Grand Rounds Home

	Fall 2018 Semester Presentations are help on Wednesdays from 11:00 a.m. to 12:30 p.m. Central Time in Austin (M-100 Lecture Hall at 1100 W. 49th Street, see map) or via webinar. October 3: Wealth is Health: Improving Access to Antipoverty Programs in Pediatric Clinics October 9: Ten Things to Know About Adverse Childhood Experiences (ACEs) October 17: Are We Ready for the Next Influenza Pandemic? October 24: Opioids: Perspectives on Medication Assisted Recovery Support October 31: Why the Death Certificate Really is a Vital Statistic - Part II November 7: Hope, Opportunity and Equity Measures: A Texas Perspective November 14: Confessions of a Topophiliac

Michael K. Hole, MD, MBA Asst. Professor, Pediatrics & Population Health, Dell Med School; LBJ School of Public Affairs, The University of Texas at Austin	Wealth is Health: Improving Access to Antipoverty Programs in Pediatric Clinics Presenter: Michael K. Hole, MD, MBA Asst. Professor, Pediatrics & Population Health, Dell Med School; LBJ School of Public Affairs, The University of Texas at Austin Description: One out of every five children in Texas grows up poor, thereby facing risk of worse health, education, and future economic outcomes. Antipoverty programs, such as tax credits, reduce both urban and rural child poverty rates, but are over 20% underused yearly due to access barriers. StreetCred, a national nonprofit, aims to build wealth and improve health by offering free tax preparation, financial coaching, incentivized savings programs, and streamlined applications for antipoverty government programs in a trusted location: pediatricians' waiting rooms. StreetCred's Co-Founder, Dr. Michael Hole, an Asst. Professor of Pediatrics and Population Health at UT Austin's Dell Medical School and LBJ School of Public Affairs, envisions one-stop shops in pediatric clinics nationwide enabling easier, faster, and cheaper access to the resources families need to build assets and raise tomorrow's workforce. Learning Objectives: Describe the US Government's most effective antipoverty programs, their relative effects on child health and learning, and access barriers causing their underutilization; Examine StreetCred, a wealth-building nonprofit in pediatricians' offices, initial studies evaluating its effectiveness, and plans for expanding its services portfolio and site locations. 1.5 Continuing Education Credits/Contact Hours Available for the Following (live event only): AMA PRA Category 1 Credits^TM Continuing Nursing Education Certified Health Education Specialists & Master-Certified Health Education Specialists Certified in Public Health Licensed Marriage and Family Therapists Licensed Professional Counselors Licensed Psychologists Registered Sanitarians Social Workers A certificate of attendance is available for those not seeking the credits/contact hours listed above. Suggested Resources: (1) Hole, MK; Marcil, LE; Vinci, RJ. Improving Access to Evidence-Based Antipoverty Government Programs in the United States: a Novel Primary Care Initiative. JAMA Pediatrics. 2017. (2) Klass P. Saving Tiny Tim—Pediatrics and Childhood Poverty in the United States. N Engl JMed. 2016; 374(23): 2201-2205 pmid: 27276559. (3) Council on Community Pediatrics. Poverty and Child Health in the United States. Pediatrics. 2016; 137(4):e20160339. (4) Marr C, Huang CC, Sherman A, Debot B. EITC and Child Tax Credit Promote Work, Reduce Poverty, and Support Children’s Development, Research Finds. Center for Budget and Policy Priorities. Updated October 2015. Available at: https://www.cbpp.org/research/federal-tax/eitc- and-child- tax-credit- promote-work- reduce-18poverty-and-support-childrens. Accessed December 28, 2017. (5) Markowitz S, Komro KA, Livingston MD, Lenhart O, Wagenaar AC. Effects of state-level Earned Income Tax Credit laws in the US on maternal health behaviors and infant health outcomes. Soc Sci Med. 2017;194:67-75. (6) Garg A, Toy S, Tripodis Y, Silverstein M, Freeman E. Addressing Social Determinants of Health at Well Child Care Visits: A Cluster RCT. Pediatrics. Feb 2015, 135 (2) e296-e304 pmid: 25560448. (7) Marcil, LE; Hole, MK; Wenren, LM; Schuler, MS; Zuckerman, BS; Vinci, RJ. Free Tax Services in Pediatric Clinics. Pediatrics. In press.
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Colleen M Bridger, MPH, PhD Director, San Antonio Metropolitan Health District	Ten Things to Know About Adverse Childhood Experiences (ACEs) Presenter: Colleen M Bridger, MPH, PhD Director, San Antonio Metropolitan Health District Description: Childhood trauma is a critical public health issue. Referred to as Adverse Childhood Experiences (ACEs), ACEs are stressful and traumatic events, such as abuse or neglect, that have been linked to poor life-long health outcomes. As the number of ACEs increases, so does the likelihood for developing chronic diseases like diabetes, heart disease and cancer as well as risky health behaviors; low life potential; and, early death. During this presentation, attendees will be introduced to ACE’s, the impact they have on health, and what can be done to overcome them. Please join nationally recognized speaker, trainer and innovations expert Colleen M. Bridger, MPH, PhD, Director of the San Antonio Metropolitan Health District for an insightful discussion on ten things to know about ACEs.Learning Objectives: Identify the three types of ACEs.Discuss the prevalence and causes of ACEs and their impact on the developing brain and bodies of children.Describe the strategies for addressing this important public health issue and helping children overcome a high ACE score. 1.5 Continuing Education Credits/Contact Hours Available for the Following (live event only): AMA PRA Category 1 Credits^TM Continuing Nursing Education Certified Health Education Specialists & Master-Certified Health Education Specialists Certified in Public Health Licensed Marriage and Family Therapists Licensed Professional Counselors Licensed Psychologists Registered Sanitarians Social Workers A certificate of attendance is available for those not seeking the credits/contact hours listed above.Suggested Resources: The Deepest Well Healing the Long-term effects of childhood adversity by Dr. Nadine Burke Harris Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14:245–258. Larkin H, Felitti VJ, Anda RF. Social work and Adverse Childhood Experiences (ACE) Research: implications for practice and health policy. Soc Work Public Health. 2014;29(1):1-16. Larkin H, Shields JJ, Anda RF. The health and social consequences of adverse childhood experiences (ACE) across the lifespan: an introduction to prevention and intervention in the community. J Prev Interv Community. 2012;40(4):263-70.
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Jennifer A. Shuford, MD, MPH Infectious Disease Medical Officer, Division for Laboratory and Infectious Disease Services, DSHS	Are We Ready for the Next Influenza Pandemic? Slides - Grand Rounds October 17 Additional Questions and Answers - October 17 Presenter: Jennifer A. Shuford, MD, MPH Infectious Disease Medical Officer, Division for Laboratory and Infectious Disease Services, DSHS Description: This year marks the 100th anniversary of the 1918 influenza (flu) pandemic that swept the globe in what was one of the deadliest disease outbreaks in recorded history, affecting half a billion people worldwide. Between 50 and 100 million people are thought to have died as a result, representing as much as 5 percent of the world’s population. Is it possible for the world to experience such a catastrophic pandemic today? This presentation will give a brief overview of influenza and how seasonal influenza affects Texas and the United States every year. It will also provide a historic overview of the 1918 pandemic and highlight achievements over the past 100 years. In addition, it will also identify ways that we are preparing for the next influenza pandemic and opportunities to improve our response to pandemic influenza. Learning Objectives: Discuss the basics of influenza viruses and the illnesses they cause. Examine the state, national, and worldwide surveillance of influenza viruses. Discuss lessons learned from the 1918 influenza pandemic. Describe the pharmaceutical and non-pharmaceutical interventions to mitigate influenza epidemics and pandemics. Discuss the factors that influence the propagation of influenza epidemics. 1.5 Continuing Education Credits/Contact Hours Available for the Following (live event only): AMA PRA Category 1 Credits^TM Continuing Nursing Education Certified Health Education Specialists & Master-Certified Health Education Specialists Certified in Public Health Registered Sanitarians Social Workers A certificate of attendance is available for those not seeking the credits/contact hours listed above. Suggested Resources: Erbelding EJ, Post DJ, Stemmy EJ, et al. A universal influenza vaccine: the strategic plan for the National Institute of Allergy and Infectious Diseases. J Infect Dis. 2018; 218(3):347-354. doi: 10.1093/infdis/jiy103. Honigsbaum M. Spanish influenza redux: revisiting the mother of all pandemics. Lancet. 2018; 391(10139):2492-2495. Iskander J, Strikas RA, Gensheimer KF, Cox NJ, Redd SC. Pandemic influenza planning, United States, 1978-2008. Emerg Infect Dis. 2013; 19(6):879-85. Koonin LM, Patel A. Timely antiviral administration during an influenza pandemic: key components. Am J Public Health. 2018; 108(S3):S215-S220. Martinez DL, Das TK. Design of non-pharmaceutical intervention strategies for pandemic influenza outbreaks. BMC Public Health. 2014; 14:1328. Paules C, Subbarao K. Influenza. Lancet. 2017; 390(10095):697-708.
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Jason Howell, MBA, PRS Executive Director of RecoveryPeople Lori K. Holleran Steiker, PhD, ACSW University of Texas – Austin, Steve Hicks School of Social Work Natalie Furdek, MEd Texas Targeted Opioid Response Recovery Specialist, Texas Health & Human Services Commission	Opioids: Perspectives on Medication Assisted Recovery Support Presenters: Jason Howell, MBA, PRS Executive Director of RecoveryPeople Lori K. Holleran Steiker, PhD, ACSW University of Texas – Austin, Steve Hicks School of Social Work Natalie Furdek, MEd Texas Targeted Opioid Response Recovery Specialist, Texas Health & Human Services Commission Description: Understanding that prolonged use of opioid drugs can change the structure and function of the brain helps explain why pharmacological treatment can have an important role in the treatment of addiction. Unless restorative, rebalancing treatment is provided, these functional brain disorders can result in worsening or sabotage of recovery attempts. The phrase “Medication-Assisted Recovery” is a practical, accurate, and non-stigmatizing way to describe a pathway to recovery made possible by physician-prescribed and monitored medications, along with other crucial recovery supports such as housing, counseling and peer support. Please join this esteemed panel for a thought provoking discussion of medication-assisted recovery services. Learning Objectives: Describe the concept of medication assistance treatment. Examine the spectrum of interventions for opioid misuse/use disorders, including abstinence based and harm reduction. Discuss the opportunities and challenges of medication assistance treatment, especially opioid replacement therapy, in recovery residence settings. Describe opioid misuse as it manifests with youth and emerging adults. Identify evidence-based practices and innovations around youth opioid misuse and recovery. 1.5 Continuing Education Credits/Contact Hours Available for the Following (live event only): AMA PRA Category 1 Credits^TM Continuing Nursing Education Certified Health Education Specialists & Master-Certified Health Education Specialists Certified in Public Health Licensed Chemical Dependency Counselors Licensed Marriage and Family Therapists Licensed Professional Counselors Licensed Psychologist Registered Sanitarians Social Workers A certificate of attendance is available for those not seeking the credits/contact hours listed above. Suggested Resources: coming soon
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Tara Das, PhD, MPH, MLIS State Registrar and Director, Vital Statistics Section, DSHS	*Why the Death Certificate Really is a Vital* Statistic - Part II Presenter: Tara Das, PhD, MPH, MLIS State Registrar and Director, Vital Statistics Section, DSHS Description: Death certificates serve a number of purposes. They are legal documents as well as public health instruments that underlie vital statistics. In part one of this series, Dr. Kimberly Molina, Bexar County Medical Examiner's Office discussed death certificates for a medical examiners perspective. This presentation will feature Tara Das, PhD, Texas State Registrar, who will discuss how death certificate data serves as a tool to describe the health of a community, identify priority public health needs, allocate resources, and evaluate interventions. She will also share case studies of how incomplete, inaccurate, or nonspecific reporting can lead to under- or over-counting of causes of deaths, which erroneously affect interventions, policy, and funding. Learning Objectives: Describe the role of vital statistics in public health. Discuss types of data quality initiatives to improve vital statistics. 1.5 Continuing Education Credits/Contact Hours Available for the Following (live event only):** AMA PRA Category 1 Credits^TM Continuing Nursing Education Certified Health Education Specialists & Master-Certified Health Education Specialists Certified in Public Health Registered Sanitarians Social Workers A certificate of attendance is available for those not seeking the credits/contact hours listed above. Suggested Resources: coming soon
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Dennis Andrulis, PhD, MPH Senior Research Scientist, Texas Health Institute; Associate Professor, University of Texas School of Public Health	Hope, Opportunity and Equity Measures: A Texas Perspective Presenter: Dennis Andrulis, PhD, MPH Senior Research Scientist, Texas Health Institute; Associate Professor, University of Texas School of Public Health Description: Polling suggests that Americans feel more divided today than at other point in the past 40 years. A sense—and frequently the reality—of being left behind in achieving the prosperity that is core to the American dream has long been the plight among people of color in this country, but is now playing out more broadly in the tragedy of the opioid crisis and the increase in midlife mortality among whites in what has been called “deaths of despair” This reality playing out in Texas and across America is prompting conversations about how we can all assure we have the opportunities to achieve that dream, regardless of race, ethnicity or socioeconomic circumstances. Please join Dennis Andrulis to learn about the effort to start a new conversation about health that is founded on the belief that every person in the U.S., no matter their background or ZIP code, should have a fair and just opportunity for the best possible health and well-being. The Health Opportunity and Equity (HOPE) Initiative, funded by the Robert Wood Johnson Foundation, tracks 28 indicators that span the life course, including health outcomes and indicators related to opportunity such as socioeconomic factors, the physical and social environment, and access to health care at the state and national level. Its approach is intended to assist policymakers, advocates, the research community and industry in setting aspirational yet achievable goals to improve the lives of all Americans. Learning Objectives: Describe a new framework for measuring health equity focused on positive progress toward goals to improve health and well-being. Discuss a new set of metrics that track and compare progress in achieving health equity overall and by income and race/ethnicity. Consider how the HOPE Initiative framework can have practical application within Texas in monitoring and directing health equity progress. 1.5 Continuing Education Credits/Contact Hours Available for the Following (live event only): AMA PRA Category 1 Credits^TM - ETHICS CREDIT Continuing Nursing Education Certified Health Education Specialists & Master-Certified Health Education Specialists Certified in Public Health Registered Sanitarians Social Workers - ETHICS CREDIT A certificate of attendance is available for those not seeking the credits/contact hours listed above. Suggested Resources: coming soon
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Este Geraghty, MD, MS, MPH, GISP Chief Medical Officer & Health Solutions Director, Esri	Confessions of a Topophiliac Presenter: Este Geraghty, MD, MS, MPH, GISP Chief Medical Officer & Health Solutions Director, Esri Description: Geography is the science that connects people, places and their interactions. To make sense of those complex interactions, many health departments employ geographic information system (GIS) technology. The resulting location intelligence offers tremendous value in promoting health, safety and well-being in the population. This session, presented on 2018’s International GIS Day, will explore how geography intersects and informs health and creates insights for better decisions. Challenges, such as addressing the opioid epidemic and homelessness will be cited as examples. Learning Objectives: Describe a new framework for measuring health equity focused on positive progress toward goals to improve health and well-being. Discuss a new set of metrics that track and compare progress in achieving health equity overall and by income and race/ethnicity. Consider how the HOPE Initiative framework can have practical application within Texas in monitoring and directing health equity progress. 1.5 Continuing Education Credits/Contact Hours Available for the Following (live event only): AMA PRA Category 1 Credits^TM Continuing Nursing Education Certified Health Education Specialists & Master-Certified Health Education Specialists Certified in Public Health Registered Sanitarians Social Workers A certificate of attendance is available for those not seeking the credits/contact hours listed above. Suggested Resources: coming soon
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Grand Rounds Home

Fall 2018 Semester