From Gin to Citizen Science

by Leah Guthrie

What we do in our free time often reflects our preoccupations. For a newly growing city like London in the eighteenth century, binge drinking gin served as a favored pastime; especially, among the developing working class who were adjusting from rural life to a crowded industrial society with poor working conditions. Gin was a very cheap antidote to the harsh realities of life with visibly numbing effects. At the height of the Gin Crisis in the 1720s, alcohol-related death rates were steadily climbing while birth rates were dropping to concerning levels. Laws restricting gin access did little to mitigate the damage until economic improvement generated a higher standard of living and new social pastimes, like coffee houses and restaurants that took advantage of the crowded and compact nature of city life (1).

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Porn Stars as Safe Sex Role Models? Measure B’s Educational Opportunity

Author’s name withheld by request

Many of us grow up emulating our favorite movie stars. But what if those movie stars were porn stars, and by acting like them we were preventing the spread of sexually transmitted diseases, such as gonorrhea and chlamydia? LA County lawmakers behind Measure B, or the “Safer Sex in the Adult Film Industry Act” perhaps had that idea.

In a recent study by Rodriguez-Hart et al., 28% of adult film actors in a 168-participant study were found to have chlamydia and/or gonorrhea 1.This statistic is more appalling when compared to the negligible percentage of legal prostitutes in Nevada with the aforementioned STDs 2. The study continued by describing how these diseases are transmitted, blaming unprotected oral and anal sex in addition to vaginal intercourse. Of the 47 (28%) participants with the STD, only 11 (23%) of them had STDs detectable through urogenital testing alone. In addition, over 90% of the oropharyngeal and rectal cases were asymptomatic. The study concluded that undiagnosed asymptomatic STDs were common and easily transmissible to sexual partners. The authors strongly believed that every performer should be tested for STDs at all anatomical sites and should have to use condoms for sex scenes. Measure B, which thoroughly addresses both of these concerns, was passed with 56% approval during the most recent election.

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What is the Real Worth of a University?

by Arthur Ruiz

Amidst the negotiations between Yeshiva University and Montefiore over the fate of Albert Einstein College of Medicine, the Einstein Community demands some answers.

Einstein Price Center

Einstein Price Center

What is a University? The word “university” comes from the Latin universitas, “the whole; aggregate”, and it is a telling definition. A university is the summation of the proficiencies and resources of its academic and scientific communities. It is more than the buildings, the labs, the physical infrastructure, the financial assets – it is the people, their expertise and their relationships that produce the real value in a place like the Albert Einstein College of Medicine.

However, this University is under threat. The status of Einstein has been up in the air for the past year, during which Einstein’s owner, Yeshiva University (YU), has been in negotiations with Montefiore Medical Group (MMG) to sell Einstein. Financial turmoil, court settlements and bad investments have cost YU $1.3 billion over the past decade, and Yeshiva finds itself unable or unwilling to continue to support Einstein. Partnering Einstein with MMG offers a way forward for Einstein, but negotiations have been stalled out in the past couple of months. Now YU, after spending an undisclosed amount of money on the efficiency consulting firm Alvarez and Marsal, has determined that eliminating the Sue Golding Graduate Program and its associated basic research program would reduce their budget deficit and ease their financial plight – but at what cost?

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Ecology for biomedical scientists and bankers: A recap of the World Science Festival (WSF) salon on “Predicting the Collapse of Complex Systems”

by Leah Guthrie

wsf Simon A. Levin, a Professor of Biology at Princeton University, opened up the World Science Fair (WSF) salon on Predicting the Collapse of Complex Systems by relating a story of how ecologists predicted the 2008 financial collapse. He starts at a meeting hosted by the New York Federal Reserve on systemic or undiversifiable risk that involves the collapse of an entire market, as opposed to a specific industry (1). Levin was one of three ecologists in attendance, and they all were all struck by the evident parallels between ecological and financial systems. Their collective thoughts were published in February of 2008 in a Nature paper entitled Ecology for Bankers (Nature 451, 893-895).

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Is Fat Shaming the Wrong Battle in the War Against Obesity?

by Kirsten Hartil

fat1

Cindy Baker, Personal Appearance, 2008-2012. Part of the image used in the flyer promoting Fat Studies: Bodies, Culture, Health. It depicts Cindy Baker in a custom-built professional mascot costume. Her Personal Appearance engages the notion of ‘fat geography addressing the lived reality of taboo bodies in spaces make for the ‘socio-normative’ body.

Phrases such as: “the obesity epidemic” and “the war on obesity” have become part of the daily lexicon of biomedical and public health researchers engaged in obesity research. The consequences of framing the discussion this way was the topic of Fat Studies: Bodies, Culture, Health, a panel discussion held at the New School on Monday June 16, 2014.

The four-member panel consisting of professors of clinical psychology, public health, art history, and history was moderated by Dr. Fabio Parasecoli, associate professor and coordinator of the Food Studies Program, the New School for Public Engagement.

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Help to Find the Health in Healthcare: A Discussion of Cost, Competing Factors, and Consequences

by Ramon A. Robertson

In Population Health: Transforming Health Care to Improve Our Health, Dr. Sederer’s central thesis, is that we must expand our collective consciousness (as medical doctors, public health specialist, and private individuals) of the tenants (or determinants) which are ultimately driving our health status outside of provisional healthcare services. Further, we must realize the modicum of worth (10%) that “healthcare” provides to our human experience, and instead, consider more closely, the truly impressive determinants that modulate the crux of our health as a population. 1

He points out that what is actually making us sick, are our poorly self-regulated behaviors and practices — “excessive and poor eating, more than moderate drinking, smoking, [lack of] physical activity, high salt and processed food intake” — that are most responsible for the steady decline in health and growth in illness. 1 Though many fall back on the genetics controlling their fate argument, Sederer points out the reality that though genetic effects are indeed hardwired, they can be modulated by environmental exposures to either remain quiescent or manifest destructively. 1 Sederer also reminds us that this discussion is not merely an academic one, as the gravity of a structurally unsound healthcare system is reflected in our country’s financial statement — in that we spend on average almost a fifth (18%) of our nation’s GDP ($2.7 trillion annually) on healthcare costs — far above any other comparably developed nation in the world. 1

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Can racism explain the increased rates of maternal and infant mortality among African Americans?

by Kirsten Hartil

This post is a modified version of a paper submitted for the Multiculture and Diversity Issues course of Einstein’s MPH Program. 

Rates of perinatal and maternal mortality are higher in the U.S. than 16 other high-income countries including the United Kingdom, Canada, Japan, Sweden and Denmark.

The Centers for Disease Control and Prevention estimates that in the U.S. every year 25,000 infants die before their first birthday. These rates are lower than most low- and middle-income countries. Sierra Leone, for example had an infant mortality rate of 117 deaths per 1,000 in 2012. Still, according to Save the Children’s 14th annual State of the World’s Mothers report, 50 percent more newborns die within their first 24 hours in the U.S. compared to all other industrialized countries combined.

Congenital malformations, pre-term birth or low birth weight, sudden infant death syndrome (SIDS), and maternal complications and injuries (e.g., suffocation) are the major causes of infant mortality in the U.S., accounting for 57% of all infant deaths in the United States in 2010.

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The Affordable Care Act & Emergency Medical Services: A Glimpse of Where We Are Now, a Vision for Change, and an Evolving Plan to Move Forward

by Ramon A. Robertson

source: www.colletonfire.com/emergmedical.htmWith an estimate of 240 million calls per year, 9-1-1 operators are shockingly busy — collectively, that’s a numbing 8 incoming calls per second in perpetuity across the nation. 2 While Emergency Medical Services (EMS) have expanded to meet the public demand, they have shriveled (by force) in their agency and potency to deliver patient-centered care to the community.  Unfortunately, it is the money trail that leads us toward the single greatest accounting contributor of their diminished efficacy: their compensation is strictly linked to a fee-for-service model, that directly rewards transportation and often overlooks (or sidelines) infield medical care. 1  To be clear: EMS is only paid if they ultimately transport patients to the hospital; the lights-and-sirens response, the onsite acute medical care, and any other instructive/supporting measures, do not alone command reimbursement. 1 From a business perspective, this sets up an unhealthy nidus for the management of patients with sub-transportative needs, and encourages over-aggressive and/or needless advanced care maneuvers and/or routing. 1  Not only does this payment model uncannily usurp the medical role of EMS workers (by relegating them to mere transportation functions), but it also adds to the already intolerable weight of non-emergent cases currently cluttering hospital emergency departments.

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Updates from the Biotech Scene in New York City: New facilities and initiatives encourage and support start-ups

by Pablo Rougerie

There is a paradox in New York City. While the city is home to world-class research institutions in biological research, places like Columbia, Mount Sinai or Rockefeller, the presence of a vibrant bioscience and technology industry is comparatively lacking. Compared with regional hubs like San Diego, Boston/Cambridge or the San Francisco Bay area, biotech employment figures of the past decade are meager in NY.  How can an area like New York, with unparalleled access to cutting-edge biological research and a surplus of well-educated scientists, be relegated to such a low profile in the biotech world?  Much of the answer is defined by two main obstacles: lack of space and lack of money. Fortunately, the end of 2013 saw important announcements and developments that have the potential to change the situation.

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The Role of the Medical Profession in Swaying Public Policy: Exploring Physician Responsibility and Advocacy

by Mark Mikhly

A version of this post was originally submitted to the AMA’s Conley Ethics Essay competition – check out last year’s winners!

An AMA sponsored essay-contest prompt asked medical students to consider the case of a physician who chose to advocate against state sponsored abstinence-only sexual education to her state AMA chapter. The question, in brief, was whether physicians’ education, training, and standing in society entitle or obligate them to speak out on issues that, while they affect the health of the public, are not directly related to physician training or the care of patients? This question applies not only to individual physicians but also to the profession as a whole.

To consider whether physicians should take positions on sex education, we will explore the nature of the relationship between the medical profession and society, the role of physicians in public health, and the concept of Social Medicine. After such discussion, as well as an examination of abstinence-only sex education, it should become evident that physicians have an imperative, rather than an option, to be actively involved on this important topic.

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