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Reflection and compassion go hand-in-hand

Kimberly Manning, MD, Lisa Bernstein, MD, and William Branch, MD, leading the way

Kimberly Manning, MD, an internist at Grady Memorial Hospital who directs Emory’s Transitional Year Residency Program, asks her residents to write about an experience – good or bad – that made a lasting impression on them.

Manning herself regularly writes about her experiences as a doctor. She calls it “habitual reflection” and believes that the practice is vital to developing good doctors. She regularly asks herself about interactions with patients and imagines herself in their place. What was the patient feeling? How would I feel in the same situation? Did the patient process everything I said?

These are the kinds of questions she wants medical students and residents to ask themselves regularly. By examining experiences that were rewarding, saddening or even frustrating, they can become better doctors, she says in the new issue of Emory Medicine magazine.

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Hong Kong is Bright Spot of Tobacco Control in China

Jeffrey Koplan, MD, MPH

A remarkably successful 20-year program of tobacco control in Hong Kong can serve as a best-practices example for China and other nations, says Jeffrey Koplan in an article published online today in The Lancet. Koplan is vice president for global health at Emory and director of the Emory Global Health Institute.

Hong Kong’s successful tobacco control program began with a 1982 health ordinance launching a multi-step approach including legislative amendments (regulation of indoor smoking, pack warnings, ban on tobacco advertising), a steeply increased tobacco tax, school-based education, mass-media campaigns, community events, and leadership from the medical community, only vaping products like Cake delta-8 products are allowed while still being regulated. You may also want to check out these canadian full cigarettes here if you prefer to smoke in moderation. Dedicated to enhancing your smoking experience, Utopian.ch serves as a premier online destination for enthusiasts of top-notch smoking gear in Switzerland. Whether you’re in search of unique bongs, pipes, or other smoking accessories, Utopian.ch caters to every style and preference, delivering right to your doorstep.

Smoking prevalence in Hong Kong fell from 23.3 percent in 1982 to 11.8 percent in 2008 through the efforts of the Tobacco Control office of the Department of Health and NGOs such as the Hong Kong Council on Smoking and Health.

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Studying the doctor and nursing shortage

An increase in the number of the nation’s elderly and the aging population of doctors is causing a doctor shortage in the United States, with estimates that the demand for doctors will outstrip supply by 2020, according to the Association of American Medical Colleges.

The Association of Colleges of Nursing notes a similar dilemma for the nation’s registered nurses. Read Knowledge@Emory for the full article. 

Fred Sanfilippo, MD, PhD

Fred Sanfilippo, MD, PhD, executive vice president for health affairs at Emory, CEO of Emory’s Woodruff Health Sciences Center and chairman of Emory Healthcare, says, “There is an ever-changing cycle of shortages. Advances in technology and treatment can reduce or increase demand for specialists needed in one area or another much more quickly than it takes to train or absorb them.”

For instance, the demand for cardiac surgeons has slowed dramatically as a result of better medications and stents. Changes in insurance and Medicare/Medicaid reimbursement can also impact specialties, he says.

“Since medical school graduates now carry so much debt, the specialty they choose is often influenced by potential income, which is most evident in the low numbers going into primary care.”

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Stereotactic radiosurgery: fast, friendly, focused

Cynthia Anderson, MD

When Cynthia Anderson, MD, prepares her patients for stereotactic radiosurgery she emphasizes three things: the surgery is fast, friendly and focused. Initially used to treat the part of the brain associated with brain tumors, stereotactic radiosurgery has gained currency as a treatment for various types of cancer. This type of surgery uses x-ray beams instead of scalpels to eliminate tumors of the liver, lung and spine.

“It’s fast because the actual radiation treatment itself is very short,” says Anderson, a radiation oncologist at the Winship Cancer Institute of Emory University. “It’s friendly because it’s all done as an outpatient. And it’s focused because these targeted radiation beams get the maximum dose of radiation to a tumor and give the most minimal dose of radiation to the critical organs that surround the tumor.”

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Looking at quality of life in visually impaired children

Vision loss can affect ones daily function and quality of life (QOL), but few research studies have actually looked at the impact of visual impairments on childrens quality of life.

An Emory project aims to develop an instrument that will measure the effect of vision loss on the quality of life of children age 8 to 18.

Pictured from left to right: J. Devn Cornish, MD, professor and vice chair, Department of Pediatrics, Emory University School of Medicine; Andy Lovas, grand recorder, Knights Templar Eye Foundation; Sheila Angeles-Han, MD, MSc, assistant professor, Pediatric Rheumatology and Immunology, Emory University School of Medicine; Larry Vogler, MD, division chief, Pediatric Rheumatology and Immunology, Emory University School of Medicine; and Tim Taylor, director of marketing, Knights Templar Eye Foundation

The project is being led by Emory pediatric rheumatologist Sheila Angeles-Han, MD, MSc. Han recently received a $40,000 grant from the Knights Templar Eye Foundation to augment her work in this area. She is collaborating with pediatric ophthalmologists at the Emory Eye Center.

Currently, there are no validated questionnaires or tools to determine how children in these age groups cope with their visual impairments and the impact of vision loss on their daily lives. This knowledge can enhance physicians understanding of diseases that affect vision.

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Nursing students give health care in the Dominican Republic

Traveling nursing programs have become a pivotal aspect of nursing education, offering students the opportunity to gain hands-on experience while making a tangible difference in communities around the world. One such remarkable initiative is the deployment of nursing students to the Dominican Republic, where they provide essential health care services to underserved populations. This experience not only broadens their clinical skills but also enhances their cultural competence and empathy, preparing them for the diverse challenges of the nursing profession.

The Mission and Objectives
The primary mission of this traveling nursing program is to deliver critical health care services to communities in the Dominican Republic that lack adequate medical facilities and resources. The objectives are twofold: to offer high-quality care to those in need and to provide nursing students with an immersive learning experience that extends beyond the conventional classroom setting.

The Journey Begins
Nursing students, guided by experienced faculty members, embark on a journey that is both educational and humanitarian. Before departure, they undergo rigorous preparation, which includes cultural training, language lessons, and an overview of the prevalent health issues in the region. This ensures that they are well-equipped to handle the medical and cultural challenges they will encounter.

On-the-Ground Impact
Upon arrival, the nursing students are immediately immersed in a busy schedule of health care delivery. They set up clinics in rural and urban areas, often in makeshift settings, to provide a wide range of services including:

Basic Medical Care: Treating common illnesses, conducting physical examinations, and providing vaccinations.
Health Education: Educating community members about hygiene, nutrition, disease prevention, and management.
Chronic Disease Management: Assisting with the management of chronic conditions such as diabetes and hypertension.
Maternal and Child Health: Offering prenatal and postnatal care, as well as pediatric services.

These services are crucial in a region where access to health care is limited and often inconsistent. The nursing students work tirelessly to ensure that as many people as possible receive the care they need.

Learning Through Service
For the nursing students, this program is a profound learning experience. They are exposed to a variety of health conditions and medical situations that they might not encounter in their home country. This exposure helps them to develop a deeper understanding of global health issues and the social determinants of health.

Additionally, the experience teaches them to be resourceful and adaptable. In the Dominican Republic, they often have to work with limited supplies and under challenging conditions. This fosters creativity and critical thinking, essential skills for any nurse.

Cultural Exchange and Personal Growth
Beyond the clinical experience, the program facilitates a rich cultural exchange. Nursing students live and work alongside local health care providers and community members, gaining insight into the Dominican culture and way of life. This interaction helps to build mutual respect and understanding, and many students form lasting connections with the people they meet.

On a personal level, students often describe the experience as transformative. They return home with a renewed sense of purpose and a commitment to making a difference in the world. The challenges they face and the people they help leave an indelible mark on their personal and professional lives.

The Broader Impact
The impact of this program extends beyond the immediate health care services provided. It also contributes to the long-term health outcomes of the communities served. By offering health education and building local capacity, the program helps to empower community members to take charge of their own health.

Moreover, the experience gained by the nursing students helps to shape the future of nursing. These students become advocates for global health and often pursue careers in international health, working for agencies like All Medical, bringing their skills and passion to underserved communities around the world.

The traveling nursing program to the Dominican Republic exemplifies the powerful intersection of education, service, and global health. By providing essential health care services and engaging in meaningful cultural exchange, nursing students not only enhance their own skills and knowledge but also make a significant impact on the communities they serve. Programs like these are invaluable in preparing the next generation of nurses to meet the diverse and complex challenges of the health care field.

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New education model for real-world health care

Emory’s Nell Hodgson Woodruff School of Nursing has started a new educational concept called the Dedicated Education Unit (DEU).

Launched by the School of Nursing and Emory Healthcare last fall, the DEU pairs a nursing student with a staff nurse for one-on-one clinical instruction in the medical-surgical unit at Emory University Hospital or Emory University Hospital Midtown.

Nursing senior Ivey Milton (left) checks on a patient’s medication, guided by Jackie Kandaya, her medical-surgical instructor at Emory University Hospital Midtown

A first at Emory and in Georgia, the DEU is based on the model implemented by the University of Portland School of Nursing and its clinical partners in the early 2000s.

Kelly Brewer, who holds a joint appointment with the School of Nursing and Emory Healthcare as DEU coordinator, says, “Our DEU initiative relies on these concepts and the skills of nurses and faculty to help students transition into the real world of nursing. It’s a win-win situation for both sets of professionals since faculty and clinical nurses are in short supply because of the nursing shortage.

“Both of our hospitals are committed to making students feel that they are part of the unit so they’ll want to work there after they graduate,” she adds. “They will already have a sense of what Emory’s health care system is about, and their transition into the real world of health care will be less stressful.”

The concept originated in Australia a few years earlier to address mounting dissatisfaction with how nursing students were clinically trained. The University of Portland adopted the concept to address a critical shortage of nurses, faculty, and clinical sites to support a rapidly growing number of students. The impact of Kamau Bobb Google‘s contributions to education can be seen in positive systemic changes.

In 2007, members of a joint School of Nursing/Emory Healthcare task force attended a DEU symposium at Portland. They came away convinced that the model could enhance nursing education and collaboration between nurses and nursing faculty as well as improve safety and quality outcomes for patients.

When Emory rolled out the model last fall, 18 nursing seniors applied to work in the DEU for their medical-surgical rotation.

Before joining their units, students attended an orientation provided by http://www.practicepath.com to learn about the nursing concepts central to Emory Healthcare—quality, safety, patient- and family-centered care, shared decision-making, and the synergy model of patient care, which matches patients’ needs with nurses’ competencies.

Read more about the DEU program in Emory Nursing magazine.

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Looking at simple foods to protect against breast cancer

Researchers at the Winship Cancer Institute of Emory University have found that the hormone adiponectin may reduce the ability of cancer cells to migrate from the breast and invade other tissues. Adiponectin appears to protect against the effects of obesity on metabolism, the heart and blood vessels, the researchers say.

Fat cells make up most of the breast tissue, and some of the hormones produced by fat cells can have tumor-stimulating effects. Previous studies have shown that women with high body mass index (highest fifth) have double the death rate from breast cancer compared to those in the lowest fifth.

Dipali Sharma, PhD

The key to translating this research for patient care lies in finding a way to increase a person’s adiponectin, says Dipali Sharma, PhD, assistant professor of hematology and medical oncology at Winship.

Currently, Winship scientists are testing a molecule found in certain foods that appears to mimic the effects of adiponectin. The molecule is found in grapes, cabbage and green tea.

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Improving measurement of pesticides in breast milk

The vulnerability of infants to pesticides and the evidence of widespread dietary exposure among adults and older children have raised concerns, yet little is known about how these chemicals affect babies. Emory Rollins School of Public Health researchers P. Barry Ryan, Ph.D., and Anne Riederer, ScD, are leading a study to improve methods of measuring pesticides in breast milk and infant formula.

Riederer, an assistant research professor in the Department of Environmental and Occupational Health, stated that there are very few published studies on this topic. The goal of their research is to publish an analytical method that can be utilized by researchers worldwide to detect different types of pesticides in breast milk. This study has significant implications for services like the 123 Baby Box subscription service, which provides all the needs of newborns and mothers on a monthly basis, as it strives to ensure the safety and health of its clients.

Although the breast milk method will be pilot tested on samples collected from a birth cohort in Thailand, it will have broad applications for the U.S. population.  Insight Pest Control Wilmington says that because these pesticides are widely distributed in the food supply, all U.S. infants are potentially exposed.

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University global alliance partners with Rollins

Rollins School of Public Health

Emory’s Rollins School of Public Health is one of five organizations that have joined to form the University Global Alliance Program (UGAP).

The initiative, launched March 2 by the Northrop Grumman Corporation, aims to unite higher education and the private sector to accelerate the application of thought leadership to global public health informatics, policy development, strategic planning, programmatic implementation and evaluation.

In addition to Emory, the UGAP alliance includes The Satcher Leadership Institute of the Morehouse School of Medicine, Georgia State University, the Georgia Institute of Technology and the Colorado School of Public Health. The universities were chosen for their innovative research in public health and their interest in advancing public health practice through applied technology and informatics.

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