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Erica Ogwumike: Shooting baskets and video – The Rice Thresher

Posted on January 29, 2020 by Danzig

By Ivanka Perez 1/28/20 9:56pm

When shes not shooting hoops on the basketball court, you can find Rice forward Erica Ogwumike shooting YouTube videos in her room. Although she graduated with her bachelors degree from Rice in December, finishing one semester early, Ogwumike continues to play for the Rice womens basketball team. Having already been accepted into medical school, Ogwumike has decided to share the lessons shes learned and capture her experiences in a memorable way through YouTube.

Since December, Ogwumike has been documenting the pivotal moments of her life on her YouTube channel, vlogging about her medical school interviews and showing viewers a day in the life of a Division 1 athlete.

People asked me for the longest [time] to start something just to share what Im doing, how I got to where Im at and [give] advice because there arent a lot of pre-med student-athletes out there, Ogwumike said.

Ogwumike first joined a basketball team in fifth grade, after tagging along to her three older sisters basketball practices after school. Ogwumike said it wasnt until her sophomore year of high school that she realized she wanted to follow her sisters footsteps again by pursuing college basketball.

My older sisters were playing basketball in college, so I saw how you could use basketball as an awesome opportunity to get a great education and [use it] as a platform for change, Ogwumike said.

After high school, Ogwumike headed off to Malibu, California to attend Pepperdine University, and played on the womens basketball team with her older sister, Olivia. After one year, both sisters decided to transfer to Rice and continue playing college basketball.

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But even with the support of her sister, Ogwumike said she still found herself needing to adjust to Rice.

The amount of time studying and trying to improve your craft, which is your sport, is increased to another level as well as your academic load, so it took a while to get adjusted to, Ogwumike said.

After two years of playing on the team, Ogwumike said shes grateful for the opportunity to witness the teams trajectory.

The growth that Ive witnessed in our program over the past [two] years surpassed any of my dreams and goals, and I am just happy to be one small part in that, Ogwumike said. This program is truly amazing [and head coach Tina] Langley is truly amazing.

Being part of a college basketball team allowed her to grow in more ways than one. Throughout the years, Ogwumike said she learned time management, resilience, communication and teamwork.

I just love the teamwork aspect of working together to achieve a collective goal, Ogwumike said.

According to Ogwumike, the physical aspect of college athletics has also been important to her.

You have to be in shape in every aspect of fitness it involves running, jumping, changing directions, strength, et cetera, Ogwumike said. I like the versatility of [fitness].

Ogwumike said she appreciates versatility in all aspects of her life, which influenced her choice of a future career. She said she loves how flexible a doctors role is, and how doctors can impact patients in all aspects of their lives.

Medicine is interwoven into many aspects such as academia, policy, law, media and more, Ogwumike said. I have so many interests that I know I can cater to all while being a physician and working towards something so altruistic each day: helping people reach their optimal level of health.

As she describes in her video How I Got Into Med School, Ogwumikes decision to pursue medicine was gradual.

I never had this [a-ha] moment it was just over time, I became more exposed to medicine, physicians [and] health care and I began to see myself in this profession, Ogwumike said. No one in my family is in medicine, so it has been a shot in the dark, but I gradually learned through the great resources at Rice and the Texas Medical Center that its what I want to pursue.

Ogwumike talks about her experiences as a pre-med on YouTube to help other users find answers to their questions. On her channel, Ogwumike has posted two videos dedicated to her medical school interviews, hoping her experiences will help students applying to medical school.

At some point, I decided that it would be cool to share the knowledge and info Ive gotten along my journey, Ogwumike said. If my channel could help someone like me in the past, it would be worth it.

Although Ogwumike began her channel to provide resources for high school students hoping to balance pre-med and college athlete commitments, it soon developed into a way for her to capture special moments in her life.

This channel has made [me] aware of living in the moment, Ogwumike said. As I go back and watch a video, I realize that there are so many great moments in my life that I easily forget about it. This channel has been a great way for me to [cherish] those memories.

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Erica Ogwumike: Shooting baskets and video - The Rice Thresher

More teens are coming out as LGBTQ, but suicide attempts remain high – PhillyVoice.com

Posted on February 12, 2020 by Danzig

Though more teenagers are identifying as sexual minorities, their rate of attempted suicide remains much higher than teens who are straight.

That disparity, the key finding of a study published Monday in the journalPediatrics, suggests that many LGBTQ teens are highly distressed.

Between 2009 and 2017, the percentage of high school students identifying as lesbian, gay, bisexual or questioning doubled from 7.3% to 14.3%, Boston University researchers found. Their data source, the Youth Risk Surveillance Behavioral Survey, did not consistently include data on the number of teens identifying as transgender.

During the same time frame, consensual, same-sex sexual contact jumped from 7.7% to 13.1%. Teen girls were twice as likely as boys to identify as a sexual minority.

And while the rate of LGBQ teens attempting suicide decreased from 26.7% in 2009 to 20.1% in 2017, it is still more than three times that of straight teens.

To lower this disparity, researchers say more support is needed for LGBTQ teens.

"It's critical that health and educational institutions have policies and programs in place to protect and improve LGBQ health such as medical school curricula and high school curricula that is inclusive of sexual minority health,"saidJulia Raifman, a health law professor at Boston University.

"Our new paper indicates that an increasing number of teenagers are identifying as LGBQ and will be affected by anti-LGBQ policies that may elevate these already very high rates of suicide attempts," she said.

Previous studies have shown that anti-LGBTQ policies are having a negative effect on the mental health of both LGBTQ teens and adults.

In a 2017 study, Raifman found a 7% decrease in all high school student suicide attempts in states that had legalized same-sex marriage. She also led a 2018 study that linked publicized cases of anti-gay discrimination to increased mental health distress among LGBTQ adults living in the states where the incidents occurred.

Her latest study was based on data from the Youth Risk Behavioral Surveillance Survey, a national school-based survey conducted by the U.S. Centers for Disease Control andPrevention and state health agencies.

Only six states Delaware, Illinois, Massachusetts, Maine, North Dakota and Rhode Island included information on sexual orientation. Just three Connecticut, Delaware and Rhode Island included data on consensual sexual behaviors.

Overall, 110,243 high school students were included in the study, but consensual sexual behavior data could only be analyzed among 25,994 students.

VR is making medical training cheaper, better, and more accessible than ever – Digital Trends

Posted on March 1, 2020 by Danzig

Sometimes, location is everything.

When Dr. Eric Bing started working at Dallas Southern Methodist University (SMU), the person in the office next to his would give him a new perspective on how virtual reality can be instrumental in teaching medical students.

SMU happens to have one of the worlds best graduate schools for video game design and Bings office neighbor, Professor Anthony Cuevas, helps create the curriculum for it. Surgery and first person shooters may seem worlds apart, but over the course of several months, the professors neighborly chitchat gave rise to a low-cost VR training system that can be implemented in locations where medical schools are limited, such as sub-saharan Africa.

In order to meet the basic need of surgical care in the developing world by 2030, the surgical workforce there would need to double, according to the Lancet Commission of Global Surgery. Shafi Ahmed, co-founder of the VR health training platform Medical Realities, has highlighted this problem as one he hopes his companys content can address. Dr. Alex Young of the startup VR company Virti is developing a platform that gives students access to training programs for free, with an eye toward improving medical care in the third world.

Bing has spent much of his medical career working in impoverished communities in south central Los Angeles as well as overseas countries like Zambia, Haiti, Nigeria, and Belize. Throughout his decades of treating patients, one challenge has always been present: Numerous people suffer and die from easily preventable and curable diseases such as cervical cancer. That condition that ended the life of Bings mother.

Precancerous cervical growths are easy to diagnose with diluted household vinegar, explains Bing. They can be removed as simply as warts. However, such treatable diseases often end lives when they could be treated because the lack of local medical expertise means needy patients schedule exams too late. In the case of cervical cancer, the disease spreads and the resulting remedy may be more extensive, such as a hysterectomy, or untreatable.

There are just not enough surgeons in developing countries to provide the care that people need.

Weve always been trying to think through How do we scale up the number of surgeons who do these procedures or any surgical procedures? explains Bing. There are just not enough surgeons in developing countries to provide the care that people need. Many sub-saharan African countries, for example, have no medical schools or just one.

Bing and Cuevas brainstormed the potential for training students in virtual reality.. While diagnostic and surgical simulations are now a regular part of many American medical school programs, theyre much harder to find in the developing world given the associated costs, which can quickly rise into six figures.

When the doctor running the med program at the University of Zambia teaching hospital stopped by SMU to pick up an honorary degree, Bing got him together with Cuevas to figure how to create a VR program.

Along with doctors and professors from the University of North Carolina, Kings College London and SMU, the three created a study on teaching oncology with low-cost virtual reality headsets. Around that time, the price of Oculus Quest had recently dropped, making the budget for VR instruction feasible.

Using SMUs VR program, numerous medical students at the University of Zambia have practiced the steps for performing a radical abdominal hysterectomy, needing to complete it within a target time and accuracy rate. The simulations operating room is outfitted with equipment commonly found in Zambia. Studying the VR surgical program, the dev team found users need to reflect on what theyre learning to retain information. As a result, no student can attempt the virtual procedure more than six times in one day.

Trainees need to reflect on what theyve learned or missed for it to stick, explains Bing, who underscores that VR learning augments class lessons and book chapters and doesnt replace them.

In U.S. teaching hospitals, you have a lot of oversight and support, explains Bing. Med schools in developing countries dont always have those necessities. By using the simulations, [students] are able to identify potential gaps in knowledge.

Dr. Alex Young was snowed in on a weekend a few years ago when he started thinking about new ways to train med students. At the time, the British orthopedic surgeon was a resident at New Yorks Hospital for Special Surgery (HSS) and reflecting on the thing his experience wasnt teaching him: how to deal with the stress of emergency medicine.

When youve got people sent to the E.R. from car accidents, you never know whats going to come through the door, says Young. Doctors at HSS, one of the United States top hospitals for orthopedic surgery, regularly see worst-case scenarios.

After working through a few difficult cases, a new surgeon might get used to that surge of adrenalin, explains Young, but new doctors often make mistakes because they panic. Theres no real way in a clinical environment to test your skills under pressure, he says.

Youngs weekend brainstorm eventually led him to co-develop Virti, a medical training platform focused on building soft skills in augmented and virtual reality simulations. Users are transported into real world scenes, either by themselves or with a team of fellow students, to diagnose and treat patients, often ones suffering trauma.

Virtis system utilizes artificial intelligence and natural language processing to analyze decision making, leadership, communication and other capabilities that arent typically a focus of med school training.

We look at how well the team communicated. Did they empathize with the patient? Did they come to the correct diagnosis? explains Young. The VR headsets can also track where the students are looking during fast-moving situations and how quickly they identify relevant problems. The company has published research showing that students who work with the Virti system have reduced stress that transfers to real-life experiences.

As Young developed Virti, he also kept in mind the experience he had working in Tanzania soon after he graduated from med school. Not only were the doctors facing stress, they also had to deal with limited resources.

Seeing the potential for training medical professionals in the developing world, Young designed the Virti platform to function on any mobile phone as well as with a VR headset. The basic level of the platform, geared at teaching new medical professionals, is free.

In 2020, the Virti team will be launching simulations specifically for med students in Kenya and Ethiopia, in partnership with Oxford University and Torbay Hospital. To develop the new scenarios, the company needs teams on the ground capturing 360 video that includes appropriate imagery and protocol for attending to patients.

Both Young and Bing view the opportunity to offer affordable, accessible medical education in underserved communities as exciting and rewarding. For those people who do this, its a lot of hard work, says Bing. There has to be meaning behind it.

Bing, in particular, sees the potential to save the lives of people stricken with easily treated diseases, such as the one that took his mothers life.

When youre able to help other people survive from these things, it helps the work have more meaning for you.

Breastfeeding and Infant Mortality – Harvard Medical School

Posted on November 24, 2019 by Danzig

Image: Getty/LightFieldStudios

A new study published by The Journal of Pediatrics shows increased rates of implementation of hospital-based breastfeeding initiatives are associated with decreased rates of infant deaths in the first six days after birth, dispelling speculation that such practices might increase infant death.

The authors of the study examined trends in the percentage of births in baby-friendly hospitals between 2004-2016, as well as the implementation of skin-to-skin care in the first hour after birth in both the U.S. population and in Massachusetts. The authors looked at trends in Sudden Unexpected Infant Deaths (SUID), including deaths by asphyxia, in the first six days after birth during the same time period.

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Despite marked increases in both the percentage of newborns being delivered in baby-friendly facilities and in the percentage of newborns experiencing skin-to-skin care, there has been a significant decrease in deaths due to SUID within the first six days after birth.

These data come as welcome news and should reassure us that these initiatives are not resulting in any increase in infant deathsin fact, just the opposite is true, said study lead author Melissa Bartick, Harvard Medical School assistant professor of medicine and an internist at Cambridge Health Alliance.

Bartick noted that widespread speculation had arisen on whether such interventions could be deadly after an opinion piece citing Massachusetts infant mortality data was published in medical literature in 2016, followed by a national study in 2018.

Both of these publications were controversial, and the related mainstream media attention they garnered characterized such deaths as being relatively common. The new study by Bartick and colleagues found that fewer than 1 percent of sudden unexpected infant deaths during the first month of life actually occur during those first six days.

Bartick noted that the peak occurrence for SUID is in the first two to four months of life. Rates of skin-to-skin care rose to nearly 100 percent in Massachusetts, yet there were zero deaths from suffocation or asphyxia.

We now recognize that evidence-based maternity care practices to support breastfeeding are associated with a decreased risk of neonatal death, said study co-author Lori Feldman-Winter, professor of pediatrics at Cooper Medical School of Rowan University.

The authors noted that skin-to-skin care is now routine for all infants, regardless of feeding method.

An additional significant finding of the study was that deaths in the first six days of life occurred disproportionately among black infants, indicating that racial disparity in infant mortality begins as early as the first six days after birth.

Adapted from a Cambridge Health Alliance news release.

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Breastfeeding and Infant Mortality - Harvard Medical School

Inside Indiana’s Precision Health Initiative: BTN LiveBIG – Big Ten Network

Posted on January 2, 2020 by Danzig

At the 200-year mark, some institutions would be content to rest on their laurels. But not Indiana University. As their bicentennial celebrations nears, the Hoosiers have dedicated themselves to a tackling what they are calling Grand Challenges, a suite of economic, social and environmental problems plaguing Indiana and the world. These challenges are marked by their impressive scale, immense impact, driven commitment to solutions, and a spirit of interdisciplinary collaboration.

One of the Grand Challenges is the Precision Health Initiative, which aims to match patients more closely and carefully with treatments that meet their individual needs. According to Anatha Shekhar, the executive associate dean of research affairs at the Indiana University School of Medicine, the initiative derives that precision by taking a decidedly holistic look at a patient's health.

"What we're trying to do here is to have a comprehensive approach to understanding a person's health, taking into account their genetics, their environment, their behavior, their culture, and to understand the diseases that are caused by these factors," Shekar explains. "We're particularly focusing on five major serious illnesses that currently have no good treatments and that are uniformly lethal or disabling."

Those five diseases include three types of cancer: triple-negative breast cancer, multiple myeloma, and pediatric sarcoma. They're also targeting diabetes, in particular gestational diabetes affecting pregnant women, as well as Alzheimer's disease.

The Precision Health Initiative was the first project to receive Grand Challenges funding. A truly transformative undertaking, Indiana is pulling together researchers and physicians from across the university ecosystem to create new approaches to prevention, treatment and health care delivery.

"The Precision Health Initiative is trying to just marshal the great resources we have here, all the scientific minds, all the technology, to attack big, bold problems," says Aaron Carroll, professor of pediatrics and associate dean for research mentoring at the IU School of Medicine.

The project is funneling $120 million into six different major scientific pillars: Genomic Medicine; Cell, Gene & Immune Therapy; Regenerative Medicine & Engineering; Psychosocial, Behavioral & Ethics; Data & Informatics; and Chemical Biology & Biotherapeutics.

Carroll likens it all to a moonshot. Where research is normally understood to move slowly, taking tiny steps towards a solution, Indiana seeks great strides founded in unfettered access to both real and mental capital. And, as the only medical school in the state, as well as a regional and national research leader, their charge is an imperative. "It's certainly very Hoosier. I think the idea that we're going to take our local expertise and really try to band together and cross boundaries to try to make a big difference, it's, it's very Indiana," Carroll says.

Clinically speaking, the Precision Health Initiative is not just seeking to draw down instances of the maladies their targeting. Rather, they seek wholesale cures for the cancers, and robust, workable preventative measures for diabetes and Alzheimer's disease.

Their patient-focused approach is already being taught to physicians-in-training at the IU School of Medicine. The importance of factors such as genetic and family medical history, sleep and eating habits, exercise levels and overall mental health is emphasized alongside traditional testing in making a diagnosis.

In the lab, Indiana researchers are matching that holistic approach to patient health with an equally vibrant understanding of how diseases operate. They're working towards a more-perfect model of exactly how cancers evolve and how they become resistant to certain treatments. Concurrently, pharmaceutical scientists are making gains in drug discovery for the treatment of Alzheimer's.

Shekhar says that the feeling among the Precision Health Initiative team is that the work being done now is serving as inspiration for others to "think big and to go for the fences rather than do incremental work."

There are, though, factors limiting the speed at which the team can make new discoveries. Key among them is the need for an expansion in data analysis and management as well as advances need in AI to help researchers make sense of extremely large data sets.

One such set derives from the All In project, which is under the Precision Health Initiative umbrella. Researchers are asking people from across the state and all walks of life to share with them a blood sample as well as specific, yet anonymous health data. This will aid immensely in their understanding of how and why diseases flourish and progress in various populations.

That particular project is indicative of the larger initiative, says Shekhar, echoing Carroll's sentiment that Indiana is uniquely positioned to helm such an audacious undertaking.

"I think Indiana is unique in that first of all, we have the largest medical school in the country, that is a state wide medical school with nine campuses," he says. "We have the largest health system in the state. We serve about two million people every year for their health needs. So, we have gone all the way from engaging large scientific teams, recruiting nearly 50 new scientists to Indiana University to work on this, to engaging nearly hundred thousand people from the community. It's an initiative that couldn't happen in very many places except in Indiana."

Originally posted here:
Inside Indiana's Precision Health Initiative: BTN LiveBIG - Big Ten Network

The ‘Single Biggest Contributor’ to Medical and Mental Illness – Medscape

Posted on January 25, 2020 by Danzig

This transcript has been edited for clarity.

Stephen M. Strakowski, MD: Hello. I'm Dr Stephen M. Strakowski, acting senior associate dean for research at the Dell Medical School at the University of Texas at Austin. I'm speaking today with two of my expert colleagues here. Dr Elizabeth Lippard is an assistant professor in our department and has been here the longest of anybody else other than me. Dr Charles Nemeroff joined us about a year ago and is now acting as chair in the department of psychiatry, in addition to creating and directing the Institute for Early Life Adversity Research.

We're speaking with Drs Lippard and Nemeroff about a seminal paper they just published in the American Journal of Psychiatry, reviewing the impact of early life adversity on people, their lives, their medical history, and potentially what goes on in the brain. I want to talk with them today about how all of us who practice mental health care might apply their important work.

To begin, can you tell us about the field of early life adversity and how common such experiences are in patients?

Charles B. Nemeroff, MD, PhD: The entire field was really launched by the phenomenal Adverse Childhood Experiences (ACE) Study, which was funded by the Centers for Disease Control and Prevention (CDC). Investigators went to Kaiser Permanente in San Diego and sampled 17,000-plus individuals.

The results were just astounding. In this nonclinical general population, the rates of child abuse in the form of physical abuse, sexual abuse, emotional abuse, and neglect were remarkably high, rangingdepending on the categoryfrom about 8% to 25%. These results have since been confirmed in several subsequent studies from the CDC and others. This is really a public health tragedy.

Strakowski: It sounds like an epidemic. If we imagined a new virus suddenly affecting 1 in 4 kids, I assume that people would be quite upset and doing something about it.

Nemeroff: This is the single biggest contributor to the risk for psychiatric and medical disorders, more than any single gene or factor. It increases the risk for heart disease, stroke, depression, drug abuse, suicide. It's awful.

Strakowski: How should people be thinking about the potential impact of these risks?

Elizabeth Lippard, PhD: Piggybacking on what Charlie was saying, if you look at the prevalence of childhood maltreatment, early life stress, and mood disorders, you see rates as high as 50%-60%. If you look at individuals with mood disorders and comorbid addiction, rates are even higher.

We consistently see across studies that it's associated not only with increased risk for onset, but also increased risk for disease recurrence. In terms of mood disorders, this means more mood symptoms occurring over time with greater severity. You also see a relationship in terms of more complicated clinical cases: more comorbidities, with addiction and medical morbidities as well.

Considering the clinical impact that it's having on disease outcomes, and how prevalent child maltreatment is, this is a large percentage of disease burden that can be directly contributed to early life stress. It points to a very powerful target that we need to be thinking about when treating disease.

Strakowski: I think when a lot of us consider these kinds of abusive histories, we tend to then jump to post-traumatic stress disorder (PTSD) as the only consequence that we need to contemplate. But you're saying that it's much broader than that.

Lippard: Yes, definitely. Whenever you think about childhood maltreatment, it really crosses diagnostic boundaries. It increases the risk for mood disorders, addiction, PTSD, schizophrenia, etc., and you see it across the board.

Nemeroff: If you look at victims of child abuse and neglect when they are adults with psychiatric disorders, they are much more treatment resistant than patients with comparable disease severity without this history. We believe that the reason for that is that early life trauma results in brain and body changes that persist for the lifetime of the individual. These folks have a different biology, a different brain, and their treatment response for bipolar disorder, for depression, for PTSD is just terribly worse than it is for people without this history.

Strakowski: You perfectly anticipated my next question. Do we have some idea of what early life trauma is doing to the person's brain or body that is setting them up for these consequences?

Lippard: We do. There's a wealth of research out there pointing toward long-lasting neurobiological and immune mechanisms, as well as the hypothalamic pituitary adrenal stress response system, and changes within these systems that may be contributing to these outcomes.

In terms of the brain, we see long-lasting changes in structure and function within systems that regulate stress response and emotional, higher-order cognitive processes. It really is giving us an insight into the brain systems that may be so critical for developing psychopathology over time following childhood maltreatment.

One of the things that's really striking to me when you look at the literature is the more recent emergence of longitudinal studies, which suggest that changes in the brain really can predict future mood symptoms, recurrence, and severity. Traditionally, we started with a wealth of cross-sectional studies in this area, but now these longitudinal studies coming out have given us a lot of power to hone in on certain systems of the brain that can hopefully be targeted for intervention.

Strakowski: Clinicians and providers across many different specialties will be watching this. This applies to patients with psychiatric conditions but, as you implied, medical conditions as well. How do you recommend they ask their patients about this?

Nemeroff: First, for the clinicians out there, it's extremely important that you get this information from the patient. You need to know it.

There are several screening tools available to help you obtain this information. There's the ACE questionnaire, although I'm not particularly fond of it. I think the Childhood Trauma Questionnaire is somewhat better. There are others as well. These are self-rating scales, so they won't take any of your time. We have every patient fill out the scales, which gives you a good indication of their history, as patients will often put things down on paper that they don't want to tell you.

Second, it often takes several visits with a patient before they're comfortable enough to talk about their trauma. I've seen many patients with treatment-resistant depression who finally revealed to me that they had suffered a childhood rape or some other awful experience. If you're seeing a treatment-resistant patient, you should be thinking about child abuse and neglect.

Strakowski: In anticipating my talk with you both today, I gave some thought to my own clinical practice. On a given day in my clinic, I bet 80% of the young people I treat have these histories. It's hard to overexaggerate the risk.

Strakowski: From a treatment perspective, do you consider maybe doing something differently if you are aware that a patient has this history?

Nemeroff: We know that in every study that we looked at, when you parse out the patients with early life trauma and compare them to those who don't have that history, they have a poorer outcome. But part of the problem is that there are no treatment trials that have specifically asked this question. In terms of designing a treatment, my gut feeling, which is not science, is that they would do better with a combination of pharmacotherapy and psychotherapy.

One of my concerns is that, as pharmaceutical companies come to realize that these patients actually have poor treatment outcomes, they're starting to eliminate them from clinical trials.

Strakowski: Which is the exact opposite of what we wish would happen.

Nemeroff: It's sort of like what's happened with pregnancy; we don't know how to treat pregnant women because they're never allowed in trials.

Strakowski: To me, it sounds like we have an epidemic for which we're not aggressively trying to find a solution. Does it feel like the psychiatric or psychological professional associations and organizations are making this issue sufficiently visible to engender some response?

Nemeroff: I think that a number of the organizations you're referring to have done their best, but it's not enough. First, from a medical education point of view, there is very little training about child abuse and neglect in the curriculum.

Strakowski: I probably received none, roughly 200 years ago when I was in training, and I'm guessing the same is true for you.

Nemeroff: Absolutely. There's very little attention paid to this. Of all of the physicians, I think pediatricians have been the most sensitive to this. But as Beth alluded to, this a population with an increased risk for diabetes, certain forms of cancer, heart disease, and stroke, and specialists in those areas don't ask about child abuse and neglect.

Strakowski: There's a lot more detail to this very important topic in the paper, authored by Drs Lippard and Nemeroff, which is titled "The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders." I hope you all will take a look at that, and I hope you found our conversation interesting. Thank you all for listening today.

Stephen Strakowski, MD, is the founding chair and professor of psychiatry at Dell Medical School, University of Texas. His research focuses on the brain changes that occur at the onset of bipolar disorder.

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The 'Single Biggest Contributor' to Medical and Mental Illness - Medscape

The American Heart Association’s Annual Conference Comes to Philly This Weekend – Philadelphia magazine

Posted on November 16, 2019 by Danzig

News

Researcher Tom Cappola tells us about the latest clinical trials and medical breakthroughs to be announced during Scientific Sessions.

Chief of the cardiovascular medicine division in the Perelman School of Medicine at the University of Pennsylvania, Tom Cappola.

For the first time in its near 100-year history, the American Heart Association (AHA)will host its annual meeting in Philadelphia. AHAs Scientific Sessions is the largest cardiovascular meeting in the United States. On November 16-18, the meeting will attract nearly 18,000 attendees from more than 100 countries to the Pennsylvania Convention Center, and an additional two million medical professionals who will participate virtually in lectures and discussions about basic, translational, clinical and population science innovations aimed at reducing disability and deaths caused by cardiovascular disease and stroke.

The American Heart Association is excited to be in Philadelphia, said Michelle Kirkwood, director of National Science Media Relations for AHA. It has been on our wish list for some time, especially since the renovations at the Pennsylvania Convention Center and the citys landmark, robust nonsmoking laws that align directly with the American Heart Associations health and wellness goals. We are excited for our thousands of attendees to visit Philadelphia.

More than 610,000 people die of heart disease in the United States every year, according to the CDC. While heart disease is a leading cause of death for both men and women, it claims the lives of over 400,000 American women each year, or one death every 80 seconds. During the three-day meeting, more than 12,000 leading physicians, scientists, cardiologists and healthcare professionals in the global cardiovascular health community will host 850 educational sessions and more than 4,100 original research presentations to unveil the late-breaking science, clinical trials, and novel therapeutics and pathways that are shaping the future of cardiovascular care.

Its very fitting for Scientific Sessions to be here, chief of the cardiovascular medicine division in the Perelman School of Medicine at the University of Pennsylvania Tom Cappola said. We have the first medical school in the country and the first teaching hospital in the country. It makes sense that these new innovations would be presented in a place where theres already been so much innovation.

Cappola will be one of several Penn researchers leading the Cardiovascular Expert Theater, Innovations in Cardiovascular Therapies session during the meeting. Here are just a few big trends in heart care that Cappola says we can expect to learn more about during this weekends meeting:

Using artificial intelligence to monitor heart health

Artificial intelligence (AI) is having a big impact on cardiovascular care. Results from two preliminary studies to be presented this weekend will show AI can be used to accurately examine electrocardiogram (ECG) test results to possibly predict irregular heartbeat and risk of death. There will also be a presentation on the Apple Heart Study, which found that the Apple Watch and other wearable remote monitoring devices may be capable of detecting atrial fibrillation (aFib), an irregular and often rapid heartbeat that can lead to blood clots, stroke, heart failure and other complications.

Identifying new risk factors for aFib and stroke

George Mason University researchers will present results from two studies that found young people who smoke marijuana regularly have an increased risk of stroke. According to the study findings, young adults between the ages 18 and 44 who reported frequent use of marijuana, cigarettes and e-cigarettes were three times more likely to suffer stroke than young adults who did not smoke marijuana at all. The study also found that African-American males between the ages of 15 and 24 faced the highest risk of being hospitalized for arrhythmia.

In one Penn study to be presented this weekend, researchers found women who are diagnosed with peripartum cardiomyopathy (PPCM) during late pregnancy or within a month following delivery are more likely to experience restored cardiac function and improved outcomes compared to those who are diagnosed later in the postpartum period. The findings underscore the need for increased awareness and monitoring of heart failure symptoms, particularly among black women, who, on average, are diagnosed significantly later than white patients, according to study results.

Making advances in genetics and genomics

Another big trend at this years meeting will be the continued advancement in genetics and genomics, and how thats impacting cardiovascular care.

I think that genomic medicine has arrived and its arriving in waves, but it will ultimately affect all aspects of cardiovascular care, Cappola said. We have lots of people getting their 23andMe for sort of recreational purposes and they dont know what to do with it. But were starting to figure out what to do with that genetic information to improve care.

Another Penn Medicine study to be presented during the meeting will show why taller people may have an increased risk of developing atrial aFib. The research found a strong link between the genetic variants associated with height and ones risk for AFib, for the first time demonstrating that height may be a causal not correlated risk factor for the condition. Researchers hope insight from human genetics in large studies like this one will help them better understand causal risk factors for common disease.

It takes expertise to find links like this. Thats why researchers go to the American Heart Association meetings. You get all the experts together, they share their knowledge and this helps us to actually figure out what to do with this genetic information, Cappola said. Thats true across the board, but its particularly important for genomic medicine as it continues to advance.

Cyberchondria: 40% of Americans have misdiagnosed themselves online – Big Think

Posted on November 16, 2019 by Danzig

Using Google to self-diagnose potential medical conditions often leads to stress and seriously inaccurate diagnoses, according to a new survey.

The survey, commissioned by a personal health testing company LetsGetChecked, polled 2,140 Americans and found that 65 percent had tried diagnosing themselves on Google. Of those respondents, 74 percent said these attempts had stressed them out. One reason: The diagnoses they found online were inaccurate more than half of the time, meaning many people falsely convince themselves they have serious illnesses.

Why not see a doctor? A majority of survey respondents said they'd avoided doctors because of factors like cost, lack of time and concerns that the doctor wouldn't take their symptoms seriously. Given these reasons, it's no wonder why many prefer the immediate consultation of "Dr. Google" or "Google University", as some health care professionals have dubbed the online self-diagnosis phenomenon. Self-diagnosing has become so common that there's even a word for people who do it too much: "cyberchondriacs".

But is there any value in using the internet to self-diagnose? David Kopp, chief executive officer of Healthline Media, argued that Googling symptoms often helps people better manage their health.

"Contrary to popular belief, consumers can typically trust what they find online," Kopp wrote in an opinion piece in Newsweek. "The three fastest growing online sources of medical information contain content written or curated by physicians. In addition, reputable government sites like the Centers for Disease Control and Prevention and the National Institutes of Health are among the most visited on the internet."

The keyword there is "reputable" there's of course no shortage of shoddy, unreliable and downright insane medical advice on the internet. Still, some sources do seem to help people self-diagnose with relative accuracy.

A 2015 study published by BMJ in 2015 examined 23 popular symptom checkers commonly used by insurance companies, medical schools and government agencies. Overall, these systems correctly diagnosed the condition on the first try 34 percent of the time, and the correct diagnosis appeared in the first three diagnoses about half of the time. (The symptom-checkers with the highest accuracy were Isabel, iTriage, Mayo Clinic and Symcat, all of which are free to use.)

Symptom-checkers often get it wrong, but they generally do a good job of telling people when to go to the hospital.

"It's not nearly as important for a patient with fever, headache, stiff neck, and confusion to know whether they have meningitis or encephalitis as it is for them to know that they should get to an ER quickly," Ateev Mehrotra, associate professor of health care policy and medicine at Harvard Medical School, told The Harvard Gazette. "These tools may be useful in patients who are trying to decide whether they should get to a doctor quickly, but in many cases, users should be cautious and not take the information they receive from online symptom checkers as gospel."

The main shortcoming of symptom-checkers is that they don't factor in your comprehensive medical history.

"Each person has a different family history, has experienced different risk factors, and has his own social history, all of which contribute to the decision-making process a physician goes through," board-certified internist Dana Corriel, MD, told Byrdie in an interview.

So, even though a symptom-search for "cough" might show "cold" next to "lung cancer", it's usually no reason to panic. But if you're unsure?

"A primary care doctor is always available for a quick visit or question on the phone," Corriel said. "They cover general internal medicine and can answer most questions about the body."

Breakthrough research from winners of the 2019 Nobel Prize in Medicine – Villages-News

Posted on October 26, 2019 by Danzig

Dr. Gabe Mirkin

Dr. Gregg L. Semenza of Johns Hopkins, Dr. William G. Kaelin Jr. of Harvard and Dr. Peter J. Ratcliffe at Oxford in London shared the 2019 Nobel Prize for discovering how your body responds when you cant meet your needs for oxygen. Their groundbreaking research is now being used to treat certain cancers, strokes, infections, anemia, heart attack risks, and some eye diseases that can cause blindness.

You need oxygen for your cells to convert food to energy. When you cant get enough oxygen, your body makes extra red blood cells to carry oxygen, makes new blood vessels to bring the oxygen to your cells, and switches to ways to convert food to energy without using oxygen. These researchers have shown how to turn genes on and off to increase or decrease oxygen levels. By decreasing available oxygen, you can: kill cancer cells, stimulate new growth of blood vessels for a person prone to heart attacks, stimulate the bone marrow to make new red cells to treat anemia.By increasing oxygen levels, you can treat kidney diseases.

Applications for Cancer TreatmentCancer cells need lots of oxygen to keep on growing, so researchers are now trying to stop cancer from spreading by blocking their supply of oxygen through blocking production of new blood vessels. Scientists have known for many years that low oxygen levels cause the kidneys and liver to make a hormone called erythropoietin (EPO), that causes the bone marrow to increase production of new red blood cells. Both Drs. Semenza and Ratcliffe showed that low oxygen levels cause all the cells in the body to make large amounts of a protein called HIF-1a that stimulates the body to increase production of blood vessels and red blood cells that increase a cancers chance of spreading.

Dr. Kaelin studied people who suffered from von Hippel-Lindau syndrome (VHL), an inherited disease in which patients have a very high risk of pancreatic and kidney cancers. The same gene that increases their cancer risk also increases the oxygen supply to cancer cells, so their cancers can grow and spread through the body. Since high levels of oxygen increase (and low levels decrease) the risk of cancer spreading through the body, blocking HIF-1a can treat cancer by preventing cancer cells from increasing oxygen supply by making new blood vessels. An angiogenesis blocker, Avastin (bevacizumab), treats brain, kidney, lung and colon cancers by blocking cancer cells from stimulating the growth of new blood vessels they need to obtain oxygen and nutrients. On the other hand, increasing HIF-1a production can increase production of red blood cells to treat anemia.

The RecipientsWilliam G. Kaelin Jr., is professor of medicine at Harvard Medical School. He earned his bachelors degree in math and chemistry at Duke University where his laboratory instructor wrote, Mr. Kaelin appears to be a bright young man whose future lies outside of the laboratory. He went to Duke Medical School and took his residency in internal medicine at Johns Hopkins. He then went to Harvard where he studied a genetic disorder, VHL, that is characterized by high risk for cancer. He found that the disease was characterized by high levels of a hormone called erythropoietin, and showed that these people have a gene that causes high oxygen levels that cause cancers to spread through the body.Gregg L. Semenzais professor of pediatrics, radiation oncology, biological chemistry, medicine, and oncology at the Johns Hopkins University. He credits his interest in science to his high school biology teacher, Rose Nelson, in Sleepy Hollow, N.Y. He went to college at Harvard and medical school at the University of Pennsylvania, where he also got a PhD. He took a pediatrics residency at Duke University Hospital and then went to Johns Hopkins where he did his breakthrough research that is now used to treat patients with cancers and heart attacks.Peter J. Ratcliffeis the director of the Target Discovery Institute at Oxford University in London, UK. In high school, he wanted to be an industrial chemist. The headmaster showed up in his chemistry classroom and told him, Peter, I think you should study medicine. The next day he changed his university application form to medical school at Cambridge University. He has specialized in kidney diseases with studies involving EPO, the hormone that is released when oxygen levels are low to cause the bone marrow to make more red blood cells.

Dr. Gabe Mirkin is a Villager. Learn more at http://www.drmirkin.com

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Breakthrough research from winners of the 2019 Nobel Prize in Medicine - Villages-News

Good Health Insurance Isn’t Enough To Fix Holes In The Social Safety Net : Shots – Health News – NPR

Posted on November 15, 2019 by Danzig

Democratic presidential candidates former Vice President Joe Biden (left), Sen. Elizabeth Warren, D-Mass., and South Bend, Ind., Mayor Pete Buttigieg (right) debate different ways to expand health coverage in America. John Minchillo/AP hide caption

The Democratic debate is less than a week away, and it's likely that health care will once again take center stage. Once again, the candidates will spar over the best way to achieve universal coverage. Once again, the progressives will talk up the benefits of "Medicare For All" while the moderates attack it for its high cost and lack of choice. Just like the last debate. And the one before.

But it's not the repetitiveness of the health care debate that bothers me. As a medical student, what bothers me is that the current health care debate is myopically focused on health insurance.

Although health insurance coverage is important, it's only part of the picture. If the goal of our health care system is to keep Americans healthy, insurance will only get us so far. Health is about much more than access to health care.

Asthma triggers when you're homeless

Take the case of a patient I helped treat this past summer, a young man in his early 20s who came into the emergency department experiencing severe shortness of breath. I could hear him wheezing before I even walked into the room.

He was sitting on the stretcher, breathing rapidly, and leaning forward with his hands on his knees the classic "tripod" position signifying respiratory distress. After the resident physician and I determined he was having an asthma attack, we controlled his symptoms with steroids and inhalers and monitored him until he improved.

As I was preparing to discharge the patient, I briefed him on some of the asthma triggers he should avoid. When I advised him to keep the windows closed to minimize his exposure to pollen, he told me that the shelter where he was staying didn't have air conditioning. It was 83 degrees outside that day.

Health insurance couldn't prevent his next asthma attack. He needed a better and more stable housing situation.

Food deserts and no ride to the doctor

The same was true for a second patient of mine who was admitted to the hospital with diabetic ketoacidosis, a life-threatening complication of diabetes resulting from poor blood sugar control. After he recovered, we discharged him home to a food desert, a neighborhood where grocery stores and fresh-food markets are scarce and where following a low-carbohydrate diet is next to impossible. Health insurance cannot solve the food insecurity in his community.

Nor could health insurance enable a third patient of mine who'd had vascular surgery to re-open a blocked artery in his leg to return for his follow-up visit. Had he done so, we would have caught his post-operative infection early. As it happened, however, he had no way of traveling the 15 miles from his home to our clinic, and his infection worsened to the point that we had to amputate two of his toes. Health insurance didn't address his transportation barriers.

Fortunately, all three patients were insured. Indeed, I'm grateful to attend medical school in Massachusetts, which has achieved near universal health insurance coverage. But sometimes insurance isn't enough. I constantly see cases like these in which acute health problems arise due to factors seemingly unrelated to medicine. Universal coverage, while a worthy goal, does not translate into universal health.

Who will fix holes in the social safety net?

A recent study that rated U.S. counties based on health outcomes found that access to medical care accounted for only 20 percent of a county's score. The other 80 percent was more readily attributable to social and economic factors like the ones affecting my patients, including housing instability, food insecurity, and access to transportation.

The health care dialogue in this political race has been dominated by the notion that we need to cover everyone, a principle I fully support. But even if we achieve that, it will only get us a fraction of the way to our goal of better health for all Americans. The German health care system is widely praised for its universal coverage, robust primary care, and low out-of-pocket costs for medical care. But it is nonetheless plagued with health disparities. In some cities, life expectancies of neighboring communities differ by up to 13 years.

To neglect these social factors in our public discourse on health care would be a mistake, not only because they are important to public health but also because policymakers are often better equipped to tackle social factors than they are medical ones. Evidence suggests that providing stable housing to homeless populations in urban areas, for instance, contributes to significantly reduced mortality.

Insurance coverage is a critical determinant of health. We should discuss it. But candidates for president should also discuss their plans to strengthen communities by addressing homelessness, food insecurity, and the other social factors that underpin America's health gap.

Thus far, these issues have received scant attention in the Democratic primary race and in the larger political dialogue about health care. We need to broaden the conversation from a narrow discussion of health insurance to a holistic conversation about health.

Suhas Gondi is a third-year medical student at Harvard Medical School. A version of this essay originally appeared in Undark, the online science magazine.

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Good Health Insurance Isn't Enough To Fix Holes In The Social Safety Net : Shots - Health News - NPR

Construction to begin next year on medical school in downtown Wichita – KFDI

Posted on November 15, 2019 by Danzig

The city of Wichita has an agreement with a development group to convert four downtown buildings into a medical school, student housing, a culinary school and a hotel.

The city council has approved an agreement with Douglas Market Development, which owns the four buildings. The former State Office Building will be converted into the Kansas Health Science Center, and the former Sutton Place building will be remodeled to have 119 units for student housing.

The former Henrys building at 124 South Broadway will be converted into a commercial kitchen and culinary school, and the former Broadway Plaza Building at 109 South Broadway will be remodeled into a 119-room hotel that will be operated as a Marriott hotel.

Assistant city manager Scot Rigby said construction on the medical school is expected to begin by March, 2020, and the first class will begin in August of 2022. Work on the other buildings will also begin by March and they would be ready for occupancy in 2022. The entire project is a $90 million investment.

Jason Gregory with the Downtown Wichita organization said the project will bring life back to four vacant buildings and it will strengthen the Douglas Avenue and Williams Street corridors.

(above image is a rendition of the State Office Building as the medical school)

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Construction to begin next year on medical school in downtown Wichita - KFDI

Preston Medical Library | The University of Tennessee …

Posted on May 14, 2019 by Danzig

Looking for ebooks in your subject?Refer to our research guides to find subject-specific lists of ebooks.

The Preston Medical Librarys mission is to assist the University of Tennessee Medical Center in providing excellence in healing, education, and discovery. The library is committed to ensuring access to clinical information through the acquisition, organization and management of collections. We provide exceptional reference, research and instruction for faculty, residents, students and physicians and outreach to the community.

Are you having difficulty accessing library content online? You can contact us anytime by describing your issue and clicking the Ask Us button.

Holiday Hours

1924 Alcoa Hwy Knoxville, TN 37920

Phone: 865-305-9525 Fax: 865-305-9527 Text: 865-262-8920 library@utmck.edu

In conjunction with the Human-Animal Bond in Tennessee (H.A.B.I.T.), the library hosts canine assisted stress-reduction visits twice weekly on Mondays and Wednesday from noon-1:00 p.m.

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Preston Medical Library | The University of Tennessee ...

The Complete List Of Texas Medical Schools

Posted on October 15, 2019 by Danzig

Texas has an abundance of medical schools already, and there are only more to come! School is on the rise, which means pre-meds are hard at work on their MCAT studies and application preparations. If you are a Texas resident, you have more options than most! Here is the complete list of Texas medical schools, including the ones slated to open within the next few years. (These are in no way ranked by prestige.)

1. Baylor College of Medicine

Average GPA: 3.88

Average MCAT: 35 out of 45

Main Program: M.D.

There are currently 743 total medical students. Of the 6,618 people who applied in the last class, 732 were interviewed (452 of which were Texas residents), and of those interviewed and accepted, 186 enrolled this past year. Approximately 139 out of the 186 students in the first-year class are Texas residents. Located in the Texas Medical Center in the ever-so-humid and large city of Houston, Baylor is one of the most prestigious and competitive medical schools in the nation. However, it was voted the most affordable private medical school with in-state tuition set at $17,498 and out-of-state tuition at $30,598. Baylor College of Medicine is ranked 18th in the nation among medical schools by U.S. News and World Report.

2. UT Southwestern Medical School at Dallas

Average GPA: 3.88

Average MCAT: 34 out of 45

Main Program: M.D.

There are currently 939 medical students, with 226 in the first-year class. Of the 4,057 people who applied, 834 received an interview (750 of which were Texas residents). Of those interviewed and accepted, 226 enrolled. Eighty-five of the students that just enrolled are from Texas and an overwhelming 61 percent of first-year students are male (so all the single ladies put your hands up!). UT Southwestern is ranked 23rd in the nation by U.S. News and World Report.

3. University of Texas Health Science Center at San Antonio

Average GPA: 3.74

Average MCAT: 32 out of 45

Main Program: M.D

There are currently 880 medical students. Of the 4,133 people who applied, 974 received an interview (847 of which were Texas residents). Of those interviewed and accepted, 212 enrolled. Eighty-nine percent of the enrolled students are from Texas and 51 percent are female. UTHSC San Antonio is ranked 70th in the nation by U.S. News and World Report. Since it is located in San Antonio, you can definitely find some of the best Tex-Mex food to eat while cramming for your boards!

4. University of Texas Medical Branch at Galveston

Average GPA: 3.87

Average MCAT: 32 out of 45

Main Program: M.D.

There are currently 900 medical students. Of the 4,091 that applied for admission, 1,053 received an interview and 949 were Texas residents. Of those who were interviewed and accepted, 228 enrolled and 57 percent are male. Again, ladies, if you are looking for the perfect doctor husband, this is another great place to go. Located near the beach, UTMB at Galveston is ranked 111th in the nation by U.S. News and World Report.

5. University of North Texas Health Science Center

Average GPA: 3.59-3.6

Average MCAT: 28 out of 45

Main Program: D.O.

UNTHSC is the only Doctor of Osteopathic Medicine program in Texas. Of the 3,006 people that applied for admission, 837 received interviews. Of those who were interviewed, 454 were accepted and 228 enrolled (209 of which were Texas residents). There are only 30 medical schools in the U.S. which offer the D.O. degree. People with a D.O. degree can be physicians and surgeons just like those of the M.D. degree, however, the D.O. degree requires 300-500 hours of studying philosophically based techniques for hands-on manipulation of the human musculoskeletal system. D.O. schools are known to be slightly easier to gain admission into. UNTHSC is located in Fort Worth (which is the best city in the state of Texas), and is ranked 158th in the nation by U.S. News and World Report.

6. Texas A&M University Health Science Center

Average GPA: 3.74

Average MCAT: 30 out of 45

Main Program: M.D.

Of the 3,791 people who applied, 714 received an interview and 668 were Texas Residents. Of the people who were accepted, 199 enrolled, 95 percent of whom were Texas residents. Fifty-four percent of first-year students are female. The school is located, unfortunately, in College Station. It is ranked 101st in the nation by U.S. News and World Report. Aside from its location, it's a great medical school. Just keep in mind that you'll have to call yourself an Aggie for the rest of your life. Whoop...

7. Texas Tech Health Science Center

Average GPA: 3.78

Average MCAT: 32 out of 45

Main Program: M.D.

Of the 3,535 people who applied, 783 received an interview, 717 of whom were Texas Residents. Out of those interviewed and accepted, 150 enrolled, 90 percent of whom were Texas residents. Fifty-six percent of the students in the first-year class are male. TTHSC is located in Lubbock, where it smells like cow droppings and is almost worse than College Station because it's straight-up in the middle of nowhere. At least you won't be distracted from studying, because there's not much to do out there in the middle of the plains of Texas. The school is ranked 104th in the nation by U.S. News and World Report. However, it does snow there, which could be fun.

8. Texas Tech Paul L. Foster School of Medicine

Average GPA: 3.6

Average MCAT: 28 out of 45

Main Program: M.D.

Located in El Paso, the Texas Tech Paul L. Foster School of Medicine has 100 students in its first-year class, 99 percent of whom are Texas residents. The current first-year class is 65 percent male and 35 percent female. Learning Spanish is an additional requirement at this school. I was not able to find as much in-depth information about this school, but I can also guess there is very good, authentic Mexican food around. Learning Spanish truly gives you an edge in Texas medicine, so I think this would also be a very solid choice of medical school.

9. UT Health Science Center at Houston

Average GPA: 3.84

Average MCAT: 33 out of 45

Main Program: M.D.

There are currently 958 medical students, with 240 of them in the first-year class. Of the 4,393 who applied, 845 received interviews (791 of whom are Texas residents). The first-year class is 55 percent male. This school is neighbored with Baylor College of Medicine. It looks like this town is "big enough for the two of us." Houston is a great place for medicine, especially since it contains THE world-class M.D. Anderson Cancer Center.

UNDER CONSTRUCTION

10. Dell Medical School

We have yet to know the average GPAs or MCATs at this medical school, because it is BRAND NEW AND NOT EVEN FINISHED BEING BUILT YET! It has, however, received preliminary accreditation, which means it will begin recruiting its first class this year. Its first class will contain 50 students in June of 2016. Dell Medical School hopes to revolutionize medical education by creating educational flexibility for students to determine their own objectives for clinical cases, commitment to innovation of care in the Austin community, focus on leadership development, integrating more technology into medicine, and increasing student presence in the community. Dell Medical School will be located in Austin, home of the Texas Longhorns, great food, live music festivals, prime hiking and camping spots in the hill country, and hippies. While the first class may seem small, it is only because the school will not be fully licensed yet. Class sizes will increase over time.

11. University of Texas Rio Grande Valley School of Medicine

The school of medicine will welcome its first class in fall of 2016. The program already has already accepted 42 medical residents to begin clinical rotations in Valley Baptist Medical Center in Harlingen, McAllen Medical Center, and Doctors Hospital at Renaissance in Edinburg.

12. TCU & UNT Medical School

TCU recently announced its partnership with UNT to create the first M.D. program in Fort Worth, in addition to the D.O. program. The school will accept its first class of 60 students in 2018. To minimize costs, it will utilize both the UNTHSC and TCU campuses and existing faculty. People who graduate from this medical school will be alumni of both UNT and TCU.

13. University of the Incarnate World Medical School

Main Program: D.O.

The University of the Incarnate World is a Catholic institution located in San Antonio. It will be the only faith-based medical school in the state of Texas. It is currently applying for its accreditation by the American Osteopathic Association in the hope of welcoming its first class of 150 medical students in July of 2017.

With the addition of the four new medical schools, Texas will tie with California for having the second most medical schools in the U.S., leaving New York at the top with 16. The opening of new medical schools and increased enrollment has been a side effect of Obamacare. Obamacare will now emphasize an increase in demand for primary-care physicians, rather than specialties, to aim for more preventative care. There will be more scholarships and loans available to students who pursue primary care. In 2013, overall medical school enrollment increased by 6.1 percent. Today, people are becoming more aware of the Doctor of Osteopathic Medicine degree. D.O. schools will expect an increased enrollment of 162 percent by 2020, whereas M.D. schools will expect an increased enrollment of 29 percent because D.O. degrees emphasize more primary, preventative care.

Texas is a melting pot for medicine, and is only becoming more prominent. Just remember to maximize your options when applying for medical school!

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The Complete List Of Texas Medical Schools

Race Is Used in Many Medical Decision-Making Tools – The New York Times

Posted on June 18, 2020 by Danzig

Unbeknown to most patients, their race is incorporated into numerous medical decision-making tools and formulas that doctors consult to decide treatment for a range of conditions and services, including heart disease, cancer and maternity care, according to a new paper published Wednesday in the New England Journal of Medicine.

The unintended result, the paper concludes, has been to direct medical resources away from black patients and to deny some black patients treatment options available to white patients.

The tools are often digital calculators on websites of medical organizations or in the case of assessing kidney function actually built into the tools commercial labs use to calculate normal values of blood tests. They assess risk and potential outcomes based on formulas derived from population studies and modeling that looked for variables associated with different outcomes.

These tests are woven into the fabric of medicine, said Dr. David Jones, the papers senior author, a Harvard historian who also teaches ethics to medical students.

Despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice, he wrote.

The paper is being published at a tense moment in American society as black communities, disproportionately affected by the coronavirus, protest unequal treatment in other areas of their lives.

Dr. Jones said he believed the developers of the tools, who often are academic researchers, are motivated by empiricism, not racism. But the results, his analysis found, have often led to black patients being steered away from treatments or procedures that white patients received.

The paper included a chart listing nine areas of medicine where there are race-based tests, and it analyzed the consequences. For example, it reported, labs routinely use a kidney function calculator that adjusts filtration rates for black patients. With the adjustment, black patients end up with slightly better rates than whites, which can be enough to make those with borderline rates ineligible to be on a kidney transplant list.

An online osteoporosis risk calculator endorsed by the National Osteoporosis Foundation, among others, calculates chances of a fracture differently for black and white women. Black women end up having a score that makes them less likely to be prescribed osteoporosis medication than white women who are similar in other respects.

An obstetric calculator based on observational data concludes that black women who had a previous cesarean birth are less likely to have a successful vaginal birth in a subsequent pregnancy.

Dr. Jones added that it is time to stop what amounts to racial profiling in medicine. We need to get off this train, he said.

The New England Journal paper built on a collection of recent findings and assessments, including those in a recent paper about kidney function by Dr. Nwanaka Denise Eneanya and her colleagues at the University of Pennsylvania.

To determine how well kidneys are working, doctors use a blood test that measures a protein called creatinine to estimate kidney filtration rate. Low filtration rates indicate a kidney problem.

Dr. Eneanyas team noted that patients with a filtration rate of less than 30 were referred to kidney specialists. They gave an example of a white patient whose level was 28, according to the calculator. A black patient with the same creatinine level would get a race correction under the formula that raises the level to 33. Consequently, the black patient would not get a referral to a specialist.

The same effect could make some black patients ineligible to be put on a list for a kidney transplant those with filtration rates of 20 or above are ineligible.

The formula originated with data from a federal study more than two decades ago that asked if a low-protein diet reduced the risk of kidney disease (it did not, the study showed). The study included precise measures of kidney function and creatinine levels, which let researchers use creatinine to estimate kidney function. The formula fit the data best when they included an adjustment for black patients.

In a more recent paper, in 2009, the researchers combined data from a number of studies to devise an improved formula, asking which variables made the formula best fit the data. Race popped up again.

The formula was widely adopted, said Dr. Melanie Hoenig, a kidney specialist at Harvard Medical School.

One of its principal authors, Dr. Lesley Inker, a kidney specialist at Tufts Medical Center, said she hears the critics.

What we say is, Youre right. I understand the difficulty in assigning race, Dr. Inker said.

She is working on developing a more accurate formula that does not include race. She added that black patients should be told that their race alters the calculation and should be given an option to have their race excluded.

But, she says, the current formula also can be an advantage for black patients. Those with filtration rates below 30 are ineligible to be prescribed metformin, the first line drug for diabetes, and SGLT2 inhibitors, a more recent class of diabetes drugs.

One problem, is that it is not clear how race is determined. It shows up in medical records but, said Dr. Peter Reese, a kidney transplant specialist and epidemiologist at the University of Pennsylvania, I worry that in some situations they look at you and assume.

With the formulas, there is no accounting for people of mixed race, as the authors of the New England Journal paper and other doctors have noted.

Even if race does have a real affect on lab values for creatinine, why assume it is because of the genetics that determine skin color, some experts asked.

It could be diet or any of a number of things, Dr. Hoenig said, noting that a large protein-heavy meal can temporarily raise creatinine levels.

One often cited explanation is the belief that black people are more muscular than white people, and muscles can release creatinine into the blood. In a recent paper, Dr. Vanessa Grubbs, a kidney specialist at the University of California, San Francisco, tried to trace the origins of that belief and found only a few decades-old studies that did not even measure muscle mass directly, including one saying black children are thinner than white children.

A group of medical students at Harvard has been trying to change the approach to assessing kidney function, with some success.

The group, including Leo Eisenstein, Danika Barry and Cameron Nutt, had heard Dr. Jones in lectures saying race was a social construct and then went into the clinic, where they were told to use a formula that corrects for race in assessing kidney function.

Instead of complaining, Dr. Hoenig told the students, why not go to the leadership and suggest a change? Labs could simply not list race when sending in blood tests for creatinine in that case the formulas default would be the level for whites. Or they could give results as a range and explain to patients that the numbers are an estimate.

A few years ago, Dr. Hoenig and the students made the rounds to executives at Beth Israel Medical Center.

We went to the chief of medicine, we went to the head of clinical labs, we went to the head of the kidney division, we went to a lot of people and spun our story, she said. They were open to it.

In 2017, Beth Israel dropped the race factor in calculating kidney function. But despite pleas for a change, no other hospitals have followed suit.

Recently though, San Francisco General has replaced race as a factor with a choice of values for kidney function depending on the doctors assessment of whether the patient was muscular or not.

Advocates of change like Dr. Hoenig say they think part of the problem is resistance to changing a system that has become part of medicine.

Dr. Darshali A. Vyas of Massachusetts General Hospital, who is first author of the New England Journal paper, said the ultimate goal is for doctors and researchers to rethink the assumption that they can use a patients race in making medical decisions.

This is a challenge to the field about how we think about race and what our default assumptions are about race, she said.

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Race Is Used in Many Medical Decision-Making Tools - The New York Times

100 years after legislators barred WSU from starting medical school, WSU’s first class of medical students start … – The Spokesman-Review

Posted on August 17, 2017 by ev1

When Washington State University opens the doors to its first class of medical students Wednesday, many of them wont know and most may not care about the political maneuvering that first made this day difficult, and then made it possible.

Just over two years ago, it wouldnt even have been legal for WSU to have its own medical school.

A 1917 law gave the University of Washington the sole authority to operate a medical school in the state, a result of the Legislature settling a turf war over academic majors between the schools in Seattle and Pullman. The state had only so much money to spend on its public colleges, and wasnt about to pay for duplicating expensive programs. UW got architecture, law, journalism and aeronautical engineering; what was then Washington State College got veterinary medicine, almost anything related to agriculture and rural life.

A medical school, when one was built, would be exclusively the right of UW, the law said in another section. That didnt happen for another 28 years, when the Legislature came up with $3.7 million for the university to set up schools of medicine and dentistry as World War II was ending.

That law stayed on the books, and UW School of Medicine expanded as Washington grew. The fact that it was the only medical school at a public university in Washington probably didnt seem so strange because the nearby states of Wyoming, Alaska, Montana and Idaho had none at all. In the 1960s, the university set up a cooperative arrangement with those states to educate their med students as well in a program called WWAMI, which takes its acronym from the first letters of the five states.

WWAMI had a presence in Pullman for years, but in the 1990s, local leaders began angling for expanded medical education in Spokane to complement one of the citys biggest growth industries, health care. One problem was they didnt have a place to put it.

Todays new medical students may look around and marvel at the grassy hillsides and river walkways of Riverpoint campus, but should realize that 25 years ago that was just a stretch of debris-strewn rail lines between Gonzaga University and Trent Avenue. The area began to change when local leaders persuaded the Legislature to build the Spokane Intercollegiate Research and Technology Institute, which was a cooperative effort between local public and private colleges. The state later built classrooms nearby for WSU and Eastern Washington University.

In 2006, WSU broke ground on a new Intercollegiate College of Nursing at Riverpoint, moving the coordinated nurses training from its old quarters near Spokane Falls Community College.

Five years later, city leaders had a new ask: a building for medical students at Riverpoint. While it was often called a med school by locals, its official title was the Biomedical and Science Center.

That was late 2011. The state still was trying to recover from the recession, and the $70 million structure wasnt in then-Gov. Christine Gregoires early budget proposal. But WSU President Elson Floyd made the hard sell and Spokane had some powerful allies in the Legislature, including then-Senate Majority Leader Lisa Brown, a Spokane Democrat whose district included Riverpoint. The final capital budget had $35 million for the building, with the understanding that the next year, the state wouldnt walk away from the project halfway through, and the rest of the money would be in the 2013-15 capital budget. It was.

Brown retired at the end of 2012 and took the job of chancellor at WSU-Spokane.

Before that building was complete, however, friction between WSU and UW got hot enough to start a brush fire.

For the 2013 school year, UW was given enough money to send 20 medical students to WWAMI in Spokane; it sent 17. Floyd said UW didnt recruit enough students to fill the slots. UW President Michael Young said the school could only find 17 students who wanted to go to Spokane. Floyd countered that if UW wouldnt cooperate, WSU would start its own medical school.

Good luck, said Young, adding that Floyd didnt know how a medical school is run. What came to be known as the medical school Apple Cup was on.

Gov. Jay Inslee a Husky alum married to a Cougar alum tried to stay out of the rivalry, and wrote a budget in late 2014 that didnt have new money for either medical school. He let the universities make their pitches to the legislative committees that would write the final budgets.

Although UW had plans to eventually have a new class of 80 med students each year at WWAMI in Spokane, it was Floyd who put on the full-court press starting in January 2015 for WSU to have its own medical school. He made repeated trips to Olympia, wowed lawmakers during committee hearings and charmed them in private meetings. He slowly made inroads into the strong support UW traditionally has from Seattle-area legislators, and his pitch for a new school with a different system to train doctors for family medicine and rural practice resonated with those from rural areas who were seeing a shortage of health care practitioners. It would be part of an overall strategy that included more medical residencies in rural hospitals and clinics and more financial aid for students who would practice in those areas.

Floyd also had some powerful allies like Mark Schoesler, the Ritzville Republican whose district includes the Pullman campus and parts of Spokane County and who by then was Senate majority leader.

When the Legislature held hearings on rewriting the 1917 law, UW said it didnt object to the change as long as money for the new school didnt come out of the WWAMI budget and hurt that program.

In March 2015, the Legislature passed a bill that gave WSU the legal authority although not the money to have its own medical school. In legislative budgets that were released a few weeks later, UW was allotted $9.7 million to expand WWAMI in Spokane and WSU was given $8 million over the next two years to cover the costs of seeking accreditation and getting ready for its first class of med students.

On April 1 of that year, Floyd, Brown and a group of smiling legislators stood behind Inslee as he signed the WSU medical school authorizing bill. There were cheers all around, but the loudest were for Floyd.

Two months later, university officials announced Floyd was taking a leave of absence to battle colon cancer. He would lose that battle before the end of the month.

In what may have been the easiest decision of the 2015 session, the Legislature moved within days to name the new medical school for Floyd.

UW would later break off its arrangements with WSU for WWAMI and enter into an agreement with nearby Gonzaga University. The competition for funding has decreased slightly as the need for doctors the two schools can produce has increased. The states 2017-19 operating budget has a total of $15 million for medical education in Spokane between the two schools.

Based on plans for the two programs, Spokane could go from having no medical school at the beginning of this decade to at least 240 med students in two schools at the end of it.

Program paves way for medical school – The Augusta Chronicle

Posted on August 22, 2017 by Danzig

Shelby Howard and Aditi Talkad might be in their first year at Medical College of Georgia but the two have been at Augusta University working toward a medical degree for three years.

The two are among 29 students who began the seven-year BS/MD program in 2014, 18 of whom are now in their first year of medical school. The combined undergraduate and health sciences programs were envisioned as one of the fruits of consolidating Augusta State and then-Georgia Health Sciences universities in 2013. Dr. Paul Wallach, vice dean for academic affairs at MCG, brought the program with him five years ago after creating similar programs at the University of South Florida.

This is my brainchild, he said, and it benefits both the students and the university.

The advantage for the student is they have a clear pathway into medical school, Wallach said. The advantage for the institution, which I thought was considerable as we were going through our consolidation, is it creates a premier program for recruitment into the undergraduate campus and permits very highly performing students to be recruited to Augusta University.

Both Howard and Talkad were considering other, larger universities in Georgia and had not heard much about Augusta prior to learning about the program. Now that has changed.

Augusta is a lot more on the map from at least when I started college, Howard said.

I think the program has put it on the map, Talkad said. There are people applying from out of state, from California, to come here to come to Augusta. She and Howard both talk to high school students about the program and its advantages.

The students along the way have had to meet the same or higher standards for others getting into medical school, including taking the Medical College Admission Test and interviewing with the Admissions Committee. The difference with these students is they had to face the committee when they were college freshmen. But they got a lot of support from the medical school faculty before they had to do it, including three mock interviews.

They groomed us for that interview, Howard said. It also let them know the level of professionalism and standards they would need to succeed in medical school, Talkad said. Some of their new classmates may just now be finding out they are surrounded by people with similar interests and passions but weve been doing that for the past three years, she said. That was a huge benefit of coming here.

It also spared them the anxiety of applications and months of waiting to find out if they would get in or not. Howard took an MCAT preparation class with students going through that process and they were so stressed out of their minds, she said. It saved us that, which I am grateful for.

And a year, Talkad added. That will be important down the road especially with how much time goes into becoming a doctor, Howard said.

The experience has also bonded them into a close-knit group that is family to each other, Talkad said.

Especially because college is such a time of personal growth and figuring out who you are so weve gone through those growing periods and growing pains with each other, Howard said.

And they expect it to stay that way.

You grow up so much with them that you dont lose track of that, Talkad said.

Reach Tom Corwin at (706) 823-3213

or tom.corwin@augustachronicle.com.

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Learning from the Recovered – Harvard Medical School

Posted on March 26, 2020 by Danzig

Researchers in the Blavatnik Institute at Harvard Medical School and at Brigham and Womens Hospital are adapting an antibody-detection tool to study the aftermath of infections by the novel coronavirus that is causing the current global pandemic.

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The tool, called VirScan, detects antibodies in people's blood that indicate active and past infections by viruses and bacteria. It was developed in 2015 by Stephen Elledge, the Gregor Mendel Professor of Genetics and of Medicine at HMS and Brigham and Womens, and two PhD candidates in the lab, George Xu and Tomasz Kula.

Because it takes 5 to 10 days for a person to develop antibodies, Elledge emphasized that VirScan would not be used to provide real-time diagnoses of infection with SARS-CoV-2, the virus that causes COVID-19.

Rather, the goal is to analyze blood samples from people who recover from infection to learn about how the virus affects the immune system and the epidemiology of the disease.

Once underway, the effort will join others around the world attempting to study post-infection blood samples. The results could lead to better estimates of true infection and lethality rates by capturing cases that may have gone undetected and could inform the development of vaccines. They could also reveal new insights into the fundamentals of human immunity.

"The situation right now is extremely difficult, but it's great to be in a position to apply all these new methods to an important human health problem," said Elledge.

How does VirScan work? How is it different from diagnostic tests?

From a single drop of blood, VirScan tests for antibodies against more than 1,000 different strains of viruses and bacteria that may have infected a person, whether around the time of testing or decades earlier. This differs from typical blood tests known as ELISA assays, which look for one pathogen at a time.

It also differs from the tests currently used to diagnose COVID-19. Those tests rely on mucus swabs from the nose and throat and look for nucleic acids that signal that the SARS-CoV-2 virus is contained in the sample.

"The CDC and other testing facilities are looking for the presence of the virus, which is critical," said Elledge. "Our assay can detect whether someone's immune system has engaged the virus. We can tell when someone has harbored the virus but doesn't have it anymore."

To create VirScan, Elledge, Kula and Xu built a library of epitopes: short protein fragments derived from the surfaces of viruses. If a person has encountered a particular viral strain, their immune system has generated antibodies against it. Those antibodies will then recognize the epitope in the VirScan library and bind to it, giving a positive result.

Elledge's lab included epitopes from several different coronaviruses in the original VirScan collection. The team is now adding epitopes from the new coronavirus as well as all other known coronaviruses not already included.

Can VirScan be used to test whether people currently have COVID-19?

For several reasons, including the fact that it takes at least a week to generate results, VirScan can't be used as a real-time diagnostic test.

"It's not feasible as a point-of-care test," said Elledge. However, he added that his team might be able to use the information gained to generate a faster version of VirScan.

When the project gets up and running, it will be critical to ensure that blood samples are taken only from people who have recovered fully from SARS-CoV-2 infections, so that vials do not contain active coronavirus particles when they enter the lab.

"We don't want to infect our researchers," said Elledge.

How can the work improve estimates of infection and fatality rates?

So far, limited testing has meant that an unknown number of people in the U.S. and beyond have been infected with SARS-CoV-2 but remain uncounted. Some may not have had symptoms. Some symptoms may have been attributed to other causes. This not only leaves individuals wondering about their infection and immunity status but also obscures the true infection rate across the population. And without knowing how many people have been infected, it's impossible to calculate the fatality ratehow likely the new coronavirus is to kill a person it infects.

Running VirScan analyses on blood, or serum, from a sizeable segment of the population can provide "a reliable estimate" of how many people were infected in a given geographic area, said Elledge. Cross-referenced with medical records of those who tested positive and died, that information can illuminate the virus's true lethality rate.

"Because right now they say, 'this many people came in and tested positive,' and 'this many died,' but if there are a lot of people who are not sick enough to go to the hospital and who don't get tested, it makes the virus look more lethal than it might be," said Elledge.

How can VirScan inform vaccine development?

VirScan promises to help Elledge and colleagues identify which parts of the virus the immune system responds to.

Recent work from his group suggests that people all over world infected with a particular virus make antibodies against the same proteins"even the same amino acids"on that virus, Elledge said.

That's surprising, considering how many epitopes viruses have and how many antibodies are in the body's arsenal, said Elledge. The findings led him to suspect that some epitopes are, in effect, decoys, and therefore, that not all antibodies have the desired neutralizing effect.

"The immune system may be sending out all these antibodies like shooting a shotgun and hoping some of the spray will hit the target, neutralizing some critical part of the virus," he said.

In principle, said Elledge, VirScan could indicate which epitopes are useful targets against the new coronavirus and which are just noise. Then researchers could eliminate the useless ones from vaccines they're developing.

How else is the lab working to assist vaccine efforts?

Antibodies aren't the only objects in the body that attack invaders. Immune cells called T cells also react to specific epitopesnot on viruses, but on the surfaces of infected cells. Alerted to danger by these epitopes, T cells can kill virus-infected cells and limit the number of viruses made in the body.

In 2005, Elledge's lab built a tool, T-Scan, that can detect these epitopes. He would now like to teach T-Scan to detect the epitopes made when cells are infected by the new coronavirus. But since cells infected by different viruses and bacteria sprout different epitopes, he first needs to know what the epitopes look like for infections with this coronavirus. That would require obtaining not only blood but also T cells from people who recover from SARS-CoV-2 infection, he said.

The goal: to identify the epitopes that trigger T-cell attacks so researchers laboring to develop COVID-19 vaccines can include them in the mix.

"T-cell epitopes are often important players in vaccines and in preventing viral infections," said Elledge. "You want to encourage T cells to kill the infected cells."

How can VirScan illuminate what SARS-CoV-2 does to the immune system?

Last year, the team used VirScan to help reveal how measles infection wipes out the immune system's memory of past infections by other viruses and bacteria. VirScan could similarly illuminate whether people develop immunity to the new coronavirus, how long they remain immune and whether infection causes more widespread damage to the immune system like measles does.

Or the virus may have other surprises in store, said Elledge.

What about the likelihood that there are different strains of the new coronavirus?

Although many mutations in the virus have been documented around the world to date, these variations "wouldn't affect antibodies much," so VirScan's results should still apply, said Elledge.

Whose samples would be analyzed?

For the initial study, Elledge envisions collecting samples from about 100 volunteers who've recovered from COVID-19. The best-case scenario would be having samples from people before and after infection, he said, although he recognizes that that would be hard to arrange.

"Many people in the lab have given samples in the past, so if anyone gets sick, we'll have a before and after, but of course we hope that doesn't happen," he said.

When will all of this be ready?

Most HMS labs have transitioned to remote work following institutional guidance aimed at containing the spread of the virus, but some have been granted permission to continue on-site work for COVID-19-related projects, including a portion of Elledge's lab.

Elledge anticipates that VirScan could be deployed to analyze samples in mid-April. Then it would be a matter of obtaining institutional review board approvals for human research and arranging the logistics of collecting the samples. Elledge is currently in talks with contacts across the HMS and broader Boston communities.

What else is in the works?

At the same time, Elledge's team is working to detect antibodies against the new coronavirus with even greater sensitivity using a tool they developed in 2014 called PLATO. Whereas VirScan uses short, linear protein fragments, PLATO uses full-length proteins known as open reading frames, or ORFs, which have a more developed 3D structure. (PLATO stands for ParalleL Analysis of Translated ORFs.)

Who is funding this work?

Elledge is an investigator of the Howard Hughes Medical Institute.

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Learning from the Recovered - Harvard Medical School

UH Manoas theatre department, School of Medicine aid in supply of personal protective equipment – KHON2

Posted on March 28, 2020 by Danzig

HONOLULU (KHON2) The shortage of personal protective equipment (PPE) for health care workers in Hawaii is increasing, and members within the University of Hawaii are working to help supply it.

A UH Manoa professor at the John A. Burns School of Medicine and the faculty, students, and staff of the UHM Department of Theatre and Dance are sewing fabric masks.

This effort is in response to the Centers for Disease Control and Preventions guidance that fabric masks are a crisis response option when other supplies have been exhausted.

According to JABSOM professor Angel Yanagihara, the masks will be pleated for a better fit and made of 100 percent densely woven breathable cotton with pockets that can be inserted with a disposable near N95 non-woven filter material, Professor Yanagihara said.

After use, the cloth masks may be treated with regular laundry soap then laundered and reused.

The first batch of cloth masks will be distributed through the University Health Partners of Hawaii, the faculty practice plan of the UH medical school, with priority given to providers and staff in primary care and emergency care specialties, who provide first-contact care for the majority of patients.

JABSOM medical students are assembling plastic face shields that are needed by frontline health care workers.

With public contributions to materials, it is hoped that these masks and shields can be extended for the support of other primary care providers (including those assessing nursing home patients) across the state of Hawaii.

Contribution to these efforts may be made here.

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UH Manoas theatre department, School of Medicine aid in supply of personal protective equipment - KHON2

I’m a final-year medical student being rushed to the frontline. I’m nervous but I’m ready – The Guardian

Posted on March 28, 2020 by Danzig

So, were being conscripted?

On Tuesday, the health secretary, Matt Hancock, announced that 5,500 final year medical students would be joining the frontline of the NHS. On hearing this news, I rushed down the stairs of my flat to my equally bewildered housemates. We had just finished six years of medical school and had completed our hurriedly reorganised final exams remotely. But we werent supposed to officially qualify and start as doctors until August. NHS staff shortages and a hugely increased demand for care mean that we will be reaching for the scrubs early.

Starting on the lowest rungs, foundation training is the term for the first two years working as a doctor and serves as the culmination of a journey spanning over half a decade of medical school. Becoming a doctor is a dream I have had since I was 14 years old. But I can think of few things more nightmarish than starting my career in the middle of a global pandemic.

I certainly feel a strong moral obligation to assist however possible in the midst of this unprecedented struggle. Many medical students, including those at my university, have completed their final examinations and were already actively seeking ways to volunteer before this was announced.

This sense of duty is nonetheless matched by fear and trepidation. A lack of testing means many healthcare workers are self-isolating at a time when demand looks set to soar. There is an overwhelming sense that the health service is heading towards a cliff edge, about to experience several months that will dwarf the winter crisis that has become an annual occurrence.

Indeed, despite being highly trained, foundation doctors the most junior of junior doctors in a hospital still require significant senior supervision to support their development. I worry that the approaching challenges could place myself or one of my peers in a position where that support is not available, risking jeopardising patient safety through no fault of our own.

Meanwhile, rumours continue to filter through of the previously fit and well patients now finding themselves on ventilators and I question if my colleagues pleas for adequate personal protective equipment will continue to fall on deaf ears.

I speak to my dad, whos back in Grimsby, on the phone. Stephen, its like the war. You need to roll your sleeves up and get to work. Hes right. Our medical schools would not graduate us, nor would the General Medical Council register us to work, if they had any doubts about our competence. Were not being conscripted, but this does feel like a battle in which we all have our part to play. I, for one, am ready.

Stephen Naulls is a final-year medical student at Imperial College London

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I'm a final-year medical student being rushed to the frontline. I'm nervous but I'm ready - The Guardian

Nutrition advice from the GP? "Medical students of today can be the agents of change" – NutraIngredients.com

Posted on March 12, 2020 by Danzig

Medical students of today can be the agents of change in bringing nutrition discussions into the GP surgery. Take what you learn today to the doctors already in practice who are struggling with confidence in how to discuss nutrition.

These were the words ofElaine Macaninch, a nutrition medical educator for Brighton and Sussex Medical School (BSMS) and nutrition lead and director ofCulinary Medicine UK,an initiative devoted to educating medical students in the basics of nutrition.

She spoke at anEducational Conference on Food,Nutrition and Health, hosted by medical student society Nutritank, at the Royal Society of Medicine inLondon, on Saturday (March 7th),where delegates received a wealth of tips on the best ways to communicate nutrition advice to their patients.

Describing the problem to the conference room full of training doctors, nutritionists, dietitians and other health experts, she revealed the results of a 'Time for Nutrition' paper from theNeed for Nutrition Education Programme (NNEdPro), due to be published shortly in 'BMJ Nutrition, Prevention and Health' whichdescribes the opinions thatdoctors and medical students have about their nutrition training.

Co-authored by Dr Luke Buckner, the papertakes data from 840 doctors and medical studentsfrom Nutritank and NNedPro led projects and some data from Brighton Medical school andshows most participants agree that nutrition is important to health but more than 70% reported receiving less than two hours worth of training in nutrition.

Just 26% of doctors said they were confident in their nutrition knowledge and 74% gave nutrition advice less than once a month.

Macaninch'srole as nutrition medical educatoratBSMSis being developed as a case study that can be replicated in other medical schools.But herportfolio goes further still - She is also executive member ofNNEdPro and ispart of the UK Nutrition in Medical Education Review Board, which sits with the Association for Nutrition and is tasked with writing a nutrition curriculum to be implemented across the UK.

Speaking at the conference, she pointed out how difficult it currently is for doctors to give their patients nutrition advice, not just because they lack the training but because they are so time restricted.

As doctors, you have about 10 minutes to talk about everything from A-Z of every health problem your patient has in the world whereas a dietitian generally has 30 minutes per consultation just to discuss nutrition.

She added that she is hopeful for change because dietitians are now part of the GP contract meaning they can refer to dietitians directly.

"With this in place, dietitians hope to be able to help reduce hospital care and help doctors prescribe supplements and reduce demand on GP's."

However, the system requires a significant boost in the number of registered nutritionists and dietitians in order to make this opportunity an effective reality -WHO's 2017 figures show there are just 2.3 nutrition professionals per 100,000 population.

The problem is that GPs will often think the waiting list is so long, whats the point in bothering to refer a patient. We would request that GP's please continue to refer and perhaps even point out the need for more dietitians!

"Im looking forward to a future, I hope, where there is more access to dietitians within primary care."

Culinary Medicine, founded by NHS GP DrRupy Aujla,works to develop nutrition training within medical schools withinteractive sessions designed to make the education as relevant and practical as possible.

We ask students to cook a meal for case studies,"explains Macaninch."For example, a patient with a high risk of cardiovascular disease or type 2 diabetes, or someone with IBS."

The programme mostly teaches individual modules to qualified doctors on weekends using the facilities at Westminster Kingsway culinary school but has also taught intensive four week modules to Bristol University Medical students as part of their undergraduate training.

The team is also is working to create a completely online version of the course.

Also speaking at the event in London,Professor Sumantra Ray, medical doctor, registered nutritionist, and founding chair and executive director of the NNEdPro, discussed the importance of nutrition for reducing lifestyle-led diseases such as type 2 diabetes.

He said its imperative that anyone giving nutrition advice makes it as individual focused as possible.

You cant just make sweeping statements and start encouraging people to cut out things like whole grains and cereal fibre and a lot of other things that low-carb evangelismhas led to as then you start to cut out phytochemicals and fibre and so forth.

Its important not to treat the numbers but to treat the individual patient. The advice needs to be holistic - we cant address food alone.

"We know that when it comes to public health interventions that have gone a bit wrong that the low fat aim has often ended up in much higher sugar and carb content which is not helpful.

Individual level action is essential and education holds the key to that sort of action."

Elizabeth Thompson, holistic doctor for the National Centre for Integrative Medicine, added that nutrition impacts people emotionally, as well as physically.

"It's important to realise we have a bit of a crisis with emotional and mental wellness and we know food can support our mental processes in a real way.

"Tart cherry, for example, has been shown to raise levels of melatonin. So before we jump tozopiclone we should realise there are other things to try."

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Nutrition advice from the GP? "Medical students of today can be the agents of change" - NutraIngredients.com

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