Penn Medicine Hospitals Named "Leaders in LGBT Healthcare Equality" by Human Rights Campaign

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Newswise (PHILADELPHIA) All four hospitals in the University of Pennsylvania Health System, including the Hospital of the University of Pennsylvania, Pennsylvania Hospital, Penn Presbyterian Medical Center, and Chester County Hospital were listed today as a 2014 LGBT Healthcare Equality Leader from Human Rights Campaign (HRC).

The Healthcare Equality Leaders were selected based on an annual survey identifying healthcare institutions that lead in efforts to offer equal care for lesbian, gay, bisexual, and transgender (LGBT) patients.

Penn Medicine hospitals earned top marks in meeting non-discrimination and training criteria that demonstrate commitment to equitable, inclusive care for LGBT patients and their families. The four hospitals standardized their patient and employee non-discrimination policies to include sexual orientation and gender identity or expression and provided LGBT patient care training for over 60 senior managers in organization leadership, nursing management, patient relations, admitting, and human resources management.

This is a major honor for our health system and reflects our commitment to advancing LGBT patient care, research, and education, says Baligh Yehia, MD, MPP, MSHP, assistant professor of Medicine and director of the Penn Medicine Program for LGBT Health.

The Penn Medicine hospitals were among a select group of 426 healthcare facilities nationwide with this distinction. These facilities meet key criteria, including patient and employee non-discrimination policies that specifically mention sexual orientation and gender identity, a guarantee of equal visitation for same-sex partners and parents, and LGBT health education for key staff members.

Leaders in LGBT Healthcare Equality change the lives of LGBT patients and their families for the better each and every day, said Chad Griffin, HRC president. LGBT people should be treated equally in all aspects of our lives, and HRC celebrates Penn Medicine for its tireless work to create an inclusive and welcoming environment for all patients.

The Penn Medicine effort was spearheaded by the newly established Penn Medicine Program for LGBT Health. Penn Medicine is the first academic medical center in the Northeast one among just a handful of academic medical centers in the U.S. to launch a program across multiple professional schools and affiliated hospitals to improve the health of LGBT individuals. Health disparities and inequalities within this community have become increasingly recognized, but are rarely addressed in todays health care settings.

With more than 1.5 million members and supporters, the HRC is the largest civil rights organization seeking equality for lesbian, gay, bisexual and transgender Americans. The Healthcare Equality Index offers healthcare facilities resources to help provide equal care to LGBT patients, as well as assistance in complying with new regulatory requirements and access to high-quality staff training.

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Penn Medicine researchers zero in on psoriasis-hypertension link

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15-Oct-2014

Contact: Katie Delach katie.delach@uphs.upenn.edu 215-349-5964 University of Pennsylvania School of Medicine @PennMedNews

PHILADELPHIA Patients with more severe psoriasis are also more likely to have uncontrolled hypertension, according to new research by a team at the Perelman School of Medicine at the University of Pennsylvania. Through a cross-sectional study using information collected from a medical records database, the results provide further evidence of a strong link between psoriasis and hypertension. Full results are now available in JAMA Dermatology.

"Over the last several years, studies have shown that psoriasis, specifically severe psoriasis, is an independent risk factor for a variety of comorbidities, putting patients suffering with this common skin disease at an increased risk for other conditions such as heart attack and stroke," says Junko Takeshita, MD, PhD, clinical instructor in the department of Dermatology at Penn Medicine and co-first author on the study. "Knowing that psoriasis is tied to other health conditions, it's vital that we have a better understanding of the systemic effects it has on other areas of the body so that we can more closely monitor these patients and provide better and preventative care."

Defining uncontrolled hypertension as blood pressure measured as at least 140/90, the researchers found a clear relationship between psoriasis and uncontrolled hypertension in patients with a confirmed diagnosis of psoriasis. Additional finding indicate there is a significant dose-response relationship, meaning that the likelihood of uncontrolled hypertension increases with greater psoriasis severity. Results of the study reveal that the patients with the highest risk of having uncontrolled blood pressure, are those with moderate to severe psoriasis, which is defined as having at least three percent of one's body surface affected by the disease.

Takeshita and colleagues examined data from a random sample of psoriasis patients included in The Health Improvement Network (THIN), an electronic medical database based in the United Kingdom that collects demographic, diagnostic, treatment, and laboratory information from a broad representative sample of the UK population. Takeshita says the psoriasis diagnostic code in the database has been validated through extensive studies looking at the condition.

The researchers concentrated on a specific group within the THIN database called the Incident Health Outcomes and Psoriasis Events (iHOPE) cohort, a random sample of about 9000 patients with a confirmed diagnosis of psoriasis and disease severity classified by their general practitioners using objective measures, specifically body surface area involvement. This permitted a level of analysis not possible in previous studies.

"Most large electronic databases such as THIN do not have information such as body surface area involvement or other direct measures of psoriasis severity, and we usually have to use surrogate measures such as receipt of a treatment that is indicated for more severe psoriasis to define psoriasis severity," Takeshita explains. "The use of surrogate measures to define psoriasis severity is not ideal for multiple reasons. For example, we know that many patients with psoriasis go untreated, so using treatment to define psoriasis severity may incorrectly identify patients who truly have severe disease as having mild disease. Furthermore, when we use treatments to define psoriasis severity, we cannot separate effects of psoriasis itself from potential psoriasis treatment effects on blood pressure control. To our knowledge, ours is the first study to evaluate the effect of objectively determined psoriasis severity on blood pressure control."

Although the work strongly suggests a correlation between hypertension and psoriasis, the cross-sectional nature of the study doesn't allow one important issue to be addressed: the "chicken or egg" question of whether psoriasis may cause hypertension or whether the presence of hypertension contributes to psoriasis. Still, the present study provides an ideal starting point for that next investigative step.

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Penn Medicine researchers zero in on psoriasis-hypertension link

New MCAT Fuels Anxiety for Medical School Applicants

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Newswise One of the biggest hurdles that college students face if they want to go to medical school is the MCAT the Medical College Admission Test. The one-day standardized multiple-choice exam, which takes more than five hours to complete, is required for admission to nearly all medical schools in the United States. According to the Association of American Medical Colleges (AAMC), more than 85,000 students take the MCAT each year.

Every 20 years the MCAT undergoes a comprehensive review and overhaul. The latest changes in the test, which take effect next April, will include a new section that reflects a growing sense within the medical profession that doctors who are conscious of important issues in the humanities including the social sciences may be better physicians than those who are not, especially with a patient population that is ever more diverse.

The MCAT change is a bit of social engineering, says Carol A. Terregino, senior associate dean for education at Rutgers Robert Wood Johnson Medical School. Make students read more, make them be more broadly educated, make them study the social sciences and really understand the impact of those disciplines on caring for patients, and maybe well have a better product. The new MCAT also will have a greater emphasis on critical analysis and reasoning skills.

Rutgers Robert Wood Johnson Medical School is one of a small group of schools across the country chosen by AAMC to evaluate the change by studying the performance of the classes they admit over the next four years as it relates to students MCAT scores. Terregino, who also oversees admissions at the school, will lead its evaluation team.

Terregino says there is no way of knowing whether the new MCAT is an improvement until she and her colleagues have analyzed the data and that process wont be complete until after the last of the classes has graduated in 2022. But she says she may have a head start in identifying aspiring physicians who have these newly emphasized skills, because Robert Wood Johnson has actively recruited students with these qualities for years.

Terregino says Rutgers Robert Wood Johnson Medical School has an innovative interview process that focuses on finding students who have a knack for understanding the complete human being who will be in their care far beyond the patients medical symptoms. Whether those students majored in science but also appreciated humanities, or did majors as far afield as English or history, they demonstrated the core personal skills that are needed in medicine, and Terregino says the school is pleased with the results.

I say to students, The more experiences you have, the more opportunities youll have to make that one-to-one connection with the patient. And what is great, she adds, is that by selecting our medical students this way I have not seen performance in medical school drop. We have no more students failing courses than before we started emphasizing the core personal competencies and humanities. Students with this added breadth of knowledge will do extraordinarily well and be competitive for top tier residency programs.

But for many students now applying, those potential pluses may seem far in the future.

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New MCAT Fuels Anxiety for Medical School Applicants

Tuning light to kill deep cancer tumors

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15-Oct-2014

Contact: Jim Fessenden james.fessenden@umassmed.edu 508-856-2688 University of Massachusetts Medical School @UMassMedNow

WORCESTER, MA An international group of scientists led by Gang Han, PhD, at the University of Massachusetts Medical School, has combined a new type of nanoparticle with an FDA-approved photodynamic therapy to effectively kill deep-set cancer cells in vivo with minimal damage to surrounding tissue and fewer side effects than chemotherapy. This promising new treatment strategy could expand the current use of photodynamic therapies to access deep-set cancer tumors.

"We are very excited at the potential for clinical practice using our enhanced red-emission nanoparticles combined with FDA-approved photodynamic drug therapy to kill malignant cells in deeper tumors," said Dr. Han, lead author of the study and assistant professor of biochemistry and molecular pharmacology at UMMS. "We have been able to do this with biocompatible low-power, deep-tissue-penetrating 980-nm near-infrared light."

In photodynamic therapy, also known as PDT, the patient is given a non-toxic light-sensitive drug, which is absorbed by all the body's cells, including the cancerous ones. Red laser lights specifically tuned to the drug molecules are then selectively turned on the tumor area. When the red light interacts with the photosensitive drug, it produces a highly reactive form of oxygen (singlet oxygen) that kills the malignant cancer cells while leaving most neighboring cells unharmed.

Because of the limited ability of the red light to penetrate tissue, however, current photodynamic therapies are only used for skin cancer or lesions in very shallow tissue. The ability to reach deeper set cancer cells could extend the use of photodynamic therapies.

In research published online by the journal ACS Nano of the American Chemical Society, Han and colleagues describe a novel strategy that makes use of a new class of upconverting nanoparticles (UCNPs), a billionth of a meter in size, which can act as a kind of relay station. These UCNPs are administered along with the photodynamic drug and convert deep penetrating near-infrared light into the visible red light that is needed in photodynamic therapies to activate the cancer-killing drug.

To achieve this light conversion, Han and colleagues engineered a UCNP to have better emissions in the red part of the spectrum by coating the nanoparticles with calcium fluoride and increasing the doping of the nanoparticles with ytterbium.

In their experiments, the researchers used the low-cost, FDA-approved photosensitizer drug aminolevulinic acid and combined it with the augmented red-emission UCNPs they had developed. Near-infrared light was then turned on the tumor location. Han and colleagues showed that the UCNPs successfully converted the near-infrared light into red light and activated the photodynamic drug at levels deeper than can be currently achieved with photodynamic therapy methods. Performed in both in vitro and with animal models, the combination therapy showed an improved destruction of the cancerous tumor using lower laser power.

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School was locked down for medical procedure, not threat

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FORSYTH COUNTY Parents, teachers and students all hope they never have to experience a real crisis situation at a school that causes a lockdown.

Thats why the procedures in place are frequently used to prepare and prevent the compromise of a schools safety, as was the case Wednesday morning.

A medical lockdown involving the need to assist a staff member at Whitlow Elementary led to concerns voiced to Forsyth County News and a reminder by Forsyth County school system that not every lockdown means a crisis is unfolding.

With more than 42,000 students and 4,300 staff members in schools throughout the district, Jennifer Caracciolo, a spokeswoman for the district, said this procedure happens daily.

Medical lockdowns are to ensure the person in the medical situation receives proper care and, if first responders are needed, that they can easily get to the individual, Caracciolo said. Learning still occurs within the classrooms.

The school system has procedures for medical lockdowns (code blue), as well as code yellow and code red lockdowns.

Code yellow procedures are used when there is a potentially dangerous situation on or near a campus, said Tim Monroe, assistant director of school safety and student discipline, in a You Tube video the system made to overview safety procedures.

During a code yellow, or medical lockdown, students remain in the classroom and continue to learn, as they are preventative procedures.

When there is an actual crisis, a code red is put into place, which involves a full lockdown of all doors on campus and instructs students to take cover. This rarely happens.

A separate code red siren is sounded for tornadoes.

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Diversity in Medical Education: It's Not So Black and White Anymore

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Newswise PHILADELPHIAA perspective piece in this weeks issue of the New England Journal of Medicine from a student at the University of Pennsylvanias Perelman School of Medicine addresses the evolution of diversity in medical education. Its not a numbers game anymore, says author Mark A. Attiah, a medical student pursuing both a Masters in translational research and bioethics. Diversity is a mindset that extends into the classroom and the hospital.

Achieving diversity in todays medical schools goes beyond bringing underrepresented students into the fold, he says. Its about creating an optimal learning environment, where people with different ideas, cultures, opinions, and experiences feel comfortable amongst each other and part of a larger dialogue to come together to solve tomorrows health care problems.

If the ultimate goal of diversity in medical schools and residency programs is to improve patient care, a good first step is to create a world where all trainees can feel supported while learning and working to the best of their ability, he writes. Establishing an inclusive learning environment means that people from all different walks of life can not only have a seat at the same table but also be comfortable in their chairs.

That, he says, can only be achieved with a commitment to diversity that is inseparable from an institutions identity and a fundamental part of its success.

For the past few decades, the definition of diversity in medical education has largely remained the same, as well as the social mandate to increase it. Many efforts have focused on improving access to the field for minorities, but this good intentions approach, he says, fails to critically examine diversitys true meaning and strips of its potential to advance the field of medicine.

The new approachcalled Diversity 3.0, a term coined by IBMfocuses on differences beyond race and ethnicity. Peoples worldviews may diverge for many reasonsowing to the experiences of military service, for example, or to sexual orientation or the language one speaks, he writes. All such characteristics and experiences figure into the new diversity, which acknowledges that shared experiences in this country no longer track simply with race. Diversity is not so black and white anymore.

The new definition shouldnt discount the old one, thoughit should build off of it, Attiah says. The definition of diversity is changing, he says. I think overall for the better, but people should keep in mind that the previous definition has merit, he says. There is still a shared narrative among minority students that has supported a collective consciousness for decades and helped improve patient care because of a rapport with patients rooted in racial or cultural similarities.

Over the last year, Penn Medicine has solidified its commitment to inclusion and diversity. Eve Higginbotham, SM, MD, Penn Medicines first Vice Dean for Inclusion and Diversity, joined last year to spearhead Penn Medicines Office of Inclusion and Diversity. Its efforts are aimed at supporting the many innovative programs underway, as well as exploring new opportunities to embrace diversity and broaden access to people of all ethnicities, historical traditions and economic backgrounds, genders, religions and disabilities, and respecting sexual orientation and veteran status.

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Tampa Bay Lightning owner Jeff Vinik will donate land for downtown USF medical school

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TAMPA Jeff Vinik wants the University of South Florida to build a new medical school on his downtown property so badly that he's willing to give the school an acre of his land to seal the deal.

The Tampa Bay Lightning owner made the offer this week to USF president Judy Genshaft and Dr. Charles Lockwood, senior vice president for USF Health and dean of the Morsani College of Medicine, according to a university spokesman.

"It would be a gift from Mr. Vinik to the university," said USF spokesman Adam Freeman, "and it would be contingent upon the Morsani College of Medicine and USF Health Heart Institute being built in that location."

Vinik's offer was made public during Wednesday's meeting of the USF Board of Trustees health workgroup, a committee that oversees USF Health's academic and medical programs. A Vinik spokesman declined to comment.

The donation from Vinik would satisfy a make-or-break condition for the project laid down by Genshaft: Last week she told the Tampa Bay Times that the university would build a downtown medical school only on donated land. She said USF would not buy any downtown property for the proposed project.

But bringing USF's new medical school to downtown would satisfy an important part of Vinik's plan to redevelop downtown Tampa.

The Lighting owner has amassed a significant chunk of southern downtown around the team's home at the Amalie Arena: the Channelside Bay Plaza outdoor mall, the Tampa Marriott Waterside Hotel & Marina and 24 empty acres around the arena.

By the end of the year, Vinik is set to unveil his plans to transform the area into a walkable entertainment district with room for retail, residential, hotel and office space. He's already planning to build a new high-rise hotel west of the arena.

But Vinik also wants to attract major employers in high-end industries to his redevelopment project, including a downtown medical school.

The land that Vinik has proposed donating to USF is "about an acre," Freeman said, at the corner of Channelside Drive and S Meridian Avenue, across the street from an arena parking lot Vinik owns next to the Tampa Bay History Center.

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