Beth A. Tarini is an Associate Professor of Pediatrics & Division Director of General Pediatrics and Adolescent Medicine at the University of Iowa. Before that, she was an Assistant Professor in the UM Department of Pediatrics and Communicable Diseases. She received her MD from Albert Einstein College of Medicine (2001) and a master's degree from the University of Washington (2006), where she was a Robert Wood Johnson Clinical Scholar. In addition to her clinical interest in preventative care, she pursues an active research program on issues of newborn screening and genetic testing.
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Melissa will speak about an internal grant to better understand provider practices, specific to involving pediatric patients in end of life planning, prognostication and involvement in difficult medical decision-making.
Imagine that for the last three months, you have had a very bad headache – the worst in your life – that won’t go away, even when you take aspirin. In addition to the headache you have also been feeling dizzy. Your doctor tells you that you need to get a brain scan to test whether the headache is being caused by something serious. There are two possible scans you can get: a Magnetic Resonance Imaging (MRI) or a Computerized Axial Tomography (CT) scan. The MRI provides a slightly more detailed picture and might find something that the CT misses, such as an extremely uncommon blood vessel problem, but nearly all problems serious enough to need treatment would be seen on either the MRI or the CT.
Research has been the focus and the strength of the faculty members affiliated with CBSSM. Researchers have pursued groundbreaking investigations topics such as:
- doctor-patient communication
- psychological adaptation to disability
- health care rationing
- social cognition
- decision aids to communicate risk
- informed consent
- deliberative democracy
An important mission of CBSSM is to extend the ethics education medical students receive at the University of Michigan. Our current curriculum efforts are focused on enriching the existing curriculum and on making instruction on medical ethics for undergraduate medical students at UM more systematic and focused. Our goal is to increase medical student interest in ethics and their competence in recognizing and resolving ethical issues. Our strategy is to weave ethics into the curriculum throughout the 4 years of training in a way that allows students to build upon what they know of ethical theory and to apply that knowledge to their clinical practice. Additionally, given CBSSM faculty expertise, our aim is to create novel ethics curriculum components that incorporate our empirical work in bioethics and our particular expertise in decision science.
CBSSM scholars perform the basic and applied scientific research that will improve health care policy and practice, to benefit patients and their families, health care providers, third-party payers, policy makers, and the general public. In our Decision of the Month web feature, we turn a recent research finding into an interactive decision that a patient or a policy maker might face.
PROGRAM IN CLINICAL ETHICS
The Program in Clinical Ethics within CBSSM represents an expansion of existing services designed to promote a culture of patient-centered excellence by developing a comprehensive set of ethics-related activities. The aims of this program are to: liaise with and provide support to the adult and pediatrics ethics committees; streamline clinical ethics consultation; assist with ethics-related policy development on a regular and proactive basis; organize and administer structured educational programs in clinical ethics; and coordinate empiric research with relevance to clinical ethics within CBSSM.
The article, "The DECISIONS Study: A Nationwide Survey of United States Adults Regarding 9 Common Medical Decisions," authored by Brian Zikmund-Fisher et al. in Medical Decision Making (September-October 2010) was recently identified as the most downloaded article in the journal of all articles published in 2009 and 2010.
Target specific oral anticoagulants (TSOAC)s including dabigatran, rivaroxaban, and apixaban represent novel alternatives to vitamin K antagonists. These medications provide an attractive choice for both physicians and patients alike due to their predictable pharmacokinetics, fixed-dose regimens, lack of routine monitoring, and fewer drug-drug interactions as compared to warfarin. However, these anticoagulants are not without their own unique features and risks, including required dose adjustments for patient specific factors such as renal function, weight, and age, and lack of a routine monitoring parameter to follow patient adherence with therapy. In addition, the cost of TSOACs and the growing number of indications they are currently approved for makes ensuring affordability as well as the correct dosage based on indication for therapy extremely important.
PI(s): Geoffrey Barnes
Co-I(s): Emily Ashjian
Funded by the NIH (R01-MH075023)
Funding Years: 2005-2010
This project examines whether persons with Alzheimer’s Disease (AD) who are incapable of providing independent informed consent to enroll in research still retain other important ethically relevant abilities—in particular, the capacity to appoint a proxy for research decision-making.
UM Affiliated Investigators: Scott Kim (PI), H. Myra Kim (Co-I)
More details can be found at NIH Reporter.
This month's grand rounds features: Michael Jibson, MD, Psychiatry Department speaking about "Psychiatry, Law, and Society: Ethical and Legal Issues in Mental Health"
Please join us for a lively discussion of medical ethics. The Bioethics Grand Rounds is co-sponsored by the Center for Bioethics and Social Sciences in Medicine, the UMHS Adult and Pediatric Medical Ethics Committee, and the Program of Society and Medicine. This educational session is open to all faculty and staff and members of the public. CME credit is available.
To meet ACCME requirements for Faculty Planner disclosure and Presenter Disclosure to participants of CME activities at UM, please be advised that the following faculty planner(s)/co-planner(s) and presenter have no personal financial relationships relevant to the activity listed below:
- Andrew Shuman, MD
- Christian Vercler, MD
Jeff Kullgren's editorial "Injecting Facts Into the Heated Debates Over Medicaid Expansion" was recently published in the Annals of Internal Medicine. In this editorial, Dr. Kullgren reviews Wherry and Miller's study on the effects of ACA on coverage, access, utilization, and health.
Link to IHPI article.
Journeys in Genetics: Ethical, Legal, and Social Implications
with Toby Citrin, J.D. and Scott Roberts, Ph.D.
September 27, 2016
3:00 - 4:00 p.m.
2610 SPH I
1415 Washington Heights
Ann Arbor, MI 48109-2029
Sponsored by Certificate Program in Public Health Genetics 20th Anniversary Seminar Series
"Journeys in Genetics" is an interactive series of seminars that will highlight the unique personal and professional paths that the Certificate Program in Public Health Genetics (CPHG) faculty members have traversed throughout their careers in the field of public health genetics. In this seminar, Professor Citrin will describe a phone call from Detroit's Mayor in 1970, a request from Francis Collins in the early '90s, creation of the Center for Public Health and Community Genomics in 2001, and projects engaging minority communities in learning about genetics and helping to shape policies to guide the field. Professor Roberts will discuss his research program on how individuals appraise and respond to personal genetic information in contexts including genetic susceptibility testing for Alzheimer's disease, cancer genomics, and direct-to-consumer genetic testing.