Renowned Dengue Expert Delivers 19th Annual WINDREF Lecture

The WINDREF building on SGU’s True Blue Campus.

A global health problem, dengue viruses are a major cause of morbidity in tropical and subtropical regions of the world. At the 19th Annual WINDREF Lecture at St. George’s University, Dr. Timothy Endy discussed the unique viral and host factors, and interactions that increase the complexity of dengue and potential vaccine development.

In his presentation titled “Understanding Dengue Pathogenesis and Essential Areas for Research”, the Chief of the Infectious Disease Division at SUNY Upstate Medical University reviewed the history of dengue research in Thailand and shares his key findings and the future directions in the study of the disease. According to Dr. Endy, in countries where dengue is endemic, the first infection happens when children are toddlers with symptoms that can be compared to a bad flu. The second infection, however, is much more worrisome—it can cause what’s called a hemorrhagic fever, which can include unstoppable bleeding inside the body. He cautions that if not treated properly, people, often children, can bleed to death.

“My research mostly focuses on why the second infection is so severe because that is really where all the illness and deaths come from—all of that was set up by the very first infection,” stated Dr. Endy. “Unfortunately, there have not been any studies that really focus on the first infection since it is so hard to find and often goes undetected by healthcare providers. Yet, inapparent dengue is an important component of the overall burden of dengue infection, as it provides a source of infection for mosquito transmission during the course of an epidemic.”

As Professor and Chair of Microbiology and Immunology and Vice Chair of Research in the Department of Medicine at Upstate, Dr. Endy is considered an international expert in the field of dengue and dengue hemorrhagic fever and emerging viral pathogens.

Additionally, Dr. Endy not only came to Grenada to provide an overview of the type of dengue research he’s been doing for almost 30 years but as part of a proposed incidence study in Grenada from 2018-2021 to be conducted in collaboration with SGU and Janssen Pharmaceuticals, LLC. The study will focus on the incidence of infection of the dengue virus in the student body and hopes to provide a better understanding of the host response to the first dengue infection.

Throughout his career, Dr. Endy has conducted basic science research in the field of virology, developed vaccine field and epidemiological study sites in Southeast and Central Asia, conducted phase I and II clinical vaccine trials, and is active in the development and management of research programs that are product oriented towards developing vaccines and diagnostics that meet FDA regulatory requirements.

Previously known as the annual Keith B. Taylor Memorial/WINDREF Lecture, the event was named for SGU’s second Vice Chancellor, whose vision and dedication to the international growth of St. George’s University led to the creation of the Windward Island Research and Education Foundation  in 1994. Since then, the lecture has drawn the attention of numerous renowned presenters willing to share their expertise on topics such as climate change, health needs, and drug abuse and addictions. Past speakers have included Dr. Robert C. Gallo, best known for his role in the discovery of the HIV’s link to AIDS; Dr. Ruth Macklin, a bioethics pioneer; and renowned cardiologist Dr. Valentin Fuster.

Wildlife Conservationist Envisions a Future for Tigers in Northeast Asia

At present, the Siberian tiger is at the tipping point for its recovery or extinction, this according to Dr. Dale Miquelle, Director for the Wildlife Conservation Society’s (WCS) Russia Program. With an estimated 3,500 tigers remaining in the world today, the goal of conservationists is to double that number by 2020, while the cost of inaction would mean their extinction by 2040.

In his recent lecture at St. George’s University, titled, “Dreaming of Donuts: A vision of tiger conservation in northeast Asia”, Dr. Miquelle pointed to poaching, loss of prey, and habitat loss/degradation as the primary reasons for the tiger’s decline. However, Dr. Miquelle believes that the Siberian tiger can be saved, detailing a plan for tiger conservation in northeast Asia.

“First, we should let ‘good’ science drive policy decisions, then secure source sites or protected areas for tigers, as well as secure habitat/populations outside of these protected areas because they represent the majority of tiger habitat,” advised Dr. Miquelle. “We also need to resolve tiger-human conflicts—these conflicts between people and tigers remove animals from the wild and turn public opinion against tigers.”

“Lastly, we need to expand tiger habitat/tiger distribution, and train the next generation of conservationists,” added Dr. Miquelle. “In the Russian Far East and northeast China, there are very few young biologists/conservationists. In Russia especially, the next generation is missing. Hence, we seek to identify, support, and train the next generation of specialists, and provide them stimuli to stay involved.”

Dr. Dale Miquelle was invited to the True Blue campus by the Department of Biology, Ecology and Conservation in the School of Arts and Sciences (SAS). Dr. Andrea Easter-Pilcher, Interim Dean of SAS, met Dr. Miquelle during a two-month sabbatical trip to Siberia and the Russian Far East as Visiting Scientists in 2015. Housed for five weeks in the WCS house in the small village of Terney on the Sea of Japan, she spent time in the field with Dr. Miquelle and other Siberian tiger, leopard, and Musk deer biologists at this biosphere reserve, which is the last stronghold for the Siberian tigers.

“We are preparing our Marine, Wildlife and Conservation Biology students for work on the global stage, as our graduates hail from Grenada, other Caribbean countries, the US, Canada, and Europe,” stated Dr. Easter-Pilcher. “Likewise, Dr. Miquelle knows how to succeed on that level, by leveraging funds, building local professional capacity, and implementing data-driven programs, all in difficult international political environments.

“Hosting someone of Dr. Miquelle’s caliber, in the wildlife and conservation biology sciences, is a testament to SGU’s intellectual breadth and global reach and is a tremendous benefit for our students and the SGU community,” she continued. “We were indeed fortunate to have Dr. Miquelle with us here at SGU.”

Trained as a biologist at Yale, University of Minnesota, and University of Idaho, Dr. Miquelle focused on moose in Minnesota and Alaska for his degrees. However, working for a year on the Tiger Ecology Project in Chitwan National Park, Nepal, with a Smithsonian-led tiger research team changed his focus and cemented his interest in both international conservation efforts and large carnivore research. In 1992, he led the field team of a joint Russian-American Siberian Tiger Project, during which time he became a passionate conservationist, using science as a platform for policy change, working in both China and Russia to ensure a future for big cats.

Currently, Dr. Miquelle also serves as Coordinator for the Wildlife Conservation Society’s Tiger Program, coordinating research and conservation actions to protect large carnivores and the ecosystems upon which they depend, focusing mainly in northeast Asia.

– Ray-Donna Peters

Increasing Patient Safety by Reducing Medical Errors

To prevent unnecessary morbidity and mortality, health professionals must have both an understanding of systems and a commitment to their improvement, this according to Dr. Abbas Hyderi, Associate Dean for Undergraduate Medical Education at University of Illinois (UIC) College of Medicine and keynote speaker at the 24th Annual Geoffrey Bourne Memorial Lecture.

Dr. Hyderi, who also serves as Associate Professor of Clinical Family Medicine at UIC, gave a lively presentation titled “Implementing the AAMC EPA #13: Identify systems failures and contribute to a culture of safety and improvement” at Bourne Lecture Hall to a group of physicians and health care administrators attending SGU’s annual clinical meetings that week.

“The goal here is to increase both the preparedness of interns from day one, as well as patient safety, by decreasing the ‘July phenomenon’,” said Dr. Hyderi. “Though there is some conflicting data, evidence shows that in the month of July there is an increase in the risk of medical errors that occur in association with this time of year in which US medical school graduates begin their residencies.”

Describing Entrustable Professional Activities (EPAs) as units of professional practice, Dr. Hyderi goes on to define these activities as tasks or responsibilities to be entrusted to the unsupervised execution by a trainee once he or she has attained specific competence.

EPA 13 in particular focuses on the expected behaviors of an entrustable learner, including their ability to recognize and report patient safety concerns in a timely manner using existing system reporting structures; to speak up and find actual and potential errors, even against hierarchy; to identify and reflect on the element of personal responsibility for errors; and to recognize causes of lapses, such as fatigue, and modify behavior or seek help.

“EPA 13 is the most aspirational of all the EPAs and could be the biggest game changer in medical education,” stated Dr. Hyderi. “Our hope is that changing our educational and clinical learning environments and systems to create a ‘speak up’ culture will support students to work on systems and not just in systems. Also, this EPA highlights that the self-regulated learning cycle is analogous to the quality improvement cycle and so students will be able to reflect on both their personal and systems contributions to medical errors and continuously improve.”

In his lecture, Dr. Hyderi also considered some of the opportunities for and barriers to incorporating EPA 13 into a school’s medical curriculum, which include the vulnerability, concerns, and hesitance that interns feel when considering when to “speak up”, and the need for more faculty champions and staff support dedicated to EPA projects. Yet, he firmly believes that EPA 13 can serve as a guide to better train students in order to significantly reduce medical errors from the very start of their internship.

“I believe we do not do enough direct observation of nor provide feedback on clinical skills training of students by the time they graduate medical school,” added Dr. Hyderi. “The goal of the five-year project is to test the feasibility of the framework, develop strategies for instruction and assessment, and vet ‘entrustment’ approaches with students being better prepared to successfully transition to graduate medical education.”

In addition to his roles at UIC, Dr. Hyderi is also actively engaged in educational research and scholarship including being the Co-Chair of the Provost’s Strategic Planning Task Force on Interprofessional Education (IPE), as well as Co-Principal Investigator for the primary care residency expansion grant for the UIC Family Medicine Residency. Currently, he is the Chair of the College-wide Curriculum Transformation Task Force and the Chicago campus lead for the prestigious five-year Association of American Medical Colleges (AAMC) Core Entrustable Professional Activities for Entering Residency (CEPAER) Project and was part of the team that represented the College at Harvard’s Shapiro Institute Millennium Conference focused on post-clerkship curriculum.

Dr. Hyderi joins a distinguished list of Bourne speakers that includes Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), and neurology pioneer Lord Walton of Detchant. The lecture series is named for St. George’s University’s first Vice Chancellor, Dr. Geoffrey H. Bourne, an educator, scientist, writer, and visionary who helped guide the University in its early development.

– Ray-Donna Peters

New Zealand Anatomy Conference Examines Impact of “Stethoscope of the Future”

A foundation component of medical education for every clinician, anatomy has recently emerged in the practice of ultrasound technology. Together, they have been called “the stethoscope of the future,” not only in a clinical setting but in the classroom.

For nearly a decade, Dr. Marios Loukas, Dean of Basic Sciences at St. George’s University, has spearheaded its implementation at SGU. As a keynote speaker at the 2017 Australasian & New Zealand Association of Clinical Anatomists (ANZACA), held at the University of Auckland from December 4-6, Dr. Loukas outlined how and why ultrasound has become an integral part of the St. George’s University curriculum.

“We’ve invested a lot in ultrasound training and we’re really ahead of the curve,” Dr. Loukas said. “As more and more schools are teaching it, it’s important that we explain how we did it, why it’s proven beneficial, some problems that we’ve faced, and how we have sorted it out.”

Ultrasound has been a platform for Dr. Loukas at past conferences, including the American Association of Clinical Anatomists (AACA) conference held in Grenada in 2012, after which several attendees obtained hands-on experience utilized SGU’s expansive ultrasound technology during a one-day postgraduate course on the True Blue campus. Dr. Loukas was appointed President of the AACA in 2017.

In New Zealand, he was joined in his presentation by Dr. Anne Agur, a Professor in the Department of Surgery at the University of Toronto and Past President of the AACA; and Dr. Brion Benninger, Executive Director of the Medical Anatomy Center at Western University of Health Sciences in Oregon.

“It was a nice balance,” said Dr. Loukas. “I was able to explain the dean perspective, including our objectives, milestones, and competencies, Dr. Agur provided the health allied sciences angle, and Dr. Benninger showed how ultrasound is integrated into his anatomy course.”

In addition, Dr. James Coey, Associate Course Director for Human Gross and Developmental Anatomy at Northumbria University, and Dr. Sara Sulaiman, Senior Lecturer in Anatomy at NU, were presented with an award for their research on how anatomy instruction across the globe, and what is the most effective way to teach the subject.

“It is imperative to drive our practice by evidence, communicate and collaborate with other medical educators to create an approach fit for today’s requirements and challenges,” Dr. Sulaiman said. “We are very thrilled having received this recognition from an esteemed organization such as ANZACA and we hope that our results and suggestions would drive further discussion and collaboration among anatomy educators.”

Earlier in 2017, Drs. Coey and Sulaiman were recognized for their work by the Anatomical Society of South Africa. In addition, second-year SGU student Jenna Kroeker was recognized by the best clinical anatomy poster presentation at the American Association of Clinical Anatomy annual meeting.

– Brett Mauser

Rutgers New Jersey Medical School Dean Delivers Annual Bourne Lecture at St. George’s University

Dr. Robert Johnson MD, Dean of Rutgers New Jersey Medical School, delivers the 23rd annual Geoffrey H. Bourne Memorial Lecture.

The success of an institution and its personnel can hinge on the professional culture it creates, this according to Dr. Robert L. Johnson, The Sharon and Joseph L. Muscarelle Endowed Dean at Rutgers New Jersey Medical School (NJMS) and keynote speaker at the 23rd Annual Geoffrey Bourne Memorial Lecture.

Dr. Johnson, who also serves as Professor of Pediatrics and Director of the Adolescent and Young Adult Medicine at NJMS, gave the presentation titled “Professionalism in Health Care” at Charter Hall before dozens of hospital administrators who were attending SGU’s annual clinical meetings.

“I think that in these days, it is one of the most important things that we can do,” Dr. Johnson said. “We need to be in charge of that. Many of the things that we used to be in charge of, we aren’t in charge of anymore. Only the profession can adequately define professionalism, set the standards, and make sure that we all adhere to them.”

The Latin phrase “primum non nocere” – or “first, do no harm” – is still the bedrock of the profession, but increased attention is devoted to creating and maintaining a professional workplace, and teaching the principles outlined in “Professionalism in the New Millennium: A Physician Charter,” a groundbreaking research study conducted by the American Board of Internal Medicine (ABIM) Foundation, the American College of Physicians (ACP)-American Society of Internal Medicine (ASIM) Foundation, and the European Federation of Internal Medicine in 2002. The Charter consisted of three fundamental principles – primacy of patient welfare, patient autonomy, and social justice – as well as 10 commitments ranging from honesty and confidentiality to professional competence and improving access to care.

Such commitments to the profession start at the top and are passed down to students not only through communication but observation, what Dr. Johnson called “the hidden curriculum.”

“What students really learn from their professors is not only based on what they say but what they do,” Dr. Johnson said. “They learn to be doctors as a result of mimicking what you do – how you talk to your patients, how you handle problems, how you handle mistakes, and how you talk to each other.”

He also stressed the importance of setting expectations for students through ceremonial events, written documents, and training, with assessments and remediation done based on their performance.

“People come to us with a variety of experiences and backgrounds that determine how they will acquire and administer new material,” Dr. Johnson said. “You must have a process for identifying problems and remediating them.”

In addition to his roles at NJMS, Dr. Johnson chairs the New Jersey Governor’s Advisory Council on HIV/AIDS and Related Blood-Borne Pathogens, as well as the Newark Ryan White Planning Council. He has previously served as the President of the New Jersey Board of Medical Examiners, the Chair of the US Department of Health and Human Services’ Council on Graduate Medical Education. Dr. Johnson joins a decorated list of Bourne speakers that includes Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), and neurology pioneer Lord Walton of Detchant. The lecture series is named for St. George’s University’s first Vice Chancellor, Dr. Geoffrey H. Bourne, an educator, scientist, writer, and visionary who helped guide the University in its early development.

Dr. Kenneth R. Bridges, Expert in Sickle Cell Research, Delivers Annual Keith B. Taylor Memorial/WINDREF Lecture

More than 100 years ago, sickle cell disease was discovered while two doctors examined Grenadian-born Walter Clement Noel. One of the world’s leading authorities on the disease, Dr. Kenneth R. Bridges, Founder and Director of the International Sickle Cell Anemia Research Foundation, delved into this disease, and its treatments, in his keynote address at the annual Keith B. Taylor Memorial/WINDREF Lecture on January 18 at St. George’s University’s Bourne Lecture Hall.

“Sickle cell disease is the world’s most common single gene disorder,” said Dr. Bridges in his address. “However, the disease is not simply a blood disorder but a systematic disorder that affects every part of the body. Tell me which area of the body you’re interested in studying and I will tell you what sickle cell disease does to it.”

Sickle cell disease is a disorder of the blood caused by an inherited abnormal hemoglobin (the oxygen-carrying protein within the red blood cells) that causes distorted (sickled) red blood cells leading to tissue and organ damage and chronic pain.

The current treatment of sickle cell disease focuses on treating symptoms while the more challenging and expensive treatments like disease modification therapies remain underutilized, including a promising new drug treatment called GBT440, which causes the inhibition of polymerization of deoxygenated sickle cells.

“The GBT440 drug was specifically and carefully designed to fit into this one area of the body where it stops the abnormal hemoglobin cells from sticking together in the first place, which is at the very start of the problem,” explained Dr. Bridges. “Now with the help of our colleagues here in Grenada, we’re hoping to recapitulate this treatment in a much more profound way and to really deliver on the promise made to Walter Clement Noel 100-plus years ago in that we will now be able to effectively treat this disorder.”

Dr. Bridges received the MD degree from Harvard Medical School, and subsequently trained in internal medicine and hematology in Boston, at Massachusetts General and Brigham and Women’s Hospitals, respectively. Following medical subspecialty training, Dr. Bridges worked on the biology of cellular iron metabolism for three years at the National Institutes of Health in Maryland. He later returned to Harvard as a member of the Hematology Division at Brigham and Women’s Hospital, where he reached the faculty rank of Associate Professor of Medicine. During this time, Dr. Bridges also maintained active clinical work and established the Joint Center for Sickle Cell and Thalassemic Disorders at the two aforementioned Boston-based institutions, emphasizing bench-to-patient translational research.

WINDREF and St. George’s University have long attracted world experts on climate change, health needs, and drug abuse and addictions, among other topics to its various lecture series. Past speakers have included Dr. Robert C. Gallo, best known for his role in the discovery of the human immunodeficiency virus (HIV); Dr. Ruth Macklin, a bioethics pioneer; and renowned cardiologist Dr. Valentin Fuster.

The annual Keith B. Taylor Memorial/WINDREF Lecture is named for SGU’s second Vice Chancellor, whose vision and dedication to the international growth of St. George’s University led to the creation of the Windward Island Research and Education Foundation (WINDREF) in 1994; was instrumental in instituting the School of Arts and Sciences in 1996; and whose memory was honored with the creation of the Keith B. Taylor Global Scholars Program and the establishment of Keith B. Taylor Hall on the True Blue campus in 2007.

Professor Ian McConnell Delivers Annual Keith B. Taylor Memorial/WINDREF Lecture at St. George’s University

Professor Ian McConnell, most recognized for his fundamental discoveries on the immune system, drew upon his distinguished career in research while delivering the Keith B. Taylor Memorial/WINDREF Lecture at Bourne Hall on November 8. His address, titled “One Health: Successes and Opportunities,” focused on the immunology of infectious diseases of both animals and man, and was delivered to an audience of more than 1,100 faculty, staff, community members, and online viewers.

ian-mcconnell-lecture

Dr. McConnell is an Emeritus Professor of Veterinary Science and Director of Research at the University of Cambridge, England. One Health has been a theme of his extensive research and teaching, with particular emphasis on zoonotic diseases and genetic diseases of animals that have parallels with genetic diseases in man. In particular, his work is currently focused on the scientific basis of infectious diseases of animals and man and how they impact public health at a global level.

“One Health is a concept that has had a long history in both medical and veterinary science,” said Dr. McConnell. “It is an important and defining concept which recognizes the interconnectedness between medicine, veterinary medicine, epidemiology, and the biomedical and biological sciences. Public health, environmental health, and biodiversity all play in to the issues and concerns affecting the health of animals and man.”

ian-mcconnell-lectureAlthough One Health is a broad subject that covers many areas in veterinary medicine, human medicine, and biological sciences, Dr. McConnell chose to focus his lecture on two areas: global infectious diseases and comparative medicine. He used the examples of the eradication of rinderpest and rabies in animals in Europe to illustrate the successes and opportunities for One Health in global infectious diseases. For comparative medicine, he discussed the opportunities for translational research in man based on the repair of spinal cord injuries in dogs.

In addition to his professorship, Dr. McConnell is a Founder Fellow of the Academy of Medical Sciences, the UKs foremost Academy of medical science. He is a Fellow of the Royal Society of Edinburgh (FRSE), and was elected to Fellowships of the Royal Society of Medicine, and Royal College of Pathologists’ on scientific merit. He is a Professorial Fellow in Veterinary Science of Darwin College Cambridge.

After he graduated in veterinary medicine from the University of Glasgow and in Natural Sciences (Pathology) from the University of Cambridge, he carried out his doctoral studies (PhD) in immunology in the laboratory of Professor Robin Coombs, one of the founding fathers of immunology, in the Department of Pathology at Cambridge. Professor McConnell also gave the 13th Annual Geoffrey H. Bourne Memorial Lecture at St. George’s University in 2007.

The Annual WINDREF and Keith B. Taylor Memorial Lecture, named after SGU’s second Vice Chancellor, has drawn the attention of numerous renowned presenters willing to share their expertise on topics such as climate change, health needs, and drug abuse and addictions. Past speakers at the lecture have included Dr. Robert C. Gallo, Director of the Institute of Human Virology at the University of Maryland School of Medicine, best known for his role in the discovery of the human immunodeficiency virus (HIV), and Dr. Valentin Fuster, a renowned cardiologist who presented on the topic, “The Worldwide Challenge of Cardiovascular Disease.”

Published on 11/15/16

Dr. Ruth Macklin Presents at Annual Keith B. Taylor Memorial WINDREF Lecture at St. George’s University

A Founder of Bioethics Field Discusses Ethical Challenges in Confronting Disasters

Dr. Ruth Macklin, one of the founders of the field of bioethics, spoke on the difficult ethical issues involved with the allocation of scarce resource in times of disaster in her lecture, Ethical Challenges in Confronting Disasters: Some Lessons Learned on April 14, 2015 at St. George’s University Caribbean House, attended by a mix of faculty, staff and members of the community.

dr ruth macklin

Using case studies which looked at the responses, outcomes, and lessons learned from Hurricanes Katrina and Sandy, as well as the earthquake in Haiti, Dr. Macklin pointed to the many complex ethical decisions disaster preparedness and response involves—from gauging the severity of a disaster to the planning, coordinating and predicting of the human response.

“In the case of medication, one of the basic pervading ethical principles is to save the most lives, where patients are treated according to the severity of their condition,” said Dr. Macklin. Patients are organized using a triage system so that those for whom immediate care might make a positive difference in outcome can be treated as quickly as possible.

“The aftermath of a disaster can be felt for a very long time, often beyond the immediate effects and treatment,” said Dr. Macklin. “At the end of the day there are no easy answers.”

Dr. Ruth Macklin is a Professor in the Department of Epidemiology and Population Health and a Dr. Shoshanah Trachtenberg Frackman Faculty Scholar in Biomedical Ethics at the Global Health Center, at the Albert Einstein College of Medicine. She has published extensively in the areas of biomedical research, public health ethics, stem cell research and end-of-life issues. Dr. Macklin has served on committees of the World Health Organization, including its vaccine advisory committee and was elected to the Institute of Medicine, a branch of the National Academy of Science. Dr. Macklin is a past president of the International Association of Bioethics and currently serves on its board of directors.

WINDREF and St. George’s University have long attracted world experts on climate change, health needs, and drug abuse and addictions, among other topics to its various lecture series.

Past speakers include, Dr. Robert C. Gallo, Director of the Institute of Human Virology at the University of Maryland School of Medicine, best known for his role in the discovery of the human immunodeficiency virus (HIV), who spoke on the topic “Virus and Epidemics: Our Attempts to Control them with emphasis on HIV and AIDS”, and Dr. Valetin Fuster, a renowned cardiologist, who presented on the topic, “The Worldwide Challenge of Cardiovascular Disease.”

This lecture was presented in partnership with the Caribbean Research Ethics Education Initiative (CREE) and supported in part by the US National Institutes of Health (HIH) Fogarty International Center.

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