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Quote of the Day: Expectations for Kindergarten Have Risen, Putting Boys at a Disadvantage

Quote of the Day: Expectations for Kindergarten Have Risen, Putting Boys at a Disadvantage

New York Times2 days ago

'The data is clear men aren't superhealthy.'
MATT ENGLAR-CARLSON, founder of the Center for Boys and Men at Cal State Fullerton, on the higher increase in suicides by young men than by women, one of several data points showing that boys and young men are struggling.

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Real Life Simulations: Mass Casualty Training in Med School
Real Life Simulations: Mass Casualty Training in Med School

Medscape

timean hour ago

  • Medscape

Real Life Simulations: Mass Casualty Training in Med School

Anyone who watched television show The Pitt on Max knows how overwhelming a mass casualty event can be for a hospital. Preparation is key, and accredited hospitals are required to hold training exercises. But these incidents don't only affect physicians in the Emergency Department. The random nature of mass shootings, natural disasters, multi-car pileups, building collapses, and the like means an all-hands-on-deck situation could happen at any time. An increasing number of medical schools see the value in preparing their students early. 'Unfortunately this is where the world is going. We need to rely on ourselves because help may not be coming,' said Jeffrey Pearl, MD, associate dean of professional health education at the University of Texas (UT) at Tyler School of Medicine. 'In the end, the first line is going to be one of us picking someone out of the rubble from a tornado and putting a tourniquet on.' Unfortunately this is where the world is going. We need to rely on ourselves because help may not be coming. More than 20 years ago, the Associations of American Medical Colleges and the CDC issued a joint report recommending disaster-related training for medical students. It's still a relatively rare offering — by 2021, only seven allopathic medical schools in the US mentioned disaster response training in their course catalogs. But just 2 years later, that number had more than doubled. Roughly 10% of allopathic medical schools now offer it, as do a number of osteopathic medical schools. 'I think the best part is, it gives you perspective as to what goes on out in the field,' said Joshua Goodman, a rising fourth-year medical student at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He's participated in the school's annual training day more than once. 'Even in non-MCI situations, you might wonder why the patient is being brought in in this condition. Why didn't they do this? Why didn't they do that? This gives you a better understanding of what it's really like out there, so you know what to expect and can act on it.' Different Approaches to the Same Concept In order to prepare their students for an unpredictable future, medical schools take a variety of tacks. At some schools, all students undergo this training. At others, it's voluntary. Scenarios include bus bombings, school shootings, landslides, and the like. Often, they're location-specific, like the New York City subway car used in Hofstra's training, done at the local fire training academy. 'They fill it with smoke, and have students come in to rescue patients,' said Thomas Kwiatkowski, MD, assistant dean for simulation and professor of emergency medicine and science education at Hofstra. 'Some victims speak a different language, which is typical for New York City. It really challenges the students.' The variations don't stop there: At both UT Tyler and Hofstra, all first-year medical students complete a full emergency medical technician course. It concludes with a mass casualty simulation, which provides the chance to really practice the skills they've just learned. 'We didn't just want them to ride along in an ambulance,' Kwiatkowski said. 'That's not going to provide anything more than observation. I wanted a true clinical experience.' A presentation on FEMA's National Incident Management System kicks off the day at Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio. Students then move on to training with emergency equipment like cervical collars and backboards. But the bulk of the day is spent at the local fire department's training center for a hands-on simulation. Training at Perelman School of Medicine, University of Pennsylvania, Philadelphia, is part of a popular 2-week elective in wilderness and disaster medicine. Medical students learn to handle scenarios including avalanches, dirty bombs, and chemical weapons. At Idaho College of Osteopathic Medicine, Meridian, Idaho, training has included a simulated music festival gone awry as well as a multi-vehicle accident. College of Osteopathic Medicine, University of New England, Portland, Maine, has held four annual mock events. Last year's program focused on the lessons learned in the 2023 mass shooting in nearby Lewiston. Investing in Realism Limited research has been done to show exactly how realistic simulations should be, but there is some that suggests the more accurately a scenario reflects real life, the more students can benefit from it. Depending on a medical school's budget, things can get quite realistic, indeed. For many, it includes going off-site to a training ground, where students must triage realistic victims even as they experience the chaos of an actual event. 'When they walk into a burn tower knowing that there's been an explosion, and they hear people screaming out and they can't see much, it's an environment that probably causes their heart rate to go up a little bit, perhaps their respiratory rate to go up a little bit,' said William Burke, DO, dean of Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio. 'I think those types of situations help you better understand, as an individual, how you might respond in real life.' William Burke, DO For the simulations' victims, most schools use a combination of mannequins and volunteers — either locals or other medical students. Often, moulage artists are brought in to apply special-effects makeup. At UT Tyler, a relatively new school, Pearl had a sizable budget to design the mass casualty training program. Faculty works with campus and local law enforcement, fire department and emergency medical services, and even the Federal Bureau of Investigation to make the event feel as real as possible for students. High-tech wound simulation includes three-dimensional printed shrapnel mounted on silicone patches that are easily applied to volunteers' bodies; bleeding systems that pump fake blood; two cut suits of repairable skin with organs that bleed — which can be operated on while actors wear them; and several mannequins with realistic injuries. A significant amount of effort goes into creating thoughtful, plausible scenarios. A school shooting is part of the simulation at Hofstra. 'The way they set it up is hyper realistic, in that you have real police officers acting, there's a lot of yelling, it's dark, there's a lot of banging on doors. It's frankly a little bit scary,' Goodman, the medical student, said. 'You really do feel like you're in a school and you have to hide but you also have to triage: Who can we get out? How are we going to get them out? Is it safe to open the door?' Decisions Under Pressure Whatever the scenario, the goal in all these simulations is the same: To help medical students learn to make life-or-death decisions quickly, under extreme circumstances. 'The first minute or two, they're a little shell shocked. After that, it's like watching your children grow up,' Pearl said. 'These are first- and second-year med students, and they're rocking and rolling.' Thomas Kwiatkowski, MD During the exercises, they must triage victims into color-coded categories. Yes, just like in The Pitt : Green goes to the walking wounded, those who need minimal help. Yellow indicates a more serious injury, but not immediately life-threatening. Red means a victim has severe injuries, but with a high potential for survival. Victims designated with a black mark are either deceased or have injuries incompatible with life. 'It's very difficult when you have to make that decision,' Kwiatkowski said. 'There are a couple of maneuvers that people do before they can decide to make someone black, but sometimes you can have someone who's talking to you, and you know that you can't save them. That's an important experience for students.' Other ethical considerations also play out. During some simulations, for instance, a school shooter is still active. Students must decide how to help children while staying safe themselves, or if and when it's worth it to risk their own lives. At Ohio University, one situation involves a bombing. Unbeknownst to the students, the bomber is among the victims. 'Students are turning victims over and see the person playing the bomber has another bomb underneath them,' Burke said. 'It helps them understand the ethics of the situation: Do you treat them the same? The answer is yes, you take care of everybody. When you ask those questions, students are thinking about things in ways they've never had to before.'

Childhood trauma linked to higher risk of endometriosis in adult women
Childhood trauma linked to higher risk of endometriosis in adult women

Yahoo

timean hour ago

  • Yahoo

Childhood trauma linked to higher risk of endometriosis in adult women

ST. PAUL, Minn., June 11 (UPI) -- A suspected link between childhood trauma and the risk of developing endometriosis in later life was strengthened Wednesday with the publication of study that showed a greater chance of the condition among women with histories of difficult childhoods. The study of hundreds of thousands of women in Sweden found those who as children experienced substance abuse, had a teenage or mentally ill parent, financial problems or a death in the family were linked to a 20% increased risk of an endometriosis diagnosis compared to women who had not been exposed. However, the risk was much greater for girls exposed more than one of those factors, rising to 60%, while those who witnessed or were subjected to violence saw more than twice the risk of developing endometriosis later in life compared to women who had not been exposed, the Swedish authors reported. The study published in the British medical journal Human Reproduction builds on earlier findings that women who experienced physical and sexual abuse as children had a 79% higher risk of developing the painful condition, which affects one in 10 reproductive-age women in the United States. Lead author Dr. Marika Rostvall, a physician and doctoral student in the Department of Global Public Health at the Karolinska Institute in Stockholm, told UPI the findings provide more evidence of the strong connection between mental and physical health. The findings "support previous studies in other areas of medicine suggesting that the mind and body are intimately connected and that psychologically taxing events can have biological consequences," she said in emailed comments. Endometriosis usually affects women in their 20s and 30s, and while there are a handful known risk factors such as starting menstruation early and having a lean body type, the cause remains unknown. The problems stem from the behavior of tissues known as endometrium, which under normal circumstances are found only in the inner lining of a woman's uterus. Those tissues grow to a thick, blood vessel-rich layer during the menstrual cycle to prepare for possible implantation of an embryo, and then shed the blood at the end of the cycle if there is no embryo present. But in some cases, endometrium behave abnormally and start growing outside of the uterus. When they do so, they can attach themselves to the ovaries, fallopian tubes, bowel, bladder or other parts of the body, triggering frequently severe pelvic pain as they carry out their monthly thickening function. As a result, endometriosis can cause excessive bleeding and even infertility -- which is the case for up to half of women with the condition -- as well as cysts, scar tissue and adhesions. Those in turn can trigger chronic pain, including during with sexual intercourse as well as during urination or bowel movements. The Swedish researchers began by looking at the health records of more 1.3 million women born in in the country between 1974 and 2001, eventually narrowing it down to 24,000 who were diagnosed with endometriosis. They then tapped several national registers to track their childhood experiences, looking for evidence of trauma or difficulties, including crimes such as violence and sexual abuse. The results, they said, demonstrate the importance of considering "the whole person" not just the symptoms of endometriosis. The negative physical consequences of psychological trauma can perhaps be traced to a compromised ability of the immune system to protect against the condition, or even in how the body perceives pain, Rostvall said. "I think the immune system is an interesting part of the puzzle when it comes to trying to understand why some women develop endometriosis," she said. "Chronic inflammation is a big part of the disease, and it has also been shown that women with endometriosis have a higher incidence of autoimmune disorders compared to healthy women. "There is a lot of interesting research being done in the area, and a deeper understanding of exactly how the immune system functions in relation to endometriosis could potentially help bring forward new kinds of treatment." Like some other women's health issues, the pain of endometriosis is often dismissed and sufferers have reported negative experiences with healthcare professionals, often in the form of providers "trivializing" symptoms, which can cause feelings of loneliness and alienation. This, in turn, can make obtaining a diagnosis difficult and prompt some to choose to avoid engaging with doctors altogether. A British psychological-based study from last year showed some women who suffered symptoms felt they had experienced a form of "medical gaslighting" in which they were made to doubt their own perceptions of pain. Rostvall said these kinds of experiences are especially relevant when the patients are women who come from socially and psychologically traumatic backgrounds. "A lot of women presenting with pain, especially socioeconomically disadvantaged women and women with psychiatric comorbidities, who are more likely to have experienced childhood adversity, have their pain dismissed. They then have to wait for a long time to receive a diagnosis and treatment, potentially allowing the condition to worsen," she said. "I think physicians should be aware of the complex linkage between the mind and body in general and be more open to listening to their patients' stories, take their pain seriously, and offer a thorough physical examination."

LQpay Expands Compliant Surcharging Solution, Optimizing Payment Strategy for Healthcare Practices
LQpay Expands Compliant Surcharging Solution, Optimizing Payment Strategy for Healthcare Practices

Yahoo

timean hour ago

  • Yahoo

LQpay Expands Compliant Surcharging Solution, Optimizing Payment Strategy for Healthcare Practices

End-to-End Compliant Credit Surcharging with Custom Integration Now Available PLANTATION, Fla., June 11, 2025 (GLOBE NEWSWIRE) -- LQpay, a leading provider of innovative patient payments and automation technology, announced the expansion of its end-to-end compliant credit card surcharging solution, empowering healthcare practices to optimize their payment strategy and more seamlessly defray operational costs without sacrificing efficiencies or the patient experience. The latest enhancements enable medical and dental organizations to pass along credit card processing fees and serve up the necessary disclosures to patients across all eligible channels, encompassing both in-office and remote payment types, such as recurring billing plans, text- and email-to-pay, card on file, etc. In addition, by leveraging its proprietary RPA (Robotics Processing Automation) technology, LQpay has the unique capability to customize the integration of these payment types into any underlying EMR/practice management system. This custom integration capability allows practices to tailor the posting and reporting of surcharged transactions according to their unique workflows, business requirements, and practice management systems. By automatically calculating and applying compliant surcharges to eligible credit card transactions and facilitating accurate record-keeping of patient accounts, healthcare practices can reduce operational expenses without increasing administrative burden. As payment processing costs continue to rise, healthcare providers face continuous pressure on operating margins. LQpay's enhanced surcharging platform offers a powerful, compliant way for practices to offset these expenses without disrupting workflows or compromising the patient experience. 'Today's healthcare practices need more than a payment processor. They need a partner who can help them navigate complexity while protecting profitability,' said Shashi Kapur, CEO of LQpay. "Based on valuable feedback from our customers and partners, along with our dedication to innovation, we are proud to be a premier payments technology provider merging end-to-end compliant surcharging with robust Robotics Processing Automation (RPA). Our expanded surcharging capabilities provide healthcare organizations with a turnkey, compliant way to reduce costs and operate more efficiently.' Since its initial introduction, LQpay's compliant surcharging feature has provided practices with a valuable tool to offset the growing expense of payment processing fees. Recognizing the evolving needs of the healthcare industry and LQpay's commitment to continuous improvement, these enhancements truly set LQpay apart in the industry, ensuring practices experience greater efficiency and maximized financial benefit. Key Benefits of LQpay's Surcharging Enhancement: Optimized payment strategy ensuring credit card processing fees are consistently offset, regardless of how patients choose to pay. Custom integration with practice management systems (PMS). Unlike generic surcharge options, payments are automatically posted according to each practice's workflow and reporting requirements. Certified, compliant solution aligned with processor mandates, card network rules, and applicable state and regional regulations. Configurable patient communications and transparent fee disclosures to ensure patients are clearly informed about surcharges before payment and provided options for alternative, non-surcharge payment methods (e.g., ACH, debit, cash). Real-time reconciliation and reporting tools with detailed dashboard, making it easy to track surcharge revenue and monitor compliance without manual record-keeping. The surcharging capability is now available to both new and existing LQpay customers using approved payment gateways. Practices eager to enhance their financial performance and reduce processing expenses are encouraged to schedule a personalized demonstration. About LQpay Based in Plantation, FL, LQpay stands as a leading end-to-end patient payments platform, dedicated to serving the healthcare, dental, and veterinary practices. By integrating cutting-edge automation, AI-powered integrations, and modern payment functionalities such as text-to-pay and auto-posting, LQpay empowers practices to streamline operations, accelerate cash flow, and elevate the overall patient financial experience. For more information or to schedule a demo, please visit CONTACT: Press Contact: 954.909.5948 info@ in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data

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