Published in the June 23, 2011, DiagnosticImaging.com
By Whitney L.J. Howell
Economic times are tough even for radiologists, but attendees of the recent Society of Nuclear Medicine (SNM) annual meeting heard first-hand some strategies for maintaining success.
Andy Savo, a senior imaging specialist with GE Healthcare and a frequent speaker on radiology, offered tips that can strengthen your practice when many patients are delaying diagnostic tests, says Kathy Hunt, president of the SNM’s Technologist Section.
“We asked Andy [Savo] to come and speak because we knew he would provide an upbeat message on how we can best serve our patients during these complicated times,” Hunt says. “Through is presentation, he helped our members reflect on their actions and take a look to see how they impact not only their patients, but other radiologists, as well.”
The current changes in health care present many challenges, she says, and Savo’s recommendations can guide you as you search for your place in the new playing field.
To read the entire article: http://www.diagnosticimaging.com/practice-management/content/article/113619/1888553
Published in the June 2011 AAMC Reporter
By Whitney L.J. Howell
As she watched the teenagers discuss their new health information database, Tirza Cannon realized why getting communities engaged in their own health care is so important.
The teenagers were unveiling HealthShack.info, a Web site that gives marginalized and homeless young people a safe place to compile and access their medical information. For Cannon, a third-year student at the University of California Davis (UC Davis) School of Medicine, the Web site illustrated how to make the community a true partner in medical research.
“These young people talked eloquently to more than 100 people about how they helped design and implement a system to house medical information,” Cannon said. “That really drove home for me that physicians must be aware of the social, economic, political, and cultural factors influencing their patients.”
HealthShack is an example of a new kind of research that has gained ground over the past decade: community-based participatory research. This method unites investigators with communities to identify health problems, the best ways to study those issues, and how to design health behavior changes that the community is most likely to adopt.
Now, a growing number of medical schools like UC Davis are introducing this research method to their students. The National Institutes of Health and the Centers for Disease Control and Prevention sparked interest in this fledgling field in 2008 when they issued a call for grant proposals in community-based research. Since then, some schools have incorporated community-based research instruction into their curricula through individual studies or full classes.
Still, the method remains a relatively new concept, and finding the right way to teach it has been difficult. In fact, a 2009 study published in Academic Medicine reported that some medical schools and teaching hospitals may be reluctant to accept or encourage community-based research because their investigators have proven success with other methods.
Being familiar with this technique, however, will benefit students as medicine continues to shift its focus to prevention, said Elizabeth Miller, M.D., UC Davis assistant professor of pediatrics and adolescent medicine.
“The amount of didactic instruction that students have received on community-based participatory research has been variable at best,” said Miller, a faculty leader for the HealthShack project. “There’s been very little room in medical education to do this type of thing, but including it is vital because it teaches students early on how to really connect with the people they will serve.”
According to Miller, UC Davis will launch a community-based prevention program in July, in which first-year medical students spend a month tackling child and family wellness issues with community partners.
Jen Kauper-Brown, M.P.H., a director in Northwestern University’s Community-Engaged Research Center, echoed Miller, stressing that community-based research lectures alone are not as effective as real-world training.
“Community-based research is hard to learn in the classroom,” she said. “We have to provide experiential learning models that fuse faculty instruction with days spent working in the community.”
In 2012, Northwestern University Feinberg School of Medicine will introduce a community engagement course series that will place students in a research project, provide on-the-ground training for community-based research skills, and offer students ongoing feedback and support from faculty and peers.
Duke University School of Medicine teaches these concepts to incoming medical students through an interprofessional course in which they learn alongside physician assistant and physical and occupational therapy students, said Mary Anne McDonald, Dr.P.H., assistant professor at Duke’s Center for Community Research.
Students also work in prenatal health and telemedicine programs through the Arizona Cancer Center at the University of Arizona College of Medicine. To help students understand how community-based research is similar to clinical skills, Ana Maria Lopez, M.D., Arizona medicine and pathology professor and telemedicine director, often draws a parallel to a basic medical activity.
“I tell students that working with community partners is a lot like getting the vital signs for an individual patient,” Lopez said. “In order for this research method to work, we have to go talk to them, see what’s working, and change course if we need to based on what they tell us.”
With the growing popularity of community-based research, it is still challenging to ignite medical student interest and make participation feasible, said McDonald. The rigors of medical school and the short length of rotations make it difficult for students to cultivate the long-term relationships that are needed to succeed.
For now, that problem has no clear solution. Getting students excited about the idea that community-based research is the next wave of medical research will depend very much on the faculty role models involved in these projects, said Kauper-Brown.
Even though there is an ongoing debate about what types of research projects can correctly claim that they truly engage the community as partners, exposing medical students to research that immerses them in the community will only have a positive impact, said Doug Brugge, Ph.D., public health and community medicine professor at Tufts University School of Medicine.
“There is no substitute for real-world experience,” said Brugge, who also directs the Tufts Community Research Center and has conducted collaborations with several neighborhoods around Boston. “You can talk or read about working with communities, but you’ll never understand how complex some community’s issues are or how difficult implementing changes can be until you ask questions and listen. Some students are shocked to see that, and it’s an important thing for them to learn.”
Published on the June 8, 2011, DiagnosticImaging.com
By Whitney L.J. Howell
Design and structure improvements in PET and MRI scanners could soon alter how you practice nuclear medicine. These changes have made combining the scans for clinical treatment a possibility, according to a presentation at this week’s Society of Nuclear Medicine (SNM) annual meeting in San Antonio.
The PET/MRI combination scanner first appeared in the mid-1990s in mouse-model cancer research conducted at the University of California-Davis (UC-Davis), but using it clinically has been impossible until now. Not only have MRI magnets distorted colors and images from nearby PET scanners, but there also hasn’t been enough space inside an MRI to accommodate a PET.
Those problems no longer exist. Using LCD screens instead of CRT screens in PET scanners prevents image distortion, and installing higher-performing gradients frees up space – 70 cm rather than 55 cm – to install a PET inside an MRI, says Bruce Rosen, M.D., Ph.D., radiology professor at Harvard Medical School and director of the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital. The wider space also reduces anxiety for patients who are claustrophobic.
Given these changes, companies, including Siemens and GE, are now working to commercialize combination scanners.
“It’s important that the technology is now advanced so these scans can play well together,” says Rosen, who delivered the SNM’s PET/MRI presentation. “Running tests simultaneously lets radiologists diagnose a problem and see how it’s working real-time. It can also save patients the inconvenience of having tests at different times.”
To read the rest of the story online: http://www.diagnosticimaging.com/molecular-imaging/content/article/113619/1875482?CID=rss&cid=dlvr.it
Published in the Spring 2011 Carolina Public Health Magazine
By Whitney L.J. Howell
During the last 20 years, North Carolina has edged toward the top of an ignominious list. The state currently has the sixth highest incidence of stroke mortality in the nation. There’s no time to waste in turning this trend around.
Annually, 27,000 North Carolinians suffer strokes; one dies every two hours. These statistics led researchers to label certain North Carolina counties as part of the “buckle” of the Stroke Belt, which runs through the southeastern United States. Stroke risk in the region is two to three times greater than the national average.
Recognizing stroke risks and symptoms and providing appropriate and timely treatment are critical to preventing stroke and lessening its long-term impacts. For more than a decade, UNC Gillings School of Global Public Health researchers have dedicated themselves to reducing the impact of the nation’s third highest killer. They identify “best practices” in stroke treatment and prevention, help hospitals implement quality of care improvement programs, and train medical personnel to recognize and respond quickly to stroke symptoms.
“We want to improve patients’ care – wherever they may be – should they have a stroke in North Carolina,” says Wayne Rosamond, PhD, epidemiology professor and principal investigator for the North Carolina Stroke Care Collaborative (NCSCC).
The NCSCC works with 56 of the state’s 102 hospitals, from Henderson County’s Park Ridge Health in the west to Carteret County General Hospital in the east. Participating hospitals range from the 25-bed Transylvania Medical Center to Pitt County Memorial (745 beds, affiliated with East Carolina University’s Brody School of Medicine), Duke University Medical Center (989 beds) and Greensboro-based Moses Cone Health System (529 beds).
With Centers for Disease Control and Prevention funding, the collaborative created an interactive database so that a hospital’s stroke care performance can be monitored and compared to similar facilities. Each month, NCSCC hosts webinars for stroke experts to address specific quality improvement topics, and they assist hospitals in giving emergency medical technicians and caregivers advanced education in both identifying and reacting appropriately to a stroke.
NCSCC annually awards up to 12 grants to fund initiatives that meet individual hospital needs. For example, for 2009–2010, Catawba Valley Medical Center received $15,000 for a stroke nurse coordinator. NCSCC also collaborates with the Registry of the Canadian Stroke Network. In February, the NCSCC joined with UNC’s Department of Emergency Medicine to participate in a seminar, presented at the International Stroke Conference 2011, about integrating a stroke registry into EMS data sources.
However, ensuring that patients receive appropriate services is only part of the stroke-prevention equation, says June Stevens, PhD, nutrition and epidemiology professor and nutrition department chair. Health care providers also should focus on helping individuals tackle obesity – a substantial, preventable stroke risk factor.
“Obesity increases the risk of stroke, because it raises the likelihood of high blood pressure,” Stevens says. “In fact, we’ve found that if you have a significant weight gain over an extended period of time, your risk is substantially higher than if you maintain your weight.”
In a soon-to-be published study of 15,000 people from North Carolina, Mississippi and Minnesota, Stevens and her colleagues found that a 10- to 30-percent weight gain between age 25 and middle age resulted in a 29 percent increase in stroke risk. Individuals who gained more than 30 percent of their body weight had a 64 percent higher risk. These results were compared to individuals who maintained their weight within 3 percent of the initial measurement.
“People already know obesity isn’t healthy,” Stevens says. “They also need to know about evidence that shows they’re at high risk for stroke – so they can do something about it.”
To read the story online: http://www.sph.unc.edu/images/stories/news/cph_2011_spring/documents/howell_stroke.pdf