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  • January 18, 2022

    By MedStar Team

    Structural racism is one of the most pressing issues facing healthcare today.  Unfortunately, academic medicine historically exacerbating the exploitation of vulnerable communities to achieve educational and research goals, especially in Black, Indigenous, and People of Color (BIPOC) communities. For example, many traditional research practices among marginalized communities highlight and, in most cases, magnify inequities in care. These can include:   

    • Community members are under informed about research methods and strategies. 

    • Researchers prioritize extraction of information from communities rather than community ownership of information.

    • Researchers accrue funding, prestige, and publications (in which academics’ voices predominate over the narrative perspective of community members) without similar accrual to participating communities.  

    • Researchers’ understanding of questions to be answered may lack cultural context because of their incomplete comprehension of community conditions.  

    The relationship between research institutions and many BIPOC communities is estranged and needs mending to dismantle racial disparities and inequitable research practices. As the area’s largest healthcare provider, MedStar Health is committed to do the work needed to address these issues in everything we do in order to advance health equity for everyone we serve.

    “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

    (March 25, 1966 speech to the Medical Committee for Human Rights)

     

    Advancing Health Equity in Early Childhood and Family Mental Health Research

    MedStar Health investigators Arrealia Gavins, Celene E. Domitrovich, Christina Morris, Jessica X. Ouyang, and Matthew G. Biel recently published research emphasizing the need to co-learn and to co-develop research with community members themselves to prioritize benefits for both participants and researchers. “Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health” was published in the Journal of the American Academy of Child & Adolescent Psychiatry. This work was done through the Early Childhood Innovation Network (ECIN),  a community-based partnership between two academic medical centers (MedStar Georgetown University Hospital & Children’s National Health System) and several community-based organizations in Washington, DC that strives to provide support to families through caregiver and child mental health services, family peer support, child social and emotional learning, initiatives to address social determinants of physical and mental health for families, and place-based support to families within select communities.  

    In this study, researchers found that to begin to undo the inherent inequities within academic medical research, particularly in studies involving children and caregivers, investigators need to consider how best to build equitable, long-term partnerships with communities through Community-Engaged Research (CEnR) or more specifically, Community-Based Participatory Research (CBPR). CBPR offers an alternative to traditional non-participatory research with a collaborative, strengths-based orientation that equitably involves researchers, community members and other stakeholders in all phases of research while embracing their unique expertise. 

    Recently documented increasing rates of depression, anxiety, and suicide in BIPOC youth, compounded by the disproportionate impact of the COVID-19 pandemic on BIPOC communities, has heightened the urgency for progress in community-based research.

    The research team started to utilize CBPR practices to advance antiracism in their clinical research work in child and family health along with working with BIPOC communities. This approach to integrate CBPR practices into the development, implementation, and evaluation of community-based interventions seeks to support early childhood mental health in primarily Black communities in Washington, DC. 

    Making an Impact: Insights & Lessons Learned from CBPR

    Through this work of the EICN, the research team found five valuable lessons from applying CBRP principles to research collaborations in community settings. 

    Intervention Practices

    Lessons Learned and Applied

    ECIN launched a group-based mindfulness parenting program to explore how to support the emotional health of parents at a Head Start early education center with the intention to reduce caregiver stress and enhance caregiver-child relationships.

     

    Lesson 1: Invest the time to build trusting relationships

    Providers set up several discussion groups with community partners and medical center-based researchers to review proposed assessment tools to be used with children and families receiving psychotherapy services.

    Lesson 2: Involve community partners in the development of the intervention theory of change and measurement strategy

     

    Clinical staff organized peer specialists to provide support to families with young children through 3 evidence-based strategies: enhancing parents’ knowledge about caregiving with young children;optimizingparent use of existing resources; and increasing parents’ access to social supports.

     

    Lesson 3: Create interventions in partnership with community members

    Clinical staff providedearly childhood mental health consultation (ECMHC) in preschool classrooms to enhance educators’capacitiesto support early childhood development and to recognize early signs of mental health concerns

    Lesson 4: Interpret findings in partnership with community members

    ECIN membersparticipatedin formal antiracism training with external experts to incorporate antiracism principles into ECIN’s operations and into the culture of the Network. ECIN formed a Racial Equity Community of Practice (RECOP), that supports 8 intervention teams in developing practices that advance racial equity goals.

    Lesson 5: Embed an antiracism focus in research structures and processes

     

    The research team found this community-based approach to be helpful in conducting research that will have a long-lasting impact on not only the community, but also on members of the research team. During a time where BIPOC families are experiencing the effect of COVID-related deaths and grief, unemployment, housing instability, and police violence; researchers have an opportunity to be engaged in the community and work to eliminate racial inequities within academic medicine and research. 

    Journal of the American Academy of Child & Adolescent Psychiatry, DOI: 10.1016/j.jaac.2021.06.018

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  • September 05, 2017

    By Andrew Sokol, MD

    Urinary tract infections, or UTIs, are one of the most common problems doctors see in women. According to the National Institute of Diabetes and Digestive and Kidney Diseases, 40 to 60 percent of women will have a UTI at some point in their lifetimes, and one in four women will have an infection that comes back after initial treatment.

    But even those high numbers may be under-reported. Many women have UTIs and never talk about them with their doctors. Some may not even realize they have an infection. I often don’t see patients until they’ve had multiple UTIs, when they’ve started missing work and are having trouble dealing with the symptoms.

    It’s important to know the facts about UTIs. Let’s discuss who’s at risk for UTIs and symptoms to watch for, as well as myths and tips about UTI prevention.

    Listen to Dr. Andrew Sokol discuss UTIs further on this Medical Intel podcast.

    What’s a UTI, and who’s at risk?

    Anyone can develop a UTI. They’re caused by bacteria, particularly bacteria from the bowel. Women have a higher risk for UTIs than men on average. That’s because, compared to men, the female urethra (the tube through which urine, or pee, passes on its way out of the body) is shorter, which makes it easier for bacteria to enter the urinary tract.

    A UTI can involve any part of the urinary tract, which goes from the kidneys through the urethra. The most common form of UTI is a bladder infection. Put another way: All bladder infections are UTIs, but not all UTIs are just bladder infections. Infection could also involve the kidneys.

    All bladder infections are #UTIs, but not all UTIs are just bladder infections. via @MedStarWHC

    Click to Tweet


    UTIs often are linked to sexual activity, which can spread bacteria from the anus to the vaginal opening, which increases a woman’s risk of developing a UTI.  

    Younger women tend to have UTIs that are mild or uncomplicated. The risks for UTIs increase as a woman enters menopause, because a lack of estrogen lowers a woman’s defenses against infection in the urinary tract. Older women may have more UTIs that are more likely to come back after being treated. We call these recurrent infections.  

    Common UTI symptoms and when to see a doctor

    No matter where in the urinary tract a UTI develops, the symptoms are similar. Women who have a UTI may experience:

    • A burning feeling with urination, called dysuria
    • An urgent need to urinate
    • Blood in the urine
    • Cramping or pain in the pelvis
    • Having to urinate more often than normal  

    Older women may not necessarily experience these symptoms. They may feel fatigued or show changes in their behavior, such as confusion or irritation, instead of having the classic symptoms of a UTI.  

    Most women are fairly accurate at diagnosing themselves with a UTI, particularly if they have common symptoms. A primary care doctor or gynecologist often can prescribe antibiotics to treat a UTI after an in-office urinalysis (a test of the patient’s urine).  

    However, UTI symptoms are similar to those of other conditions, including:

    That’s why women who have symptoms that don’t go away on their own or that come back repeatedly need to see a urogynecologist like me. A urogynecologist specializes in problems of the female urinary system and pelvic floor. We can determine if these symptoms are due to a UTI or some other condition, such as a physical issue that makes a woman more likely to develop UTIs.  

    Request an appointment with one of our urogynecologists if you have UTI symptoms that keep coming back.

    One of our urogynecologists may be able to help.

    Request an Appointment


    The most common question I hear from women about UTIs is how to prevent them in the first place. Unfortunately, there are many commonly held beliefs about what women can do to treat or avoid UTIs which are not supported by scientific evidence.  

    Myths about avoiding UTIs

    Some women, and even some doctors, say cranberry juice or tablets can lower a woman’s risk. But recent research indicates that cranberry tablets may not make a difference in a woman’s risk for developing a UTI.  

    One of the suggestions I hear most often is that women should increase the amount of water they drink to increase how often they have to urinate and flush out any bacteria. That hasn’t been proven to work very well, but the “eight-glasses-of-water-a-day” myth persists despite no scientific evidence supporting its benefits.

    Drinking too much water can lead to having to urinate more often, a greater urgency to urinate and other symptoms similar to those of a UTI, making women think they have an infection when their bodies are just getting rid of the excessive fluid they’re drinking. This is especially true in women who consume excessive amounts of caffeine (such as by drinking coffee, tea and soda).  

    Tips to prevent a UTI

    There are many commonly shared strategies for lowering the risk of UTIs. For women who develop UTIs after having sex, I often suggest urinating after sexual intercourse, as well as washing with soap and water afterward. Some women are more likely to develop UTIs if they use certain methods of birth control, including spermicidal jellies, diaphragms or even condoms in some cases. If that’s the case, I may recommend changing the method of birth control a woman uses in addition to urinating after sex and washing with soap and water.  

    Wiping from front to back whenever going to the bathroom is another important tip. The idea here is to lower the chance of spreading bacteria from the anus to the vaginal opening, where bacteria could enter the urethra. Unfortunately, there isn’t much data on this, but it’s a common-sense strategy for women to try.

    If simple behavioral modifications such as cleaning with soap and water and urinating after sex fail, some women are candidates for prophylactic antibiotics—drugs used to prevent an infection, rather than to treat an infection that already exists. If a patient tests positive for two UTIs within six months or three within a year, she may be a candidate for preventative antibiotics which can be taken after sex, daily, or if symptoms develop.  

    When a woman experiences UTI symptoms, it’s natural for the mind to go to the worst-case scenario. It can be scary to see blood in the urine or feel a burning sensation during urination. But UTIs usually aren’t cause for great concern. And if a woman has symptoms that keep coming back or that don’t get better, seeing a specialist can ease her fears and point her toward the right course of prevention and care.   

  • September 04, 2017

    By MedStar Health

    “Integrated Health Systems that successfully integrate quality, safety and value both within and outside traditional health care disciplines in research, education and clinical care applications and outcomes will assume leadership positions in shaping this century’s global health care agenda.”
    Institute of Medicine

    By David Mayer, MD

    Welcome to the MedStar Institute for Quality and Safety (MIQS) (www.MedStarIQS.org) The MedStar Health Institute for Quality and Safety aligns with, and catalyzes, the innovation and implementation power within MedStar Health through the synergistic interaction with our internal partners at the MedStar Institute for Innovation (MI2); the MedStar Health Research Institute (MHRI); the MedStar National Center for Human Factors in Healthcare; and the MedStar Simulation, Training & Education Lab (SiTEL).

    Since 2012, MedStar Health has made significant investments towards the goal of providing the highest quality, safest care possible to the communities we serve. While we still have work ahead of us in order to achieve this goal, we have seen significant reductions in preventable medical harm events as well as improvements in clinical quality outcomes in patient care across our system, which includes 10 hospitals and 300 ambulatory care sites.

    Examples of MedStar’s commitment to quality and safety include:

    1) A system-wide rollout of high reliability training and risk reduction tools to over 30,000 associates, caregivers, leaders and board members focused on the elimination of preventable harm to our patients and those who care for them.

    2) Through strategic partnerships with Georgetown University and others, we have built and deployed a wide offering of educational programs that advance safety science and quality improvement. These educational programs include:

    • Best-in-class patient safety summer camps for medical and nursing students and well as resident physicians through our Academy for Emerging Leaders in Patient Safety (AELPS) also known as The Telluride Experience. Over 200 future healthcare leaders each year receive full scholarships to one of our patient safety summer camps held in Telluride CO, Napa CA, Washington, D.C., Sydney Australia, and Doha Qatar.
    • An Executive Masters in Quality and Safety Leadership for those wanting higher level degree training in quality and safety.
    • A growing number of online quality improvement and patient safety educational programs.

    3) Created the Center for Open and Honest Communication (COHC) in healthcare led by Tim McDonald, MD, JD. Working with the Agency in Healthcare Research and Quality (AHRQ), MedStar led the development, piloting and implementation of the Communication and Optimal Resolution (CANDOR) toolkit. The CANDOR toolkit includes a best-in-class Event Review (Root Cause Analysis) model developed by experts in patient safety, human factors and the National Transportation Safety Bureau (NTSB), as well as information on how to implement a Care for the Caregiver program within hospitals. Dr. McDonald, an international leader in open and honest communication after preventable harm events, is currently leading CANDOR training and implementation at over 200 hospitals across the country.

    4) Created the International Training Center for Bloodless Medicine where care teams from across the world can learn and train on the newer techniques that have been developed to provide optimal care to Jehovah’s Witnesses, who do not accept transfusions of blood or its primary components. Through a generous philanthropic contribution from the New York Community Trust, the training will be free to all care teams.

    5) Continuously engage patients and families as partners in healthcare quality, safety, and system redesign strategies. Through the creation of a national, as well as local, Patient and Family Advisory Councils for Quality and Safety (PFACQS) at all of our hospitals, the patient/family voice is part of all our quality and safety efforts.

    Eliminating Preventable Harm, continuously improving Quality, optimizing Patient Experience and driving Value in healthcare are the now widely recognized drivers of a paradigm shift within the U.S. health system. The MedStar Institute for Quality and Safety will provide the resources, passion and expertise and will continue with MedStar Health’s commitment to the Quadruple Aim: Better care for patients, better health for the communities we serve, lower costs, and support for the healthcare workforce to stem dissatisfaction and burnout.

    We hope you will visit our website, learn more about the MedStar Institute for Quality and Safety, attend a learning session or collaborate with us in the pursuit of zero preventable harm.

     
  • September 01, 2017

    By MedStar Health Research Institute

    Research Grand Rounds are sponsored by MedStar Health Research Institute and Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) and bring together the MedStar Health community for a learning experience focusing on a different topic each month.

    Research Grand Rounds are open to all members of the research team, from principal investigators to clinical and research coordinators and trainees. Topics covered in the Research Grand Rounds range from community-focused research to best practices and are intended to increase collaboration within the research community in and outside of MedStar Health.

    Use of Large Sequence Datasets for Epidemic Mapping to Understand HIV Transmission Dynamics in the Mid-Atlantic United States
    Presented by Seble Kassaye, MD, MS
    Georgetown University Medical Center, Department of Medicine, Division of Infectious Disease

    October 13, 2017
    12 Noon to 1 PM – Presentation
    1 PM to 1:30 PM – Lunch
    MedStar Washington Hospital Center, 6th Floor, CTEC Theater
    110 Irving Street, NW, Washington, D.C., 20010

    The full schedule for the academic year 2017-2018 is still being finalized. Check back soon for more information. For more information, please contact Research@medstar.net.

  • September 01, 2017

    By MedStar Health Research Institute

    Research Grand Rounds are sponsored by MedStar Health Research Institute and Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) and bring together the MedStar Health community for a learning experience focusing on a different topic each month.

    Research Grand Rounds are open to all members of the research team, from principal investigators to clinical and research coordinators and trainees. Topics covered in the Research Grand Rounds range from community-focused research to best practices and are intended to increase collaboration within the research community in and outside of MedStar Health.

    All in a Multicenter Trial
    Presented by Vanita Aroda, MD
    Former Scientific Center Director of the MedStar Health Community Clinical Research Center

    September 8, 2017
    12 Noon to 1 PM – Presentation
    1 PM to 1:30 PM – Lunch
    MedStar Washington Hospital Center, 6th Floor, CTEC Theater
    110 Irving Street, NW, Washington, D.C., 20010

    The full schedule for the academic year 2017-2018 is still being finalized. Check back soon for more information. For more information, please contact Research@medstar.net.

  • September 01, 2017

    By MedStar Health Research Institute

    Developing a Mechanistic Model-Based Approach to Assess Cardiac Safety of New Drugs” will address the public health and regulatory need for a new paradigm to assess cardiac safety of new drugs; the cutting edge science that underpins that paradigm; the current status of ongoing validation studies; and the expected impact of this novel mechanistic, model-informed approach.

    Presented by:
    David Strauss, MD, PhD
    Director, Division of Applied Regulatory Science
    FDA’s Center for Drug Evaluation and Research

    In the 1990s to early 2000s, multiple drugs were removed from the market because they caused arrhythmias and sudden death. In response, regulatory guidelines were implemented that have successfully prevented such occurrences by focusing on detecting hERG potassium channel block in cells and QT prolongation on the electrocardiogram. However, this approach is not very specific because some drugs are flagged as posing a risk and thus can be dropped from development when they are actually safe. Learn more about this presentation.

    David Strauss, MD, PhD, is a leader in translational sciences regulatory research. Before serving in his current role as Director of the Division of Applied Regulatory Science in FDA’s Center for Drug Evaluation and Research (CDER), Dr. Strauss was Senior Advisor for Translational and Experimental Medicine in CDER’s Office of Clinical Pharmacology and a medical officer and premarket medical device reviewer in the Center for Devices and Radiological Health.

    Thursday, September 14, 2017
    12:00pm
     – 1:00pm EST
    Register for the webcast here.

    The FDA Grand Rounds is webcast every other month to highlight cutting-edge research underway across the Agency and its impact on protecting and advancing public health. Each session features an FDA scientist presenting on a key public health challenge and how FDA is applying science to its regulatory activities. The 45-minute presentation is followed by questions from the audience. 

  • September 01, 2017

    By MedStar Health Research Institute

    The Innovation Center for Biomedical Informatics invites you to attend the 6th Annual Biomedical Informatics Symposiumto be held on Friday, October 27, at the Georgetown University Conference Center.

    This free, one-day event brings depth, breadth, and excellence with high-quality talks and discussions by key leaders and innovators in the field of Biomedical Informatics and Advanced Healthcare Technologies. It includes talks by academic, industry, and government leaders in clinical and translational sciences who will highlight applications of informatics science and tools to advance precision medicine.

    • Patty Brennan, RN, PhD, Director, National Library of Medicine will deliver a keynote.
    • New pre-symposium hands-on "Bioinformatics for Immuno-Oncology and Translational Research Workshop (BigData)"
    • Poster abstract submission is now open 
    • Planned sessions in new and emerging areas including the following:
      • Distributed, large cancer networks driving precision oncology
      • Current trends in molecular diagnostics
      • Will AI/machine learning deliver for biomedicine? How soon? 
      • Are we training the next generation of data scientists to take on emerging challenges? 

    Program Agenda and Registration.

    Friday, October 27
    8:00 am to 6:00 pm
    Georgetown Conference Center
    3800 Reservoir Rd NW
    Washington, D.C., 20007

    The deadline for abstract submission is September 15th, 2017.

    Early Bird Registration ends on September 7, 2017

    This event is co-organized by Georgetown Lombardi Comprehensive Cancer Center (LCCC), Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) and the Georgetown University Innovation Center for Biomedical Informatics.