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<< Introduction to the MSTAR program at UCSF >>
<< List of research mentors at UCSF >>
Introduction to the MSTAR program at UCSF
Dear prospective MSTAR student,
Welcome to the MSTAR program at UCSF! We are a satellite program of the UCLA MSTAR training site, meaning that we enact our own research and clinical activities for students based in San Francisco, but coordinate the applications process and “big-picture” national activities with program leaders at UCLA.
The UCSF MSTAR program is primarily open to UCSF students with an interest in aging research. However, on a space-available basis we can accommodate students from other institutions. Students who are interested in applying to the UCSF site are strongly encouraged to contact Dr. Mike Steinman (the site director) at
The main focus of the MSTAR program at UCSF is a mentored research experience. Typically, once students are accepted into the program we help to match them with mentors (see the list of mentors later in this document). However, it is also possible for students who already have a research mentor to join the program.
In addition to the mentored research experience, two other core elements run throughout the summer. First, we arrange a variety of clinical experiences in geriatrics and related fields for students. These vary from week to week, but typically occur on Mondays and last for a half-day. Second, we offer a didactic program with small-group teaching and “meet-the-professor” sessions related to research and clinical care of older adults. These sessions occur on Tuesday mornings. In addition, students are required to attend our geriatrics research works-in-progress conference, which occurs Wednesday mornings from 8:15 – 9:30 AM.
In the latter part of the summer, all MSTAR students at UCSF fly to LA to present their research in a symposium with MSTAR students based in LA, Seattle, and Denver. In addition, we strongly encourage all MSTAR students to submit their research to the annual meeting of the American Geriatrics Society, which occurs in May of each year (for example, if a student is with us the summer of 2012, she or he would go to the AGS meeting in May 2013). There is a special student symposium at the meeting, and it’s a great opportunity to present your research, meet other students from around the country, and get a flavor for the wider community of geriatrics and aging research. We cover expenses to attend both the LA and AGS meetings.
Finally, a few other logistical considerations bear mention
· To allow for maximum productivity over the summer, we ask that students complete web-based research compliance trainings before starting their MSTAR experience (these trainings are required for all people at UCSF who do research). This typically involves a few hours of completing a handful of web-based courses.
· The stipend check is scheduled to arrive in mid- to late June, so please be sure to plan your finances accordingly (i.e. if you start June 1st, don’t expect a check the first week you are here).
As noted above, any students who are interested in applying to the UCSF program should contact me. Thank you for your interest in MSTAR!
Yours,
Michael Steinman, MD
Associate Professor of Medicine (Division of Geriatrics), UCSF
Site Director, MSTAR program
Email:
Tel: (415) 221.4810 x3677
12.13.2011
UCSF mentors for the MSTAR program
RESEARCH MENTORS IN THE UCSF DIVISION OF GERIATRICS
RESEARCH MENTORS IN OTHER UCSF DIVISIONS AND DEPARTMENTS (see below)
RESEARCH MENTORS IN THE UCSF DIVISION OF GERIATRICS
· Kenneth Covinsky, MD
· C. Seth Landefeld, MD
· Sei Lee, MD, MAS
· Edgar Pierluissi, MD
· Alexander Smith, MD
· Michael Steinman, MD
· Rebecca Sudore, MD
· Louise Walter, MD
· Brie Williams, MD, MS
Ken Covinsky, MD, MPH
My colleagues and I are interested in the broad determinants of health outcomes in older persons. We use epidemiologic datasets to examine predictors of health outcomes, and to develop models to distinguish between elders at high and low risk of health outcomes. We are particularly interested in functional status---both in terms of understanding the determinants of functional status outcomes, and the role of functional status in predicting other health outcomes.
Much of our work using the Health and Retirement Study (HRS), a large study of health outcomes in US persons over the age of 50. The HRS survey provides opportunities to address a wide range of research questions in the elderly. The HRS study can be accessed at http://hrsonline.isr.umich.edu/.
C. Seth Landefeld, MD
Dr. Landefeld is chief of the UCSF Division of Geriatrics. His primary research focus is on the quality of care for hospitalized elders, in particular the impact of structured care settings on outcomes in vulnerable older populations. He also maintains an active interest in research on anticoagulation.
Sei Lee, MD, MAS
Dr. Lee has 3 main areas of research interest:
1) Prognosis and Risk-Adjustment: I’m interested in how best to predict which subjects are going to do well, and which subjects are going to do poorly. I’ve studied the importance of factors such as chronic conditions, functional limitations, self-rated health and socioeconomic status and have examined whether accounting for these factors affects the protective effects of moderate alcohol use and volunteering.
2) Geriatric Diabetes: I’m interested in how varying levels of glycemic control affects geriatric outcomes such as incontinence, falls and functional decline in the frail elderly.
3) Quality Measurement: I’m interested in how best to measure healthcare quality and am currently working on a project developing quality indicators for Medicaid Home and Community-Based Services.
Edgar Pierluisi, MD
My research focuses on improving care for hospitalized older adults, especially those with mild cognitive impairment and Alzheimer’s disease. On going projects include understanding patient and nurse attitudes towards exercise in the hospital, predictors of disability during hospitalization, and depression trajectories in the year after discharge. Previous medical student projects have included and analysis of the effectiveness of an Acute Care for Elders Unit in a Public Hospital and Patient Expectations and Attitudes Towards Exercise in the Hospital.
Alex Smith, MD
I am interested in improving palliative and end-of-life care for older adults. My current projects focus on the epidemiology of symptoms and health services utilization in the last two years of life, using a nationally representative survey linked to Medicare claims data, and improving palliative care in the emergency department.
Michael Steinman, MD
Dr. Steinman's research focused on understanding and improving the quality of prescribing for elders with multiple chronic conditions. His research program includes studies of risk factors for adverse drug reactions in ambulatory elders; reasons why physicians do not adherence to guideline-recommended practices; assessing prescribing quality and defining best practices in patients with common combinations of diseases; and measurement of physician performance in the management of hypertension. In addition, Dr. Steinman maintains an active research interest in the impact of pharmaceutical industry marketing on physician prescribing behavior.
Rebecca Sudore, MD
Dr. Sudore, Assistant Professor at the University of California, San Francisco (UCSF) received her MD from UCSF where she also completed her Internal Medicine residency, and Geriatrics and Research Fellowships and became board certified in Hospice and Palliative Medicine. She has an active geriatrics clinic and attends on the Palliative Care Consult Service. Dr. Sudore’s research focuses on the intersection of limited health literacy, geriatrics, end-of-life care, and medical decision making. She published the first prospective study demonstrating the effect of limited literacy on mortality in the elderly, and has shown that elders with limited literacy have greater difficulty making medical decisions for informed consent and advance care planning. She has designed and tested interventions to improve patient decision making by creating an informed consent process for patients with limited literacy and an advance directive that is both literacy and culturally appropriate. Both interventions have been shown to benefit patients – particularly those with literacy and/or language barriers. Her NIA K23 and subsequent VA CDA is focused on creating culturally and literacy appropriate tools to help patients define the value they place on the burden and outcomes of treatment with the goal of better enabling patients to engage in the advance care planning process.
Louise Walter, MD
Title of Project: Impact of Health Status on Colorectal Cancer Screening in Older Adults
The goal of this project is to improve our ability to target colorectal cancer screening to healthy elderly veterans who may reasonably benefit and to avoid screening in unhealthy elderly veterans for whom the burdens outweigh the potential benefits. Because persons with limited life expectancies may be harmed by screening, and because life expectancy is better predicted by health status than by age alone, most colorectal cancer screening guidelines recommend screening decisions take into account an older person’s health status. However, it is unclear to what extent colorectal cancer screening is actually targeted to healthy older persons and avoided in unhealthy older persons with limited life expectancies. This study describes how patterns of use and outcomes of colorectal cancer screening vary according to health status among older veterans. This project will provide information necessary to design guidelines, interventions, and quality indicators that encourage screening healthy elderly veterans who are often under-screened and discourage screening unhealthy elderly veterans who are more likely to be harmed than benefit. This is an ongoing study in which students may participate in a structured review of the literature, in analyses of existing data, and in potentially reviewing some medical charts to understand why some healthy elderly veterans are not screened while some unhealthy elderly veterans are screened.
Brie Williams, MD, MS
Brie Williams, MD, MS is an Assistant Professor of Medicine in the Division of Geriatrics at the University of California, San Francisco. She received her MD and MS in Community Medicine from the Mount Sinai School of Medicine, was an Internal Medicine Resident at UCSF, and was a Clinician Educator in the Division of General Internal Medicine at UCSF before returning to a Geriatrics Fellowship at UCSF. Dr. Williams’ current work focuses on the intersection between geriatric medicine and the legal system. She is interested in the health of older adults who come into contact with the law either as perpetrators or as victims of crime. Her current research focuses on understanding and improving the healthcare of incarcerated older adults and of older adults who will soon be released to the community.
RESEARCH MENTORS IN OTHER UCSF DIVISIONS AND DEPARTMENTS
· Deborah Barnes, PhD, MPH
· Beth Cohen, MD
· Alison Huang, MD, MAS
· Bruce Miller, MD
· Eliseo Perez-Stable, MD
· Tung Nguyen, MD
· Urmimala Sarkar, MD
· Mary Whooley, MD
· Kristine Yaffe, MD
· Ed Yelin, MD
Deborah Barnes, PhD, MPH
Dr. Barnes is an Associate Professor in the Department of Psychiatry at UCSF, a Mental Health & Health Services Research PI at the San Francisco VA Medical Center, and a Senior Investigator with UCSF's Program for the Aging Century. She is also affiliated with the Osher Center for Integrative Medicine.
Dr. Barnes' research focuses on identification of factors that may prevent, delay onset or ameliorate the symptoms of cognitive impairment and dementia in older adults. She is particularly interested in the potential protective effects of physical and mental activity and is PI of several randomized, controlled trials in this area. Her research also explores the complex association between depression and dementia.
Beth Cohen, MD
Alison Huang, MD, MAS
Dr. Huang's research is directed at understanding the complex relationships between atrophic changes in the urogenital tract, self-reported vaginal and urinary tract symptoms, vaginal and urinary tract infections, and sexual function and related quality-of-life domains in older women. Her long-term goal is to promote understanding and improve management of urogenital and menopausal health and associated quality of life in older women of diverse backgrounds.
Bruce Miller, MD
Dr. Miller is Director of the UCSF Memory and Aging Center:
Mission: Our mission is to provide the highest quality of care for individuals with cognitive problems, to conduct research on causes and cures for degenerative brain diseases, and to educate health professionals, patients and their families.
History: In 1998, Dr. Bruce Miller, Dr. Joel Kramer, Dr. Kristine Yaffe and Rosalie Gearhart started the Memory and Aging Center. There are approximately 1500 clinic appointments per year (500 new patient and 1000 follow-up visits). There are 300-500 individuals participating in the center’s research projects per year.
New diagnostic and treatment approaches to Alzheimer’s disease (AD) and non-AD dementias, including Frontotemporal Dementia, Creutzfeldt-Jakob disease, and Mild Cognitive Impairment have been established at UCSF.
Eliseo Perez-Stable, MD
My research is focused on health and health care disparities by race and ethnicity with a special emphasis on cancer prevention and cigarette smoking cessation among Latino populations. In 1993, I co-founded the Medical Effectiveness Research Center for Diverse Populations (MERC) in collaboration with A. Eugene Washington, MD and was Co-Director until July 2005 when I became Director. MERC is made up by a team of multidisciplinary investigators focused on health disparities by race/ethnicity with a special emphasis on cancer prevention, reproductive health, patient-doctor communication, and aging. My work has elucidated the causes of health disparities in Latinos and tested innovative strategies to improve the quality of care for Latinos. We found that web based cessation intervention in Spanish and English showed abstinence rates of 15% to 24% at one year, comparable to quit lines and nicotine replacement. We have also studied smoking patterns in Argentina among adults and youth. With a R01, we conducted a prospective cohort study to characterize smoking patterns among 3500 mostly indigenous youth living in Northwest Argentina. In the new cycle we plan to test a community-based smoking prevention intervention targeted at youth in two northwestern provinces and a physician-mediated smoking cessation intervention for adults in Buenos Aires. With NCI funding, we have studied the impact of uncertain mammography interpretations on women, finding problems with communication, patient misunderstandings, and an association with significant depressive symptoms. We have found that vulnerable populations (Latina immigrants in #118) and jail inmates in #119) frequently do not receive recommended breast and cervical cancer screening. We are currently studying how risk perception of diverse women affects obtaining cancer screening tests, use of a drug to prevent breast cancer and decisions to stop Pap smears and obtain a test for HPV. The Center for Aging in Diverse Communities (CADC) supports investigators from diverse ethnic backgrounds and conducts methodological studies applicable to aging in diverse communities. CADC funded investigators published on patient perception of how cultural factors affect quality of care, genetic admixture of Latinos with asthma and response to treatments, how Latinos contribute to the role of race and genetics, the epidemiology of dementia in different ethnic communities, the role of language and specialty care in determining the quality of care of patients with diabetes, and the efficacy of a church-based intervention to promote use of adult immunizations. We are currently conducting analyses of an evaluation of a video medical interpretation technology for limited English-proficient patients in both inpatient and ambulatory care settings. CADC has made methodological contributions concerning recruitment of diverse participants, translation guidelines, measures of acculturation, perceived discrimination and social class.