8 The Future of Transplant 40 the internet and your brain 44 A Student’s guide to sleep
DECEMBER 2014 ISSUE No. 11 & 12
Introduction Dear Readers,
This issue of the Examiner might seem heftier than usual. At over fifty pages, it is our longest publication to date. This issue is a joint issue, combining together all of the articles our journalists wrote for issues 11 and 12, spanning the time frame of February 2014 - October 2014.
One of the most challenging aspects of running a student publication is ensuring the continuity of the journal, despite the loss of our student members as they graduate each semester. Since its revival by students in 2011, the Examiner has been publishing and printing nearly two issues a semester. However, last semester, Spring 2014, we were unable to print Issue 11 due to the lack of student funds allocated to our organization. This year, after being allocated printing funds, we decided to put out a joint issue of Issue 11 and Issue 12, so that the painstaking efforts of our journalists from last semester would not be lost merely because the leadership of the organization changed. This idea has been made possible by the patience of our journalists and editors, and we are excited to present to you an overview of the most relevant health issues faced by the Rutgers community in 2014. Thank you for reading!
Shireen Hamza Editor-in-Chief, 2014-2015
TA B L E O F C O N T E N T S 11 Current research: The cancer institute of NJ 12 Breast cancer screening in New Brunswick 14 The Largest biorepository in the world is on busch campus 16 Ebola at rutgers? 18 Rutgers scream theatre 20 Are we scrolling our way to stress?
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the future of transplant
44
22 Rutgers health insurance inadequate for the price
how to sleep: a student’s guide to mastering dormancy
23 On the overdose vigil 24 The rising trend of internet addiction on campus
36 Interview with Nisha baide: why pharmacy and insight 38 the effects of obamacare
26 RU Washing your hands?
40 how the internet is changing your brain
27 Which MCAT is your match?
43 cultural competency
30 milking it: do dietary recommendations give dairy too much credit?
50 what health profession organization is right for you?
32 introduction to energy drinks 101
52 research at rutgers
34 A promise to care
54 References
S TA F F EDITOR-IN-CHIEF Shireen Hamza MANAGING EDITORS Isaac Song Nikhitha Kotha Sri Puli Aayush Visaria Sailaja Darisipudi Chir-Wei Stephanie Yuen LAYOUT EDITOR Ivana Ganihong WEBSITE MANAGER Emily Moore PUBLIC RELATIONS CHAIRS Pujitha Talasila Fiona Kim TREASURER Nithya Gandham JOURNALISTS Sumra Alvi Santhoshi Kotrike Samanvitha Vaidyula Safia Ansari Sagar Shah Shruti Jadhav Mounica Sreedhara Mina Lee Divya Mohanraj Soundarya Nattuva Emily Moore
Issue 12 Dear Rutgers Community, In the past year, the global community has been faced by a number of pressing issues regarding health. In this issue of the Examiner, we bring some of these issues to the attention of the Rutgers community. Undoubtedly, a much-discussed issue has been the Ebola outbreak in West African countries. Myths propagated by the mainstream media are dispelled in a few of this issue’s articles. Certain health-related challenges for the Rutgers community are also discussed, such as student dissatisfaction with the increased price of the student health care, as well as the way that sexual assaults and addiction are discussed on campus. The articles discuss ways that the issues they raise are being handled, or not, on campus. One student organized a vigil for those who have passed away from overdose, in an attempt to reduce the stigma surrounding addiction. And, on a lighter but still urgent note, one of our journalists did some investigative work to find anecdotal evidence about RU students’ hygiene habits! “Think globally, act locally,” as the much-touted slogan goes. This issue includes a number of ways that people living in New Brunswick can take advantage of medical research. One article brings to attention the accessible and affordable breast cancer screenings and mammograms offered by hospitals in New Brunswick. Some other recommendations can be integrated by individuals into their lives, whether it be monitoring and changing stress-inducing smartphone usage with an app or reducing non-academic internet usage by spending time more time engaging in extra-curriculars and social activity. Students considering a profession in healthcare or biomedical research will be especially interested in articles on two research institutions on campus: the Rutgers University Cell and DNA Repository Infinite Biologics and the Cancer Institute of New Jersey. A summary of recent advances in research that lead us closer to 3D organ printing recommends students to get a taste of this new technology on a basic level by checking out the 3D printing club. Students can also find an article on the changes in the MCAT starting in 2015 and the Health Professions Office. We humbly present Issue 12 to the community, acknowledging with gratitude that the Examiner could not exist without student participation, student funds, and student readers. Shireen Hamza Editor-in-Chief, 2014-2015
By santhoshi kotrike
the future of transplant
3d bioprinting
The success of recent 3D printing endeavors in the healthcare industry has raised expectations for the advent of 3D bioprinted organs. A recent discovery makes it seem that this goal will soon be a reality.
In July 2014, researchers at the University
tissue layer by layer. The resulting product is then
of Sydney, Harvard, Stanford and MIT were able to create a functioning vascular network of
incubated in order for the layers to fuse together. Using a bio-printer streamlines the process
capillaries, similar to our own circulatory system.1 Human cells need to be connected to a blood
because a computer program increases accuracy and allows for the creation of multiple tissues at
supply for nutrition, waste disposal, and oxygen, and replicating a vascular system to supply a large
one time. In the last couple of years, there have
area of the body is an enormous feat. 3D Printing is the creation of a three dimensional product from a digital file.2 This is done by designing a digital model that is then cut into many two-dimensional layers. A 3D printer then reads the layers, builds each one with the appropriate materials, and fuses the layers together. While 3D printing typically uses materials such as plastics and metals, the materials used in a biotechnology context are actual living cells. The process is called 3D bioprinting, and it is similar to how a normal inkjet printer works.2 After establishing the design, researchers need to prepare an appropriate ‘ink’ made of living cells. This bio-ink is created from harvested tissue or stem cells that then reproduce. The bioprinter then injects the ink in a specific pattern, building the
been multiple great discoveries, advancing the bioprinting technique. Researchers have already created many types of viable tissues. One prominent company on the forefront of bioprinting is Organovo. Established in 2007 by Dr. Gabor Forsacs from the University of Missouri, the company strives to create bioprinted tissues for research and therapeutic purposes.3 The company created a commercial 3D bioprinter called the NovoGen MMX, which is unique because it functions without the use of a scaffold. Many times scaffolds cause inflammation in the body and result in tissue rejection; instead, Dr. Forsacs relies on “the cells’ intrinsic ability to develop an innate shape and structure.”4 His method is to use ‘biopaper,’ which is an aqueous gel that temporarily holds the shape of the bioprinted layers. It allows for the
THE EXAMINER
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The Organ Gap Widens 150,000 Waiting List Transplants Donors
121,272
Number of People
120,000
90,000 74,078
60,000
30,000
28,954
23,266
14,257
11,934
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year cells to naturally arrange themselves and removes the threat of rejection. Since its inception, Organovo has shown extraordinary results, such as in April of 2013, when they presented the first bioprinted living liver tissue.3 This discovery accelerated the progress of creating a whole liver organ. There are many ways that bioprinted material can be used to improve healthcare. One application would be transplantation. With the increasing quality of life and extension of life spans, transplants are in high demand. However, the disparity between the availability of organs and number of patients needing them is a significant issue. Many people have died because of the low availability of organs. The need
for organs is growing, yet the number of organs available remains about the same. According to the OPTN/SRTR Annual Report, in 2013 there were 14,257 donors, 28,954 transplants, and 121,272 patients on the waiting list.8 Another shocking statistic is that approximately 18 people die every day because of the low availability of organs.8 Bioprinting organs can help increase the supply of needed organs as well as make them more personalized. The organ would be created from the patient’s own cells, so the risk of transplant rejection is low. As a result, there may be no need for immunosuppressant drugs, and those who receive transplants could live without fear of that complication.
9
There are important implications for drug development, since pharmaceutical companies face the problem of testing their drugs. While animal models and cell models are currently used to test drugs, these models cannot exactly predict a drug’s effect on a human body. Keith Murphy, CEO of Organovo, says that using human tissue models would give more accurate data on the effects of the tested drug.4 In August 2014, Organovo released the results of its collaboration with a pharmaceutical company to test the toxicity of a drug on its 3D Liver model. Previously, current models did not accurately predict the toxicity of the drug, leading to liver damage in human trials. However, the results of testing the 3D model were surprising; the model had shown that the drug was toxic.7 Dr. Luis Bertassoni, the University of Sydney lead researcher on vascular networks, describes his vision for the future of organ bioprinting: “Imagine being able to walk into a hospital and have a full organ printed - or bio-printed, as we call it - with all the cells, proteins and blood vessels in the right place, simply by pushing the ‘print’ button in your computer screen.”1 This hypothetical situation is slowly becoming a reality. While we wait, are you interested in trying out regular 3D printing for yourself? Rutgers has a club called the Rutgers Makerspace which allows students to work with 3D printers on campus. The club meets on Wednesdays at 8 PM at 35 Berrue Circle on the Livingston Campus.
“
Imagine being able to walk into a hospital and have a full organ printed - or bio-printed, as we call it - with all the cells, proteins and blood vessels in the right place, simply by pushing the ‘print’ button in your computer screen.
THE EXAMINER
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By Mounica Sreedhara
current research
The Cancer Institute of NJ
Dr. Grace Lu-Yao, a cancer epidemiologist at CINJ and a professor of medicine at Rutgers Robert Wood Johnson Medical School, studies prostate cancer and hormonal therapy. Her research specifically deals with the use of Androgen Deprivation Therapy (ADT) as a treatment for prostate cancer. ADT works by immobilizing male hormones that are known to promote prostate growth. It has been the preferred alternative to surgery and radiation for the last 15 years.3 However, her most recent findings suggest that its sole use may be detrimental, particularly in older people. “Because of the potential side effects of osteoporosis, diabetes and decreased muscle tone, clinicians must carefully consider the rationale behind ADT treatment if used as the primary therapy for older patients,� she explains. 3 Although ADT treatment must be administered with careful consideration in older populations, the effects of its sole use on younger populations are as yet unknown.3
Another project at CINJ specifically deals with the cells that primarily initiate prostate cancer. Dr. Hatem E. Sabaawy, a principal investigator and a professor of medicine at Robert Wood Johnson Medical School, is focusing on the tumor initiating cells (TICs) of prostate cancer through the use of zebrafish xenografts (transplants of living cells from species to species). Tumor initiating cells (TICs) have the ability to self-renew and proliferate significantly in order to allow the expansion of malignant cells.1 Because these cells are commonly resistant to conventional chemotherapies and hormone therapies, prostate cancer has become difficult to fight. Dr. Hatem E. Sabaaway approaches these cells from a new direction by targeting their self-renewal properties. His research suggests that the utilization of zebrafish xenografts can help researchers evaluate new therapies that target TICs.1
Yet another project involves Ras genes. This project, is led by Dr. Eileen White, the associate director of Basic Science at CINJ and a professor of Molecular Biology and Biochemistry at Rutgers University. She notes that more than a third of all human cancers are triggered by mutations in the Ras family of genes.2 The Ras gene controls a specific family of proteins involved in cellular signaling. The expression of the Ras gene plays a crucial role in the spread of cancer.2 Normally when Ras is activated, it also activates autophagy, which is the destruction of unnecessary cellular components through lysosomal activity.2 However, Ras-driven cancer cells remodel proteins through autophagy by selectively targeting proteins for degradation.2 Dr.White’s recent research reveals that autophagy affects a majority of proteins in Ras-driven cancer cells, suggesting that the inhibition of autophagy can allow for a means of fighting aggressive cancers.2
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By samanvitha vaidya
Breast Cancer Screening
in New Brunswick After actress Angelina Jolie shared the preventative measures she is taking
Breast Care program, located in the third floor of the RWJ hospital in Somerset, the
against breast cancer, she triggered a “domino” effect. In May 2013, Jolie revealed
staff offers comprehensive, personalized breast screening health services and
that she will undergo a double mastectomy after testing positive for a mutation in the
evaluations with the highest degrees of confidentiality.6 For individuals with a low
BRCA1 gene.1 The mutation, according to her doctors, reveals an 87% risk of developing breast cancer.2
income or inadequate insurance coverage, the hospital provides free mammograms with a grant from the New Jersey
Research from a study confirms a 144% increase in number of
Cancer Education and Early Detection program.7 Saint Peter’s University Hospital
individuals testing for mutations since Jolie’s announcement.3
operates the Women’s Imaging Center, an ambulatory resource catering to the
The new trend—influenced by Jolie— motivated many people
needs of Central Jersey residents for breast cancer screening. Some of their services
to acknowledge the dangers associated with breast cancer and take a stand
include mammography, breast biopsy, and ultrasounds.8
towards precaution. Breast cancer consists of malignant
There has been a recorded rise of cancer cases among women under forty
tumors that develop breast tissue and eventually spreads through the entire body by means of invading neighboring lymph nodes and organs. Although more invasive forms of the cancer targets individuals between the ages of 55 or above, it is equally important for younger individuals to acknowledge the dangers associated with the condition.4 According to research conducted by Robert Wood Johnson Hospital, one in every seven women develops breast cancer during her lifetime.5 Through the Sanofi U.S.
years of age. Unfortunately, it is difficult for doctors to detect breast cancer in younger women. Research shows that a delay in diagnosis occurs because younger women have denser breast tissue compared to women above forty. Lumps or other preliminary symptoms do not appear to individuals through self-examination until the cancer has progressed to later stages.9 Moreover, convincing college students to take preventative measures against breast cancer is challenging because of their mindsets. Undergraduates often ignore
One in every seven women develops breast cancer.
THE EXAMINER
12
symptoms because they believe they are too young to be at risk, or because they have a lack of cancer in their family history. They are so engrossed by academic, personal, or professional tensions that they hesitate to talk to anyone about medical conditions or symptoms they face. Angelina Jolie’s statement garnered a lot of attention. “I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.”10 During her interview, Jolie explained that she discussed her personal health concerns publicly to encourage women to take control of their health. According to medical sources, women who embody a mutation in the BRCA 1 gene have an almost 80% risk of developing breast cancer.11 Since genetic testing is the only way to learn whether one has this mutation or not, women should learn about their options and ensure they make the proper choice regarding their health. For more information regarding the Sanofi U.S. Breast Care program, contact Robert Wood Johnson Hospital at 908704-3740. For more information regarding screening and other information, contact Saint Peter’s University Hospital at 732-7458600.
The BRCA genes are tumor suppressor genes that are important in repairing DNA. When these genes are mutated, DNA may not be properly repaired, leading to an increased risk for cancer.
13
The Largest Biorepository in the World is on Busch Campus
THE EXAMINER
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By emily moore Just steps from the Allison Road Classroom building on Busch, in an ordinary building that a harried student might not even notice, is the largest biorepository in the world: the Rutgers University Cell and DNA Repository (RUCDR). RUCDR is a biorepository, the goal of which “is to understand the genetic causes of common, complex diseases and to discover diagnoses, treatments, and, eventually, cures for these diseases.”1 This mission has proven highly relevant to the medical community, as scientists continue to recognize that most human diseases have their roots in genetic mutations, whether inherited at birth or during someone’s lifetime.2 Examples of everyday diseases linked to genetic abnormalities include devastating conditions such as cancer, cystic fibrosis, and heart disease.2 Biorepositories, also known as biobanks, are defined by the National Cancer Institute as “‘libraries’ where biospecimens are stored and made available for scientists to study for clinical or research purposes.”3 Biospecimens, or biosamples, “are materials taken from the human body, such as tissue, plasma, and urine” that are then analyzed in the laboratory.3 RUCDR specifically focuses on “[extracting] tissue to produce DNA,RNA, and other products” and conducting “genetic analysis on samples it receives.”4 The center also offers a number of research services and facilities to prospective collaborators.5 For instance, services like genotyping and sequencing are available for in-depth analysis of samples, cell labs are staffed around the clock, and thousands of feet of storage under tightly controlled conditions host various biomaterials.5 The record-breaking size of the biorepository has attracted interest from researchers both in the United States and abroad.1 This distinction has also seemed to generate substantial grants and donations, which have provided RUCDR with vital financial backing. For instance, the National
Institute of Mental Health granted the center $44.5 million last year to study the genetic underpinnings of mental health disorders.4 As recently as this past September, an anonymous $10 million donation was given to support the expansion of cancer studies at Rutgers.6 The bulk of the money will support “precision medical clinical trials” at the Rutgers Cancer Institute of New Jersey, as researchers and physicians try to develop targeted gene-based cancer therapeutics.6 To contribute to this ambitious goal, the RUCDR will receive funds to work on “advanced genomic analysis of cancers.”6 This is a laborious task that involves searching for genetic mutations that appear in cancer cells of the same type.6 Once identified, such mutations could guide physicians as to the most effective treatment plans for patients suffering from that cancer type.6 Precise treatments do not currently exist for most cancers, partly because genetically sequencing someone’s tumor cells in pursuit of the correct mutation can be a months-long ordeal.6 Rutgers researchers hope that the donation will allow them to develop a more efficient process to identify these gene mutations so that oncologists may ultimately offer more effective treatment options to their patients.6 The presence of the RUCDR boosts opportunities for undergraduate students at Rutgers. A number of faculty members are associated with the RUCDR, meaning that students seeking out research mentors might find one who allows them to work on projects involving the biorepository. To that end, $1 million from the aforementioned September 2014 gift has been allocated for the creation of a “cancer genetics” academic program for undergraduates.6 Future Rutgers students will learn the skills needed to succeed in what medical oncologist Shidar Ganesan from the Rutgers Cancer Institute of New Jersey has called the “kind of genomic analysis [that] is going to be a growing part of medicine.”6 Without a doubt, the RUCDR has and will continue to elevate and enable the genetic research efforts here at Rutgers.
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By divya mohanraj
Ebola at Rutgers? asking the wrong questions about ebola Ever since the first outbreak of Ebola in Africa and the symbolic arrival of the first two Americans
of the Dallas County Department of Health and Human Services, said of Thomas Duncan that “…
that were flown in from Africa to the United States for immediate treatment, the media thrust Ebola
there were five people in the patient's immediate household and about 12 to 18 other ‘contacts’ —
into the spotlight. Recent news media coverage on the issue has created a great divide in the United
including members of an ambulance crew — all of whom would be monitored closely for 21 days.”2
States as to whether Americans are at risk of this disease or are safe from harm, and many officials
Forty-three people were being monitored for being in contact with Thomas Duncan, a recently
have stepped forward to say that this is not the case. Asking whether Ebola is coming to Rutgers is asking the wrong question. Students of science should be
deceased victim of Ebola, and have now been released, and officials have stated that they deserve our compassion after going through this ordeal.3
asking and answering better questions, that promote accurate understandings of how this virus works
Ebola has taken Liberia, Sierra Leone, and Guinea by storm and has affected the West African population
and who is really at risk. Ebola virus can be detected through real-
with the highest mortality rate, up to date. These countries were gravely affected by the transmission
time PCR (polymerase chain reaction) testing and the symptoms of Ebola progress from minor to
of Ebola virus and require foreign assistance to treat the thousands of people coming to local hospitals in
severe ranging from high fever, to severe headache, muscle pain, and bleeding (the most severe
Africa.
symptom during the final stages of the disease). It is clear that since the Ebola virus can only be
face an Ebola outbreak in the United States or that it will get to the point where we are unable
transmitted by a person who is symptomatic. The Ebola virus may have originated from fruit bats. According to The Washington Post article, The Animal Source of the Ebola Outbreak in West Africa Eludes Scientists, medical science reporter Dr. Tina Hesman Saey states, “Some of the evidence implicating bats comes from a study in the April edition of the journal Viruses by Olival and David Hayman of Massey University in Palmerston North, New Zealand. The researchers mapped the ranges of fruit bat species that might carry Ebola or related viruses,” which shows that bats may be the trigger to this highly infectious disease outbreak.1 Although sources have not confirmed whether bats are the root cause, an abundance of sources claim that bats are involved. Dr. Christopher Perkins, the medical director
to control it. We have a plethora of resources to treat and care for many patients in a short period of time. The Ebola virus spreads through contact with an infected person’s bodily fluids and with the amount of protective gear and equipment in the U.S., it is definitely feasible to control this disease. The healthcare system in African countries varies from region to region. For instance, in Liberia, the healthcare system is primarily managed by the public sector and has a great deal of financial issues due to past political instability. Ebola can be managed with the right medicine, mass access to healthcare services and facilities, and the restoration of fluid balance in the body. According to Professor Kevin Sumner, Health Director of Middle-Brook Regional Health Commission, “The public health and healthcare
THE EXAMINER
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There is a very low probability that we will
Some evidence implicates fruit bats as the triggers for the Ebola outbreak.
systems in the United States are very robust and these systems working collaboratively are very effective at preventing and controlling communicable disease outbreaks. Therefore, I think that it is highly unlikely that the Rutgers community, or any of our communities, are at much risk from this disease.� It is advisable that fellow Americans keep in mind that they are not in immediate danger. If we look into the possibility of Ebola virus spreading to Rutgers University, and it is not likely that Ebola virus will actually reach New Brunswick, perhaps it is time we ask more questions about the people in immediate risk in various West African countries. Rutgers University students can help spread awareness about this disease by making it a point to speak up about these issues and talk to other students about the nature of the disease and the warning that has been issued by the Center for Disease Control and Prevention. According to the CDC, an issue of caution was released to U.S. colleges and universities to provide medical assistance to those who may have travelled to Guinea, Sierra Leone, Liberia, Lagos or Port Harcourt, Nigeria, or Dakar, Senegal within twenty-one days of the outbreak.4 It is recommended that students and faculty get checked if this applies to them, but otherwise, it is in our best interests to promote public health awareness and inform others about the possibilities (or lack thereof) of contracting this disease, and what the next steps would be for those at risk.
17
25-30% of college students have experienced dating violence at least once.
Rutgers SCREAM Theatre “Look, man, you can’t say I didn’t warn you,” Matt says, walking towards Ethan menacingly. Puffing out their chests, Matt and the guys begin closing in on Ethan in a tight, threatening circle. Frantically attempting to back away, Ethan trips over a stray shoelace and tumbles backward, flailing his arms. “I said I’m sorry,” he spits out, knowing well what is coming next. The guys around him get closer, and Ethan’s breathing gets shallower – is there any escaping now? The curtain draws and the lights come back on, illuminating a theatre full of wide-eyed Rutgers students. The audience members are engrossed in what they are watching – fortunately not an actual bullying scene, but an interactive skit being performed by their own peers. The actors turn towards the audience and bow. One of them poses a question to the audience: “If you saw this
THE EXAMINER
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happening to a stranger on the street, what would you do?” This is a typical performance by SCREAM Theatre – Rutgers’ only peer improvisational theatre group associated with the Office for Violence Prevention and Victim Assistance at Rutgers University. The “SCREAM” in SCREAM Theatre actually stands for Students Challenging Realities and Educating Against Myths. Consisting of mostly undergraduate students, the group uses interactive skits to educate audiences on interpersonal violence such as stalking, sexual harassment and assault, domestic and dating violence, and bullying. Most of the acting is improvised on the spot – there are no scripts to memorize or strict stage directions to follow. According to Lindsey, the group’s training coordinator, this allows the actors of SCREAM Theatre to truly connect with the audience.
By shruti jadhav “We want to become one with the audience,” she says, “and want them to know that we’re not there to lecture them.” The organization was started back in 1991, when the University President issued a mandate requiring every incoming first-year Rutgers student to participate in a program on sexual assault. The Office of Sexual Assault Services and the Department of Health Education teamed up to create a program that would combine theatre with peer education to teach students about sexual violence prevention. Since then, SCREAM Theatre has grown into a program that reaches not only every incoming Rutgers student at New Student Orientation, but also Greek life and
performance to portray the fact that what affects some of us ultimately affects us all as a community. “We foster a sense of accountability,” says SCREAM Theatre rehearsal coordinator Jessica Clark. “Knowing that we advocate for everyone makes students feel safer on campus and fosters a sense of comfort.” It is up to us to create a safe and healthy environment for everyone. And although we may not be able to eradicate violence completely, we can always amend the way we view those affected by it. If you want to help increase awareness of interpersonal violence issues in the creative way that SCREAM Theatre does, why not get involved with the group itself? SCREAM Theatre is non-auditioning and
athletic audiences, local high schools, and youth groups nationwide. Today, the group addresses
welcomes everyone. Members do not need to have prior acting experience to perform, but even those
various issues of interpersonal violence in addition to sexual assault and harassment.
who simply prefer to attend the meetings and discuss violence prevention strategies are welcome. One of
The members of SCREAM Theatre are dedicated to educating their peers about how
the group’s newest members, Josh Weiss, joined the group about a month ago and is already busy
violence on a college campus can develop and affect victims, perpetrators, and witnesses. College students
training to perform in sexual and dating violence skits. He says about his experience, “It’s amazing…it feels
are busy, prone to stress and burnout. Dangers such as harassment and dating violence can send a victim
great to actually be making a difference. Even if you don’t perform, you still get educated by coming to the
over the edge. Approximately 25 to 30% of male and female college students, according to a report by
meetings.” The group meets every Tuesday at 9:15 PM in Room 213 in Murray Hall on College Avenue
Clark University’s Anti-Violence Education Program, have experienced dating violence at least once in their relationships. And according to the Rape, Abuse, and Incest National Network, sexual assault victims are several times more likely to struggle with long-term mental health consequences such as depression, substance abuse, self-harm, and suicidal thoughts. Victims of dating violence and assault face not only the pain of traumatic memories and the fear of having to see their attackers, but also the harsh stigma society often places on the victims of such assaults. “She was asking for it” and “she deserved that” are still phrases found in discussions of sexual assault, reflecting a corrosive, victim-blaming attitude that contributes to the victims’ deep emotional scars. One of SCREAM Theatre’s goals is to do away with this victim-blaming attitude by using theatrical
to work on SCREAM Theatre events, discuss violence prevention, and play improve or educational games. You’ll be helping make Rutgers a safer, more positive place with every word you contribute. If you are a victim, or do not feel comfortable speaking out on these issues, a few places on campus are designated “safe spaces” where victims of sexual and gender violence can find people with understanding attitudes. The Women’s Center, on the 3rd floor of the Douglass Campus Center, as well as the Center for Social Justice, in Tillett Hall on Livingston Campus, can provide a safe space. The Center for Social Justice also provides “Safe(r) Space Trainings” once a month for student leaders seeking to learn how to make their organizations a welcoming and safe for all.
19
By sumra alvi
Are we scrolling our way to stress? You’re standing on the bus and the first thing you notice is that no one is talking. Empty silence is only interrupted by the occasional, faint sounds of fingers pitter-pattering along iPhone and android screens, the sound of people scrolling through Twitter and Facebook feeds or swiping for Instagram filters. Is our attachment to technology hurting us? Studies show that excessive smartphone usage is beginning to induce stress in people to the point where it is difficult to achieve relaxation and strong attention levels.1 But there are ways your technology can help you learn how to better use your technology. Researchers are beginning to call the culture of constantly checking a phone for emails or texts or status updates the “always on” phenomenon. The “always on” culture has a negative impact on the brain. According to Dr. Christine Grant, from Coventry University’s Centre for Research in Psychology, “your mind is never resting, [and] you’re not giving your body time to recover, so you’re always stressed.”2 So if you’re wondering why you can’t keep your eyes open during class, even after a decent eight to nine hours of sleep, it could be that you are not getting enough restful time. A study was conducted by the British Psychological Society in which researchers surveyed 100 university students and retail/public sector employees in order to understand the relationship between their stress levels and their need to constantly check their phones. Researcher Richard Balding came to the conclusion that “the more an individual becomes stressed and worried, the more compulsive behaviors such as checking will occur.”1 All of a sudden, the casual practice of checking your phone for messages during class has turned into a strategy to cope with stress. This natural impulse is causing researchers believe it is reducing our attention spans. Will we be able to fight off this desire to compulsively check our phones in times of stress? And if we can’t, will it just cause more stress? Ironically, there’s an App to check for that! Dartmouth College researchers have designed an Android app specific for college students called StudentLife. It tracks the social interactions, physical activity, sleep and stress levels of the user by using sensors from the phone (including phone usage, location, date, WiFi and audio) as well as short surveys throughout the day asking how they’re feeling. All of this data is then graphed continuously throughout the semester. So what’s the conclusion? It’s simple: increased physical activity + interactions with friends and family + enough sleep = better grades + reduction of health risks, like stress or depression.3 Evidently, technology has allowed us to reach a new level of understanding, not just about the world but also about ourselves. The real challenge is finding a way to balance these new advancements in technology with our own health and well-being.
THE EXAMINER
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By safia Ansari
Op-Ed: Rutgers Health Insurance Inadequate for the Price This year, students at Rutgers University were automatically charged over $700 for their fall semester’s Student Health Care, unless they waived the charge by providing proof of other insurance. Last year, students were charged close to $300 for the fall semester, and it is unclear why the same product costs us twice as much. The requirement for students to buy health insurance predates the 2010 Affordable Care Act, which mandates most people in the U.S. to be insured. According to Rutgers’ official healthcare website, the plans offered by the school provide “comprehensive” coverage at an “affordable” price. Upon closer look, the items covered include a certain amount for emergency room treatment, inpatient hospitalization, outpatient surgery, labs, preventative care, and x-rays are actually included. Usually, preventative care such as prescription drugs, nutritional management, and vaccines are not covered, even though most visits to the health center involve such a purchase. Eye care and dental care are not provided, and there is no mention of mental health or behavioral disorders. Health care insurance at Rutgers should be of equal quality to other health care insurances. In New Jersey, even Medicaid usually covers dental care. The lack of dental care is a problem for students. I personally chipped a tooth at the dining hall last year, and because my family lives in New Jersey, I was able to go home over the weekend and go to the dentist. For out-of-state students and those without access to financial support from a biological family, this is not an option. The same problem arises with eye care. Basic health care needs should not be a compromise. There is absolutely no coverage for behavioral problems, excluding those with behavioral disorders and learning disabilities who may have specific treatment needs. Student health insurance plans at other universities, such as TCNJ and St. John’s, specifically include treatment for mental health issues and substance abuse. As students who already pay a great deal to attend Rutgers, we should be able to expect facilities and truly comprehensive treatment. This is surprisingly not the case at a University with access to large hospitals and research labs. Rutgers’ first priority should be to keep all of its students healthy. As students, there is little we can do about the policy itself, except raise our voices to express this urgent need.
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By shireen hamza
On the “Overdose Vigil”: A Talk with Organizer Francine Glacer A vigil was held on the steps of Brower Commons, on the night of October 21st, “in honor of students, alumni, and loved ones who have lost their battle with any addiction.” The names of those who the community had lost to overdose were read aloud, and a
“
There are students on campus who do not want to seek help because of the stigma.
slideshow of pictures of the deceased was displayed. Speakers at the event included NJ State Senator Joe Vitale, Linda Blaustein Surks, a Rutgers alumnus in recovery, and Francine Glaser, who organized the event. I caught up with Glaser the next day to learn more about her journey planning this vigil. Glaser, an SAS student of class 2015 majoring in Planning and Public Policy, decided to get involved in raising awareness about addiction after hearing of the heroin epidemic last winter, 2013-2014. She found out that the Rutgers administration knew of students lost to this disease, but they had not honored them. She said that, as a member of student government, she felt it her civic responsibility to raise awareness about their struggle in an effort to humanize addiction and combat the stigma surrounding it. For her social action project, under the auspices of the Institute for Women’s Leadership, Glaser chose to organize this vigil. “Addiction is regarded as a decision, rather than a physical disorder,” said Glaser. She wanted people to explain at the vigil that it should be treated like any other bodily disease, which is beyond the control of the person suffering from it. “It’s like drinking water, but never being satiated.” Glaser takes this educational work seriously, because “there are students on campus who do not want to seek help because of the stigma.” While planning the vigil, Glaser also reached out to the Health Outreach Prevention and Education (H.O.P.E.) office at Rutgers, located at 8 Lafayette Street on the College Avenue Campus. She said that their staff, and the staff of Rutgers health services more broadly, are very progressive, and that H.O.P.E. is nationally recognized because of their understanding on issues of addiction and mental health. If you are interested in learning more about “Alcohol & Drug,” “Mental Health,” or “Sexual Health” related issues, you can contact H.O.P.E. to request a workshop or to become a peer educator yourself at 848-932-1965. You can also stop by their office before 4:30 pm on weekdays.
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By mina lee
X
The Rising Trend of Internet Addiction on Campus Think back to how many times you
work or homework.
used the Internet today for non-academic purposes. Have you absent-mindedly scrolled
Helen Wang, a sophomore at Rutgers, has personally experienced impairment in many
through Facebook more than a dozen times? Or watched viral videos or vlogs on Youtube
aspects of her life due to her habit of overusing the Internet. She admits, “I always use Netflix
while procrastinating for that Expos paper? For some students, surfing the Internet becomes an
when I’m supposed to study. I watch Youtube videos when I’m supposed to be sleeping, and
addiction that often branches from an underlying emotional or psychological condition. Internet addiction can be classified in the same category
I often cancel plans with friends to spend more time online.” Most likely, she is not the only student facing these consequences.
as compulsive disorders such as gambling addiction. Internet addicts spend hours a day
At Alfred University, administrators found a shocking correlation between high Internet
on the computer or mobile devices, and often suffer from impaired performance in academics
use and the rate of expulsion. It was observed that successful students with high SAT scores
and social relationships, not to mention various physical consequences like sleep-deprivation.
were expelled from the university, and further investigation showed that 43% of these students
At Rutgers, especially, the number of students who overuse the Internet has been
failed because of excessive Internet use. If we want to avoid such a situation at
rising over the past five years. In 2010, 7.3% of undergraduate students at Rutgers spent
Rutgers University, students need to learn to curb their Internet use. One of the best ways
more than 30 hours per week on the computer or smartphone for non-academic purposes. In 2013, the percentage rose to a whopping 15% of the undergraduate population. If this trend continues, it is inevitable that some students may develop Internet addiction. College students are vulnerable to overuse of the Internet, due to newfound independence, large blocks of free time, and easily accessible Wi-Fi. This is why Internet addiction can be so difficult to detect—it is easy to make excuses to use the Internet for
to avoid getting tangled up in the Internet is to find interactive outlets offline—extracurricular involvement, outdoor activities, and even just hanging out with friends can direct your attention away from the laptop. Rutgers Counseling, ADAP & Psychiatric Services (CAPS) provides confidential counseling for Internet addicts as well. If you ever feel that you’re spending too much time on the Internet, take advantage of all the activities and services that Rutgers has to offer.
THE EXAMINER
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25
By Sagar Shah
RU Washing Your Hands? How hygienic are your fellow peers? In an investigative outing, I went and found out. At 4:00 pm, I hid out in the Busch Dining Hall men’s bathroom stall to see just how many people actually wash their hands thoroughly with soap. To my surprise, in the men’s bathroom thirty eight students washed their hands with water and soap, five students washed with only water, and seven did not wash their hands at all. It was truly a Rutgers triumph to watch the majority of our students practicing proper hygiene, but what about the rest? I interviewed Mr. Joe, a janitor who has been working at Davidson Hall (a dorm on Busch campus) for over twenty years, on his thoughts on cleanliness in the bathrooms. Mr. Joe mentioned how students are inconsiderate of others in using the bathroom. “Treat it like this is your house. Other people have to use the facility,” said Mr. Joe. I also asked Mr. Joe his worst experience with the bathrooms. “Someone defecated in the shower. And not once but a few times,” said Mr. Joe. The police were called and the student was later expelled from Rutgers. Mr. Joe mentioned that the bathrooms he cleans up after are said to be some of the “better ones.” Bathrooms are one of the most common places to pick up athlete’s foot. Athlete’s foot usually spreads there because the moistness of bathrooms allows the fungus to thrive. Once one gets athlete’s foot, one feels an itching and burning sensation and one’s skin becomes cracked. A strong odor might arise from the infected area, as well. There’s no doubt that in the transition from high school to college, hygiene becomes a component of the typical college student’s life that is not highly prioritized. Just think of the last time you went over to a friend’s apartment or house, only to find food waste, beer cans, and other trash littering the rooms. I asked a student from Davidson Hall on his thoughts on the cleanliness of Rutgers facilities. “Rutgers is clean in some areas, but I once saw a rat or mouse in Busch Dining Hall,” he said. Students as well as staff at Rutgers seem to be having a difficult time keeping facilities clean. If everyone took Mr. Joe’s advice and treated shared facilities well, out of respect for the others that will use and clean them, the job of staff like Mr. Joe would not be nearly so difficult.
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By Soundarya nattuva
Which MCAT is your Match? The most dreaded exam for premedical students has always been the Medical College Admission Test (MCAT). In previous years, the most frequently asked question regarding this test has been, “When should I take the MCAT?” However, with the upcoming changes to the test in Spring of 2015, a more prevalent concern now is, “Which MCAT should I take?” In order to properly answer that question, it is necessary to understand how MCAT2015 differs from the current MCAT. The main alteration in MCAT2015 is that it aims to assess knowledge and skills as they adapt with the dynamic society.2 This is done by the integration of a new section, called the Psychological, tip for pre-meds Social, and Biological Foundations of Behavior, designed Make use of the resources offered to evaluate students’ ability to understand people.2 online such as the Khan Academy videos. Additional changes to the test include new biochemistry These videos are the result of collaboration material in the biological systems section.2 The 2015 MCAT between the Princeton-based Robert Wood has a more holistic approach, requiring students to think Johnson Foundation, AAMC and Khan broadly, ethically, and strategically. The timing and scoring Academy.3 The array of videos covers topics aspects of the test have also been modified. Currently, the from Organ systems to Physical Processes to MCAT is scored out of a maximum of 45 points, and each Society and Culture.3 Instructors in the video section is worth 15. Each section of MCAT2015 will be demonstrate concepts clearly through colorful scored between 118 and 132 points, and the total midpoint 1 visuals, historical information, and in-depth will be 500. Furthermore, the overall length of the new 1 explanations.3 version is almost double that of the incumbent. While the shorter time and lesser material present a strong motivation to take the MCAT earlier, the answer to when exactly one should take the exam depends on the desired year of enrollment. According to AAMC, students who are seeking admission between 2016 and 2019 can take either version whereas those that will begin medical school in 2020 or later need to take the newer edition.2 Fortunately, students who are planning to take the present MCAT are offered plenty of testing dates to choose from, because of the increase in demand to take the current version. The current MCAT will be offered through the end of January of 2015.2 Nonetheless, it should be noted that each medical school has its own requirements with respect to the MCAT. It is best to consult with the school advisors and with 2015 MSAR in addition to visiting the specific university’s website, since some medical schools are not accepting the new MCATs until a certain date. Robert Wood Johnson Medical School requires students to have taken the MCAT by September of the year of application, and within three years of that time.5 The New Jersey Medical School’s stance on MCAT scores is that the test must be taken by October of the year the student is applying.4 Which MCAT will you take? If you are still not sure about which MCAT is your right match, you can always visit an advisor at the Rutgers Health Professions Office located on Busch Campus. Moreover, you can always look through the informational books at our Health Professions Office. Call the admissions office or email an advisor regarding the requirements for your desired medical schools - be proactive!
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S TA F F EDITOR-IN-CHIEF Vishal Patel MANAGING EDITORS Shireen Hamza Yuli Noah LAYOUT EDITOR Ivana Ganihong PUBLIC RELATIONS CHAIRS Reshman Shiwdin Erum Farooqui Anshika Verma TREASURER Kaiwal Patel SECRETARY Dhaval Mehta JOURNALISTS Neha Kayastha Jasmeet Bawa Nithya Gandham Emily Moore Ronak Patel Meghna Dev Chir Wei Stephanie Yuen Fiona Kim Mounica Sreedhara Aayush Visaria Sailaja Darisipudi EDITORS Isaac Song Nikhitha Kotha Kristin Baresich Meghna Dev Sri Puli Evagelia Stavrakis Hima Sathian Pujitha Talasila Sahitya Cherukuri
Issue 11 Dear Readers, Welcome to the eleventh issue of The Examiner – Rutgers Pre-Health Journal! We are Rutgers University’s premier prehealth media publication that is ran for and by undergraduate students with the mission of informing fellow pre-health students on current events in the healthcare field. This issue continues our goal of being a multidisciplinary journal that attempts to bridge the current gap between the traditional sciences and the humanities. We have tried to accomplish this by presenting diverse issues relating to healthcare policies, geopolitical issues, fun columns, complex societal issues, health economics, medical school admissions, etc. to demonstrate how these seemingly unrelated topics might affect the future of the healthcare professionals. We would like to thank and congratulate our executive staff, journalists, editors, RUSA allocations, and faculty as well as administrative advisors for contributing to this issue and ultimately to serve the needs of the Rutgers pre-health community. We hope that you enjoy reading The Examiner, and we would sincerely appreciate your feedback on our Facebook page, Twitter, or at ruexaminer@gmail.com. Thanks and regards, Vishal Patel Editor-in-Chief, 2013-2014
Milking It: Do Dietary Recommendations Give Dairy Too Much Credit? “got milk?”® This ubiquitous marketing campaign has bombarded Americans with images of milkmustached celebrities for longer than many Rutgers students have been alive. Beginning in 1993, the California Milk Processor Board unleashed the series of advertisements aimed at increasing national milk consumption.1 A typical ad encourages viewers to “drink 3 glasses of low fat or fat free milk a day,” while the Board’s website emphasizes that milk can support bones and muscles, promote better sleep, ward off cavities, and confer numerous other health benefits.1,2 While milk certainly possesses some nutritional merit, is it necessary for people to drink three whole glasses of milk every day? Is it truly the staple of a healthy diet this campaign makes it out to be?
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By Emily Moore The California Milk Processor Board “is funded through contributions from California dairy processors,” suggesting that its push for milk represents not only a public health mission, but perhaps also a profitdriven mission.3 Complicating the matter further is the fact that the “got milk?”® creators are “overseen by the state Department of Food and Agriculture.”3 This relationship between the food industry and the state government might have inspired the federal government, as the United States Department of Agriculture (USDA) has declared that everyone over the age of eight should consume exactly what those “got milk?”® advertisements encourage us to consume: three cups of dairy per day.4 To promote adherence to these dairy demands, the USDA defines a multitude of food choices as equivalent to one cup of milk. According to ChooseMyPlate.gov, the colorful website designed by the USDA to cultivate healthier American diets, a cup of milk can mean anything from eight ounces of cow’s milk to a couple of slices of cheddar cheese to even three scoops of ice cream.5 This dairy suggestion might seem like a dairy overload, and there is evidence for that. The Harvard School of Public Health (HSPH) asserts that ChooseMyPlate.gov overvalues dairy in its guidelines for a healthy diet.6 They question dairy’s role in the prevention of conditions like osteoporosis and bone fractures, and point to possible links between excessive dairy intake and the risk of developing prostate or ovarian cancer.6 Other downsides of excess dairy include its sugar content (12 g per cup of low fat milk), its saturated fat content (1.5 g per cup of low fat milk), and its “hormones and growth factors,” which might worsen acne.7,8 Such health downsides, along with the fact that the dairy consumption recommendation is set by a government agency, lead HSPH to state that the standard dairy intake suggestion “seems to reflect the interests of the powerful dairy industry more than the latest science.”6 This calls into question the extent to which dairy should be recommended. In contrast to the information found on ChooseMyPlate.gov, HSPH advises just 1-2 dairy servings or an appropriate amount of vitamin D and calcium supplements per day.6 Compelling evidence against the push for dairy also lies in the fact that millions of people worldwide do not consume milk products at all. Lactose intolerance, a lactase enzyme deficiency
that keeps the human body from properly digesting the milk sugar lactose, can cause physical symptoms such as nausea and abdominal pain.9 Genetic factors or small intestine problems can contribute to the development of this condition.9 Studies have shown that lactose intolerance varies dramatically by race or ethnicity. In China, southern Africa, and southern Latin America, 80-100% of the population as a whole displays lactose intolerance.10 High rates of the condition occur in southeast Asia, India, the Middle East, and northern Africa as well.10 Lactose intolerance proves far less common in the U.S., northern Europe, and Australia, where it appears in just 20% or less of the overall population.10 But breaking down the U.S. population by race or ethnicity reveals that dairy difficulties affect some groups more than others. For example, while only 13% of Caucasians experience lactose intolerance, 74% of African Americans and 53% of Hispanics do.11 If milk were as crucial a dietary element as it is presented to be in the U.S., how could all of the millions of lactose intolerant people in our nation and across the globe achieve balanced nutrition? Are the U.S. dairy consumption guidelines irresponsible and insensitive to vast numbers of people who cannot properly digest milk? ChooseMyPlate.gov only addresses lactose intolerance under an asterisk at the bottom of its page on dairy. The site suggests “smaller portions” of regular dairy, “lactose-free and lower lactose products,” or “calcium-fortified soymilk” as possible alternatives for those with lactose issues, and warns that foods such as “rice or almond beverages may provide calcium, but may not provide the other nutrients found in dairy products.”5 Intriguingly, all of the products mentioned as suitable dairy alternatives either still contain milk (Lactaid®, a common producer of lactose-free milk, simply adds lactase to fat free milk) or substitute it with soy – a major U.S. crop that represents over thirty-seven billion dollars in sales and that is second only to corn in terms of profitability.12,13 Such facts cast further doubt on whether it is public nutrition or the interests of the agriculture industry behind the current dietary guidelines for dairy consumption in this country. From children in the school lunch line to Rutgers students at the dining hall to shoppers at the grocery store, perhaps it is time for all Americans to truly re-think what we drink.
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Introduction to Energy Drinks 101
becoming a red bull university
Since the introduction of carbonated sodas, the energy drink was the next big thing to hit the soft drink industry. In the mid 1900’s, the first progenitors of energy drinks were originally spotted overseas in Europe and Asia. These earlier versions mainly took the form of caffeine filled beverages mixed with herbal tonics. Meanwhile, in the United States, the energy drink fad never really stuck. That is until April 1, 1887 when Red Bull first debuted and grew exponentially, changing the face of energy performance forever. 1 With the entrance into the 21st century, studying on college campuses was revolutionized with a new dependence on energy drinks. There are signs of the impact of energy drinks everywhere on the Rutgers campus. Half the fridges in convenience stores are dedicated to energy drinks. There are Red Bull sponsored campus events like the DJ Thre3style party. There’s even a mini cooper with a giant Red Bull can on top, parked on College Avenue! We are RU, but the R doesn’t stand for Rutgers, it stands for Red Bull. And Red Bull University is a real thing. It’s the name of a brand awareness program that endorses student managers through advertisement. There’s even a group of Red Bull girls called Wings Team who accomplish the same goal.2 (They’re the ones who drive said canned cars and accessorize with can shaped backpacks).
By fiona kim
Does this mean Rutgers condones energy drinks? Research by Rutgers Poison
regulate minerals. However, no substantial evidence of such exists. Guarana is a brown
Control would suggest otherwise. In fact, regulation of energy drinks has varied
berry-like shrub grown in forests of Brazil and South America. It is harvested for its caffeine
increasingly over time. It was only recently, since July 2013, that the FDAA banned a large
potency (two times more caffeine than coffee beans). And a fun fact: in forests it functions as
portion of energy drinks for use of DMAA (1, 3-dimethlyamine), a synthetic amphetamine
an insecticide! Other herbal ingredients such as green tea extract and ginseng have also
derivative. Previously, DMAA was used in drugs for ADHD, weight loss, and body building.3
shown no significant benefits other than as sources of caffeine.5
Because studies found that DMAA was related
Due to these additional sources,
to health risks, energy drink companies have ditched this ingredient and substituted it with
you may be overdosing on caffeine without even realizing it. There have been certain
other fillers. However, energy drinks still pose a threat of caffeine toxicity.
extreme cases in which young adolescents unknowingly consumed beyond the suggested
The root of the problem persists in the fact that most people don’t notice total caffeine
daily intake and have been hospitalized. One case involved 14-year-old Anais Fournier
intake. The average person should ingest at most 300mg of caffeine a day. In an extreme
from Maryland. One morning, Anais Fournier purchased a Monster from her local deli. After
case, too much can cause heart palpitations, increased blood pressure, dehydration,
feeling the effects of a caffeine-sugar buzz she proceeded to buy another can that same
sleeplessness, upset stomach, and increased urination.4 However, energy drinks can range from a modest 50mg of caffeine to as much as 450mg of caffeine in one can. Not to mention the other ingredients in energy drinks have no real beneficial effect and are added only to increase caffeine amounts not listed on the nutrition label. Taurine, for example, is an organic compound naturally found in meat and fish. This amino acid has been believed to help
night. By the next day she was taken to the hospital for a cardiac arrest and died from cardiac arrhythmia due to caffeine toxicity.6 Those two cans contained only 480mg of caffeine. Though this case was rare, it was not unrelated. The effects of caffeine are real enough––in fact you depend on it. However, incidences such as what happened to Anais Fournier spring from a dangerous lack of knowledge.
symptoms of caffeine toxicity + dizziness + increased thirst + uncontrolled muscle movement + vomiting + tachycardia
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A Prom to Care
THE EXAMINER
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BY JASMEET BAWA
mise re As the EE bus makes its way up and down George St––for those of us that take it often––we have seen the same New Brunswick residents climb onboard. Sometimes they will ask us for a cough drop, other times a dollar. Sometimes they will tell us that they are homeless, other times we can hear it over our discomfort, tacitly understood from the number of times we have seen them with the same bags week after week. Over 100,000 residents in Middlesex County are uninsured and, according to the U.S. Census, 31.4% of New Brunswick’s residents were below the poverty line from 2008-2012.[1][2] Hannah Janoowalla is well acquainted with this reality. A fourth year student at Robert Wood Johnson Medical School, Janoowalla turned to medicine with the desire to improve lives daily and create long term social change (Janoowalla H, email interview, Feb 17, 2014). One way she fulfills this desire is by volunteering with the Promise Clinic. The clinic provides needed care to uninsured New Brunswick residents through basic health care, screenings, and patient education.[3] One important service provided by the clinic is a community joint effort. The Eric B. Chandler Health Center, located across from Rockoff Hall, is New Jersey’s only health center that is federally qualified and owned by a medical school, our own Robert Wood Johnson. It provides a plethora of primary care services and accepts various forms of insurance, and even a sliding fee scaled based on the Federal Poverty guidelines. On Thursday evenings, the Health Center alots space for the Promise Clinic in order to provide primary care services to uninsured clients from Elijah’s Promise Soup Kitchen.[3] The Promise Clinic is also an educational experience for medical students, providing them with early clinical exposure. Students from all levels are paired into teams with doctors and assigned patients, and are able to follow a patient over the course of their medical treatment as the clinic provides long-term care for its patients. Janoowalla believes this continuity of care model allows for a doctor-patient relationship that is “even more important in the healing process than medical knowledge.” (Janoowalla H, email interview, Feb 17, 2014) Working at the clinic also provides students the opportunity to “facilitat[e] communication between health care and social service providers”.[3] Since the clinic only works with students from Robert Wood Johnson, to aspiring medical students, Janoowalla offered some words of advice: “Never lose your idealism and commitment to why you decided to go into this field. It is a long and arduous process where you have to make a lot of sacrifices and constantly doubt yourself, but retain your humility and don’t let peer and teachers who are jaded and have lost their ideals change you. Use the skills you have now to help, and although you may feel like you don’t have many, you really do.” (email interview, Feb 17, 2014)
Interview with Nisha Bide: Why Pharmacy and Insight What is Pharmacy all about? Why should you consider the field and what steps could you be taking now? What should you expect in the future? I interviewed PharmD Candidate, Nisha Bhide to help answer some of these questions and give more insight into the field. Bhide is in her final year of the six-year pharmacy program at the Ernest Mario School of Pharmacy at Rutgers University. She is currently a registered pharmacy technician at Robert Wood Johnson University Hospital, was President of the Rutgers Student Chapter of the New Jersey Society of Health-system Pharmacists from 2012-2013, has been involved with many professional pharmacy organizations, and has numerous professional experiences.
Q: Why did you want to become a Pharmacist? A: I decided to attend pharmacy school because I
wanted to interact with patients and use my skills and expertise to help them get healthier. There are so many opportunities to impact patient care (in the hospital, community, ambulatory care, or industry setting) that studying to be a pharmacist made perfect sense. Pharmacists are the most accessible healthcare professionals and they can really make an impact on public health. When one is a senior in high school or a freshman in college, it’s kind of hard to know what exactly you want to do with the rest of your life. For me personally, I knew that I wanted to go into healthcare. A lot of opportunities came about through reaching out to different people and trying to understand what the profession of pharmacy was all about. I tried to get involved in anything that interested me and tried to seek mentors that had similar passions to mine. I currently work as a pharmacy technician at Robert Wood Johnson University Hospital in New Brunswick. I’ve been working there for about 4 and 1/2 years, since my freshman year of pharmacy school. I think that’s the most hands-on way to know what a Pharmacist does and what career options are available after graduation.
Q: Which experiences were most meaningful and why? A: So many experiences have been extremely
meaningful throughout my education. Throughout pharmacy school I developed strong leadership skills and a passion for administrative opportunities, which compliment my academic experiences. Being involved nationally with the ASHP Pharmacy Student Forum Executive Committee has helped me decide what
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36
types of residency positions I want to pursue and has helped me meet amazing students and practitioners from around the country. Also, working in and being on rotation in many different hospitals has solidified my passion for health-system pharmacy. From my first professional year when I completed a research paper in the Department of Pharmacy Practice & Administration to my fourth professional year when I presented a poster regarding “Maintaining Pharmacy Services During the Construction of an Oncology Satellite”, I have additionally developed an interest in pharmacy process assessment and quality improvement. Working as a pharmacy technician at for the past 5 years, completing two different summer internships, in addition to six advanced practice experiential rotations has confirmed my passion and interest in the hospital setting.
Q: What resources on campus did you find helpful, and why? A: Being involved with a professional pharmaceutical
fraternity and involvement within professional pharmacy organizations have been great resources throughout pharmacy school. There are organizations that represent different types of pharmacists, including community pharmacists, national chain drug store pharmacists, manage care pharmacists, health-system pharmacists and many more. I get to give back to my profession by being involved and it’s great opportunity to meet different people in the profession. I’ve gained many opportunities, and also great mentors, advisors, and people who help me become the professional I hope to be. There is also an intangible part, where you belong and you can give back while advocating for your profession. When I started at Pharmacy school many people close to me were not aware that pharmacists work in the
By Meghna Dev
hospital setting?’ I like to motivate other people to be involved and realize that advocacy is very important.
Q: What are your career goals/goals for after graduation? A: Currently, I am interviewing for post-graduate residency positions. I would like to work in a hospital or health-system after graduation and hope to continue being involved with leadership opportunities in professional pharmacy organizations.
Upon completion of professional school, as with any professional pharmacy school, one obtains a PharmD degree, short for Doctor of Pharmacy. After graduation, there are many opportunities for post-graduate training including certifications, residencies, and pharmaceutical fellowships. Many people choose to do specialized residencies including ambulatory care or pursue academia.
Q: What advice does you have for someone interested in pharmacy? A: Talk to as many students, practitioners, and
professors as possible. They are in it and can give students the most insight. Students can come to a pharmacy event or attend a career night in the pharmacy school. Ask questions and keep an eye out for things that are happening in the pharmacy school. It can also be important to network and be involved in different organizations. Also, I would suggest researching possible career opportunities in the profession and see if those opportunities align with potential professional future long-term goals.” Rutgers has a six-year program that accepts students from high school and allows admission directly into
professional school after two years of undergraduate education. However, many students not enrolled in six-year programs first obtain a bachelors degree, take the PCAT (Pharmacy College Admission Test), and then attend Pharmacy school as a four-year graduate program (some schools have three-year accelerated programs). Rutgers also allows students to apply as transfer students who may have taken the PCAT or already have a Bachelor’s degree. Many of the transfer students are from Rutgers themselves.
Q: Why would you recommend this field to others, especially those who aren’t sure what they want to do? A: Well everyone should explore all opportunities. I
would recommend the profession if you’re interested in medications and patient care. I think it’s really important that everyone weighs their options and does their research. If you are someone who would enjoy learning about a majority of medications that exist in the world, how they work, how they act in the body, and how they are used, pharmacy may be the profession for you. I would encourage students to go for what they are excited about or passionate about, especially as an undergrad because undergraduate years are really the time to explore. Patients’ lives are very serious and all the work that we do is very detail-oriented. Good pharmacists also tend to have strong communication skills. Articulation is important in a corporate, hospital, community, or any other setting. The job of any healthcare professional is to serve the patient. As a pharmacist, the goal is to make sure that your actions produce the best outcome for the patient. It’s not for everyone, but many can be successful in this field.
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By mounica sreedhara
The Effects of Obamacare The recent modification of the Obamacare website, which has now been declared glitchfree, serves as an information unit to help the general population understand Obamacare and provide access to a marketplace for purchasing health insurance. Obamacare, also known as the Affordable Care Act (ACA), was signed into law by Obama with the purpose of lowering the rate of uninsured. Many people in the past have chosen not to purchase health insurance because they could not afford it. Under Obamacare, every individual is required to purchase health insurance and all health insurance companies are required to cover the minimum standards for every applicant regardless of pre-existing conditions, gender, or race. Accordingly, individuals who fail to purchase health insurance are required to pay a penalty fee of $95 per year or 1% of yearly household income. The focus of Obamacare is to provide a chance for all individuals to purchase quality and affordable health insurance. For college students, the Obamacare website will help in making a decision about which insurance plan is the most affordable for purchase. Yet, what Obamacare means for current students and what it could mean for students after they graduate remain to be questioned. The new healthcare regulations under Obamacare require college plans to include many different benefits including mental health benefits,
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substance and chemical abuse treatments; all preexisting conditions; pregnancy, wellness, and preventative care visits; and contraception and abortions.3 While the health benefits provided for students under these college plans are numerous, the cost for health care also becomes increasingly expensive. This could have a major impact since more expensive health-care plans will add to the financial burden that college students already encounter with high student loan debt and high tuition rates. In the state of New Jersey, all college students were required to have health insurance even before Obamacare came into effect.3 However, what previously cost $100-$600 per year has now risen to $1,700 per year as the mandated coverage under Obamacare.3 At Rutgers, this substantial increase in student costs for health insurance is because of the additional health benefits that the university must cover for students under Obamacare regulations. The previous bareminimum insurance plans costing $100-$600 did not meet the minimum coverage standards set by Obamacare.2 The more comprehensive medical coverage plans now include benefits such as emergency room treatment, inpatient hospitalization, outpatient surgery, lab and x-rays as well as preventive care.5 Furthermore, students are covered whether they incur an illness or injury on campus, at home or overseas.5 For instance, if students study abroad for a semester or travel
abroad for vacation , they will be covered for the same services as if they were on campus or at home.5 Obamacare also allows students to latch onto their parents’ health-care plan until the age of 26. At Rutgers, 21 percent of full-time students buy insurance through the university.4 In New Jersey, the majority of college students have health coverage through their parents’ policies, but an estimated 80,000 or more students have been buying coverage through their colleges.4 While the Obamacare website provides access to many plans and students have the option of purchasing health care provided by their universities, many students have opted for health coverage under their parents’ plan as the most affordable choice. Furthermore, Obamacare may also impact students looking to work after graduation. This will impact the job market. Obamacare requires that all businesses employing 50 or more full-time workers provide health-care coverage to all of their full-time employees. The risk that comes with this requirement is that businesses might start to cut their employees’ hours and lay off employees or hire fewer people in the future to cut down costs that are allocated for health coverage.1 This possible reduction in employment could lower students’ opportunities for work after graduation. Ultimately, the year of 2014 is significant in that Obamacare will go into complete effect, affecting students in the present and into the future.
39
Those of us with RUWireless_Secure on our phones have not failed to recognize the omniscient presence of the Internet in the Rutgers campus. Every time we walk into a building, we are automatically connected to cyberspace. As college students, we live in a society where Google and Wikipedia have replaced pen and paper in value towards obtaining an education; where Facebook, Twitter and Instagram have become defining characteristics of any social experience; where smartphones and tablets have become as travel-essential as keys and a wallet. Although the Internet’s role in everyday life is now accepted as an integral part of “our generation,” Generation X, the complete extent of its influence is beyond imagination. Not only has it changed the social aspects of our lives, the Internet has affected us biologically in the way we think and feel.
By ronak patel
Nucleus Accumbens (NAcc) Dopamine release in the NAcc is linked with reinforcement learning and may play a role in why we keep using facebook.
Evidence suggests that the Internet is leading
gave students not using the search engine false
to remapping of neural circuitry, reprogramming of memory faculties1, and dramatic shifts in cognitive
feedback that they had correctly answered all the trivia questions. Surprisingly, even with this positive
processing—all of which contribute to an enhanced perception of self2. Daniel Wegner, a psychology
but false feedback, this group did not rank higher in self-confidence than the Internet group. These
professor at Harvard University, explains how being connected online all the time has changed our
results hint that increases in cognitive self-esteem after using Google are not just due to the immediate
subjective sense of self as borders between personal memories and the information in the World Wide Web begin to blur. The distinction between the internal and external world changes radically when there is reliance on the Internet. A study of college students attempted to demonstrate how our thoughts readily turn to search engines when posed with a trivia question. The students were asked to answer trivia questions with or without the assistance of Google and then had to rate themselves on a cognitive selfesteem scale. Those who had used the Internet to search for answers had significantly higher cognitive self-esteem. Incredibly, even though answers came verbatim from a Web site, people in the study had the illusion that their own mental capacities
positive feedback that comes from providing the right answers. Rather, simply using Google gives people the sense that the Internet has become part of their own cognitive tool set2. There have been efforts to explain how the Internet contributes to our enhanced self-perception. In fact, studies have found that unidirectional Internet-based communication such as blogging and tweeting may capitalize on the intrinsic rewards associated with social sharing3. Biologically, this taps into the brain’s intrinsic reward, learning and pleasure system, specifically the nucleus accumbens (NAcc). An area in the limbic system, the NAcc has evolutionarily been responsible for processing natural rewards such as food and sex. Dopamine
had produced this information. A control study
release in the accumbens occurs in anticipation of
41
reward, and facilitates many kinds of approach and goal-oriented behaviors. Although its main function it to process behaviors essential for reproductive success, it is known that the NAcc also plays an important role in nonessential, extrinsic rewards, most notably drug seeking and habitual behaviors. It has also been shown that social rewards obtained through the Internet can also activate this same process. Obtaining “likes” on Facebook may be more meaningful to the user than the simple click of a button; they may in fact be activating the brain’s natural reward system, compelling users to pursue the social rewards that follow social sharing on such media sites3. There has long been evidence that individuals flock to the Internet to fulfill intrapsychic needs and obtain social rewards without incurring personal costs. Experimenting with alternate identities has allowed users to live a virtual life so vicariously that they almost forget their own reality and identity4. Although most people acknowledge the paramount influence of the Internet on our lives, not many understand how the interwebs have grown to shape our own evolution. Accompanying the tremendous growth of the Internet has been a comparable cognitive and neurological growth. Although the future impact of these subtle changes is not very well understood, this shift does not mean that we are in danger of losing our own identity and sense of direction. Instead, we may be merging the mind with something greater; forming a transactive partnership with an information source more powerful than any the world has ever seen5. Whether we like it or not, the Internet is already changing the way we think. A virtual follow on Twitter has the potential to affect our brains on a very literal
DANIEL WEGNER, PhD A pioneer in social psychology at Harvard University most famous for his experiments in thought suppression.
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neuropsychological level. So rather than viewing our generation’s increasing self-reliance on the Internet as an evil, perhaps we should consider the positive outcomes it promises and look forward to an Internet-centric world.
Cultural Competency
By chir-wei stephanie yuen The American Association of Medical Colleges considers cultural competency to be “having the capacity to function effectively as an individual or an organization within the context of the cultural beliefs, practices, and needs presented by patients and their communities.”1 A culturally competent medical professional should understand how a patient’s ethnicity, race, and culture affect aspects of his or her health and how to work within that framework to best serve the patient’s needs. Cultural competence is increasingly important for health professionals in the United States, as the country becomes increasingly diverse. Cultural competency requires health practitioners to consider the intersections of patients’ identities such as sex, age, class, race, religion, sexual orientation, ethnicity, and so forth. One portion of cultural competency is understanding how health issues such as chronic heart conditions, high blood pressure, and such differ in the extent that they affect different racial groups. Becoming culturally competent means becoming aware of stereotypes that surround different class and racial groups in medicine, and promoting the degree to which patient decisions are made in conversation with patients and their families.2 The communication necessary for successful patient communication is a difficulty for many doctors with patients who have limited English language capabilities, and requires doctors to learn how to work with interpreters. Interestingly, cultural competency also includes learning how to deal with those who have different epistemological frameworks when it comes to medicine, healthiness, and disease. For example, the treatment of folk diseases, conditions not recognized by the modern biomedical framework but are deeply embedded and understood within the context of certain cultural beliefs, requires health practitioners to be aware of medicine beyond the modern, Western context.3 There has been an institutional response to this need for culturally competent medical workers caring for an increasingly diverse American population. In 2007, the state of New Jersey passed a law requiring that all medical schools within the state must integrate cultural competency into their curriculums for then-current and future medical students. Furthermore, physicians getting their licenses renewed after 2009 have to complete at least six hours’ worth of cultural competency training.4 Several leading medical universities have implemented other plans in addressing this issue, like John Hopkins University, which established an Office of Diversity and Cultural Competence. The Office holds events, seminars, and conferences aimed at promoting awareness of cultural and ethnic differences relevant to medicine.5 The importance of instilling proper cultural competency in physicians must not be trivialized. On a survey conducted by the Kaiser Family Foundation, patients expressed significant concern that they or their families (65% and 58% of patients respectively) would experience unfair treatment when seeking medical help due to their ethnic/racial background. 6 Subpar care due to racism and cultural insensitivity has lead to mutual distrust – antithetical to what constitutes a beneficial relationship between patients and physicians. In a 2005 study review done by Dr. Mary Beach of 34 studies on matters of cultural competence, patient satisfaction and physician skill was better after competence training, although the effects of training on patient outcomes are unclear.7 Medical practitioners like nurses, physicians, technicians and physician’s assistants do not spring whole from Zeus’ head, like Athena, armed with knowledge and ready to apply it with a judicious hand. They, like all of us, grew up grounded in a particular time and place, immersed in social mores and (mis)understandings of other cultures. However, a large part of their training is acquiring the ability to empathize and to understand an ill person’s perspective, with the goal of uplifting his or her quality of life. Cultural competency is a necessary extension of that skill, and it makes for a humane and high-quality physician.
43
p e e l S o t How
a student’s guide to mastering dormancy
Scientists recommend 8 hours of sleep per day. The average college student sleeps barely 6.5 hours a night, and even less during exam periods!
Every day, thousands of Rutgers students are compromising their sleep to finish work, spend time with friends, and attend meetings and events. We spend nearly one-third of our lives sleeping; however, these college years are notoriously sleep-deprived, with an average Rutgers student
opposed to the recommended 8 hours a day). Optimizing one’s sleep schedule and learning about external factors affecting sleep quality is the best way to compensate for the past, present, and future sleepless days. There are many theories about the purpose
getting shut-eye for less than 6.5 hours a day (as
of sleep. Some scientists claim that sleep serves
By aayush visaria
y Looking at the artifical light of a cell phone before you sleep may disrupt your sleep cycle.
as a period for the consolidation of memories and the processing of information learned throughout the day.6 Others say it might be an evolutionary adaptation, developed to conserve energy during times when activity would be perilous. A relatively new theory describes sleeps as a rejuvenating and
2013, researchers at the University of Rochester found that the brain disposes of unwanted cellular debris and aggregations during sleep. In particular, waste is flushed out through the cerebrospinal fluid, which cycles through the brain’s ventricles continuously.13 Amyloid plaques,
cleansing mechanism for the brain. In October
which contribute to the onset of several mental
3+ hrs before sleeping
1-2 hrs before sleeping
The hour before sleeping
Exercise
Exercise increases cortisol levels which are involved in keeping you alert - making it difficult to sleep if done less than 3 hours before sleep
Light exercise is okay if this is the only time available.
Instead of exercise, use this time to do meditation, which can, among other benefits, allow for quality sleep
Eating/ Diet
Eating dinner in this interval is ideal, as there is enough time for food to be digested properly.
If necessary, eat light during this time interval. If you are very hungry, eat foods that tend to not interrupt sleep, like dairy foods or carbohydrates.
Do not eat anything in this interval. It is better to wait and have a good breakfast the next morning.
Light
Have a spot where natural light radiates into your dorm in the morning. Synchronizing your sleep-wake cycle with natural light is the ideal plan.
Try to finish work that involves a computer or watch TV during this interval. Artificial light can hinder sleep.
Use this time to catch up on reading or paper-related tasks. Listening to music to induce sleep can also help you achieve quality sleep.
Try to keep bed cool, neat, and comfortable.
Reducing noise can be helpful. “White noise” from a fan or some other appliance can actually help induce sleep.
Sleep Environment
diseases, were discovered to be removed through
Answers to these questions require us to question
this mechanism during sleep, leading to many questions about the importance of sleep and the association of disease with the lack of sleep.8 Scientists recommend that the average adult should sleep 7-9 hours a night, although it can be slightly lower or higher depending on the individual. It is not a mystery that college life eliminates all hope of having a perfect sleep schedule. The average college student sleeps barely 6.5 hours a night, and even less during exam periods.1 How do people cope with such “sleep debt” and what strategies are there to alleviate the burden of exhaustion due to sleep deprivation?
the very notion of sleep and our current pattern of sleep. Are ~8 hours of sleep necessary? Is this sleep-wake cycle a byproduct of society’s work schedule or evolutionarily advantageous? Before the advent of artificial light and before the Industrial Revolution, people may have led biphasic lifestyles. They slept twice, once in the late evening and then again a few hours later. A number of western works from the 1800s refer to them as “first sleep” and “second sleep”.5 Even today, many people feel sleepy in the afternoon, suggesting a possible internal, biphasic sleep cycle. 80% of mammals have biphasic cycles.12
THE EXAMINER
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Furthermore, some countries already live biphasic lifestyles by having an afternoon siesta. For the rest of the western world, artificial light and the subsequent increase in production and progress have left society with only one sleep time. A study done by Wehr et. al. in 1992 suggests that when humans are kept away from artificial light, they adopt a biphasic sleep cycle.12 The US Air Force also conducted a study to assist in fatigue and irregular sleep patterns that accompany pilots’ work. The report states that in total, eight hours of sleep is necessary every day. They can be distributed throughout the day, however, without any noticeable
Naps are most effective when they are...
adverse effects. Nevertheless, the longer the intervals of sleep, the better a person functions at his/her capacity.4 The quality of sleep is equally important to its quantity. Cell phones are one of the many culprits that negatively affect sleep. Radiation from cell phones disrupts sleep, as shown by a 2008 study funded by major phone companies.10 Looking at an artificial blue
90
light screen like that of a cell phone or computer before sleeping can also disrupt the sleep cycle. One of suggestions thus given by researchers who conducted the 2008 study is to invest in an actual alarm clock rather than utilizing the cell phone’s alarm app because it will decrease the proclivity to look at one’s phone and decrease
10
minutes
minutes
exposure to radiation.7 Other than cell phones, indirect effects of diet, noise, and light can decrease sleep quality and cause one to inadvertently wake up during crucial times in one of the sleep stages (See table for more information). If you feel exhausted when you wake up, it may be because you are waking up during REM sleep or deep sleep (Stage N3). Sleep is controlled primarily by two cycles: circadian rhythms and ultradian cycles occurring during sleep. The circadian rhythm, controlled by the suprachiasmatic nucleus of the hypothalamus, is an endogenous cycle of approximately 24 hours that affects physiological changes that occur throughout the day (i.e. body temperature, melatonin levels etc.). The ultradian cycle characterizing sleep is a 90-120 minute cycle that switches between REM (rapid eye
30 minutes
47
movement) sleep and NREM (non-REM) sleep. NREM sleep consists of three stages (1, 2, and N3), each of which delves deeper into the unconscious brain.1 All levels are vital for brain functioning and mental health. The strategy should be to wake up when the ultradian 90-120 minute cycle ends, right before the next REM period. This will result in a faster recovery from sleep inertia (post-sleep grogginess). Sometimes, college faculty and students do not have 90 minutes to spare but still want to get some sleep. “Power naps” can be effective. The key is to wake up before you enter stage N3.3 If one enters stage N3 of NREM sleep, sleep inertia will likely result because one has entered the normal sleep cycle. A Flinders University study concluded that 30 minutes is the maximum time for a short nap under 90 minutes.3 Shorter naps of 6-10 minutes are also enough to enhance memory and recapitulation.9 Even with opportunities for short naps and intermittent sleep time, students
“
and faculty still accumulate sleep debt throughout the weekdays. Most students tend to sleep more on the weekends to make up for sleep lost during the week. But can “sleep debt” ever be Accumulated sleep debt during the week repaid? Researchers from Penn State, the University caused the brains of participants to of Crete, the University of Athens and the New function less quickly and efficiently, but York School of Medicine conducted a study on 30 making up for sleep during the weekend participants, who slept only six hours on weekdays did not restore brain functionality. The and 10 hours per day on the weekend. Accumulated researchers suggest that it takes many sleep debt during the week caused the brains of weeks of appropriate sleep to regain lost participants to function less quickly and efficiently, but making up for sleep during the weekend did not memory skills and clarity of thinking. restore brain functionality. The researchers suggest that it takes many weeks of appropriate sleep to regain lost memory skills and clarity of thinking. Fortunately, other physiological responses such as inflammatory changes and hormonal changes do go back to normal within one weekend of increased sleep.11 While there are many factors that play into an advantageous sleep pattern for a Rutgers student, proper diet and reduced cell phone use are two often-overlooked gateways to quality sleep. As for quantity of sleep, one should experiment with power naps and polyphasic sleep patterns to determine the most effective sleep pattern within a college schedule. However, research is still necessary to completely validate polyphasic sleep patterns as advantageous. Students should aim to sleep for 7-9 hours at night, when both the circadian rhythm and sleep cycle are synchronized. Sleep has always been important, but the real question is: how much of a priority is sleep for you? The critical decision comes, unfortunately, when you have to decide between sleeping and studying. Is sleep important enough to wait until the morning to do an essay due at noon? Following the above suggestions and experimenting with different sleep patterns will ultimately lead you to an answer, and to a healthier lifestyle as a member of the Rutgers community.
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48
by neha kayastha
The Human Dimension of Medicine Harvard Medical School professor Francis W. Peabody said nearly a century ago, “For the secret of the care of the patient is in caring for the patient.”1 More recently, the medical community has slowly realized that the act of caring for the patient has been lost amongst healthcare providers. The culture of healthcare has morphed such that the disease is relevant, but the patient is irrelevant. This attitude has been reflected in patient satisfaction surveys, where physician attitude is tied into the majority of patient complaints and is linked to the most common reasons for lawsuits.2 As a result, the medical community is realizing that while it is necessary for doctors to be able to think critically, it is equally important for them to understand how they are acting towards their patients. A truly competent physician is one who is humanistic, “seek[ing] to understand the patient as a person, focusing on individual values, goals, and preferences with respect to clinical decisions.”3 At the end of the day, medicine is centered on the personal relationship between the physician and patient. Bringing humanism back to medicine can restore this damaged relationship. At every stage of the process of becoming a doctor, efforts are being made to restore humanism. The new 2015 MCAT will now have a section on psychology and sociology, requiring premedical students to expand their horizons beyond the natural sciences. Many medical schools are now attempting to weave the themes of ethics, professionalism, and patient care into their curriculums. Through Accountable Care Organizations and by linking payment to quality outcomes, the Affordable Care Act is taking steps that require doctors to once again place the importance of quality of care over quantity of care. I recently spoke with Dr. Dorian Wilson, a liver transplant surgeon and Director of the Healthcare Foundation Center for Humanism and Medicine at Rutgers New Jersey Medical School. Dr. Wilson and I discussed how increasing pressures on physicians to see a greater number of patients in less time has contributed to the loss of humanism in medicine. He also postulated that the advent of technology has played a role in removing the physician from the patient. As he stated, “technology is necessary but not sufficient.” Dr. Wilson’s goal is to help medical students become physicians who will alleviate suffering through humility, kindness, and respect, all the while achieving personal growth. Since the Humanism Center was established at NJMS 10 years ago, Dr. Wilson says that he has noticed “slow but steady” change. Each year, students are graduating from NJMS, having made a positive impact on the Rutgers and Newark community and embracing humanism in their life philosophy. So what does Dr. Wilson prescribe to the humanist? He places many things on the to-do list, including: Listen to the patient in a judgment- and value-free manner. Obtain medical histories that incorporate a patient’s belief system through understanding of cultural diversity and alternative medicine treatment. Admit when you don’t know something, and recognize when to seek consultation. Be open to learning experiences from all members of the healthcare team. Be a good listener.1 As people who will always be interacting with others, whether in the medical field or not, we should strive to embody the traits of a humanist.
49
What health profession organization is r Being a future health profession student can be an intimidating thing at Rutgers University. Sure, you know that you need to take science classes and maintain a good GPA in order to be admitted to the professional school of your choice, but the myriad career opportunities available in the health professions field can be overwhelming for even the brightest of pupils to know where to begin “becoming qualified.” Luckily, Rutgers has a wealth of organizations to help students seeking a career as a pharmacist, physician, physical therapist and more!
contact
healthprofessionsunited.ru@gmail.com
contact
wihpru@gmail.com
contact
ruexaminer@gmail.com
contact njpha.rsc@gmail.com
THE EXAMINER
50
Health Professions United
There are many more professionals in the
health professions than just doctors and nurses. Hospitals and other health care providers work in complex networks of various professionals working towards the common goal of improving patient care. Many professional schools express their desire for diverse health professions to work together as a team. Collaboration saves time and prevents miscommunications between, for example, the physical therapist who assigns the patient exercises for a prosthetic limb and the surgeon who performed the orthopedic surgery. Health Professions United seeks to unite students who are interested in different health professions, so they can better understand and communicate with each other. As Danielle Levin, a senior CBN major and co-president of the club says, “the purpose of our club is twofold: to help students who already know what they want to do after college gain an understanding of what other professions are about, and to inform students who know they want to be in the health professions field but are unsure of which profession to pursue to.” HPU accomplishes this by hosting speakers from different health professions such as dentistry and surgery at meetings, to share their experiences with the club members. HPU also has meetings devoted to different group activities like medical ethics interview practices and team building activities designed to foster development between members. In the past, HPU has raised money for Ronald McDonald House with its Scarlett Ball for Hope and planned trips to the Bodies Exhibit and the Museum of Sex in New York City. HPU meets every other Monday in the Busch Campus Center at 9:00 and serves pizza at its meetings.
s right for you?
By sailaja darisipudi
Women in the Health Professions
New Jersey Public Health Association
Women have made great strides in the past 50 in the health professions field. But women
Public Health is an extremely important field in the health professions, which impacts
have historically been discriminated against in areas devoted to science, and the impacts of that
government policy on health care reform and works to stabilize health care concerns for
discrimination are still present today. Women in the Health Professions acts as a support system
the public. If a student is interested in learning more information about public health, NJPHA
for women who are interested in pursuing the health professions. WIHP’s “goals are to unite
is the perfect organization for him or her. Hima Santhiam, a junior public health major and
and acknowledge women in the scientific community whether in medicine, research, public health, pharmaceuticals, nursing, or other health
regular member of NJPHA adds that the club is involved in “public health related activities such as Habitat for Humanity, and hosts
professions, and to foster lifelong connections for our members which will transcend beyond
informational panels with faculty, students, and professionals in the public health field
Rutgers and into the professional world,” says Daphne Bienkiewicz, the Secretary of WIHP and
and networking events with faculty.” This is an excellent opportunity for public health majors
a senior at Rutgers. WIHP does not have regular meetings, but instead has interactive panels
to network and find internship opportunities. NJPHA meets Tuesdays at 8:30 in the Rutgers
designed to prepare students for the professional world outside of college. Professionals knowledgeable in areas such as career guidance, graduate university admissions, and scientific research often speak at these panels. The times of the meetings change every month but usually meet between 7 and 9 at the Busch Campus Center.
The Examiner If you like what you see in this journal, and you are interesting in writing about pertinent health/pre-health issues for the Rutgers community, consider becoming a journalist for The Examiner! We publish two issues a semester, and we are always looking for interested students to join the organization. The importance of writing in the health professions cannot be exaggerated.
Student Center.
As important as classes are, college is
also an opportunity to network with peers who share your professional interests. A fantastic way to learn more about your possible career in a casual setting is getting involved in a professional organization. The organizations spotlighted in this article are just a few of the many organizations at Rutgers University devoted to helping students interested in the health professions. Students who are looking to learn more should visit http://getinvolved.rutgers. edu/organizations. Rutgers is a treasure of trove of opportunities – be brave enough to take the first step of attending a meeting and share in its collective wealth.
51
RESEARCH AT RUTGERS What’s one of the best ways to apply your academic knowledge to real-world experience, while honing your critical thinking and writing skills?1 Research! Participating in research as an
1
Evidence indicates that Alzheimer’s disease is associated with mitochondrial dysfunction.
Mitochondrial function is essential to cells in the human body, particularly neurons, as it
undergraduate is an opportunity to push yourself intellectually, and gain insight into the discovery of
provides for the high-energy demands of the cell. Damaged mitochondria can result in serious
brand-new knowledge. There are many reasons to participate in research—whether you are looking
neurodegenerative disorders, including Alzheimer’s. The Department of Cell Biology and Neuroscience
to add another noteworthy item to your resume or just want to gain a deeper understanding of the
is looking into finding out how to target these damaged mitochondria and eliminate them from
world around us, research is a valuable activity.
the body—which could potentially have a huge
Regardless of what your future plans may be, it serves as a gateway to success that can equip you
impact on the treatment of Alzheimer’s. 3
with experience and lifelong skills like discipline and organization—qualities that will be useful in applying to graduate school as well as jobs, and building your career. 1 If there is any place that offers exciting
2
Wade into the Raritan River to learn about how to decrease obstacles to spawning migrations
for shad and river herring. The migration of river herring, which are now listed as a “species of
innovative research opportunities to undergraduate students, it is right here at Rutgers.
special concern” by the National Marines Fisheries Service, has been found to be impeded by the
presence of dams in rivers, especially throughout New Jersey. In response, special fish passage
With such diverse course offerings, faculty
and departments, it’s no surprise that Rutgers has a vast array of research opportunities in the sciences and the humanities. Below are just a few examples of opportunities available to undergraduates at Rutgers:
structures have been built in dams to facilitate the upstream passage of fish. You can help measure the effectiveness of these pathways by working directly with the fish and their migration data. 4
By NITHYA GANDHAM
3
Learn about factors that affect development through the lens of a twin study. Students will
research program that seeks to match students with a research opportunity of interest. These programs
collect and analyze data and complete literature searches, learning both technical and theoretical
require students to participate in hands-on research for five or more hours a week during the semester,
aspects of research. Past projects in this area have included the impact of older siblings on the
and offer a thousand dollar stipend. The RA program aims specifically to aid students who have had
development of twins, the influence of genetic factors on different aspects of phonological
no prior research experience, and there are no minimum GPA requirements.
development, and the effect of perinatal infection on children’s development.5
It’s never too late to get involved. If you check out the Aresty website, you can get a better
These are only some of the topics that professors are studying here at Rutgers University—
understanding of their requirements and application process, along with plenty of current opportunities
and you can get involved! Students can choose to volunteer, be a research subject, take a
that are available. Who knows – you might just find the perfect match for your interests and goals!
research course, or fulfill research departmental requirements. One of the easiest ways to find research opportunities is to apply through the Aresty Research Center. Aresty is an undergraduate
REFERENCES Pages 8-10: The Future of Transplant 1 A step closer to bio-printing transplantable tissues and organs. (2014, July 2). University of Sydney. Retrieved September 25, 2014, from http://sydney.edu.au/news/84. html?newscategoryid=1&newsstoryid=13715 2 What is 3D printing? (n.d.). 3d Printing.com. Retrieved September 23, 2014, from http://3dprinting.com/what-is-3d-printing/ 3 Marris, E. (2008, March 20). How to print out a blood vessel. Nature. Retrieved September 28, 2014, from http://www.nature.com/news/2008/080320/full/news.2008.675.html 4 Printing a bit of me. (2014, March 8). The Economist. Retrieved September 28, 2014, from http://www.economist.com/news/technology-quarterly/21598322-bioprinting-buildingliving-tissue-3d-printer-becoming-new-business 5 Organovo Describes First Fully Cellular 3D Bioprinted Liver Tissue. (n.d.). Organovo Holdings, Inc. Retrieved September 25, 2014, from http://ir.organovo.com/news/ press-releases/press-releases-details/2013/Organovo-Describes-First-Fully-Cellular-3DBioprinted-Liver-Tissue/ 6 Clark, Liat. (2013, April 24). Bioengineers 3D print tiny functioning human liver. Wired UK. Retrieved September 25, 2014, from http://www.wired.co.uk/news/archive/201304/24/3d-printed-liver 7 Organovo Highlights Liver Toxicology Achievement, Reports Q1 Fiscal 2015 Results. (2014, August 12). Organovo Holdings, Inc. Retrieved September 29, 2014, from http://ir.organovo.com/news/press-releases/press-releases-details/2014/OrganovoHighlights-Liver-Toxicology-Achievement-Reports-Q1-Fiscal-2015-Results 8 The Need Is Real: Data. (n.d.). Retrieved October 2, 2014, from http://organdonor.gov/ about/data.html Page 11: The Cancer Institute of NJ 1 Bansal, N., Davis, S., Tereshchenko, I., Budak-Alpdogan, T., Zhong, H., Stein, M., Sabaawy, H. (2014, February). Enrichment of human prostate cancer cells with tumor initiating properties in mouse and zebrafish xenografts by differential adhesion. Abstract. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939797/ 2 Rutgers Cancer Institute of New Jersey. (2014, August 28). Research reveals mechanism behind cell protein remodeling. ScienceDaily. Retrieved from www.sciencedaily.com/ releases/2014/08/140828135240.htm 3 Rutgers Cancer Institute of New Jersey. (2014, July 14). 15-year overall survival benefit lacking in older men treated with hormone therapy for early-stage prostate cancer. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2014/07/140714181915. htm 4 Rutgers Cancer Institute of New Jersey. (2014). About Rutgers Cancer Institute of New Jersey. Retrieved from http://cinj.org/about-cinj/about-rutgers-cancer-institute-newjersey Image retrieved from http://upload.wikimedia.org/wikipedia/commons/5/59/Acinar_ cell_carcinoma_of_the_pancreas_-_very_high_mag.jpg [Credit to Nephron under the Creative Commons Attribution-Share Alike 3.0 Unported license. Page 12-13: Breast Cancer Screening in New Brunswick 1 Eby, M. (2014, March 6). Angelina Jolie on her double mastectomy: ‘There’s still another surgery to have’ . NY Daily News. Retrieved September 28, 2014, from http://www. nydailynews.com/entertainment/gossip/angelina-jolie-surgery-double-mastectomyarticle-1.1713241 2 Jolie, A. (2013, May 14). My Medical Choice. New York Times. Retrieved October 19, 2014, from http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=1& 3 Evans, G., Barwell, J., Eccles, D., Collins, A., Izatt, L., Jacobs, C., ... Murray, A. (n.d.). The Angelina Jolie effect: How high celebrity profile can have a major impact on provision of cancer related services. Breast Cancer Research. Retrieved October 19, 2014, from http://breast-cancer-research.com/content/16/5/442 3 Stages of Breast Cancer. (2014, January 22). Retrieved October 19, 2014, from http://www. breastcancer.org/symptoms/diagnosis/staging 5 Breast Care & Mammography. (n.d.).Steeplechase Cancer Center. Retrieved September 28, 2014, from http://www.rwjuh.edu/scc/breastcaremammography.aspx 6 Breast Care & Mammography. (n.d.).Steeplechase Cancer Center. Retrieved September 28, 2014, from http://www.rwjuh.edu/scc/breastcaremammography.aspx 7 NJ Department of Health - Cancer Resources. (n.d.). Retrieved October 19, 2014, from http://www.state.nj.us/health/cancer/njceed/ 8 Women’s Health. (n.d.). Saint Peter’s Healthcare System. Retrieved September 28, 2014, from http://www.saintpetershcs.com/Womens-Health/ 9 Breast Cancer in Young Women. (n.d.). Retrieved October 19, 2014, from http://www. webmd.com/breast-cancer/guide/breast-cancer-young-women 10 Jolie, A. (2013, May 14). My Medical Choice. New York Times. Retrieved October 19, 2014, from http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=1& 11 Genetics. (2014, August 21). Retrieved September 28, 2014, from http://www.breastcancer. org/risk/factors/genetics Page 14-15: The Largest Biorepository in the World on Busch Campus 1 RUCDR Infinite Biologics. Our Mission and About Us. Retrieved from http://www.rucdr.org/ 2 National Human Genome Research Institute. (2012, February 27). What are genetic disorders?. Retrieved from http://www.genome.gov/19016930 3 National Cancer Institute Biorepositories and Biospecimen Research Branch. (2014, July 28). What are Biospecimens and Biorepositories. Retrieved from http://biospecimens. cancer.gov/patientcorner/ 4 Rutgers Office of Research and Economic Development. (2013, June 27). NIMH Awards $44.5 Million Grant to RUCDR Infinite Biologics. Retrieved from https://ored.rutgers.edu/ content/nimh-awards-445-million-grant-rucdr-infinite-biologics 5 RUCDR Infinite Biologics. Academic/Science. Retrieved from http://www.rucdr.org/ science 6 O’Brien, K. (2014, September 9). Rutgers receives $10 million donation for cancer research. Retrieved from http://www.nj.com/healthfit/index.ssf/2014/09/rutgers_receives_10_ million_donation_for_cancer_research.html
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Page 16-17: Ebola at Rutgers? 1 Saey, H. T. (2014). The Animal Source of the Ebola Outbreak in West Africa Eludes Scientists (pg. 1). 2 Texas Ebola Patient Had Contact With School-Age Kids, Perry Says. (2014, October 1). Retrieved October 1, 2014, from http://www.nbcnews.com/storyline/ebola-virusoutbreak/texas-ebola-patient-had-contact-school-age-kids-perry-says-n215976 3 Dallas releases 43 from Ebola quarantine. Officials plead for compassion not stigma. (2014, October 20). Retrieved October 24, 2014, from http://www.washingtonpost.com/news/ to-your-health/wp/2014/10/20/dallas-officials-plead-for-compassion-not-stigma-as-43leave-ebola-isolation/health/wp/2014/10/20/dallas-officials-plead-for-compassion-notstigma-as-43-leave-ebola-isolation/ 4 Berman, M. J. (2014, September 30). As Ebola confirmed in U.S., CDC Vows: ‘We’re stopping it in its tracks’. Retrieved September 30, 2014, from http://www.washingtonpost.com/newsto-your-health/wp/2014/09/30/cdc-confirms-first-case-of-ebola-in-the-u-s/ Page 18-19: Rutgers SCREAM Theatre Images retrieved from Rutgers SCREAM facebook pages. Page 20-21: Are we Scrolling our Way to Stress? 1 Sample, I. (2014, September 18). Are smartphones making our working lives more stressful? The Guardian. Retrieved from http://www.theguardian.com/technology/2014/ sep/18/smartphones-making-working-lives-more-stressful. 2 Chansanchai, A. (2012, January 17). Study: Checking smartphones increases stress. Today. Retrieved from http://www.today.com/money/study-checking-smartphones-increasesstress-117739. 3 Svokos, A. (2014, September 30). Smartphone App Can Figure Out When College Students Are Stressed. The Huffington Post. Retrieved from http://www.huffingtonpost. com/2014/09/30/smartphone-stressed_n_5901708.html. Page 22: Rutgers Health Insurance Inadequate for the Price 1 Rutgers University Health Insurance Plan 2014-2015 Academic Year. (n.d.). Retrieved from University Health Plans, Inc. website: https://www.universityhealthplans.com/letters/ letter.cgi?school_id=269 2 Student Injury and Sickness Insurance Plan. (n.d.). Retrieved October 17, 2014, from First Student website: http://www.firststudent.com/cms/files/Brochure_TCNJ_v5_3_3_14_ WEB_ID152707.pdf 3 Why Enroll in the Student Health Insurance Plan? (n.d.). Retrieved October 17, 2014, from Rutgers Health Services website: http://health.rutgers.edu/services-and-costs/healthinsurance-hard-waiver-system/why-enroll-in-the-student-health-insurance-plan Page 23: On the Overdose Vigil Image retrieved from https://unsplash.imgix.net/reserve/wVlfnlTbRtK8eGvbnBZI_ VolkanOlmez_005.jpg?q=75&fm=jpg&s=de70d125f08a3fbb40d6b9984af5c3ad [Credit to Volkan Olmez] Page 24-25: The Rising Trend of Internet Addiction on Campus 1 Kandell, J. (2009). Internet Addiction on Campus: The Vulnerability of College Students. CyberPsychology & Behavior, 1(1), 11-17. doi:10.1089/cpb.1998.1.11 2 Rutgers Office of Institutional Research & Academic Planning. (2010). 2010 Academic Year SERU Survey. Retrieved from http://oirap.rutgers.edu/surveys/SERU/2010/ TimeSpentByLevel.pdf 3 Rutgers Office of Institutional Research & Academic Planning. (2013). The Student Experience in the Research University. Retrieved from http://oirap.rutgers.edu/surveys/ SERU/2013/School%20of%20Arts%20and%20Sciences%202013%20Report.pdf 4 Young, K. (2004). Internet Addiction: A New Clinical Phenomenon and Its Consequences. American Behavioral Scientist, 48(4), 402-415. doi:10.1177/0002764204270278 Image retrieved from splitshire.com Page 27: Which MCAT is Your Match? 1 Association of American Medical Colleges. (2014). How is the MCAT2015 Scored? Retrieved from https://www.aamc.org/students/applying/mcat/mcat2015/ mcat2015scores/ 2 Association of American Medical Colleges. (2014). Which Exam Will You Take? Retrieved from https://www.aamc.org/students/applying/mcat/332616/whichexamwillyoutake. html 3 Khan Academy. (2014). MCAT. Retrieved from https://www.khanacademy.org/test-prep/ mcat 4 Rutgers New Jersey Medical School. (2014). Applying to NJMS – MD Program. Retrieved from http://njms.rutgers.edu/admissions/prospective/apply_md.cfm 5 Rutgers Robert Wood Johnson Medical School. (2014). The Application Process. Retrieved from http://rwjms.rutgers.edu/education/admissions/selection_process.html Pages 30-31: Got Milk? 1 California Milk Processor Board. Health Benefits. Retrieved from http://www.gotmilk. com/#/health-benefits 2 Just Jared. (2008, October 28). Taylor Swift: Got Milk?. Retrieved from http://www. justjared.com/2008/10/28/taylor-swift-got-milk/ 3 Williams, J. (2011, July 12). Milk PMS Campaign: New Ads Draw Criticism. Retrieved from http://www.huffingtonpost.com/2011/07/12/milk-pms-campaign-ads_n_896672.html 4 United States Department of Agriculture. How Much Food from the Dairy Group Is Needed Daily?. Retrieved from http://www.choosemyplate.gov/food-groups/dairy-amount.html 5 United States Department of Agriculture. What Counts as a Cup in the Dairy Group?. Retrieved from http://www.choosemyplate.gov/food-groups/dairy-counts.html 6 Harvard School of Public Health. Food Pyramids and Plates: What Should You Really Eat?. Retrieved from http://www.hsph.harvard.edu/nutritionsource/pyramid-full-story/#The-
Problems-with-MyPyramid-and-MyPlate Organic Valley Family of Farms. Lowfat 1% Milk. Retrieved from http://www.organicvalley. coop/products/milk/lowfat-1/ 8 American Academy of Dermatology. (2013, February 5). Growing evidence suggests possible link between diet and acne. Retrieved from http://www.aad.org/stories-andnews/news-releases/growing-evidence-suggests-possible-link-between-diet-and-acne 9 National Digestive Diseases Information Clearinghouse. (2012, April 23). Lactose intolerance. Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/ lactoseintolerance/ 10 Encyclopædia Britannica. (2012). [Map of lactose intolerance in different parts of the globe]. lactose intolerance, global distribution. Retrieved from http://www.britannica. com/EBchecked/media/157598/Global-distribution-of-lactose-intolerance-in-humans 11 Yamamoto, B. (2012, November 21). Map of Milk Consumption & Lactose Intolerance Around the World. Retrieved from http://www.foodbeast.com/2012/11/21/map-of-milkconsumption-lactose-intolerance-around-the-world/ 12 Lactaid ® Brand. LACTAID Fat Free Milk. Retrieved from http://www.lactaid.com/ products/fat-free-milk 13 EPA Ag Center. (2013, April 11). Major Crops Grown in the United States. Retrieved from http://www.epa.gov/oecaagct/ag101/cropmajor.html 7
Pages 32-33: Introduction to Energy Drinks 1 Heckman, M.A., Sherry, K. and De Mejia, E. G. (2010), Energy Drinks: An Assessment of Their Market Size, Consumer Demographics, Ingredient Profile, Functionality, and Regulations in the United States. Comprehensive Reviews in Food Science and Food Safety, 9: 303–317. 2 “Red Bull USA.” Red Bull. N.p., n.d. Web. Feb. 2014. <http://www.redbullusa.com/cs/ Satellite/en_US/Red-Bull-Wings-Team/001242965768603#wtr-content>. 3 “DMAA in Dietary Supplement.” Food and Drug Administration. N.p., 16 July 2013. Web. Feb. 2014. Ahmad, Zaira, and Daryl Minch. “Energy Drinks: The Truth Behind the Boost.” Energy Drinks: The Truth Behind the Boost (2009): n. pag. Rutgers New Jersey Agricultural Experiment Station. Web. <http://somerset.njaes.rutgers.edu/pdfs/fs1108.pdf>. 4 Yoquinto, Luke. “The Truth About Guarana.” LiveScience. TechMedia Network, 27 Jan. 2012. Web. Feb. 2014. <http://www.livescience.com/36119-truth-guarana.html>. 5 “Monster Energy Drink Maker Sued for 14-year-old’s Death.” CBSNews. CBS Interactive, 22 Oct. 2012. Web. Feb. 2014. Pages 34-35: A Promise to Care 1 Gaboda, D., Lloyd, K., Nova, J., & Cantor J. C. (May 2013). Uninsured in New Jersey by County: How Many are Eligible for New Coverage under the ACA?. Retrieved from http:// www.cshp.rutgers.edu/publications/uninsured-in-new-jersey-by-county-how-many-areeligible-for-new-coverage-under-the-aca 2 United States Census Bureau. (Jan 7, 2014). State & County QuickFacts. Retrieved from http://quickfacts.census.gov/qfd/states/34/3451210.html 3 The Promise Clinic. (2013). About Us. Retrieved from http://rwjms3.rwjms.rutgers.edu/ promise_clinic/about.html Bus image retrieved from http://commons.wikimedia.org/wiki/File:Rutgers_University_ New_Flyer_D60LF_2014.jpg [Credit to Adam E. Moreira under the Creative Commons Attribution-Share Alike 3.0 Unported License] Clinic image retrieved from http://rwjms.rutgers.edu/patient_care/chandler/locations.html Human image retrieved from http://www.flickr.com/photos/72098626@N00/4299779303 [Credit to Ed Yourdon under the Creative Commons Attribution-Share Alike 2.0 Generic license] Pages 38-39: The Effects of Obamacare 1 Blanchard, D. (2014, January). Obamacare Could Have a Negative Impact On Employment. Industry Week/IW, 263 (1). Retrieved from http://eds.a.ebscohost.com.proxy.libraries. rutgers.edu/eds/pdfviewer/pdfviewer?sid=2055f496-72d8-4249-b85f-b6075d4e9188%40s essionmgr4003&id=9&hid=4208 2 Diskin, C. & Alex, P. (2013, October). New health law puts many N.J. college students in coverage limbo. New Jersey.com. Retreived from http://www.northjersey.com/news/ bergen/New_health_law_puts_many_NJ_college_students_in_coverage_limbo___. html?page=all 3 Eck, A. (2013, March). College Students Stung by Obamacare. USA Today Magazine, 141 (2814). Retrieved from http://eds.b.ebscohost.com.proxy.libraries.rutgers.edu/eds/ results?sid=3a7028e3-21f1-4925965a2e0293303972%40sessionmgr110&vid=1&hid=1 15&bquery=College+students+stung+%22by%22+obamacare&bdata=JnR5cGU9MCZ zaXRlPWVkcy1saXZl 4 Kitchenman, A. (2013, Ocotber). College Students Get Crash Course on New Options for Health Insurance Plans. NJ Spotlight. Retrieved from http://www.njspotlight.com/ stories/13/10/08/college-students-get-crash-course-on-new-options-for-healthinsurance-plans/ 5 Why Enroll in the Student Health Insurance Plan? Retrieved from http://health.rutgers.edu/ services-and-costs/health-insurance-hard-waiver-system/why-enroll-in-the-studenthealth-insurance-plan Pages 40-41: How the Internet is Changing Your Brain 1 Carr, N. (2008). Is Google Making Us Stoopid?. The Atlantic, 56-63. 2 Wegner, D. M., & Ward, A. F. (2013). How Google Is Changing Your Brain.Scientific American, 309(6), 58-61. 3 Tamir, D. I., & Mitchell, J. P. (2012). Disclosing information about the self is intrinsically rewarding. Proceedings of the National Academy of Sciences,109(21), 8038-8043. 4 Ward, A. F. (2013). Supernormal: How the Internet Is Changing Our Memories and Our Minds. Psychological Inquiry, 24(4), 341-348. 5 Wegner, D. M. (1995). A computer network model of human transactive memory. social cognition, 13(3), 319-339. Image of Daniel Wegner retrieved from http://www.danwegner.net/wegner2008.jpg
Page 43: Cultural Competency 1 https://www.aamc.org/download/54338/data/culturalcomped.pdf 2 http://www.hrsa.gov/culturalcompetence/cultcomp.pdf 3 http://www.ncbi.nlm.nih.gov/pubmed/8309032/ 4 http://www.state.nj.us/lps/ca/bme/press/cultural.htm 5 http://www.hopkinsmedicine.org/diversity_cultural_competence/diversity_initiatives/ 6 http://kaiserfamilyfoundation.files.wordpress.com/2013/01/race-ethnicity-medical-carechartpack-1999.pdf 7 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137284/ Page 44-48: How to Sleep 1 Austin, B. (2007). Sleep deprivation in the college student: A problem worth addressing. Washington University College of Nursing, 4-10. Retrieved from https://research.wsulibs. wsu.edu/xmlui/bitstream/handle/2376/3621/B_Austin_019795826.pdf?sequence=1 2 Bhopal, N., & Khatwa, U. (2014). Sleep deprivation and human development. Sleep Deprivation and Disease, 91-99. 3 Brooks, A., & Lack, L. (2006). A brief afternoon nap following nocturnal sleep restriction: Which nap duration is most recuperative? Sleep, 831-840. Retrieved from http://www. ncbi.nlm.nih.gov/pubmed/16796222 4 Caldwell, J. (2003). An overview of the utility of stimulants as a fatigue countermeasure for aviators. United States Air Force Research Laboratory, 19-24. Retrieved from http://oai. dtic.mil/oai/oai?verb=getRecord&metadataPrefix=html&identifier=ADA413128 5 Ekirch, A. R. (n.d.). Sleep we have lost: Pre-industrial slumber in the british isles. The American Historical Review, 106(2). Retrieved from http://web.archive.org/ web/20110629110723/http://www.historycooperative.org/journals/ahr/106.2/ah000343. html 6 Hobson, J. A., & Pace-Schott, E. F. (2002). The cognitive neuroscience of sleep: Neuronal systems, consciousness and learning. Nature Reviews Neuroscience, 3, 679-693. http:// dx.doi.org/10.1038/nrn915 7 How mobile phones affect sleep. (2013, February 15). Retrieved February 16, 2014, from Huffington Post website: http://www.huffingtonpost.com/2013/02/15/phones-sleepmobile-_n_2680805.html 8 Iliff, J. J. (2012). A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Science Translational Medicine, 4(147), 147. http://dx.doi.org/10.1126/scitranslmed.3003748 9 Lahl, O., Wispel, C., Willigens, B., & Pietrowsky, R. (2008). An ultra short episode of sleep is sufficient to promote declarative memory performance. Journal of Sleep Research, 3-10. http://dx.doi.org/10.1111/j.1365-2869.2008.00622.x. 10 Mobile phone radiation disrupts sleep, causes headaches. (2008, January 21). Retrieved February 16, 2014, from Economic Times website: http://articles.economictimes. indiatimes.com/2008-01-21/news/27697646_1_mobile-phone-radiation-phones-fromexposure-scenarios-bengt-arnetz 11 Pejovic, S. (2013). The effects of recovery sleep after one workweek of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performance. American Journal of Physiology - Endocrinology and Metabolism. http:// dx.doi.org/10.1152/ajpendo.00301.2013 12 Science: Dymaxion sleep. (1943). Time Magazine. Retrieved from http://web.archive.org/ web/20131008220104/http://content.time.com/time/magazine/article/0,9171,774680,00. html 13 Xie, L., & Kang, H. (2013). Sleep drives metabolite clearance from the adult brain. Science, 342(6156), 373-377. http://dx.doi.org/10.1126/science.1241224 Image retrieved from unsplash.com [Credit to Aleksi Tappura] Page 49: The Human Dimension of Medicine 1 The Healthcare Foundation Center for Humanism and Medicine. Humansim [Pamphlet]. Newark, NJ: New Jersey Medical School. 2 Has Medicine Lost Its Compassion And Humanism? Retrieved from http://www.ama-assn. org//ama/pub/education-careers/graduate-medical-education/question-of-month/ medicine-lost-compassion.page. 3 Pamela Hartzband and Jerome Groopman (2009). Keeping the Patient in the Equation — Humanism and Health Care Reform. Retrieved from http://www.nejm.org/doi/ full/10.1056 NEJMp0904813. Pages 52-53: Research at Rutgers 1 Rutgers University (2014). Undergraduate opportunities. Rutgers University. Retrieved from http://www.rutgers.edu/research/undergraduate-opportunities. 2 Rutgers University (2014). Aresty research center. Rutgers Undergraduate Academic Affairs. Retrieved from https://aresty.rutgers.edu/. 3 Rutgers University (2014). Aresty research assistant: Mechanisms for mitochondrial quality control in Alzheimer’s disease, and its impact on neuropathology. Rutgers Undergraduate Academic Affairs. Retrieved from https://secure.rutgers.edu/urs/ projects/projectDetails.aspx?ID=1848. 4 Rutgers University (2014). Aresty research assistant: Tracking shad and river herring on their spawning migrations on the Raritan River. Retrieved from https://secure.rutgers. edu/urs/projects/projectDetails.aspx?ID=1931. 5 Rutgers University (2014). Aresty research assistant: Perinatal environment & genetic interactions (PEGI) study: A twin study of linguistic and nonlinguistic development. Retrieved from https://secure.rutgers.edu/urs/projects/projectDetails.aspx?ID=1880. Twins image retrieved from http://commons.wikimedia.org/wiki/File:Twins_2004.jpg [Credit to Glow at the Danish language Wikipedia under the Creative Commons AttributionShare Alike 3.0 Unported License] Herring image retrieved from http://news.neaq.org/2012/04/little-fish-with-big-impactstarting.html [Credit to Jim Nagus, TN Wildlife Resources] Mitochondria image retrieved from http://commons.wikimedia.org/wiki/ File:DAPIMitoTrackerRedAlexaFluor488BPAE.jpg under the Creative Commons Attribution-Share Alike 3.0 Unported License
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