tag:blogger.com,1999:blog-58268997248991341472024-03-13T03:35:20.056-04:00Publicly Speaking | AMA-MSS CGPHPublic Health highlights brought to you by the Committee on Global and Public Health, part of the Medical Student Section of the AMA.Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.comBlogger50125tag:blogger.com,1999:blog-5826899724899134147.post-83432459804019722062012-07-01T06:26:00.002-04:002012-07-01T06:26:41.286-04:00Free Cloud-Based EMRsI ran across this post by Paul Levy the other day:<blockquote class="tr_bq">
<br /><span style="color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20px; text-align: left;">"By the way, speaking of </span><a href="http://runningahospital.blogspot.com/2012/06/can-we-make-it-even-more-meaningful-and.html" style="color: #999999; font-family: Georgia, serif; font-size: 13px; line-height: 20px; text-align: left; text-decoration: none;">electronic medical records and meaningful use</a><span style="color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20px; text-align: left;">, we cannot fail to mention the upstart company </span><a href="http://www.practicefusion.com/?utm_medium=sem&utm_source=google&utm_campaign=GGCC00024A00089AD00320" style="color: #999999; font-family: Georgia, serif; font-size: 13px; line-height: 20px; text-align: left; text-decoration: none;">Practice Fusion</a><span style="color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20px; text-align: left;">. Focusing mainly on independent physician practices, Practice Fusion CEO's says, "We’re effectively the Salesforce for doctors, and the Facebook for health.” Doctors can sign up for free for an EMR that will meet the meaningful use criteria, making them eligible for the $44,000 in federal incentive payments. The service offers labs, e-prescribing, scheduling, charting, and billing. The revenue model is based on advertising by labs, pharmacies, and drug companies who want to be seen by these medical decisions-makers. The company promises that the basic EMR services will always be free, but I suspect that future revenue may also come from enhanced services."</span></blockquote>
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<a href="http://runningahospital.blogspot.com/2012/06/this-is-not-cold-fusion.html">http://runningahospital.blogspot.com/2012/06/this-is-not-cold-fusion.html</a></blockquote>
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What a thought that we now have fully functional and integrated EMRs hosted entirely in the cloud that are free for the end users (docs and clinics). Since it's cloud based, you also don't need to have servers to host data and don't need to worry about updates to a proprietary piece of software. </div>
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I wonder what a product like this will do for the free clinics and other small primary care practices in our country that previously may have been resistant to adopting electronic record systems because of prohibitive up front costs (of both time and money)!</div>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com1tag:blogger.com,1999:blog-5826899724899134147.post-7277480666327953912012-06-08T17:52:00.000-04:002012-06-08T17:52:01.993-04:00Unintended Consequences / Vaccination StrugglesSo it appears vaccination coverage isn't just a developed country problem and docs across the world are dealing with some of the exact same problems: <i>rumors swaying public opinion</i>.<br />
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Whether is is the (completely discredited) connection between MMR vaccines and Autism or now the connection that Pakistanis are making between polio vaccination campaigns and foreign spies, these stories are hurting those kids who are getting ill with preventable diseases.<br />
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Take a look at this CNN <a href="http://www.cnn.com/2012/06/06/world/asia/pakistan-polio-vaccination/index.html?eref=rss_health&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fcnn_health+%28RSS%3A+Health%29">article</a> for the whole story (video included). In a nutshell, the local media highly published a story that the US was (in part) able to gain access to the Bin Laden compound through a fake vaccination scheme and this has since engendered massive distrust of vaccination initiatives. Perhaps the greatest tragedy in this case is Pakistan is one of several countries where polio is still endemic, so failed vaccination campaigns mean kids will grow up paralyzed. Pretty heavy consequences indeed.Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-39428986480761306072012-05-02T11:41:00.000-04:002012-05-02T11:42:22.357-04:00April Newsletter<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">The April edition of our quarterly newsletter, Publicly Speaking, is out with some great ideas about how you can get involved internationally. If you would like any additional information from any of the authors let us know and we'll happily connect you! </span><br />
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<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Have a great week! </span><br />
<a href="http://www.scribd.com/doc/92098843/CGPH-Publicly-Speaking-April-2012-Newsletter" style="-x-system-font: none; display: block; font-family: Helvetica,Arial,Sans-serif; font-size-adjust: none; font-size: 14px; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal; margin: 12px auto 6px auto; text-decoration: underline;" title="View CGPH - Publicly Speaking (April 2012 Newsletter) on Scribd">CGPH - Publicly Speaking (April 2012 Newsletter)</a><iframe class="scribd_iframe_embed" data-aspect-ratio="1.5" data-auto-height="true" frameborder="0" height="600" id="doc_87756" scrolling="no" src="http://www.scribd.com/embeds/92098843/content?start_page=1&view_mode=list&access_key=key-wt6u1pimk4mwukipxgn" width="100%"></iframe>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-83332534185616988422012-04-30T23:23:00.003-04:002012-05-03T14:01:00.416-04:00Public Health Education Resource<span class="Apple-style-span" style="font-family: Tahoma; font-size: 13px;"></span><br />
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If you've been looking for a public health education resource the information below is a great place to start. Should you have any questions we'd happily put you in contact with the creators. Feel free to e-mail me at lauren.page.black@gmail.com should you wish to speak with them.<br />
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Have a great week!<br />
Lauren-Page<br />
AMA Committee on Global and Public Health </div>
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In response to an informal needs assessment administered by the Regional Medicine-Public Health Education Centers Initiative (an effort to better integrate public health content and skills into medical education supported by AAMC’s cooperative agreement with the Centers for Disease Control and Prevention), and the AAMC’s Organization of Student Representatives (OSR), we have developed a modular power point presentation that we hope will be a helpful resource for students and faculty at your institution.</div>
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These slides were developed for medical students and faculty. They provide an overview of the relationship between medicine and public health, review why public health is relevant to medical education and careers, and include recommendations and resources to improve public health content in medical education.</div>
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Users may select slides and incorporate them into their curricula, presentations, and other efforts to advocate for improving public health perspectives at their institutions.</div>
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The slides are divided into seven sections to facilitate their use:</div>
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•What is public health? What is the relationship between medicine and public health?</div>
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•What determines health?</div>
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•How is public health important to your training and careers?</div>
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•What do we know about student perspectives on public health in medical education?</div>
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•Enhancing public health in your curriculum and training</div>
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•Specializing in Public Health and Preventive Medicine</div>
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•Resources</div>
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•CDC Professional Student Programs and the Epidemic Intelligence Service</div>
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The slide-set can be accessed online at <a href="http://www.aamc.org/rmphec" target="_blank">www.aamc.org/rmphec</a> at the bottom of the right-hand column under Student Resources.</div>
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<br /></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-1308689459938960542012-04-13T00:19:00.001-04:002012-04-13T00:20:53.574-04:00There’s more to food culture than just restaurants<!--StartFragment--> <p class="MsoNormal" style="margin-bottom:16.0pt;mso-pagination:none;mso-layout-grid-align: none;text-autospace:none"><span style="mso-bidi-font-size:16.0pt;font-family: "Times New Roman"">Actor Wendell Pierce, best known for his roles on HBO’s “The Wire” and “Treme,” is now a proud business owner in his hometown of New Orleans. After opening a convenience store this winter, he and a local business partner plan to open a string of grocery stores beginning this summer. His aim is two-fold: to encourage economic growth in New Orleans and to bring nutritious and affordable food to a food desert. </span></p><p class="MsoNormal" style="margin-bottom:16.0pt;mso-pagination:none;mso-layout-grid-align: none;text-autospace:none"><span style="mso-bidi-font-size:16.0pt;font-family: "Times New Roman"">The lack of grocery stores in New Orleans is a problem made more prominent post-Katrina. The majority of the 21 supermarkets that do exist today are not close to the areas hardest hit. A 2007 survey from Tulane showed that although 58% of low-income residents do not have access to a car, 60% must travel a considerable distance (3 miles) to reach a grocery store. </span></p><p class="MsoNormal" style="margin-bottom:16.0pt;mso-pagination:none;mso-layout-grid-align: none;text-autospace:none"><span style="mso-bidi-font-size:16.0pt;font-family: "Times New Roman"">At first, Pierce intended to come back to New Orleans and just build houses but soon recognized that convenient access to healthy food was necessary for the successful revitalization of the neighborhood. “You start to realize all the parts of infrastructure that are needed,” he comments on his newfound awareness of the complex inter-connectedness of basic necessities.</span></p><p class="MsoNormal" style="margin-bottom:16.0pt;mso-pagination:none;mso-layout-grid-align: none;text-autospace:none"><span style="mso-bidi-font-size:16.0pt;font-family: "Times New Roman"">With the opening of Sterling Farms, his new full-service grocery store, Pierce hopes to revive the sense of community surrounding food that he says characterized much of his childhood. In addition to all the expected services of a grocery store, Sterling Farms will address the specific needs of this community by providing a free shuttle for shoppers and a monthly cookout to raise community funds. Since losing a bid to launch the stores in his own neighborhood of Pontchartrain Park, Pierce has looked elsewhere.<span style="mso-spacerun: yes"> </span>Sterling Farms will be located across the Mississippi in Marrero, LA, a neighborhood in which a quarter of households earn less than $25,000 a year.<span style="mso-spacerun: yes"> </span>In lieu of a fixed rent, he will pay 2% of sales that exceed $9 million yearly.</span></p><p class="MsoNormal" style="margin-bottom:16.0pt;mso-pagination:none;mso-layout-grid-align: none;text-autospace:none"><span style="mso-bidi-font-size:16.0pt;font-family: "Times New Roman"">Pierce acknowledges the parallels between the lessons he is learning and his personal frustrations with systemic malfunction and those depicted in “The Wire” and “Treme.” “It’s life imitating art, and art imitating life,” Mr. Pierce said.</span></p><p class="MsoNormal" style="margin-bottom:16.0pt;mso-pagination:none;mso-layout-grid-align: none;text-autospace:none"><span style="mso-bidi-font-size:16.0pt;font-family: "Times New Roman"">Check out the full New York Times article at: <span style="color:#0000CA">http://www.nytimes.com/2012/03/07/dining/wendell-pierce-to-open-a-grocery-store-in-new-orleans.html?hp</span></span></p> <p class="MsoNormal" style="margin-bottom:16.0pt;mso-pagination:none;mso-layout-grid-align: none;text-autospace:none"><span style="mso-bidi-font-size:16.0pt;font-family: "Times New Roman""> </span><span style="mso-bidi-font-size:16.0pt; font-family:Georgia;mso-bidi-font-family:Georgia"><o:p></o:p></span></p> <p class="MsoNormal"><span style="mso-bidi-font-size:16.0pt;font-family:"Times New Roman""> </span><span style="mso-bidi-font-size:15.0pt;font-family:"Times New Roman";mso-bidi-font-family: Georgia"><o:p></o:p></span></p> <!--EndFragment-->Mariamhttp://www.blogger.com/profile/16065979607755463199noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-89273917694206358322012-03-27T18:12:00.003-04:002012-03-27T18:17:52.826-04:00The Birth of a Movement<!--StartFragment--> <p class="MsoNormal">My love for Lady Gaga is no secret, but since the launch of her new “Born This Way Foundation,” I have even more reason to sing her praises.<span style="mso-spacerun: yes"> </span>Last month, Lady Gaga shared the stage of Sanders Theatre at Harvard with Oprah Winfrey to launch what she calls a movement to “challenge meanness and cruelty by inspiring young people.”<span style="mso-spacerun: yes"> </span>It is more than an anti-bullying campaign but a youth empowerment campaign that aims to change an entire culture.</p><p class="MsoNormal">The three pillars of her campaign are safety, skills, and opportunity.<span style="mso-spacerun: yes"> </span>She aims to create a culture in which every person feels safe, has the skills to stand up for one another, and uses the opportunities that arise to spread the message of tolerance.</p><p class="MsoNormal">Probably my favorite moment from the launch event was when Alyssa, a very brave young person who was a member of the opening panel, was asked to explain what she does at school.<span style="mso-spacerun: yes"> </span>She said, “I try to set an example...then the rest will follow.”<span style="mso-spacerun: yes"> </span>Telling stories of success will be an important part of what the foundation does.</p><p class="MsoNormal">There has been a lot of attention paid recently to cyber-bullying because of its visibility, but statistics show that the most common type of bullying is still face-to-face.<span style="mso-spacerun: yes"> </span>Incidentally, the foundation is partnering with Blue State Digital to use social media to spread the message of love and acceptance.</p><p class="MsoNormal">I applaud Lady Gaga’s efforts to reach out to experts, disseminate information, and begin interdisciplinary dialogues.<span style="mso-spacerun: yes"> </span>Her partners include the MacArthur Foundation and the Berkman Center for Internet and Society at Harvard.<span style="mso-spacerun: yes"> </span>Secretary of Health and Human Services Kathleen Sebelius, Deepak Chopra, and psychologist Susan Swearer all participated in her launch event.</p><p class="MsoNormal">This foundation intends to improve the health and well being of young people from the bottom up. Lady Gaga understands this will take time.<span style="mso-spacerun: yes"> </span>Tell a friend and spread the message!</p><p class="MsoNormal">Watch the <a href="http://bornthiswayfoundation.org/live">launch of the Born This Way Foundation </a>and read some notes from <a href="http://cyber.law.harvard.edu/node/7491">“The Kinder and Braver World Project”</a> from the Berkman Center.</p> <!--EndFragment-->Mariamhttp://www.blogger.com/profile/16065979607755463199noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-89702681773584752902012-03-11T20:34:00.003-04:002012-03-11T20:38:38.493-04:00The International Medical Brain Drain – Are we to blame?<!--StartFragment--> <p class="MsoNormal">I read an interesting New York Times article today addressing the shortage of doctors in the developing world.<span style="mso-spacerun: yes"> </span>There are some disturbing statistics: </p><p class="MsoNormal">- In the US, there is 1 doctor for every 416 people vs. 1 for every 23,000 in Zambia</p><p class="MsoNormal">- The median salary of a surgeon in New Jersey is $216,000 in New Jersey vs. $24,000 in Zambia</p><p class="MsoNormal">- One in 4 doctors in the US is trained overseas</p><p class="MsoNormal">Is America to blame for the shortage of doctors in sub-Saharan Africa? <span style="mso-spacerun: yes"> </span>There is a great demand in the US for doctors, especially primary care physicians: statistics project a shortage of 200,000 doctors in this country in 10 years.<span style="mso-spacerun: yes"> </span>With high salaries, innovative technology, and enticing immigration laws, the US attracts more foreign doctors every year than Britain, Canada, and Australia combined.<span style="mso-spacerun: yes"> </span>Some states have legislation that allows foreign doctors to stay in the US after residency if they would practice in underserved or rural communities here.<span style="mso-spacerun: yes"> </span>So far, more than 8,500 doctors have done so.<span style="mso-spacerun: yes"> </span>But what is a gain to one country is a loss to another.</p><p class="MsoNormal"><span style="mso-spacerun: yes">A 2008 article in the Lancet suggested that that the active recruitment of medical professionals from Africa be viewed as a human rights violation.<span style="mso-spacerun: yes"> </span>It described recruitment agencies that woo medical workers through advertisements, workshops, e-mails, and even text-messages.</span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">But for some doctors, it is the plain reality of practicing in their homeland that causes them to leave.<span style="mso-spacerun: yes"> </span>Dr. Kunj Desai, from Zambia, now a resident in surgery in New Jersey, described repeated instances of senseless death due to lack of resources. <span style="mso-spacerun: yes"> </span>“We were just pretending to be doctors,” he said of his time at University Teaching Hospital in Lusaka, Zambia.</span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">There is some international funding for training and retention of local doctors but Western aid agencies often hire local talent to do research, not see patients, contributing to an “internal brain drain.”</span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">The solution probably involves a combination of more high-quality training programs and hospital resources, higher salaries, and better working conditions for foreign physicians in the developing world.<span style="mso-spacerun: yes"> </span>What the US can do instead of recruit foreign physicians is to contribute to the existing infrastructure for the delivery of medical care in other countries.<span style="mso-spacerun: yes"> </span>On the issue of teaching, I am particularly interested in exchange programs for residents, which allow both parties valuable training experiences.</span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">Check out the full article at:</span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">http://www.nytimes.com/2012/03/11/magazine/america-is-stealing-foreign-doctors.html</span></span></span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-left:0in;mso-add-space:auto"><o:p> </o:p></p> <p class="MsoListParagraphCxSpMiddle" style="margin-left:0in;mso-add-space:auto"><span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span></p> <p class="MsoListParagraphCxSpLast"><o:p> </o:p></p> <!--EndFragment-->Mariamhttp://www.blogger.com/profile/16065979607755463199noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-15211377608693212652012-03-07T17:27:00.003-05:002012-03-07T17:27:57.093-05:00Public Health in a Military SettingFor anyone interested in the military system of delivering medical care and offering public health interventions, here is a link to a perspective piece in the NEJM this week:<br />
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<a href="http://www.nejm.org/doi/full/10.1056/NEJMp1112981?query=health-policy-and-reform">http://www.nejm.org/doi/full/10.1056/NEJMp1112981?query=health-policy-and-reform</a><br />
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It deals with issues of protecting the health and welfare of our soldiers while they are deployed. In fact, throughout history, many more casualties in war stem from disease and other public health concerns and do not come directly from combat itself. We're doing better these days, but a lot of the success hinges on whether or not soldiers are compliant with the interventions recommended. For example, as a consequence of not adhering with anti-malarial prophylaxis, a large section of a unit of marines needed to be evacuated to the states for treatment of ... malaria.<br />
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Take a moment and check out the article!Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-92076212027320533312012-02-28T22:22:00.007-05:002012-02-28T23:23:31.872-05:00Give and You Shall Receive: A Call for Organ Donors<!--StartFragment--> <p class="MsoNormal">Successful attempts to increase the number of organ donors have been elusive, confounded by ethical and religious questions and ambiguities.<span style="mso-spacerun: yes"> </span>In the US, we have the opt-in system: people can register at any time to be organ donors, but nearly 18 people die every day waiting on the transplant list.<span style="mso-spacerun: yes"> </span>Spain and Austria have the opt-out system: people are presumed organ-donors unless they (or family) say otherwise, but the number of donations doesn’t necessarily differ.<span style="mso-spacerun: yes"> </span>Is it time to try a new system?<span style="mso-spacerun: yes"> </span>If you are willing to donate your own organs, should you get priority to receive an organ?<span style="mso-spacerun: yes"> </span>A new law, to take effect in Israel in April, will do just that.<span style="mso-spacerun: yes"> </span></p><p class="MsoNormal"><span style="mso-spacerun: yes"></span><span style="mso-spacerun: yes">Patients who have organ donor cards or whose family members have donated an organ in the past will get priority for transplant over other patients who are at the same level of medical severity.<i style="mso-bidi-font-style: normal"><span style="mso-spacerun: yes"> </span></i>The law will provide for adequate compensation for the donor, including 40 days of lost wages and medical expenses paid.</span></p><p class="MsoNormal"><span style="mso-spacerun: yes">The hope is that this law will encourage more people to register as organ donors, and so far it has been effective.<span style="mso-spacerun: yes"> </span>After a massive 10-week advertising campaign targeting shopping malls, billboards, and newspapers, 70,000 people registered as donors.</span></p><p class="MsoNormal"><span style="mso-spacerun: yes">The law was created in careful coordination with rabbis and religious leaders, which should make it appealing to most Israelis.<span style="mso-spacerun: yes"> </span>What complicates matters is the orthodox interpretation of brain death and the Haredi rule against organ donation.<span style="mso-spacerun: yes"> </span>This puts an entire group at a disadvantage under this new system. <span style="mso-spacerun: yes"> </span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">Are systems that grant non-medical priority to some people on the transplant list inherently unjust?<span style="mso-spacerun: yes"> </span>Perhaps.<span style="mso-spacerun: yes"> </span>But I believe that the real injustice lies in systems where wealth buys an advantage and the poor are taken advantage of.<span style="mso-spacerun: yes"> </span>What I like about this new practice is that it paradoxically equalizes the playing field – money can’t buy you priority on the transplant list but altruism can, and we all have the capability for that.<span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">As a fourth year medical student, I did a transplant surgery rotation that taught me that the decisions we make about our organs after death often have effects greater than we had imagined.<span style="mso-spacerun: yes"> </span>I will never forget what a new liver meant for my patient, a 35-year-old mother of two.<span style="mso-spacerun: yes"> </span>She had become less alert and aware over the course of two weeks, dipping into the phases of inexplicable hemolytic crisis and encephalopathy that characterize hepatic decompensation.<span style="mso-spacerun: yes"> </span>We got the call about a donor on a Friday afternoon and by nighttime had successfully transplanted the liver in my patient.<span style="mso-spacerun: yes"> </span>The next morning, I went to visit her in the ICU.<span style="mso-spacerun: yes"> </span>She greeted me with the first coherent salutation I had heard from her in a long time.</span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">I never knew the name of the donor, just that she was in her 50s, in good health, and brain-dead.<span style="mso-spacerun: yes"> </span>What I do know is that her decision to be an organ donor turned a tragedy into an opportunity for new life for a perfect stranger.<span style="mso-spacerun: yes"> </span>She would deserve the same.<span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span></span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">Check out Dr. Ofri’s post on the NYT Well Blog:</span></span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">http://well.blogs.nytimes.com/2012/02/16/in-israel-a-new-approach-to-organ-donation/<span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span></span></span></span></span></p> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal"><o:p> </o:p></p> <!--EndFragment-->Mariamhttp://www.blogger.com/profile/16065979607755463199noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-46665776148191981822012-01-27T20:47:00.004-05:002012-01-27T21:02:20.420-05:00Romance, Revenge, and....Responsibility?<!--StartFragment--> <p class="MsoNormal">This can change people’s attitudes and behaviors.<span style="mso-spacerun: yes"> </span>It has even been described as “a real catalyst for social change.”<span style="mso-spacerun: yes"> </span>Nope, we’re not talking about politics or literature.<span style="mso-spacerun: yes"> </span>We’re talking about soap operas.<span style="mso-spacerun: yes"> </span>Yes, that cataclysmic romance between Felipe and Elena may actually be teaching you a thing or two about public health.<span style="mso-spacerun: yes"> </span>With a viewership in the millions and characters that people can relate to, soap operas are an excellent medium for delivering education and social messages.</p><p class="MsoNormal">According to an article in the New York Times, the first soap opera that intentionally attempted education was a 1969 Peruvian <i style="mso-bidi-font-style:normal">telenovela</i> called “Simplemente Maria,” in which a country girl moves to the city and learns to read and sew.<span style="mso-spacerun: yes"> </span>After Maria marries her literacy teacher, enrollment in literacy classes in Peru skyrocketed.<span style="mso-spacerun: yes"> </span>A similar pro-literacy <i style="mso-bidi-font-style:normal">telenovela</i> in Mexico called “Ven Conmigo” had comparable effects.</p><p class="MsoNormal">But can soap operas influence behaviors such as safe sex and family planning?<span style="mso-spacerun: yes"> </span>That seems to be the case.<span style="mso-spacerun: yes"> </span>Regular viewers of “Soul City” in South Africa are significantly more likely to use condoms during sex, and soap opera viewers in Brazil have lower fertility rates than their counterparts.<span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span></p><p class="MsoNormal"><span style="mso-spacerun: yes">The creators of socially conscious soap operas understand the importance of collaborating with local organizations to provide helplines and social services, and can even receive funding from the government or international donors (such as USAID) for their work.</span></p><p class="MsoNormal"><span style="mso-spacerun: yes">Read the article (and watch a clip from Kenya’s “Makutanu Junction”) at:<span style="mso-spacerun: yes"> </span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"></span><span style="mso-spacerun: yes">http://opinionator.blogs.nytimes.com/2012/01/26/steamy-plots-with-a-social-message/</span></span></p> <!--EndFragment-->Mariamhttp://www.blogger.com/profile/16065979607755463199noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-22331621995102423912012-01-24T16:02:00.000-05:002012-01-24T16:02:23.656-05:00Public Health Headlines<div class="tr_bq">
<a href="http://www.blogger.com/blogger.g?blogID=5826899724899134147" name="1350fc8d48149d42_S7" style="background-color: white; font-family: arial, sans-serif; font-size: 12px; line-height: 18px; text-decoration: none;"></a></div>
<br />A couple of public health headlines taken from the AMA Morning Rounds this week: <br /><br /><blockquote>
<b>US obesity rates may be leveling off.</b></blockquote>
<blockquote>
<b></b>New data indicating that US obesity rates have stabilized generated extensive news coverage, including segments on two national television networks, with many sources contrasting the high prevalence of obesity with the fact that rates are not climbing. NBC Nightly News (1/17, story 6, 2:45, Williams) reported, "in new numbers just out, the CDC finds about one in three American adults and one in six kids and teenagers in this country are heavy enough to be considered obese." The CBS Evening News (1/17, story 8, 0:20, Pelley) reported that "these are about the same levels as in 2003."<br /> The <a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012011801ama&r=4184730-8f07&l=006-eb7&t=c">AP</a> (1/18) reports that two "CDC reports summarize results of national health surveys in children and adults, which are conducted every two years." According to the AP, "The 2009-2010 reports involved nearly 6,000 adults and about 4,000 children, from infancy through age 19." The findings, divided into two reports (one on <a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012011801ama&r=4184730-8f07&l=007-18f&t=c">adults</a> and one on<a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012011801ama&r=4184730-8f07&l=008-6bb&t=c">children and adolescents</a> ) "were released online in the Journal of the American Medical Association."<br /><a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012011801ama&r=4184730-8f07&l=009-266&t=c">USA Today</a> (1/18, Hellmich) reports in "Your Life" that, according to the data, "The average body mass index (BMI) of men rose to 28.7 in 2010 up from 27.7 in 2000," while "the average BMI" of women "remained unchanged at about 28.5."<br /><br /><b>Only 25% of kids use sunscreen regularly.</b></blockquote>
<blockquote>
The <a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012012401ama&r=4184730-4d30&l=02c-a2b&t=c">Los Angeles Times</a> (1/24, Roan) "Booster Shots" blog reports that "kids are really bad about using sunscreen consistently," according to a <a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012012401ama&r=4184730-4d30&l=02d-430&t=c">study</a> published Jan. 23 online in Pediatrics. "Researchers studied fifth-grade children in Massachusetts in 2004 and then re-surveyed the same 360 children three years later. In the first survey, more than half of the kids said they had experienced at least one sunburn, and this rate did not change three years later."<br /> "Despite numerous efforts to encourage people to wear sunscreen, a new study shows only 1 in 4 children regularly uses sunscreen," <a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012012401ama&r=4184730-4d30&l=02e-f83&t=c">WebMD</a> (1/24, Warner) reports. "The results showed that half of the children reported routinely wearing sunscreen in 2004, but only 25% did so in 2007." The article adds, "Researchers say the results show that the time between ages 11 and 14 is a critical time in developing attitudes about tanning and wearing sunscreen, especially among girls."<br /><a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012012401ama&r=4184730-4d30&l=02f-698&t=c">ABC News</a> (1/24, Carollo) points out, "Most of the study participants said they liked the appearance of a tan, and the number of children who said they spent time in the sun to get a tan increased over the three-year period." Lead author Stephen Dusza, said, "At the same time, there was a signficant reduction in reported sunscreen use." Notably, "Dusza and dermatologists not involved in the research said the findings highlight the importance of finding effective ways to educate children of this impressionable age group about sun safety and the potential dangers of excessive exposure to ultraviolet light."<br /></blockquote>
<span style="background-color: white; color: #222222; font-family: arial, sans-serif; font-size: 12px; line-height: 18px;"></span>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-84032874944140448352012-01-17T11:00:00.001-05:002012-01-17T11:10:07.644-05:00Let's pay more attention...<span style="font-family: inherit;">Once again, saw an interesting public health headline in the <i>AMA Morning Rounds</i> email this morning.</span><br />
<div>
<span style="font-family: inherit;"><br /></span></div>
<div>
<b><span style="font-family: inherit;">"Report notes increase in accidents of people wearing headphones while walking"</span></b></div>
<div>
<b><span style="font-family: inherit;"><br /></span></b></div>
<div>
<span style="font-family: inherit;">A slightly closer read sheds a little more light on what they're looking at. This was a retrospective study of accidents over a 7 year period. The accidents mentioned weren't simply stepping wrong off a side-walk or walking into a light-post.... we're dealing with people getting hit and killed by trains and the like!</span></div>
<div>
<span style="font-family: inherit;"><br /></span></div>
<div>
<span style="font-family: inherit;">In something along the lines of 30% of the cases, a warning sound was present before the victim was hit, but they did not respond (presumably because the music / sound from the headphones drowned out the warning sound).</span></div>
<div>
<span style="font-family: inherit;"><br /></span></div>
<div>
<span style="font-family: inherit;">This sure says a lot for a simpler and more attentive approach to life -- perhaps we don't <i>always</i> need to be plugged into our electronics (especially when around trains and fast moving cars).</span></div>
<div>
<span style="font-family: inherit;"><br /></span></div>
<div>
<span style="font-family: inherit;">For more info: The <u style="background-color: white; color: #222222; line-height: 18px;"><a href="http://abcnews.go.com/watch/world-news-with-diane-sawyer/SH5585921/VD55163493/world-news-116-cruise-ship-disaster-how-could-it-happen">ABC World News</a></u><span style="background-color: white; color: #222222; line-height: 18px;"> spot (16:42 into full broadcast from 1/16), an article in </span><a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012011701ama&r=4184730-79e9&l=020-10e&t=c" style="background-color: white; color: #0e4d96; line-height: 18px;" target="_blank"><u>HealthDay</u></a><span style="background-color: white; color: #222222; line-height: 18px;"> , the </span><a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012011701ama&r=4184730-79e9&l=021-24b&t=c" style="background-color: white; color: #0e4d96; line-height: 18px;" target="_blank"><u>study</u></a><span style="background-color: white; color: #222222; line-height: 18px;"> itself, and another article in </span><u style="background-color: white; line-height: 18px;"><a href="http://mailview.bulletinhealthcare.com/mailview.aspx?m=2012011701ama&r=4184730-79e9&l=022-5e7&t=c" style="background-color: white; color: #0e4d96; line-height: 18px;" target="_blank">MedPage Today</a><span style="color: #222222;">.</span></u></span></div>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-69237253510149763692012-01-09T11:52:00.000-05:002012-01-09T11:52:20.045-05:00Joint Commission Sentinel Event Alert -- SleepinessThe Joint Commission published a short article last month on sleep deprivation and it's effects on patient (and provider) safety. There are a lot of issues at play here and changing the culture of how we learn and practice medicine isn't quite as simple as saying, "Let's work fewer hours." Though to guide our discussions, it is useful to understand what has been presented in the literature.<br />
<br />
A selection (quoting from the <a href="http://www.jointcommission.org/assets/1/18/SEA_48.pdf">Joint Commission article</a> -- full sources can be found in the article) from a 2007 article in the Joint Commission Journal on Quality and Patient Safety:<br />
<br />
<blockquote class="tr_bq">
"The article reports that residents who work traditional schedules with recurrent 24-hour shifts:</blockquote>
<blockquote>
- make 36% more serious preventable adverse events than individuals who work no more than 16 consecutive hours<br />- make 5 times as many serious diagnostic errors<br />- have twice as many on-the-job attentional failures at night<br />- experience 61 % more needlestick and other sharp injuries after their 20th consecutive hour of work<br />- experience a 1.5 to 2 standard deviation deterioration in performance relative to baseline rested performance on both clinical and non-clinical tasks<br />- report making 300% more fatigue related preventable adverse events that led to a patient’s death"</blockquote>
<br />
<br />
Lockley SW, et al: Effects of health care provider work hours and sleep deprivation on safety and performance. The Joint Commission Journal on Quality and Patient Safety, November 2007;33(11)7-18, <a href="http://www.jointcommission.org/JQPS_11_07/">http://www.jointcommission.org/JQPS_11_07/</a><br />Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-52462341837293703042012-01-02T14:27:00.001-05:002012-01-02T14:31:09.919-05:00The 90%<!--StartFragment--> <p class="MsoNormal">While vacationing in New York last week, I visited an incredible exhibit at the United Nations visitor’s lobby showcasing innovative solutions to problems facing the world’s urban poor: safety, clean water, the spread of disease, and transportation.</p><p class="MsoNormal">The exhibit, called “Design With the Other 90 Percent: Cities,” focuses on the nearly one billion people (the 90%) living in informal settlements throughout the world.<span style="mso-spacerun: yes"> </span>The recurrent themes of the exhibit were incremental design, the use of cheap and local materials for construction, and efficient use of waste.<span style="mso-spacerun: yes"> </span></p><p class="MsoNormal"><span style="mso-spacerun: yes">The concept of incremental design was applied to everything from bicycles to buildings.<span style="mso-spacerun: yes"> </span>There was a bicycle that could be re-assembled to make a cart.<span style="mso-spacerun: yes"> </span>In Chile, architects designed basic houses (including bathrooms and kitchens) that could then be modified and tailored to the needs of future residents by those residents.</span></p><p class="MsoNormal"><span style="mso-spacerun: yes">In Paraguay, loofah panels were used to build walls and elsewhere, sandbags were utilized for insulation.<span style="mso-spacerun: yes"> </span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">There is a “biolatrine” in Kenya that converts human waste to fertilizer and gas for cooking and heating, a communal oven, also in Kenya, that uses trash as fuel, and various systems for recycling and water purification.<span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">On the medicine front, there are public health campaigns waged through text message, HIV self-testing kits with instructions in both pictures and words, and “medikits” that include low-cost medical devices made from locally available inexpensive parts.<span style="mso-spacerun: yes"> </span></span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">Some of the coolest work in my opinion is the drawing of informal settlement maps that identify locations for water and sanitation in addition to schools and clinics.<span style="mso-spacerun: yes"> </span>These maps function both as a medium for sharing information between residents and a way to identify priorities for change in the community.<span style="mso-spacerun: yes"> </span>It goes to show that data collection is an important first step in community improvement projects.<span style="mso-spacerun: yes"> </span><span style="mso-spacerun: yes"> </span></span></span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">These projects were collaborations between NGOs, architects, engineers, community members, and sometimes local governments too.<span style="mso-spacerun: yes"> </span></span></span></span></span></span></p><p class="MsoNormal"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes"><span style="mso-spacerun: yes">Overall, it was a thoughtful and creative portrayal of ideas for sustainable change.<span style="mso-spacerun: yes"> </span>The exhibit ends on January 9<sup>th</sup>.<span style="mso-spacerun: yes"> </span>Check it out if you’re in the area!</span></span></span></span></span></span></p> <p class="MsoNormal"><o:p> </o:p></p> <!--EndFragment-->Mariamhttp://www.blogger.com/profile/16065979607755463199noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-8125233541154690722011-12-28T18:36:00.001-05:002011-12-28T18:36:45.453-05:00Article: W.H.O. Reports 25 Percent Drop in Malaria Deaths in a Decade - NYTimes.com<div></div><div>Coordinated efforts through the WHO over the past year have dropped deaths from malaria by 25% according to a recent NY Times article. </div><div><br></div><div>Issues we're still dealing with: the 600,000+ deaths annually from malaria, a disease that rapidly develops resistance (especially to mono-drug therapy), and continued set-backs related to funding shortages and political instability. None of these are particularly new challenges in combating this disease or others.</div><div><br></div><div>Read the whole article at the link below:<b><br></b></div><div><strong><br></strong></div><div><strong>W.H.O. Reports 25 Percent Drop in Malaria Deaths in a Decade - <a href="http://NYTimes.com">NYTimes.com</a></strong><br><a href="http://www.nytimes.com/2011/12/27/health/who-reports-25-percent-drop-in-malaria-deaths-in-a-decade.html?_r=1&partner=rss&emc=rss">http://www.nytimes.com/2011/12/27/health/who-reports-25-percent-drop-in-malaria-deaths-in-a-decade.html?_r=1&partner=rss&emc=rss</a><br><br>(Sent from <a href="http://flipboard.com">Flipboard</a>)</div><div><br></div>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-48888483402257638092011-12-19T13:37:00.001-05:002011-12-20T08:57:14.076-05:00Selected Public Health Headlines-A new method of sterilizing hospital rooms using pulses of UV light was recently studied at a MA hospital and showed promising results : <a href="http://runningahospital.blogspot.com/2011/12/cooley-dickinson-kos-c-diff.html?m=1">http://runningahospital.blogspot.com/2011/12/cooley-dickinson-kos-c-diff.html?m=1</a><br> <br><br>- An article in the NY Times reported obesity rates on city schoolchildren are down 5.5% over 5 years. <a href="http://www.nytimes.com/schoolbook/2011/12/15/obesity-in-new-york-children-on-the-decline-officials-say/">http://www.nytimes.com/schoolbook/2011/12/15/obesity-in-new-york-children-on-the-decline-officials-say/</a><br> <br>- The CDC recently issued a report on sexual violence in US bsed on a survey of over 16000 adults. 1/4 American women report a violent attack by a husband or boyfriend. 1/5 have been sexually assaulted (rape, attempted rape). 1/6 have been stalked. Compare this to 1/71 males reporting being raped. For women, 30% of those raped experience their first trauma berween 11 and 17 years of age; 12 % before 10 years of age. The full report can be found here: <a href="http://www.cdc.gov/ViolencePrevention/pdf/NISVS_Report2010-a.pdf">http://www.cdc.gov/ViolencePrevention/pdf/NISVS_Report2010-a.pdf</a> ( the report is exhaustive; the executive summary is brief)<br> <br><br>- Adolescents are using more marijuana and less alcohol and cigarettes. A government report claims 1/15 high-schoolers use marijuana on a daily basis. <a href="http://drugabuse.gov/newsroom/11/mtf11overview.html">http://drugabuse.gov/newsroom/11/mtf11overview.html</a>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-57888694206059443362011-12-08T15:30:00.000-05:002011-12-08T15:30:10.002-05:00Publicly Speaking - Dec 2011 Newsletter<a href="http://www.scribd.com/doc/75149670/CGPH-Publicly-Speaking-Dec-2011-Newsletter" style="-x-system-font: none; display: block; font-family: Helvetica,Arial,Sans-serif; font-size-adjust: none; font-size: 14px; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal; margin: 12px auto 6px auto; text-decoration: underline;" title="View CGPH - Publicly Speaking (Dec 2011 Newsletter) on Scribd">CGPH - Publicly Speaking (Dec 2011 Newsletter)</a><iframe class="scribd_iframe_embed" data-aspect-ratio="0.772727272727273" data-auto-height="true" frameborder="0" height="600" id="doc_32166" scrolling="no" src="http://www.scribd.com/embeds/75149670/content?start_page=1&view_mode=list&access_key=key-1xdilwmr2dsr0xxphjst" width="100%"></iframe><script type="text/javascript">
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</script>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-55025274816065636992011-12-08T15:15:00.000-05:002011-12-08T15:55:37.354-05:00Global Health Scholarship Opportunities<div style="text-align: center;">
<b>Child Family Health International (CFHI) GLOBAL HEALTH PROGRAMS</b></div>
<b><div style="text-align: center;">
<b>2012 SUMMER SCHOLARSHIPS NOW AVAILABLE, 2013 DATES OPEN</b></div>
</b><br /><b>CFHI GLOBAL HEALTH SCHOLARSHIPS</b><br /><br />Never done before, CFHI is offering scholarships for summer programs, our busiest time of the year. These four (4) partial scholarships in the amount of US $1,000 may be awarded towards participation in any May & June 2012 <a href="http://www.cfhi.org/web/index.php/program/viewall">CFHI Global Health Education Program</a>. <br /><br />- One scholarship will be designated for CFHI's <a href="http://www.cfhi.org/web/index.php/program/show/id/304">Opthalmology Rotation in New Delhi, India</a><br />- One designated for CFHI's <a href="http://www.cfhi.org/web/index.php/program/show/id/315">Dental Program in Quito, Ecuador</a>. <br /><br />All interested in global health are encouraged to apply. Deadline January 16th , 2012. For more details see CFHI's <a href="http://www.cfhi.org/web/index.php/xcms/showpage/page/Scholarships">Scholarship Page</a>.<br /><br /><b>2013 PROGRAM DATES NOW OPEN</b><br /><br />2013 program dates are now open and CHFI is now accepting 2012 and 2013 applications on a rolling basis. CFHI continues to offer <a href="http://www.cfhi.org/web/index.php/xcms/showpage/page/Academic_Credit_for_CFHI_programs_NA">academic credit</a> and fundraising assistance. For more details on any of CFHI’s <a href="http://www.cfhi.org/web/index.php/program/viewall">20+ programs</a>, visit the <a href="http://www.cfhi.org/">website</a> or <a href="http://www.cfhi.org/web/index.php/home/contact">contact them</a>.<br /><br /><b>CFHI - Socially Responsible Global Health Education Programs</b><br /><br />Child Family Health International (CFHI) is a nonprofit that offers socially responsible Global Health Education Programs for health sciences students of all levels. Through CFHI participants go on 4-16 week placements alongside local physicians in underserved communities. Participants rotate through clinics and hospitals, attend medical lectures, and become immersed in the healthcare system of the community.<br /><br /><div>
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CFHI is an NGO in Special Consultative Status with the ECOSOC of the United Nations</div>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-59934110240519157822011-12-06T09:37:00.000-05:002011-12-06T09:37:05.002-05:00A Lesson in Estimating PrevalenceEstimations of the prevalence of behaviors do not necessarily match with reality.<br />
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Prevalence itself is the total number of cases divided by the number of people at risk for being cases (<a href="http://en.wikipedia.org/wiki/Prevalence">Wiki</a>). If you're calculating from measured numbers, this is easy. If you're dealing with perceptions -- not so much. <br />
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In particular, it is very easy to over-estimate the prevalence of a behavior or a disease that seems particularly dramatic. Taken one way -- if you see a disease in medical school, you're less likely to think of it as rare (...there are at least enough cases out there that <i>you</i> were able to see it). Taken another way -- when you were in high school, it probably seemed like <i>everyone</i> was having sex. <br />
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The American Academy of Pediatrics published a study on the <i><a href="http://pediatrics.aappublications.org/content/early/2011/11/30/peds.2011-1730.abstract">Prevalence and Characteristics of Youth Sexting </a> </i>this week that found the prevalence of sending sexually explicit texts was as low as 1.0% (much lower than previous studies reporting the level somewhere north of 10%).Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-38179135692836245582011-12-02T16:56:00.001-05:002011-12-02T16:56:36.093-05:00U.S. medical 'trash' saving lives abroad<div></div><div><font class="Apple-style-span" color="#444444">I'd like to point you towards an article from CNN yesterday dealing with the redistribution of unused medical supplies towards developing countries. While the language is perhaps a bit inflammatory (our trash becomes their treasure), our MSS has discussed this issue at several recent meetings.</font></div><div><span class="Apple-style-span" style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.292969); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); "><br></span></div><div><span class="Apple-style-span" style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.292969); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); ">Chief among concerns from our section is the thought that folks abroad might be getting second rate medical care by using expired supplies. In some cases (drugs that expire and may become dangerous or ineffective), this is clearly an ethical issue. In many others (equipment that can be re-sterilized or used without concern of degradation), this is a great way to redistribute unused supplies to the benefit of the poor.</span></div><div><span class="Apple-style-span" style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.292969); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); "><br></span></div><div><span class="Apple-style-span" style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.292969); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);">Take a look at the article and see some examples how this is taking place and helping deliver care in the real world.</span></div><div><span class="Apple-style-span" style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.292969); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);"><br></span></div><div><span class="Apple-style-span" style="-webkit-tap-highlight-color: rgba(26, 26, 26, 0.292969); -webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469);"><br></span></div><div><div class="article"> <div class="header"> <b>U.S. medical 'trash' saving lives abroad</b> </div> <div class="source"> Published on <a href="http://rss.cnn.com/~r/rss/cnn_health/~3/JX9hyGTfsQg/index.html">CNN.com - Health</a> | shared via <a href="http://www.feedly.com">feedly mobile</a> </div> <div> Third World hospitals are saving lives with medical materials discarded in the U.S.<div> </div> </div> <br> </div> <div class="footer"><br></div></div>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-38120992999391667452011-11-23T08:56:00.004-05:002011-11-23T09:05:25.904-05:00Boosting Adherence to Antiretrovirals / UN AIDS reports AIDS epidemic may be reaching plateauI already had HIV on the mind yesterday when I saw this news brief from the AMA (below). I had the privilege to hear a professor from Tufts speak about strategies to monitor and encourage adherence to antiretroviral therapy. There was an old thought that perhaps we shouldn't offer antiretrovirals to Africa because folks in resource limited settings wouldn't be able to adequately adhere to the regimen and would breed resistance. That's a scary proposition!</p><br />
Well, the data flips that perspective upside down. Turns out, adherence studies in a half dozen or so cities in the US (think NYC, San Francisco, Hartford, and others) show Americans only reach 50-70% adherence rates while our counterparts in Africa frequently surpass 95%. Turns out they harness their social capital much more effectively and it boosts adherence. Imagine asking a friend or neighbor for money so you can get lifesaving drugs (or even so you could get the transportation needed to pick them up). To maintain the relationship, you're going to make darn sure you take those medications.</p><br />
What about the issue of taking meds at the same time when you don't have a clock? You'd be amazed how creative folks can be - one gentleman had nearly perfect compliance over the course of a month (he timed his meds to a radio news broadcast at 7am and 7pm daily). He struggled a bit the next month, but that was because he fell in love and donated some pills to his HIV positive girlfriend who was running short on medications. So what turned out to be the best estimate of adherence? It was data from the pharmacy regarding prescription refills, this estimates the maximum possible adherence (and would miss the case of a patient sharing meds with others), but lined up very nicely with actual viral suppression rates.</p><br />
In other news, this article below was published as part of the AMA Morning Rounds.</p><blockquote>UN AIDS report suggests AIDS epidemic has plateaued. The New York Times (11/22, D5, McNeil, Subscription Publication) reports, "The world's AIDS epidemic has hit a plateau, with 2.7 million people becoming newly infected each year for the last five years, according to the annual report (pdf) released Monday by UNAIDS, the United Nations agency fighting the disease." The report also notes that "last year, 1.35 million got on treatment for the first time, meaning 200 people were newly infected for each 100 newly treated," compared with "two years ago, when 250 were infected for each 100 treated." However, "donor funds dropped about 10 percent last year as the worldwide economic crisis made some countries cut their donations." The report also compares a number of countries, pointing out that a large number of new cases are driven by "drug addicts, who are notoriously hard to reach, and also by groups like gay men and prostitutes who in conservative societies...have furtive, rapid sex -- a high-risk behavior." </p> The Washington Post (11/22, Brown) reports, "The biggest advances have occurred in sub-Saharan Africa, where a massive rollout of antiretroviral drugs, increasing acceptance of circumcision and changes in sexual behavior are driving new cases of infection to the lowest number in years." In contrast, "the big exception to the global trend is in the countries of the former Soviet Union and Central Asia, where there has been a 250 percent increase in people with HIV from 2001 to 2010. </p> Bloomberg News (11/22, Bennett) details, "A failure in Russia to implement harm-reduction programs such as offering drug users clean needles, or switching them to methadone tablets from heroin injections, is fueling the spread of the virus, said Paul De Lay, the deputy executive director of the Geneva-based agency." De Lay added that "five years ago they were really starting to see a turnaround," but now the progress has "pretty much fallen apart" and UNAIDS is pushing "for the surrounding countries not to follow the Russian Federation model." </p> The AP (11/22) reports that while "UNAIDS says it is working toward zero new HIV infections, zero discrimination and zero AIDS-related deaths," critics contend "that the body's aim of wiping out the disease is overly optimistic...considering there is no vaccine, millions remain untreated and donations have slumped amid the economic crisis." </p> CQ (11/22, Bristol, Subscription Publication) notes, "New infections reduced by 21 percent since they topped out in 1997. Deaths, which peaked in 2005, had also fallen by 21 percent by the end of last year. ... The report attributed progress in reducing the disease to changes in sexual behavior, especially among younger people who are reducing their number of sexual partners and using condoms more." The UK's Telegraph (11/22) reports, "A significant expansion in access to treatment helped slash the number of Aids-related deaths in 2010, bringing the number of people living with HIV to a record 34 million," according to the United Nations. Also covering the story are Reuters (11/22, Kelland) and BBC News (11/22)"<blockquote><blockquote></blockquote></blockquote></blockquote>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-71262121269972864422011-11-19T23:08:00.003-05:002011-11-19T23:32:24.753-05:00All I need is a little help from my friends...<!--StartFragment--> <p class="MsoNormal">Although my roommate has thus far been unable to convince me to join her at bikram yoga, a couple of news items this week attest to the powers of peer pressure in changing one’s lifestyle.</p><p class="MsoNormal">The first is a study out of Stanford about the families of patients who underwent gastric bypass surgery.<span style="mso-spacerun: yes"> </span>The investigators found that obese <i style="mso-bidi-font-style: normal">family members</i> of bariatric patients lost an average of 3% of their total weight in the first year following the surgery – this is equivalent to the amount of weight loss achieved on the average diet plan such as the Atkins diet.<span style="mso-spacerun: yes"> </span>So although the family member wasn’t officially on the post-op bariatric diet, it is as if they were. </p><p class="MsoNormal">The second is a program called the “Daniel Plan” created by Rick Warren (best known for “The Purpose Driven Life”) at his church in California.<span style="mso-spacerun: yes"> </span>Warren has used what he calls “the healing power of the group” to motivate members of his church to lose weight; he effectively utilizes the existing foundation of church small groups not only for spiritual growth but also physical betterment.<span style="mso-spacerun: yes"> </span>The first point of his six-point program is to “connect” or create partnerships that foster positive change.<span style="mso-spacerun: yes"> </span>Fourteen thousand people signed up and 72% lost weight.<span style="mso-spacerun: yes"> </span>A survey found that participants lost nearly 7 more pounds following the plan in a group than they following the plan on their own.</p><p class="MsoNormal"><span style="mso-spacerun: yes">Both of the above examples involve groups – either natural or constructed.<span style="mso-spacerun: yes"> </span>What is fascinating about the Stanford study is that the weight loss was unintentional – it was purely a product of environment.<span style="mso-spacerun: yes"> </span>The other interesting thing is that there is really nothing inherently special about either diet plan.<span style="mso-spacerun: yes"> </span>What is amazing is the difference the support of a group makes in adhering to that plan.<span style="mso-spacerun: yes"> </span>Not surprisingly, this has great implications for global and public health.<span style="mso-spacerun: yes"> </span>It is one of the reasons why Alcoholics Anonymous and Partners in Health have been so successful.</span></p><p class="MsoNormal"><span style="mso-spacerun: yes">Message to my roommate: if exercise is anything like nutrition, the stats are on your side!<span style="mso-spacerun: yes"> </span>Eventually, I may succumb to your good example.</span></p><p class="MsoNormal"><span style="mso-spacerun: yes">(Arch. Surg. 2011;146:1185-90)</span></p> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal"><o:p> </o:p></p> <!--EndFragment-->Mariamhttp://www.blogger.com/profile/16065979607755463199noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-65019456561203168282011-11-02T18:25:00.005-04:002011-11-02T18:31:04.664-04:00Practicing what we preach: Hospital Cafeterias<span class="Apple-style-span" style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">It's relatively common knowledge in the medical field and to many people that poor diet and physical inactivity is a leading "actual" cause of death. It is quickly catching up to tobacco and may soon overtake it to become </span><i style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">the </i><span class="Apple-style-span" style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">leading cause of death in America; no question, a leading public health threat. </span><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); "><br /></div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">So it may seem ironic when a cafeteria at a health care institution actively promotes a leading cause of death. While many institutions have taken the steps to a smoke free campus, saturated fat filled cheese pizza, fries, hamburgers, hot dogs, and macaroni and cheese still seems to be the rule, not the exception. </div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); "><br /></div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">How would we feel if a hospital not only <i>allowed</i> tobacco on campus, but sold cigarrettes from vending machines? From a public health standpoint, these practices are equally harmful.<br /><br />The cynical side of me recognizes that other than institutional philosophy, there has been little financial incentive for a hospital cafeteria to provide healthful food (and perhaps even has some incentive to keep their vascular surgeons and cardiac cath lab busy!). This may change if the new payment system under discussion, Accountable Care Organizations becomes the norm where the hospital or provider group stands to save money by promoting a healthy patient population. </div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); "><br /></div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">So far, it is the rare hospital that has made health a priority. <a href="http://www.annarbor.com/news/st-joseph-ann-arbor-opens-new-health-conscious-cafeteria-wednesday/" style="color: rgb(0, 0, 153) !important; text-decoration: none; ">St Joseph Mercy Ann Arbor</a> is one of those, employing a chef from Google and investing $1million to remodel their cafeteria in the name of health; reducing portion sizes, color coding options to help indicate nutritional value, and saying goodbye to their deep fryer. </div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); "><br /></div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">By popular request, <a href="http://www.woofood.org/" style="color: rgb(0, 0, 153) !important; text-decoration: none; ">WooFood</a> is actively working with the Cafeteria at UMass Memorial to promote change that will at least encourage healthful options. (Disclaimer; the author of this post is a founding member of WooFood). The need has been recognized by many people including the CEO of UMass Memorial who has stated that the healthcare community needs to practice what it preaches when it comes to healthful options.</div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); "><br /></div><div style="color: rgb(98, 98, 98); font-family: 'Trebuchet MS'; font-size: 13px; line-height: 22px; background-color: rgb(255, 255, 255); ">What are your thoughts on hospital cafeteria food? How is the food at <i>your </i>school's or hospital's cafeteria? Does a hospital cafeteria have a responsibility to serve healthful foods because it is a healthcare institution?</div>Mitchhttp://www.blogger.com/profile/09163698910466488144noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-761630875838789262011-10-27T08:26:00.001-04:002011-10-27T08:26:17.534-04:00Food for Thought - Comments on a Pediatrician's Reaction to the Haitian Earthquake<div style="font-family: inherit;">
Last week, I had a chance to hear a pediatrician from Massachusetts (Dr. Dennis Rosen from Children's) talk about his experiences in Haiti in the months following the earthquake. Many of the experiences he described demonstrated the incredible ingenuity required to practice in such a resource poor and devastated setting. He told stories through pictures and the pictures spoke volumes about the condition health care in the country, both before and after the disaster.</div>
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When they could not find an incubator for preterm baby, one was fashioned from a cardboard box and a desk lamp. The baby in a box lived in soon they did this for many more. They saw many children who were malnourished and didn't quite know what to do. This was a condition the Haitian doctors and residents took great pride in knowing how to treat: " This we do very well." <br /><br />Taking a photographic tour through the pediatric wards in Haiti - the small tents crammed with patients, parents sleeping underneath their children's cribs in streams of water flowing through the tents, parents taking children home with defects like omphaloceles - one found it difficult to not what to render assistance. Stepping past the urges to offer assistance perhaps the most important lessons of the night were lessons of perspective. There were numerous doctors in the audience who commented on a Haitian health care system that was largely in a similar condition when they visited 30 or 40 years ago. Certainly the economy was no better at that time. We discussed some of the disorganization that ensues when aid pours in from many sources. When aid is given without regard to the specific needs on the ground, there tends to be a mismatch between what supplies are given and what is actually required. <br /><br /><br />The take home? ... Perhaps aid is best rendered through established and organized groups instead of individual donations or traveling as part of a small contingent.</div>
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He reminded us of the Chinese proverb:</div>
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"Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime."</div>
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In some ways, rendering aid after the disaster works a bit like this. There's an immediate need we need to help out with, but for a lasting change, aid needs to be delivered in a sustainable way that seeks to build up the infrastructure and the economy of the country in need. <br />
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<br /></div>Andrewhttp://www.blogger.com/profile/16492809570931499998noreply@blogger.com0tag:blogger.com,1999:blog-5826899724899134147.post-41082601025130224862011-10-25T18:52:00.002-04:002011-10-25T18:57:18.368-04:00Deadline for Photo Submission this Saturday!The Committee on Global and Public Health is preparing a photographic newsletter featuring the public health and global health initiatives of medical students at various medical schools throughout the country. If you have photographs of members of your Chapter engaging in a global or community health project, working at a free clinic, teaching at a local school, etc. please send them <span style="font-weight: bold;">along with a brief caption</span> to Lauren.page.black@gmail.com <span style="font-weight: bold;">by Saturday October 29th</span>. Please note that in addition to this newsletter these photos may be used in other CGPH publications and programs.<br /><br />Thanks,<br />Lauren Page Black<br />Vice-Chair, Committee on Global and Public HealthUnknownnoreply@blogger.com0