Jersey-Robert Wood Johnson Medical School Research Articles

Increasing Awareness of Disaster Preparedness: Online Modules for Pre-Clerkship Medical Students

OPEN ACCESSJune 7, 2013Increasing Awareness of Disaster Preparedness: Online Modules for Pre-Clerkship Medical Students Laryssa A. Patti, MD, Norma Saks, EdD Laryssa A. Patti, MD Rutgers, Robert Wood Johnson Medical School Google Scholar More articles by this author , Norma Saks, EdD University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9441 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstract Introduction: In 2003, the Expert Panel on Bioterrorism Education for Medical Students, an inter-professional task force convened by the Association of American Medical Colleges, recommended the inclusion of disaster preparedness training in the medical student curriculum. However, few medical schools include disaster preparedness topics in their curricula. This resource provides educational material on disaster preparedness for first- and second-year medical students. It includes three short modules on disaster preparedness topics, consisting of: (1) the Incident Command System, a tool used to organize emergency response (2) triage, a process of determining the priority of patient treatment based on the severity of their injuries, and (3) weapons of mass destruction, materials that can cause harm and damage to large numbers of people or structures. Methods: The information in these modules is presented in separate 10–15 minute interactive online formats (45–60 minutes total), and can be used as a unit or individually. This resource includes a pre- and posttest for evaluation of student learning and a module evaluation form. Results: Fifteen first- and second-year medical students at Robert Wood Johnson Medical School volunteered to use this resource. The modules were made available on the school's internal course management system and pre- and posttest results and survey information were collected anonymously through the system. Pre- and posttest scores indicated that students gained knowledge regarding the topics covered in the modules; average scores increased from 63% to 83% correct. Overall, students responded positively to the use of the online format as a way of providing information. Thirteen reported this being their first exposure to disaster preparedness topics during medical school. All reported that the material in the modules was easy to understand, and 14 would recommend the modules to a classmate. Ten participants reported feeling “more prepared to help in a disaster.” Discussion: Few medical schools include disaster preparedness topics in their curricula. This resource provides educational material on a number of disaster preparedness topics for first- and second-year medical students. Educational Objectives By the end of the module, learners will be able to: Apply knowledge of weapons of mass destruction by using patient scenarios to differentiate between biological, chemical, nuclear, and explosive exposures.Define the Incident Command System (ICS), and identify situations in which ICS application would be relevant.Explain the purpose of triage and the simple triage and rapid treatment (START) algorithm, and apply these concepts of triage to patient scenarios. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Incident Command System Module-Disaster Preparedness.pptx Instructor Guide - Disaster Preparedness.docx Module Evaluation Survey - Disaster Preparedness.docx Pre and Post Test_Questions - Disaster Preparedness.docx Triage Module-Disaster Preparedness.pptx Weapons of Mass Destruction Module - Disaster Preparedness.pptx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2013 Patti and Saks. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsEMSICSDisaster PreparednessTerrorismWeapons of Mass DestructionTriageModuleBiological/Chemical TerrorismIncident Command SystemEmergency Medical ServicesDisasters Disclosures None to report. Funding/Support None to report. Loading ...

Ask the Experts: Accelerated partial breast irradiation: the future of radiation therapy for breast cancer?

Bruce G Haffty is currently Professor and Chairman of the Department of Radiation Oncology of the University of Medicine and Dentistry, New Jersey-Robert Wood Johnson Medical School and New Jersey Medical School, and Associate Director of the Cancer Institute of New Jersey (NJ, USA). His medical school and residency training were at Yale University School of Medicine (CT, USA), and he spent the majority of his academic career at Yale School of Medicine, Department of Therapeutic Radiology. He moved to the Robert Wood Johnson Medical School and Cancer Institute of New Jersey in 2005. Haffty is internationally recognized as an expert in breast radiation oncology and has published over 300 peer-reviewed articles, 30 book chapters and numerous editorials and letters. Much of his recent research has been supported by the Breast Cancer Research Foundation. He is consistently listed as one of the country’s leading physicians by Best Doctors in America, Ladies Home Journal, Good Housekeeping, America’s Top Doctors, Top Doctors for Cancer and Top Doctors in New York and New Jersey. In addition to a busy clinical practice, Haffty has served on numerous national committees related to research and education in breast cancer and radiation oncology. He is a past president of the American Radium Society and is the immediate past president of the American Board of Radiology. He is currently Associate Editor of the Journal of Clinical Oncology and President-Elect of the American Society of Radiation Oncology.

Program and AbstractsThirty-third Annual Meeting of the Surgical Infection SocietyLas Vegas, NevadaApril 12–15, 2013

Program and AbstractsThirty-third Annual Meeting of the Surgical Infection SocietyLas Vegas, NevadaApril 12–15, 2013

Diagnosis and Treatment of Erectile Dysfunction for Reduction of Cardiovascular Risk

We established erectile dysfunction as an often neglected but valuable marker of cardiovascular risk, particularly in younger men and men with diabetes. We also reviewed evidence that lifestyle change, combined with informed prescribing of pharmacotherapies used to mitigate cardiovascular risk, can improve overall vascular health and sexual functioning in men with erectile dysfunction. We performed a PubMed® search for articles and guidelines pertinent to relationships between erectile dysfunction and cardiovascular disease, cardiovascular and all cause mortality, and pharmacotherapies for dyslipidemia and hypertension. The clinical guidance presented incorporates the current literature and the expertise of the multispecialty investigator group. Numerous cardiovascular risk assessment tools exist but risk stratification remains challenging, particularly in patients at low or intermediate short-term risk. Erectile dysfunction has a predictive value for cardiovascular events that is comparable to or better than that of traditional risk factors. Interventional studies support lifestyle changes as a means of improving overall vascular health as well as sexual functioning. Statins, diuretics, β-blockers and renin-angiotensin system modifiers may positively or negatively affect erectile function. Furthermore, the phosphodiesterase type 5 inhibitors used to treat erectile dysfunction may have systemic vascular benefits. Erectile dysfunction treatment should be considered secondary to decreasing cardiovascular risk. However, informed prescribing may prevent worsening sexual function in men receiving pharmacotherapy for dyslipidemia and hypertension. As the first point of medical contact for men with erectile dysfunction symptoms, the primary care physician or urologist has a unique opportunity to identify those who require early intervention to prevent cardiovascular disease.

Is Supersize More than Just Too Much Food?

Is Supersize More than Just Too Much Food?

Basic Science for the Clinician: 50

From the Division of Rheumatology and Connective Tissue Research, Department of Medicine, Department of Pediatrics, and Department of Molecular Genetics & Microbiology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ. Correspondence: Leonard H. Sigal, MD, FACP, FACR, MEB 484, Division of Rheumatology, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, 1 R W Johnson Place, New Brunswick, NJ 08903-001. E-mail: [email protected]

A simple technique to improve oxygenation and prevent severe desaturation in deeply sedated patients during colonoscopy

Department of Anaesthesiology, Univ of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, USA

A technically simple and effective face tent improves oxygenation and prevents severe O2 desaturation in deeply sedated patients during retrobulbar block at no additional health cost

Department of Anaesthesiology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, USA

APA Honors Innovative Mental Health Programs

APA Honors Innovative Mental Health Programs

Lost in Translation

On Being a Doctor17 March 2009Lost in TranslationMark Saxena, MDMark Saxena, MDFrom the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08903.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-6-200903170-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Marta walked into my office, a seasoned veteran. She had been getting monthly international normalized ratio checks, annual eye exams, and quarterly hemoglobin A1c tests for years. On my first day as an intern, she looked at me skeptically and said, “Doctor Sa-sss-ayna?” I was the new doctor with a funny name but also the one who was about to surprise her. For the Spanish-speaking patients in our residency office, we use local college students formally trained as Spanish interpreters to translate. I asked Marta, “Do you prefer to speak in English or Spanish?” She said “Spanish,” and as I ... Author, Article, and Disclosure InformationAffiliations: From the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08903.Corresponding Author: Mark Saxena, MD, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, MEB 486, PO Box 19, New Brunswick, NJ 08903; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited by„Pamiętam, zdarzyło się to w sobotę rano, około 10”. Fachowe publikacje medyczne oparte na relacjach pacjentów i lekarzy 17 March 2009Volume 150, Issue 6Page: 419-420KeywordsHypercholesterolemiaInternational normalized ratioLower back painMouthPerceptionResidencyScarsStatinsTongueTraumatic injury ePublished: 17 March 2009 Issue Published: 17 March 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

PathMiner: A Web-Based Tool for Computer-Assisted Diagnostics in Pathology

Large-scale, multisite collaboration has become indispensable for a wide range of research and clinical activities that rely on the capacity of individuals to dynamically acquire, share, and assess images and correlated data. In this paper, we report the development of a Web-based system, PathMiner , for interactive telemedicine, intelligent archiving, and automated decision support in pathology. The PathMiner system supports network-based submission of queries and can automatically locate and retrieve digitized pathology specimens along with correlated molecular studies of cases from "ground-truth" databases that exhibit spectral and spatial profiles consistent with a given query image. The statistically most probable diagnosis is provided to the individual who is seeking decision support. To test the system under real-case scenarios, a pipeline infrastructure was developed and a network-based test laboratory was established at strategic sites at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, the University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, The Cancer Institute of New Jersey, and Rutgers University. The average five-class classification accuracy of the system was 93.18% based on a tenfold cross validation on a close dataset containing 3691 imaged specimens. We also conducted prospective performance studies with the PathMiner system in real applications in which the specimens exhibited large variations in staining characters compared with the training data. The average five-class classification accuracy in this open-set experiment was 87.22%. We also provide the comparative results with the previous literature and the PathMiner system shows superior performance.

Activator protein-1 transcription factors are associated with progression and recurrence of prostate cancer: Ouyang X, Jessen WJ, Al-Ahmadie H, Serio AM, Lin Y, Shih WJ, Reuter VE, Scardino PT, Shen MM, Aronow BJ, Vickers AJ, Gerald WL, Abate-Shen C, Center for Advanced Biotechnology and Medicine, University of Medicine and Dentistry, New Jersey-Robert Wood Johnson Medical School, Piscataway, NJ

To identify biomarkers that discriminate the aggressive forms of prostate cancer, we performed gene expression profiling of prostate tumors using a genetically engineered mouse model that recapitulates the stages of human prostate cancer, namely Nkx3.1; Pten mutant mice. We observed a significant deregulation of the epidermal growth factor and mitogen-activated protein kinase (MAPK) signaling pathways, as well as their major downstream effectors–the activator protein-1 transcription factors c-Fos and c-Jun. Forced expression of c-Fos and c-Jun in prostate cancer cells promotes tumorigenicity and results in activation of extracellular signal-regulated kinase (Erk) MAPK signaling. In human prostate cancer, up-regulation of c-Fos and c-Jun proteins occurs in advanced disease and is correlated with Erk MAPK pathway activation, whereas high levels of c-Jun expression are associated with disease recurrence. Our analyses reveal a hitherto unappreciated role for AP-1 transcription factors in prostate cancer progression and identify c-Jun as a marker of high-risk prostate cancer. This study provides a striking example of how accurate mouse models can provide insights on molecular processes involved in progression and recurrence of human cancer.

Helicobacter pylori in Children With Chronic Idiopathic Thrombocytopenic Purpura: Are the Obstacles in the Way Typical in Pediatric Hematology?

*Division of Oncology/Hematology, University Children's Hospital, Basel, Switzerland †Division of Pediatric Hematology and Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ Commentary on JPHO 06-310R2 and JPHO 06-344R2. Reprints: Thomas Kühne, MD, Division of Oncology/Hematology, University Children's Hospital, Postfach, Römergasse 8, CH-4005 Basel, Switzerland (e-mail: [email protected]).

Children’s Health Centers: Past, Present, and Future

A physician who conducted some of the first studies documenting the effect of lead poisoning on children. An epidemiologist studying the effects of exposure to diethylstilbestrol (DES). A toxicologist pointing out the many different chemical exposures associated with impulsivity. Though each of their disciplines uses a different language, all of these scientists study the links between the environment and childhood disease. They are just a few of the researchers who converged at the “Children’s Environmental Health Research: Past, Present, and Future” conference held 22–23 January 2007 at the NIEHS. Sponsored in full by the NIEHS and planned jointly with the EPA, the conference aimed to get scientists talking about what types of research have been most effective. The result was recommendations to help chart the course for NIEHS children’s environmental health research over the next five to ten years, including the future of the Centers for Children’s Environmental Health and Disease Prevention Research.

Successful Tobacco Dependence Treatment in Schizophrenia

Individuals with schizophrenia smoke at rates three times higher than the general population in the United States, with smoking prevalence rates of at least 60% (1, 2). International studies have also typically found increased rates of smoking among persons with schizophrenia (3). A pattern of heavy smoking (more than 20 cigarettes per day) and severe nicotine dependence (4, 5) is characteristic. Smokers with schizophrenia have increased nicotine and cotinine levels that are attributed to increased nicotine intake per cigarette (6–8). Higher blood nicotine levels are associated with greater severity of tobacco dependence and more difficulty quitting. High nicotine levels may be needed for activation of low-affinity alpha-7 nicotinic receptors, which are reduced in both number and function in schizophrenia (9, 10). Evidence for this self-medication hypothesis comes from abnormal electrophysiological measures and saccadic eye movements that are reversed or improved when nicotine is administered by smoking cigarettes or with high-dose nicotine gum or nasal spray (11–13). Despite nicotine being beneficial, tobacco is not a pharmaceutical and is associated with more than 4,000 toxins and more than 60 carcinogens. Nicotine can be delivered more safely in commercially available nicotine products, including gum, nasal spray, inhalers, and patches. Schizophrenia is associated with a 20% reduced life expectancy and increased rates of smoking-related respiratory and cardiovascular diseases compared to members of the general population (14, 15). A 10-year study of elevated risk of coronary heart disease in schizophrenia showed that the risk remained extremely high even after control was added for factors such as weight and body mass index and was attributable mainly to smoking (16). Besides health, tobacco use results in other consequences, with smokers suffering financially and socially. Smokers with schizophrenia spend almost one-third of their monthly disability income on cigarettes (17). Smoking influences community integration because smokers have less income to spend on clothing and housing. As the smoking rate decreases among the general population, there is also the stigma in being a smoker in addition to the stigma of having mental illness. This can reduce success in obtaining employment, housing, or interpersonal relationships. Studies have found that heavy smoking among individuals with schizophrenia is associated with higher levels of positive symptoms and higher antipsychotic medication doses (18, 19). Despite the magnitude of tobacco use problems, quit rates for seriously mentally ill smokers are significantly lower than in the general population (5, 20). Individuals with schizophrenia are able to quit smoking, although the success is about half that of other groups (21–23). Contributing factors likely include lower motivation to quit tobacco use, fewer lifetime quit attempts, and increased severity of nicotine dependence. Another important consideration is that access to treatment for this group is reduced. Few mental health professionals identify and treat tobacco use in their patients (24, 25). Tobacco dependence interventions provided in primary care and public health settings are often brief and may lack the intensity or specialization needed for this population to stop smoking. These services often rely on a highly motivated and organized client who is ready to quit. In 2001, the University of Medicine and Dentistry of New Jersey—Robert Wood Johnson Medical School and Tobacco Dependence Program both collaborated to develop specialized services for smokers with schizophrenia and other mental illnesses. These differed from traditional services in several ways: services were open ended and not limited to a set number of contacts, all patients were encouraged to use a combination approach of pharmacotherapy and counseling, and there was no requirement to set a quit date to be in treatment. An addictions psychiatrist and mental health social worker that was also a certified tobacco treatment specialist provided most services. Both individual and group counseling services were available. More than 300 smokers with schizophrenia and other serious mental illnesses have received these specialty services and achieve long-term abstinence rates as high as those without a history of mental health problems (26). We describe here the treatment of one such patient.

Reduction of Stroke Risk Factors

In October 2006, a panel of experts participated in a teleconference to discuss the reduction of stroke risk factors in patients at risk for stroke. The panel was chaired by John B. Kostis, MD, Professor and Chairman, Department of Medicine at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ. Also participating were Philip B. Gorelick, MD, MPH, Director, Center for Stroke Research, University of Illinois College of Medicine, Chicago, IL, and Franz H. Messerli, MD, St Luke's-Roosevelt Hospital Center, New York, NY.

A Tobacco Treatment Model for Persons With Serious Mental Illness

A Tobacco Treatment Model for Persons With Serious Mental Illness

Health and the Environment after Hurricane Katrina

Health and the Environment after Hurricane Katrina

Pediatric Clinical Research in Benign Hematology

From the *Division of Oncology/Hematology, University Children's Hospital, Basel, Switzerland; and †Division of Pediatric Hematology and Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ. Received for publication August 23, 2005; accepted October 20, 2005. Reprints: Thomas Kühne, Division of Oncology/Hematology, University Children's Hospital, Roemergasse 8, Basel, Switzerland (e-mail: [email protected]).

Quantifying estrogen treatment effect on vagina tissue: cellular age matters

University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Department of Obstetrics, Gynecology and Reproductive Sciences and Medicine, New Brunswick, NJ