Meeting #26

Carmel, CA

March 28 - 31, 2012

Minutes of the AMSP Meeting
March 28, 2012 through March 31, 2012
in Carmel, CA

Wednesday, March 28, 2012
The meeting began with an opening session in the afternoon at the Highlands Inn Hotel. Present at the meeting were second-year scholars Michael Mancino (University of Arkansas), Tom Nguyen (University of Cincinnati), Camila Silveira (University of Sao Paulo, Brazil), and Ann Manzardo (University of Kansas). First-year scholars included Roberta Agabio (University of Cagliari, Sardinia, Italy), Courtney Bagge (University of Mississippi), Erik Gunderson (University of Virginia, Charlottesville), Iliyan Ivanov (Mt. Sinai, New York), Claire Wilcox (University of New Mexico), and Jennifer Hanner (University of North Carolina). Also present were Marc Schuckit (Director), Marianne Guschwan (Assistant Director), and Marcy Gregg (Administrator). The group adjourned for a working dinner at Grasings Restaurant in Carmel. The evening was used for networking, outlining the next three days’ work, and answering questions regarding the meeting and our goals.

Thursday, March 29, 2012
The group got together at 8:00 a.m. Most of the morning was spent with a discussion of the “How to Give A Lecture” presentation, including ideas on how the material might have been presented more clearly for the first-year scholars. Among the issues that arose was the need to be certain that first-year scholars recognize that the sentence fragment style of outline should be included for the very first draft; the need for everyone to recognize and stick to the agreed upon deadlines for developing their lectures; the difficulty scholars face in working to be certain that the lecture is appropriate for first-year medical students; the challenges in keeping the flow of logic clear (a process helped by the sentence fragment outline approach); the need to remember that the lecturers are to be used by other teachers around the world, and related topics. This session was very important regarding solidifying the lessons learned through the process of developing the lecture outline and slides, as well as offering guidance on how Marc will present the material to the new scholars at their first meeting in October 2012.

Roberta Agabio of University of Cagliari, first-year scholar, presented her lecture on “Acute Alcohol Intoxication.” This was a very effective lecture with very clear slides. The group had several relatively simple suggested changes for the slides, but all scholars felt that this was a lecture that will be useful to visitors to the AMSP website. We were all impressed with Roberta’s lecture style, her eye contact with the audience, and her mastery of the material.

The next activity was a working lunch where career development issues were discussed. This included a lively discussion regarding the suggestion by Claire Wilcox that it is useful to consider the four or so major cornerstones in one’s career as it is when thinking about the four major points for a specific lecture. These cornerstones can help guide each person in when it is best to say no to a request, activities they should seek out, as well as how to allocate time. The majority of the discussion focused on how to generate clinical and research monies in this tight budget time. Among the options that were discussed were to seek out a job in an academic setting, but as related to a well-funded clinical program (such as the VA); applying for relatively small grants; looking for ways to gather data for research while carrying out clinical activities; and collaborating with other investigators who have datasets already developed and available for use.

Following lunch, second-year scholar Michael Mancino presented his modified lecture on Amphetamine Use Disorders. The presentation was given with very good command of the information, but now the material was modified into a shorter lecture as might be given to county administrators who are asked to make decisions about allocation of monies related to a recently recognized epidemic of amphetamine misuse. The material was presented on a level appropriate for such administrators, and a compelling argument was made for the severity of the problems.

The remainder of the afternoon was used for reports of AMSP-related accomplishments at universities.

Claire Wilcox, first-year scholar, reported her developments from the University of New Mexico. She is currently providing SUD medical education lectures in a variety of contexts, including via telehealth to primary care and other rural providers (ECHO), to the School of Pharmacy, and to residents in various contexts (first, second, third, and fourth years). Dr. Wilcox organized the Addictions Journal Club, is the Dual Diagnosis Clinic Didactics Coordinator and lecturer, as well as the Addictions Fellowship Didactics Coordinator, and supervises residents doing psychotherapy and medical students interested in research. Over the last six months, she gave Grand Rounds in her department on “Impaired Decision-Making in SUD” using a version of the slides she developed for AMSP, and she has referred people to the AMSP website numerous times (when approached to help individuals coordinating addictions lecture series). Dr. Wilcox refined a variety of either old (cannabis use disorders, assessment and treatment of individuals with co-occurring disorders) or new (research presentation on the role of genotype alterations in predicting changes in brain activation to alcohol cues) talks using what she has learned while in AMSP. She believes her confidence in public speaking situations has increased significantly, and when reviewing others’ research articles she has applied the principles learned from Dr. Schuckit in AMSP. In the future, she will continue to revise existing lectures (such as her co-occurring disorders talk) using the AMSP approach, and wants to work to improve resident didactics (perhaps by starting a ‘Curriculum Development Committee’ inviting interested faculty to attend a ‘How to Give a Lecture’ talk and then edit each other’s talks). She will increase her mentoring of other faculty, residents and perhaps med students on career development and/or lifestyle issues, exploring the idea that perhaps decision-making on career issues can be done using an approach similar to that used in developing lectures (e.g., to what degree is taking on a new task in the service one of my four major career goals).

Jennifer Hanner, first-year scholar from the University of North Carolina, reported that in the past six months she has continued her work as a clinician educator in the UNC Department of Psychiatry, and in the UNC School of Medicine’s curriculum on substance use disorders for first-year medical students, which consisted of a full day of lectures and small groups with live patient discussants. Dr. Hanner participated as small group discussion leader and helped with planning for a presentation of two clinical vignettes demonstrating principals of motivational interviewing. She was asked to increase her involvement in the coordination of the curriculum in the future, as the current responsible faculty member may be retiring soon, and she was asked to participate in the Brain and Behavior course for second-year medical students. She gave two lectures overviewing substance use disorders, which were well received. Dr. Hanner continues to provide weekly 30-minute lectures on various substance use disorders-related topics to residents and medical students during the Friday afternoon outpatient clinic she supervises. She also gave lectures in the didactic curriculum of the Psychosomatic Medicine Fellowship focused on substance use disorders encountered on the Inpatient Consultation-Liaison Psychiatry Service. Dr. Hanner will explore ways to build on her role as an educator at the School of Medicine and to increase interest by students in the treatment of substance use disorders. She has met the student leaders of the Psychiatrist Interest Group and plans to work with them in the coming months in developing options for further student involvement.

Camila Silveira, second-year scholar from the University of Sao Paulo, Brazil, presented her AMSP-related accomplishments. Dr. Silveira continues to provide four hours of didactic sessions and four hours of practical classes for second-year medical students on epidemiology, diagnosis and treatment of substance use disorders. All medical lectures have been improved following the AMSP techniques. Camila’s group (section of psychiatric epidemiology) has also incorporated the AMSP techniques, and recently had two papers approved in major journals. Dr. Silveira presented the lecture “How to Give A Lecture” four times over the past two years, and she continues to coordinate the NGO Call Center for Information on Alcohol and Health, whose main purpose is to generate source information from prominent scientific journals on topics related to alcohol use. She is pleased to report that the Chair of the Institute of Psychiatry at her university gave her an appointment to provide feedback to him on her AMSP participation, and he expressed enthusiastic interest in having Dr. Schuckit visit the University of Sao Paulo to share with Brazilian professionals his experiences related to AMSP, as well as his scientific and academic life.

The meeting adjourned at 2:30 in the afternoon. Scholars were on their own for dinner that evening.

Friday, March 30, 2012
The group reconvened at 8:00 a.m. for a working breakfast and presentations. The first item on the agenda was the report of accomplishments by Roberta Agabio, first-year scholar from the University of Cagliari, Sardinia, Italy. Over the last six months, Dr. Agabio carried out a survey on existing medical school classes on AUDs already developed in the University of Cagliari, Italy, which revealed that the only class on AUDs was her class of 12 hours for the final-year medical students. She recently modified the slides for this group according to the “AMSP method,” and lectures to be developed based on using the AMSP website to the Directors of some Degree Courses, including Medicine, Psychology and Professional Nursing at her University; and in the next few months, she will start new classes in these degree courses. Dr. Agabio has already translated into Italian the lesson “How to Give a Lecture” in the AMSP website and delivered this lecture two times over the last six months. In the next months, Dr. Agabio will present her lecture on Acute Alcohol Intoxication that was developed for AMSP at the University of Cagliari for Italian and foreign students. Dr. Agabio will also organize a specific course on AUDs for primary care physicians prepared according to the “AMSP method.”

Tom Nguyen (second-year scholar from the University of Cincinnati) next presented his lecture on the use of vaccines in the treatment of substance use disorders, as modified to a half-hour lecture to be developed to pharmacy graduate students. Tom’s lecture was effective, well organized, and well delivered. Dr. Nguyen handled questions very well and had full knowledge of his topic area.

Next, Ann Manzardo (second-year scholar from the University of Kansas) presented her AMSP-related-accomplishments at her university. Dr. Manzardo continues to increase her visibility within the Department of Psychiatry and Behavioral Sciences at the University of Kansas Medical Center through increased didactics and lectures, and assuming a more prominent role in the educational program for medical students and psychiatry residences since joining AMSP. Dr. Manzardo has applied AMSP methodology in all of her existing and newly developed lectures. Her teaching load has increased to include a course on the Biological Basis of Substance Use Disorders, which she developed for medical students and psychiatry residents, and she developed a lecture on the Genetics of Alcoholism that is offered to undergraduate students in the pharmacy program at the University of Kansas, Lawrence. She continues to work with student representatives to develop new ways to address questions and concerns regarding the educational program on alcoholism. She presented her AMSP lecture on Nutritional Deficiency in Alcoholism to the “Lunar Society” (a local student group). In addition, she provided direct mentorship on alcoholism-related research for two psychiatry residents and one medical student, and the Capstone Project for a MSPH student, and last fall she graduated with a Masters of Science in Clinical Research and has published four original manuscripts so far this year, with additional projects in the works.

Courtney Bagge (first-year scholar from the University of Mississippi Medical Center) next presented her lecture entitled “Acute Alcohol Use and Suicide Attempts.” This was an excellent lecture with very well developed slides, and the group had few suggestions regarding slides or outline. The presentation went smoothly with excellent eye contact to the audience and demonstrated a wonderful mastery of the material presented.

Next, Camila Silveira (second-year scholar from the University of Sao Paulo, Brazil) gave her full lecture on alcohol use and problems from a global perspective. Following her excellent presentation, the group participated in an exercise to demonstrate how lectures developed for one audience can be easily modified for another group. Here, the slide sorter mode for PowerPoint was used for Camila to first choose 20 slides that might be appropriate for a meeting with representatives of industry where she emphasizes how nonscientists can understand and interpret epidemiological data despite the wide ranging differences in jargon used across different studies. Camila was then asked to reshuffle the slides and come up with 20 slides (including several slides that need to be made) that might be appropriate for another group of nonscientists who were interested in how to develop prevention programs based on the worldwide epidemiology data. The entire group worked with Camila on this process, and the new lectures were thought to be potentially highly effective.

Second-year scholar, Ann Manzardo, from the University of Kansas, then participated in an exercise based on her full lecture as delivered during her first year in AMSP. The complex topic related to alcohol and nutrition, and Ann was asked to use the slide sorter mode of PowerPoint and participate in a discussion on how she would be able to easily cut back from ~40 slides to 20 slides and from 45 minutes to a half-hour lecture. The exercise took only 15 minutes and Ann was asked to use no more than 45 minutes that afternoon and evening to prepare a lecture to now be delivered to the group on Saturday morning. Thus, with less than one hour of effort, a major change could be made in a lecture that allows the material developed for one audience and/or timeframe to be used for yet another audience and/or timeframe.

The group then progressed to a working lunch discussing career development issues. Topics included the upcoming DSM-5 and the impact it might have on clinical work; interpreting and carrying out reviews of papers for journals; the pros and cons of approaching a senior investigator to serve as a coauthor on a paper; the assets and liabilities of blind reviews (where the reviewer does not know the name of the author) versus unblinded reviews, as are used in most journals.

After lunch, first-year scholar, Erik Gunderson of the University of Virginia School of Medicine, delivered his lecture entitled “Risk Management During Opioid Analgesic Prescribing for Chronic Pain.” This was a highly effective lecture delivered with great sensitivity to both the suffering of patients, as well as the multiple directions in which a clinician is torn when dealing with a patient with chronic pain syndromes. As is true of all the other lectures that have been part of this meeting, the material, including outline and slides, were highly appropriate for the Website and likely to be of great use for the field in general.

In the final presentation of the Friday session, Iliyan Ivanov of the Mount Sinai School of Medicine, a first-year scholar, presented his lecture entitled “New Insights into Substance Use Disorders Gained from Brain Imaging.” This was a challenging lecture because the method of study (functional brain imaging) is highly technical, while the audience (first-year medical students) is not assumed to be very knowledgeable. Iliyan demonstrated an approach to focusing on the key issues of how imaging can help us understand more about the underlying biology of substance use disorders, as well as the implications of this knowledge on prevention and treatment. Overall, this was a fine lecture, with most of the discussion focusing on how a few of the slides might be made more easy to read and how brain imaging slides might focus on a bit more narrow topic area with resulting simplification. With very little additional work, this lecture will be a valued addition to the AMSP website.

The group adjourned at 3:15 p.m. Friday afternoon. The informal, networking-based evening get-together was carried out in Carmel at the Andre’s Bouchee Restaurant.

Saturday, March 31, 2012
AMSP reassembled at 7:30 a.m. – the early Saturday start time and extended hours of meeting on Friday had been arranged because storms had been forecast to move into the Carmel area on Saturday morning and people needed a greater amount of time to travel to their airports.

The first goal was the presentation of the lecture by Claire Wilcox, first-year scholar from the University of New Mexico, entitled “Impaired Decision-Making in Substance Use Disorders.” Similar to Iliyan’s presentation, Claire also faced the challenge of taking a highly complex, brain imaging-based lecture and make it appropriate and useful for medical students. She did this by focusing on three stages of decision-making, and using the fMRI and related results to demonstrate the underlying neurochemistry and brain structures that contribute to decision-making. The lecture was structured around a case presentation of an impaired physician who had serious substance-related problems. The organization, slides, and delivery were all very impressive. The discussion offered several thoughts of slide copy that might be slightly modified, but the lecture was very close to being appropriate for listing on the AMSP website.

This was followed by the lecture by the first-year scholars, Jennifer Hanner, from the University of North Carolina Medical School, presenting the lecture on “Alcohol Use Disorders in General Hospital Patients.” This was another effective lecture, directed appropriately at medical students, with good slide copy and an easy-to-follow outline. This lecture is also close to being appropriate for uploading to the AMSP website.

Ann Manzardo, second-year scholar from the University of Kansas, then delivered her half-hour lecture based on less than 20 slides as had been developed through the exercise on the previous days. Her topic related to alcohol and nutrition, but with a much shortened timeframe. Ann’s material, delivery, and slides were all excellent. This served as a fine example of how quickly material can be modified from one lecture to the next.

The morning progressed to the delivery of updates of the AMSP-related accomplishments by the remaining scholars.

Michael Mancino of the University of Arkansas for Medical Sciences (UAMS) presented his report on activities to enhance education on drugs and alcohol. In the last six months he was promoted to Associate Professor on the Clinician Scientist Track and was granted tenure to take effect in July 2012. Dr. Mancino also presented at the UAMS Department of Internal Medicine Grand Rounds, Donald Reynolds Center on Aging, and at the University of Texas Health Science Center’s Grand Rounds on geriatric substance use disorders. Dr. Mancino is in the process of altering his clinical practice to allow for more seamless education and research opportunities in his role as as Program Director of the Substance Abuse Treatment Clinic. Since his involvement in the AMSP, he has been able to add an additional lecture on Physician Impairment to the second-year medical student behavioral science course, and has also been able to enhance education in the College of Medicine at UAMS regarding prescription opioid dependence specifically by offering a fourth-year elective for Psychiatry Residents in the Substance Use Disorder Treatment Program. He recently organized a “Half and Half” Buprenorphine Training course sponsored by the American Association for Addiction Psychiatry for all UAMS Psychiatry Residents, allowing them to receive waivers to prescribe buprenorphine once licensed and in possession of a DEA number. Dr. Mancino continues to gather data and is in the process of completing his project designed to characterize amphetamine withdrawal in methamphetamine-dependent individuals, and continues his participation in ongoing collaborations with other substance abuse researchers, while developing newer collaborations with other faculty interested in substance abuse at the University of Arkansas.

Erik Gunderson of the University of Virginia (UVA) School of Medicine in the Department of Psychiatry & Neurobehavioral Sciences and the Department of Medicine presented his accomplishments in the last six months and what he plans for the next year to enhance medical education on drugs and alcohol. Dr. Gunderson’s prior and future efforts target all levels of physician training, including pre-medical undergraduates, medical students, house staff, and practicing physicians. For pre-medical undergraduate students interested in Addiction Medicine, he led a small group discussion on career development sponsored by the Alpha Epislon Delta (AED) national pre-medical honor society. For medical students, he used the AMSP approach to develop his substance use disorder lecture and outline for the Mind, Brain and Behavior Course (Spring 2012). Interested undergraduate and medical students have participated in Dr. Gunderson's research activities, including a student who presented a poster at the Annual Meeting of the Association for Medical Education and Research on Substance Abuse (AMERSA). For medical house staff, Dr. Gunderson utilized AMSP techniques to prepare and present a noon conference lecture on substance use disorders and chronic pain. He gave a case-based lecture on risk management during opioid analgesic prescribing to Addiction Psychiatry Fellows at Columbia University College of Physicians and Surgeons, where Dr. Gunderson maintains an Adjunct Research Scientist appointment, a presentation that led to publication of a letter to the editor in American Family Physician on the importance of screening for cannabis use among primary care patients with a chronic cough. AMSP lecture preparation and delivery strategies were utilized when preparing a research talk on synthetic cannabinoid consumption delivered at the November 2011 Annual Meeting of the Association for Medical Education and Research on Substance Abuse (AMERSA). Preparation of an AMSP talk on risk management during opioid analgesic prescribing for chronic pain helped improve a chapter on pain management that Dr. Gunderson co-authored for Richard Saitz’s upcoming textbook on treatment of unhealthy alcohol use. Dr. Schuckit’s guidance on diagnostic criteria during AMSP lecture development, including anticipated DSM-V revisions, enhanced Dr. Gunderson’s opioid section for a chapter in a psychiatric handbook edited by Dr. Bankole Johnson. For practicing physicians in the community, Dr. Gunderson led a "Meet-the-Professor" group on substance use disorders in primary care at the 38th Annual Recent Advances in Clinical Medicine Conference, which was sponsored by the UVA School of Medicine Department of Medicine. He developed an outline and lecture on designer drugs, which he presented at the American Society Addiction Medicine (ASAM) 2011 course on the State of the Art in Addiction Medicine. During the next six months, Dr. Gunderson will continue his current teaching as above and use AMSP approaches to update the medical student team-based learning slides and lecture notes. The ASAM program committee asked him to present an adapted version of the designer drugs lecture (described above) in a symposium at the upcoming ASAM Annual Meeting, April 2012, and he was elected Secretary on the Executive Committee for AMERSA, a multidisciplinary organization dedicated to advancing medical education on substance use. Lastly, Dr. Gunderson continues his role as a Physician Clinical Support System (PCSS) national mentor on the use of buprenorphine treatment for opioid dependence. He will present an online webinar lecture for the PCSS on clinical practice models of buprenorphine induction, the process by which the medication is initiated. At the recent AMSP meeting, Dr. Gunderson worked with his senior scholar mentor, Michael Mancino, M.D., to create an outline for the webinar. The AMSP approach was extremely helpful for organizing the topic, and the slides will be designed in accordance with AMSP guidelines.

Tom Nguyen of the University of Cincinnati College of Medicine reported on his accomplishments. Dr. Nguyen continues to serve as Coordinator of Medical Student Education, and provides didactics to second- and third-year medical students utilizing the AMSP format. In addition, he lectures to second- and third-year psychiatry residents, as well as to the Addiction Psychiatry and Addiction Medicine fellows. He assists fellows to develop their formal presentations using the AMSP format for their outlines and slides, and he continues to serve as a study physician for the nicotine vaccine clinical trial. Every year Dr. Nguyen gives a lecture to the incoming medical students about "Physician Wellness." Since the last AMSP meeting, he has received the Golden Apple Award for Teaching Excellence from the graduating senior medical students. He also wrote a review article on "Substance use disorders among adult bipolar patients" with the chairman, Dr. Strakowski. Dr. Nguyen also serves as the local FAA physician providing substance abuse evaluation and outpatient treatment for pilots. He has been invited to give a presentation concerning substance use disorders in pregnant females to the Department of OB-GYN at Good Samaritan Hospital. In September he was asked to give a presentation at the American Society of Addiction Medicine Certification Review Course, and he has been invited to participate on a panel with the Hamilton County Health Department concerning pregnant females with substance use disorders. He plans to utilize the AMSP format for all of his slide presentations.

Iliyan Ivanov from the Mount Sinai School of Medicine next gave his report of AMSP-related accomplishments. During the prior six months, Dr. Ivanov delivered lectures that included: “Neuroimaging and SUD” for second-year med students; “Neurobiology of SUD” for psychiatry residents; “SUD in Adolescence” for Child Psychiatry fellows; and “Treatments in ADHD Youths with SUD” for the Child Psychiatry Journal Club. Iliyan also offered talks on childhood disruptive behavior disorders and adolescent substance use at national and international conferences, including the annual meetings for the American Academy of Child and Adolescent Psychiatry, Society for Neuroscience, and the 6th World Congress of Controversies in Neurology, and was an invited speaker at the 20th World Congress of The International Association for Child and Adolescent Psychiatry and Allied Professions and the annual meeting of the American Psychological Association. In addition, he is first author on a paper “Parental substance abuse and function of the motivation and behavioral inhibition systems in drug-naïve youth,” which is in press in the journal, Psychiatry Research Neuroimaging; a co-author on a paper in press at The Archives of General Psychiatry; and is first author on a chapter on the topic of Cocaine and Methamphetamine SUD in Adolescence that will be submitted by September 2012. Lastly, he is co-investigator in a T-34 grant with the objective of assessing the efficacy of treatment of veranicline in patients with nicotine use disorders, and on an R01 neuroimaging study looking at the neurobiological effects of stimulant vs. non-stimulant medications in ADHD youth to be funded in July 2012. Beginning July 2012, Dr. Ivanov will become director of a newly developed program at the at the Bronx VA (affiliate of Mount Sinai School of Medicine) as an expert in adolescent psychiatry on issues related to chronic mental illness and SUD.

Courtney Bagge, first-year scholar from the University of Mississippi Medical Center (UMMC) presented her recent accomplishments. She met with representatives from the UMMC School of Medicine to review the medical student curriculum in terms of alcohol and drug education, and to discuss educating residents and fellows about substance use disorders using AMSP methods. In addition, she surveyed lecturers of existing courses to document what is being offered on alcohol and drugs. As a result of these meetings, Dr. Bagge used AMSP methods to lecture to psychology residents on “Dialectical Behavior Therapy Skills for the Treatment of Alcohol Use Disorders,” and will adapt this lecture for medical students, and to present an invited lecture on “Impulsivity and Alcohol Use Disorders” to UMMC graduate students in Neuroscience. Dr. Bagge mentored psychology undergraduates, early-level graduate students, and residents in using AMSP techniques to present clinical case conferences, research rounds, and lectures for community providers, as well as to organize manuscripts for publication. She had active participation by students at all levels of training in her ongoing and expanding alcoholism research program, and was recently selected as a mentor for the prestigious Medical Student Research Program’s Summer Student Research Fellowship. She has three more publications in press and one manuscript under review, has revised an R21 application to National Institute on Alcohol Abuse and Alcoholism, and submitted a renewal application for the National Institute of Health Clinical Research Loan Repayment Program focusing on substance use disorders within suicide attempts, and she continues to collect data on a project funded by the American Foundation for Suicide Prevention focusing on novel methodologies in the examination of acute alcohol use and suicide attempts. Dr. Bagge has been invited to give a variety of lectures that include: presenting on “Acute Alcohol Use and Suicide Attempts” to first-year medical students; leading small group interviewing courses focusing on substance-disordered patients; providing a lecture on “How to Give a Lecture” and “Suicide Safety Planning” to psychiatry residents; creating a lecture on “Mood Disorders” to the Physicians Assistant’s Program at another institution, Mississippi College; and using AMSP methods to create an in-service training to a low- to no-cost community clinic. Dr. Bagge is starting a Mood Disorders Outpatient Clinic where she will supervise psychiatry and psychology residents treating patients with mood and comorbid substance use disorders. Finally, she will present research focusing on acute alcohol use at a national conference, and will continue to mentor and involve students at all levels of training in conducting and publishing alcohol research.

Next, the meeting closed with a series of goals. These included graduation plaques for the excellent second-year scholars who are moving on; a discussion about the next meeting where new first-year scholars will be joining AMSP and the core cadre of current first-year scholars will be moving into their second year; thanks were offered to everyone; and everyone offered heartfelt appreciation to Marcy Gregg for organizing the meeting, meals, and for all the work she will be doing for travel reimbursements. The scholars were reminded to get their reports to Marc within two days of the meeting and their final lectures to him for posting in the AMSP website within two weeks.

Layout and design by Brian Klima