Inside Duke Medicine - January 2009 (vol. 18 No. 1)

VOLUME 18 NO. 1 n inside.dukemedicine.org n January 2009

photo by bill stagg

Woodard receives 2008 Clark Award A 24-year employee who daily lives Duke Medicine’s commitment to Durham and the larger community received the Susan B. Clark Administrative Leadership Award.

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Benefits A new section of news you can use debuts, beginning on Page 5

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n this issue, a new quarterly section premieres. “Benefits” provides the latest information on how to get the most out of your Duke benefits. The four-page section starts on Page 5.

Sarah Woodard, administrative coordinator in the office of Steve Smith, the chief human resources officer of Duke University Health System, accepted the award during a special luncheon held on Dec. 18. “I truly feel honored, because Susan was a friend and colleague for so many years,” said Woodard, who lives in Durham with her husband, Mike, who is also a Duke employee. “Susan had so many beautiful qualities that I aspire to.” Victor J. Dzau, M.D., chancellor of health affairs and CEO of Duke University Health System, hosted the awards luncheon. The award was first given in 2007. It commemorates Clark’s remarkable 33-year Duke career and is among the top honors given to DUHS employees. Woodard was nominated by Starr Browning, the executive director of Duke HomeCare & Hospice, where Woodard is an active and long-time volunteer who has helped families cope with the end of life. Browning also noted that Woodard is an extraordinarily active volunteer, from her work with Duke University Hospital’s annual Asthma Walk to work with the Duke-Durham Campaign, Durham Sister Cities, Mallarme Chamber Players, N.C. Jaycees AIDS Hospital, the Junior League of Durham and Orange Counties, and her church. Woodard’s volunteer work, Browning wrote, “exemplifies the best of community service and sends a message to her community that Duke Medicine is truly extraordinary because extraordinary Duke Medicine staff like Sarah care enough to make a difference.” n

calendar

inquiry

on the web

King Day activities

Engineering repair

Make your comment

A calendar of selected Duke Medicine events surrounding Dr. Martin Luther King Jr. Day. Also find online links to more activities.

Duke scientists are working on therapies in which stem cells create new tissue inside the body.

Inside Online has been taking reader comments. Read what others have shared and learn how to leave your own perspective.

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January 2009

c o mm u n i t y

g o o d i de a s

Duke, Durham County make commitment to patients

PowerPoint’s privacy pitfalls

Duke Medicine News & Communications

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n November, the Durham County Board of Commissioners approved an amendment to the lease between the Durham County Hospital Corporation (DCHC) and Duke University Health System (DUHS) for Durham Regional Hospital that calls for an extension of the original 1998 lease term from 20 years to an annually renewable 40-year term. This amendment took effect Jan. 1, and extends the horizon of Duke’s commitment to the citizens of Durham County for the foreseeable future. “This lease amendment is important to Durham for many reasons,” said Ellen Reckhow, chair of the Durham County Board of Commissioners. “It not only ensures the long term success of Durham Regional as a leading community hospital, but also reflects a commitment and conviction by the County and DUHS to increase the support and funding of Lincoln Community Health Center and Durham County Emergency Medical Services.” Victor J. Dzau, M.D., chancellor for health affairs and CEO of Duke University Health System said the health system is committed to the long-term health of the citizens of Durham and that lease amendment will enable Duke to provide them the very best in health services well into the future. “I want to especially commend the county commissioners for their forward-thinking action on behalf of the citizens of Durham County and its surrounding communities,” Dzau said. “Over the past 10 years, working closely with DCHC, we have invested nearly $80 million in capital improvements to Durham Regional, and as part of the lease agreement have made very significant contributions to Lincoln Community Health Center and Durham County Emergency Medical Services.” Recent capital investments in Durham Regional Hospital have supported the creation of a state-of-thescience, 22-bed intensive care unit that opened in August, and a hospital-based outpatient clinic to house the Duke

During the past decade, presentations of all types have rapidly moved from traditional hard-copy slides to digital presentations. In the medical field in general, and in the imaging fields in particular, film-based slides have largely been abandoned in favor of electronic presentations. While convenient and effective for presentations, digital images in PowerPoint presentations can cause security issues. Online or other distributions of PowerPoint presentations that contain diagnostic images often contain protected health information, or PHI.

Duke Medicine and Durham County have agreed to extend the lease on Durham Regional Hospital from 20 years to a 40-year term, renewable annually, that extends Duke’s commitment for the foreseeable future. file photo

is intended to recognize hospitals that provide the highest level of nursing care. “We are committed to strategically growing programs that serve the citizens of Durham County both now and over the long-term,” Dzau said. “Our goal is to see Durham Regional Hospital become “We are committed to strategically growing recognized widely as a model for innovative programs that serve the citizens of Durham services and technology County both now and over the long-term.“ in a community hospital setting that brings together the best in community-based diagnostic imaging equipment, and physicians and clinical faculty from a install a new pharmacy supply system. renowned academic medical center.” n Other longer-range capital projects include renovating the women’s services unit and expanding and renovating the DRH and Inside Online Emergency Department. Recent Durham Regional The lease amendment paves the way Hospital headlines from for longer-term investments by DUHS Inside Online: with the goal of establishing Durham DRH gets outpatient Regional Hospital as the premier weightloss clinic community hospital in North Carolina. The lease extension announcement Durham Regional gets comes one week after Durham Regional Magnet designation Hospital announced it had achieved Gullie receives Friends of Magnet designation for excellence Nursing Award in nursing by the American Nurse’s Find the latest DRH news at: Credentialing Center (ANCC). Only http://inside.dukemedicine.org five percent of the nation’s hospitals have earned Magnet designation, which

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PHI includes any individually identifiable health information related to the health or condition of a person, and it must be protected.

Center for Metabolic & Weight Loss Surgery. In the next year, or so, there are planned investments of many millions of dollars to replace a cardiac catheterization lab, renovate triage rooms for the hospital’s obstetrics unit, upgrade

Inside Duke Medicine, the employee newspaper for the Duke University Health System, is published monthly by Duke Medicine News & Communications. Your comments, story ideas and photo contributions are always welcome and appreciated. Deadline for submissions is the second Friday of each month.

TIP: To maintain control of medical images, convert PowerPoint slideshows to PDF documents.

When diagnostic images are copied or inserted into the PowerPoint slide, PHI is then cropped “off the slide” and is not seen when the slide is projected. However, anyone with access to the PowerPoint file can reverse these steps and uncover the hidden PHI, resulting in an unauthorized disclosure. Such disclosures are against Duke Policy and the HIPAA Privacy Rule. Duke Health Technology Solution’s recommendation is to convert all existing PowerPoint presentations on the Web to PDF (Portable Document Format) files. PDF files are the only files that should be available for Web presentation and download, as opposed to offering PowerPoint. Once a file is converted into PDF, those having access to view the presentation will not be able to manipulate any of the images to reveal ‘hidden’ PHI. For more information contact the Information Security Office at http:// www.iso.duke.edu

Contact us Campus mail: DUMC 104030 Deliveries: 2200 W. Main St., Suite 910-B, Durham, NC 27705 Phone: 919.660.1318 E-mail: [email protected] Credits Cartoon: Josh Taylor

Staff Editor: Anton Zuiker Managing Editor: Mark Schreiner Science Editor: Kelly Malcom Designer: Vanessa DeJongh Inside Online Editors: Bill Stagg and Erin Pratt Copyright © 2008 Duke University Health System

Inside Duke Medicine

January 2009

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CAL E N D AR

January

Your insider's guide to what's happening at Duke Medicine

Events honoring Dr. King Jan. 13 12:30-1:30 p.m. William J. Fulkerson, M.D., presents the first Dr. Martin Luther King, Jr. Community Caregiver Award at Duke Hospital. Searle Center Lecture Hall. Lunch will be served. Seating is limited, and registration is required. ActiveStaffer Course Registration Number: EDS316 Jan. 14 3-4 p.m. “The Secret Game” Video and Discussion. In the 1940s, a secret basketball game was played between the students at what was then called N.C. College for Negroes (now N.C. Central University) and a team of students from Duke’s Medical School. The lessons learned during the game changed the players’ lives forever. Video encourages viewers to ponder topics related to teamwork and diversity. The session will include opportunities to watch and discuss this touching, true story. 2002 Duke North Lecture Hall. ActiveStaffer Course Registration Number: EDS317 Other showings: Jan. 16: 9-10 a.m. Duke North Lecture Hall. ActiveStaffer Course Registration Number: EDS319 Jan. 22: 12-1 p.m. Durham Regional Hospital’s First Level Classroom. Free admission and parking. Details: 470-4278. Jan. 23: 12-3 p.m. The film will run continuously (approximately every 20 minutes). Durham Regional Hospital’s First Level Classroom.

Rev. Martin Luther King, Jr., Ph.D. Photo courtesy wikipedia commons

give Feb. 28 6 p.m.-12 a.m. 2nd Annual Blue Jean Ball benefiting Duke OB/GYN Global Health. The evening begins with a silent auction open to the public. Dinner and dancing starts at 9 p.m. Tickets are $100 each. Hilton on Hillsborough Road in Durham. Details: 660-2378

learn Jan. 7 5:30-7 p.m. Changing from Within: Mindful Eating Level I. Join practitioners at Duke Integrative Medicine for an eightsession course on this innovative approach to weight loss. When you bring close attention to your mind, body and behaviors, you begin to observe the subtle-

ties of your eating patterns. The information, skills training, and group support of this program will guide you in making lifestyle changes that will help you respond in a healthier way, resulting in a healthy weight that you can maintain over time. Duke Integrative Medicine, Center for Living Campus. Details: 684-9901 Jan. 14 4:30-6 p.m. University Seminar on Global Health with Daniel Schmitt, associate professor and Chair of the Department of Evolutionary Anthropology at Duke University. Schmitt is an evolutionary anthropologist with a primary interest in the way primates (including humans) control loading patterns on their skeletal system. He will discuss “Evolution, Obesity, and Arthritis: Understanding Human Health from an Evolutionary Perspective.” The event is free, but registration is appreciated. John Hope Franklin Center. Free parking is available across the street in the Pickens Clinic

Jan. 15 12:30-1:30 p.m. Lecture by J. Kameron Carter, Ph.D., associate professor in theology and black church studies at the Duke Divinity School. Searle Center Lecture Hall. There will also be an original play by students from Hillside High School’s awardwinning drama program. Lunch will be served. Seating is limited, and registration is required. ActiveStaffer Course Registration Number: EDS318

lot. Light refreshments will be served. Register: http:// globalhealth.duke.edu/news-events/calendar/

do Jan. 18 12-4 p.m. Family Free Day at the Nasher Museum of Art. Celebrate “Escultura Social: A New Generation of Art from Mexico City” with live entertainment, hands-on projects and gallery hunts. Limited, free tickets available at the door only. Details: 684-3314 Jan. 22 4:30-5 p.m. School of Nursing Annual Global Health Lecture. Sir George Alleyne, a distinguished leader in health from Barbados, will discuss the changing nature of health problems in the world today, the fundamental differences between international health and global

Jan. 20 5 p.m. Candlelight Vigil at Durham Regional Hospital’s main lobby. A reflection and tribute to MLK. Open to the public. Free admission and parking. Details: 470-4278 Jan. 21 8:30-9:30 a.m. Prayer Breakfast. “The Dream is Still Alive” with speaker Charles Johnson, M.D., the first African American on faculty at Duke University Medical Center. Durham Regional Hospital Auditorium. Free admission and parking. Details: 470-4278 Jan. 21 12-1 p.m. Diversity Matters Lunch & Learn, a panel discussion about diversity led by Judy Seidenstein, Duke Office of Institutional Equity. Durham Regional Hospital’s First Level Classroom. Free admission and parking. Details: 470-4278 Jan. 21 5-10 p.m. MLK Million Meals Service. Join in celebrating the legacy of Dr. Martin Luther King, Jr. by assembling meals to be sent to people suffering from severe hunger around the world. First Shift: 5:30-7:30 p.m.; Second Shift: 8-10 p.m. Transportation will be provided. Meet in front of the bus stop near the Chapel, West Campus. Event location: NCCU Walker Complex, 1801 Fayetteville St., Durham. Details: 684-4377 Jan. 23 7 p.m. Musical Extravaganza Celebration of MLK Performances by the DRH Choir and community talent. Durham Regional Hospital’s Auditorium. Free admission and parking. Details: 470-4278 More Events See a full listing of university-wide MLK events at: http:// mlk.duke.edu/ For more information, call 681-3149.

health, and the ongoing need for partnerships to bring many disciplines to bear on reducing health disparities in his presentation. School of Nursing. Details: 684-9320

How to submit: Send calendar listings to [email protected]

Want more info? Duke Health events: http://www.dukehealth.org Duke University events: http://calendar.duke.edu

Inside Duke Medicine

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January 2009

BULL E TINS

AT A GLANC E

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The best strategy in life is diligence.

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— Chinese proverb

■■INSIDE JOKE

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9 The number of years running that Triangle residents have rated Duke University Medical Center the best-quality hospital in the Durham area, earning Duke a 2008-2009 Consumer Choice Award from the National Research Corporation.

Source: dukehealth.org

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Now is the time for faculty in the Duke University School of Medicine to apply and nominate their colleagues for faculty awards. The Office for Faculty Development is accepting applications for the Ruth and A. Morris Williams, Jr. Faculty Research Prize, and nominations for the Leonard Palumbo Jr., M.D., Faculty Achievement Award, and the Leonard B. Tow Humanism in Medicine Award. Faculty panels appointed by the dean will select the winners.

The Palumbo Faculty Achievement Award recognizes a faculty member who displays dedication to compassionate patient care and excellence in the teaching and mentoring of young physicians. The Humanism in Medicine Award is designed to recognize compassion and sensitivity in the delivery of health care. The award is presented annually to a faculty member. The deadline to apply for the Williams Research Prize is 5 p.m., Feb. 26. The nomination deadline for the Palumbo and Humanism awards is 5 p.m., Feb.16. Complete descriptions and application instructions are available at http://facdev. medschool.duke.edu.

This year, as part of the observance of Black History Month in February, the Duke Medical Center Library and Archives have invited two special guests to share stories of trailblazing experiences at Duke. This annual event, entitled “Tea with Trailblazers,” will be held 2:30 p.m., Feb. 9 in the Duke Medical Center Library’s first floor stacks area. Featured speakers for the event will be Danny O. Jacobs, M.D., M.P.H., chair of the danny o. jacobs, M.D., M.P.H. Department of Surgery; and Haywood Brown, M.D., chair of the Department of Obstetrics and Gynecology. Both of these speakers are African American leaders and pioneers at Duke Medicine. After Jacobs and Brown speak about their experiences as trailblazers, the audience will have a chance to ask questions. At 4:30 that afternoon, the library and archives, along with the tea panelists, will hold a special reception to unveil “Opening Doors: Contemporary African American Academic Surgeons,” a traveling exhibit created by the National Library of Medicine and The Reginald F. Lewis Museum of Maryland African American History and Culture.

Awards season is coming – apply now

The Williams Prize was created to advance research opportunities for younger faculty members and to help publicize the caliber of medical research underway at Duke. The 2009 award will recognize outstanding contributions in basic science research.

Trailblazers speak, open new exhibit

haywood brown, m.d.

Katelyn Crowder surfs the Web on a laptop provided by Bringing the Outside World Inside Foundation. Photo Courtesy of Duke Children’s Hospital & Health Center

Computers keep young patients connected

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atients at Duke Children’s Hospital & Health Center have an easier time staying connected to the world via the Internet, thanks to Bringing the Outside World Inside Foundation(BOWI). The foundation donated more than $17,000 for 15 laptop computers and to establish the BOWI Computer Lending Library. Each laptop has been configured to operate on the Duke wireless network. Laptops from the BOWI Computer Lending Library will be distributed to

the patients and families by the nurses and the child life specialists. Following each use, laptops will be cleaned before use by the next patient. BOWI was started in 1996 by Lee and Nancy Rosenbluth at a Philadelphia children’s hospital. “We wanted to enable the children to communicate with their parents, friends, and teachers during the recovery process so that they would not feel isolated from their friends and family,” said Lee Rosenbluth. n

This exhibit highlights four contemporary African American academic surgeons and educators. The exhibit will be on display in the library from February until the end of April. Other special exhibits will also be displayed in and around the library to honor Black History Month, including four wax figures of medical pioneers from the National Great Blacks in Wax Museum; a Black History Month exhibit in Duke North throughout the month of February; and an exhibit on the Society of Black Academic Surgeons in the lower level of the library throughout February. All events and exhibits are free and open to the public. More information: Jessica Roseberry, 383-2653 or jessica. roseberry@ duke.edu Hear other Duke trailblazers tell their stories at http://inside.dukemedicine. org. Just search for “trailblazers.”

Benefits

A Quarterly Supplement to Inside Duke Medicine hr.duke.edu n inside.dukemedicine.org n January 2009

long term care

Enroll yourself and family members in Duke’s long term care insurance benefit for protection during unexpected life events. Page 6 p r o f e s s i o n a l de v e l o pme n t

Nancy Gump, right, an administrative assistant in Duke’s Fuqua School of Business, received donated time from faculty and staff, so she could care for her husband, Donald, who was diagnosed with colon cancer.

Time is on their side Kiel Program allows faculty and staff to donate time off to colleagues in need

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he news for Nancy Gump came as a shock. According to doctors, her husband, Donald, only had days or weeks left to live after being diagnosed with colon cancer. Gump, an administrative assistant in the Fuqua School of Business, needed time with her husband, but she only had a week’s worth of vacation left. That’s when her co-workers stepped in to help. After all her vacation and sick days were gone, Gump relied on Duke’s voluntary Kiel Memorial Vacation/PTO Donation Program to provide her with time off from late June to September of this year. The Kiel program allows Duke faculty and staff to make donations of accrued vacation time or paid time off to fellow employees in time of need. “It’s the benefit of peace of mind,” said Gump, who has worked at Duke five years and has been married to Donald for nearly 30. “It lets you

“In the 40 years that I’ve been working, I never had that opportunity with other places where fellow employees could help you by donating their time,” she said. “They didn’t have to do it, but they did and that says a lot about the people at Duke.” – Nancy Gump, administrative assistant know that you’re loved by your fellow co-workers and that you’re part of a family. I’m so fortunate that I’m at Duke to be able to have that.” During 86 days, Gump benefited from the Kiel donations, so she could care for Donald, who died in his sleep Nov. 22 after he beat the odds for about six months longer than expected. She used the time to take care of household chores with some help from Donald, but she was also in charge of paying bills and balancing the couple’s checkbook. Gump said the biggest portion of her time away from work was helping Donald with everyday

activities he couldn’t manage on his own – from getting out of chairs to walking to the restroom and helping with daily hygiene. In 2007 alone, Duke employees donated nearly 29,000 hours to fellow co-workers through the Kiel program. In addition to giving vacation or paid time off to a specific person, Duke faculty and staff can also contribute to a general pool. Donated hours can only be used by faculty and staff if they or their dependents face serious illness or injury. The Kiel program was introduced in 1999 to honor Susan Kiel, a former see TIME, p.8

Hone your public speaking skills by joining Duke Toastmasters Club in 2009. Page 8 virtual weight loss

Duke employee Tiwath Godley lost 100 pounds using Duke’s online resources through Live for Life. Determination and a positive attitude made her successful. Page 7

Benefits

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Duke Credit Union offers stability in uncertain times

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uke research associate Karthik Vishwanath, Ph.D., and his wife, Vrinda Kalia, did their homework before buying a new home in southwest Durham. After calculating how much they could afford and comparing rates at several banks, they applied for, and received, a mortgage through the Duke University Federal Credit Union. “Now we’re paying about $850 a month to own a home, which is only a little more than we paid for rent,” Vishwanath said. Despite the national credit crisis, the Duke Credit Union has not toughened lending criteria, said Dan Berry, chief operating officer. The credit union offers competitive loan rates for qualified buyers for home equity and mortgages, automobiles and educational expenses. Unlike lenders that offered subprime loans and are experiencing a high rate of late payments and foreclosures, Duke Credit Union’s delinquency rate in 2008 is only about 1 percent, Berry said. “This means that one out of 100 of our loans is not being paid as agreed,” he said. “Our loan portfolio is stable because our policies have never allowed borrowers to take out loans based on unrealistic repayment plans. We’re the same reliable lender that we’ve always been.” The credit union’s strong reputation has encouraged 425 new members to join this year, boosting ability to make loans, Berry said. “With members trusting us with additional deposits in these difficult economic times, Duke Credit Union has the resources to lend,” he said. Nationally, about 90 million people belong to about 8,000 credit unions. Deposits are insured by the National Credit Union Administration (NCUA), a federal agency in Washington. Coverage was increased to $250,000 on individual accounts; $250,000 on Individual Retirement

January 2009

Long term care insurance for the unexpected

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ean Ross hopes to spend her golden years jet-setting around the globe. “I love traveling and when I retire, I have a long list of places I want to visit,” said Ross, 55, a staff specialist with the Office of the University Registrar. She realizes, though, that life doesn’t always go as planned. That’s why she is enrolled in Duke’s group long term care insurance provided by Prudential. It covers expenses for nursing homes, assisted-living facilities, home health care and adult day care. Benefits-eligible staff and faculty can enroll year-round to purchase long term care insurance for themselves, spousal partners, parents, parents-in-law, grandparents, grandparents-in-law and children age 18 and older, including those who live outside North Carolina.

Duke research associate Karthik Vishwanath, right, and his wife, Vrinda Kalia, received a mortgage for a home in Durham through the Duke Credit Union.

said Scott Baker, the credit union’s mortgage lending officer. “In the past few months, things have really been picking up,” Baker said. “This August, I had 18 applications for first “The credit union has great rates and mortgages, compared to six last August.” they sat down with us to discuss our Many loans are with the HomeExpress program options to make sure our mortgage that provides 100 percent payment was one we could afford.“ financing for applicants Karthik Vishwanath, Ph.D., Duke research associate with a credit score of 660 or higher. Vishwanath, who received a which are non-profit and tax-exempt, HomeExpress loan, encourages typically offer lower interest rates on loans and higher rates on savings than Duke employees to check out the credit union. commercial lenders. “They have good rates and sat “Credit unions like Duke’s really down with us to discuss our options are weathering this storm well,” said to make sure it was a payment we Hood, a Durham resident. could definitely afford,” he said. So far this year, the Duke Credit “That helped us feel comfortable Union has approved more than 40 because we didn’t want to overmortgages for homes valued at a stretch our budget.” n total of more than $5 million, and — By Missy Baxter the applications keep rolling in, Accounts through Dec. 31, 2009, as part of the federal financial stabilization package. Rodney Hood, vice chairman of NCUA, said credit unions like Duke’s,

Writer, Office of Communication Services

Fast Fact Employees who enroll later than 60 days from date of hire must complete medical questionnaires for Prudential’s review before coverage is granted. But during special enrollment in February, employees are not required to complete questionnaires, unless they enroll in the unlimited lifetime maximum benefit. Dependents are required to complete medical questionnaires.

Duke Benefits will mail long term care enrollment packets to employee homes in January for special enrollment Feb. 2-23. Information sessions are Feb. 3-12. Long term care generally covers people with prolonged physical illness, a disability or cognitive impairment such as Alzheimer’s disease. Without insurance, care can be expensive; the national average cost in 2008 for a private room in a nursing home is $209 per day, according to the AARP. “Long term care insurance helps protect your assets and gives you the flexibility and freedom to choose where you get care,” said Saundra Daniels, Duke Benefits plan manager. Health insurance does not typically cover long term care costs. With Prudential’s long term care plan, Duke policy holders can select from a variety of daily benefit maximums and coverage limits. Monthly premiums vary based on the insured person’s age and coverage level. For example, a 40-year-old unmarried employee would pay $26.99 see LONG TERM, p.8

Benefits

January 2009

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Virtual weight loss

Duke employee loses 100 pounds using online resources

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iwatha Godley was in denial about her eating habits and weight. “I used to tell my doctor that I was taking her advice, that I was eating right and exercising,” said Godley, a nursing care assistant and health unit coordinator in ambulatory surgery in Duke University Hospital. “I’d tell her that I had a salad for lunch when I really had a fast food burger.” Godley weighed 290 pounds, her heaviest, in 2000 and had been overweight more than 19 years. But in the past three years, she has lost 100 pounds. Without surgery, diet pills or yo-yo dieting, she got moving on her own with Duke’s online health and fitness tips. Godley, 39, signed up earlier this year for the online initiative, Eat Wise and Exercise, offered by LIVE FOR LIFE, Duke’s employee wellness program. She learned about nutrition and exercise, and now receives a daily e-mail with tips for a healthier lifestyle. Godley took the electronic route because she doesn’t have time to participate in LIVE FOR LIFE fitness and nutrition activities and workshops due to her hectic schedule, she said. Because she works in patient care, she’s unable to leave her department for breaks during the day, and as a single mother with two children, including one with disabilities, she’s eager to get home after work. Her favorite virtual motivation has been the e-mail tip of the day. She finds the cooking tips about cooking with less sodium and fat, and the quick, easy recipes especially helpful. “I used to print them out and tape them to the desk as reminders,” Godley said. “It was very encouraging, and it was also convenient.” In 2005, Godley faced reality after seeing a photograph of herself at her youngest daughter’s soccer game. She said she couldn’t believe “how big” she looked. “I didn’t like what I saw,” Godley said. “That December, I just started walking. I didn’t go far, and I got out of breath

Tiwatha Godley, right, regularly exercises with her daughter Jayda Henry, at Planet Fitness gym in Raleigh. Godley went from a size 26 to a size 14 in the past three years.

“She’s decided to take charge of her life. She’s focused on having an overall, healthy lifestyle, not on being thin or on a quick-fix.” Jennifer Jo, M.D., Duke primary care physician quickly. But I didn’t give up.” Godley’s determination and positive attitude have made her successful, said her Duke primary care physician, Jennifer Jo, M.D. “She decided to take charge of her life,” Jo said. “She’s focused on having an overall, healthy lifestyle, not on being thin or on a quick-fix. I’m very proud of her because I know how difficult it was for her to initially be honest with herself.” Godley said she realized her unhealthy habits affected her daughters. They were following in her footsteps, especially her youngest daughter, Jayda Henry, 12. Now, mother and daughter exercise together.

“My daughters keep me going,” Godley said. “I want to be healthy for them, and I want them to be healthy. Before, I couldn’t be involved in their activities. I’d get home from work and take a nap. Now they can hardly keep up with me.” Godley’s seen the rewards. She ran her first half-marathon in August and received a Lifestyle Change Award this year from the American Heart Association. She weighs about 190 but wants to lose 25 pounds before she turns 40 in May. “My goal is to be a healthy size by then,” she said. n — By Elizabeth Michalka Writer/Public Relations Specialist Senior Fuqua School of Business

v i de o o n l i n e

100 Pounds Watch a video about Tiwatha Godley’s weight loss journey at http://hr.duke.edu

Find health, fitness and nutrition tips at http://hr.duke.edu/eohs/livelife/index.html

Benefits

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January 2009

TIME, cont. Duke nurse who died in 1996. The program was the brainchild of three Duke nurses, Jennifer Kell and two others, all of whom were friends with Kiel and knew her work in the general medicine and pediatric wards at Duke Hospital. Kiel worked at Duke for less than two years and didn’t have much time off when she became ill. “We wanted to promote that helpfulness and spirit of community that can come when something bad happens to somebody and you don’t know what to do,” said Kell, who left Duke in 2006. “If you donate eight hours of PTO time, that would be huge to someone and you know you were supporting somebody else.” When the Kiel program launched, there were already more than 1,000 hours worth of donations from Duke employees. “We were very pleased and grateful to the university for working with us to try to build a better system, a better community,” Kell said. Sylvia Alston, Kiel’s former supervisor and now associate chief nursing officer for Recruitment and Hospital Administrative Systems, said the program shows the impact that a few people can have on each other. Alston has donated time to the program. “I may not be able to do anything about someone’s illness or their diagnosis, but donating time to them is a way that I can help.” Sheila Alexander, an administrative assistant in the executive vice president’s office, has also benefited through her colleagues’ generosity. She was diagnosed with glaucoma last May and needed more than the 18 accrued days she had saved to go through three surgeries, including an emergency operation to save an optic nerve in her left eye. “I don’t know what I would have done without the Kiel program,” said

LONG TERM, cont. monthly, without the inflation option, to cover long term care expenses with a daily benefit maximum of $200 and a total lifetime benefit maximum of $219,000. Prudential offers an automatic inflation option to help protect against rising healthcare costs by locking in the premium for the life of the policy, an important consideration. Ross purchased long term care

Donate Time The voluntary Kiel program allows faculty and staff to donate vacation or paid time off to co-workers who have exhausted time off because of catastrophic illness or injury to themselves or an eligible family member.

Who’s eligible?

“I don’t know what I would have done without the Kiel program. It was a blessing to know that I didn’t have to worry about not getting a paycheck or losing my benefits because I had to take so much time off.“ Sheila Alexander, administrative assistant Executive Vice President’s Office

Alexander, who missed about three months of work. “It was a blessing to know that I didn’t have to worry about not getting a paycheck or losing my benefits because I had to take so much time off.” When Alexander needed to draw from the Kiel pool, her colleague Anne Light, assistant to the executive vice president, sent a request to Alexander’s current and former co-workers to donate time. Approximately 500 hours were donated to Alexander. “Sheila is a valued employee who was in a hard spot, and I knew she had a number of friends and colleagues at Duke willing to support her,” said Light, who donated some of her own time off to Alexander. Alexander was touched by the

insurance about 10 years ago and recently increased her daily benefit maximum from $100 to $250 for care received in nursing homes and assisted living facilities. “I read an article that said the number one cause of bankruptcy is from medical bills during an illness,” Ross said. “I signed up for long term care insurance because I don’t want that to happen to me.” n — By Missy Baxter Writer, Office of Communication Services

Faculty and staff of Duke University and Health System, or eligible family members, must be diagnosed with a medical event that requires the employee to be out of work for at least four weeks.

Who can donate? Eligible faculty and staff can contribute accrued vacation or paid time off in four-hour increments to a specific person, or general pool.

news briefs

Free financial seminars address credit and retirement If current economic conditions have you concerned about credit, debt and retirement, the Duke Federal Credit Union may have a free financial seminar for you. January seminars include: Creditability: Build a Strong Credit History, 12:30 p.m. to 1:30 p.m. Jan. 13, Duke Credit Union, 2200 W. Main St.; and Planning for Retirement: the Basics, 12:30 p.m. to 1:30 p.m. Jan. 27, Searle Center. To register, visit dukefcu.org and select “seminar sign-up” under Quick Links. You can also register by sending e-mail to [email protected] or calling (919) 660-9745.

How?

A toast to professional development

To receive or donate time, complete a form online at hr.duke.edu/policies/ time_away/kiel_program

Hone your public speaking skills by joining the Duke Toastmasters Club in 2009.

generosity. “They gave up time that they could have used themselves,” she said. “That really meant a lot to me.” Gump, the administrative assistant in Fuqua, has only been able to build her paid time off up to “a few hours,” she said. The Gumps had a nurse who stayed with Donald seven hours a day, but Nancy Gump still took some time off to fill in gaps when the nurse couldn’t be there. “In the 40 years that I’ve been working, I never had that opportunity with other places where fellow employees could help you by donating their time,” she said. “They didn’t have to do it, but they did and that says a lot about the people at Duke.” n — By Bryan Roth and Elizabeth Michalka Office of Communication Services

The club, formed in 2003, is a local chapter of Toastmasters International comprising Duke staff and faculty from various departments. The group typically meets from 7 a.m. to 8 a.m. on the second and fourth Wednesday of each month in the Duke Credit Union at Erwin Square, 2200 W. Main St. The club’s next meeting is at 7 a.m., Jan. 14. Staff and faculty can attend an initial meeting as a guest without paying a membership fee. To join, members pay a one-time enrollment fee of $20 and a recurring fee of $39 every six months. For more information, visit duketoastmasters.org or send an e-mail to public_ [email protected].

Benefits Benefits is published quarterly by Duke’s Office of Communication Services as a supplement to Inside Duke Medicine. Benefits invites your feedback and suggestions for future story topics. Please call (919) 681-4533 or send e-mail to [email protected] Editor: Leanora Minai (919) 681-4533 [email protected]

Jean Ross has big plans for retirement, but is also protecting herself with long term care insurance.

Assistant Vice President: Paul S. Grantham (919) 681-4534 [email protected]

The Science & Research Supplement to Inside Duke Medicine VOLUME 18 NO. 1

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F E ATUR E

Acupuncture effective against headaches Acupuncture is more effective than medication in reducing the severity and frequency of chronic headaches, according to a new analysis conducted by Duke University Medical Center researchers. The National Institutes of Health recommended acupuncture as a viable treatment for chronic headaches a decade ago and, while research in this field has increased, there have been conflicting reports about its efficacy. “We combed through the literature and conducted the most comprehensive review of available data done to date using only the most rigorously-executed trials,” says Tong Joo (T.J.) Gan, M.D., a Duke anesthesiologist who lead the analysis. “Acupuncture is becoming a favorable option for a variety of purposes ranging from enhancing fertility to decreasing post-operative pain because people experience significantly fewer side effects and it can be less expensive than other options,” Gan says. “This analysis reinforces that acupuncture also is a successful source of relief from chronic headaches.”

Statin resistance explained Scientists at Duke University Medical Center have identified genetic mutations that may help explain why some people don’t respond very well to statins, drugs taken by millions of Americans to fight high cholesterol and prevent coronary artery disease. The findings, published in the Dec. 17 issue of Circulation: Cardiovascular Genetics, suggest that some patients may fail to see lower LDL cholesterol levels from taking the drugs – no matter what the dose – because of their genetic makeup. Statins are generally effective in lowering low-density lipoprotein cholesterol, or LDL (the so-called “bad” cholesterol) – even slashing LDL levels in half, in some cases. But in about 20 percent of patients, statins fail to bring LDL into target range, a phenomenon known as “statin resistance.” Geoffrey Ginsburg, M.D., Ph.D., director of the Center for Genomic Medicine in Duke’s Institute for Genome Sciences & Policy, says race, age and smoking status may exert modest influence on statin response, but he believes genetic variation may play a more powerful role.

Duke scientists are experimenting with using adult stem cells and biomedical engineering to repair damaged tissue. illustration by vanessa dejongh

Engineered repair By Kelly Malcom

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he ability to rapidly regenerate and heal after injury is a staple in science fiction but Duke scientists are working to make this remarkable ability a reality in humans. They are doing this by combining the promise of stem cells, cells that have the ability to renew themselves, with biomedical engineering. In essence, researchers such as Brigid Hogan, Ph.D., of Cell Biology, Farshid Guilak, Ph.D., and Nenad Bursac, Ph.D., of Biomedical Engineering, and Howard Rockman, M.D., of Cardiology are teaming to develop potential therapies that incorporate tailor-made patches of replacement cells that can be inserted into the body to replace tissue that has been lost. Within the past 40 years, scientists have discovered the presence of stem cells throughout the adult body, including within bone marrow and fat and in unexpected areas such as the brain. Scientists can take these stem cells and induce them to become pluripotent, or capable of forming other cell types. Research on adult stems cells has ramped up in the face of controversies over the use of embryonic stem cells, stem cells from days old human embryos that have the capacity to form any cell type in the body. “Using these pluripotent stem cells for healing therapies has some advantages over embryonic stem cells,” says

The architecture of the heart muscle, whose fibers are aligned in a twisted arrangement for efficient blood pumping, require a patch of cells with a corresponding alignment. Bursac’s lab has been attempting to achieve this by using MRI imaging of the heart. “We then create a patch structure made of a mixture of cells and hydrogel, that match the MRI image much the way a circuit board is created by depositing metal in controlled way,” he explained. The mesh is then filled with a hydrogel full of holes. “On crosssection, the tissue patch resembles Swiss cheese with “The idea is to create a biological elongated pores.” The coating for these devices, so that pore-design in the hydrogel when they’re implanted, they’re was created to address a persistent problem in tissue recognized as native to the body.“ engineering, said Bursac. “Currently, there is no way to ance of controversy. “Whether you vascularize implanted tissue. agree or disagree with the moral controversy over embryonic stem cells, Therefore, most patches are restrained to a thickness of a couple hundred there is controversy,” said Klitzman. microns. Any thicker and the core of “If you can achieve the same results the patched tissue tends to die for lack from adult stem cells and avoid of oxygen and nutrients from blood.” controversy, it’s beneficial to getting The pores within the hydrogel allow the treatments to market.” for increased access to nutrients, cell Several of the treatments involve a alignment, and the propagation of complex combination of engineering electrical signals necessary for a and cell biology that can be compared coordinated heartbeat. to restoring a priceless mosaic. Bursac has been testing his patch Nenad Bursac’s lab has been working to develop a patch of stem cell with the help of Howard Rockman, and Lan Mao, M.D., who has successderived cardiomyocytes that can be fully sutured a patch to a beating surgically attached to a heart damaged by a heart attack. see REPAIR, p.10 Bruce Klitzman, Ph.D., assistant research professor in the departments of Cell Biology and Biomedical Engineering. One, he explains, is the avoidance of an immune response against foreign tissue. For traditional transplants and the proposed transplantation of stem cells from human embryos, immunosuppression drugs must be administered to prevent this reaction. Cells derived from one’s own body would not be rejected. The second advantage is the avoid-

Inquiry

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Young and old brains process memories differently

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euroscientists from Duke University Medical Center have discovered that older people use their brains differently than younger people when it comes to storing memories, particularly those associated with negative emotions. The study, appearing online in the January issue of Psychological Science, is a novel look at how brain connections change with age. Older adults, average age 70, and younger adults, average age 24, were shown a series of 30 photographs while their brains were imaged in a functional MRI (fMRI) machine. Some of the photos were neutral in nature and others had strong negative content such as attacking snakes, mutilated bodies and violent acts. While in the fMRI machine, the subjects looked at the photos and ranked them on a pleasantness scale. Then they completed an unexpected recall task following the fMRI scan to determine whether the brain activity that occurred while looking at the pictures could predict later memory. The results were sorted according to the numbers of negative and neutral pictures that were remembered or missed by each group. The scientists found that older adults have less connectivity between an area of the brain that generates emotions and a region involved in memory and learning. But they also found that the older adults have

Professor mentors Siemens awardees Craig B. Bennett, Ph.D. assistant professor in the Department of Biochemistry, was the faculty mentor to two winners of the prestigious Siemens Competition. Sajith M. Wickramasekara and Andrew Y. Guo, who attend the North Carolina School of Science and Mathematics in Durham, won the $100,000 scholarship for their project entitled “A Functional Genomic Framework for Chemotherapeutic Drug Improvement and Identification”

When it comes to storing memories, particularly those associated with negative emotions, older people use a different system than do younger people. illustration by vanessa dejongh

Center for Cognitive Neuroscience. If the older adults are using more thinking than feeling, “that may be one reason why older adults showed a reduction in memory for pictures “The older subjects were using a with a more negative emotional content.” different system to help them to better “It wasn’t surprisencode pictures they could remember.“ ing that older people showed a reduction in memory for negative pictures, but it Young adults used more of the was surprising that the older subjects brain regions typically involved in were using a different system to help emotion and recalling memories. them to better encode those pictures “The younger adults were able to they could remember,” said lead recall more of the negative photos,” author Peggy St. Jacques, a graduate said Roberto Cabeza, Ph.D., senior student in the Cabeza laboratory. n author and Duke professor in the stronger connections with the frontal cortex, the higher thinking area of the brain that controls these lower-order parts of the brain.

cartilage that can one day be used to replace that lost in degenerative joint mouse heart. “A mouse heart beats diseases such as arthritis. 600 times a minute; the suturing of “Because cartilage has no blood this patch is a testament to the surgical supply, once it’s gone, it’s gone,” he skills of Rockman’s group.” They are explained. His lab has successfully working now to refine the technique. grown cartilage in culture using stem cells derived from fat. “From “We can take fat stem cells, separate one liposuction, you can get them from the fat and treat them so billions of fat stem cells. We they develop bone and cartilage cells.“ take those cells, separate them from the fat and treat them Bursac hopes the treatment will lead to with growth factors so that they develop eventual patches that can be used to bone and cartilage cells.” Guilak will repair hearts in people. soon start tests in animals to see how Beyond mending broken hearts, well the cartilage stands up to force. researcher Farshid Guilak has atGuilak has also recently teamed tempted to address aching joints. His with Hogan of Cell Biology to develop most recent work has involved develmesh scaffolding flexible enough to be oping polymer fiber matrices to grow molded into a tube like the human

REPAIR, cont.

January 2009

trachea. Hogan is interested in seeing how tracheal stem cells differentiate and establish themselves into the different cell layers of the trachea. Tissue engineering is also being used to improve the biocompatibility of implanted devices such as glucose sensors for diabetics. “The idea is to create a biological coating for these devices using stem cells, outside the body, so that when the device is implanted, it is recognized as native to the body,” said Klitzman. “We are taking a team approach to repair,” commented Hogan. “We hope to combine basic, translational and clinical science to stimulate tissue growth, stop the immflamatory response and develop the best delivery model for stem cells.” n

Their research has the potential to easily identify new chemotherapeutic drugs and greatly improve existing ones. The team’s project combined traditional genetics with cutting edge computational modeling to streamline the gene discovery process. Their project addresses the need in the field to identify new genes to target for cancer therapy. Their approach has the potential to identify novel treatments that could lead the way to personalized medicine in the future. “Working with these two students has been a very rewarding experience for me,” said Bennett. “Both are very intelligent and motivated individuals and I predict that either could have a very productive research career in the field of their choosing.”

Research Events As part of the Duke/UNC Collaborative speaker series, the Trent History of Medicine Society will host the next lecture on Jan.13 in the History of Medicine Reading Room, 102 Duke Medical Center Library. Priscilla Wald, Ph.D., Professor of English and Women’s Studies at Duke University will present on “Clones, Chimeras, and Other Creatures of the Biotech Revolution: Towards a Genomic Mythology.” Call 660-1143 for more information. The Genomic Medicine Forum presents a talk entitled “A New Look at Family History” on Jan. 29 from 9 – 10 a.m. in Fitzpatrick-CIEMAS 2240. Julianne O’Daniel, research associate at the Institute for Genome Sciences will present on “The Duke Personal Variome Project.” For more information contact Rita Chambers, [email protected].

Science Editor: Kelly Malcom Inquiry features science and researchrelated news items from Duke Medicine News and Communications and other Duke departments. To submit content, contact us at [email protected]

Inside Duke Medicine

January 2009

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Sharon Freedman, M.D., has been named service chief of the pediatric eye division at Duke Eye Center, to succeed Edward G. Buckley, M.D., who was named permanent vice dean for education at Duke University School of Medicine.

Amy P. Murtha, M.D., and Geeta K. Swamy, M.D., of the Division of MaternalFetal Medicine, and Patrick Seed, M.D., Ph.D., of the Division of Pediatric Infectious Diseases, were invited to join 100 investigators from across the country to establish a new, national initiative to inspire more research into preterm birth and find workable solutions to this public health problem.

“We have all held Dr. Freedman in the Sharon freedman, very highest regard as m.d. a department leader and I believe this transition will be very seamless,” said Eye Center Chairman David L. Epstein, M.D.

The new initiative is being funded by the March of Dimes and the Burroughs Wellcome Fund.

... Berlain Hatfield, MSN, has been named administrative director for Duke Eye Center and the Duke Ambulatory Surgery Center. Hatfield was previously clinical operations director for perianesthesia at the Ambulatory Surgery Center. ... John Vargas has been named administrative director of the Duke Neurodiagnostic & Sleep Labs. Vargas has worked in various leadership roles within Duke Medicine for the past seven years, most recently at Integrative Medicine. ... Ranjan Sudan, M.D., has been welcomed as the new medical director of the Duke Center for Metabolic & Weight Loss Surgery. Last fall, the center moved its outpatient clinic to an expanded state-of-the-art facility at Durham Regional Hospital’s Health Services Center, 407 Crutchfield St. The hospital also updated its operating rooms and added six bariatric inpatient suites, designed to ranjan sudan, M.D. meet the needs of weight loss surgery patients. All surgical procedures performed by the program are done at Durham Regional Hospital. Sudan has previously served as director of bariatric and robotic surgery programs at Creighton University and the University of Nebraska. He is board certified in general surgery as well as adult and child psychiatry. Sudan’s interests include laparoscopic/robotic bariatric surgery and GI surgery as well as endoscopy. “The new clinic has been specifically designed to cater to bariatric surgery patients and include appropriate access, equipment, examining rooms and personnel,” Sudan said. “Our patients and providers have immediately noticed the difference and are thrilled with the changes.” The program performs both Roux-en-Y and Lap-Band procedures.

John Drewry, right, is getting to know his grandchildren, thanks to a lifesaving heart transplant at Duke. In gratitude, he has given $100,000 to the Heart Transplant Research and Education Fund in the Department of Cardiology. MURTHA

A chance to be Grandpops Heart transplant survivor says thank you By Marty Fisher

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motion washes over John Drewry every so often as he tells his story. “It’s a common reaction we transplant patients have,” he says. “It’s hard to control our emotions.” Drewry received a heart transplant at Duke on the first day of spring, March 20, 2008. Just a few months earlier, he and his wife, Diane, had made all the arrangements for his funeral. “We knew John was probably going to die,” says Diane. “We were prepared.” Drewry, a former naval architect, received the grim diagnosis of hypertrophic cardiomyopathy, a genetic thickening of the heart muscle. There is no cure, except a new heart. “I wanted to live longer than age 65,” he says. “My research led me to Duke University and the transplant team headed by Dr. Joseph Rogers.” Drewry called Duke and spoke with a transplant coordinator. A few days later, he received a call back. It was late December—almost Christmas—and the woman on the phone said Rogers would like to see him the first week of January. “Dr. Rogers immediately impressed me,” says Drewry. “He made me feel welcome, and he explained the whole situation.” Rogers thought that transplantation could provide Mr. Drewry with an improvement in survival and quality of life, but that his age and other medical conditions defined him as a non-standard candidate. Fortunately, Duke has an innovative program that offers transplantation to individuals who fall outside the traditional transplant criteria by matching them with hearts

rejected by other transplant programs. The Drewrys arrived at Duke Hospital on Feb. 5. Diane stationed herself at her husband’s side for what would be a grueling seven-week wait in Duke Hospital.

“Dr. Rogers immediately impressed me. He made me feel welcome, and he explained the whole situation.“ Drewry’s health was failing when they finally got the call that a donor heart was available for him. His transplant surgeon was Carmelo Milano, M.D. “I hoped he would be my surgeon,” says Drewry. In the OR that night, Milano carefully removed Drewry’s diseased heart. The Drewrys went home in early April to begin what they hoped would be an uneventful recovery. John was getting better every day, but in early June, Diane suspected trouble when John woke up during the night, feverish and short of breath. In no time, his blood pressure dropped to 80 over 40. Diane immediately called Dr. Rogers, who advised the emergency room physician at Obici Hospital in Suffolk, Va. “I started to fall apart and fervently hoped he would not die after all we’d been through. Knowing Dr. Rogers was at Duke waiting for John to arrive made it so much easier for me,” she says. “It all came to a good ending,” says John. “I was extremely lucky.” In gratitude, he has given $100,000 to the Heart Transplant Research and Education Fund in the Department of Cardiology. n

SWAMY

SEED

“This comes at a critical time as the rates of preterm birth continue to rise and disparity between races increases,” Murtha said. “This disparity is particularly important in the state of North Carolina, which just received an F grade from the March of Dimes on its 2008 Premature Birth Report Card.” The trio of researchers was invited to participate in the meeting because they are nationally recognized leaders in the area of preterm birth research. Right now they are involved in several multidisciplinary research efforts designed to understand the etiology and consequence of preterm birth. ... Toni Cutson, M.D., medical director for Duke HomeCare & Hospice, was elected to the National Hospice and Palliative Care Organization’s 2009 board.

lives November 2008 Dorothy Lunsford, a former Medical Center housekeeping employee, died Nov. 4. Lunsford worked at Duke from 1978 to 1991. Myrtle Mangum, a former heart station employee, died Nov. 14. Mangum worked at Duke from 1973 to 1980. Veronica Burt, a former medical sciences employee, died Nov. 20. Burt worked at Duke from 1979 to 2008. Page Anderson, M.D., professor of pediatrics, died Nov. 29. Anderson began work at Duke in 1972.

October 2008 Carolyn Ross, a former employee at the Center for Brain Imaging, died Oct. 5. Ross worked at Duke from 1989 to 2006. Luther Milton, a medical administration employee, died Oct. 16. Milton started to work at Duke in 1991.

Inside Duke Medicine

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January 2009

on the web

make your

comment

What’s your favorite stethoscope? E

very week on Inside Online, there is an opportunity to comment on a community subject, and hear what other colleagues think. It’s just one part of the active daily community life at http:// inside.dukemedicine.org. Last month, there was a lively discussion about that ubiquitous symbol of medicine, the humble stethoscope. To the typical patient, perhaps, it’s just that rubberand-metal doohickey used to listen to the heart and lungs. But to the people who use stethoscopes for a living, it takes some thought to select the right one for the job. Our conversation started after Barbara Sheline, M.D., M.P.H., talked with first-year medical students recently about how to select a good device and the Littman Classic II she uses. Some of the comments we received are reprinted on this page. So, go to Inside Online regularly to join the conversation!

Just a few of the comments made recently on Inside Online: “Remember, 98 percent of the time, it’s not the hearing, but the processing that matters. Consider what individual instruments are doing when you listen to music on the radio. What are the drums doing? What is the tuba doing? What are the strings doing? Your ability to isolate and identify an individual instrument isn’t a matter of what you’re hearing, but rather how you are choosing to process what you hear.”

...

“Having had many stethoscopes in my nearly 30 years of cardiology practice, I could write the book on the subject but will mercifully give just a few ‘pearls.’ All stethoscopes need a functioning diaphragm and bell. The tubing should not be longer than about 18 inches. The ear pieces need to be comfortable and the yoke not too tight. My current favorite model is the W. Proctor Harvey (Duke Medical School ‘43) Model (three-head version) from Tycos. It has black tubing. The most important component, however, is between the ear pieces.”

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engraved in small letters my name on the metal of the stethoscope. I dare a doctor to take it. :)”

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“While I am working here at Duke as a financial analyst, in my prior life before moving to N.C., I spent my spare time as a volunteer EMT for 17 years. I used, and still have, a Littman Classic II. It stood up to the rough and tumble of the field and nothing worked better in a patient’s living room, on the side of the road at a motor vehicle accident, or in the back of a noisy ambulance racing down the rough rural roads of New Hampshire. The color? Light blue (it was a gift from my nurse mother).”

“Hunter green Littman Cardiology IISE was my first stethoscope in 1994. You can get by with less, but you don’t need more.”

“I am a nurse and have used several brands of stethoscopes. I agree that Littmann stethoscopes are good. But I personally don’t own one. I have an Adscope Cardiology one-sided stethoscope. Its amazing! … The only con to this kind of stethoscope is the heaviness on your neck after awhile due to the head of it being solid metal. I own a black stethoscope. (It has to match your scrubs:) I

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