Division Chair: Jane Potter, M.D.
Number of people in the division:
- UNMC employees: 8 faculty + 1 fellow + 14 staff = 23 total
- UNMC Physicians employees: 6 staff
New Faculty:
- Elizabeth Harlow, M.D., assistant professor, specializes in outpatient clinic and medical home model. Started November 2012
New Programs:
- REACH – REACH Out Primary Care Program (Resources for Enhancing Alzheimer’s Caregiver Health: Offering Useful Treatment) — is a pilot study funded by the UNMC College of Public Health Dean’s Pilot Grant Program. The primary purpose of the study is a multicomponent intervention among family caregivers of persons with Alzheimer’s disease or related disorders. This intervention seeks to increase caregiver knowledge, skills, and well-being, while enhancing support to caregivers and finding new ways of helping. REACH-Out Primary Care is a 16-week intervention which involves both group and individual sessions. Sessions are held every three weeks and individual sessions scheduled in the same week. Caregivers will be eligible for subsidies to provide respite during their participation. Research data will be collected and analyzed to improve the quality of life for an Alzheimer’s caregiver at a larger scale in the future.
- Exercise is Medicine® – In 2007, the American College of Sports Medicine teamed up with the American Medical Association to launch a national initiative known as Exercise is Medicine®. The overarching goal of this initiative is for health care providers to treat exercise as a “vital sign” by making assessment of physical activity level a standard part of every patient’s office visit. With this in mind, the plan is for health care providers to counsel patients regarding physical activity, based on their activity level and health concerns, or refer them to a fitness professional for an exercise prescription. In response to this initiative, UNMC’s EngAge Wellness developed an Exercise is Medicine® provider referral program. Patient’s referred to EngAge Wellness receive a functional fitness assessment, balance assessment, individualized fitness program (designed by an exercise science degreed professional), and a free two-week participation in the EngAge Wellness program. In addition, the referring provider will receive feedback regarding their patient’s progress.
- Patient Centered Medical Home – The Geriatric Medicine Clinic is a patient centered medical home (PCMC) and has been team based for more than 20 years. This approach emphasizes coordination of care, quality and patient safety, as well as ease of access. To strengthen teamwork, all staff members are trained in Team STEPPS (Strategies and Tools to Enhance Performance and Patient Safety).
Nurse practitioners, pharmacists, social workers, RN educators/case managers, and medical assistants work together with physicians to deliver patient care. Within the Home Instead Center for Successful Aging, we also work closely with physical therapists and exercise and wellness specialists at the EngAge Wellness Center. Patients and often family caregivers are central members of the team. Patients work closely with their primary physician and health care team to identify goals, potential barriers and the tools and resources needed to achieve those goals.
Significant Grants:
- NIH/NIA – “Modifying Age-Related Changes in Mouse Neuroinflammation & Functional Behaviors.”
Principal Investigator: Stephen Bonasera, M.D., Ph.D.
Dr. Bonasera’s laboratory is focused on the neurobiology of normal aging. With funding support from NIH grant AG031158, we have found a potential pattern of regional brain gene expression associated with functional losses, such as diminished mobility or weight loss. If a mouse has an age-related problem with a specific behavior, we see this pattern of gene expression occur in the brain region that regulates this behavior. The molecules involved in this pattern have been previously described to have immune functions, but in the aging brain, these molecules do not localize to immune cells. Rather, dysregulation of these molecules appears to impair the organization of synapses. This synaptic dysfunction in turn impairs normal brain neurotransmission, leading to behavioral deficits. Our future work is directed toward understanding the specific molecular pathways involved in this process, with the hope that we can identify target molecules for therapy to slow or prevent functional losses.
- Alzheimer’s Association – “Multimodal Monitoring of Functional Status in Moderate Alzheimer’s Disease.”
Principal Investigator: Stephen Bonasera, M.D., Ph.D.
To translate these findings to clinical populations, we first must develop an accurate way to measure an individual’s functional status over long observation periods in a minimally invasive manner. In work supported by the Alzheimer’s Association, we have found that smartphones can be ideal devices to accomplish this task. We have repurposed cell phones to measure an individual’s day-to-day activity, as well as determine where this activity occurs within the home and community. Our validation studies suggest that this approach far surpasses the accuracy obtained through standard questionnaires and physical assessments, while being easy for individuals to complete.
- Donald W. Reynolds Foundation – “Next Steps in Physicians’ Training in Geriatrics.”
Principal Investigator: Jane Potter, M.D.
This grant focuses on improving the ability of physicians to work with other disciplines in teams, targeting medical students, residents, geriatrics fellows, faculty and inter-professional teams including a “medical home.” Inter-professional training activities are organized around geriatrics content that is of interest to the providers. This project aims to produce exportable products for use by other health professions training centers who share the goal of interdisciplinary team training in geriatrics.
Other Highlights:
Teaching Awards –
- Ed Vandenberg, M.D. — Outstanding Teaching and Instructional Creativity Award (OTICA). A UNMC faculty member since 1998, Dr. Vandenberg has earned a reputation for his commitment to working across disciplines to improve curricula, particularly in the area of geriatrics. He was cited for his work in assisting students as they transition from medical school to residency. While serious about teaching, Dr. Vandenberg doesn’t hesitate to incorporate humor into his lectures – his lecture on falls among the elderly, which he delivers in full knight’s armor, is famous among students. His “GERI Pearls” – brief summaries on various geriatric topics – also have become legendary on campus.
- Bill Lyons, M.D. — Outstanding Teacher of the Year Award. He was honored for his outstanding work in directing learning, advising students, and facilitating human relations.
Recent faculty publications:
- Lyons WL. Back Pain, (Chapter editor), Geriatrics Review Syllabus, 8th ed., Audio Companion, Birmingham, AL: Oakstone Medical Publishing for American Geriatrics Society, in press 2013.
- Ham RJ, Sloane PD, Warshaw GA, Potter JF, Flaherty E, eds. Ham's Primary Care Geriatrics: A Case Based Approach , 6th Edition, Mosby/Elsevier, Philadelphia, PA, 2013.
- Balas MC, Bonasera SJ, Cohen MZ, Hertzog M, Sisson JH, Potter JF, Fitch A, Burke WJ. A novel approach of measuring functional recovery in older survivors of critical care: The mobile monitoring procedure. J Appl Gerontol, in press.
- Parkison S, Carlson J, Chaudoin TR, Hoke TA, Schenk AK, Goulding EH, Pérez LC, Bonasera SJ. A low cost, reliable, high-throughput system for rodent behavioral phenotyping in a home cage environment. IEEE Eng Med Biol August; 2392-2395, 2012.
- Balas, Michele C., Stephen J. Bonasera, Marlene Z. Cohen, Melody Hertzog, Joseph H. Sisson, Jane F. Potter, Abby Fitch, and William J. Burke. "Measuring Functional Recovery in Older Patients Discharged From Intensive Care Units Is Advanced Technology an Option?" Journal of Applied Gerontology (2013).