The Examiner: Rutgers Pre-Health Journal Issue 13

MAY 2015 ISSUE No. 13

S TA F F EDITOR-IN-CHIEF Shireen Hamza MANAGING EDITORS Isaac Song Nikhitha Kotha Sri Puli Aayush Visaria Chir-Wei Stephanie Yuen LAYOUT EDITOR Ivana Ganihong WEBSITE MANAGER Emily Moore PUBLIC RELATIONS CHAIRS Pujitha Talasila Fiona Kim TREASURER Nithya Gandham JOURNALISTS Abishek Dave Kendall Flannigan Anna Harootunian Dillon Heyck Juliana Irizarry Shruti Jadhav Divya Mohanraj Sabrina Mohsin Emily Moore Soundarya Nattuva Aimee Parado Mounica Sreedhara Samanvitha Vaidyula

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TA B L E O F C O N T E N T S 6 RU for water

24 tumorous towns

8 the perks to caffeine

26 finding a path from off the shore to U.S. residencies

10 interview with a first year medical student 12 clinical relevance: why hospital volunteering matters

28 rutgers health centers: to go or not to go 29 creatine

14 the current measles outbreak

32 sign-tracking and addiction

17 coming fall 2015: midwifery dnp

34 rutgers hosa

18 Bringing chemistry to life

35 condom grams

20 dental hygiene at rutgers

36 references

22 eating gluten-free on campus

By shruti jadhav

RU for Water Although we are fortunate enough to be able to take it for granted, clean water is a resource that thousands in less developed nations still struggle to get access to daily. Every day, a waterrelated illness will cause the death of one in five children – particularly children who happen to be living in countries struggling to fight the Ebola crisis: Liberia, Guinea, and Sierra Leone. Although the problem itself is enormous, the solution starts small, which is why this semester, I along with my fellow Rutgers classmates taking The Byrne Seminar: Fundraising for International Causes decided to make a difference.

At the beginning of the semester, our professor, Dr. Ronald Quincy of the Rutgers School of Social Work, presented the sixteen of us with a challenge: utilize the power of crowdsourcing and social media to make a difference. After several class sessions of discussing various issues in the world and what we could do to alleviate them, we came to a consensus: we would help the victims of the Ebola crisis gain access to the clean water they desperately need, one sip of clean water at a time.

The WaterisLife Straw, a portable water purifier with a brilliantly simple yet efficient design, can easily purify any water source to create clean drinkable water. The purifier is shaped like a straw, and the user simply places one end of the straw into a water source and drinks water from the other end. A system of membrane filters, active carbon, and iodized crystals in the straw trap small particles as well as water-borne microorganisms.

Based on the fact that one individual will consume

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about two to three liters of water a day, each straw is expected to last an entire year. And at a cost of only ten dollars per unit, the purifier is extremely economical.

The designer and distributer of the straw, a nonprofit organization called WaterisLife, is dedicated to implementing clean water sanitation programs in less-developed nations. The organization actually uses the WaterisLife Straw as a stepping stone to implementing more stable water sanitation programs in villages: a team will distribute the straws to villages in need and then work to build water wells and establish water sanitation education programs as long-term measures.

WaterisLife has already successfully implemented such programs, including watersource excavations and public sanitation interventions, in various regions, including Haiti, Ghana, Kenya, and India. The organization itself was created when current WaterisLife chairman Ken Surrite realized while working at an orphanage in Northern Kenya that children were regularly drinking water from retention ponds and contaminated wells. With the help of a water purification factory, Surrite founded an organization that would make efforts to solve the problem of improper water sanitation in thirdworld villages, and WaterisLife was thus born.

Surrite’s creation of the WaterisLife straw helped the organization’s campaigns rocket to success.

Although remarkably simple, one straw can mean the difference between life and death

for a child, which is why we decided to launch RUforWater – a campaign that raises money to purchase and distribute water filter straws from WaterisLife. Each $10 donation will go towards one straw – making a huge impact in a small way. The straws will be distributed to villages in Sierra Leone and Guinea, in areas with fragile sanitation and healthcare systems that have been weakened by the Ebola pandemic.

Our project website, found at indiegogo.com/ campaigns/water-is-life—5, details our story – we are simply a small, humble group of students who saw the best possible opportunity to make a difference and grabbed it. “It’s a wonderful cause, and our students are making great efforts to help those in Sierra Leone and Liberia,” says Professor Quincy, who guided us through the entire process, from brainstorming campaign ideas to launching our crowdsourcing website. It seems that ironically, the key to fixing the world’s most colossal problems is to think not big, but small – tiny steps are what it really takes to make changes happen. If you would like to help give the gift of clean water to the world’s most vulnerable population, simply go to https://www.indiegogo. com/projects/water-is-life--5 make a donation to our cause. Fundraising is still underway, and every donation makes a difference. We want nothing The WaterisLife Straw, a more than to give back, as much as we can, to help portable water purifier with a restore the most fragile brilliantly simple yet efficient corners of the world.

design, can easily purify any water source to create clean drinkable water.

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By kendall flannigan

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People who drank more than four cups of coffee a day on average had a 20% lower risk of developing melanoma over a 10 year period

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current research

research at rutgers:

THE PERKS TO CAFFEINE Skin cancer is the most common cancer is the United States, and melanoma is the most common form of cancer for young adults 25-29 years old and the second most common for young people 15-29 years old3. While certain people are more prone to developing skin cancer due to inherited traits such as predisposition to burning, one of the largest risk factors is exposure to UV radiation2. UV radiation causes damage to the body at the cellular level; it induces genetic mutations such as pyrimidine dimers or single or double stranded DNA breaks. These kinds of mutations can alter the way cells function, and potentially lead to cancer.

The late Allan Conny, a renowned pharmacologist and cancer researcher at Rutgers University Ernest Mario School of Pharmacy, conducted a study to measure the effect of caffeine and exercise on tumor development. SKH-1 mice, a strain of hairless mice, were divided into four groups: one given an exercise wheel, another given caffeine supplemented water (the equivalent of a cup or two of coffee for a human), another given both, and a control group that was given neither an exercise wheel nor caffeinated water.2 All of the mice were exposed to UVB light periodically for an equal amount of time over the course of the experiment.

It was found that mice with regular exercise and caffeine performed better than the control SKH-1 mice. An enzyme called UVB-induced caspace 3 is critical in the cell death (apoptosis) that prevents tumors. This enzyme was stimulated by 92% in caffeinated mice, 120% in mice with an exercise wheel, and 389% in mice exposed to both regimens. Additionally it was found that tumor formation was inhibited by 25% in caffeinated mice, 35% in exercising mice, and 62% in mice doing both.1 The researchers also suspected that fat thickness may have played a role in the speed of apoptosis, as reduced dermal fat tissue thickness was correlated with increased apoptosis. They tested whether surgically removing tissue fat from the mice before UV exposure would benefit them. The mice with pre-removed fat received an increased rate of apoptosis in their epidermis and a decreased rate of skin damage.1 This suggested to researchers that tissue fat may secrete substances that inhibit apoptosis in precancerous cells, thus increasing the likelihood of a carcinogenic effect.

Similar conclusions have been drawn by the researchers at the National Cancer institute. Researcher Erikka Loftfield and her colleagues found that people who drank more than four cups of coffee a day on average had a 20% lower risk of developing melanoma over a 10 year period.4 This result did not hold true for decaffeinated coffees.

They conjectured that the caffeine, polyphenols, and other compounds within the coffee are what provide the drinker with an improved resistance to UV damage. So perhaps on your next walk around campus, you’ll consider grabbing a coffee and scheduling in some gym time. You might be taking a dose of preventative medicine along with your morning caffeine buzz.

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Interview with Esha Shah, First Year Medical Student at RWJMS Q: Tell us a little bit about yourself.

Hi, my name is Esha. I am a senior at RU and also a 1st year medical student in the RWJ BA/MD program.

Although I am a full time RWJMS 1st year student, I am still considered a senior at Rutgers. I have wanted to pursue a career in medicine ever since I was 10 years old. A lot of people change their minds as they get older or as college progresses, but for me I always wanted to be a doctor and I never deterred from that.

This drive helped me throughout high school, college and has led me to where I am now.

Q: There are many Medical schools nationwide. What made you choose RWJ? I chose Robert Wood Johnson Medical School because their curriculum stuck out to me. When I was looking into other medical schools, RWJ has a unique systemic system which not all other schools have.

Classes allow you to be completely involved and thorough with a subject by focusing on one class at a time. For instance, we start off with a general overview of Biological sciences for two months, and then start anatomy and then go into separate systems. RWJ also incorporates, along with other medical schools, patient centered medicine into their curriculum.

They want you to not only be knowledgeable as a doctor, but also to learn how to be a good doctor.

This emphasis on patient centered medicine and interactions with patients, helps students learn how to be compassionate and empathize with their patients.

Learning to interact with patients requires a good foundation and practice. RWJMS is able to provide many opportunities for students to do just that and interact with patients in a “real-world” setting.

Q: How are your peers at RWJ? You hear many RWJ students say, ‘Robert Wood Johnson is amazing’ and it is. Everyone gets

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along with each other and it creates an amazing environment. Everyone has the same goal and there isn’t a competition for who will get there first and so there is a lot of collaboration on how to succeed and do well. For example, if someone makes a study guide, they put it on our Facebook group so that it can benefit everyone. Overall, everyone gets along really well which I believe shows that the admissions office does a great job hand picking their students.

Q: Applying to Medical school requires a lot of time, energy and skill. How did you tackle your application process?

For me personally, I applied to the Rutgers-RWJMS BA/ MD program. You apply at the end of sophomore year and you find out whether you get in two months later.

When I first came into college I wasn’t even aware of the program. I talked with the Health professions office about it and they informed me about this 7-year BA/ MD program. At first I was hesitant because I did not think I could reach the requirements, and they told me it was a very competitive program. The requirements are a year of organic chemistry, general chemistry, biology, a semester of math and English, as well as five letters of recommendation. For me, the hardest part was getting the five letters of recommendations.

It was only my sophomore year and meeting a professor and getting to know them took time. But I made an effort to get to know my professors through office hours which eventually led them to accept my request for a letter of recommendation.

Q: What tips do you have for preparing for a Medical School interview?

The RWJMS interview is slightly different in comparison to other medical schools. They hold multiple mini interviews, MMI, in which there are a number different stations and each station consists of a different scenario. You have two minutes to prepare

By soundarya nattuva

and then you go into the room and talk to the proctor for about six minutes. To me, it was kind of intimidating because the proctors are not allowed to talk to you so it is just you responding to the scenario without further questions or prompts. This isn’t your typical 1 hour interview with a dean or a faculty member. This type of interview tests your ability to think on your feet and also illustrates your thought process during situations to the admissions officers. Personally, to prepare for the interview, I searched for practice MMI questions and scenarios online and for YouTube videos which I found very helpful.

Q: How can a student succeed in college?

The most important thing is time management and I always emphasize that. Time management will help you to stay on track so that you do not fall behind don’t have to study for hours each day but if you keep up with the material as the weeks ago, it will help a lot. Also, talking to a professor or TA can help clarify questions you may have. I found studying with a group of friends helpful and it helps to talk things out to see if you truly know the material. If you can teach something, then you thoroughly know the concept. That’s when I know I am ready for an exam. Additionally, if a professor gives you resources, make sure to use them. They’re giving you practice exams/materials for a reason.

Q: How can a student gain acceptance into medical school?

If only there was an answer to that. A good candidate for medical school needs a balance. Getting into medical school is becoming challenging because every candidate is getting more and more competitive, so you have to be just as competitive. As a student, admission officers look for someone who is well rounded. A doctor is not someone who is simply book smart; he or she has to be able to interact with patients, know how to care for them, to contribute

to the community and have other interests besides science. The admissions committee also wants to see that you have a passion for medicine and really want to pursue this career path. Many students show this passion through health-related extracurriculars such as shadowing, volunteer and other health-related activities.

Q: How do you deal with stress?

When I feel stressed, I write out what I have to do and when to do it. This helps me stay organized and allows me to manage my time and relax a little. For me, it is also important to create a list that is realistic or I will stress out more if I don’t finish my list. Sleep is also a very important factor for me. I am one of those people who preach sleep. I think everyone should get a good night sleep because it helps you de-stress. If you schedule your work and put in time to sleep, it will put your mind at ease.

Q: Is there something you haven’t done and wanted to do during your career at Rutgers?

When I was in undergrad, I wish I had taken some classes that I was interested in and was able to explore further. Being pre-med, most of my classes were science orientated and there wasn’t much time to take other classes that peaked my interest. Rutgers has hundreds of classes, classes on topics you wouldn’t even imagine so it would have been nice to explore some of those options more thoroughly.

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Clinical Relevance: Why Hospital Volunteering Matters GPA and MCAT: two hallowed numbers that premed students often assume determine admission into medical school. But a perfect 4.0 and 45 reveal nothing about whether someone truly grasps what it means to work in a healthcare setting. If an applicant has not experienced or enjoyed interacting with patients, handling intensely stressful situations, and simply being in a medical environment, how can admissions officers feel confident in opening the gates of their school to that person? The health professions office at Indiana University puts it bluntly: if “your application shows little or no direct exposure to the practice of medicine, you will not be convincing to an admissions committee.”1 In fact, in a study conducted by the Association of American Medical Colleges, medical community service and work experience were found to be important factors in both interview invitations and “offer acceptances”; for the latter, medical community service actually ranked more highly than cumulative GPA and MCAT scores.2 Accumulating meaningful clinical experience should therefore be included on every medical school hopeful’s priority list.

Clinical experience refers to time spent in an environment where patients receive medical care from physicians or other healthcare professionals.3 By this definition, hospital volunteering offers students an excellent opportunity to achieve clinical experience.

Countless pre-med students have chosen to routinely donate their time to support a local hospital. Volunteer responsibilities differ not only by hospital, but also by department, supervisor, staff, etc., meaning that each volunteer who makes this commitment will walk away with a unique set of clinical observations. Emergency room volunteers might witness a more fast-paced side of medicine than those stationed in an intensive care unit. Helping out in a telemetry unit and a postoperative care unit both require patient and family member interaction, but very different forms of it. One volunteer might have a routine shift, consisting of the same tasks from week to week; others could have more unpredictability. No matter the specific assignment, any clinical hospital volunteering experience will demonstrate what Dr. Michelle Whitehurst-Cook, a medical school admissions officer, has identified as essential in applicants: that they “understand the lifestyle” and have taken the time “to explore the

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medical environment to make sure that medicine is really what [they] want.”3 All pre-med students should keep this in mind− not just to impress admissions committees, but also to benefit themselves! Hospital volunteering allows students to meaningfully vet the field of medicine and determine if it is an ideal fit prior to plunging into medical school.

Before signing up to become a hospital volunteer, it is important to recognize that this experience does not always pan out perfectly. Depending on the specific department and shift of their assignments, some people feel underutilized or mismatched as a volunteer. In this case, the solution may be as simple as communicating with the hospital’s volunteer coordinator(s), along with nurses or other department staff. Expressing concerns with an assignment and exploring potential ways to improve upon it can lead to a more enriching experience. Switching to another wing of the hospital, arriving at a busier time of the day, or identifying innovative ways to lend a hand are just a few suggestions worth considering if hospital volunteering has not lived up to expectations in some other way.4 If the activity as a whole seems dull, remember that hospital volunteers can legally only do so much; they cannot provide actual medical care for patients. Still, for the typical college student who has not yet gained “proper qualifications and skills” as a trained medical professional, “one is left with volunteering as the main means for getting patient contact.”4 And in terms of personal growth, even the more indirect patient interactions, such as “comforting patients, talking with them and their families, transporting them, etc. are essential experiences in your development as a caregiver.”4 Keep in mind as well that, as with many pre-med activities, hospital volunteering can generate competitiveness. People accumulate hundreds of hours at the hospital, determined to persevere until they reach a target amount. But hospital volunteering should not transform into a numbers game. Upholding a long-term commitment to volunteering does demonstrate dedication and responsibility (and in some cases, a volunteer program will require a minimum time commitment), but no magic number of hours ensures a medical school acceptance. As Emory University advises its pre-health students, “[i]t’s not how long you shadow that matters, it is the impact

By emily moore

on you and the quality of the experience”; the same is true of volunteering in a healthcare setting.5 If hospital volunteering does not seem like the best fit, students can investigate the multitude of other options that provide comparable clinical experience. Physician shadowing allows students to follow doctors throughout their workdays and observe how they most effectively interact with patients, how hectic physician schedules can become, and other reality checks about the true practice of modern medicine. Students seeking to earn money while gaining clinical experience might consider becoming

Hospital volunteering allows students to meaningfully vet the field of medicine and determine if it is an ideal fit prior to plunging into medical school an emergency medical technician (EMT). EMTs actually assist with treating patients in emergencies, granting them incredible hands-on medical experience.6 Scribing offers another route to paid clinical experience. Medical scribes work alongside physicians; their tasks include obtaining patient information and working on documentation for Electronic Health Records.7 Medical assistants and certified nurse aides (CNAs) also work directly in patient care, but these jobs require more extensive training and time commitments.6 Students interested in these kinds of paid clinical opportunities can consider the Rutgers School of Health Related Professions (SHRP), which offers preparation for a diversity of medically relevant careers.

Phlebotomists, for instance, who collect and process blood specimens in hospitals, labs, and/or doctor’s offices, have patient interaction inherent in their job description.8 Students can apply to the SHRP’s Phlebotomy & Specimen Accessioning Certificate Program and gain this incredible clinical experience.8 Of course, pursuing those careers while in college could be quite difficult.4 These options may therefore be better suited to a gap year.

Intrigued by the idea of hospital volunteering? Reach out to these local hospitals to find out about opportunities in our community!

Robert Wood Johnson University Hospital (732) 937-8507 St. Peter’s University Hospital (732) 745-8573 Raritan Bay Medical Center (732) 324-5006 University Medical Center of Princeton at Plainsboro (609) 853-6010

Without a doubt, hospital volunteering and other clinical experiences form an essential part of successful medical school applications- and luckily for Rutgers students, opportunities abound close to our campus!

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THE CURRENT

MEASLES OUTBREAK

A recent case of measles was identified in a one-yearold infant in Jersey City, New Jersey in early February of this year, which marked the first known measles case in the state of New Jersey in 2015 (Darragh, 2015). The N.J. Department of Health coordinated with the U.S. Centers for Disease Control and Prevention to mitigate the issue and the child has officially recovered. The infant has not yet been vaccinated with the MMR vaccine due to the age restrictions of the vaccine (12-15 months of age for first dose) but was monitored for the disappearance of the major symptoms of the disease: fever, cough, conjunctivitis, and runny nose. The N.J. health authorities were able to effectively control the situation as this was a single, isolated case and the infant was monitored until recovery. Although it is very unlikely that there will be a measles outbreak at Rutgers University, it is important to note that refusing to take the MMR or measles vaccine can contribute to the development of a measles outbreak.

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By Divya Mohanraj The U.S. Centers for Disease Control and Prevention had issued a statement that measles was eradicated from the United States in the year 2000 because of the very effective measles vaccine that was administered across the nation (CDC, 2012). However, recent developments of the disease were seen in patches across the state of California this past January and over one hundred cases of people with measles have been reported (Zipprich, et al., 2015). It is believed that the spread of this virus originated from an infected overseas visitor who went to Disneyland last December 2014. In an attempt to understand the reality of the California measles outbreak, I spoke to Dr. Amisha Malhotra, Associate Professor of Pediatrics and Pediatric Infectious Disease Specialist at Rutgers-Robert Wood Johnson Medical School, within the Division of Pediatric Infectious Disease.

According to Dr. Malhotra, “’Herd’ immunity is a concept that applies to a population and a decline in herd immunity allows for outbreaks of vaccinepreventable diseases like measles.” She believes that this is what we are seeing in California, as well as in fourteen other states within the U.S. that are experiencing similar outbreaks of the measles.

Thus, it is crucial to encourage families to vaccinate their children in order to prevent further measles outbreaks within the United States.

Measles is one of the major causes of death among young children worldwide. It is a highly contagious and infectious viral illness that causes a high fever, which lasts from four to seven days, cough, runny nose, conjunctivitis, body aches, and tiny white Koplik spots that may appear inside of the mouth about two to three days after symptoms begin. It also causes patients to have red rashes that cover their faces and necks and may spread to the upper and lower extremities. Measles can easily be transmitted through respiratory droplets of mucus and saliva when an infected individual coughs, sneezes, breathes, or speaks. Young

children under the age of five years, as well as those with weak immune systems, are at the highest risk of contracting the disease. According to the World Health Organization, “The virus remains active and contagious in the air or on infected surfaces for up to 2 hours. It can be transmitted by an infected person from 4 days prior to the onset of the rash

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Measles is one of the major causes of death among young children worldwide.

to 4 days after the rash erupts,” (WHO, 2015) and if the disease is left untreated, the infected person may contract pneumonia, ear infection, or in worse cases, may die. Measles is much more complicated with children under the age of five years and there is a high chance of complications with encephalitis (swelling of the brain) and central nervous system damage to the brain post-infection.

Although there is no treatment for the measles virus, affected individuals can manage symptoms by maintaining good nutrition and electrolyte balance with hydration until the symptoms subside.

However, the symptoms of this illness can be fully prevented with the MMR vaccine, which was first developed and licensed by Maurice Hilleman at Merck in the United States during the early 1970’s.

It is a combination vaccine that includes three live, weakened viruses of measles, mumps, and rubella (German measles), in order to prevent all three. It must be taken as two separate doses in order to be ninety-seven percent effective in protecting against the measles virus (Centers for Disease Control and Prevention [CDC], 2015). It is recommended that the MMR vaccine be given to children at around one year of age and followed up with a second dose at the age of four or five years to provide immunity.

Those who remain unvaccinated into adulthood can take the vaccine at any age.

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>> The recent measles outbreak in California has sparked great controversy over the safety of the MMR vaccine, and it has prompted anti-vaccination movements among parents, who refused to vaccinate their children in fear of the potential side effects. Many parents continue to remain fearful of the side effects of the MMR vaccine and whether the vaccine causes autistic enterocolitis. On the other hand, many licensed physicians across the U.S. argue the opposite and have urged parents to vaccinate their children if they have not done so already, as there is no concrete link between the MMR vaccine and autism.

Is the measles, mumps, and rubella (MMR) vaccine connected to autism?

According to the article, “The Myth of MMR and Autism Debunked,” authored by Dr. Michael J. Smith in the Encyclopedia on Early Childhood Development, “we can now conclusively say that the science does not support an association between MMR vaccine and autism,” (Smith, 2013).

Previous research suggesting causation and correlation between the MMR vaccine and autism has been refuted. This claim traces back to the clinical research study conducted by Dr. Andrew Wakefield, a widely known former gastrointestinal surgeon and researcher, and his colleagues in London. They authored a highly controversial article known as, “Ileallymphoid nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children,” (Wakefield et al., 1998) which was published in the esteemed medical journal The Lancet in 1998. This study showed that eight of the twelve children tested in the United Kingdom showed symptoms of autism after receiving the MMR vaccine and the time period between the date of vaccination and the onset of the neurologic symptoms of autism was an astonishing 6.3 days.

Wakefield and his colleagues proposed,

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“(1) MMR vaccine causes intestinal inflammation; (2) intestinal inflammation results in a change in intestinal barrier function that allows for the entrance of gutderived peptides that exert an ‘opioid effect’ on the brain; and (3) gut-derived peptides cause a dysregulation of the endogenous opioid system and subsequent disruption of normal brain development,” (Offit & Coffin, 2003) which shows that their hypothesis aimed to identify causation between the MMR vaccine and the onset of ‘autistic enterocolitis’, a specific form of bowel disease and regressive autism. Dr. Wakefield coined the term to describe a disease that involves the loss of language and other cognitive skills which are characteristic of autism and the development of inflammatory bowel disease. However, scientific research conducted after Wakefield’s study found no such reproducible, concrete connection and refuted the conclusion made in his report. The lack of transparency and reproducibility in Wakefield’s study prevented him from establishing causation between the MMR combination vaccine and the subsequent onset of autism. His work received great media scrutiny, which ultimately led him to lose his medical license. The article was officially retracted

by The Lancet in 2010.

It is important for the Rutgers University community to continue to limit disease transmission by urging students to practice personal hygiene and take routine, recommended vaccinations. Both students and the general public ought to know how measles can be transmitted and that they should contact the nearest emergency center if they suspect that they have measles. The measles incubation period in which symptoms may appear is about seven to twenty-one days after infection (Kutty et al., 2014).

By Dillon Heyck

COMING FALL 2015: MIDWIFERY DNP Next semester nursing students will have a new program to look forward to as the previous midwifery Master’s program will become a Doctor of Nursing Practice (DNP) program- one that isn’t solely new to Rutgers, but also to the professional nursing world.

As a little background on what a midwife is, midwives are experts in aiding women who are expecting, assisting in family planning, and even prescribing some medications. Tasks most notably are affiliated with midwives are caring for a mother’s health before and after childbirth. The path to becoming a midwife can get a little complicated.

One does not actually need a degree or certificate to become a midwife.1 However, hospitals and birth centers prefer if a nurse are at least certified.

A degree program in midwifery is designed to offer experience and introduce prospective midwives to issues they may face, therefore naturally broadening their prospects.

In order to become certified, one must pass an exam and hold work experience- a degree can cover this work experience. Elaine Diegmann, the Midwifery Program Director wrote, “The midwifery program makes students eligible to take the certification exam offered by the [American Midwifery Certification Board]. Once a student passes this exam a nurse is considered a CNM [Certified Nurse Midwife].” The current program at Rutgers has a pass rate of over 90%.

The current post-baccalaureate program offers students with advanced clinical training and opens more doors for them within advanced nursing care, typically inside hospitals. Diegmann added, “the DNP will assess the changing health pattern of women across their life spans.” Students in this program will additionally be exposed to diverse birth care practices to tailor a mother’s needs and wishes.

Interestingly, the American College of NurseMidwives does not require one to receive a DNP in nursing to become a nurse. The ACNM actually stated they are opposed to requiring midwives to need a DNP due to consideration of work and time.

Current data on employees with a DNP is also very low (again, this is a relatively new program) so there is hardly measure if those with a DNP will be paid more.2 At Rutgers, midwifery students can enter the DNP straight from earning their Bachelors, without any Post-Bachelorette work. Still, it’s hard to not succumb to the ideology that more knowledge is good knowledge, making the DNP program appealing for those who want to succeed in their field. Nurse-midwifery has an “excellent” job outlook and has new opportunities coming its way.3 For students with an advanced background, what could be better?

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By Juliana Irizarry

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rofessor Darrin York, New Jersey’s most recent recipient of the Carnegie Foundation for the Advancement of Teaching Professor of the Year award, began work in 2010 at Rutgers’ Chemistry Department in an unexpected way. York took on the daunting task of remodeling the entire general chemistry curriculum in order to provide personalized education to over two thousand general chemistry students.

“Because I mean chemistry is hard… I mean I love chemistry, but it’s hard. We can’t make the periodic table any smaller, but what we can do is give students all of the tools we can possibly think of to give them the best chance at success.”

His work culminated in the development of online recitations named “Chemistry Interactive Problem Solving Sessions,” or ChIPS. He places emphasis on facilitating individual learning methods and class participation. While class participation has improved, he believes that the program has greater potential.

He explains, “Right now we’re not using the technology nearly to what we envisioned it.” Plans are in place for an “Academic Social Network” which would allow students to be matched into peer mentorships and allow lecturers to become facilitators in order to further emphasize active, collaborative learning. Ideally, the lecturer would provide minimal instruction and students sorted into groups based on needs and abilities would independently find solutions to problems especially relevant to their learning

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Think like a scientist. We’re really trying to teach you [a subject] but what we really want to get you to do, is apply this knowledge to a completely different problem. Maybe even a problem that hasn’t even been invented yet.

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Bringing Chemistry to Life online academics and words from a celebrated professor

needs. Effectively, these smaller, computer-generated groups would allow for more personalized education for a large student population. York advocates for an active approach to education, in contrast to the more passive, traditional learning model based on lectures and exams.

In addition to academics, York emphasizes the importance of undergraduate research. “Everybody that is here at Rutgers has an opportunity… this is a high powered research institution… and there are not too many places where there is such a wealth of opportunity to engage in research and see what it is all about.” His own research lab investigates the structure of RNA within the Center of Integrative Proteomics Research on Busch Campus.

Research is an educational opportunity he particularly recommends to pre-medical students, citing the relative lack of opportunity to participate in discovery once in medical school, a phenomenon which he personally encountered during his education.

York originally attended medical school, after receiving his undergraduate degree in Chemistry, but he soon found that the curriculum did not satisfy his desire to understand the mechanisms behind his medical training.

“I was premed, you know, because my mom told me I was premed… I was kind of going through the motions… I was interested but it didn’t feel real. It didn’t feel like, ‘This is your thing. This is exciting. I want to be the best in this because I get a real good feeling about it.’” Following this realization, he returned to his research background and eventually received his PhD in Chemistry from the University of North Carolina at Chapel Hill in 1993 with extensive postgraduate work

under several renowned scientists, including Nobel Chemistry Prize winner Martin Karplus.

His cites an initially turbulent relationship with physical chemistry as the spark for his interest in chemistry. “I was not well prepared [for physical chemistry]... I had never made a connection between what I was doing in my math classes and what I was doing in chemistry. I remember I failed horribly my first test and I wasn’t getting it. I kept on going back. Half the semester I was stuck on the first chapter… But I kept trying…. It was almost too late. I barely eeked out like a C. I almost failed that class. But I remember at the end of the class when I was working a problem that looked impossibly hard and it would make sense in the end it was like I scored a touchdown… It was the first time I was in a class where I was really excited about learning something.” Professor York’s genuine enthusiasm for chemistry directly translates into his educational methods. In addition to his work in online education technology, his contributions to the general chemistry department at Rutgers include the development of a chemistry lecture demonstration facility and flexible walk-in office hours.

Among his most valued advice for aspiring health professionals is “Think like a scientist.” He describes this as: “We’re really trying to teach you [a subject] but what we really want to get you to do, is apply this knowledge to a completely different problem. Maybe even a problem that hasn’t even been invented yet.

Something you’re going to discover along the way as a scientist or as a doctor, and be able to transform those skills to a completely different area. That’s what research and even medicine is about.”

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Dental Hygiene at Rutgers After a long day of classes or a night out with friends, sleep might be the only thing on a student’s mind. For that tired student, going to the bathroom to practice good dental hygiene might seem like a tremendous effort.

Unfortunately, more often than not, sleep wins out, and personal hygiene, in particular, dental hygiene, is ignored. However, practicing good dental hygiene should be an essential part of everyone’s daily routine.

According to the American Dental Association (ADA), everyone should brush their teeth twice a day for two minutes with fluoride toothpaste and a soft-bristled toothbrush held at a 45-degree angle to the gums and moved gently.­1 Brushing teeth is necessary to prevent cavities and remove plaque, a film of bacteria that builds up on teeth.2 In addition to brushing, flossing should be part of a daily dental routine. The ADA recommends flossing at least once each day. Flossing helps prevent gum disease and cavities and removes plaque in areas between the teeth that cannot be reached by just a toothbrush. If not removed by flossing, the plaque might harden.3 In a survey, 254 current Rutgers students of various class years and majors answered questions concerning dental hygiene. It was found that only 64% of students brush their teeth the recommended two times a day.

Twenty-four percent of students said they only brush once a day, and three percent reported not brushing their teeth daily. Also, six percent brush three times a day, and the remaining three percent brush more than three times.

Half of the students that took the survey answered “No” to the question “Do you floss at least once a day?”. Thirty-seven percent of students answered “Sometimes,” and only 13% of students answered “Yes.” Dental hygiene is not limited to brushing and flossing. Other things must be done, including changing toothbrushes every three or four months or sooner if the toothbrush’s bristles become frayed.1 A worn out toothbrush will not clean teeth effectively. Forty-nine percent of the students that took the survey reported changing their toothbrush every three or four months, and another 13% change their toothbrush every month or two months. Twentythree percent of students use their toothbrushes until they look worn out, but the remaining 14% use the same toothbrush for six months or longer.

Although not crucial to good dental hygiene, a number of students use an electric toothbrush or a tongue scraper. Manual toothbrushes are effective, but an electric toothbrush can be helpful for people that have arthritis or have difficulties using a manual toothbrush.4 The bristle movement of an electric toothbrush can also help remove more plaque and improve gum health.4 Most students (74%), however, reported that they do not use an electric toothbrush.

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By aimee parado The tongue scraper seems to be slightly more popular than electric toothbrushes, with less students reporting to not using tongue scrapers (67%). Currently, there is not much research on the effectiveness of tongue scrapers, but the research done so far says that a tongue scraper can be temporarily effective for curing bad breath.5 A tongue scraper can also help with a coated tongue. A coated tongue is caused by bacteria overgrowth, which can be the result of smoking, dry mouth, poor oral hygiene, or medication use.5 Sixty-seven percent of the survey participants also said they have worn braces at one point. Of the students that are supposed to wear a retainer, most students answered that they do not wear their retainer (57%). However, retainers must be worn in order to prevent teeth from shifting back to their original positions.6 Another part of maintaining good dental health does not take place at the bathroom sink but requires visiting a dentist regularly. People should go to the dentist twice a year, but people with a low risk of dental problems might be able to go once a year,

while people with a high risk of dental disease should go every three or four months or even more.7 People with high risk include smokers, diabetics, people that currently have gum disease, people with a weak immune response to bacterial infection, and people that tend to have cavities or plaque build up.7 In the survey, 59% of students report to going to the dentist every six months. The number of students that go to their dentist regularly needs to increase because regular visits allow a dentist to catch problems early so that the problems can be treated before they get worse.

The survey results indicate that although many students already practice good dental hygiene, there are still many students that do not, and by not doing so, they are putting themselves at a greater risk for dental problems later in life, even after college. Remember: teeth must be brushed twice a day, everyday, and flossed. Make sure to visit your dentist every six months and change your toothbrush every three to four months or sooner if the toothbrush becomes worn out. Performing these actions now can save a lot of time, money, and toothache in the future.

How often do RU students brush their teeth?

3%

Do not brush daily

24%

Brush once a day

64%

Brush twice a day

6%

Brush three times day

3%

Brush more than 3 times a day

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By sabrina mohsin

Eating Gluten-Free on Campus You have heard about it on the news, seen it in grocery stores, and you may even have it in your own kitchen —gluten-free food is the newest health craze.

In recent years, more people have been experimenting with gluten-free diets. But do they understand the science behind this trendy lifestyle choice? Gluten is a protein found in barley, wheat, oats, and rye.1 For some, eating gluten-free is a healthy alternative to their normal diet. However, for those with gluten sensitivity, it is an obligation to their health. There are different levels of gluten sensitivity, the most severe form being the autoimmune disorder, celiac disease.

Normally, as food travels through the digestive system, small hair-like structures called microvilli help to absorb nutrients from food. Unfortunately, when gluten enters the digestive system of a celiac disease patient, the microvilli are attacked by the immune system, causing them to flatten and lose their ability to absorb nutrients.2 This can result in symptoms such as an inability to gain weight, bloating, headaches, and fatigue which can lead to long term health conditions like dementia or infertility.3 According to The New York Times, celiac disease is more prevalent today than it was 50 years ago.4 Doctors believe this trend to be a result of the current ways wheat is being processed, as well as the abundance of gluten in various food products.

Currently, gluten is used as a thickening agent or filler in almost everything from soy sauce to salad dressing.

Dr. Treskova, a well-known gastroenterologist working in the NY/NJ area who diagnosed me with celiac disease in 2011, attributes this rise in awareness to “the belief that modern day grains have more gluten.”

She explains how without a gluten-free diet, patients are “more susceptible to autoimmune diseases affecting the brain (ataxia) or diabetes.” There is no current cure for celiac disease, but maintaining a

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strict gluten-free diet reduces the associated symptoms. Considering the pervasiveness of this protein, Rutgers prides itself on providing students and faculty with celiac disease and other gluten sensitivities the opportunity to eat healthy on campus. With the help of the school dietician, dining faculty, and glutenfree programs it is possible to live gluten-free on campus.

The Livingston Dining Commons offers students the opportunity to inquire about their food by calling the staff prior to arriving at the dining hall. Students can order whatever is being prepared that day, but with the assurance that it will be made in-accordance with their dietary restrictions. The dining hall also provides gluten-free cookies, brownies, and other pastries. Peggy Policastro has been working as a dietician at Rutgers for several years now. Ms. Policastro remarks, “Students with specialized dietary needs may not be able to eat from the regular line offerings. Dietary accommodations must be made to ensure these students have access to wholesome, nutritious foods which are also medically safe. All students with a medically documented nutritional need have individualized nutrition care plans that are shared with appropriate dining hall management.” Recently, the Livingston Dining Commons began to participate in a “text to order” program where students can send a direct text message to the dining hall staff to have their meal cooked to order. Ms. Policastro states that, “both Dining Services Managers and students

appear pleased with the text to order program.” Having personally used the program, I can reaffirm that statement. While running around campus from class to class, the “text to order” program makes it easy and convenient to order food specialized to your diet.

The “text to order” program allows students with special dietary needs to message dining hall staff and have meals cooked to order.

People with gluten intolerance, celiac disease, and other dietary restrictions have the opportunity at Rutgers to eat well and live healthy. The resources here are abundant, but without reaching out to the campus dietician and dining staff, one cannot completely enjoy all that this school has to offer. If you or someone you know has gluten sensitivity, contact the campus dietician and dining hall today to begin the journey to living gluten-free at Rutgers!

DID YOU KNOW? Gluten is a composite protein made when the proteins gliadin and glutenin are combined. Gliadin and glutenin are found in wheat, barley, rye, and other related grains.

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Tumorous Towns Malignant tumors arise when cancerous cells congregate within the body. But what happens when cancer cases congregate within the population? The result may be a cancer cluster, defined as an elevated cancer rate among people in a specific geographic region during a set period of time.1 Clusters are typically composed of cancers with similar causes and are often found to occur in groups not normally affected by cancer at such rates.2 Environmental carcinogens, especially hazardous chemicals, can lead to cancer clusters if they come into contact with a sufficient number of individuals in a given area.1 Existence of a cancer cluster is quite tough to prove; some suspicious cases turn out to be products of random chance, while others have unclear causes, locations, and/or timing.2 Genetic variability among individuals, which can influence cancer vulnerability, can also make it difficult to characterize a cause-andeffect relationship between a widespread carcinogen exposure and a cancer cluster.2 Detection methods may not even be scientifically advanced enough to characterize a cluster’s culprit.2 Legal activity related to cancer clusters often presents a hurdle as well. In North Carolina, for instance, a statute Cancer cluster - an elevated cancer of limitations set at rate among people in a specific ten years makes it geographic region during a set challenging to sue an entity possibly period of time responsible for

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the release of a carcinogen; cancer clusters can take longer than a decade to appear, so sufficient evidence might not accumulate until it is too late.4 Despite the difficulties in diagnosing cancer clusters, over a thousand claims are made annually in the United States.2 One such claim that gained recent media attention came from Toms River, a coastal township located just an hour southeast of Rutgers. Back in the 1980s and 1990s, an unusual number of Toms River children were diagnosed with cancers such as neuroblastoma and leukemia.3,4 For reasons not understood, girls appeared to be disproportionately affected.4 Parents and activists have blamed these cases on chemical wastes that, as a result of inappropriate disposal methods, had found their way into the township’s drinking supply years earlier.3 Multiple research efforts have failed to definitively prove the chemicals to be the cause of the heightened childhood cancer numbers.3 But an intriguing development occurred early in February 2015. The National Toxicology Program publically released a 2012 report related to this case, wherein it states that exposure to styrene-acrylonitrile trimer, a chemical that had contaminated the Toms River drinking water, was associated with nervous system problems in laboratory rats.5 Yet the report did not find styrene-acrylonitrile trimer to be carcinogenic.5 Some critics of the recently released study argue styreneacrylonitrile trimer was tested in the wrong form, may

By emily moore not have even been the chemical causing the problem, and does not represent the entire composition of the drinking water in question.3,5 Others point to the conspicuous nervous system issues seen in the rats. Given that neuroblastoma involves the nervous system, they suspect there is some carcinogenicity to this substance that is especially relevant to the type of cancer observed in the affected Toms River individuals.3 Whether the Toms River case will ever successfully achieve the cancer cluster designation remains uncertain, although the likelihood does not seem promising considering the research findings.

In the meantime, one has to consider the effectiveness of the current system for classifying environmentally induced cancer clusters. Do the official requirements set standards too high, causing actual cancer cluster incidences and dangerous carcinogenic sources to fall through the cracks? Or is this phenomenon truly as rare as the official data portrays it, with only a couple of cases in recent years being confirmed as environmentally caused?4 Intriguingly, although the Toms River case failed to be named a cancer cluster, the source site of the chemical waste underwent a federally supported cleanup in 1983.5 Perhaps this proves that even if an official classification of “cancer cluster” is not made, the approach of prevention applies just as well to the health of a community as it does to the health of a human body.

In the 1980’s and 1990’s, an unusual number of children were diagnosed with cancer in Tom’s River, NJ. It has been suspected that exposure to styreneacrylonitrile trimers through drinking water is responsible for the sudden increase in children’s cancer rates.

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By mounica sreedhara

Finding a Path from Off the Shore to U.S. Residencies Every year a larger number of foreign medical school graduates (FMGs) come to the United States for a residency. The prospect of practicing in a technologically advanced country like the U.S. is quite desirable. Yet the transition from a foreign medical graduate to a successful medical practitioner in the U.S. can be challenging.

Not only is it difficult for FMGs to be admitted into a residency, but also affording expenses in the U.S. can be a financial hardship. Moreover, other struggles may emerge for FMGs, who must soundly integrate into both the clinical and cultural environments of this country. How successful are FMGs in this path and adaptation to American medical practice?

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For most foreign medical school graduates, applying for a residency slot is an extensive and costly process. Before applying, FMGs are required to prove that they speak English, pass the three separate steps of the United States Medical Licensing Examination (USMLE), volunteer or work in a hospital, and obtain American recommendation letters.4 Most FMGs are permitted in the U.S. on a working visa and therefore must be employed to pay for it.4 Even after completing the appropriate requirements, there is no guarantee that FMGs will obtain a residency position. Every year, about 8,000 FMGs, not including the U.S. citizens who go to medical school abroad, apply to the national residency match system.3 Approximately 3,000 of them successfully match to a residency slot.3 This is a relatively low success rate and in several years the residency match rate for FMGs is expected to decline further.4 FMGs who are U.S. citizens and have studied abroad in places such as the Caribbean islands also have a hard time obtaining residencies. Roughly 53% of U.S. citizens from foreign medical schools match to residencies compared to 94% of U.S. medical graduates (USMGs).2 Even after FMGs manage to secure a residency, they are less likely to match to the more prestigious and lucrative positions, and some end up in rural or poor urban hospitals.2 What is the cause of such dismal prospects for foreign medical graduates? Dr.Ramarao Kompella, a FMG from Andra Pradesh, India, who now practices in Seven Rivers Medical Center in Florida, details the problems he faced during his residency application process. Dr. Kompella explains, “I was aware that there was a kind of social labeling among admissions that my education would be inadequate and that I would not be properly qualified to treat my patients.

I was adamant about relinquishing this false image and luckily, I found a senior practicing physician who believed in my abilities and defended me before the admissions committee.” The low success rates among FMGs results primarily from this stigma that they are not capable of providing the appropriate quality of care. Although there are differences in the way FMGs are trained, the idea that they provide low quality of care is a misconception. A study conducted in 2010 explored the differences in clinical outcomes for patients cared for by FMGs and USMGs. This study focused specifically on patient mortality rates and it was found that there were no significant mortality differences when comparing the two groups. Another remarkable discovery from this study was that nonU.S. medical graduates, which excludes U.S. citizens who studied abroad, had significantly lower mortality

rates among their patients than those cared for by U.S. medical graduates.3 The results indicate that FMGs are comparable or even better than U.S. medical graduates.3 These findings are especially important in light of the impending shortage of primary care physicians in the United States because international graduates could provide a way of addressing the shortfall.

After the struggles in securing a residency, some non-U.S. FMGs face further obstacles as they must become accustomed to an entirely unfamiliar cultural and work environment. One such FMG was Dr. Kavitha Thukkaram, a practicing physician in Edison, New Jersey who attended medical school in Chennai, Tamil Nadu, India and completed her residency in UMDNJ. She explains, “My experience was a little nerve-racking at first. Although I didn’t have much trouble communicating, I had to adjust to how hands-on the training was during my residency.

Like other FMGs, I had some initial trouble in using the technology because I was not exposed to this standard of technology back home.” Due to the lack of advanced technologies in other countries, some graduates are not very familiar with tools such as CT scans, MRI, and angiographies.1 They are often trained to rely on subtle physical signs for a diagnosis and these differences in training may lead to some initial problems.1 Furthermore, some FMGs may also face a cultural shock when they start working in a U.S. hospital. For instance, calling a nurse “Sister” in a U.S. hospital may produce no response from the nurse and calling a senior resident “Sir” may be interpreted as a sign of submissiveness.1 In other cases, FMGs often remain silent on the ward rounds and wait until they are asked a question, which may be misinterpreted as a sign of ignorance or as an inability to participate in discussion.1 Although these are manifestations of a polite upbringing or the cultural background of a person, they may put some FMGs at a disadvantage.1 Therefore, FMGs initially need to be dynamic and make crucial observations to adapt quickly to their environments.

Although the transition can initially be long and gruesome for an international student, with time and commitment it is possible to become a successfully practicing physician in the U.S. After completing the necessary requirements for a residency position and adjusting to the work atmosphere, one may find that the life ahead is worthwhile. As the physicians I have interviewed have revealed, the secret to success for FMGs is perseverance.

27

Rutgers Health Centers: To Go or Not to Go Have you ever set foot in any of the health centers around campus? Moreover, did you even know that Rutgers has health centers? This past week I did a survey with twenty random Rutgers students. Twelve students claimed that they have never gone to a health center, five stated that they rarely go, and three said that they visit regularly. Although this survey only has a small sample size and ignores many factors such as involvement in sports and place of residence, these preliminary results suggest that there are students in our university who have never visited a health center and may not know much about them. Furthermore, it is possible that even those who do visit may not be completely aware all the services provided by Rutgers health centers. If you do not really know what services are offered or have wondered whether you would be comfortable going to a health center, just follow along and hopefully your concerns will be put to rest!

There are three health centers at Rutgers—Hurtado Health Center, Busch-Livingston Health Center, and Willets Health Center. Hurtado Health Center is located on the College Avenue Campus and is the largest of the three. The Willets Health Center is located on the Cook/ Douglass campus and the Busch-Livingston Health Center is located on the Livingston campus. All three health centers offer hassle-free appointment based visits that allow students to come to the health center at a time that is most convenient. Students are generally not permitted to simply “walk-in” to the health center.

This is an effort to give them the right amount of time with the clinician best suited for the condition as well as to choose a time that is most suitable to their schedules.

Each of the health centers has a team of professionals including physicians, nurse practitioners, and medical assistants dedicated to promoting good health. When you call or register for an appointment online, you can even specify your Hurtado Health preference for a particular Center provider as well as the busch-livingston gender of the provider.3 Health Center You can make an appointment for physical willets Health exams or for treatment of

1

2

3

Center

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By mounica sreedhara

acute problems such as colds, urinary tract infections, vomiting, rashes, and acne. 3 Appointments can also be made for accidents and injuries such as sprains, fractures and lacerations, or even for the treatment of chronic illnesses such as asthma or diabetes. 3 The health centers do their best to accommodate students immediately and often times, you may be given an appointment on the same day. 3 The Health centers are open to all students and exhibit strict confidentiality regarding health information.

Students can expect the staff at the health centers to be sensitive and knowledgeable about Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) students’ medical issues.1 The health centers provide an environment that is both inclusive and supportive of diversity in the areas of sexual orientation and gender identity/expression.1 The health centers also emphasize women and men’s health separately, with services ranging from routine pelvic and breast examinations to counseling regarding pregnancy options for women and from information on self-testicular examinations to treatment for swellings and lumps for men.2,5 The health centers are adept at providing students with specialized care as the staff includes experts in college health who are skilled at identifying and treating most health problems. The staff comprises of specialists in internal medicine, family practice, pediatrics, sports medicine and adult medicine.4 Occasionally a health concern may arise that calls for further specialization, in which case the clinician provide a referral to a professional in the local community for further evaluation.4 However, this is rare and most students can expect their health needs for both preventative health care and routine medical care to be provided by Rutgers health services.

Ultimately, the Rutgers health centers exist to meet the specific health and fitness needs of all students in a responsible manner and to provide comfortable and safe environments for students to voice their concerns.

At their utmost priority is quality of care. If you have concerns about your health or just want to take some interest in your general wellbeing, do not hesitate to reach out to any one of the health centers!

By Abhishek Dave

Creatine Anyone trying to optimize their workouts knows that there are countless supplements available online, or at a local GNC (General Nutrient Center) store.

Many salespeople will offer creatine, and though it is not a steroid, it has many effects one should be aware of.

Creatine is a naturally occurring amino acid found in many animals, including humans, unlike soy or whey protein. It can be found in the liver, kidney and pancreas. Creatine can be converted to creatine phosphate or phosphocreatine that can be stored in muscles and used for making Adenine Triphosphate (ATP), an energy storage unit used by the body. Though it is a hormone that the human body already makes, it does not work in the same way for everyone, especially those who naturally produce a high amount of creatine.

While taking creatine, people must greatly increase their water intake. For every 1 mg of creatine, one should take in 20 ounces of water, because this allows the cells to stay hydrated and go through protein synthesis faster. So if 5 mg of creatine is ingested, then one should take in at least about one gallon of water to synthesize the amount of creatine taken up by the body. Creatine should be taken in moderation.

An overdose of creatine can cause one’s body to stop naturally making creatine. If the cells are getting creatine from an outside source, the hypothalamus will signal to the liver and kidneys to stop making it.

This can make a person very dependent on creatine. Creatine can also cause kidney damage if it is taken over a long period of time. The optimal time to use creatine is when one is trying to gain weight and muscle mass, so a maximum of three to nine months. After that, the user should slowly decrease the amount of creatine consumed and perhaps switch to protein supplements.

creatine

An informal survey at the Rutgers gym showed that most people have a general understanding of what creatine is. Some newcomers to the gym do not know what the substance is at all. When asked what the effects of creatine is most people were inclined to say “it helps you get bigger faster” or “helps you bulk up.” But all should also be aware that creatine should only be taken by those who work out very regularly. There should be more awareness about the possible risks that come with it, such as kidney damage, bad gas, diarrhea, bloating, stomach cramps or the fact that creatine may just not work for every person.

Creatine should only be taken for a limited time period with proper water intake, and only if one plans to engage in regular vigorous exercise. Otherwise, people should look to other supplements – and research them well!

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Rutgers programs Against Violence

“

We have something going on every single month of the year because we know that is not enough to do just something once. We are always looking at awareness programming, making people aware of the issue.

After the White House Task Force assigned Rutgers University’s Center on Violence Against-Women and Children to conduct a campus survey, students were encouraged to voice their opinions on gender violence on college campuses.

The iSPEAK survey—held from October 27th to November 11th—allowed students to express their concerns about sexual assaults on campus.1 Representatives and staff from the Center on Violence Against Women and Children held information centers throughout student centers, libraries, and other offices in order to answer any questions or spread information regarding the confidential survey. By completing the survey online, almost 11,735 students responded, providing a 28% response rate for Rutgers University, New Brunswick.2 Gender violence is a prominent issue on college campuses, especially with rising cases in schools and colleges. According to the The United States Department of Justice’s Office on Violence Against Women, about 19% of college women reported their experiences with an attempt or complete assaults.3 Although

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By Samanvitha Vaidyula educational amendments are implemented to protect students from any form of genderrelated violence, it is equally important for students to learn about the provisions and facilities provided by their university or institution. The implementation of the Grants to Sexual Assault, Domestic Violence, Dating Violence, and Stalking on Campus Program authorized in 1998 funded universities to hold comprehensive responses or programs to help reduce crimes involving harassment or violence.4 Rutgers University’s Office of Violence Prevention and Victim Assistance (VPVA) provides counseling and advocacy services to Rutgers students through trained professionals.5 Some of the services provided by VPVA include crisis intervention, counseling and advocacy. Crisis intervention functions as a 24 hours a day, 7 days a week service that assists students through phone service and informs them about options suitable for their issues.6 Meanwhile, counseling and advocacy are two additional services that help students garner the support they need as victims of crimes.7According to Anne Ruth Koenick, Director of VPVA, the staff undergo at least 60 hours of training and ensure that they meet the needs of the students from accompanying them to health services to navigating the legal system, or even contacting any faculty or staff members under their behalf.8 In addition to their counseling services, VPVA is responsible for administering outreach programs and events to influence students to serve as active bystanders and advocates who help victims when witnessing a crime.

Throughout nine months of the year, the VPVA plans events to bring awareness and acknowledge the precautions that can prevent individuals from being victimized. “We have something going on every single month of the year because we know that is not enough to do just something once….We are always looking at awareness programming, making people aware of the issue.”9 In her words, Koenick emphasizes the importance of engaging students in issues that impact a college campus and the necessity to remind students to request for help when they need it. The Clothesline Project, an event held

by the VPVA, honors individuals who experienced violence through a visual display of decorated shirts hung along the trees on Voorhees Mall.10 Inspired by a mission originated in Cape Cod, Massachusetts in 1990 as a way to break silence regarding violence, Rutgers University began its own project in 1998.

Shirts are designed and created by Rutgers students and faculty who have experienced violence firsthand or by individuals who are honoring someone who are unable to make their own shirts. Students are welcome to contribute to the project each year by adding a new shirt to the present collection of 400 shirts.11 Additionally, the VPVA hosts a 2-day event known as Silent Witness at the Rutgers Student Center MPR lounge. The Silent Witness Exhibit is a memorial to the residents of Middlesex County who have been murdered in domestic violence cases.12 In another event known as Healing the Wounded Heart, visual art created by survivors of sexual, domestic, and other forms of interpersonal violence is promoted through a display.13 During these events hosted by Rutgers University’s services, students can learn from the experiences of others as well as understand the feelings of victims.

Moreover, VPVA’s largest program consists of the performance by the Students Challenging Realities and Educating Against Myths Theater (SCREAM). In this interactive program, college students perform skits to portray realistic circumstances where interpersonal violence may occur.14 The performance reaches about 5,000 students annually, especially incoming freshmen at the New Student Orientation.

After the performance, a question and answer session allows students to discuss the behavior exhibited by the characters and helps them differentiate between right and wrong.15 Overall, Rutgers University’s services cater to the immediate needs of students undergoing any form of violence as well as long-term needs during the course of their academic career. By encouraging undergraduates to participate in programs and events, Rutgers intends to build a community that serves to aid one another and represent individuals who are active bystanders and advocates. The collaborative effort of Rutgers students and staff intend to influence students to make the right decision and get help during their time of need.

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By sabrina mohsin

Sign-Tracking and Addiction Whether it is smoking, unhealthy eating, or physical inactivity, many of us struggle with bad habits everyday. Unfortunately, these habits can sometimes escalate into addictions that can be as severe as alcohol or drug abuse. How does this transition occur and can it be prevented? A research team at the Center of Alcohol Studies at Rutgers University may have found the answer. An addiction is described as a chronic disorder that is primarily associated with a lack of self- control.1 The addicts are draw to an object or substance even when they are aware of the health consequences.

For many, addiction is a complex and difficult disorder to comprehend, but connecting signtracking to addictions clarifies why addicts act the way they do and why it is difficult to quit.

Sign-tracking, also known as auto shaping, occurs when a conditioned stimulus (CS) consistently cues an unconditioned stimulus (US).2 A conditioned stimulus eventually evokes a response while an unconditioned stimulus automatically elicits a response. This concept can help us better understand drug or alcohol addiction as, “sign-tracking procedures resemble the ritual of drug-taking, in that the drug user typically Sign-tracking procedures will see a small object just resemble the ritual of before experiencing the drug-taking, in that the rewarding effects of the drug. drug user typically will For example, when having see a small object just an alcoholic beverage, the before experiencing the rewarding effects of the user sees the cocktail glass, then, shortly thereafter, drug feels the rewarding effects of alcohol.”3 Unfortunately, many people are unaware of the phenomenon of sign-tracking. Nevertheless, when introduced to this concept they are quick to identify themselves as “sign-trackers.” Such knowledge can benefit

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alcoholics or drug addicts as it provides them with answers as to why they consistently act the way they do. This understanding can not only help them give answers to their loved ones about their conditions, but it can also lead to the road of recovery. Michelle Lincks, a former undergraduate research assistant, affirms this as she has seen addiction affect her mother without knowing why and how it was occurring. Initially, Michelle believed that her mother did not stop her addiction because she did not love her and did not want the addiction to stop. After learning about sign tracking, she understood that her mother was simply a victim who had no control over her actions. Michelle adds, “Understanding signtracking has definitely improved my relationship with my mother.”

Dr. Arthur Tomie, professor and addiction research scientist at Rutgers University, and his team use lab rats to study the role of objects as signals. In a series of repeated studies, researchers introduced the lab rats to a lever. Once the rat tapped on the lever, a reward of food was deposited into the cage and after several trials, the rat began to identify the lever as the reward and began to chew and gnaw on the lever. Objects that signal a reward, after several attempts, become the item of interest and the subject will begin to behave differently towards it. Such results were also seen when experimenting with an alcohol sipper as reviewed by Dr. Tomie and Nikyta Sharma. A male rat was placed into a cage with an alcoholic sipper and after some time, was introduced to a female rat. When the male rat was introduced to the female rat it began to drink more excessively than when the female rat was absent.4 In sign-tracking terms, social interactions or certain objects like a wine glass can trigger alcoholics to behave unconsciously. Essentially, when actions become

disconnected from intentions a person begins to suffer from addiction.

This connection between addiction and signtracking is exactly what the book “The Tail of the Raccoon,” co-written by Barbara Zito and Dr. Arthur Tomie, attempts to convey to the audience. This book is especially catered for elementary and middle school students as they are taught about addiction through a raccoon named Sign Tracker.

With the help of colorful images, the book targets the youth, the group who is usually impacted by addiction the most. Dr. Tomie believes it is important to teach children as young as six years old about why people become addicts and how it can be prevented. He adds, “Children need to be aware that actions can become disconnected from intentions and the way that this happens is when you experience repeated pairings of an object and a reward. This sheds a different light on the behavior of the addict.” According to Alcohol Rehab Services, people who begin to drink alcohol at a younger age become more dependent on their addiction and therefore find it difficult to stop. In fact, statistical data reveals that 16% of alcoholics drank before the age of 12 and only 9% began drinking at the age of 15.5 We have seen programs like D.A.R.E teach to elementary school children about the dangers of addiction and drug abuse for many years, yet these programs do not convey the message as strongly as they should. Dr. Tomie and his research team are planning to distribute “The Tail of the Raccoon” to New Brunswick public schools with the hope that people will to see addiction as something that can be stopped. Dr. Tomie remarks, “Once people understand that addicts lose self-control and are doing it even while trying not to, I believe that they are more likely to decline to do it, before it is too late. I believe that reading the story will save many young lives.”

“

Dr. Tomie believes it is important to teach children as young as six years old about why people become addicts and how it can be prevented

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By shruti jadhav

Rutgers HOSA: How One of Rutgers’ Youngest Student Body Health Professions Organizations is Helping Its Students Succeed Being a future health profession student at Rutgers University can be a daunting experience. With challenging classes to juggle, GPAs to maintain, and shadowing opportunities to compete for, students looking to apply for health professions programs such as pharmacy, medicine, and physical therapy often feel overwhelmed by the standards expected of them and the resources thrown at them. Luckily, one brilliant, fairly new student body organization, Health Occupations Students of America (HOSA), promises to come to their rescue.

Only in its third year at Rutgers, HOSA is a national student organization that welcomes all students interested in pursuing health-related careers, whether they have a clear-cut educational plan in mind or are simply looking into the field to find out if it is right for them. Its goal is to promote career and education opportunities in healthcare and to enhance the delivery of health care to the local community. Because of its unique two-fold approach, HOSA helps its members not only by educating them and helping them plan their futures, but also by actively involving them in the promotion of good health practices.

Founded in 2012 by current HOSA vice president Andrew E. Barra, the Rutgers HOSA chapter is now in its third year and is growing in numbers each semester.

Good healthcare relies on effective collaboration among healthcare professionals to achieve clear goals, which is why each year Rutgers HOSA members participate in an annual national HOSA conference that tests its members’ healthcare knowledge, skills, and character.

The conference takes the form of various competitions in which students can compete individually or in teams.

Some are knowledge-based tests on relevant subjects such as medical terminology and medical spelling. Others are creative events that involve designing health posters or demonstrating CPR and yet others require competitors to create long-term projects educating community members on health issues. The conference is held at the state level

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each spring, where the Rutgers chapter competes with other collegiate HOSA chapters from across New Jersey.

The top three teams and/or individual competitors in each category advance to the national round, which is held in the summer and consists of approximately 16 competing chapters. Currently, Rutgers is only in its third year of competition, but has advanced to nationals both years in the past and has taken first place in the nation for HOSA Bowl, a competition that tests’ competitors’ knowledge about various health topics and the HOSA organization itself.

This semester, the over-fifty members in Rutgers HOSA have already grouped themselves into teams and registered for the competitive events they will be participating in at the 2015 NJ HOSA State Conference.

Each team has been assigned a leader, who helps the competitors prepare by directing team strategies and recommending resources to study from. “Our main goal is to guide students and test them on their skills so that they will be prepared for competition,” says current HOSA president Hernan Chadha. Competitions allow students to learn health-related skills, expand their knowledge of health professions, and gain confidence that will help them succeed in the health professions – whether that confidence is gained from perusing medical literature, learning EMT skills, or developing a medical innovation.

At a large university like our own it is often difficult for prehealth students to obtain hands-on experience in health fields, and the national HOSA conference offers a brilliant opportunity to do so.

Besides helping students prepare for competition, Rutgers HOSA also provides its members with temporary glimpses into the lives of working healthcare professionals.

In February, the organization hosted two renowned guest speakers: a podiatrist who also happened to be a Rutgers alumnus and a graduate student from Rutgers School of Pharmacy. A career in healthcare is a lifelong commitment

By Anna Harootunian

and, by being exposed to the realities of the health professions early on, students can decide if this commitment is right for them.

HOSA president Hernan Chadha, who is working on his medical school application and aspires to become a physician, says that although his interest in the medical field was cultivated early at his medical science magnet high school, carving out his undergraduate path at Rutgers was not always easy. “I was kind of lost at the beginning,” he admits, acknowledging the overwhelming feelings many other pre-health students experience. At a large research university like Rutgers, undergraduates are bombarded with resources such as internship opportunities and application advising, but often unsure about how to go about utilizing these resources. In addition, many are unsure about which career exactly they are aiming for, or whether the health field is even right for them, causing them to shy away from promising but intimidating opportunities. Rutgers HOSA aims to bridge this gap – it welcomes every type of student, and has something to offer for everyone, from the dedicated premed student to the unsure undergraduate who is just learning about physician assisting. “HOSA is for everyone,” Chadha says. “And for us, every day is a learning experience.”

condom grams This year, Silvers apartments took a risqué spin on the conventional candy gram service. Instead of a box of Sweethearts or a little bag of chocolate, the residents were given the option of sending one another condoms or dental dams along with an appropriately awkward sexual and pun-y message. After all, there is no better way to tell someone “I lube you” than to send a notso-subtle message on Valentine’s Day! Some of the optional prewritten messages were “It’s Valentine’s Day, be safe when you lay!” and “I hope your day is well! When I saw your face, in love I swiftly fell!”

Dry humor aside, not many people know what a dental dam is.

In fact, most people do not know about methods of contraception outside of the traditional male condom or hormonal birth control pills. Dental dams are small pieces of latex used for oral-vaginal or oral-anal sex. They help protect against the transmission of sexual transmitted infections by providing a barrier to secretions that could contain bacteria and viruses. Like condoms, they may vary in size, flavor, and color and do not guarantee 100% protection from STIs. However, using no protection does guarantee transmission of disease.

Dental dams and condoms are also provided through the Rutgers Health Services on campus. There seems to be a need for them. Based on data collected by the Rutgers Health Services, the most commonly diagnosed STIs among Rutgers students are HPV and chlamydia. However, both of these diseases are treatable, and the HPV infection (if benign) usually clears up by itself over time. The virus itself cannot be eliminated, but the infection caused by the virus can clear up. Rutgers Health Services estimates that about 20% of Rutgers students engaging in sexual activity may be infected with herpes and about 25-35% may be infected with HPV. As for chlamydia, it is the most frequently reported infectious disease and the most commonly reported STD in the United States.

You cannot tell if someone has an STI by looking at them and you may not know right away if you have one yourself. To be safe, and to stay safe, students can take advantage of the screenings for STIs that Rutgers Health Services offers as well as use condoms and dental dams (though the attached cheeky messages such as “I lube you” are optional).

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