Washington School Research Articles

Complete decongestive therapy phase 1: an expert consensus document.

This document was drafted by interdisciplinary experts informed by the evidence and guided by their extensive lymphedema clinical experience at the 2023 American Cancer Society(ACS) Lymphedema Summit: Forward Momentum: Future Steps in Lymphedema Management hosted by the ACS, Lymphology Association of North America, and the Washington School of Medicine in St. Louis, Missouri. Consensus statements were derived from a facilitated workshop and multiple follow-up discussions and meetings combining available evidence and clinical expertise. The consensus statements find that the essential components of complete decongestive therapy (CDT) are examination, compression, manual techniques (this may include but is not limited to manual lymph drainage), exercise, skin care, education, and self-management. Adjunctive interventions and alternatives may complement CDT. CDT should be provided by specifically trained healthcare practitioners in lymphedema management, preferably a certified lymphedema therapist. The individual's lymphedema etiology and presentation, comorbidities, and other pertinent clinical information will determine the components of CDT applied and the frequency and duration of care.

Training a rural oral health workforce: Effects of rural background on dentist practice choice

AbstractPurposeThe Regional Initiatives in Dental Education (RIDE) program is an educational track of the University of Washington School of Dentistry that aims to produce leaders who practice in rural areas of the Pacific Northwest. This study assesses outcomes of the first 10 years of the RIDE program. The hypothesis tested is that rural background is the most important predictor of long‐term rural dental practice.MethodsThis descriptive study assessed existing data including graduates' location of practice, demographics, rurality of origin, parental occupation, and practice type over time. Subjects are all graduates of the RIDE program from 2012 to 2021 (N = 80), and range in age from 25 to 50 years. Statistical analyses were utilized to explore associations.ResultsWithin the study sample 78% of graduates practiced in a rural and/or underserved area, 32.5% of graduates pursued post‐graduate dental training, 40% participated in Medicaid, and 78% practiced in the Pacific Northwest at the time of analysis (March 2023). Statistical analysis demonstrated a strong association and medium to large effect sizes between both rural upbringing and training sites and established dental practice in a rural region.ConclusionsGraduates of the RIDE program practice in rural areas in greater proportion compared to the general population of practicing dentists. RIDE graduates from the study period tended to be male, and white, and practice in a health professional shortage area or rural site. The rurality of origin analysis was confounded by the substantial number of graduates from Spokane, Washington, an urban area surrounded by extensive rural territory.

Charterization, Gentrification, and the Geography of Opening and Closing Schools in Washington, DC

Charterization, Gentrification, and the Geography of Opening and Closing Schools in Washington, DC

A Washington School “Thing”

A Washington School “Thing”

Leveraging Maker Learning in STEM to Promote Children's Interest in Cancer Research: A Pilot Program.

Children's early awareness about cancer, through exposure to cancer biology and prevention strategies and research principles, is a promising focus of education and learning. It may also benefit the pipeline of people entering into science, technology, engineering, and math (STEM) careers. We describe an educational pilot program for elementary school students, using developmentally appropriate activities focused on cancer at a museum dedicated to children's maker-centered learning and STEM. The program was implemented through a public school in Washington, DC serving students underrepresented in STEM. Program conceptualization, museum and school engagement, and maker learning pedagogy are described, as well as curricular outcomes. A total of N = 111 students (44% female, 75% Black/African American, 5% Latine) participated in a day-long field trip. Museum educators, assisted by cancer center researchers, led a multipart workshop on cancer and the environment and hands-on rotation of activities in microbiology, immunology, and ultraviolet radiation safety; students then completed self-report evaluations. Results indicate that nearly all (> 95%) students practiced activities typical of a STEM professional at the program, and > 70% correctly answered factual questions about topics studied. Importantly, 87-94% demonstrated clear STEM interest, a sense of belonging in the field, and practice implementing skills for success in STEM (e.g., perseverance, imagination, teamwork). This pilot demonstrated acceptability and feasibility in delivering a cancer-focused curriculum to underserved elementary students using maker learning while favorably impacting key objectives. Future scale-up of this program is warranted, with the potential to increase students' motivation to engage in STEM and cancer research.

Simulation clinic waste audit assessment and recommendations at the University of Washington School of Dentistry.

Dentistry produces waste contributing to climate change and adverse health outcomes, thus reducing waste is essential; however, there has been minimal emphasis on sustainability or climate action in dentistry. Waste audits quantify the type and amount of waste produced and may inform waste reduction strategies. We conducted a waste audit to identify areas of potential waste reduction and recommend interventions to reduce waste. In this cross-sectional study, we conducted a waste audit of garbage produced during a typical 4-hour pre-clinical restorative dentistry simulation exercise. The sample was composed of 72 second-year dental students. This exercise is part of a standard curriculum with a uniform format regarding supplies used and participants. Potentially infectious materials were not used during this exercise. In total, 26.6kg of waste was discarded. Plastic was the largest contributor by mass (57.5%), followed by paper barriers (19.6%), then impression materials (6.5%). We found 894 gloves and 70 masks discarded. Based on these findings, we categorized waste reduction opportunities into policy changes, purchasing sustainable materials, and increasing awareness through education. Specific suggested actions include: relaxing glove and gown requirements during laboratory simulations; replacing single use items with more sustainable options; increasing use of intraoral scanners; and posting informational signage with examples of what can be recycled.

Associations between a technical assistance model to build school organizational capacity and improvements in student perceptions of school climate.

Organizational capacity building-the process of developing leadership, collecting and analyzing data, building buy-in, and implementing programming-is foundational to effectively changing schools, and frequently relies on technical assistance. This study employed a quasi-experimental, repeated measured design to evaluate the role of technical assistance provided through Safe School Certification model in improving school climate. Schools worked through an eight-element framework, using data from a sample of six middle and high schools in Washington, D.C. that completed data collection in all years of the evaluation. Students in schools receiving technical assistance for implementing the SSC Framework had more positive changes in perceptions of school climate than students in schools that did not receive support, but those differences were small. The results from this study offer limited evidence that providing schools with technical assistance to improve organizational capacity is associated with more positive student perceptions of school climate.

Revealing key role of T cells in neurodegenerative diseases, with potential to develop new targeted therapies.

David M. Holtzman and his team at the University of Washington School of Medicine have made breakthroughs in their research on neurodegenerative diseases. They discovered that the infiltration of T cells into the brain, instigated by activated microglia, is a critical factor in the progression of tauopathy. The groundbreaking findings were published in Nature on March 8, 2023. This research delineates a pivotal immune hub linked to tauopathy and neurodegeneration; a complex interplay involving activated microglia and T cell responses. This discovery could potentially become a target for developing therapeutic interventions for Alzheimer's disease and primary neurodegeneration.

“Close and desirable for whom?”: parents traversing racialised spaces and places in gentrifying U.S. schools

ABSTRACT Within public schools in gentrifying U.S. neighbourhoods, affluent, White families’ priorities collide with those of families from economically disadvantaged and racially minoritized groups. Grounded in raced-classed theories of space and place, we examine how various indicators of gentrification intersect with parents’ experiences in schools and how parents negotiate competing claims to space amid neighbourhood change. We foreground interviews with parents from gentrifying schools in Greater Boston and Washington D.C. Findings reveal how neighbourhood racial and socioeconomic changes informed parents’ connections to schools. Residential proximity to schools and commercial centres shaped parents’ sense of belonging in schools. Parents’ negotiation of racial, spatial, and classed hierarchies in schools and neighbourhoods reveals a need to situate their experiences and perspectives as foundations for school reforms and urban planning initiatives that address and contest social and educational inequities.

Law schools clearly affirming their missions

In early December, the University of Washington School of Law became one of a growing number of U.S. law schools deciding to end their participation in U.S. News & World Report rankings.

Law schools clearly affirming their missions

In early December, the University of Washington School of Law became one of a growing number of U.S. law schools that have decided to end their participation in the U.S. News & World Report ranking methodology.

When the Student Gave Me Feedback.

1B. Fu is clinical associate professor, Department of Family Medicine, University of Washington School of Medicine, and director, Mayutica Institute, Seattle, Washington; email: [email protected]; Twitter: @theimprovdoc; ORCID: http://orcid.org/0000-0003-4267-679X.

Need for pediatric specifications for chronic pain diagnoses in the International Classification of Diseases (ICD-11).

aGerman Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany bDepartment of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany cDepartment of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom dDepartment of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States eSeattle Children's Research Institute, Seattle, WA, United States *Corresponding author. Address: Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Dr.-Friedrich Steiner Str.5, 45711 Datteln, Germany. Tel.: +49-2363-975-180; fax: +49-2363-975-181. E-mail address: [email protected] (J. Wager).

Pathogenesis and immune response: editorial Biomedical research discoveries: acceptance, controversies and current challenges to improving human health

Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA Correspondence to Dennis L. Stevens, PhD, MD, 4461 East Victory Road, Meridian, ID 83642 USA. E-mail: [email protected]

Editorial introductions.

Editorial introductions.

Lessons Learned From Integrating Anti-Oppression Pedagogy in a Graduate-Level Course in Epidemiology.

Despite the high burden of injury and violence globally and disproportionate burden on marginalized communities, few US schools of public health and departments of epidemiology offer classes focused on injury and violence, and even fewer are taught with an antiracist or anti-oppression framework. Recent years have brought renewed focus to incorporating antiracist and anti-oppression principles to pedagogy. Public health professionals have increasingly grappled with how we teach, conduct research, and advocate for just policies, which are shaped by interlocking systems of oppression. Although all areas of epidemiology are shaped by these structures, motivations for those who study injury and violence ought to be especially keen. In this commentary, we illustrate how anti-oppression can be integrated into course development and delivery with a case study of a graduate-level course at the University of Washington School of Public Health on injury and violence epidemiology. We include feedback from an epidemiology faculty reviewer, as well as narratives from students describing what worked and what did not. We offer our reflections and lessons learned, hoping to encourage others within public health and epidemiology to adopt an anti-oppression framework in developing classes and programs, particularly those related to injury and violence.

Impact of Pre-Advanced Pharmacy Practice Experience (APPE) Curriculum on Student Pharmacists’ Professional Identity Formation

ObjectiveTo (1) evaluate changes in student pharmacists’ professional identity during a curriculum prior to advanced pharmacy practice experiences (APPEs) and (2) describe the components of a pre-APPE curriculum that positively and negatively influenced students’ professional identity formation (PIF). MethodsThe University of Washington School of Pharmacy launched a new curriculum in 2019 featuring components intentionally designed to support students’ PIF. The Macleod-Clark Professional Identity Scale (MCPIS) was administered to the class of 2023 before starting pharmacy school (pre) and upon completion of the pre-APPE curriculum (post). The postsurvey also contained 2 open-response questions asking students to identify the most positive and negative influences on their PIF. Mean pre- and post-responses were calculated for all MCPIS items and each MCPIS item and compared using paired t tests. Responses to the open-ended questions were sorted into categories using inductive thematic analysis and frequencies were calculated. ResultsA total of 99 students (96%) completed both surveys. Mean MCPIS pre-scores and post-scores were both 3.3, indicating no statistically significant change in professional identity. The most frequently reported positive influences on PIF were didactic coursework (40%), experiential learning (30%), and student organizations (27%). The most frequently reported negative influences were didactic coursework (27%), none (25%), and perceptions of the pharmacy profession (22%). ConclusionStudents’ overall professional identity, as measured by the MCPIS, did not change during the pre-APPE curriculum. Didactic coursework had the most common positive and negative influence on professional identity prior to APPEs.

90 Developing a Clinical and Translational Research Pathway Across Three Health Sciences Disciplines

OBJECTIVES/GOALS: The design and phased roll-out of a CTSA competency-based longitudinal Clinical and Translational Research (CTR) curriculum pathway that can be integrated into the training of health sciences professional degree programs at three regional institutions. The outcome will be an increased number of health science professionals participating in CTR. METHODS/STUDY POPULATION: Based on an environmental scan, student surveys to assess interest, and feedback from regional stakeholders, a CTR pathway program was developed. The pathway curriculum will be grounded in 6 key focus areas derived from the Core Competencies in Clinical and Translational Research and prioritized based on regional need. The CTR pathway is currently being developed for the University of Washington School of Medicine, with additional implementations at the Washington State University School of Pharmacy and the Montana State University School of Nursing. Students will complete training modules and a mentored research project that is integrated into their specific course of study. RESULTS/ANTICIPATED RESULTS: In addition to the initial assessments and curriculum, an Advisory Committee will be established. Mentors, site leads, and research project partnerships across the region will be identified. Modifications will be made according to the local needs at both Montana State University and Washington State University. After the pilot launch and roll-out, the pathway curriculum will be adapted for other disciplines based on input from content experts and pathway evaluation data. Student retention in CTR fields will be tracked, with a goal to increase the number of CTR investigators and professionals across WWAMI in the next decade. CTR pathway processes and training resources will be shared with the CTSA consortium and other health sciences professional training sites. DISCUSSION/SIGNIFICANCE: Development of the CTR workforce is a priority to increase national capabilities in clinical and translational science. Building on a recognized need for targeted and longitudinal engagement, a CTR pathway is being established for health sciences students in the WWAMI region.

Law schools clearly affirming their missions

In early December, the University of Washington School of Law became one of a growing number of U.S. law schools that have decided to end their participation in the U.S. News and World Report rankings process.

Cell-Based Therapies: Strategies for Regeneration.

The neural retina of mammals, like most of the rest of the central nervous system, does not regenerate new neurons after they are lost through damage or disease. The ability of nonmammalian vertebrates, like fish and amphibians, is remarkable, and lessons learned over the last 20 years have revealed some of the mechanisms underlying this potential. This knowledge has recently been applied to mammals to develop methods that can stimulate regeneration in mice. In this review, we highlight the progress in this area, and propose a "wish list" of how the clinical implementation of regenerative strategies could be applicable to various human retinal diseases.