine residency program. JPS hired her full-time in 1995. Dr. Siy, the past president of the Tarrant County Medical Society, has since cared for thousands of Texans. Missouri’s loss was Texas’ gain. “I was trained by the state of Missouri and its medical school. But I came to Texas for post-grad training, and I’ve stayed ever since,” said Dr. Siy, Assistant Professor at

UNT Health Science Center. “When you enter into residency training, you develop connections to the community and ties to opportunities for jobs. It’s just natural that you’d stay.” Dr. Siy’s journey to Fort Worth illustrates the transforming power of medical education ¬– and why the partnership between UNTHSC and Texas Christian University is so critical to the future of health care in North Texas. The new TCU and UNTHSC School of Medicine has gone from concept to reality in just four years, with an inaugural class of 60 students starting classes in July. Already, the school has served as a catalyst, bringing some of the region’s largest and most vital hospitals and health care systems to the table with a shared goal: to transform lives in North Texas through better health care. The proof can be found in the creation of hundreds of new residency positions,


medical education

SOLUTIONS

At a glance MEETING THE PHYSICIAN SHORTAGE THE NEED Where young doctors spend their residencies often determines where they practice. Only 2 percent of the total residency slots in Texas are located in Fort Worth.

THE RESULT When their local residencies end, more doctors will stay in North Texas area to practice, helping alleviate the doctor shortage locally and statewide.

THE REMEDY A new agreement between UNTHSC, TCU and Medical City Healthcare will create 500 new residency slots in the Dallas-Fort Worth area in the next seven years. More such agreements are ahead.

ensuring that future Dr. Siys don’t have to leave home to establish their medical careers. The School of Medicine, working in partnership with UNTHSC’s original medical school, the Texas College of Osteopathic Medicine, will help make sure that more Texas-trained medical school graduates stay here. The philosophy is simple, said Stuart Flynn, MD, founding Dean of the TCU and UNTHSC School of Medicine. “Train them locally, keep them locally,” Dr. Flynn said.

are training enough physicians,” Dr. Flynn said. “What we need is more GME.” Graduate medical education, better known as residencies, is the three-year training period (minimum) that doctors undertake after graduating from medical school. During residencies, newly licensed physicians train under the guidance of experienced practitioners. Nationwide, there are more medical school graduates than residency positions, meaning some new docs have nowhere to train. Their careers fizzle before they start. It’s a bad return on the huge investment

Fort Worth Mayor Betsy Price congratulates Dean Stuart Flynn at the celebration held when the TCU and UNTHSC School of Medicine received preliminary accreditation.

Physician shortage In 2016, Texas ranked 41st nationwide in physicians per capita and 47th in primary care doctors, according to the 2017 State Physician Workforce Data Report. Last year Texas, home to the most uninsured residents in the nation, also gained more new people than any other state, increasing its population to 29 million. The growth exacerbates the state’s physician shortage. Thirtyfive Texas counties have no practicing physicians at all, while roughly 85 counties have fewer than five, according to Merritt Hawkins, a physician recruiting firm. The shortage is not for lack of new medical schools. The TCU and UNTHSC School of Medicine will be the fourth new medical school to open in Texas since 2016, with two more coming online in the next few years. “We’re getting to the point where we

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that states make in training doctors. Texas is on the right side of this equation for now, with more first-year residency positions (1,868) than estimated medical school graduates (1,722), according to the Texas Higher Education Coordinating Board. That is expected to change by 2021, unless someone can figure out a way to grow more residency positions. “Texas invests in these medical students,” said W. Stephen Love, President and CEO of the Dallas-Fort Worth Hospital Council. “We need to do everything we can to keep them within the state of Texas.”

funding for residencies from $14.3 million in 2014-15 to $97.1 million in 2018-19. Senator Nelson is calling for $157 million in the upcoming two-year budget cycle to fund even more residencies. She praised the public-private partnership among UNTHSC, TCU and Medical City as essential to keeping more physicians in Texas. “This partnership brings an established health care system with 14 hospitals in the Dallas-Fort Worth area together with a graduate university, without straining state resources,” she said. “It will be key

“Texas invests in these medical students. We need to do everything we can to keep them within the state of Texas.” — Stephen Love ›

W. Stephen Love, President and CEO of the Dallas-Fort Worth Hospital Council

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Enter UNTHSC, TCU and Medical City Healthcare. Last year, UNTHSC President Michael Williams, DO, MD, led efforts to create more local training opportunities for UNTHSC’s medical, pharmacy, physical therapy and physician assistant students, as well as develop new residency spots in Texas. The result: Medical City has pledged to develop 500 new residency positions over the next seven years in its 14 hospitals across the Dallas-Fort Worth area. Other hospitals and health care systems are also planning residency partnerships with UNTHSC and TCU. The new positions are key, especially in residency-starved Fort Worth, home to less than 2 percent of the state’s residency programs. Dallas, by comparison, has roughly 20 percent of Texas residency programs. Tarrant County has the capacity to create approximately 700 new residency positions, Dr. Flynn said. The Texas Legislature has been doing its part to support graduate medical education as well. Prompted by Senator Jane Nelson of Flower Mound, state lawmakers have increased biennium

in creating a pipeline of physician talent while ensuring our physicians are the best and brightest." Transforming medical education UNTHSC spent years trying to establish an MD program. But the school didn’t find a feasible path forward until Dr. Williams invited TCU Chancellor Victor J. Boschini Jr. to breakfast in 2015 and pitched him on this innovative idea. Dr. Williams, a UNTHSC alumnus, anesthesiologist and former hospital CEO, said it is past time for a new approach to medical school training, where educational models have remained largely static for decades. He wants medical students with exceptional communication skills, high levels of emotional intelligence and the ability to work in teams alongside pharmacists, PAs, PTs and other members of a health care team. Most of all, he said, he wants UNTHSCtrained doctors to keep their patients at the center of everything they do. “We’ve all seen how patients are treated in health care settings,” he said. “How can


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biotechnology, pharmaceutical and life sciences firms. “Medicine is changing as fast as you and I can breathe. Most places are training in a 2018 model, which is the 2008 model, which is the 1998 model,” Dr. Flynn said. “Where is medicine going to be 10 or 15 years from now? How are we preparing our students to be ready? “Students want to come here. We want them to be here. And I want our curriculum to be so innovative that they’ll be saying, ‘I wonder what I get to learn today?’”

A white coat from the new school frames a scene from the accreditation celebration.

The Interdisciplinary Research and Education Building, home of the TCU and UNTHSC School of Medicine

we get our physicians to focus on patients in a different way?” At the new School of Medicine, students will follow patients very early in their training as part of their longitudinal integrated clerkships. In many medical schools, significant patient encounters don’t begin until the third year. The curriculum will focus on communication, critical thinking, design thinking and health care delivery systems. An Assistant Dean of Narrative Reflection and Patient Communication will help students build skills in awareness, listening, inquiry and engagement to foster better relations among physicians and their patients, their teams and their communities. Med schools often are big drivers of research. UNTHSC, for example, received $52.4 million in research awards last year, much of it earned by faculty in the Graduate School of Biomedical Sciences. Dr. Flynn envisions more of the same for the School of Medicine, with an emphasis on partnering with Fort Worth

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DNA

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With at-home genetic testing, consumers should proceed with caution By Jan Jarvis

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Melody Josserand took an at-home DNA test to find out where her ancestors came from. She learned much more.

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elody Josserand took an at-home DNA test on a lark, hoping to find out what part of Europe her ancestors were from. The DNA analyst at UNT H e a l t h Science Center knew she was adopted, but says she never was particularly curious about her biological parents. But as soon as the results came back, her heart began to pound. Listed at the very top of possible matches was someone who shared her DNA. Josserand could stop there and never know who the match was, or she could message the person. She sent the message. Three days later, after supplying a few details about her birth, she got a reply: “I’m your mother.” Josserand is among the more than 12 million people who have purchased DNA tests in which a saliva sample is used to survey a person’s

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genome. For some, the results can be life changing; for others, a waste of money. Beyond identifying living relatives, the athome tests have become popular ways to fill in family trees, trace lineages back for centuries or even learn the exact breed of your pet dog. They also have garnered attention for helping solve crimes and mysteries spanning decades. Along with the tests’ growing popularity have come concerns about privacy, legal issues or the prospect of personal data getting into the wrong hands. People are often ill prepared for the Pandora’s box of possibilities that DNA tests can open. “Before anyone takes one of these tests, they should think twice about what it could reveal,” said Michael Coble, PhD, Associate Professor of Microbiology, Immunology and Genetics.


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At a glance DNA ANCESTRY TESTS

Family trees As a DNA analyst, Josserand said she believes she was better prepared than most people to handle the test results. She stays in touch with her new-found relatives, including two half-siblings, through social media, email and greeting cards. But even she was surprised by her emotional reaction to finding her birth mother. “Yes, I had a better understanding of what could happen,” she said. “But that still doesn’t tell you anything about how you’ll feel when find your biological parent.” If Josserand was jolted, imagine the shock others experience when facing unexpected family news. In one instance, a woman believed both of her parents were of Western European descent until a DNA tests showed she had ancestors from Eastern Europe. “A paternity test later proved her dad could not possibly be her biological father,” Dr. Coble said. “The biological father was someone who worked at the fertility clinic where the mother had in vitro fertilization, using what she thought was her husband’s sperm.” Most people who take DNA tests do not get such dramatic news. But as databases grow, so do the odds of unexpected matches. Both parties have to use the same DNA testing company for a match to occur, Dr. Coble said. So if one person uses AncestoryDNA and another uses 23AndMe, they are not going to connect since the companies do not share their data. GEDmatch, a database established in 2010, has improved the odds by allowing users to upload their genomic information and search profiles from different companies. In 2018, the

THE DOWNSIDE The tests’ growing popularity has raised privacy concerns, and some people are not prepared for unexpected results. Many are disappointed at the range of accuracy in some tests.

THE RIGHT SIDE Law enforcement has used the tests to close unsolved cases and bring the guilty to justice.

site claimed it has helped 10,000 adoptees find their biological parents. It has also been used by law enforcement to solve cases. Ancestral roots Millions of people have taken DNA tests hoping to discover their family’s history. While DNA tests are able to identify close matches, they are not as accurate when it comes to locating remote villages and ancient addresses. Geographic information is only as good as the reference data the DNA company uses, Dr. Coble said. “If the company has a well-established data base, then you might find a very good approximation of where your ancestors came from,” he said. “Otherwise, it’s the company’s best guess.”

Josserand, who is adopted, sent an email introducing herself to a person identified in a DNA test as sharing her genetic signature. This is the message she got in return.

THE UPSIDE At least 12 million people have purchased DNA kits to trace their ancestral roots. One site claims it has helped 10,000 adoptees find their biological parents.

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“Before anyone takes one of these tests, they should think twice about what it could reveal.” — Dr. Michael Coble

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Criminal cases Joseph James DeAngelo never sent his DNA to an online genealogy service, but at least several of his relatives did. That proved to be his undoing. DeAngelo, a former police officer, now faces charges for crimes connected to California’s notorious Golden State Killer and is suspected in dozens of rapes and murders in the 1970s and 1980s. DeAngelo might have escaped arrest had it not been for a relative’s DNA that was stored in the public site GEDMatch. Finding the match was still a huge long shot. “It’s not like you get the name of the killer as a match,” Dr. Coble said. “This entails the building of a large family tree and then trying to find a list of men in that family tree who were the right age, at the right location, at about the right time of the crimes being committed.” The first candidate was not DeAngelo but instead a man who was retired and living in Oregon. A DNA test quickly ruled him out. But eventually investigators zeroed in on DeAngelo and collected a DNA sample that he unknowingly left in a public place. That sample was matched to evidence from multiple rapes and homicides. The case has focused a lot of attention on

The odds are better for the estimated 70 percent of Americans whose ancestors are from Europe. Someone whose ancestors are from Africa, Central and South America or Asia are likely to face a tougher time because of a limited number of people who are in the databases. The world has changed so much over the centuries that is makes it difficult to pinpoint where someone’s ancestors are from, Dr. Coble said. Migration in the last 100 years alone has added to the challenge of locating remote villages and small towns. “There once was a company that claimed they could identify which tribe your ancestors came from in Africa,” Dr. Coble said. “The unfortunate stain of slavery and the diaspora of tens of millions of individuals makes this claim a bit dubious. “If you’re hoping to discover exactly where you came from, well, that’s a little tenuous.”

Joseph James DeAngelo, who has been charged for crimes connected to California’s Golden State Killer, might have escaped justice except for the fact that a relative decided to take an in-home DNA test.

how DNA testing can be used to solve crimes. DNA can be stored indefinitely, which can raise privacy issues down the road. Individuals who store their DNA on GEDMatch are made aware that their genetic information could be used by law enforcement, Dr. Coble said. Doggy DNA DNA tests have found another commercial purpose: helping pets owners identify the breed of their dogs. Darlene is a fluffy, friendly black dog who was dumped at a mobile home park in Weatherford. When Jill Johnson adopted the pooch, she suspected she was a Labradoodle. DNA test results showed Darlene was a combination of American Staffordshire Terrier, poodle and cocker spaniel. “I was just dumbfounded by the results,” said Johnson, a UNTHSC photographer. “They just seemed way off.” What is true for humans is true for dogs, Dr. Coble said. DNA results are only as good as a company’s database. Companies with the largest databases can recognize more than 350 breeds, including wolves and coyotes. People should enter the world of DNA testing with their eyes wide open. “The real power of these tests lies in the ability to identify close relatives,” Dr. Coble said. “These DNA tests can end up telling you things you may have never wanted to know.”

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UNT HEALTH SCIENCE CENTER Dr. 56 Jeff Beeson on the UNTHSC campus

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Coming home to change health care By Alex Branch

Dr. Jeff Beeson has seen plenty of change at UNTHSC over the years. Now he is leading a transformation in patient care.

eff Beeson, DO, grew up with UNT Health Science Center. As a kid, he watched Fourth of July fireworks with his father Don, the school’s long-time police chief, from a rooftop when it was just a medical school. He set up street cones to mark the route of the Cowtown Marathon, founded by UNTHSC in 1979. As an adult, he earned his degree from the Texas College of Osteopathic Medicine. During that time, Dr. Beeson watched the campus grow from a fledging medical school to a thriving six-school Health Science Center that drives medical education and research in Fort Worth with a mindset of innovation. Today, Dr. Beeson is leading change on the campus he considers home. As Chief Medical Officer, he is guiding the transformation

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As a kid, Dr. Jeff Beeson, left, watched Fourth of July fireworks from this roof with his dad, Don Beeson, UNTHSC’s former police chief.

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of UNTHSC patient care delivery to an interprofessional, patient-centered model with better outcomes. “In our country, health care delivery has been a model that is most convenient for the provider,” Dr. Beeson said. “It is not what is necessarily most beneficial to patients. We are creating a medical team that focuses on addressing the specific health needs of every patient.” It’s an innovative change, but Dr. Beeson is accustomed to change. He has worked as an emergency medical technician, a paramedic, a registered nurse, a flight nurse, an emergency room physician and member of a FEMA Urban Search and Rescue Team. He oversaw innovative projects as Medical Director at MedStar Mobile Healthcare and directed a medical command center for a Dallas health care

company that provided cutting-edge mobile care. “Everything I have done was as part of a team — on ambulances, in emergency rooms or on search and rescue,” Dr. Beeson said. “We have a great team to meet our goal at the Health Science Center.” Innovative learning labs UNTHSC is known as a premier postgraduate medical education institution in North Texas. Perhaps less recognized is the high-quality clinical care it has long provided. UNT Health, the university’s clinical arm, operates clinics serving family medicine, pediatrics, osteopathic manipulative medicine, cardiology, dermatology, gastroenterology, allergy, geriatrics and vascular surgery. The clinics have about 120,000 patient interactions a year.


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"We are creating a medical team that focuses on addressing the specific health needs of every patient.” The primary clinic is the Health Pavilion, a six-story facility on campus. UNT Health also operates a clinic in south Fort Worth that provides care in an underserved neighborhood. What sets UNT Health apart from other medical practices is that it leverages the strengths of a health science center and collaborates with UNTHSC schools, colleges and institutes to transform lives, said Provost Charles Taylor, PharmD. Its health care providers also are faculty, who balance time between teaching, research, and improving health and promoting wellness. Providing patient care on the campus of a medical education institution has advantages. For example, UNT Health providers have access to SaferCare Texas, an institute focused on reducing medical errors and preventable harm to patients, and the Office of Interprofessional Education and Practice, which prepares students from different disciplines to provide quality care to individuals and families as a team. Providers practicing in the Health Pavilion share space with the Institute of Translational Research, where UNTHSC researchers focus on translating basic science into new treatments and diagnostics for patients faster than ever before. UNTHSC clinics are innovative learning laboratories for talented students, who perfect their craft alongside faculty health practitioners who are teachers and mentors. “We have all the resources we need to provide innovative, forward-thinking health care that’s high quality, affordable and that offers an excellent patient experience,” Dr. Taylor said. “Now is our opportunity to look under the hood, so to speak, and make sure we tie it all together.”

Patients’ best interests Patient-centered health care sounds great. But what does it really mean? Imagine you have diabetes, Dr. Beeson said. It’s a disease with a lot of secondary effects, impacting your kidneys, heart, eyes and more. In a traditional provider-centered delivery model, you go see your familymedicine physician. He or she may prescribe medication but also refer you to a specialist, such as a cardiologist, optometrist or dietician. Sometimes your doctor wants you to see several specialists. “Soon you are being sent to all these different places for different doctors,” Dr. Beeson said. “It’s neither convenient nor in your best health interests.” However, in a patient-centered delivery model, you come see your family physician at the UNTHSC Health Pavilion. Your physician wants you to see a specialist, but all the specialists — physician assistants, physical therapists, pharmacists and more — are right there

— Dr. Jeff Beeson

Physician Assistant Monica Summerhill cuts the ribbon at the opening of the Priority Care Clinic in the Health Pavilion, aided by Dr. Beeson and HSC President Michael Williams.

Schedule an appointment: • See one of our UNT Health providers by calling 817-735-DOCS

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working alongside your doctor. “Instead of sending you to all these people, we are sending people to you,” Dr. Beeson said. “If the physician needs input from a pharmacist, a pharmacist is right down the hall who could say, ‘You know, there may be a better medication for this patient.’ “Now that’s a health-care delivery model that is truly in the best interests of the patient.”

TCOM student Chelsee Greer watches as Dr. David Mason treats patient Georgia Roberts.

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‘I look forward to it’ Patients and their families benefiting from patient-centered care at UNT Health agree. Carole Young brought her mother, Barbara Brown, to the Health Pavilion in January to meet with a team of UNTHSC geriatric experts — Physician

Sarah Ross, DO, Neuropsychologist April Wiechmann, PhD, Medical Social Worker Natasha Bahr, LMSW, and Pharmacist Shara Elrod, PharmD. They sat together at a table as part of the unique UNTHSC Geriatric Assessment and Planning Program (GAAP) intended to improve the physical and mental function of older patients. Brown is in the early stages of Alzheimer’s disease. For 45 minutes, the group discussed results from a neurocognitive exam, her prescriptions and community organizations that could help the family. “It’s not something you experience very often in health care,” Young said. “Everyone sits down together, completely focused on helping Mom and all her specific needs. I look forward to it every time.”


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Carole Young, center left, and her mother, Barbara Brown, seated on her right, discuss her mother’s treatment with a group of UNTHSC geriatrics experts.

Transformation continues On his way into work each morning, Dr. Beeson sees change that already has made the Health Pavilion a better patient experience. The patient waiting rooms were renovated. The first-floor lobby now includes flat-screen TVs. A new call center was created to handle patients’ needs, and private rooms for health coaching were added. A new Priority Care Clinic on the third floor provides same-day urgent care for UNTHSC team members and their families, and helps arrange follow-up care. UNTHSC also has partnered with Catalyst Health Network, an independent accountable care organization, to help manage patient populations and improve outcomes. It’s a far different environment than when Dr. Beeson watched fireworks from the roof. “It’s an exciting time,” he said. “We have the potential to become a model for the way health care should be delivered in Fort Worth.”

‘A better patient experience’ Changes in the Health Pavilion include: • Renovated waiting rooms • A new and improved call center • Private rooms for health coaching • Large-screen TVs in the lobby area • New Priority Care Clinic to provide same-day urgent care for UNTHSC team members and their families

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A generous boost to dementia research Dr. Sid O’Bryant will hold endowed chair established by Schooler gift By Alex Branch

Dr. Sid O’Bryant is Director of the Institute for Translational Research.

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generous estate gift from a longtime community volunteer whose family was impacted by dementia will establish a $3 million endowed chair to support groundbreaking research into Alzheimer’s disease and other translational research projects at UNT Health Science Center. Sid O’Bryant, PhD, Professor and

Director of the Institute for Translational Research, will hold the Dr. Joe and Peggy Schooler Endowed Chair in Pharmacology and Neuroscience. Two endowed scholarships also will be created through the estate gift. The endowment will support the University and Dr. O’Bryant, who is


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working to develop a blood test to detect Alzheimer’s disease within a primary care setting. His work is the first-ever study of a blood-screening test for biomarkers to be used with primary care patients. “The endowment from Dr. Joe and Peggy Schooler is of tremendous importance to the advancement of translational research at UNTHSC, which is geared to improving the lives of patients suffering from neurodegenerative diseases,” Dr. O’Bryant said. “This endowment will help support the ongoing research as well as pave the way for new

to the Alzheimer’s Association. For most patients, the blood test could be done in their doctor’s office and provide relief from the fear of having Alzheimer’s. For those whose results are positive, there would be the benefit of early detection and treatment planning. Dr. O’Bryant also oversees one of the largest and most comprehensive studies ever conducted in the United States focused on Mexican-Americans and dementia. This five-year study began in 2017 and is funded by a $12 million grant from the National Institutes of Health.

Support UNTHSC • Call 817-735-2018 or visit unthsc.edu/giving to learn more

“I am humbled by the family’s generosity and proud to join them in the fight against these terrible brain diseases.” — Dr. Sid O'Bryant lines of work to be conducted. “I am humbled by the family’s generosity and proud to join them in the fight against these terrible brain diseases.” The Institute of Translational Research was recently established under Dr. O’Bryant’s leadership to translate basic science into treatments and new procedures for Alzheimer’s and other diseases, and to reduce the time it takes for patients to experience the benefits. The University was honored that Mrs. Schooler entrusted it with the gift, said Charles Taylor, PharmD, Provost and Executive Vice President of Academic Affairs. “We are excited for Dr. O’Bryant to lead us in this new strategic direction and know he will be a tremendous steward of this substantial gift,” Dr. Taylor said. “We have a wonderful platform for our team of scientists to gain new knowledge and translate those discoveries to directly improve the lives of patients.” The blood test Dr. O’Bryant is pursing could be a game-changer for the diagnosis and treatment of Alzheimer’s, which afflicts 5.7 million Americans, according

Mrs. Schooler was married for 24 years to Dr. Joe F. Schooler Jr., a physician who opened a private practice in Fort Worth in 1963. Dr. Schooler died in 2008. Mrs. Schooler was an active community volunteer. She scheduled drivers for her Woodhaven neighborhood’s Citizens on Patrol group and, even at age 82, helped the Fort Worth Police Department by portraying a witness or “walking wounded’ victim during officer training scenarios. Her interest in Alzheimer’s and dementia was personal. She cared for her mother, who suffered from dementia, and spoke about how difficult it was to experience how it impacted her mother. Mrs. Schooler died in September 2017. Her generosity in establishing the planned gift to support scientific research at UNTHSC was no surprise to people who knew her. “Peggy was the most generous person I have ever known,” family friend Rick Disney said. “I know of at least two people Peggy helped out financially when they had tough times due to medical issues. We lost a great friend with her passing.”

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The globe-trotting Migala brothers don’t often find themselves in the same place. When they do, as they did here in 2009, Withold, Henri and Alexandre, from left, have interesting stories to tell.

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magine a movie about the Migala brothers, and it looks like scenes from “Indiana Jones,” “Contagion” and “Hacksaw Ridge” spliced together. Alexandre Migala, DO, a Kung Fu first-degree black belt, hears bullets plinking against his armored car in Sarajevo while treating the wounded during the Bosnian war. Witold Migala, PhD, MPH, backpack full of vaccines, traipses through remote clay-hut villages in Nigeria, hunting viruses mostly eradicated in the Western world. Henri Migala, EdD, MPH, encounters steely-eyed child soldiers with AK-47s at roadside checkpoints while building a support system for children with AIDS in Uganda. The three UNT Health Science Center alumni could fill a Hollywood screenwrit-

er’s notebook with their adventures improving third-world public health systems, responding to disasters and conflicts, and helping make the world a safer place. “No, not many boring stories get told when the family gets together,” Alexandre said. Alexandre earned his degree from the Texas College of Osteopathic Medicine (TCOM) and has mentored students as a preceptor. Witold and Henri were in the first UNTHSC class to earn master of public health degrees, and both served on committees to create the School of Public Health. Witold went on to be in the first public health PhD cohort to graduate from UNTHSC. The brothers attribute their sense of service to international experiences during childhood and UNTHSC’s emphasis on


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helping underserved populations. “There are a number of great quotes out there about how travel makes one more sympathetic to the human condition,” said Witold, Associate Professor and Program Director in the Department of Biostatistics and Epidemiology. “I think we all realized early on that so many people around the world need help.”

Alexandre Migala treated injured international peacekeepers during the Bosnia war in the 1990s.

A family resilience Like any great adventure movie, the story of the Migala brothers would have a prequel. It would be about their parents, Marian and Anne. Marian was a Polish resistance fighter against the Nazis during World War II. After Germany lost and the Soviets assumed power, he resisted Communist rule until fleeing to Paris. There, he discovered widespread poverty. But he met Anne, who had aided the resistance movement by hiding and transporting soldiers and Jewish refugees on her family farm. Marian and Anne married and had three kids — sons Witold and Henri, and a daughter Therese. Marian learned French and put himself through architecture school. In the 1960s, he immigrated his family to the United States, though he spoke no English. He learned his third language and got a job designing military bases for the Army and Air Force Exchange Service. Marian and Anne had two more sons — Arthur and Alexandre. Military projects moved the family of seven around the world, from Thailand to Germany, before settling in Texas. The fearlessness and resilience of Marian and Anne was not lost on their children.

Some German children had trespassed onto the military base and were severely injured in a blast. Alexandre, just one year out of TCOM, treaded gingerly around the copper casings of aging 40 mm grenades. The first Migala brother to attend UNTHSC, Alexandre arrived at the Fort Worth medical school almost by accident. While studying medieval renaissance history at the University of Texas at Arlington, he went to a student Biological Society meeting, mostly because he heard there would be free sandwiches. He signed an attendance form, which found its way to TCOM. Soon he got a letter from the medical school inviting him to visit. “I figured, ‘Why not?’” Alexandre said. “I went to campus and was immediately

From surgeon to special forces In an old Nazi tank base near the Bavarian Alps, Dr. Alexandre Migala crept up a grassy slope littered with hidden explosives.

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or treated 2,173 refugees and American expats while civil war raged outside the U.S. embassy. Today, Alexandre is Medical Director at the Texas Health Emergency Room in North Richland Hills, and a Colonel in the U.S. Army Reserve as the Command Surgeon for the 84th Training Command. “I can honestly say I was never afraid to die; only to fail those whom I was sworn to care for,” Alexandre said. “Because during a mission, your world shrinks down to one goal: treating the life right in front you. Otherwise, you are of no use to anyone.”

Henri Migala worked in a program in South Africa that helped mothers with HIV stay alive and healthy.

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blown away by the care and focus the faculty put into helping students succeed.” He earned a U.S. Army scholarship and did training rotations with military doctors. After graduation in 1993, one of those doctor connected him to a U.S. Army Special Forces unit that needed a new surgeon. Less than a month after Alexandre joined his unit, he found himself participating in the minefield rescue in the Alps. Afterward, the Chief of Staff for the European Command presented Alexandre a medal. “The Special Forces guys walked up and said, ‘You’re one of us now,” Alexandre said. “I had proven I was willing to put my life on the line, and that’s what these guys do every day.” In Bosnia, Alexandre treated injured international peacekeepers in a clinic set up in a shipping container. In Liberia, he and other medical personnel evacuated

Disease and danger Only a lengthy montage could convey Witold’s and Henri’s public health service. Between them, they have helped the U.S. Centers for Disease Control and Prevention, World Health Organization and United Nations establish vaccination campaigns to eradicate polio in Madagascar, Haiti, Nepal and Nigeria. Witold has taken on other infectious disease initiatives, involving cholera, typhoid and guinea worm outbreaks. Henri has joined humanitarian aid activities on food security, water and sanitation, HIV/AIDS, and disaster relief in 18 countries. Crowded bus rides, exotic foods and occasional dangers fill their storyline. “I worry mostly about two things when I’m in remote areas of developing countries: children with guns and drug-resistant diseases – especially tuberculosis,” said Henri, now Director of the University of California San Diego International House. In Nepal, a translator was fixed to Henri’s side, whispering translations in his ear. Soon after, Henri received an email from headquarters saying his translator was coughing up blood and pieces of lung. Henri tested positive for TB. It took nine months of daily medication to cure him. Witold served 10 years as chief


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recalled. “It has been over 10 years and his image, the sound of his hollow voice, are still so crystal clear.”

Marian Migala, patriarch of the Migala clan, fought the Nazis as a Polish resistance fighter and eventually came to the United States to forge a new life.

A lasting impact Every morning a 90-year-old man wakes up and dresses faithfully in suspenders and a bolo tie. Marian Migala, the family patriarch, lives in a Dallas suburb. Anne died in 2010. More than a half century ago, Marian brought his family to America, and he is proud his children succeeded. His daughter, Therese Migala Moncrief is a Fort Worth community leader, philanthropist and filmmaker. The fourth son, Arthur Migala, is a college mathematics professor. During the holidays, Witold surprised Alexandre and Henri with a framed photo of a single brick donated to support renovation of Alumni Plaza at UNTHSC. Inscribed on it are the brothers’ names and graduation dates, the closing credits to this story about three men who have made a lasting impact on the world.

Withold Migala organized a polio vaccination campaign in northern Nigeria in 2012.

epidemiologist for the city of Fort Worth. After 9/11, he was appointed Executive Director of the city’s bioterrorism program and led the crafting of the city’s response plan to a bioweapons attack, including developing plans for mass emergency vaccination campaigns. That expertise came in handy in 2012, when he was part of a CDC/WHO mission to establish polio vaccination coverage in Nigeria. In three months, Witold organized two campaigns that resulted in the vaccination of nearly 3 million children. Obstacles on these missions abound. Electricity is spotty, roads are rugged and rural areas may have no currency. Earning the trust of locals is notoriously difficult. “Some of the obstacles are rooted in Western arrogance,” Witold said. “Vaccination teams used to set up clinics without consulting local leaders or health practitioners. The locals, feeling slighted, would start rumors that vaccinations will give the boys AIDS and make girls infertile. “Now the first thing we do is meet with the village elders and traditional healers. We tell them we have good medicine, but it will only work if we have their medicine too. And, without fail, we garner their support. It’s simply a matter of respect and validation.” Humanitarian work exposes the Migalas to profound poverty and unspeakable tragedy. In 2004, Henri arrived in Sri Lanka with an emergency response team just four days after an enormous tsunami crashed ashore. Henri was assigned to a village where 1,600 died. One traumatized father told him that after the first wave, he clung to a rock with his screaming 2-year-old on his back. But a second bigger wave struck and washed the boy away. “The depth and despair of this man’s emotion was unforgettable,” Henri

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The Faces of HSC T

he students who make their way to the UNT Health Science Center campus come from an astonishing variety of places and from a dizzying range of backgrounds. For many, Fort Worth is a long way from home. And for all, the Health Science Center offers an experience like no other they’ve ever known. We caught up with a sampling of our students and asked them the question, “What does UNTHSC mean to you?”

HSC is a place I can be accepted as me. A place where I can achieve my biggest dream. HSC is my new family.”

HSC is the place I call home. Where classmates have become family and a place that I can achieve my dreams.”

Sharanya Ajakumar

Anisha Mahajan

Victoria Taskov

TCOM

TCOM

TCOM

HSC is a place where I can follow my dreams and build a future surrounded by some of the greatest people.” Sumera Hussain TCOM 70

HSC is a place where everyone always pushes you to be the best possible version of yourself.”

UNT HEALTH SCIENCE CENTER


SOLUTIONS

short takes

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SOLUTIONS

faces of HSC

Great vibe. Great place with great people.” Marc Esquivel College of Pharmacy

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UNT HEALTH SCIENCE CENTER


faces of HSC

SOLUTIONS

A great school for opportunity. A school filled with smart professors who want the best out of you.” David Brefo Physical Therapy

Today's physicians can always use more compassion and love for their patients, and the HSC embodies these values in all that it does.” Kevin Honan TCOM

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faces of HSC

SOLUTIONS

HSC is a platform to pursue my dream, which is helping others through the power of medicine.” Maryam Burney TCOM

The place where people from all walks of life come to learn how to help others.” Zachary Sumner TCOM

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SOLUTIONS

faces of HSC

HSC allows me to work with other health professionals like I will in the future. It provides me with all the tools and resources to excel in the present, but also in the future.� Kiran Khanani College of Pharmacy

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YOUR PROVIDER OF THE FUTURE

Sean Jamieson

Physician Assistant 2020 u n t h s c . e d u /S e a n

Profile for UNT Health Science Center

Solutions Spring 2019  

Solutions Spring 2019  

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