Spring 2015
All in: Teaming up for a healthier Nevada

synapse: University of Nevada, Reno School of Medicine

Mario Gaspar de Alba discusses a medical case with resident David Carl

In search of behavioral and developmental concerns in children

Mario Gaspar de Alba, M.D., right, a board-certified behavioral and developmental pediatrician in Las Vegas, discusses a medical case with first-year pediatric resident David Carl, M.D. In the foreground are some of the toys and tools that help Gaspar de Alba evaluate and diagnose children with behavioral and developmental issues including attention deficit hyperactivity syndrome and autism. Photo by Edgar Antonio Núñez.

When it comes to improving the health and health care of Nevada, it takes a state. The School of Medicine is cultivating collaborators statewide who are equally dedicated to advancing the cause of good health.

Story by Anne McMillin, APR and David O. Perez

As a community-based medical school, the School of Medicine enjoys a long tradition, dating back to its inception in 1969, of being connected to the Nevada community at multiple touch points.

From reaching out to potential students to partnering with like-minded heath care institutions to provide better patient care, the School of Medicine is deeply involved in the community to improve the health and health care of Nevadans.

Joint autism center in Las Vegas

A collaborative effort that began in 2012 is being formalized between Nevada’s two universities and a private organization for the benefit of southern Nevada’s youngest citizens.

The University of Nevada, Las Vegas Center for Autism Spectrum Disorders, the University of Nevada School of Medicine and the Grant-A-Gift Autism Foundation are working together in multidisciplinary teams to evaluate, diagnose and offer treatment options for families with children suffering from autism and related disorders.

The three organizations combined their expertise to grow the UNLV Center for Autism Spectrum Disorders into a full-service clinic, according to Mario Gaspar De Alba, M.D., a developmental behavioral pediatrician with the School of Medicine.

Teams of speech therapists, psychologists, social workers, vocational therapists, board-certified behavioral analysts, developmental behavioral pediatricians and occupational therapists evaluate young patients and develop a plan of “next steps” for the family, all in one convenient location.

The synergism of these three organizations allows for consolidation, collaboration and coordination of talents and resources.

Increased efficiencies enable scientists to confer with clinicians, therapists, teachers, parents, counselors and advocates as they work together from their different perspectives to provide quality evidence-based treatment and the most comprehensive continuum of services.

“Grant-a-Gift is excited to partner with UNLV and the School of Medicine in creating the most comprehensive center of care for families living with autism and related neurological disorders in Nevada,” said Lynda Tache, founder and executive director of the Grant-A-Gift Autism Foundation.

“Through this collaboration, we will be able to expand current services and offer new and innovative treatments with research that will give families hope of a better future.”

Tache’s son was diagnosed with autism nine years ago by a team of autism specialists that included the School of Medicine’s Colleen Morris, M.D., a genetic pediatrician.

The partnership provides medical research on the causes and treatment of autism, education of health care providers to accelerate early detection and timely treatment, outreach to families to inform them of their options, a continuum of care from childhood through the life span and stronger and more cohesive advocacy.

Hearts at Hug High

High school students had the opportunity to gain hands-on medical experience working with the High Sierra Area Health Education Center and medical students from the School of Medicine as they were guided through basic anatomy in the dissection of pig hearts last December at Hug High School in Reno.

The interactive learning experience is part of the Health Sciences Academy offered to students at Hug High interested in pursuing post-secondary education and careers in health and medicine.

Medical and health services are integrated into the traditional high school curriculum with a focus on hands-on experience facilitated by School of Medicine faculty and students.

School-based health centers

Working in partnership with the Clark County School District, School of Medicine is providing free health care to underserved youth in Nevada’s largest city. With the help of Nevin Wilson, M.D., and David Parks, M.D., School of Medicine pediatricians, four district schools currently house medical school operated school-based health centers.

School-based health centers serve youth ages four to 19 attending the partnered school. The health centers provide immunizations, sports physicals and minor emergency care.

Some specialized clinics assist with asthma care, but all health centers are equipped to address general health needs. Centers operate during regular school hours with no cost to students.

No health insurance is required, only a signed permission slip from a parent or guardian.

The four clinics operated by School of Medicine pediatric residents and faculty include Matt Kelly Elementary School, which was the first to open a health center in 2009.

K.R. Booker Elementary School, Grant Sawyer Middle School and West Preparatory Academy followed soon after.

According to Wilson, Mary Beth Hogan, M.D., has been involved with writing two grants to help fund the asthma side of the project and Dodds Simangan, D.O., a co-chief resident in pediatrics, has done much of the work to ensure the health centers function properly.

“There have been good, positive responses from the clinics and the community and that all depends on clinic location and providers. It is important that we look over our children’s health care so they can attend school,” said Sally Jost, director of health services for the Clark County School District.

The health centers are funded through grants and corporate donations, including a recent $50,000 grant from the United Way of Southern Nevada and obtained by the Nevada Youth Alliance.

Through the School of Medicine and the Nevada Youth Alliance partnership, which dates back to 2008, School of Medicine community health programs such as the school-based health centers have been able to secure several private and federal grants.

“Over the past several years the School of Medicine, in partnership with Nevada Youth Alliance, has served thousands of youth and their families. Additional partners such as Amerigroup Community Care and REACH, affiliated with the Mexican consulate, have joined to assist the School of Medicine’s school-based health centers,” explained David Osman, the Amerigroup senior community relations representative.

According to Osman, approximately 3,000 youth have the opportunity to be served and have access to preventive health care at all four school clinics operated by the School of Medicine.

Annual preview day

Arranged by the School of Medicine’s Office of Admissions and Student Affairs, about 40 undergraduate pre-medical students from the University of Nevada, Las Vegas and Nevada State College toured the medical school’s Reno campus as part of the annual preview day event designed to introduce potential applicants to the medical school’s admissions process.

The day-long event, on Jan. 13, kicked off over breakfast with a welcome from Melissa Piasecki, M.D., senior associate dean for academic affairs. Tim Baker, M.D.’04, associate dean of medical education, gave an introduction on how the School of Medicine prepares doctors for tomorrow’s practice of medicine and Cherie Singer, Ph.D., associate dean for admissions and student affairs, discussed the medical school admissions process.

The students then proceeded to the anatomy lab in the Pennington Health Sciences building on campus where they broke into groups led by current medical students to have a brief anatomy lesson.

Davy Warner, Class of 2017; Laura Stroup, Class of 2015 and Spencer Van Dyck, Class of 2016 led the anatomy overview at three tables each focusing on a different section of the human body: limbs, the head and the torso.

The undergraduates ended their day with exploratory rotations as medical school faculty and staff made presentations on the multiple mini interview process, strategies for taking the MCAT, dual degree programs and writing personal statements for the admissions application.

Office for Community Faculty

Last year, the School of Medicine embarked on an initiative to increase its capacity for student clinical education and to extend its partnerships with community physicians in a more formal and comprehensive manner by creating its new Office for Community Faculty, located at Renown Regional Medical Center in Reno.

“This collaboration was a natural fit for us,” said Max Coppes, M.D., Ph.D., MBA, executive vice president, chief medical and academic officer for Renown Health.

“As an organization we are committed to helping our community increase the number of physicians who can serve the health care needs of northern Nevada.”

The Office for Community Faculty is not only generously supported by Renown Health, it also will serve northern Nevada physicians who want to be more connected to the medical school’s teaching mission.

“This office will be an important part of our relationship with physicians in the community,” said Melissa Piasecki, M.D., senior associate dean for academic affairs.

“We want to develop this office to be targeted to the needs of our community physicians. As a community-based medical school, it is important that we support these faculty in their teaching roles.”

Piasecki said that following a search for a director for the new office, the goal is to take an individualized approach to understanding and enhancing the value of faculty appointments for community physicians.

The Office for Community Faculty will be supported by the Savitt Medical Library, for training and access to online resources; the Office for Faculty Affairs and Development and the Office for Continuing Medical Education along with other new resources identified in the next few months.

These resources and services will be determined by a needs assessment put forward by the new director to community physicians, whether as individuals or entire medical groups.

Ultimately, Piasecki said: “We want this office to evolve in a way that meets the needs of our community physicians and supports them as School of Medicine educators.”

Community physicians will have a particularly important role in developing medical student clerkships in surgery and obstetrics and gynecology in northern Nevada. Community faculty will also be critical to expanding the School of Medicine’s residency training programs in Reno.

Teaching those who assess autism

The University Center for Autism and Neurodevelopment Assessment Team, or UCAN, has been providing assessment and diagnostic services for children in northern Nevada for nearly eight years.

Working under the premise that no one professional discipline possesses the entire skill set necessary to accurately diagnose autism and related disorders, the assessment team pulls together medical and behavioral specialists to assess children from different perspectives.

Team members include Nevada Early Intervention Services, Washoe County School District, Northern Nevada Child and Adolescent Services, University of Nevada, Reno’s Center for Excellence in Developmental Disabilities and the School of Medicine’s Departments of Speech Pathology and Audiology and Psychiatry.

Additional team members from private agencies across northern Nevada also participate.

Moving beyond assessment, the team has added to its repertoire and is now offering formal training to health care professionals across the state.

“We conducted a training workshop in 2014 for 55 professionals across the state in how to administer an autism assessment instrument in the context of an interdisciplinary setting,” said Debra Vigil, Ph.D., a UCAN leader in the Department of Speech Pathology and Audiology.

Taking the training another step farther, UCAN started production this winter on a set of videos aimed at training Nevada’s child care workers on recognizing early developmental concerns and then compassionately bringing those concerns to parents. These videos will help in meeting the 15 continuing education units required by Nevada’s child care workers.

The training workshops and videos follow best practices guidelines from the Center for Disease Control’s “Learn the Signs, Act Early” program.

Resources for the workshops and videos come from the Justin Hope Foundation, Children’s Cabinet, Washoe County Social Services, Title V Maternal and Child Health program and the Leadership Education in Neurodevelopment and Related Disabilities programs.