TCU and UNTHSC School of Medicine associate professor Amber Heck, Ph.D., has been chosen as the 2020 recipient of the International Association of Medical Science Educators (IAMSE) Early Career Award for Excellence in Teaching and Innovation.

I am honored and humbled to receive this award and to be chosen by my colleagues and mentors within IAMSE, Heck said in a news release from HSC.The award honors an IAMSE member who has made significant innovations, particularly with respect to teaching, in the short time they have focused their careers toward enhancing teaching, learning and learner assessment, according to their website.

Heck teaches physiology at the Fort Worth medical school and her responsibilities include curriculum design and development and active learning facilitation in cell biology and physiology. Heck joined the IAMSE in 2016 as a fellow and is currently an active member of the organizations scholarship committee.

I have watched the careers of past winners as well as their innovations and contributions to medical education, Heck said. I am thrilled to be now be mentioned in the same group as them. The IAMSE has pushed awardees to continue to pursue innovative projects in the field of academic medicine and I plan to continue to do that.The TCU and UNTHSC School of Medicine, Fort Worths M.D. school, opened with a class of 60 students in July 2019. FWBP Staff

Read the original:

Fort Worth M.D. School faculty member wins award for excellence in teaching and innovation - fortworthbusiness.com

When Shelter-In-Place was ordered in March, and Campbell University moved all instruction to online, Meredith Culbertson was an MS-III enjoying rotations at Cape Fear Valley Health providing care and learning in the hands-on, dynamic atmosphere that is the rich reward after two years in lecture and lab. Meredith shares the challenges COVID-19 brought to the second half of her third year and the anxieties she and her classmateshave as they prepare to apply for residency

What is the difference between MS-I/II years and MS-III/IV years of medical school?MS-I/II years are primarily lecture and lab instruction. When we apply to med school and throughout our first two years, all many of us do is dream about getting into the hospital finally getting to clinical rotations. The reason we stress and study ridiculous hours those first two years (and then those excruciating months at the end of 2nd year when we are preparing for boards) is to make it to clinical rotations its like a mini graduation! Its a huge victory, and you feel proud of what we are doing.

For me, I believe the amount we learn in clinical years is enormously different and more helpful. Now when I see a question, I can actually picture that patient because Ive had that patient. I feel very confident about how to treat that patient in real life or in a board style question because now I have had that experience. COVID-19 ripped that away from us and put us back into first and second year.

As MS-IVs, typically we would spend months on away rotations in preparation for applying for residency in the spring. Medical schools nationally are struggling to figure out what the process is going to be and most of us are very stressed about our schedules and requirements. We just dont know if we are even going to be able to do away rotations. I am pursuing Emergency Medicine, and we need a specialized Standardized Letter of Evaluation (SLOE) without it you struggle to get into certain programs. Emergency Medicine Resident Association (EMRA) is working with all the program directors to be more lenient like other residencies (family medicine, pediatrics, etc.) to accept letters from non-residency emergency departments to help us through the application process. Theyare limiting everyone to one ED rotation tomake sure everyone across United States has at least one rotation through an emergency department with a residency before the Match. So, for my class when it comes to The Match, there are just a lot of unknowns and that heightens the stress and frustration.

How did COVID-19 change your MS-III year?

I feel like COVID-19 has stolen our education from us because what weve been doing the past few months is not real rotations. It was very frustrating for us because we felt like we went backwards back to the classroom and lectures in front of a computer versus being in the hospital learning from life experiences. Many of us struggle to learn from books and lecture, but excel in clinical. For me personally, I really excelled for 8-9 months on rotations, and I struggled to not loose motivation and inspiration when that was suddenly taken away.

So, a lot of us were very frustrated and were complaining especially in the beginning when everything was constantly changing. But, we had to remind ourselves that we are the lucky ones because we still have opportunities to help people in other ways some people signed up to babysit, to deliver groceries, we did a pediatric supply drive and we will soon have jobs that will make a huge difference.

How would you say you have been affected personally?

I am a very sociable person and being kinda isolated doing everything remotely has been hard. It definitely messes with your psyche sometimes. I knew going into this career theres a chance that we might get sick and even really ill I feel like I know that better than most because Im immunocompromised. This is not your normal sickness. We all need to be careful and abide by the guidelines, but sometimes its really hard and frustrating when all you want to do is to get back into the hospital and help.

Also, my sister is a physician in Colorado. She has MS and had COVID-19 for a month. Shes had to live separately from her husband since that time because he is an anesthesiologist and early on had to provide his own PPE. It was very stressful for them living a part and making sure she didnt get reinfected. So, as students, we have to remember people like them and consider ourselves lucky and not complain because it could be so much worse.

What do you think we can learn from COVID-19?

I think its been a learning experience for everyone on how to grow and learn with the new normal. We cant be mad with what has happened. There are still so many opportunities for us to help in other capacities and thats all we can do right now. Sit down and get through the grunt work knowing that at some point we will get back what we had. We just have to look at the here and now and hope the best for the future knowing were all in this together.

Your MS-III year officially ended on June 30th. What was that last month like?I just tried to focus on studying for boards fingers crossed my boards dont get cancelled. I will have to travel to Louisville, KY to take them. I continued taking my dog to the park and survived another month on alternative schedule.

I was supposed to be on surgery my last month as an MS-III. This is what I shared on Facebook the last day of rotations:Today is bittersweet. We are doing the right thing by sheltering in place due to COVID-19, but today was supposed to be the start of my last rotation in the hospital as. 3rd year medical student. Instead of doing surgeries in the hospital, I am making the most of it by hunkering down in the books, practicing my skills, and watching surgeries. We must stay positive and find new ways to challenged ourselves and continue our education to advance our medical careers. So, this month, I will not complain, but make the best of itvirtual surgery.

Now, I am back in the hospital and its been great, but also very weird. Its like riding a bike. You learned how, but youve lost some of the skill, so youre stumbling through how to do it again and now there are lots of new guidelines especially in the emergency department.

N 95 masks do give you bruises, but I dont care that I get bruises or feel tired because this is what I want to do. I love learning something new every day and working hard. I get to be in a place that I feel I belong, and I fit in with a great group of people that are just like me. There are amazing people here at Cape Fear Valley Health who go above beyond.

Im still very nervous about this residency application season and how it will unfold with all four of my audition rotations being canceled. I have a lower board score, so I wanted to make sure I can show them in person how I excel in hopes they will look past my board score. Again, its just very much an unknown, but we have some really good attendings who are understanding and working with us, so Im hopeful.

See the original post:

Reflections on COVID-19: The Impact on MS-III's | Blogs | Campbell University - Campbell University News

Arizona has expanded its coronavirus testing capacity thanks to several partnerships with universities and labs. But test results are taking up to two weeks for some individuals meaning a lot of people who dont have COVID-19 are quarantining while awaiting results.

Doctor Shad Marvasti with the University of Arizona College of Medicine Phoenix says that until labs are able to return test results faster, anybody who gets a test should isolate themselves until they no longer have any symptoms.

"(If) you have no fevers or any other symptoms, or youre feeling better, you could tentatively begin resuming activities," Marvasti said. "Being more cautious in terms of your contact with the elderly, those with chronic conditions, and as all of us should be doing, wearing a mask in public and keeping our distance."

COVID-19 statistics from across the country are showing that states with mandatory mask orders are faring better than states without including Arizona.

Marvasti says Arizona is a global hotspot of the disease and not having a statewide mask mandate makes the state look foolish.

"(Other states) have the statewide mask mandate, and yet we have this crisis and are a hotspot and we dont, doesnt seem to make common sense to me," he said. "I think we also need to add with the ordinances, and I this varies from city to city, some kind of fine or fee to help ensure enforcement."

Short of another shutdown, Marvasti says mandatory face masks would be the most effective way of reducing infection rates across the state.

Read The Latest News On The Coronavirus Disease

Continued here:

Expert: Mandate Masks, Speed Up Test Results In AZ - KJZZ

Note: This is part of a series of stories about former Michigan State players who have gone on to interesting or unique post-basketball careers. Previously: Adam Ballinger, artist; Delvon Roe, actor; Anthony Ianni, public speaker

Four decades later, the memory of his first practice against Earvin Magic Johnson is a vivid one for Michael Longaker.

As a sophomore guard for Michigan State in 1977-78, Longaker was among those tasked with defending the Spartans star newcomer. He spent that day exhausting himself while chasing the bigger and more athletic Johnson around Jenison Fieldhouse.

But the challenges didnt stop even when practice did. After leaving the court, Longaker balled up the tape on his ankles and threw it in a wastebasket. Johnson promptly grabbed the ball of tape and boasted he could sink the wastebasket shot from further away.

I was like Oh my gosh, what a nightmare, Longaker said. That was a window into how competitive Earvin was at everything.

While they competed in practice, the two teamed up to help Michigan State win the schools first national title in 1979. Johnson was the face of the team, while Longaker was a role player helping keep Johnson and others sharp in practice every day.

After Michigan State, the two teammates went to California and found plenty of professional success.

Johnson, of course, won five NBA titles and three MVP awards in his Hall of Fame career for the Lakers.

Longaker, meanwhile, settled in Northern California and became a leader in a different field: medicine.

I do something very different from my teammates, I imagine, Longaker said this week from his office.

Longaker has spent the last two decades at Stanford University, where hes a professor at the School of Medicine and the co-director of the Institute for Stem Cell Biology and Regenerative Medicine. His work focuses on scarring and how to regenerate skin and improve wound healing.

Its a field of study far different than the matchup zone he worked to master under Jud Heathcote. But playing and studying at Michigan State, he said, set him up for a successful career in medicine.

I cant overstate the role that Michigan State has played in my career, Longaker said.

Longaker spent four years at Michigan State working hard in practices like that first one and fighting for playing time on some immensely talented Spartans teams.

His contributions were often not seen on box scores. Later in his career, Heathcote started asking Longer for his thoughts before and during games. He saw Longaker as a potential future coach.

Longaker, though, had other career plans. He initially planned on going into dentistry, but a summer spent doing research with James Potchen, then the chair of Michigan States Department of Radiology, sold him on a career in medicine.

Heathcote ended up writing a letter of recommendation that helped Longaker get into Harvard Medical School. But even then, he still held out hope to see his former player on the sideline one day.

I said Coach, Im kind of committed to being a physician, Longaker said.

Longaker finished medical school with the intent of becoming a pediatric heart surgeon. But during a year of research during his residency at the University of California, San Francisco, he was assigned to work under a doctor who operated on children before they were born and asked to investigate how embryos heal wounds.

His findings, that embryos heal without scars in their first two trimesters, set his career on a different course. One year of research turned into four, then was followed by more training in New York and Los Angeles before he landed at Stanford in 2000.

Now, most of his work is in directing a lab that focuses on skin and the skeleton, developing techniques to use stem cells to improve wound healing and prevent scarring. His work has earned him numerous awards and hes been an inventor on over 40 patents and patent applications.

Its been great, Longaker said. I couldnt have predicted it.

That world is far removed from that of Michigan State basketball, but Longaker finds ways to bridge his past and his present. He has two sons who follow the program closely he was elated this week in the afterglow of commitments from Emoni Bates and Max Christie and typically attends multiple games per year. Tom Izzo didnt join Heathcotes staff until after Longaker left, but the two have developed a friendship over the years.

Longaker has also become involved with the sports program at his employer (he attended the 2013 Rose Bowl wearing a split T-shirt featuring both Stanford and Michigan State) Former Stanford running back Bryce Love, the 2017 Heisman Trophy runner-up, worked in Longakers lab while completing his degree in human biology, and Oscar da Silva, an All-Pac 12 forward for the Cardinal, counts Longaker as his academic mentor.

One of Longakers recent trips back to East Lansing was last year, for the 40th anniversary of the 1979 national title. And when that team meets again in another decade, Longaker hopes his smarts can help reverse the outcome of that first practice way back when.

I always joked with my teammates, at our 50-year reunion, Im going to dominate, Longaker said.

View original post here:

Michael Longaker won a national title at Michigan State, then dove into the world of medicine - MLive.com

More residents are pursuing fellowship each year, according to data from the National Resident Matching Program. The decision to opt for additional trainingin lieu of going straight into practiceis a personal one. It is also one that residents must make early on in their training as they plot their career course.

A recent resident who opted to skip fellowship and become an attending physician offers his insight on the answers to five questions that informed his decision and could be helpful to other medical and surgical residents.

After three years as an emergency medicine resident at McGovern Medical School at the University of Texas Health Science Center in Houston, July 1 marked the first day in the emergency department as an attending physician for Jason Lesnick, MD. He opted to go directly to practiceaccepting a position in the emergency medicine department at nearby Memorial Hermann Northeast Hospitalinstead of pursuing a fellowship position.

The decision to pursue a fellowship is all about what you plan to do eventually, Dr. Lesnick said. For emergency medicine, you dont need to a fellowship. A lot of my friends who do orthopedic surgery, almost all of them subspecialized, whether they want to do hip or ankle or upper extremity [surgery], there are multiple chances for them to get additional training beyond residency and thats sort of the standard for their specialty.

Learn the top five factors fellowship program directors look for in applicants.

Training longer will mean you have less time to maximize your income. When pondering fellowship, you should consider your potential income losses by extending training and the potential gains your additional training could yield. Dr. Lesnick noted that physicians are significantly behind the curve when it comes to savings relative to their peers who are typically working and saving some of their take-home pay during the time that doctors spend accruing more debt in medical school.

Dr. Lesnick has interest in potentially working in C-suite positions down the road, which could be something a physician trains for with a one- or two-year administrative fellowship. Still, he felt much of that experience could be gained outside of a fellowship, and by going into practice his salary is a multiple of what it would have been during fellowship.

If you do a two-year [administrative] fellowship, theyll pay for your MBA as well, he said. The problem is the cost of an MBA plus the salary you would make as a fellow is still significantly less than what you can make as a community physician. My plan is to get my MBA on my own and that still keeps every option open for me while keeping me from losing a large sum of money potentially available to me.

Learn how much youll spend looking for a fellowship.

In choosing to eschew fellowship, Dr. Lesnick considered geography. He wanted to stay in the Houston area and begin building a life with his fiance. As a recent chief resident at one of the larger emergency medicine programs in the city, he was confident he could secure an attending position in the area.

The experience [of pursuing fellowship] is obviously an incredibly valuable opportunity, Dr. Lesnick said. The learning that could come from it, the mentorship and connections are very valuable. But, by having done residency in a big city and having worked with people in a large program already, I was looking at it in the sense that I already had those connections. So that aspect was less of a factor for me.

I was really not interested in moving from Houston right now. Im very happy here with my fiance. We didnt see much of a point in moving for one maybe two years and having to move again after that, eventually.

Learn how the choice to subspecialize differs by gender.

Deferring income to pursue fellowship means that you are also likely to wait on paying down your loans in any significant fashion. Dr. Lesnick saw that as a con of going for a fellowship position.

By continuing to live like a resident while collecting an attendings salary he believes he can pay down his loans entirely in around two years.

Loans feel like hundreds of thousands of little weights you carry around with you, Dr. Lesnick said. Theres pressure I feel to want to get that done with as soon as possible and by going straight into practice without a fellowship I will be able to do it much faster.

Learn the three items you should have on your loan-repayment checklist during residency.

Seek out physicians and mentors whose opinions you value and get their input on what additional value a fellowship could offer.

The most important thing is to talk to multiple people who have been there and done what you want to do and ask them do you think its worth it for you to do, Dr. Lesnick said. For those who have already done it you can ask would you go back and do it again?

Ultimately, Dr. Lesnick said, you shouldnt skip a fellowship if its what you have your heart set on.

You have to take a good long hard look in the mirror and ask yourself what are your future goals? Dr. Lesnick said. If a fellowship is necessary to reach those goals, you wont be happy unless you do it. If you are pursuing a career that doesnt require a fellowship, I would posit that it might not be worth your time.

With summer application deadlines for several subspecialties looming, make use ofFREIDAa recently revamped comprehensive AMA tool that captures data on more than 12,000 residency and fellowship programs accredited by the Accreditation Council for Graduate Medical Education.

Continue reading here:

Thinking about fellowship? Ask yourself these 5 questions - American Medical Association

Were aiming for the week of July 27 to have all that available. The week prior would be essential communication that needs to go out, for example, if were under Plan B, there is some communication wed like to push out a little bit earlier in regards to how the students will be grouped because that is high-priority info for parents to know, and then follow up that next week, the week of the 27th, with more detailed plans for each area.

KCS is operating as is much of the state on three plans for the potential re-opening of schools. Plan A is 100 percent attendance on campus. Plan B is 50 percent and Plan C is completely online learning.

Gov. Cooper is expected to make an announcement this week on what the official plan will be. Schools can place more harsh restrictions than Cooper allows, but they cannot lighten them.

KCS Superintendent Chip Buckwell said he has heard Coopers announcement could come as soon as Tuesday, but it could also come Wednesday or Thursday.

The general consensus is the announcement will be Wednesday, and if that is the case, or if it happens Tuesday, KCS is planning a meeting Thursday morning with Cabarrus Health Alliance to consult on the plan and then there will be another Board of Education Meeting on Monday at 2 p.m. for the Board to approve or disapprove of the plan officially moving forward.

Here is the original post:

KCS says they're well prepared for Gov. Cooper's announcement on school re-openings, now they just need official guidance - Independent Tribune

Three years ago, Michael Osterholm laid out in a book the scenario of a global influenza pandemic originating in China that portended the current COVID-19 situation with eerie accuracy. Though Osterholm did not know when such a pandemic would occur, he was certain it would.

When [a pandemic] happens, Osterholm wrote, it will spread before we realize what is happening. ... And unless we are prepared, it would be like trying to contain the wind. Infectious disease is the deadliest enemy faced by all of humankind.

Now that COVID-19 has emerged as that enemy, Osterholm has been in constant demand. Regional, national, and international mediaincluding CNN, MSNBC, CBS, and even irreverent comedian and podcast host Joe Roganhave sought him out repeatedly. The Washington Post and New York Times have published his op-eds. The Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services, and the World Health Organization all seek his counsel.

Osterholm has deep knowledge of infectious diseases, a long track record of being ahead of the curve in understanding their impact, and a decided knack for distilling complex situations into comprehensible terms. Along the way, he has raised visibility for the University of Minnesota and the School of Public Health (SPH) as a source of credible, reliable information at the heart of a global pandemic.

A teacher and a mentor

After completing his bachelors degree at Luther College, Osterholm did his graduate work at the University. He began working at the Minnesota Department of Health (MDH) as a graduate student in 1975 and rose to the level of state epidemiologist in 1984, a position he held for 15 years.

He founded the U of Ms Center for Infectious Disease Research and Policy (CIDRAP) in 2001. He wanted to ground policy in solid science, with the mission to prevent illness and death from targeted infectious disease threats through research and the translation of scientific information into real-world, practical applications, policies, and solutions.

I wish I had 10 Michaels to raise the profile of the importance of prevention around the planet.

Throughout his long tenure, Osterholm has taught. Hes a Distinguished Teaching Professor in the Division of Environmental Health Sciences in the School of Public Health and an adjunct professor in the medical school. The single most important thing I do is teaching, which Ive been doing for 44 years, he says.

Mikes been able to train many people in a variety of roles to work in different capacities, says Kristen Ehresmann, director of the Infectious Disease Epidemiology, Prevention and Control Division at MDH.

Back in 1979, as an SPH graduate student, Ehresmann became a research assistant under Osterholm at the MDH. Three decades later, shes leading what she calls the guts of the response to COVID-19. Shes quoted nearly daily in the media, offering both cautions and explanations.

In addition to Osterholm and Ehresmann, media have sought out at least a dozen more SPH alumni and faculty to interpret and analyze various aspects of the coronavirus pandemic. A group of faculty and students have also worked with the MDH on models employing the most recent data to map and predict the spread of the pandemic to help hospitals prepare for potential spikes.

SPH dean John Finnegan says its not surprising that health authorities and the public are looking to the University for this expertise or that U of M alumni are fortifying the ranks of those responding to the pandemic.

Finnegan has been especially proud of Osterholms role lately. He says, I wish I had 10 Michaels to raise the profile of the importance of prevention around the planet.

Explore the CIDRAP COVID-19 podcasts.

Read the original:

And then it happened - UMN News

Medical experts weigh in on whether or not to send kids back to school in the fall

While many politicians have been weighing in, FOX 4 Asked the medical experts for their opinion.

DALLAS - Now that Texas is leaving it up to parents to decide whether to return to school or continue with a virtual education, many parents are struggling to decide which decision is best for their child.

While many politicians have been weighing in, FOX 4 Asked the medical experts for their opinion.

The doctors agree that unlike other respiratory illnesses, it is rare for children to become seriously ill from COVID-19. However, that is not necessarily the case for their teachers or their grandparents they may see outside of school.

Dr. Albert Karam, a Dallas pediatrician, says with only six months of data on COVID-19, there is no right, wrong or easy answer. He recommends parents weigh the risk versus benefit for their families.

Medication risks versus benefit. Most of the time, the benefit outweighs the risk, he said. In this case with school, we know kids need not only cognitive learning, behaviorally, socially, these kids physically, emotionally need each other the way our country has run for 100 years now.

Dr. Mark Casanova, president of the Dallas County Medical Society, says other countries have been able to successfully reopen schools. But that is likely due to widespread compliance with mask-wearing and physical distancing in their societies as a whole.

Their mask-wearing and physical distancing have been different than here in U.S. Can it be done? Yes. We are seeing evidence of that, Dr. Casanova said. But it needs to be done as part of a package deal.

Dr. Julie Linderman, a pediatrician at Inwood Village Pediatrics in Dallas, says the CDC data on death rates paints an interesting picture. At the height of the death rate, the line for 0 to 24-year-olds stayed flat, while it increased with each older age bracket.

Kids are by far the least affected population, which is really counter-intuitive because typically with respiratory illness kids in the past have been the most affected group, she said.

Dr. Linderman says when schools reopen, teachers should still social distance from other teachers. Families should be cautious if their households include grandparents or those at high risk. She believes reopening schools to in-person attendance is important for children's overall wellbeing.

There are a lot of parents who can do some virtual school. Maybe one parent stays home or has a flex schedule, she said. But there is a huge percentage of the population that does not have that ability. The kids really suffer.

Dr. Linderman recommends that once children return to school, it would be wise for them to physically distance themselves from their grandparents while wearing masks.

Read more:

Medical experts weigh in on whether or not to send kids back to school in the fall - FOX 4 Dallas

Even as COVID-19 cases surge across the nation, hospitals and physician practices are working to figure out how to bring back some non-emergency services and procedures that had been put off for months. Questions remain about what this new normal will look like. For one thing, virtual care is here to stay, says Dr. Richard Isaacs, CEO and executive director of the Permanente Medical Group, and president and CEO of the Mid-Atlantic Permanente Medical Group, Kaiser Permanentes two largest medical group practices. He expects roughly 60% of Kaiser members visits will be virtual in the future. He recently spoke with Modern Healthcare Managing Editor Matthew Weinstock. The following is an edited transcript.

MH: How are your medical groups handling the recent spike in cases?

Isaacs: Ive been very impressed with the physician groups on both coasts, and in (Northern) California, we were one of the first areas that received patients from Japan via plane, and also via ship. This was around the middle of February, and we learned (a lot) about coronavirus, and it was unprecedented. There was a fair amount of uncertainty, and there continues to be uncertainty, but we helped lead the states effort in dealing with these patients, who were scheduled to be disembarked from the ship and be repatriated to Travis Air Force Base. However, the Department of Defense felt that, at that point, it was a national security issue, so we were involved in repatriating COVID-positive patients to various hospitals across Northern California, and about 50% of our hospitals received the first COVID patients here in Northern California. We were very much involved in the suppression strategies, and we were excited because early on we flattened the curve like nowhere else on the globe. California was the front-runner in preventing (the spread of) this disease.

However, over the last three to four weeks, weve been seeing another surge of the disease across the entire state of California, and (more than) half of the states are currently surging.

MH: What does that mean for practices that are trying to balance the surge, but also bringing back non-emergency procedures?

Isaacs: Early on, we continued to take care of all of the patients who had essential needs. We took care of all emergencies, all cancer surgeries were managed, which was about 50% of our normal volume in Northern California, which we did in February, March and April. About three weeks ago, as the shelter-in-place orders were lifted, we started opening back up. We take care of 4.5 million members in Northern California and another 800,000 in the mid-Atlantic region. We have patients who have been waiting for their elective care. The biggest challenge for me right now is the delay in screening. When people were sheltering in place, they werent getting their typical mammography, colorectal cancer screening, so theres some queuing of patients who really need to get this essential screening care.

MH: How do you start building that back into the routine?

Isaacs: The priority has been patient safety and also staff safety. Were working very hard to ensure that we maintain social distancing in the medical office buildings and in the hospital, and that we encourage people to come in when theyre healthy. We do screening at the entry of every medical office. If someone has symptoms of COVID-19 or they have fever, we take care of them in a different setting. So the goal is to keep COVID-free medical offices and manage patients for their essential needs.

MH: Youve talked about battling the pandemic on two endsCOVID-19, but also the pandemic of fear. How are you talking to patients about coming back when they may be fearful of exposing themselves in a medical setting?

Isaacs: The medical office is the most trusted place where you can be, because we have regular processes that sterilize and sanitize the hallways and the medical examination rooms. People are doing essential grocery shopping. Its much safer to be in a Kaiser Permanente facility than in any place in the community today.

MH: Kaiser was at the forefront of using telehealth even before the COVID crisis. How has that grown during the pandemic?

Isaacs: We started our video-first strategy in March. We knew that patients were sheltering in place, and there was that pandemic of fear. We encourage patients to pursue the video-first strategy and see their primary-care physician on video. Were currently doing close to 80% of all examinations and medical care on a video-first platform, and the patients who need to be seen are then triaged into the appropriate venue for care.

Were seeing tremendous satisfaction with the care from home. We deliver supplies and medications right to their front door, and its hugely satisfying for our membership.

MH: Are there specialties where you started offering telehealth because of the pandemic that you hadnt done before?

Isaacs: The Permanente medical groups have been leaders in telemedicine. The first foray was dermatology, and in a pre-COVID world, 90% of all initial dermatology consults were being done via video or secure message with a photograph. Were very experienced with telemedicine, but in the COVID world, with sheltering in place, it pretty much spanned every specialtypediatrics, OB-GYN, primary care, family medicine, mental health, internal medicine are all doing large percentages of video visits, and my job now is to harvest all of these learnings from the COVID experience, because this is an incredible way to deliver care. Im very pleased, and the doctors are excited, because its very user-friendly for the physician, their care team, and also the patients.

MH: Does this become the new norm post-COVID? How does that permanently transform what youre doing?

Isaacs: I believe its going to completely transform. Its the integration of technology with care delivery, and we will have the ability to do video 24/7, 365, and ideally, youre having a video with a patient and a physician who knows you very well. With our electronic medical record system, were able to connect all 12.5 million members that we take care of across the United States. We have all of their information at our fingertips. If a patient needs a physician or advice at 2 in the morning on a Saturday, they can reach us and get a video visit with a provider who will have all of their information.

MH: How do you address it from a physician-training standpoint? How do you make everybody on your team feel comfortable doing it on an ongoing basis?

Isaacs: We developed protocols for how to do video care effectively, and we train our physicians in the appropriate technique. Obviously, this is a secure environment. We want the patients to understand that its a one-on-one evaluation, and we just provide the environment for the physicians to do their job.

As we learn in medical school, the majority of all diagnoses are achieved (when) taking the (patients) history. The physical helps clarify some things, but the majority of diagnoses are made during the initial contact and conversation.

MH: Do you expect your physicians will return to an office setting, or will they be doing most of their work remotely now?

Isaacs: Were trying to determine whats the appropriate mix. I think that there will always be a need for face-to-face and office examinations. Right now, its looking like 60% of all visits in the future could be done via video, with an exam for the other 40%, when needed.

MH: Getting back to the surge in cases, how are you managing burnout and morale among your physicians?

Isaacs: I talk a lot about the trifecta of uncertainty, which does contribute to some burnout, because we dont know how long this is going to last. The trifecta is: When will there be a vaccine? When will we have enough herd immunity that we can go back to some semblance of normalcy? Thats No. 1.

No. 2 is the uncertainty of the economic recovery, and it looked like we were heading back toward job recovery about three, four weeks ago in several states, and now the governors are talking about sheltering in place again.

The third uncertainty, and unfortunately this whole COVID-19 with the economic sequelae, (helped reveal) the racial unrest, social injustice, and (expose) years of systemic racism in this country.

As far as the burnout goes, its really about collaborating as a team. Were all in this together, and the Permanente medical groups are integrated multispecialty groups that actually care about each other, and more importantly, care about the care delivery to the population. Its amazing to see how our subspecialists have really risen to the occasion and are supporting everyone in primary care, as theres been a shift in burden from some specialty care to primary care.

My job is to make it easy for people to do the right thing. Having the resources, the tools, the technology helps eliminate some of that burnout, and just knowing that youre in this together has been very helpful.

More here:

Dr. Richard Isaacs: Video-first doctor visits are here to stay - ModernHealthcare.com

Visit the News Hub

This episode of 'Show Me the Science' focuses on monitoring and identifying pathogens that might jump from animals into humans

Scientists prepare to take a skin biopsy from the wing of a bat as part of a health check in Peru. Wildlife biologists, infectious disease experts and others, including scientists at Washington University School of Medicine in St. Louis, are proposing a decentralized, global wildlife biosurveillance system to identify before the next pandemic emerges animal viruses that have the potential to cause human disease.

A new episode of our podcast, Show Me the Science, has been posted. At present, these episodes are highlighting research and patient care on the Washington University Medical Campus as our scientists and clinicians confront the COVID-19 pandemic.

The virus that causes COVID-19 is thought to have originated in wild bats that live in caves around Wuhan, China. Many devastating epidemics in recent years including SARS, Ebola and HIV/AIDS were caused by animal viruses that spilled over into people. Before another pandemic begins, a diverse group of infectious disease experts, ecologists, wildlife biologists and other experts say that a new, decentralized, global system of wildlife surveillance must be established to identify animal viruses in wild animals that have the potential to infect and sicken people.

In this episode, Jennifer A. Philips, MD, PhD, an associate professor of medicine and co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis, and Gideon Erkenswick, PhD, a postdoctoral research associate in Philips lab and director of Field Projects International, discuss why we need an early-detection system for viruses that have the potential to trigger the next pandemic and how it would work.

The podcast Show Me the Science is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Experts propose decentralized system to monitor wildlife markets, other hot spots

Full Transcript

[music plays]

Jim Dryden (host): Hello, and welcome to Show Me the Science, a podcast about the research, teaching and patient care as well as the students, staff and faculty at Washington University School of Medicine in St. Louis, Missouri, the Show Me state. My name is Jim Dryden, and Im your host this week. Weve been focusing these podcasts on the COVID-19 pandemic and Washington Universitys response. This week, were discussing where COVID-19 might have come from and how to detect the next virus with pandemic potential before it spreads. Its thought that the virus that causes COVID-19 may have originated in wild bats that live in caves around Wuhan, China. Like many devastating epidemics in recent decades from Ebola to HIV/AIDS, its thought this pandemic was triggered by an animal virus that spilled over into the human population. Now, a diverse group of infectious diseases experts, wildlife biologists, ecologists and others, including researchers at Washington University School of Medicine in St. Louis, is proposing that a global system of wildlife surveillance could and should be established to identify viruses from animals that have the potential to infect people.

Jennifer Philips, MD, PhD: Its hard to say how often it happens, but its happened enough in our history, and when the wrong pathogen enters the human population where we dont have adequate immunity, then the cost to human life can be enormous. And as weve seen the social disruption that is caused can also be really tremendous.

Dryden: Thats Washington University infectious diseases specialist Jennifer Philips, one of the authors of a new article on biosurveillance published in the journal Science. Shes part of the international team proposing that we pay closer attention to emerging infectious diseases by monitoring wild animals around the world. It would have been very difficult to do this sort of work even 10 years ago, but Gideon Erkenswick, a postdoctoral researcher in Philips laboratory, who also is a director of Field Projects International, a research organization focused on studying wildlife, says it is possible now to do complicated surveillance even in very remote places.

Gideon Erkenswick, PhD: There is and have been few groups that have been doing this work. Theres been a lot of hand-waving from individuals that have recognized for a long time how important biosurveillance is, but theres not been a lot of commitment to it internationally. For example, we still dont have any standardized international regulation on the movement of wildlife that reflects disease risks.

Dryden: Currently, there are scientists studying animals stationed in many places around the world. Erkenswick says with the technology now available, it would be possible to put resources together to learn more about potentially emerging viruses before they can cross from some of those animals into humans. He says a decentralized, global wildlife biosurveillance system would have the potential to identify viruses that could cause human disease before the next pandemic emerges.

Erkenswick: You would have diverse groups of people who are trained and cognizant of the risks we are now all very aware of, especially with SARS-CoV-2. You would be collecting samples from bats. You would visit caves, you would go into natural habitat, collect samples in wildlife markets. You probably would collect samples from rural communities where theres a lot of overlap between wildlife habitats, and then you would bring them to a nearby location where, again, using safe technique you extract RNA and DNA and directly on-site sequence for conserved regions within viral genomes. You can prescreen things fairly rapidly for the presence of an infectious agent.

Dryden: So without getting too terribly technical, what kind of tools would those be?

Erkenswick: So the kind of things were talking about in terms of new technology are portable sequencers. Theres a new sequencer thats literally the size of a USB stick and can fit in your pocket, and you can carry that to a rainforest, and then you sequence it right on the spot. If you do encounter something like SARS-CoV-2, if you chance upon it, do you really want to be collecting it, storing it, bringing it all over the place before you figure out if theres something potentially worrisome in it? The ideal situation is, on the spot, you can safely assess whether there is something there.

Dryden: And its not as simple as looking for sick animals in this cave or in the wet market because the viruses that would affect us like SARS-CoV-2 may or may not make the animals sick, correct?

Philips: Right. Thats absolutely true. So especially bats are able to tolerate a lot of viruses without necessarily being sick. And so just sampling sick animals is not really an adequate way to do biosurveillance. There have been a small number of government-funded biosurveillance efforts. And these programs are really sort of groundbreaking in beginning to do this kind of work, and they have done amazing work, but theyre very focused and localized so the sampling is quite intermittent in just certain locations. And theres just few regional labs that do the analysis. And so there hasnt thats, I guess, the start of whats needed, but it hasnt really provided the kind of global sampling that is probably needed. Or touched upon the variety of environments in wildlife markets and in the wildlife trade, where humans and wildlife do come into contact with one another. And I think the other point thats worth making is that these biosurveillance systems that we do have right now, because theres sort of no global consensus, no global effort, theyre subject to political whims of a few countries.

Dryden: Now, how common is it that animal viruses can cross over into humans? Its not uncommon, correct?

Philips: When it happens, we only know about it if there is really transmission between humans or ongoing transmission, or if we happen to identify an individual whos sick and comes to medical attention and actually gets a rare diagnosis. So we dont know how many times it necessarily happens, but we know its happened many times in our lifetime. So even in the last 20 years, this has happened at least three times in the case of coronaviruses, starting with the SARS epidemic and then MERS and now, of course, SARS-CoV-2, the virus that is causing the COVID-19 pandemic. And its not restricted to coronaviruses either, so other viruses in our lifetime have transmitted infection and those include HIV and Ebola among others. Its hard to say how often it happens, but its happened enough in our history. And when the wrong pathogen enters the human population where we dont have adequate immunity, then the cost to human life can be enormous. And as weve seen, the social disruption that is caused can also be really tremendous.

Dryden: So where does the idea for a decentralized, global surveillance system come from?

Erkenswick: There is and have been few groups that have been doing this work. And theres been a lot of hand-waving from individuals that have recognized for a long time how important biosurveillance is, but theres not been a lot of commitment to it internationally. For example, we still dont have any standardized international regulation on the movement of wildlife that reflects disease risks.

Philips: Well, I think this came together because we really brought together a group of individuals who have really diverse expertise and interests, people with human, animal and environmental expertise, with the understanding that all of these things are really inextricably linked together. We thought that bringing this group of people together was important to try to come up with ideas of how we could prevent this kind of thing from happening again in the future. And, as a group, we brainstormed what could be critical next steps to create more effective biosurveillance infrastructure, I would say. Thats something that would have to be practical, affordable. It has to be safe for people who are doing the biosurveillance or the sampling. It has to be feasible. But one thing thats really happened in the last five years is that theres more affordable and portable technology that could really be implemented more widely around the world and could take advantage of the local expertise at, really, sites of wildlife-human interface.

Erkenswick: Thats why we did it. We felt there was a need for this diverse group of peoples voices to be heard in a collective way. You want to go to places where theres no theres very little overlap between human communities and wildlife populations. So you know whats natural because it is totally normal for a species to have their own viruses and bacterial infections, and they cope with them, and they survive just fine, and theyre not necessarily infectious to us. So you want to know whats in the natural system, then you want to know whats different when these animals, wildlife and humans are in contact.

Dryden: Now a system like this would do surveillance of wild animals like bats, certainly, but what about domestic animals, even pets?

Erkenswick: Domestic animals and pets are very much part of that human-wildlife interface. If you live in the rainforest in Southeast Asia and you have a dog or a cat, and its roaming around and goes into the forests and attacks a primate or a bat, so yeah, absolutely. And you want to know if that exchange is being mediated by domestic animals, absolutely.

Dryden: What sorts of global biosurveillance systems do we have in place now, if any?

Erkenswick: In the lead up to this article, some of the things we did was contact a lot of colleagues we know throughout the world that do wildlife research in Madagascar, in Indonesia, in Peru, in Ecuador and we just literally surveyed friends and associates, Where do you take animals when theyre sick? And in almost every situation, it was, Nowhere. We dispose of things. We collect things. We store them, but really theres nobody offering to do this work, and its expensive. Here in the U.S., we have just vaulted forward on our capacity to do pathogen screening. I mean, in high school, you have kids running PCR machines and extracting DNA and in some cases sequencing DNA. In places where zoonotic risks are greatest, you just have light microscopes. Its not that the capacity to do genetic or genomic-based pathogen detection couldnt be there. There are smart people with a lot of experience that just dont have the tools. And the idea behind this paper is that it can be done affordably. We can utilize all of those people on the ground to do much better biosurveillance.

Dryden: If they have the equipment in place, is it easy to know that this is something that can cross over from one species to another, or do you know that it can make people sick when people start getting sick?

Philips: Theres not one answer to that question. Part of risk assessment builds upon all the knowledge that our virologists have built up over the years. So for some microbes or some viruses that we know are related to viruses that infect humans like coronaviruses, then we start to learn something about that. And we can make some predictions. We know whether a population of viruses now that are circulating in bats have the sequence that would allow them to attach to the receptors that would enable them to infect human cells. Or we may know something about whether theyre dissimilar enough from circulating viruses that humans might lack immunity to those viruses. So sometimes it builds upon the knowledge that we have. And then sometimes we can take new viruses and see whether they do infect human cells in the lab, or even just whether if we replace the sequence of a virus that we work within the lab with a sequence thats circulating in the wild, how would that impact its ability to infect human cells or to infect an animal model. And then I think theres a lot of unknown about just what is circulating and what is the potential. And so part of it is starting to gain more information about that interface.

Dryden: So this is a way to identify viruses, but can knowing about these viruses keep us safer, maybe even prevent this type of outbreak next time?

Philips: Yeah. I think especially and this is very much what happens with influenza. I think thats the case where its most developed. And one can certainly see with coronaviruses that having this information allows you to stay ahead in terms of therapeutics and interventions. So hopefully, we will have effective therapeutics. Well have monoclonal antibodies, maybe, and vaccines that work for SARS-CoV-2. And we would like to have more broadly neutralizing antibodies or broadly effective therapeutics. And we can ensure that we stay ahead of whats in the wildlife population, right, that interface. Weve had three epidemics in 20 years. Its not that rare an event. So we should be trying to make sure that we can stay ahead in terms of our therapies and our interventions.

[music plays]

Dryden: Erkenswick, Philips and their colleagues around the world have proposed better biosurveillance, but governments and funders still need to cooperate to make the idea a reality. But considering the thousands who have died and been hospitalized and the millions of jobs lost due to the pandemic, perhaps setting up such programs to screen for viruses would be a money saver in the long run. They say that as humans and animals continue to interact in new ways and in new locations, its virtually certain other animal pathogens also will cross over to humans in the future. But without a decentralized, global system of biosurveillance, it wont be possible to predict how and when that will happen.

Show Me the Science is a production of the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis. The goal of this project is to keep you informed and maybe teach you some things that will give you hope. Thanks for tuning in. Im Jim Dryden. Stay safe.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

Related press release here

See more here:

Podcast: Wildlife surveillance may help identify the next pandemic - Washington University School of Medicine in St. Louis

War.

Invisible enemy.

Front lines.

Invader.

All of these military terms, and more, have been used by the president, politicians, journalists and even health care experts to frame the ongoing confrontation against COVID-19.

But Tabitha Moses, an M.D./Ph.D., student at the Wayne State University School of Medicine, believes employing military language in the struggle with the pandemic may actually impede efforts.

The Conversation published Mosess column, How Talking About the Coronavirus as an Enemy Combatant Can Backfire,"on July 10.

These military-inspired metaphors serve a purpose. Unlike the dense linguistic landscape of science and medicine, their messages are clear: Danger. Buckle Down. Cooperate. In fact, studies have shown that sometimes military metaphors can help unite people against a common enemy. They can convey a sense of urgency so that people drop what theyre doing and start paying attention, Moses writes. However, as someone who has studied the way language influences behavior, I know that this kind of rhetoric can have long-term effects that are less positive, particularly within health and medicine. In fact, research has shown that these metaphors can cause people to make decisions that go against sound medical advice.

The use of military metaphors, said Moses, has been shown to alter behavior, but not always for the better. People may become more likely to take risks, overtreat themselves and be less likely to engage in preventive activities, she wrote. Such language can also imply to others that those who do become infected may be stigmatized as weak.

Employing militarist lingo can also cause the public to behave illogically, said Moses, 30, who has completed two years of medical training and is entering her third year in graduate school in pursuit of her doctoral degree.

The use of this type of metaphor in a variety of contexts has concerned me for a while, said Moses, who was born in England and moved to the United States at age 18. In college I majored in cognitive science and philosophy with a focus in bioethics, and am acutely aware of the impact of language on behavior. As COVID-19 escalated, it became clear how this type of metaphor could be harming the efforts to flatten the curve. Additionally, in conversations with my peers in health care, I realized that most did not realize the effect of this language on their patients, so I felt it important to provide this background and context.

Moses, who wants to practice and conduct research in psychiatry, with an emphasis on substance abuse, said she hopes the column will make people aware of the way metaphors can impact those around them, and adjust their language and behavior to improve responses to the pandemic.

After obtaining her undergraduate and masters degrees from Johns Hopkins University, Moses worked in public health research in Baltimore. She then moved to Michigan to attend the Wayne State University School of Medicine.

I knew that for medical school I would want to attend a school in an urban environment where there were ample opportunities to be actively involved with the community, she said. WSU was one of the best schools I looked at in terms of having a diverse range of opportunities to work with and help the community, from projects like public school outreach and the communities gardens, to the free clinics. I also wanted to attend an M.D./Ph.D. program, and WSU had researchers who were active in my fields of interest.

The Conversation is a not-for-profit service that provides columns by leading scholars and academic experts to the Associated Press, which distributes the pieces to thousands of newsrooms across the nation. It has published many pieces by Wayne State University faculty members, including David Rosenberg, M.D., chair, and Arash Javanbakht, M.D., associate professor of the Department of Psychiatry and Behavioral Neurosciences.

The rest is here:

Student writes that military metaphors could cause more harm when talking about COVID-19 - The South End

When U-M opened the nations first university-owned hospital in this converted professor's house in 1869, no physicians actually saw the patients who stayed there. Instead, the Medical School faculty would examine or operate on patients in front of the medical students in the schools main building, across the field now known as the Diag.

A steward named John Carrington was hired to oversee the hospital building, and his wife served as matron. Together they checked patients in, made sure they were fed and had clean linens and well-tended fires in the winter, and charged them room and board. The medical care was free.

But by 1874, the faculty recognized the need for a physician to examine patients as they arrived, and provide care during their stay. The Regents set forth the duties of a new type of employee called a hospital physician as follows:

Examine patients as they arrive, assign them quarters after they have paid the admission fee, and notify the physician to whose department they belong.

See that they receive proper food and that accurate record is kept of the treatment of each case. Dispense all the medicine himself and charge regular drug store prices, and charge for all dressings.

See that the hospital is kept in a comfortable and cleanly condition, shall prevent persons not belonging in the hospital from lounging in the building, and promptly report any irregularities occurring therein.

They authorized the hiring of Robert J. Peare, M.D., an Irish immigrant who had graduated from the Medical School in 1869, as the first Hospital Physician. He oversaw the care of the 185 patients who stayed in the hospital often for weeks at a time when the hospital was open from October to July of his first year.

By 1876, a large addition to the hospital opened, called the Pavilion Hospital, and the first nurses were hired to work with this first resident physician and faculty.

As more and more patients sought care from U-M physicians, the Regents in 1877 authorized the hiring of one of the Medical Schools newest graduates, Alexander Maclean, M.D., as the first Hospital Surgeon.

Maclean even had a role in getting out the word that the hospital had expanded and had room for patients.

Inadvertisements starting in 1878in the Michigan Medical News, a statewide journal, he wrote that great improvements have been made in the equipment and accommodations of the Hospital so that every provision has been secured for the comfort and treatment of the sick and afflicted.

He also explained in the ads that the resident physician would be available at the hospital to examine and treat patients arriving during the nine months of the year that the hospital was open. The exception: those arriving on Wednesday and Saturday mornings were encouraged to go directly to the Medical School building on East University Avenue, to be examined and treated by faculty during their clinic hours.

Maclean especially called for the supervisors of county houses facilities set up for the care of the poor in each Michigan county to send patients to this well equipped public hospital rather than allowing them to languish or die where they were.

Despite their usefulness in this advertising campaign, historical accounts say that house physicians in these early years were essential to the proper conduct of a hospital, (but) for many years they occupied an inferior position and were more or less looked down upon by the hospital chiefs.

By 1890, medical educators became convinced that post-graduation experience and training under the guidance of senior physicians was important for young doctors, before they could enter practice on their own.

At Johns Hopkins University, William Osler established Americas first formal residency program in 1889, as the institutions first hospital opened and became a training ground for the students and recent graduates of the medical school founded a few years before.

In addition to the house staff, U-Ms first young physicians to be called interns were hired in 1899, and were paid $125 a year. They also received room and board in the hospital or nearby houses.

They were typically the top students in each graduating medical class, who competed fiercely to be chosen to stay on for additional training at the brand-new hospitals that had opened in 1891 on Catherine Street.

The Regents voted to keep the hospitals open every summer, starting in 1897, after a decade of being open during occasional summers but often closing for financial reasons. They spent extra funding from the state for summer operations to support staff salaries and operating costs. The start date for each summer was July 1 still the traditional start date for interns to this day.

But Medical School professors soon recognized that some of their graduating students had asked for recommendations from faculty to try to secure internships at more than one hospital. Those faculty physicians even found themselves apologizing to their colleagues when a student took one hospitals offer over another.

To remedy this, the faculty created a committee in 1911 to oversee all requests and recommendations for internships. They even briefly considered making the intern year a fifth year of medical school, devoted solely to clinical care, but this wasnt put into practice.

In 1912, Reuben Peterson, M.D., a professor of obstetrics and gynecology,wrote a reportto the Council on Medical Education of the American Medical Association, about the plight of interns.

He called for a more formalized approach to their training, to make the most of their time and ensure they were well-trained as well as serving patients. Hospitals and medical schools should partner on the selection and oversight of interns.

That approach, adopted at Michigan and eventually hospitals nationwide, persists today through the system of accreditation of academic residency programs at teaching hospitals nationwide.

By 1914, U-M had so many interns on board that it moved a house from another part of Ann Arbor to the grounds of the hospital to accommodate them. It soon needed expanding, and interns even moved in to occupy part of the hospital administration building.

In 1922, a new law required all medical school graduates to serve a year in an accredited hospital before they could enter practice. By 1927, the Medical School had formed a Department of Postgraduate Medicine to offer short courses in various fields to trainees from hospitals across Michigan, and to physicians already in practice.

The number of early-career medical trainees working at U-M hospitals continued to grow. According to the1941 edition of the Encyclopedic History of the University of Michigan, in 1940 thirty-five interns were on the Hospital staff. They rotated among the various clinical services. There were also approximately forty assistant residents, who served for a second year, and thirty resident physicians, who stayed for a third year.

This designation of program year, abbreviated PGY, tracked where a resident was in his or her training, and is still used today.

In order to keep interns and residents from leaving because they were unhappy with their living quarters, in 1939 an entire building called theInterns Residencewas added to the main University Hospital that had opened in the 1920s.

It could house 75 men, in private rooms with private baths. It even had a recreation room, kitchen, dark room for photography, and handball court though these were carefully built to be away from the bedrooms so that noise from interns enjoying their off hours wouldnt disturb those who had just finished a shift and needed sleep.

As new departments formed within the Medical School, they formalized training programs for interns and residents who had chosen to focus on that departments specialty. Competition for spots increased, as the reputation of the programs spread nationwide. The intern year was no longer a separate program from residency, but rather a nickname for the first year.

Fellowships, for those who had completed residency but wanted further sub-specialty training, became more common often funded by National Institutes of Health training grants.

In 1974, exactly 100 years after the hiring of the first U-M house physician, the House Officers Association became the official collective bargaining organization for U-M interns and residents. The origins of the organization are told in itsHouse Officers Association history.

Today, Michigan Medicine has106 post-medical school training programs 26 residency programs and 80 fellowship programs. Theyre coordinated through the academic departments of the Medical School, and theOffice of Graduate Medical Education. Every year, around July 1, about 400 physicians start their internship or residency at Michigan Medicine.

At any given time, nearly 1,300 physicians bear the title of house officer at U-M from the interns who start July 1 to senior residents who do research and provide leadership to their junior colleagues. And just as in 1874, Michigan Medicines hospitals and clinics couldnt operate without them.

See original here:

Doctors in the House: History of Medical Interns and Residents at Michigan Medicine - Michigan Medicine

NEW YORK On an afternoon in early April, while New York City was in the throes of what would be the deadliest days of the coronavirus pandemic, Dr. Lorna Breen found herself alone in the still of her apartment in Manhattan.

She picked up her phone and dialed her younger sister, Jennifer Feist.

The two were just 22 months apart and had the kind of bond that comes from growing up sharing a bedroom and wearing matching outfits. Feist, 47, a lawyer in Charlottesville, Virginia, was accustomed to hearing from her sister nearly every day.

Lately, their conversations had been bleak.

Breen worked at NewYork-Presbyterian Allen Hospital in Manhattan, where she supervised the emergency department. The unit had become a brutal battleground, with supplies depleting at a distressing rate and doctors and nurses falling ill.

When Breen called this time, she sounded odd. Her voice was distant, as if she was in shock.

I dont know what to do, she said. I cant get out of the chair.

Breen was a consummate overachiever, one who directed her life with assurance.

When she graduated from medical school, she insisted on studying both emergency and internal medicine, although it meant a longer residency. She took up snowboarding, cello and salsa dancing as an adult. Once, after she had difficulty breathing at the beginning of a half-marathon, she finished the race, then headed to a hospital and diagnosed herself with pulmonary emboli blood clots in the lungs that can be fatal.

In addition to managing a busy emergency department, she was in a dual-degree masters program at Cornell University.

Breen was gifted, confident, clever. Unflappable.

But the woman speaking to Feist that day was hesitant and confused.

Feist quickly arranged for her sister to be picked up by two friends who would ferry her to Baltimore, where Feist could meet them to take her to family in Virginia. When Breen finally climbed into Feists car that night, she was nearly catatonic, unable to answer simple questions. Her brain, her sister said, seemed broken.

They drove together for a few hours, heading to the University of Virginia Medical Center. When they arrived, Breen checked into the psychiatric ward.

Breen, 49, had suffered a breakdown when the city was desperate for heroes. And she was certain her career would not survive it.

Her family members tried to convince her otherwise. After all, she had no apparent history of mental health problems, and the past month had been one of extremes for everyone.

Breen was doubtful. An insidious stigma about mental health persisted within the medical community.

Lorna kept saying, I think everybody knows Im struggling, Feist said. She was so embarrassed.

Lorna Breen, an athletic and motivated student, headed off to Cornell University to study microbiology before earning a masters degree in anatomy. After medical school in Virginia, she was determined to study two specialties in her residency because she knew emergency doctors suffered high stress. She wanted to have internal medicine as an option down the road.

In 2004, Breen joined the sprawling NewYork-Presbyterian medical system, working at Columbia University Medical Center and the smaller NewYork-Presbyterian Allen Hospital, called simply the Allen.

As if to ensure relief from her intense job, Breen planned thrilling trips, joined a ski club, played cello in an orchestra, took her salsa classes and attended Redeemer Presbyterian, a church that attracted high-achieving professionals.

In 2011, Breen was promoted to the helm of the emergency department, where colleagues said she tended to solve problems with systematic precision and preferred concrete solutions.

She liked structure, said Dr. James Giglio, who was then her boss. She liked working in an organized world.

That world would later distort and crumple. By early this year, the coronavirus was slipping into New York, undetected and underestimated.

In late February, as elected officials were still assuring the public that the virus did not pose a serious threat, Breen sat down at her computer and updated a contingency plan addressed to her family.

She had created it after the Sept. 11 terrorist attacks and revised it after Hurricane Sandy hit in 2012; it was her methodical response to calamity. The coronavirus, she was convinced, would catch hospitals off guard.

A week later, she went on a planned vacation with Feist, her sister, in Big Sky, Montana. By the time Breen returned from the trip, a state of emergency had been declared in New York.

Breen reported back to work March 14, arriving to questions about the departments stock of personal protective equipment and whether staff members could get Tyvek protective suits.

Four days later, Breen showed symptoms of COVID-19. Feverish and exhausted, she quarantined at home to recover. She slept up to 14 hours in a row, was drained by small tasks, lost 5 pounds. But she still tried to sort out work problems, like a shortage of oxygen tanks.

The last weekend in March, Breen went on a walk and felt wiped out. But she told her work she would be back soon. She knew they needed more hands.

When Breen returned to work April 1, the city was on the verge of a grim bench mark: Deaths would soon peak at more than 800 in a single day. The scene at the Allen prompted a disturbing realization: She and her emergency department were outmatched. She called her sister, Feist, upset about the chaos.

Co-workers noted that she looked frazzled. And she was not exuding her usual confidence. Still, she managed that week to call in to a video meeting with her Bible study group. She also reached out to classmates in her postgraduate program, concerned about a group project. She was anxious she was not doing her part.

She started working long days that bled into one another. On April 4, Breen spent about 15 hours at work, according to a colleague.

The following day, she seemed confused and overwhelmed, said the colleague, who had never before seen Breen in such a state. Breen wrote a message to her Bible study group.

Im drowning right now May be AWOL for a while, she typed.

She soon stopped replying to friends messages altogether.

Despite their often hero status, health care workers experience pressure that can be paralyzing. Emergency doctors are particularly vulnerable to post-traumatic stress while working in a profession that encourages toughing it out. The pandemic intensified both the demands made of doctors and the pressure to endure those demands.

When Breen finally called her sister for help April 9, she sounded so unlike herself that Feist wondered if the virus had somehow altered her sisters brain. Although research is still preliminary when it comes to COVID-19s effects on the brain, there is growing evidence that the disease, or the way the body responds to it, can cause a range of neurological issues.

Feist called Dr. Angela Mills, who, as chief of emergency medicine, was Breens supervisor.

When Mills arrived at Breens apartment, Breen looked strange. She was quiet, only speaking when questioned. Even then she gave only one- or two-word answers.

Mills asked if she felt like she wanted to hurt herself. Breen indicated yes.

A friend of Breens who was a psychiatrist arrived to pick her up. After spending some time in the car with Breen, the friend called Feist and said her sister needed to go to the hospital.

Breen spent about 11 days as an inpatient in the psychiatric ward. While in the hospital, she chatted on the phone with her friend Anna Ochoa. Ochoa felt good after hanging up. Her friend seemed strong.

Breen was soon discharged, and she stayed with her mother in Charlottesville, where she was a bit more herself, even making jokes. She mentioned returning to her MBA studies. She started going for long runs. Family members talked about getting her back to New York.

But on April 26, Breen killed herself.

It is impossible to know for sure why someone takes her own life. And Breen did not leave a note to unravel the why.

Still, when the casualties of the coronavirus are tallied, Breens family believes she should be counted among them that she was destroyed by the sheer number of people she could not save, that she was devastated by the notion that her professional history was permanently marred, and mortified to have cried for help in the first place.

NewYork-Presbyterian said in a statement that Dr. Breen was a heroic, remarkably skilled, compassionate and dedicated clinical leader who cared deeply for her patients and colleagues.

If Breen is lionized along with the legions of other health care workers who gave so much maybe too much of themselves, then her shattered family also wants her to be saluted for exposing something more difficult to acknowledge: the culture within the medical community that makes suffering easy to overlook or hide, the trauma that doctors comfortably diagnose but are reluctant to personally reveal.

If the culture had been different, that thought would have never even occurred to her, which is why I need to change the culture, Feist said.

For Breens friend Ochoa, their last conversation has become especially crushing. Ochoa cannot stop hearing Breen repeat: I couldnt help anyone. I couldnt do anything. I just wanted to help people, and I couldnt do anything.

Sign up and receive coronavirus news and breaking updates, from our newsroom to your inbox.

See original here:

I couldnt do anything: The virus and an ER doctors suicide - Boston.com

The states only specialty heart, lung, and vascular center announced Thursday a a new partnership with Sidney Kimmel Medical College at Thomas Jefferson University for Deborahs Fellowship Programs.

PEMBERTON TOWNSHIP Deborah Heart and Lung Center has partnered with a top medical school in Philadelphia.

The states only specialty heart, lung, and vascular center announced Thursday a new partnership with Sidney Kimmel Medical College at Thomas Jefferson University for Deborahs Fellowship Programs.

The new partnership could expand more subspecialty training at Deborah, according to Dr. Vincent Pompili, chair of the department of cardiovascular medicine at Deborah.

"Partnership with Jefferson will enhance our resources and help deliver an exceptional educational experience and opportunity," said Pompili in a statement. "The Sidney Kimmel Medical College at Thomas Jefferson University is well-renowned and respected for its progressive medical school education and research, offers a perfect complement to Deborahs specialty training."

Physicians who plan on specializing in general cardiology, electrophysiology, interventional cardiology, advanced heart failure, and vascular surgery apply each year for a coveted spot in Deborahs Fellowship Program, where they receive intensive specialty training.

Fellows at Deborah work side-by-side with physicians at the hospital, training in advanced cardiovascular techniques, and work on cutting-edge clinical trials.

"As a specialty educational training site, we need to partner with a medical college with accredited Internal Medicine core standards and established residency program. Thomas Jefferson University meets those requirements and also brings a connection and synergy to our program," noted Pompili.

"The legacy and commitment at Deborah to its training programs aligns well with Jeffersons mission to educate the physicians of the future with clinical and scientific knowledge, as well as the human skills of empathy and creativity," said David Paskin, MD, vice dean, graduate medical education and affiliates at Thomas Jefferson University.

See the original post:

Deborah Heart and Lung Center partners with Thomas Jefferson University - GoErie.com

By COLLIN BINKLEYAP Education Writer

A medical association that the White House has cited in its press to reopen schools is pushing back against President Donald Trump's repeated threats to cut federal funding if schools don't open this fall.

In a joint statement with national education unions and a superintendents group, the American Academy of Pediatrics on Friday said decisions should be made by health experts and local leaders. The groups argued that schools will need more money to reopen safely during the coronavirus pandemic and that cuts could ultimately harm students.

The statement comes at a time when schools across the nation are weighing decisions for the fall as Trump pushes them to reopen. Millions of parents are still waiting to hear if their children will be returning to school, but some of the nation's largest districts have said students will be in the classroom only a few days a week.

"Public health agencies must make recommendations based on evidence, not politics," the groups wrote in the statement. "Withholding funding from schools that do not open in person full-time would be a misguided approach, putting already financially strapped schools in an impossible position that would threaten the health of students and teachers."

Trump, however, repeated his threat on Friday, saying on Twitter that virtual learning has been "terrible" compared with in-person classes.

"Not even close! Schools must be open in the Fall. If not open, why would the Federal Government give Funding? It won't!!!" he wrote. Trump issued a similar warning on Twitter on Wednesday, saying other nations had successfully opened schools and that a fall reopening is "important for the children and families. May cut off funding if not open!"

Trump has not said what funding he would withhold or under what authority. But White House spokeswoman Kayleigh McEnany has said the president wants to use future coronavirus relief funding as leverage. McEnany said Trump wants to "substantially bump up money for education" in the next relief package but only for schools that reopen.

"He is looking at potentially redirecting that to make sure it goes to the student," McEnany said at a Wednesday press briefing. She added that the funding would be "tied to the student and not to a district where schools are closed."

Trump has been insistent that schools reopen despite growing coronavirus outbreaks in parts of the U.S. The White House hosted a summit on the topic on Tuesday, gathering health and education leaders who said students should return to the classroom this fall to continue their academics and to regain access to meal programs and mental health services.

Among those at the event was Dr. Sally Goza, president of the American Academy of Pediatrics, who called for schools to open.

"Being away from peers, teachers, and school services has lasting effects for children," Goza said at the roundtable. "Although this will not be easy, pediatricians strongly advocate that we start with the goal of having students physically present in school this fall."

Her comments echoed guidelines issued by the group in June, which said time away from school can lead to social isolation and make it harder for schools to identify learning deficits, child abuse, depression and other problems.

Vice President Mike Pence, Education Secretary Betsy DeVos and McEnany have repeatedly, and as recently as Wednesday, cited the American Academy of Pediatrics in defense of Trump's approach.

But Friday's statement acknowledged that it may be best for some schools to stay online. School leaders, health experts, teachers and parents should be at the center of reopening decisions, the groups said, "taking into account the spread of COVID-19 in their communities and the capacities of school districts to adapt safety protocols to make in-person learning safe and feasible."

"For instance, schools in areas with high levels of COVID-19 community spread should not be compelled to reopen against the judgment of local experts," the statement said. "A one-size-fits-all approach is not appropriate for return to school decisions."

New York City's public school district, the nation's largest, said students will be in classrooms two or three times a week and learn remotely in between. DeVos has opposed that kind of approach, saying it fails students and taxpayers.

Read the original here:

Medical group cited by Trump denounces school funding threat - Sumter Item

By Heather Leah, WRAL multiplatform producer

Raleigh, N.C. The stone walls of St. Agnes Hospital are more than a century old. Although the structure is hollowed-out and overgrown with curtains of ivy, the building's remains hold memories from an era of segregation in medical care.

St. Agnes Hospital is viewed by many as a symbol of strength and resilience in the aftermath of slavery. It was hand-built by the students of St. Augustine's College. In fact, students even quarried the stone from the earth themselves.

The hospital was established in 1896, within a single generation of enslaved people being freed from local plantations, to provide much-needed care to Raleigh's Black residents, as well as provide medical training for Black students.

The stone structure that remains today was completed in 1909 and included 75 beds, a nursing college and a nurses' home. St. Agnes provided the highest-quality medical care for the Black community of any hospital between Washington, D.C., and New Orleans.

"It served over 75,000 African-Americans in three states during its existence," said a brief video documentary on the history of the school, produced on behalf of a current fundraiser being held by St. Augustine's University.

The hospital closed in the early 1960s, when WakeMed allowed hospital buildings to become integrated; however, the hallways within were still kept segregated.

The parallels between 2020 and 1918 are astounding, according to Linda Dallas, an artist and assistant professor of visual art at Saint Augustine's University.

When asked what the students who built St. Agnes Hospital in 1909 would think when seeing modern times, she said, laughingly, "I think they'd say in some ways this is just the same as the world they lived in!"

The St. Agnes Hospital building was built in 1909. In 1918, there was the global flu pandemic. Thank goodness St. Agnes was in place the last time we had a pandemic. Can you imagine going through this and while having absolutely no access to a hospital? said Dallas.

In 1919 when Raleigh was going through a pandemic, the political upheaval of that time was comparable to the political upheaval that were going through at this time," she said.

The summer of 1919 was known as the Red Summer, in which the highest number of lynchings in this country were ever recorded.

I think in some ways, they would think, Oh, this is different. But in some ways they would think this is just the same as the world were living in.

In that same period, the country was also trying to adjust to social changes brought on by the Industrial Revolution. Dallas said that on the first day electricity came to St. Augustine's and St. Agnes' campus, students came out and cheered for the electricians who wired the building.

"They didn't turn on the lights right away. They waited until it got dark, and they turned on the lights and cheered," said Dallas.

Dallas compares the changes of the Industrial Revolution, with the social changes modern people are experiencing with the Technological or Informational Revolution.

As bad as the 1918 influenza pandemic was, the Black community would have had even greater losses if St. Agnes had not been here in Raleigh.

St. Agnes almost looks like a castle standing in downtown Raleigh. Many locals have reported driving past the building and wondering about its origins.

Since St. Agnes has been closed around 60 years, decades of growth have begun overtaking the walls. Trees and plants are growing up through the basement floor; ivy is carpeting the stone walls.

Only the basement is accessible, as the floors, doors and windows are long gone. Some locals mistakenly believe the structure was destroyed by fire, but actually the building's innards were actually pulled out intentionally, leaving only the shell behind.

It's a visually stunning place, one-of-a-kind in Raleigh. Some of the building's skeleton reveals where doors and rooms once stood. A secondary section of brick is connected by what looks like a wooden walkway. Tree branches and leaves can be seen waving out upper windows.

Three smaller windows towards the front of the building have a unique shape. According to Michael Palko, who wrote on the history of St. Agnes Hospital, those three windows indicate where the hospital's chapel once sat.

With no floors or modern indications of the hospital's layout, it can be difficult to envision how the hospital appeared during its heyday. Where were babies born? Where did surgeries happen? Where did nurses eat lunch?

By delving into the history, old images and stories, perhaps we can provide a clearer image of how St. Agnes Hospital once functioned and gain a better understanding of its role in Raleigh history.

Many locals have no idea the first four-year medical school was established right here in Raleigh: Leonard Medical School at Shaw University.

In 1882, roughly 14 years prior to the founding of St. Agnes Hospital, Shaw made history as the first institution in the entire country to offer a four-year program for med students. Over the next 36 years, the Medical School in Leonard Hall graduated almost 400 physicians, including Aaron Moore, the first Black doctor in Durham, according to the Raleigh Historic Development Commission.

Over 137 years old, this iconic building can still be seen on Shaws campus.

St. Agnes Hospital and teaching program was founded within the context of Shaw making history with its medical program. Sarah Hunter, the wife of St. Augustine's University's principal, raised the funds to open a small medical facility on campus. As the demand for institutionalized health care grew, the facility grew, eventually leading to building the St. Agnes Hospital in 1909.

The quality of care at St. Agnes was renowned. Because St. Agnes did not have access to as much funding and high tech equipment as local white-only hospitals, doctors at St. Agnes had to rely on exceeding skill and training. Some stories say the local white hospitals would allow doctors from St. Agnes to "moonlight" and come help perform complex procedures.

As history in 2020 parallels circumstances from around a century ago right here in Raleigh, many locals have begun approaching history with a sense of pessimism. However, Dallas said, Theres no place on the surface of the planet earth that doesnt have a history that is a combination of wonderful things and horrible things.

History, she said, is like people: Full of wonderful things and also full of horrible things. You cant blind yourself to either of those things.

Dallas said, "Can you imagine the courage of Sarah Hunter, a white woman who pushed to establish a college for Black Americans in 1896? So it wasnt all horrible, but it wasnt all wonderful either. We have to be willing to see the entire picture."

Art plays a major role helping people see the entire picture, said Dallas.

She said, "Think of all the major art movements that came to be during the turn of the century in the early 1900s: Cubism, expressionism, all the isms!"

Poets, film makers, writers and visual artists from that century could be seen as mentors for living in this time period: Pandemic, racial tensions and new technologies.

One artist even created a rendering of how St. Agnes Hospital may have looked during its years in service.

The date for the exhibit isn't set, but Dallas expects it to take place from early August all the way into November. The art created by Black locals, expressing their feelings during this era, will stand in front of St. Agnes, allowing viewers to reflect on the parallels between history and modern times.

Dallas hopes to open the gates to St. Agnes for a one-day event, allowing visitors to walk close to the building to get a better look at this critically important piece of history.

Take a look at the website for Envision St. Agnes to keep a look out for fundraisers, events and art exhibits on the St. Agnes Hospital campus.

Follow the Envision St. Agnes Facebook page.

Take a look at the history of Oberlin Village, one of Wake County's freedmen's villages formed in the aftermath of the emancipation of slavery.

Or, hear the story of Joseph Holt, Jr., the first black student in Raleigh to challenge segregated schools. At just 13 years old, he faced death threats, hate mail and threats to abduct him, as his family fought for equal education.

Have ideas for more hidden history? Email hleah@wral.com.

Read this article:

Inside the walls of St. Agnes Hospital: History of segregated health care in Raleigh - WRAL.com

Data collected from the Association of American Medical Colleges shows that from 2018-2020 UNDs medical school ranked in the 100th percentile higher than any other school in the database for the fraction of its graduating medical student class to identify as American Indian. In recent years prior to 2018, the school ranked in the 99th percentile.

In its nearly 50 year history, the INMED program has produced almost 1,000 American Indian health professionals, including more than 250 physicians.

I like to say that an organization like the UND SMHS is characterized by not just what it says, but also by what it does, Joshua Wynne, vice president for Health Affairs at UND and dean of the medical school, said in a statement. The INMED program is a testament to our commitment to deliver on the imperative to move toward more health equity implicit in former President Nixons Special Message on Indian Affairs.

Nixon gave that policy speech 50 years ago this month on July 8, 1970.

Donald Warne, director of the INMED and master of public health programs at the UND medical school, said the policy speech not only paved the way for reversing the federal governments termination policy, which had rescinded the sovereignty of American Indian tribes, but strove to improve American Indian health in several ways.

Warne said people, including his students, are sometimes surprised to hear that Nixon was instrumental in promoting tribal sovereignty. The 1970s was an important decade for indigenous rights, including taking over management of schools from the Bureau of Indian Affairs and improved access to and control over tribes' health care needs. The 1970s also brought the American Indian Religious Freedom Act, which reversed a law that had made indiginous religious practices illegal in the 1880s.

In the 1970s, it was kind of a renaissance of American Indian policy and law, Warne said.

Nixon's policy reversal also played a direct role in creating UNDs Indians Into Medicine program, which was founded in 1973. The program was originally established through federal appropriations. The programs mission is to improve American Indian health and producing more American Indian health care providers, from physicians and physical therapists to occupational therapists and public health researchers.

I think without federal support, this would not be as successful as it is, Warne said, noting there is a long way to go to address disparities in education and health. But at least at UND, we're doing our part.

The medical school is also launching a new doctoral program in indigenous health, the first of its kind.

I think in many ways, the University of North Dakota is well positioned to be the national leader in medical education, and public health education and doctorate level, health professions education really for many years to come, Warne said. Our starting point is really a national leader, but I envision a lot more growth from here as well.

Original post:

UND continues to lead the nation in American Indian physicians - Grand Forks Herald

Achievements, promotions and recognition

Strictly Business: A roundup of business and retail news right to your inbox.

On the job

Caroline Glackin, an assistant professor in the department of management, marketing and entrepreneurship of Fayetteville State Universitys Broadwell College of Business and Economics, has been named associate editor of entrepreneurship for the International Journal of Instructional Cases. Glackin will serve a three-year term.

Interventional pulmonologist Adam Belanger has joined FirstHealth Specialty Services and Pinehurst Medical Clinic in practice with Michael Pritchett. Originally from Vermont, Belanger earned his undergraduate degree from Boston University and attended medical school at Mount Sinai School of Medicine in New York. He completed an internal medicine residency at Washington University in St. Louis. He recently completed a fellowship in pulmonary and critical care medicine as well as additional training in interventional pulmonology at the University of North Carolina at Chapel Hill.

Spring Lake Alderwoman Soa Cooper was elected to the board of directors of the N.C. League of Municipalities, representing District 7. Fayetteville City Councilman Johnny Dawkins is a board member representing large cities.

Ulysses Taylor, a professor of accounting and chairman of the department of accounting, finance, health care and information systems, has been named interim dean of the Broadwell College of Business and Economics at Fayetteville State University. The appointment was recommended by Lee Brown, former dean of the college, who will become interim provost on Aug. 1. Taylor has been a member of the FSU faculty since 1992 and a department chairman since 1997. He is a former board member of the Greater Fayetteville Chamber of Commerce and Fayetteville/Cumberland County Economic Development Alliance. He chairs the FSU Development Corp. and is a board member and treasurer of Capitol Encore Academy, a charter school. Taylor received his bachelors degree in business administration in accounting from FSU, an MBA from East Carolina University, and a law degree from North Carolina Central University School of Law.

Grants

Cape Fear Valley Health has been awarded $149,747 by the North Carolina Healthcare Foundations COVID-19 "Fill the Gap" Response Fund. The money will help fund behavioral health support for frontline health care workers, enhanced discharge support for underserved patients, and increasing nursing coverage to allow additional breaks in COVID-19 treatment units.

Community Care of the Lower Cape Fear has received a $350,000 grant from the N.C. Department of Health and Human Services Division of Public Health-Womens Health Branch to improve maternal morbidity and mortality rates in Perinatal Care Region V. Funding supports the Perinatal Nurse Champion program, focusing on maternal health initiatives to identify guidelines and educate providers in the states birthing hospitals, community health centers, health departments and physician practices. The agency covers Cumberland, Robeson, Harnett, Hoke, Bladen, Sampson, Moore, New Hanover, Brunswick, Columbus, Montgomery, Richmond and Scotland counties.

Read the original post:

Business Observer for the week of July 12 - The Fayetteville Observer

If you could prolong your life by a few more years (or even live to be 100), would you do it? I can't think of many people who would say no.

I've devoted my entire career to geriatrics, a field that specializes in the care of older adults. I helped start one of the first geriatrics programs in the U.S. at Harvard Medical School, and I'm currently a professor of medicine and public health at Brown University.

Having been a geriatrician for 55 years, the one question I'm constantly asked by folks of all ages is, "What are the most important everyday habits that can lead to a longer, more vibrant life?" I've given a lot of guidance on this to my patients, and I've seen positive results in people who follow them, including myself.

I celebrated my eightieth birthday this year, and I'm still going strong. I feel about as healthy and sharp as I did a decade ago. (Even my medical school interns don't stand a chance at beating me in squash, a sport I play several times a week.)

At 80, I've outlived the average American's life expectancy, which, for the first time in 100 years, has been on the decline. In 2014, our anticipated lifespan was 78.9 years, according to the Centers for Disease Control and Prevention. In 2017, it dropped to 78.6 years.

If you ask me, the biggest drivers are obesity, physical inactivity, smoking and substance abuse.But the good news is that it's never too late to change your lifestyle.

Here are some of the simplest things you can do nowto increase your chances of living a longer, healthier life:

I believe in the power of a Mediterranean-like diet (think: a combination of Italian and Greek dishes).

According to theDietary Guidelines for Americans, this plant-based diet filled with fresh fruits and vegetables, whole grains and healthy fats can help prevent chronic disease and promote overall health.

I like to think of the Mediterranean diet as more of a lifestyle routine than a strict plan you follow for a while and then abandon, because it can be hard to keep up with. Want a T-bone steak every month? Go for it! But try to avoid processed and fast foods. Include seafood, lean meats and nuts in your meals instead.

Fatty fish, such as salmon, sardines and albacore tuna, are staplesfor a goodMediterraneandiet. They're rich omega-3s, which research shows can help reduce your risk of heart disease and stroke. The American Heart Association recommends two 3.5-ounce servings of fish (particularly the fatty kind) weekly.

Extra-virgin olive oil, another staple of the diet, canhelp prevent heart attacks, stroke and cardiovascular death, even among people at higher risk.

Studies have shown that obesity and physical inactivity are two of the biggest contributors to diseases and a shortened lifespan. Fight back with exercise, which not only improves physical function, but also helps reduce the risk fordepression,canceranddiabetes.

TheAmerican Cancer Societyrecommends two and a half to five hours of moderate physical activity (e.g., walking, gardening) a week, or one to two and a half hours of vigorous physical activity (e.g., running, aerobics) a week.

I gravitate toward squash and anything else that gets my heart and respiratory rates up. But just 30 minutes of walking every day can make a difference.

Start moving now and keep it up. It can help add years to your life.

As everybody already knows, smoking has deadly consequences. It can cause health issues like heart disease, cancer, lung disease and emphysema, among many others. Research shows that even "light smoking" (as little as one cigarette a day) can greatly increase your risk of dying early.

But the benefits of quitting smoking start pretty quickly. The risk for a heart attack drops sharply just one year after quitting, according to the CDC. And, after two to five years, the chance of stroke could fall to roughly the same as a non-smoker.

Another thing: Don't be fooled into thinking vaping is a healthier alternative. Although there's limited research on the long-term effects of vaping, a recent study found that using e-cigarettes damages arteries in the same way that traditional cigarettes do.

Preventive care can help uncover health issues early, so schedule wellness exams as often as your health care provider recommends.

Some of the most important screenings and exams include cholesterol, blood pressure, skin cancer, and breast and cervical cancer for women (pap smears begin at age 21, mammograms start at 40). Depending on your family history, your doctor may suggest others.

Keeping up with these annual visits is a chance to review your lifestyle choices (e.g., diet, exercise habits, smoking status, alcohol use) and common behavioral health problems (e.g., stress, anxiety, depression). It's also an ideal time to talk about specific screening tests that you probably never even knew about.

You can discuss with your doctor the benefits and risks of certain tests or vaccinations to help make a shared decision about whether or not you want to have them. The key is to stay better informed and engaged about your ongoing health.

I can't stress enough the importance of protecting your mental health.Studiesshow that having a major mental illness can shorten your lifespan by 14 to 32 years

If you're concerned, ask your general physicianto give you amental health assessment, which can help pinpoint problems.

Also, make time for stress relief activities, such as meditation and yoga. Engaging in meaningful hobbies and connecting socially with other people can have a powerful influence on your mental well-being and happiness.

It may be hard do some of these things during a pandemic (and with social distancing orders in place), but don't underestimate the power of video calls with friends and relatives; seeing people, even on a small screen, can be emotionally rewarding.

Richard W. Besdine, MD, is a Professor of Medicine and Health Services Policy and Practice at Brown University.He is a member and former president of theAmerican Geriatrics Society.Dr. Besdine has authored more than 125 scholarly publications on aging, and trained in internal medicine, infectious diseases and immunology at Boston's Beth Israel Hospital and Harvard Medical School.

Don't miss:

Go here to see the original:

An 80-year-old doctor and longevity expert shares his 5 habits for a longer life: 'It's never too late to start' - CNBC

In 2011, Dr. Breen was promoted to the helm of the emergency department, where colleagues said she tended to solve problems with systematic precision and preferred concrete solutions.

She liked structure, said Dr. James Giglio, who was then her boss. She liked working in an organized world.

That world would later distort and crumple. By early this year, the coronavirus was slipping into New York, undetected and underestimated.

In late February, as elected officials were still assuring the public that the virus did not pose a serious threat, Dr. Breen sat down at her computer and updated a contingency plan addressed to her family. It was a compilation of instructions on where to find her passwords, routes she would use if she had to get out of the city and how family members should contact one another.

She had created it after the Sept. 11, 2001, terrorist attacks and revised it after Hurricane Sandy hit in 2012 it was her methodical response to calamity.

The coronavirus, she was convinced, would catch hospitals off guard.

A week later, she went on a planned vacation with Ms. Feist, her sister, in Big Sky, Mont. They sat in a hot tub and mused about going to Italy in a few years. By the time Dr. Breen returned from the trip, a state of emergency had been declared in New York.

At the Allen, discussions about staffing and supplies escalated. A lawyer from New Rochelle, N.Y., had been diagnosed recently with Covid-19 even though he had not traveled to any areas where the disease was known to be spreading. It was one of the first indications that the virus had already taken hold in the state, and a red flag for the NewYork-Presbyterian system, where he was a patient.

Link:

I Couldnt Do Anything: The Virus and an E.R. Doctors Suicide - The New York Times