MEET PETER KUHN, AT THE HEART OF A NEW ERA IN USC LIFE SCIENCE CAMPUS NEWS| PG 5
CHANGES TO LUNCHES IN LOCAL SCHOOL CAFETERIAS
WHY IT’S SO IMPORTANT TO UNBOIL AN EGG
RESEARCH| PG 3
Measles outbreak in the “Happiest Place on Earth”
CURRENT EVENTS | PG 11 CENTERSPREAD | PG 6-7
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TROJAN HEALTH CONNECTION www.trojanhealthconnection.com
Volume V | Issue II
Local CRE outbreak puts medical scope manufacturer in spotlight By ARMAN ZADEH Associate Editor This past February, news of a deadly “superbug” outbreak at UCLA Ronald Reagan Hospital circulated throughout Southern California. The bacteria responsible, known as CRE (carbapenem-resistant Enterobacteriaceae) infected seven hospital patients between October and January, two of whom later died. UCLA first discovered the infections in late January and linked the bacteria to contaminated medical scopes used at the hospital. The duodenoscopes, typically used in endoscopic retrograde cholangiopancreatography (ERCP) to view ducts in the gastrointestinal system, were manufactured by Olympus Corp. of Americas. Late in February, the FDA learned that Olympus never obtained permission to sell its duodenoscope. “Why didn’t we notice it? I don’t know,” deputy director of strategy for the FDA’s Office of External
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CRE as pictured under a scanning electron microscope. Affairs Karen Riley said. product. Although the device has been How It Started on the market since 2010, OlymThe superbug outbreak can be pus only applied for clearance traced back to a unique design to sell the scopes last year at flaw in Olympic Corp.’s device. In the FDA’s request, stating that the duodenoscope’s newest modthey did not think their compa- ification, the company covered ny needed permission to sell its part of CONTINUED ON PAGE 2
Obama’s new precision medicine initiative By MICHELLE NGAN Writer In the State of the Union address earlier this year, President Barack Obama announced a precision medicine initiative that is changing the way we think of research. This new method has the potential to revolutionize current approaches and treatments for a variety of disease. In a January 30th speech at the National Institute of Health (NIH), President Obama de-
scribed his precision medicine initiative as a plan “that brings America closer to curing diseases like cancer and diabetes, and gives all of us access, potentially to the personalized information that we need to keep ourselves and our families healthier. According to the NIH, the definition of precision medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.”
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Obama gives a speech at the White House regarding his initiative.
However, while the name “precision medicine” suggests individualized care of patients, Obama’s initiative instead focuses on developing treatments for patients with different subgroups of a disease using genetic information. The use of genetics as a treatment for disease is a relatively new technology; it gained momentum with the Human Genome Project, completed in 2003, an international effort to map the entire human genome sequence. Much of the existing research on precision medicine using genetics currently focuses on the treatment and prevention of different cancers. The Cancer Genome Atlas, a project under the National Cancer Institute (NCI), has sequenced the genomes of nearly thirty forms of cancer through analysis of tissues samples. In the NCI’s 2014 article, “Precision Cancer Medicine: The Future is Now, Only Better,” Schilsky and colleagues determined that targeted therapy of various cancers resulted in positive responses from patients with metastatic cancer, or cancer that has spread from CONTINUED ON PAGE 8
April 22, 2015
How to go gluten-free in 2015 By AISHA VAIYANI Writer Fad diets have grown and faded in popularity throughout the years in the United States. Endorsed by medical experts as well as celebrities, food fads like the South Beach diet and the Zone diet have periodically been promoted as the new and revolutionary way to become healthy. The gluten-free diet is the newest addition to fad diets, first gaining popularity in 2011 with the publication of Wheat Belly. Written by Dr. William Davis, Wheat Belly became a New York Times bestseller shortly after it was published. Dr. Davis promoted the elimination of wheat as the best way to lose weight and maintain optimal health. Grains like wheat, barley, rye, and triticale contain gluten, a protein. Gluten is frequently found in baked goods like bread, given that it helps dough rise and maintain elasticity as well as shape. The end result is soft and fluffy with a chewy texture. Furthermore, gluten can be found in several other foods like pastas, cereals, salad dressings, and soups. Many processed foods may contain gluten, making it necessary for someone to stringently read nutrition labels when adhering to this diet. With that being said, why do people make the decision to go gluten-free? There are several reasons for this, ranging from being diagnosed with gluten intolerance to wanting to lose weight. About 1% of Americans suffer from Celiac disease, an autoimmune disorder in which the villi of the small intestine are damaged upon consumption of gluten. This hinders the absorption of nutrients and causes symptoms like abdominal swelling, bloating, weakness, and fatigue. Those who suffer from celi-
ac-like symptoms but are diagnosed with neither celiac disease nor a wheat allergy are described as having non-celiac gluten sensitivity (NCGS). Individuals with NCGS typically exclude gluten from their diet in order to alleviate symptoms such as irritable bowel syndrome, abdominal pain, and bloating. The publication of Wheat Belly, along with endorsements by celebrities like Miley Cyrus has launched the gluten-free diet as the latest fad for losing weight. For many people, the decision to adhere to this diet often is made without the recommendation of a health professional. These individuals may abstain from gluten solely to shed a few pounds or to feel h e a l t h i e r, but are often unaware of some of the consequences of this change in diet. Going gluten-free can put someone at risk for deficiencies in vitamins, minerals, and fiber. Furthermore, many processed products that are marketed as gluten-free contain relatively higher amounts of salt and trans fats, meaning that they are not necessarily the healthier option. Ultimately, the key to going gluten-free is to not rely on self-diagnosis. The most reliable way to detect gluten intolerance is by visiting a doctor. Additionally, it is important to note that going gluten-free is not as simple as cutting out specific foods from one’s diet. Someone who decides to go gluten free must compensate by consuming foods that are rich in the vitamins and nutrients that their modified diet is lacking. Going gluten-free does have its merits, but it is critical that this decision is made for the right reasons. The best place to start in making this decision is not necessarily on Miley Cyrus’ Twitter, but in your doctor’s office.
Someone who decides to go gluten free must compensate with dietary adjustments.
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Gluten can be found in bread, pastas, cereals, dressings and soups.
ONLINE EXCLUSIVES Global News: Polio Eradication | In Remembrance: Dorothy Thomas | Student Life: Healthy Sleeping Habits
TROJAN HEALTH CONNECTION | April 22, 2015
“Superbug” from page 1: the elevator shaft in an effort to make it more resistant to infections. This modification, however, proved to be the device’s biggest flaw as it was the same part linked to the superbug’s origin at UCLA. “The company clearly made these modifications to make the device safer, but it seems to be that it wasn’t safer,” Riley said. Two weeks after the events at UCLA, Cedars-Sinai Hospital reported that four patients had been infected with CRE originating from Olympus Corp. duodenoscopes. The only patient death at Cedars from CRE was not conclusively linked to the bacteria. Since then, Cedars has stopped all procedures with the device and Olympus has worked with the hospitals and the FDA to fix its problem. At around the same time as the UCLA outbreak, in late January, a Seattle hospital reported 11 deaths from CRE originating from Olympus duodenoscopes, as well. The Outbreak as a Reﬂection of UCLA’s Health Score? How do these recent events reflect the behavior of UCLA hospital as a whole? One way to try and answer that question is to look at the hospital’s health score. In a survey conducted by The Leapfrog Group, a nonprofit that creates health scores that have been cited in the New York Times and MSNBC, the UCLA Ronald Reagan Medical Center received an overall grade of “C” in the fall of 2014. In four of the five major categories created by the health score, UCLA either is on par or exceeds national averages, these categories being “Safety Problems in Surgery”, Staff Follows Steps to Make Surgery Safer”, “Right Staffing to Prevent Safety Problems” and “Hospital Uses Standard Safety Protocols”. However, in the one remaining category, “Infection and Safety Problems”, UCLA performs below average in five of seven sub-categories. One of these categories includes “Surgical site infection after colon surgery”. Extrapolating from that information what you will, one way to defend UCLA against its health scores and observe this superbug outbreak as an isolated incident could be to simply look at the health score of the other superbug infected hospital, Cedars-Sinai in Los Angeles. Cedars-Sinai received an over-
all health score of “A” from the Leapfrog Group in the fall of 2014, performing above average in a majority of categories. So perhaps superbug outbreaks cannot be linked to a hospital’s normal behavior? It may be important to note, however, that Cedars-Sinai, like UCLA, still received a below average rating in the sub-category “Surgical site infection after colon surgery”, remembering that CRE infections originated from tools used in the same system. About CRE and the Future of Superbugs Carbapenem-resistant Enterobacteriaceae describes a family of microorganisms that has a high resistance to antibiotics. Enterobacteriaceae includes the species E. Coli and other bacteria common to the human gut. The antibiotic used to normally control enterobacteriaceae, carbapenem, is used as a “last resort” for most bacterial infections. This relatively strong antibiotic has little effect on CRE. In its evaluation of CRE, the CDC refers to one report thats cites the superbug can contribute to death in nearly 50 percent of those infected. For reference, Staphylococcus aureus (MRSA), one of the deadliest bacteria in the world, has a mortality rate ranging from 20-50 percent. The future of superbugs worries many scientists and researchers as it becomes more and more apparent that the increased use of antibiotics in medicine has sped up survivability of microorganisms in antibiotics, and bacterial mutability seems only to be speeding up. A report from Health Care Dive states “Antibiotic-resistant bacteria kill at least 700,000 people per year and the anticipated death rate is rising rapidly, with projections of another 10 million deaths by 2050 unless a solution is found.” In lieu of the recent Ebola outbreak, Bill Gates has become one major spokesperson on behalf of a solution to difficult to treat diseases, from bacteria and viruses alike. “A more difficult pathogen [than Ebola] could come along; a form of the flu, a form of SARS, or some type of virus that we haven’t seen before,” Gates said. “We don’t know [if] it will happen, but it’s a high enough change that one of the lessons of Ebola should be to ask ourselves: Are we as ready for that as we should be?”
Interested in joining Trojan Health Connection? Apply to be a part of the Fall 2015 staff! Email us at trojanhealthconnection@gmail. com for more information
Letter from the Editors:
SPRING 2015 STAFF EDITORS-IN-CHIEF
Varun AWASTHI Emily HE
Section Janie CHEN Layout Ana HILLEBOE
Abram ESTAFANOUS Jackie KRUGLYAKOVA
Jehan BISTA Jessica FRANKEBERGER Brittney KUO Olivia PANCHAL Izma SHABBIR Arman ZADEH
Dear Reader, Welcome to the spring edition of Trojan Health Connection! Our newspaper is proud of our multimedia team. We want to expand our news coverage in all media outlets. Check out our piece on Adderall on our Youtube page. We interview Psychiatrist-in-chief at the Keck Hospital and a USC student who has ADHD. Also, our website features a monthly medical mystery cartoon series. In this issue, we highlight the topic of vaccines on page 6-7. We delve into the recent measles outbreak in Disneyland as well as debunking common myths about vaccines.We also cover new developments in a vaccine for triple-negative breast cancer. Additionally, we feature innovative breakthroughs in science research. On page 3, you can read about how researchers found a way to unboil an egg, which poses possible uses in cancer treatment. Also, we report on various campus news and study aboard opportunities. Check out page 4 for health related aboard courses. On page 5, we profile a couple new USC professors, and their fascinating research and experience. To our staff and graduating seniors, thank you for your hard work! We could not have done this without you. Your passion inspires us and we are so proud of you! Thank you for reading! See you next semester! Sincerely, Emily and Varun
Web Sana AZAM Layout Ana HILLEBOE Funding Annette EOM Asst. Funding Mehak KHAN Asst. Layout Natalie LI Video Cameron QUON PR Matthew URNESS
Deena BAUM Sasha PARK
Dalton BANH Nicole BASLER Diana CHEN Rachel DONG Cristina GAGO Zaira GASANOVA Alexis HUNTER Marie KAAKIJIAN Emily LIN Michelle NGAN Rachel Polcyn Sharmila RAJU David SUTTER Lauren TAYLOR Lu TIAN Aisha VAIYANI
Reducing mental health stigma By OLIVIA PANCHAL Associate Editor On Friday, April 17th, Health Sciences Education Program hosted a slam poetry event at Ground Zero called “Slamming Down the Stigma: Mind and Body,” designed to reduce the stigma associated with mental illness. This event brought attention to the issues with mental health services on the USC campus. In 2011, the Princeton Review released its list of colleges with the best health services, and, guess who topped the list? UCLA. If for no other reason than Trojan Pride, USC needs to improve its health services for its students and improving mental health services is the most effective place to start. According to a study by the National Alliance on Mental Illness (NAMI), college students are the most susceptible to mental illnesses. One out of every four college students suffers from some form of mental illness, including depression. However, 75 percent of college students do not seek any help for this Representations of people with mental illness as unstable or crazy by the media and popular culture has created a stigma around mental health that makes talking about it difficult. While the Engemann Health Center offers some services for
students with mental health problems including individual and group counseling, they could make some improvements in order to reverse this stigma and make mental health services as accessible as possible.
“Students, faculty and administration need to understand that mental illness is just like any other type of illness.” -Ariana Aboulaﬁa, student
According to Dr. Kelly Greco, a psychologist at Engemann, there are 34 staff members devoted to mental health, but only 3 psychiatrists. This is not enough to address the most prevalent problem among a student body of over 40,000. Furthermore, University policy only allows these psychiatrists to prescribe students medicine in conjunction with long-term therapy– which Engemann does not offer. “This creates a situation in which the University does not have anyone who can actually
prescribe students [mental health] medication, which is not only an issue of practicality but also one that - inadvertently I’m sure - reinforces mental health stigma,” says Ariana Aboulafia, a USC student passionate about destigmatizing mental health. This policy however, raises the question: why can students get drugs for physical injuries, but not for mental illnesses? “[This] widens the gap between physical and mental ailments,”Aboulafia said. The USC Administration and Engemann need to make changes, but we as a campus also need to change. In order to combat stigma, we have to stop perpetuating it. “USC students, faculty and administration need to understand that mental illness is just like any other type of illness,” Aboulafia says. “There is no ‘one size fits all’ approach to mental health, nor is there a singular, ‘band aid’ approach to treating those that suffer from mental illnesses.” Greco encourages all students to seek out groups like Active Minds, NAMI and Free Minds, groups that educate others about mental illness and overall wellness. “No one can escape from stress and experiencing some loss, which may occur during the college years,” Greco said.
April, 22, 2015 | TROJAN HEALTH CONNECTION
Biological basis of morality By MEHAK KHAN Assistant Funding Chair
seau himself called infants to be “perfect idiots...knowing nothing.” How can it then be possible to employ these these “little blobs,” as Dr. Wynn termed them, to be subjects in academic research? The answer comes with a particularly playful experimental setup. Wynn presented different scenarios using puppets and colorful props to five- and nine-month year old babies. In one case, a puppet struggles to open a box of toys until a another puppet comes to help as an example of “good” behavior. The scene is then repeated but with a “bad” behavior, as different puppet rudely slams the box shut. The infant is then presented both the good and bad puppets and asked to reach for one.
The result? Over seventy-five percent of babies tested reached for the nicer puppet, evidencing a Morality has long been considmoral component to their puppet ered among the defining features preference. of human existence. UnsurprisWith such reverberating coningly, great philosophers such as clusion, Wynn was driven to exRousseau and Kant spent their pand the questions of her study. days formulating how our ethiIn a second setup, infants were cal consciousness arises. Today, shown a stuffed bunny that stole the same discussion lives on, but the puppet’s ball, as a bad behavsome of the methods to reach a ior. Then, the “bad” bunny tried conclusion are anything but tradito open a box while holding a toy, tional. In a research study by Yale but a new puppet slams the box Psychology, Dr. Karen Wynn’s shut to prevent him. team has turned to the human inThis new puppet’s maneuver fant to find the answer to one of acts as a punishment to the bunhumanity’s most provoking quesny’s theft. Astoundingly, 81 pertions: where does our morality cent of babies favored the puppet come from? who punished the bunny over the Psychology has long deemed “bad” bunny, indicating the bababies to be essentially useless in bies upheld the delivery of justice. experimental testing. Even RousThe implications for this conclusion are deep. Humans, represented through infants, seem to be born with an innate sense of morality and justice. Why then is it necessary to have justice systems like the Supreme Court or our own Student Judicial Affairs and Community Standards (SJACS)? Any student who has gone through SJACS knows how severely violations to academic integrity are treated. Even with the biological predisposition to morality suggested by Dr. Wynn and the severe punishments of SJACS, cheating remains an issue. Perhaps in the PHOTO COURTESY OF YALE PSYCHOLOGY course of our lives, that intrinsic Dr. Karen Wynn of Yale Psychology used five- and nine-month old in- understanding of right and wrong fants to investigate whether humans may a biological predisposition is clouded for the sake of self-into morality. terest.
Science of unboiling an egg By DAVID SUTTER Writer Scientists at the University of California at Irvine have developed a technique to unboil an egg, and this scientific breakthrough has the potential to dramatically reduce costs for the countless medical research procedures that require the unfolding of proteins. The clear, viscous, “whites” of an uncooked egg are composed of millions of proteins, folded in an ordered way. When heated, these proteins randomly tangle, just like DNA strands during the simultaneous process of synthesis and cell packaging. This state of entanglement is known as aggregation and has slowed the manufacturing process of recombinant DNA for years. Also, it has been identified as a source of mutations responsible for the spread of cancer. As of January 23rd, post-doctorate Dr. Tom Yuan, and principle investigator, Gregory Weiss at UC Irvine have made a breakthrough with their paper, “Shear-Stress-Mediated Refolding of Proteins from Aggregates and Inclusion Bodies” published in the journal of ChemBioChem. Recombining DNA is used for a swath of medical applications such as the production of insulin, vaccines, growth hormones, monoclonal antibodies, and anti-
biotics. In a global environment where Type I diabetes is projected to affect 366 million individuals by 2030, and the quality healthcare is a socioeconomic luxury, these products have become increasingly crucial and expensive. The current procedure to engineer proteins in an organized way has been to “scrub, rinse, spin and refold”, a process that can take days. The newly proposed method can accomplish this in one-hundredth the time. The invention is known as a Vortex Fluid Device. Similar to a top-of-the-line centrifuge, this machine spins dissolved proteins at high speed, and temperatures up to 90ºC. Stretched onto a thin glass film, the proteins straighten
and are able to refold into their original structure. This invention relies on a delicate difference in force between the air to liquid interface and the glass to liquid interface, to stretch the proteins rather than, “scrub and rise” them. Protein disposition has an expansive application in day-to-day life. Besides ameliorating corporate inefficiencies, it offers new inroads in cancer treatment and increases accessibility to expensive antibiotics. Although not yet implemented beyond Weiss’s UCI research lab, the Vortex Fluid Device has potential to become an integral technique in medicine and the larger social movement in affordable healthcare.
PHOTO COURTSEY OF BIOQUICK NEWS
UCI scientists have developed a technique to unboil an egg, which can be used to reduce costs for future medical treatments.
Hypertension drug slows aortic growth in Marfan Syndrome By DALTON BANH Writer In 1986, Flo Hyman, an Olympic medalist in women’s volleyball, suddenly collapsed and died during a match. The autopsy revealed that the cause of her death was an aortic dissection—a rupture of the largest artery in the body. Hyman had undiagnosed Marfan syndrome, a rare genetic disorder (affecting approximately 1 in 5,000 individuals) that is characterized by weakened connective tissue, like in the walls of blood vessels. Although the main cause of early mortality in Marfan patients is aortic dissection, the syndrome also affects multiple body systems, particularly the skeletal system. Clinical presentation of the disorder can vary greatly depending on the individual, but common physical features include unusual height, long and slender limbs, abnormal curvature of the spine, indentation or protrusion of the chest, excessive joint flexibility, lens dislocation, and higher risk of pneumothorax (lung collapse). Currently, there is no cure for Marfan syndrome but various specialists closely monitor patients depending on their symptoms. In addition to restriction of heavy exercise, the standard treatment plan for Marfan patients has been the use of beta-blockers, which have been shown to slow aortic root growth and reduce the incidence of aortic dissection. The molecular basis of Marfan is a defect in fibrillin-1, which is expressed by the FBN1 gene located on chromosome 15. Fibrillin-1 is responsible for the regulation of the growth factor TGF-β, which is involved in the activation and signaling of many developmental and cellular processes. TGF-β dysregulation is postulated to be the primary cause of the abnormal connective tissue exhibited in Marfan syndrome. Laboratory research done on mouse models has suggested that losartan, a hypertension drug, could slow aortic root growth and even reverse many symptoms of Marfan syndrome by restoring normal TGF-β levels. A clinical trial conducted by the Pediatric Heart Network studied the effectiveness of losartan in reducing aortic root diameter and rate of enlargement. The study enrolled 608 Marfan patients ranging from 6 months to 25 years of age from 2007 to 2011. The trial participants were randomized and given one of two medications—losartan or the beta-blocker atenolol. Cardiologists monitored aortic growth and regularly followed up with the patients over a period of three years. The results of the trial were published in the November 2014 issue of the New England Journal
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Olympian Flo Hyman died during a volleyball match due to undiagnosed Marfan Syndrome.
of Medicine. The study found that patients in both treatment groups displayed decreased aortic root growth, and that a younger age at the beginning of treatment was associated with a larger decrease. However, the study also found that there was no statistically significant difference between atenolol and losartan in decreasing aortic root growth. Although this study did not support the hypothesized advantages of losartan over atenolol, it found that losartan could function as an alternative treatment for Marfan patients, especially in cases where beta-blockers cause undesirable side effects. This study also demonstrated that initiation of treatment with these medications at an early age correlated with a stronger protective effect in slowing aortic enlargement, highlighting the importance of early diagnosis in Marfan syndrome. Only a few decades ago, a lack of awareness and understanding of Marfan syndrome resulted in many missed diagnoses like in Flo Hyman’s case. Today, advances in the scientific research used to understand the molecular and genetic basis of Marfan syndrome, drug discovery, as well as an increase in awareness of the disorder through advocacy groups (such as the Marfan Foundation) have all aided in early diagnosis.
TROJAN HEALTH CONNECTION | April 22, 2015
Dornsife offers health related Problems Without Passports courses: MDA 499 and BISC 428 By ZAIRA GASANOVA Writer Issues in healthcare transcend the walls of the classroom, the boundaries of neighborhoods and the borders between countries. USC Problems Without Passports (PWP) summer courses provide students with the opportunities to learn about global challenges and equip them with the knowledge they need to find innovative solutions. PWP courses range from exploring foreign policy to environmental science. MDA-499, Health, Disease, Language and Culture in Guatemala, and BISC428, The Biology of Tropical Diseases, are two courses that explore subjects pertinent to transnational healthcare. These courses combine research exercises with study in Guatemala and England, respectively. Dr. Erin Quinn, USC Dornsife’s associate dean for science and health and the faculty instructor of the MDA-499 course believes that gaining a broader perspective on global health is what the PWP classes are all about. Quinn was previously the faculty member associated with the BISC-428 course, and this is the first year that she will kick off the program in Guatemala. “We need broadly trained individuals who understand health and disease from every angle,
are able to critically analyze and interpret data, communicate effectively, incorporate social and cultural perspectives, collaborate to solve problems, manage economic resources and think proactively,” Quinn said. BISC-428 is taught by Oxford University global medicine faculty experts at St. Catherine’s College, and encompasses five themes: challenges in global health, health policy and public health, tropical medicine, vaccinology and international development and health. Summer 2015 will be the fifth summer that this course will have been offered. Students study major diseases that plague developing countries, such as malaria, HIV/AIDS, snake bites, diabetes, obesity and cardiovascular disease while reviewing strategies used to treat these diseases and health policy issues that can help prevent them. “In the course, they learn a holistic approach to medicine, which is important in remote or under-resourced communities,” Quinn said. “The course takes into account what challenges exist, the systems of healthcare in place and what treatments are available.” Students sit for two lectures each weekday morning and spend the afternoons visiting local Oxford attractions such as the Bodleian Library, the Ashmolean Museum and the Blenheim Place.
Kings College: Health and Society By RACHEL DONG Writer Kings College, located in the heart of London, is a top research university that offers pre-medical students the opportunity to gain clinical experience while studying abroad through its Health and Society program. Kings College is a study abroad program offered by USC and Health and Society is among the many classes Kings College has to offer. Because students in the program are required to take at least three additional courses for undergraduate major credit at USC, most students who study abroad at Kings College consist of International Relations, English, Biological Sciences, and Neuroscience majors. Amy Zhao, sophomore and Global Health major, is studying at Kings College this Spring. In addition to her Health and Society class, her classes include “Causes of War” and “Worlds of the British Empire.” The Health and Society program offers opportunities to shadow doctors in many different fields. “You see a lot of patients of different backgrounds that you wouldn’t normally see in the
states because the NHS is available to so many people. We get to shadow a general medicine, HIV, and osteopathy clinic,” said Zhao. This program also exposes students to the administrative side of healthcare. Zhao comments, “You even get to see a lot of how appointments are structured differently in the UK compared to the US.” Zhao says that the program is well rounded and different from what a “typical pre-med class” would be. Class assignments consist of clinical placements, lectures, essays concerning ethical issues, and presentations. With a class of 11 students this spring, there are many opportunities to learn directly from physicians in the field. Applications for the Health and Society program are due March 1, 2015 for the fall semester, and October 1, 2015 for the Spring 2016 semester. This is one month earlier than the standard study abroad application deadline for Kings. Overall, Kings College offers a good opportunity for pre-medical students to take major courses and gain critical clinical experience while abroad. More information on the Health and Society program can be found on the Kings College website.
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University of Oxford faculty help combat global health challenges. In past years, information has been presented diversely, such as through outdoor lectures that provide insight into alternative treatments for diseases and broaden their understanding of holistic medicine. They team up to write research papers on a global health topic and then presented their findings to their peers. Besides just experiencing the cities as students, PWP members also get to experience the cities as tourists. For example in London, they take course-related field trips to London to visit the Hunterian Museum, the British Museum, Guys Hospital and Gloucestershire to visit the Edward Jenner Museum. Two of the weekends are booked with additional side trips to Stratford-upon-Avon
to see a Shakespeare play and to Wiltshire County to visit Stonehenge and the Salisbury Cathedral. The cultural exposure grants students new perspectives on the field that they are studying. “What’s interesting is to see the change that occurs from their initial approach about potential solutions before they go to Oxford, and then their perspective to approaching the problem once they’ve attended the lectures,” Quinn said. “After three weeks, students are able to make a huge leap from their previously held belief model of ‘build large hospitals, prescribe drugs,’ to understanding that finding a solution that is local, low-cost, culturally acceptable and readily available is perhaps the best choice in solving
a health care issue.” The Guatemala course will focus on the challenge of delivering healthcare to non-English speaking patients, which is a modern problem encountered by many practitioners throughout the United States. Students will be immersed in Guatemalan culture through lectures taught in Spanish. Learning about the complex relationships between healthcare issues and socioeconomics issues, language and cultural context, students also get to experience guest speakers who cover healthcare in Guatemala, challenges in global health, health policy and infectious and chronic diseases. To be eligible for these courses, students must be on a pre-health track emphasis, enrolled at USC for the incoming fall semester, and have a USC cumulative GPA of 3.0 or higher. Dornslife students are also eligible for a Summer Undergraduate Research Fund (SURF) scholarship. “In preparing young people to go into careers in health, there has to be a real understanding of humanness, of who we are as people,” Quinn said, “because just understanding the physiological aspects of the body is not enough.” Interested students must to go through an application process and can find more information at http://dornsife.usc.edu/problems-without-passports.
April 22, 2015 | TROJAN HEALTH CONNECTION
en a toy camera and I started taking random pictures. By the time I was in high school I had a serious camera; I was in the yearbook department and we got access to a darkroom, lots of film— so I started from there, but for a long time it was a hobby. It turns out my grandfather was a photographer, which I found out later. But then about 15 or 16 years ago it became not just a hobby but a serious passion and I think every year since then it’s grown more and more into something that I take very seriously— I may not have very much time for it— but I take it very seriously. THC: I saw from your website you have sort of a unique approach, or technique, with infrared photography. Can you talk a little bit about how that works? VP: There used to be infrared film, and there may still be. The way it works is that infrared film is sensitive to heat, and to the infrared part of the spectrum (and this falls perfectly into what I’m teaching in physics). Your eyes see all the way to violet but besides violet there’s ultraviolet, which gives us our tans, and then on the other side of red there’s infrared, which our eyes can’t see,
but warm objects give off infrared light. In fact, the human body gives off infrared light, at a temperature that it normally is. So early on I fell in love with [infrared photography] because it gives you a black and white picture that is colored by warmth: whatever you see that is bright white is warm and whatever you see that is dark or black is going to be cold or in shadow. So there’s going to be a starkness between life and death, dark and light. THC: What advice do you have for aspiring doctors and scientists who also are interested in the arts as you are? VP: I think it is important for someone who is in the sciences to have some sort of balance in their lives. I mean I’ve met medical doctors who are great photographers. I’ll speak to photography because that’s my art— of course if you’re into music, that is equally great. But as a scientist you deal with chemical symbols every day, or you deal with engineering every day, it’s important to have balances because it engages your mind in a way that is different than your daily experience. And I think that is very, very important.
New pre-health professor: Vahé Peroomian By ANA HILLEBOE Senior Layout Editor This interview has been edited for the print edition. To read the full version, in which Peroomian talks more about his charitable work, his involvement with Glendale Community College and his art, please visit trojanhealthconnection.com. This semester, USC welcomed Vahé Peroomian as a new professor to its Department of Physics & Astronomy. Peroomian’s day job may involve his research in space science and teaching physics to pre-health and engineering students in PHYS 135b and PHYS 151, but he also keeps busy in his free time. Peroomian not only serves as president of the board of trustees at Glendale Community College, where he has implemented unique programs based on community feedback, but is additionally president of Glendale Youth Alliance, a charity organization that connects underprivileged youths with employment opportunities. An exhibited and published photographer, Peroomian is also a strong proponent of the arts. I sat down with Professor Pe-
PHOTO COURTESY OF MAYRA ORTIZ
Peroomian offering his photos for auction to benefit the Glendale Youth Alliance March 13.
roomian at his office in Stauffer Hall of Science, where one of his infrared photos hangs over his desk, to talk about his diverse interests, how he’s liking teaching physics at his alma mater’s rival, and his philosophy on balancing science and art. Trojan Health Connection: You have an impressive educational background— with your Bachelors, Masters, and Ph.D. in physics, all from UCLA. What brought you across town to work at USC? Vahé Peroomian: That’s a good question, because not only did I get my education from there, I
Society Criminalizes Mental Illness By IZMA SHABBIR Associate Editor Every year, almost 20 percent of the American population is diagnosed with some form of mental illness. Nearly 1 in 5 patients are diagnosed as mentally ill. College students are not exempt from this statistic. Schizophrenia in particular is largely associated with college students, as it usually develops between the ages of 16 and 25. In fact, a 2012 survey conducted by the National Alliance on Mental Illness found that at least 6 percent of college students are also schizophrenic patients. This remains a problematic issue because schizophrenia’s symptoms are exacerbated by drug use and excessive stress—both factors that are known to be especially prevalent on college campuses. Schizophrenia can develop during young adulthood but remains, even with treatments, until late adulthood. In fact, on a college campus, schizophrenia is not limited to students. Dr. Elyn Saks is a chaired professor of law, psychiatry, and psychology at the USC Gould School of Law and teaches at both the Keck School of Medicine’s Institute of Psychiatry and the Law, UC San Diego medical school. She is also a summa cum laude Vanderbilt graduate, Oxford University graduate and Yale Law School graduate. She has been a schizophrenic patient since young adulthood. Saks has recently written of her experiences in mental institutions and the poor professional treatment of mentally ill patients in her memoir The Center Cannot
Hold and has hosted the TED talk, “A Tale of Mental Illness— from the Inside.” In her talk, she defines schizophrenia as “a brain disease [whose] defining feature is psychosis, or being out of touch with reality. Delusions and hallucinations are hallmarks of the illness.” She has experienced three extensive hospitalizations, and during the three, she was violently restrained. Though she was admitted to the hospitals for help, she was instead treated violently and harmed by physical restraints. “Once in the [emergency room,]…the doctor and his whole team of goons swooped down, lifted me high into the air, and slammed me down on a metal bed with such force that I saw stars,” Saks said in her TED talk. “They strapped my legs and arms to the metal bed with thick leather straps...[and] a sound came out of my mouth that I’d never heard before: half groan, half scream, barely human and pure terror.” Over the next five months, Saks was involuntarily hospitalized. Spending up to 20 hours a day with her arms and legs tied down with a net restraining her chest, Saks asserts that she was never violent, threatening, or harmful. In the United States, one in three people who receive hospital restraints die as a result of suffocation, heart attack, strangulation or even being choked by her own vomit. To read the conclusion of Dr. Saks’ story, please visit our website at trojanhealthconnection.com.
also taught there for many years. I was at a juncture in my life where I needed some change. UCLA has a great physics program, but as far as my own position was concerned, I was both a professor and actively doing research. And so I was looking to expand my horizons, maybe take a break from research for a bit and concentrate on teaching, and so when the USC job offer came I couldn’t resist. THC: Now, moving on to your interest in photography— where did that come from? VP: It started as a kid. I was giv-
Kuhn’s entrepreneurial take on research By JANIE CHEN Section Editor Peter Kuhn, Professor of Biological Sciences here at USC and prominent biomedical scientist, has pioneered cancer detection technology with an entrepreneur’s mindset. His innovative mentality takes research to a new level and focuses on studying cancer specifically in human beings, eliminating the need for any translational science. Kuhn’s group formed the San Diego-based startup Epic Sciences in 2008 to commercialize circulating tumor cell (CTCs) detection technology. Their technique unveils detailed personalized information to help doctors better understand metastasis on an individual basis. Kuhn feels so strongly about pursuing science as an entrepreneur because he defines the entrepreneurship spirit as “assuming
responsibility to take something all the way through.” This mentality greatly depicts a nontraditional approach to research. It is no longer science for the sake of science. Kuhn lists human impact as his purpose and says, “Staying true to the rare event concept allows you to evolve, modify and pivot on the technology.” This kind of nimble approach opens up his options when it comes to experimentation; he is able to try new experiments and going outside of the box without losing sight of the fundamental purpose to do biomedical research: changing cancer into a fully managed disease. A physicist by training, it is no wonder that Kuhn conducts biomedical research with a distinct style. Becuase his formal training was not in the biological sciences, he has no preconceived notion about what cancer is or what it is
supposed to be. His only methodology is to listen, learn, and collaborate all to meet his goal of visualizing the progression of carcinomas to see how these aggressive forms of cancer grow. Kuhn has shown that the interesting thing about cancer is that it uses the blood to communicate with the rest of the body, which is how Kuhn decided to start studying the disease there. As long as the cancer and its progress can be visualized through the blood, researchers will be able to better understand the disease. He believes that the world we live in today is the most interesting time to conduct this type of research. Kuhn says, “our understanding of biology in its broadest sense is so great and our tools are so exquisite that the opportunities are completely unlimited.”
COURTESY OF MICHELSONMEDICAL.ORG
Kuhn (right) works with faculty from the Keck School of Medicine and Viterbi School of Engineering.
CENTER FEATURE: THE V
In 1998, British surgeon Andrew Wakeﬁeld published a study falsely linking the measles, mumps, and rubella (MMR) vaccine with autism. Although this claim has been discredited multiple times, an increasing number of parents have refused to vaccinate their children as a result of this study. Decreased vaccine rates have ultimately contributed to recent measles outbreaks, several originating from Disneyland in December 2014. In the midst of this vaccination debate, developments in vaccines continue to be made, including a new vaccine for women with triple-negative breast cancer. Here are some statistics that illustrate the state of the immunization controversy today. Exemption Rates 2013-2014 school year: 26 states reported not meeting government target of 95% coverage for MMR 2015 school year: 48 states allow religious exemptions 20 states allow philosophical exemptions Costs $63 billion in cost of illness averted due to vaccines. Speciﬁcally, treatment costs of $1.4 billion averted. Efﬁcacy Recent case reports in US vs. Pre-vaccine era estimated annual morbidity in US: Polio: 0 vs. 16,316, 100% reduction Hepatitis: 11,269 vs. 66,232, 83% reduction Smallpox: 0 vs. 29,005 100% reduction Measles Elimination In 2000, CDC documented complete measles elimination in the US In 2014, a breakout of about 830 cases of measles in 27 states occured Source: CDC Vaccination reports 2010-2014
Introduction by VARUN AWASTHI Infographics and Layout by ANA HILLEBOE and NATALIE LI
DISNEYLAND MEASLES OUTBREAK By NICOLE BASLER Writer
It may be considered the happiest place on Earth, but in recent months, Disneyland has been identified as the site of a highly contagious and potentially dangerous virus: the measles virus. The outbreak, which began late last year, likely stemmed from a traveler who became infected overseas, then visited the amusement park while infectious. Dr. Anne Schuchat of Centers for Disease Control and Prevention (CDC) said, “We don’t know exactly how this outbreak started but we do think it was likely a person infected with measles overseas.” Since the infection, a total of 142 people in 7 states were reported to have suffered from measles, and more cases can be expected. According to Dr. Gil Chavez, state epidemiologist of California, “We have had, in two and a half weeks, as many cases as we had in all of last year (in California). From this particular outbreak, we can expect to see additional cases.” According to the CDC, measles is a highly infectious disease caused by the measles virus, which lives in the throats and noses of infected individuals. The virus can be transmitted through coughing and sneezing. Symptoms include fever, cough, runny nose, red, watery eyes, tiny white spots (Kopik spots) inside the mouth, and a rash over one’s body.
Although measles can infect people of various ages, it mainly affects young children. During the pre-vaccine era, nearly all children contracted measles by the time they were 15 years of age. 3 to 4 million people were infected each year, an estimated 400 to 500 people died, and 48,000 people were hospitalized. However, today measles can be prevented with the MMR (measles, mumps, and rubella) vaccine. One dose of the MMR vaccine is 93% effective against contraction of the virus after exposure, and two doses of the MMR vaccine are 97% effective. In the United States, widespread use of the measles vaccination led to a 99% reduction in measles. In 2000, the United States declared measles eliminated with most of the existing measles cases occurring outside the United States. Despite this elimination, small outbreaks of measles cases have occurred in the United States in recent years. Although there has been an ongoing outbreak of measles in the Philippines, there has been little evidence linking the U.S. cases to those in the Philippines. Various other nations have also reported increases in the number of measles infections witnessed this year. Schuchat said, “This is a wakeup call to make sure that we keep measles from regaining a foothold in our country.” Schuchat urges health care pro-
viders to be on the lookout for the measles virus and expect an increase in its frequency during medical visits. The primary reason for the spread of measles is the failure to obtain vaccination. Some people cannot get the vaccination for medical reasons; for instance, those with damaged or compromised immune systems are exempt. However, others refuse to get the vaccination due to personal and philosophical reasons. The recent outbreak of measles, which stemmed from Disneyland, has caused a controversial debate over whether obtaining certain vaccinations should be required for all individuals and their children. Most of the children infected at Disneyland had not been vaccinated, but more adults than usual have been infected this year as well. Those individuals who are opposed to vaccination strongly believe in a link between vaccinations and unwanted side effects and diseases. For instance, some people believe there is a link between the MMR vaccine and autism. Others believe that vaccinations are both unnecessary and unnatural, and the body will protect itself from vaccine-preventable diseases. In addition, some believe that vaccinations are given to prevent diseases that are not serious, and too many of these vaccinations are given to children in the first two years of their lives.
Those who support the use of vaccinations believe that vaccinations keep individuals and those around them healthy by preventing serious diseases and are safe and effective. Despite these claims, there is no evidence of the supposed connection between vaccinations and other unwanted diseases. Vaccine supporters maintain that vaccinations will not infect an individual with the disease it is designed to prevent. In addition, supporters believe that the cost of not getting vaccinations is too great. Vaccine-preventable diseases have not been completely eliminated worldwide and can spread rapidly between populations. Vaccinations serve as a safe way to prevent the spread of these diseases. Regarding the case of the measles outbreak, Schuchat said, “This is not a problem of the measles vaccine not working. It’s a problem of the measles vaccine not being used. Measles can be a very serious disease and people need to be vaccinated.” State officials recently announced on April 17 that the Disneyland measles outbreak is over. In total, 131 people were infected in the US and Mexico. Still, the controversy over vaccines is yet to be resolved. Regardless of differing opinions on vaccination, an understanding must be reached in order to achieve common public health goals.
42 Ca Dis ing
HE VACCINATION DEBATE
False studies behind immunization invalidated By NATALIE LI Assistant Layout Manager In light of the measles outbreak originating from Disneyland, the controversy over the importance of child vaccinations has come to the forefront of public debate. Different opinions on vaccinations correlating with autism, sudden death syndrome (SIDS), or decreased immunity have been widely debated, but what truly are the benefits and/ or consequences of vaccines? Vaccines contain disease antigens, which are dead or weakened forms of the disease that the vaccine protects against. By introducing these antigens into a human system, one’s immune system is strengthened by first recognizing the foreign bodies, generating more defender cells to fight the infection, and storing a copy of the disease in their memory for future attacks. According to the Centers for Disease Control and Prevention, kids who are not immunized are at a greater risk of disease. A significant point of the debate of whether or not to vaccinate originated from a 1998 case study demonstrating a correlation between autism and the M.M.R. (measles, mumps, rubella)
SASHA PARK / TROJAN HEALTH CONNECTION
1 in 10 parents don’t follow the CDC recommended vaccination schedule for their children
(SIDS), are still present. These theories have also been disproved by extensive research, with a potential explanation for this concern being similar reasoning as above: that the time period in which vaccines are first given coincide with when these developmental disorders usually emerge. The CDC vaccination timeline calls for a series of 14 inoculations by the age of six, and while this may seem like a lot of vaccines or chemicals to subject one’s children to, the consequences of not vaccinating far outweigh the concerns of vaccines causing other developmental problems or having potentially toxic ingredients. Vaccinations were designed to prevent some of the most infectious diseases from becoming rampant outbreaks, and as recent events have demonstrated, not vaccinating can have serious costs, such as the return of the measles in the US. Nowadays, with the possibility of having vaccines given through nasal sprays in addition to injections, the practice is becoming more noninvasive and patient-friendly. While there will always be potential risks for any medical procedure or technique, the evidence of vaccination benefits are conclusive. Approximate
92-94% immunization rate needed to maintain herd immunity
SOURCE: CDC VACCINATION REPORTS 2014
Cancer vaccines promising By JEHAN BISTA Editor
The number of credible studies linking vaccines and autism
vaccine. The reasoning behind this research was that autism tends to appear around the age of one, the same time vaccines are typically given. However, numerous scientists have thus disproved this correlation being a direct link of causation between the two, as well as introduced new evidence highlighting the unethical methods and undisclosed financial conflicts of the author. The medical journal has retracted the paper, and a spokesman for the Centers for Disease Control and Prevention (CDC) has since given a statement that the retraction of the study is significant in that it “builds on the overwhelming body of research by the world’s leading scientists that concludes there is no link between M.M.R. vaccine and autism.” However, this was not before it led to a significant decrease in vaccinations that year, and the false notion is still widely circulated. Furthermore, other concerns about the correlation of vaccines to other developmental disorders, such as the incidence of sudden infant death syndrome
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April 22, 2015 | TROJAN HEALTH CONNECTION
MULTI-STATE MEASLES OUTBREAK CASES LINKED TO DISNEYLAND SOURCE: CALIFORNIA DEPT. OF PUBLIC HEALTH AND MARICOPA COUNTY DEPT. OF PUBLIC HEALTH
GRAPHIC COURTESY OF FOX59.COM
42 of the 59 measles cases as of December 2014 originated from California, where the measles outbreak has been directly linked to the Disneyland park. Several cases have spread to Mexico and neighboring states Washington, Oregon, New Mexico, Utah, and Colorado.
Women with breast cancer may no longer have to resort to surgery, chemotherapy, or even radiation therapy in order to treat their symptoms. Indeed, the future of breast cancer treatment is pointing towards another alternative: vaccines. The vast majority of breast cancer cells typically test positive for 3 different hormonal receptors: estrogen, progesterone, and HER2. Women with breast cancer typically produce excess amounts of these hormones, leading to rampant cell growth. Women with estrogen-positive breast cancer can be treated with drugs such as Toremifene and Tamoxifen, which specifically target (and block) estrogen receptors. Some women may also use aromatase inhibitors (AIs) such as Exemestane and Letrozole to reduce their estrogen levels. These drugs work by inhibiting an enzyme in fat tissue known as aromatase, which is responsible for some estrogen formation in post-menopausal women. Similarly, there is medicine for women with defective HER2 genes. Mutations in the HER2 gene, which is responsible for breast cell
proliferation, lead to uncontrolled cell division and ultimately cancer. Certain medications such as Herceptin and Tykerb can be used to inhibit HER2 receptors. The term “triple-negative” refers to breast cancer cells that test negative for estrogen, progesterone, and HER2. This type, which affects only 15-20% of women with the disease, is typically found in young African-American and Hispanic women, as well as women with mutations in their BRCA1 gene (BRCA1 is responsible for suppressing tumors and becomes inactivated due to mutations). Due to the lack of hormonal therapy options, patients with triple-negative breast cancer can currently only rely on chemotherapy, surgery, and radiation therapy for their symptoms. However, despite their efficacy chemotherapy drugs cannot differentiate between healthy and cancerous cells. Consequently, this method is neither safe nor cost-effective. Perhaps the answer does not lie in any of these procedures. Researchers at the Mayo Clinic in Jacksonville are currently running clinical trials for a vaccine for women with triple-negative breast cancer. The potential vaccine would work by inhibiting the folate receptor alpha protein, which is overactive in
80% of women with triple-negative breast cancer. Women who have had their tumors surgically removed and have cells that test positive for this protein will be eligible for this vaccine. Of course, these researchers are neither the first nor the last to research the possibility of vaccines
Due to the lack of hormonal therapy options,
patients with triple-negative breast cancer can currently only rely on chemotherapy, surgery, and radiation therapy for their symptoms. in breast cancer treatment. Just last year, researchers at Washington University School of Medicine ran clinical trials to test a vaccine that targets a protein known as mammaglobin-A, which is present in 80% of women with breast cancer. According to Dr. William Gillanders, the vice chairman for research in the department of surgery at the university, there “is preliminary evidence that the vaccine may have an impact on breast cancer progression.”
TROJAN HEALTH CONNECTION | April 22, 2015
Ultrasounds in the emergency room enhances diagnostics By LAUREN TAYLOR Writer
PHOTO COURTESY OF DISRUPT 3D
Japanese surgeon Maki Sugimoto holds a 3-D replica of a patient’s liver.
The future of excellent patient care lies in 3-D printers By JACKIE KRUGLYAKOVA Editor Only several years ago, an eye surgeon had to explain a potential surgery to his patient through complex medical terminologies. He or she could not get a precise understanding of a bone structure from an image on a screen or rotate the model skull in directions achievable with a patient on the operating table. Today, 3-D printers are transforming medical care, awarding physicians new angles from which to practice, and giving their patients a deeper understanding of the world of medicine. 3-D printing is a new technology aimed at creating three-dimensional models from digital files, such as CTI or MRI scans. Medical engineers can utilize different materials and dyes to make sensible models of a patient’s anatomy. Many hospitals now have in-house laboratories for the construction of such technology. Among many other hospitals throughout the nation, Children’s Hospital has embarked on one of the most challenging and ambitious programs to incorporate 3-D printing technology into medical care. The potential of this new technology is not limited to facilitating complex surgical procedures. It can also provide doctors with tangible medical tools, reducing the lengths of surgical operations and drastically reducing medical costs. Children’s Hospital in Boston has already produced more than 170 prints over the past 18 months, printing not just replica brains, but also skulls, spines, blood vessels, and rib cages. “When it comes time to operate, you don’t have to fiddle around, it’s all there,” said Dr. Frank J. Rybicki, chief of medical imaging at the Ottawa Hospital and chairman and professor of radiology at the University of Ot-
tawa. “You have unprecedented surgical planning, and you have unprecedented accuracy.” Dr. Weinstock, the director of the Pediatric Simulator Program at Boston Children’s, believes 3-D printing refines team communication and builds a network of roles centered around the patient’s needs. Furthermore, his program improves confidence and trust before a complex procedure. The facility itself is also an exact replica of a real surgical suite with beeping monitors and clinging tools. With these simulations, surgeons can make practice cuts before a major surgery, allowing them a blueprint with which they can run their trials. Research conducted by The Department of Veterans Affairs showed that such surgical simulations in medical scenarios reduced patient deaths and injuries by as much as 18 percent. However, while 3-D printing does reduce surgical complications, the procedure also presents some potential risks. For instance, surgeons performing an operation on the skull must work carefully without damaging critical areas of the brain. In addition, there are cases when the patient’s immune system rejects the material, making it difficult to perform the procedure. Many hospitals throughout the nation have returned to 3-D printers as a technology to produce customized implants. Tufts Medical Center is creating prosthetics ears for infants born without ears, and Brigham and Women’s Hospital is experimenting with 3D models to facilitate facial surgeries. As 3-D printing technology improves, so will medical care. Utilizing this new technology will allow physicians to weave catheters through replica blood vessels, map out aneurysms in the brain, and easily identify properties of tumor tissue.
Ultrasound was once solely used to show future mothers their baby’s progressive growth and development. However, the use of ultrasound has developed rapidly in recent years. Initially used only for trauma patient evaluations, clinicians are now using ultrasound to diagnose life-threating conditions. UC Irvine physician Dr. Chris Fox became an advocate for the increasing practice of using ultrasound in the ER after an encounter with a young woman with respiratory distress was rushed into the hospital. What initially looked like an asthma attack was actually some-
thing much more dangerous. Fox used the sound-wave probe to see that her abdomen was filled with blood, which he traced to the fetus within her uterus. He immediately sent her into surgery. “Without the ultrasound scanner, she would have died from a ruptured ectopic pregnancy,” said Fox in an interview in UC Irvine’s official school newspaper. Since then, he has gone on to become the 3rd ER physician to specialize in emergency radiology. Emergency ultrasound can also be used to improve the efficiency and safety of minimally invasive surgeries such as heart catheterization and can even be used to generate three-dimensional displays of the human body. In the emergency department,
PHOTO COURTESY OF 3DAND4D.COM
This image shows how realistic 3-D ultrasounds are to life. Due to their high level of detail, 3-D ultrasounds have a promising future in emergency medicine. “Precision” from page 1: the point of origin to other places of the body. President Obama’s initiative would, among other goals, continue funding cancer research, particularly studies that focus on genomic mapping in relation to different types of cancer. Of the $215 million delegated to the plan in the president’s 2016 proposed fiscal budget, $103 million would go towards a research cohort, $70 million to the NCI, $10 million to the Food and Drug Administration, and $5 million to help “sync” preexisting genomic databases. The largest project being funded by the precision medicine initiative is a nationwide research cohort, which would map out the genomes of one million volunteers, gathering biological specimens and testing new drugs and devices. According to the American Association for the Advancement of Science, the research cohort will include both healthy and sick individuals from pre-existing studies in an attempt to better represent the general population. It will also bring focus to patient privacy and health information systems; research volunteers will be able to view their health records, as well as view who is accessing their records. In The New England Journal of Medicine, NIH Director Dr. Francis Collins and NCI Director
Dr. Harold Varmus wrote, “Such a varied array of research activities will propel our understanding of diseases —their origins and mechanisms, and opportunities for prevention and treatment — laying a firm, broad foundation for precision medicine.” While this initiative has garnered the support of many researchers, others have voiced their concerns about the plan for various reasons. Cynthia Graber,
“General-care physicians seem to understand that their lack of training is a hindrance.” -Cynthia Graber
writing for The New Yorker, wrote that the problem lies with the doctors and their unfamiliarity with applying genetics to patient treatment. “Part of the dearth of genetics expertise among physicians stems from the fact that many of those currently practicing went to medical school before the human genome was sequenced,” she wrote in a February article titled, “The Problem With Precision Medicine.” In addition, she noted that
diagnostic screening ultrasounds are commonly used for abdominal, pelvic, and trauma examinations. Generally, a patient with severe abdominal pain is directed to get an abdominal or pelvic CT scan, which costs over $3,000, emits high amounts of radiation, and provides delayed results. Bedside ultrasound, however, produces results within minutes, is cheaper, and emits no harmful radiation. The information provided by bedside ultrasounds is sufficient to make a diagnosis in most cases. Similarly, ultrasounds can be used to evaluate trauma patients. The FAST exam identifies patients with blunt or penetrating trauma. Compared to a CT scan, the FAST exam is cheaper, lacks radiation, and can easily be repeated. Pelvic ultrasounds are mainly used on pregnant women who report pelvic pain or vaginal bleeding. Ultrasound can be used to detect intrauterine pregnancies, fetal cardiac activity, and (like in Dr. Fox’s case) ectopic pregnancies. Ultrasound is both safe and efficient, which is critical for immediate patient care in the ER. By using ultrasound, physicians can get patients to the operating room more quickly and potentially decrease mortality rates. The progression of the ultrasound has come a long way: from showing life, it can now help save it as well. “general-care physicians seem to understand that their lack of training is a hindrance,” citing a 2014 study in Genetics in Medicine that found that many respondents “expressed reservations about not fully understanding test results or not being able to devote the time necessary to discuss testing options and outcomes with patients.” In her Forbes article “Obama’s Not-So-Daring Precision Medicine Plan”, Meredith Salisbury was critical of another aspect of the initiative, believing that the funding allocated to the initiative would not be sufficient to execute the program as well as President Obama wished. “For an area of medicine that promises to be critical in delivering better healthcare to patients,” she wrote, “the plan should have been bigger and more ambitious.” The success of the new precision medicine plan remains to be seen, as President Obama submitted a request to approve the budget late January. If approved, those involved remain optimistic that it will change the current state of medicine. “With sufficient resources and a strong, sustained commitment of time, energy, and ingenuity from the scientific, medical, and patient communities,” Collins and Varmus wrote, “the full potential of precision medicine can ultimately be realized to give everyone the best chance at good health.”
WELLNESS 9 Wearable technology: propelling healthcare to the next generation
April 22, 2014 | TROJAN HEALTH CONNECTION
By MARIE KAAKIJIAN Writer A few years ago, the idea of wearing a fitness tracker may have seemed futuristic, but today this is not the case. In fact, according to Roy Wallack, author of the LA Times article “Wearable technology catapulting health and fitness into future”, the market of wearable technology is predicted to grow to an 80 billion dollar industry by the year 2020. The accelerated rise of wearable technology has undoubtedly brought many amenities to the average consumer, including the ability to link with a compatible smartphone and its applications. What exactly does this mean for the healthcare industry? Sir Bruce Keogh, an expert with the NHS in England, believes, like many other experts in the field, that wearable technology will certainly revolutionize the existing practice of healthcare. Specifically, Dr. Keogh envisions a time in which technology will “enable you
PHOTO COURTESY OF: THE INDEPENDENT
Apple’s iWatch, the newest piece of wearable technology, has the potential to revolutionize healthcare. to predict things, [and act early].” In other words, he foresees a time when he as a doctor will be able to use data collected from a patient using wearable technology to emphasize preventative care and intervene before major emergencies occur. Considering that most modern wearable technology
Fasting can promote better health By ABRAM ESTAFANOUS Editor Fasting has been an integral part of nearly all spiritual traditions for several millennia. The actual practice of fasting typically includes a willful abstinence from consuming food and drinks for a given time period that can vary in length. While various religions prescribe fasting to uplift the spirit, modern scientific research is beginning to demonstrate the potential benefits that fasting can have on the body. USC Longevity Institute director Dr. Valter Longo’s research on mice has demonstrated the benefits of fasting on longevity and prevention of certain diseases, such as diabetes and Parkinson disease. These positive health outcomes can be in part traced to oxidative damage. Common metabolism in the body that breaks down glucose from food sources and generates energy via ATP may potentially produce reactive oxygen species. These species are free radicals because they have unpaired electrons, which cause oxidative damage to cell structures and are associated with many diseases and aging. Under normal conditions, the body uses antioxidant enzymes, such as superoxide dismutase, to neutralize the effect of these reactive species by donating or accepting electrons. Antioxidants are richly present in fruits and vegetables, and may be found in common supplements as well. However, the body’s antiox-
idant system is not completely perfect. Oxidative damage by the free radical oxygen species causes aging and disease. This is where Longo’s research on decreasing calorie intake as a means to at least partly counteract oxidative damage comes in. The study, published in 2010 in the journal “Science,” demonstrated a link between fasting and increased life span. In the study, mice with decreased nutrient-sensing pathway activity ultimately demonstrated an increased life span over mice that had not been subjected to the fasting condition. The crux of the matter may have to do with the growth hormone. Longo’s research showed that fasting inactivated the growth hormone in mice. Growth hormone acts as an accelerator that promotes excess activity of cells, even when they don’t need to be hyperactive. Cellular hyperactivity is associated with oxidative stress and DNA damage. Indeed, other research by Longo has demonstrated a correlation between fasting and reduction in cancer and diabetes, in addition to aging. While the exact mechanism is not completely understood at this point in time, the connection between decreased nutrient intake and the inactivation of growth hormone is the current working model. It is off this model that researchers hope to demonstrate a more specific description of the benefits of the ancient practice of fasting with the enduring desire of longevity and disease prevention.
items measure complex numbers, like the respiratory rate, fluid levels, and the mental and physical stresses of the body, this claim is highly possible in the next few years. A specific instance of this occurs when dealing with recovering stress fractured patients. Dr.
Keogh notes that, in his experience, patients who monitor their steps taken daily using a digital wearable device and reduce them by half see remarkable relief from their symptoms of their stress fracture conditions. As a result, Dr. Keogh is able to use digital data to guide his patients into a
more realistic and accurate course of treatment. Another measure of stress, the galvanic skin response, functions in a similar vein. For instance, wearable devices that measure this figure give doctors insight into the amount of sweat leaving the body, thus indicating situations which Dr. Robert Duggard of Orlando Health claims “present the patient with the greatest sources of anxiety.” Collecting and using this information opens infinite possibilities to mitigating and relaxing the effects of major stressful events. Dr. Duggard echoes this statement, claiming that this information can also be used to craft the individual action plan of a specific patient. As the increase of information and monitoring improves, the ability to create a more healthy lifestyle improves, and it is important for people to take advantage of the opportunities people have to make a difference in their lives – starting with the digital wearable device.
The science behind stress By RACHEL POLCYN Writer With midterm season in full swing and finals just around the corner, many college students are experiencing health-related symptoms of stress, such as feeling sick or exhausted after a busy week of exams, club meetings, and other obligations. Such symptoms are indicative of the fact that stress has an evident effect on the physical health of an individual. What underlies those physical effects, however, is an important topic of consideration. Firstly, defining stress itself is something that even researchers often find difficult to do. Hans Seyle, who coined the term in 1936 to describe “the non-specific response of the body to any demand for change,” famously
replied to a reporter asking for a definition that “everyone knows what stress is, but nobody really knows.” The American Institute of Stress uses a roller coaster analogy to attempt to describe stress as the sense of being in a distressful situation because of a perceived lack of control. In other words, although many people are on the same roller coaster ride, they have different experiences during the ride based on how much control they believe they have. While individuals may vary in their stressful experiences, stress still manages to have a widespread and pronounced effect on the physical condition of a majority of people. The main reason stress has a significant effect on the body is that it changes hormone levels. According to Mayo Clinic, when a threat, like a large
PHOTO COURESY OF OLDGOLDANDBLACK.COM
The pressures of college can often lead students to experience negative health consequences of stress.
dog barking, is encountered, the hypothalamus in the brain prompts adrenal glands atop the kidneys to release adrenaline and cortisol. Adrenaline increases the heart rate and blood pressure, while cortisol increases glucose in the bloodstream and suppresses the digestive and reproductive systems. When the threat is gone, hormone levels return to normal. Long-term increased cortisol levels from constantly present stressors also have negative effects on the immune system as a result of the changing hormone levels within the body. These effects manifest themselves as several physical symptoms such as low energy, headaches, insomnia, upset stomach, changes in appetite, depression, anxiety, aches, pains, and tense muscles. However, a study conducted in 2012 by Stanford University School of Medicine scientist Firdaus Dhabhar challenged the longstanding belief that all types of stress suppress the immune system. The aforementioned long-term stress carries negative implications, but the results from Dhabhar’s study indicate that different kinds of stress, such as short-term stress, can actually heighten the immune system. This good version of stress, called eustress, can lead to higher productivity or help one avoid dangerous situations. Students experiencing the former symptoms of chronic stress can consult the Stress Relief Clinic at Engemann Student Health Center, which offers several services to help USC students dealing with the more negative effects of stressors. Their many programs include one-on-one consultations to assess stressors and identify beneficial campus resources or programs, restorative yoga, mindfulness based stress reduction, and biofeedback training.
FOOD & HEALTH
TROJAN HEALTH CONNECTION | April 22, 2015
FDA pushes for omega-3 use during preganancy By BRITTNEY KUO Associate Editor Low figures of American fish consumption have led the FDA to update and reemphasize their guidelines for fish consumption in the past year, particularly in terms of expectant mothers who have to be particularly careful about what they eat. The FDA affirms that fish consumption is vital to maintaining a healthy diet and encourages expectant women to incorporate more fish in their diet to not only improve their own general health, but also to benefit the health of their future child. Fish yields many benefits for not only expectant mothers, but also individuals in general, providing essential nutrients for the body such as protein, omega-3 fatty acids, and iron. Omega-3 in particular has a role in decreasing the risk of heart disease and honing cognitive functions, among a host of other health benefits. Expectant women in particular need to incorporate an adequate amount of omega-3 in their diet, as the fetus utilizes omega-3 for its own nervous system development, resulting in significantly
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The FDA is trying to convince pregnant women to consume more ﬁsh and omega-3 fatty acids and iron. decreased levels in the mother’s body that need to be replenished. Mothers who plan on breast-feeding their child are also recommended to eat more fish, as omega-3s are used in order to make breast milk—a contributing factor to the depleted levels of the fatty acid post-pregnancy. Fish consumption not only proves beneficial to the mother, but also aids in healthy devel-
opment for the fetus within the womb and beyond. The nutrients within fish promote healthy growth and development of the child. In particular, omega-3 fatty acids are integral in improving a child’s vision and neural development, according to the American Pregnancy Association. However, pregnant women must also take heed of what kind of fish they eat and avoid eating
raw fish or fish high in mercury. A majority of fish have methylmercury, a neurotoxin derived from mercury that gathers in bodies of water that can be dangerous for nervous system function. While most fish contain small amounts of mercury and do not pose a risk when eaten in small quantities, individuals should avoid consuming a large amount of fish with high mercury con-
tent. Thus, the FDA suggests that pregnant or breastfeeding women should avoid eating fish such as swordfish, tilefish from the Gulf of Mexico, shark, and king mackerel—all of which have extremely high mercury levels. Expectant mothers should also consume fish that has been properly cooked, in order to prevent the consumption of microbes present in raw fish that can compromise the immune systems of both the mother and child, which are especially vulnerable during pregnancy. Despite the concern over mercury intake, fish in recommended amounts nevertheless proves to positively benefit the overall health and nutrition of an individual, especially for pregnant women and their children. Alternatives to getting the adequate nutrients for those who are vegetarian or cannot consume fish include taking omega-3 supplements or at most eating foods high in plant-based omega-3 fatty acids such as tofu, flaxseed, and walnuts. Ultimately, incorporating fish or equivalent nutrients more regularly into diet plans is vital in maintaining or improving heart and nervous system function within an individual.
Myths on healthy foods busted Fad diets challenge lifestyle redesigns By DIANA CHEN Writer
Foods are oftentimes labeled healthy as part of a marketing scheme to urge consumers to buy certain food products. We have researched some common “healthy” foods that college students encounter and reveal the truth behind the ingredient list.. MYTH 1: Energy bars are nutritious and a great snack for before or after a workout. Truth: Most protein bars are actually candy bars in disguise. They are high in sugar, high in fructose corn syrup, and often contain unhealthy contents such as trans fats and artificial sweeteners. Companies that boast “0 grams trans fat” often include many other forms of partially hydrogenated oils in their bars, which are trans fat. This is primarily due to the fact that in America anything less than 0.5g of trans fat can be labeled as “0g trans fat.” Furthermore, since many protein bars often taste powdery and gritty, companies boost the flavor by adding unhealthy ingredients such as milk chocolate chips. For example, granola bars such as Quaker Chewy Granola Bars each contain 3g of sugar, which is as much as half a Snickers Bar. This is about 10% of the maximum amount of added sugars per day recommended by the American Heart Association, which recommends under 25g for women and under 37g for men. MYTH 2: Whole-wheat bread is a healthier alternative to white bread. Truth: “Whole-wheat” or “multi-grain” might sound healthy for you, but in reality these breads can contain up to 70% refined grains, which means
it is not 100% whole-grain. Refined grains have been modified greatly from their natural source, whole grains, and thus have lost a large amount of their nutrients. Even though the refining process adds back certain nutrients such as iron and riboflavin, this only accounts for a small portion of the nutrients lost. Next time you are at the grocery store, instead of looking for “whole-wheat,” “multi-grain,” or even “100% natural” bread, look for bread labeled “100% whole grain”. MYTH 3: Yogurt is good for weight loss and is at the same time full of probiotics, “good” bacteria that our body needs. Truth: It is true that yogurt contains probiotics, healthy bacteria that is already present in our digestive tracts which promote digestion and boost the immune system. However, it is also true that many store bought yogurt brands such as Dannon and Yo-
plait contain large amounts of sugar and are processed in a way that decreases the number of probiotic cultures. Furthermore, yogurt that is marketed towards children is so high in sugar one could almost call it a “liquid candy bar.” For example, Danimals yogurt contains 3 tablespoons of sugar each in a tiny bottle that is less than half a cup of yogurt. According to the American Heart Association, this equals half the maximum daily amount of added sugars recommended for an adult female and half of the maximum amount recommended for an adult male. To make sure that you are getting the healthiest yogurt, look for plain, unadulterated yogurt with live, active cultures. You can even make your own yogurt by buying the requisite bacteria, adding milk directly to it and then adding natural sweeteners such as honey or agave nectar for flavoring.
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Granola bars and protein bars are unhealthier than many realize.
By SANA AZAM Web Manager Healthcare costs have risen significantly over the last half-century, yet more and more patients are entering hospitals with chronic conditions that will require months, if not years, of care. Adopting more long-term lifestyle changes over temporary dieting offers a better solution to health problems. The concept of dieting in western society has been highly romanticized. “Diet” is most commonly used in reference to a restricting regimen aimed at improving fitness or weight loss, which is actually the definition for what is known as a “fad diet.” Fad diets though, which are what usually come to mind when the word “diet” is used, create short-term starvation scenarios that are not sustainable. “This is the truth behind fad diets: in general, you will lose weight in a short period of time, but chances are that you will gain back more weight than you had originally lost,” said Dr. Nicole Avena of Psychology Today. A study by Elizabeth Applegate and Louis Grivetti found that specific foods, proteins, carbohydrates, vitamins and minerals, are important because they provide certain nutrients for humans. TMany of these can be found in raw, unprocessed foods but due to the high percentage of processed foods in the average first world diet supplements are now necessary to compensate the difference. A study by Dr. Philip Tuso and colleagues found that eating a
plant-based diet is one of the better options. “Healthy eating may be best achieved with a plantbased diet, which we define as a regimen that encourages whole, plant-based foods and discourages meats, dairy products, and eggs as well as all refined and processed foods,” said Tuso and his colleagues in the study. For most people, this type of diet is better known as veganism. Veganism has become the most recent dieting phenomenon. According to Medical News Today, the three main reasons that individuals choose to adopt veganism include animal rights, environmental effects, and health. Veganism calls for the cessation of any use of animal by-products. There are many benefits of adopting a vegan lifestyle rather than practices such as temporary fad dieting. The two most significant effects are a reduced risk of cardiovascular disease and associated issues, as well as early prevention against various forms of cancer. These two major chronic diseases are the cause of many hospital visits by patients in the developed world, especially as we stay alive longer and eat increasingly unhealthier. There is still dispute over the lack of some essential nutrients in a vegan diet, and more research is needed to solidify the best options for improved health. However, actively adopting the ideas that veganism promotes—such as making more plant-based dietary choices—has some promise in regard to the future of long-term healthy lifestyles.
April 22, 2015 | TROJAN HEALTH CONNECTION
Humans or soldiers: neurological enhancement By SHARMILA RAJU Writer Science fiction films such as TScience fiction films such as Terminator and I, Robot envision a future with artificially intelligent militaristic robots and machine-like soldiers dominating the warfront. Although these films exaggerate the concept of a world with robotic soldiers and the dire threat they could pose to humanity, neurologically enhanced soldiers may no longer be a figment of science fiction imagination. The technology exists and research has proven that soldiers can be neurologically enhanced to improve their performance on the battlefield. In recent years, a significant portion of military scientific research funding has been dedicated to neuroscience in the hopes that ideas previously thought to be science fiction could become a reality. Within the next few decades, practical variations of neuroenhancement methods will start to appear in military operations. The 21st century’s highly evolved warfare and dynamic warfront has brought military
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Neuroenhancement increases soldiers’ battlefield performance. science and technology closer together than ever before. As warfare has transformed, so have the military’s technological needs. The capacity of an army now relies more heavily on intelligence gathering and cognitive efficiency instead of physical vigor as it did before the Cold War. The effort to optimize a person’s cognitive ability through neuropharmacological methods, brain stimulation, or brain-machine interfaces is now collectively desig-
Scientists create artificial muscle By ALEXIS HUNTER Writer Researchers at Duke University have artificially created human skeletal muscle that is able to contract like actual human muscle in the lab. These grown myobundles are able to duplicate the electrical and chemical responses of human skeletal muscle to pharmaceutical drugs. The muscle itself was engineered by extracting and multiplying human muscle cells, which were then molded and exposed to a nourishing gel, resulting in cells that are able to align and fuse into muscle fibers. This discovery opens the door for better and safer physiological and pharmacological testing by allowing a better alternative to previous drug tests, which include costly animal testing and invasive experimenting on patients. These cells may also “provide a pre-clinical assay for predictive screening of novel therapeutics for a broad range of muscle-related disorders,” which could benefit patients suffering from a range of muscle-related diseases.
In addition, this bioengineered muscle could be integrated with other organ systems such as the liver or heart for more predictive toxicology studies, which suggests that scientists may not be far from creating a bioengineered human in the future. Despite being groundbreaking, this news may not be viewed by everyone positively. There is what some would consider an ethical dilemma on how far science can go before it crosses what is considered the “god boundary,” which describes the increasing rate at which science seems to do what was considered to be outside human capability. Here, the “god boundary” refers to creating a human. However, whether one believes in a higher order or not, some wonder if it is ethical for science to move into this new realm of creation, where it is possible to create functioning human beings that would only be used for testing drugs for the sick. While these advances in science may seem unbelievable, the time may come when society must face these ethical dilemmas.
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Artificial human muscle may allow safer pharmacological testing.
nated as “performance neuroenhancement.” Currently, only neuropharmacological methods of neuroenhancement have been used in the military. Neuropharmacological enhancement typically uses prescribed orally administered chemicals to sharpen the senses. The controversial “Go pill” used by the military consists of dextroamphetamine, a chemical that keeps U.S. Air Force pilots from falling asleep during stressful air
combat situations. Military scientists are looking into perfecting brain stimulation methods and brain-machine interfaces for in-field utilization. Brain stimulation application consists of either transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS), which can result in improved learning of procedural tasks, improved and increased rate of memory consolidation, and increased maintenance of vigilance without deterioration. Previously these methods required the application of gel to allow electrode stimulation to work, but the advent of “dry electrode recording” could allow the creation of helmets to be used in the battlefield for the aforementioned cognitive improvements. A soldier receiving tDCS or TMS to critical brain areas could selectively improve certain cognitive abilities without stepping foot in a laboratory. Additionally, brain-machine interfaces (BMIs) seek to short-circuit natural neural signaling and could allow personnel to recognize concealed objects faster during horizon scanning than an opponent without this tech-
nology. Recognition of a threat a few seconds earlier could be the difference between life and death for a squadron. These militaristic neuroenhancement methods are past proving efficacy and are in later stages of development for practical application. The rapid advancement and exponential growth of science innovation means that neuroenhancement technologies will expand and further develop very quickly. A cursory Google search of “dry electrode recording” shows that the concept was once merely a suggestion at the end of research papers but became commercially available within just a few years. It is plausible that commercial development of neuroenhancement will affect civilians and thus change the framework of healthcare in the future. The speed at which neuroscience technology is amplifying predicts a future where new dilemmas regarding neuroenhancement could arise within the military sector, neuroscience research, and physicians. Ethical paradigms of military and commercial neuroenhancement may need to be addressed in the near future.
The war on poor nutrition BY CRISTINA GAGO Writer
With U.S. childhood obesity rates nearly quadrupling over the past 30 years, one thing is obvious: American nutritional standards are deeply flawed. Where better to ignite our much-needed nutritional revolution and reshape the daily diet of America’s youth than in the school cafeteria? Transforming the lunchroom into a platform for the reinvention of nutritional standards, the U.S. Department of Agriculture brought necessary reform—the first of its kind in 15 years—to the USDA Nutrition Standards in the National School Lunch and Breakfast Programs in 2012. With Harvard School of Public Health researchers claiming that these “are the strongest [standards] implemented by the USDA to date, and…will likely have important health implications for children,” we find ourselves questioning the results nearly three years later. Rebalancing the cafeteria lunch tray, schools have recently pushed high-sugar foods off the menu, making room for heartier fruits and vegetables. While reform is necessary, as evidenced by the current obesity epidemic, nearly 81.2% of schools report increased food waste as a result of the reform, according to the School Nutrition Association. One fifth-grade teacher working in South Los Angeles, for example, verifies this statistic, claiming that “over 90% of [her] kids say they dislike the new menu.” Witnessing devastating reductions in overall milk consumption, this teacher observes kids consciously tossing rather than drinking their the only op-
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Unhealthy food continues to be a health problem in US schools. tion: unsweetened milk. Understanding the need to reduce sugar intake, she fears that the absolute removal of flavored milk products will result in significant nutritional gaps, as her students and others from the national pool of nearly 32 million children depending on school meals refuse to consume the “healthy” alternative. This reported increase in perceived waste, especially with regard to vegetables, however, does not appear to accurately align with empirically-measured levels of school cafeteria waste, as a Harvard School of Public Health study suggests that entrée, fruit and vegetable waste has not increased following the reform. Although today’s students produce significant food waste, this is not an emerging concern, but, rather, a decades-old issue, as an estimated 60-75% of vegetables presented in school lunches continue to be tossed in trash bins. In addition to studying how
much is wasted, Montana State University researchers also focus on what is tossed, finding that the vegetable component makes its way into the garbage most frequently. Ultimately, these findings raise concern by suggesting that essential aspects of student meals are fed to the trash, demonstrating the need to improve overall food quality and attractiveness. But, don’t worry—there may still be hope. Contrasting the consistency of high food waste levels, this study also discovered an encouraging increase in overall target food consumption, as fruit intake increased by 23.0% and vegetable intake increased by 16.2% following the reform, suggesting that the school breakfast and lunch updated standards have already positively impacted eating habits in young students. Winning in some respects and losing in others, the war on poor nutrition continues to progress but is nowhere near over.
MEDICAL SCHOOL SPOTLIGHT
TROJAN HEALTH CONNECTION | April 22, 2015
UC Davis offers intellectual and community exploration By VARUN AWASTHI Editor-in-Chief Located in Sacramento, CA, UC Davis School of Medicine offers its students a curriculum that is focused on a mastery of six major competencies including patient care, knowledge, interpersonal communication skills, professionalism, system-based practice and life-long learning. The traditional block curriculum integrates content in the basic sciences and clinical medicine with important core principles such as population medicine, ethics, socio-economics, behavioral medicine, and patient centered-care. The curriculum is also innovative in multiple respects. A variety of teaching methods and technologies are implemented allowing for learning through both discovery and collaboration. UC Davis emphasizes learning that is self-directed and interactive through small groups along with self-assessment and frequent formative feedback. In addition to traditional exam formats, standardized patients and simulation technologies are also used for assessment of learning. The flexibility of the curriculum gives students multiple opportunities for career exploration and community service, with elective credit available for participation in student-run community health clinics. Curriculum Year 1 consists of two blocks including Foundations and Mechanisms & Disease. The first portion of the three-year doctoring
curriculum is presented concurrently with these two blocks and includes physical examination training with standardized patients. Patient cases are presented through a problem-based learning approach and ultimately connect concepts in basic science to applications in clinical medicine. An introduction to epidemiology/biostatistics and behavioral medicine are also included in year 1. Additionally, the Professionalism, Ethics and Cultural Enrichment (TEAM-PEACE) longitudinal curriculum begins in year 1, in which students are required to attend preceptorships throughout the community and home visits.
Class of 2017 Proﬁle #43 Best Research #19 Best Primary Care Total Enrollment: 437 Faculty-student ratio 1:7:1
Applications Accepted: June 1 Deadline: October 1 Application Fee: $90 Acceptances: 10/15 - 7/15
Top Specialties Chosen by Students
Anesthesiology Emergency Medicine Family Practice Internal Medicine Obstetrics/Gynecology
Orthopaedic Surgery Pediatrics Psychiatry Radiology - Diagnostic Surgery - General
Median Overall GPA: 3.73 10th Percentile Overall GPA: 3.29 90th Percentile Overall GPA: 3.95 Median Science GPA: 3.69 10th Percentile Science GPA: 3.18 90th Percentile Science GPA: 3.97 Median MCAT Total Numeric Score: 32
Gender Distribution (Men/Women): 55%/45% In-State/Out-of-State: 100%/0%
Tuition (California Resident): $37,509 / year Tuition (National/International Resident): $49,754 / year 6,108 Verified Applications 497 Interviewed (MMI) 110 Matriculated 1.8% Acceptance Rate
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Year 2 consists of three blocks including brain and behavior, skin and bones, and pathophysiology. The second portion of the doctoring curriculum is also taught concurrently with these three blocks and emphasizes epidemiology, health care assessments, advanced clinical skills and patient assessment. TEAMPEACE continues through which students learn to more comprehensively perform and document patient assessments. Year 3 consists six eight-week rotations in internal medicine, surgery, pediatrics, obstetrics/gynecology, psychiatry, and primary care. The third and final por-
tion of the doctoring curriculum teaches students about interviewing techniques, evidence-based medicine, clinical reasoning, clinical epidemiology, and ethics/ jurisprudence. Year 4 consists of 32 weeks of learning activities for studentsthat can include active internships, advanced clinical clerkships, and clinical didactic courses. Students must also complete a 4-week scholarly project or a special study module. The special study module gives students the opportunity to focus on an in-depth multidisciplinary topic of interest, while the scholarly project requires independent research with
a faculty member. Dual Degrees A number of dual degrees are available at UC Davis. As part of the Physician Scientist Training Program (PSTP), the dual MD/ PhD option allows students interested in a career in academic medicine to extensively pursue research in a certain area of science, such as microbiology, immunology, and biomedical engineering in addition to the training provided through the MD. This program typically takes eight years. A five-year MD/MPH program is also available for students interested in community health and prepares them for careers in both medicine and public health. Other dual degrees include MD/ MBA for students interested in the management aspects of medicine, and MD/MAS for students interested in clinical research. Hospital Afﬁliation UC Davis Medical Center is the primary teaching hospital affiliated with UC Davis School of Medicine. This 619-bed hospital admits 30,000 patients per year and has more than 1 million patient visits each year. The 2014-15 US News and World Report ranked UC Davis Medical Center in the nation’s top hospitals in 10 medical specialties. Other affiliated hospitals include UC Davis Children’s Hospital, UC Davis Cancer Center, Shriners Hospital for Children-Northern California, Sacramento Veterans Affairs Medical Center, and Kaiser Permanente Medical Centers located in Sacramento, Roseville, and South Sacramento.