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Month: May 2024

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Healthy Living @ Himmelfarb

June 2024 study break guide with image of pride heart, field with a picnic basket, lounge chair and musical notes in the sky

Millennium Stage Films: Extraordinary Cinema
Location: REACH Video Wall, Kennedy Center
Dates: Every Friday thru August 30, 2024. Film starts at sundown or 8:30 PM
Cost: FREE!

June Screenings:
June 7: Dreamgirls
June 14: 10,000 Dreams: A Festival of Asian Choreography
June 21: Elemental
June 28: Ratatouille

Enjoy outdoor movie screenings this summer on the Kennedy Center REACH Video Wall. No tickets are required but registration is encouraged so you can get the most up-to-date status of the films. If not registered, check the website day of the film screening for cancelation or location changes. You’re welcome to bring blankets and chairs. Bring a picnic to their outdoor spaces during non-event times. Coolers must be limited to 16 quarts or smaller. Personal chairs must be limited to 36" high or smaller.

Capital Pride 17th Street Block Party
Date: Saturday, June 8, 2024. 12:00 PM – 10:00 PM
Location: 17th Street NW, Dupont Neighborhood
Cost: FREE!

The historic Dupont neighborhood party will feature local food, beverages, and various activities in celebration of Pride. Dine indoors or outside along 17th Street at over a dozen iconic restaurants and eateries in this historic neighborhood. The DC Water Quench buggy will be there so bring your reusable water bottles and hydrate throughout the day! Get totally radical and have a dance-off in the street! Enjoy a live DJ from 12:00 pm-10:00 pm. Bring your little ones to Stead Park between 10:00 am-3:00 pm for free kid’s activities, games, and story hour.

Rock the Dock at The Wharf - Special Juneteenth Concert
Date: Wednesday, June 19, 2024. The Juneteenth Extended Concert is from 3:00 PM-9:00 PM. All other summer concerts start at 7:00 PM.
Location: DC Wharf. 760 Maine Ave., SW
Cost: FREE!

Summer never sounded better! Head to the DC Wharf for free concerts on the Transit Pier every Wednesday. With R&B, Americana, Motown, Jazz, Reggae, and your favorite pop covers, there is something for everyone. The Juneteenth extended concert will feature performances by:
3:00pm-4:30pm: JWX: The Jarreau Williams Experience
5:00pm-6:30pm: Jogo Project
7:00pm-9:00pm: Be’la Dona (R&B/Soul/Go-Go)

32nd Annual Giant BBQ Battle
Date: Saturday, June 22 – 11:00 AM-9:00 PM /Sunday, June 23: 11:00 AM-7:00 PM
Location: Pennsylvania Ave. (between 3rd & 7th Streets)
Cost: One day pass: $20+fees (good for Saturday, June 22 OR Sunday, June 23)

Get ready for the BBQ Summer Games XXXII. Foodies, families, and friends can taste the triumph at this legendary two-day festival of flavors and fun. Don’t sit on the sidelines! Grab your tickets and be a part of history. Pass includes event admission, over 100 free food and beverage samples (while supplies last), live music on 3 Stages, expert cooking demonstrations, interactive exhibits, children's activities, sports action for the Washington Wizards, Mystics, Capital and Cap City Go-Go, and BBQ from across the country. Plus witness BBQ's best in the National BBQ Championship Contest.

Science Solstice Saturday
Date: Saturday, June 22, 2024. 10:00 AM-4:00 PM
Location: National Zoo
Cost: FREE! Entry passes will be made available one month before the event date.

The Smithsonian marks the first Saturday of summer, Solstice Saturday, by hosting programs and performances throughout the day and night. Get ready for a free, fun-filled immersive scientific experience at the Zoo! On Solstice Saturday, visitors can engage with scientists, researchers, and animal experts to learn how science is shaping the future of wildlife conservation.

2024 Smithsonian Folklife Festival
Date: June 26–July 1, 2024. Hours: 11:00 AM-5:30 PM. Evening concerts Friday- Sunday 5:30 PM-7:00 PM
Location: National Mall (between 3rd & 7th Streets)
Cost: FREE!

In 2024, the festival highlights, “Indigenous Voices of the Americas: Celebrating the National Museum of the American Indian”. Four primary themes will include, Relevance, Resistance, Representation, and Reclamation. Join the celebration with stories, songs, and dance. Experience ancestral foods like the Three Sisters (beans, corn, and squash) and inventive, sustainable cuisines. Learn stories that underlie Indigenous sports and games. Hear how Indigenous youth are reclaiming their languages through spoken word and hip-hop. Explore traditional arts that flourish in their connections to place and environmental knowledge.

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Sometimes researching can be more complicated than it appears. Below, we take a look at predatory publishing, what it is, and how to avoid it.

A title card that says predatory publishing
Narration: A label next in the bottom left corner denotes the speaker as “Rebecca, Librarian, Amature Cartoonist.”
Pp Page 1
Rebecca in the boat, looks down concerned at the sea, where multiple shark fins can be seen poking through the waves. The speech bubble states “But there metaphorical waters can prove treacherous. And unlike real sharks, these threats to scientific knowledge provide little benefit to the scholarly ecosystem”
Narration: “Introducing Predatory Publishing” is at the top of the page. At the bottom, there is a label for the shark, which states “Ponzi, the Shark” Image: A shark wearing a top hat and bow tie waves a fin, looking smug.
Panel 4 Narration: “But what are predatory publishers?” Image: Rebecca looking stern, looks forward with a parrot on her shoulder. “Predatory publishers are journals that only exist to make money.” panel 5 Image: A white man with blonde hair and old fashion clothes, holding onto ship wreckage like Jack in Titanic, looks at a mermaid with brown skin, black hair and a purple tail. In the background there is other evidence of a ship wreck. The man says “What do you mean “make money?” to which the mermaid replies “You didn’t know?”
Pp Page 1
Image: Now under the sea, the mermaid from earlier gestures to a treasure chest full of gold. Other sea life float in the background. She says “Scientific publishing is a huge business. One publisher, had a profit margin of almost 40% in 2023 (1). In contrast, Apple’s was 44% (2).
Pp Page 1
Panel 1 Narration: To best understand how publishers make so much money, one must learn how the publishing process works. Image: The parrot from earlier says “Polly want an explanation!” Panel 2 Narration: “Traditional publishing looks something like this. Scientists submit to journals who publish it to the world (ideally). And money flows like this: scientists submit to journals for free (or a small fee) and publishers pay to publish the work to the world, who pay higher costs in return for access. Publishers get work for free that is edited for free and then charge individuals, libraries, ect for access. Image: A flow chart of a beaker, a journal and the Earth is shown demonstrating the relationship described in the narration.
Narration: This can lead to science being behind a paywall, especially for scientists, schools and others who can’t afford to pay. Image: Rebecca and Polly the parrot stand on opposite sides of a poster with a picture of a journal on it. The poster says “$$$$ science.” Rebecca, talking to Polly, says “I can’t afford this.” Polly, who is resting on a bird perch, says “Polly can’t even afford a cracker…”
Panel 1 Narration: SO a new model was born: open access. It looks like the traditional model but money flows like this (authors pay to journals to publish their work and journals pay to publish to the world). The idea is the author pays a fee to ensure wider access. Image: A flow chart of a beaker, a journal and the Earth is shown demonstrating the relationship described in the narration. Panel 2: Narration: Ideally, the rest works the same. Scientists submit their best works, it’s peer reviewed and if it passes muster, it’s published like traditional publishing. Image: We see the Earth in space with an Astronaut floating in the foreground. The astronaut says “I even get access out here!” There is also a UFO floating over the Earth as a gag.
Narration: Except…what if instead of being discerning about what you publish, you just accept everything? After all, the more articles you accept, the more money you make in fees.
Pp 2
Narration: This is the business model of predatory publishers: accept anything and make a profit from the fees. Some tactics of predatory publishers include: Image: A wanted poster of Ponzi the shark is affixed to a brick wall. On the poster, Ponzi looks alarmed. The text of the poster says “wanted: fraud.”
Narration: Pretending to be respected journals by spoofing the name of a more reputable publication. Image: A bald Black scientist wearing glasses looks concerned at Ponzi, who looks the same except for a drawn on fake mustache. Both of them stand next to posters. The scientist’s poster says “submit to Nature.” Ponzi’s poster states “submit to Natures.”
Panel 1 Narration: Or they’ll ue the name of a defunct journal that has a better reputation. Image: Ponzi the shark is seen floating underwater over a human skeleton. There are two labels affixed to each. The skeleton is labeled as “human sciences.” Ponzi is labeled as “human sciences 2.0” Panel 2: Narration: They might offer services like peer review with no intention of doing it, or claim rapid turn around times. Image: A white and yellow tropical fish stares at a piece of paper on a fish hook. The paper says “pls review in 24 hours.” Question marks are shown over the fish’s head.
Narration: The reason this is a huge issue is partially one of quality. Predatory publishers flood scientific literature with B.S that can be dangerous.
Pp 2
Narration: The other issue impacts scientists: those tricked into publishing in these journals can see a hit to their reputations. Image: A line up of three figures is shown with a text box underneath. The first two figures are literal clowns in full makeup while the third is a scientist with brown skin and brown hair looking horrified in their direction. The text underneath the three states” This issue: Balloon animals found to boost happiness page 8. The speed of trick flowers page 32. New cells found in clinical trials page 41.
Panel 1: Image: The shipwrecked sailor holding onto wood planks from page 1 floats in the ocean. He asks “So what do we do about this? Give up on open access?” Panel 2: Image: Rebecca is seen balancing on the mast of the ship with the sail behind her. He says “of course not! Open science is important. We just need to be careful.”
Narration: Look for red flags. Things like: Image: A red flag is seen in the sky. On the red flag there is a yellow circle which showcases Ponzi the shark.
Panel 1 Narration: Editors who have frank credentials, lack expertise that matches the journal or don’t exist at all. Image: A volleyball with a face painted on it in red (much like Wilson in Castaway) rests on a beach. Below it, a text box states: “Editor in Chief: Wilson V. Ball” Panel 2: Narration: Having a weird street address for a business or no about page. Image: An underwater cave is shown, There is a wooden sign in front of the cave that says “home of Natures.”
Panel 1 Narration: You’re naked to submit work entirely unsolicited. Image: An anglerfish with a letter in the place of its light antenna, floats in the deep sea. With sharp teeth it says “You got mail.” Panel 2: Narration: Promising rapid publication. Image: A stopwatch on a chain is shown with the intervals of 15, 30 and 45 on it. The top interval says “publish.”
Panel 1 Narration: Unsure about a publisher? You can ask a librarian or try using Cabells, a director of publishing opportunities. It identifies predatory publishers. We offer access to Cabells through Himmelfarb. Image: The interface of Cabells is shown where journals are marked as predatory. Panel 2 Narration: Good luck! Image: Rebecca is seen in the bird's nest, giving a salute to the audience. The ocean and sun can be seen behind her,
A list of sources\ Yup K. How Scientific Publishers’ Extreme Fees Put Profit Over Progress. Published online May 31, 2023. Accessed May 6, 2024. https://www.thenation.com/article/society/neuroimage-elsevier-editorial-board-journal-profit/ Miglani J. Apple Sales And Profits Analysis For FY 2023 — Top 10 Insights. Forrester. Published November 21, 2023. Accessed May 6, 2024. https://www.forrester.com/blogs/apple-sales-and-profits-analysis-for-fy-2023-top-10-insights/ Bueter R. Research Guides: Predatory Publishing: Home. Himmelfarb Health Science Library. Accessed May 29, 2024. https://guides.himmelfarb.gwu.edu/PredatoryPublishing/Home

Sources:

  1. Yup K. How Scientific Publishers’ Extreme Fees Put Profit Over Progress. Published online May 31, 2023. Accessed May 6, 2024. https://www.thenation.com/article/society/neuroimage-elsevier-editorial-board-journal-profit/
  2. Miglani J. Apple Sales And Profits Analysis For FY 2023 — Top 10 Insights. Forrester. Published November 21, 2023. Accessed May 6, 2024. https://www.forrester.com/blogs/apple-sales-and-profits-analysis-for-fy-2023-top-10-insights/
  3. Bueter R. Research Guides: Predatory Publishing: Home. Himmelfarb Health Science Library. Accessed May 29, 2024. https://guides.himmelfarb.gwu.edu/PredatoryPublishing/Home

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Three male doctors in white coats in a black and white photo taken in 1892
Dr. William Coley (center), public domain photo from https://commons.wikimedia.org/wiki/File:William_Coley_1892.jpg

May is Melanoma Awareness Month, which serves as an annual reminder to visit a dermatologist regularly for a skin check. Melanoma affects every skin tone. Visit Himmelfarb's collection, Diversity in Dermatology, to explore our library resources on this topic.

This year, let’s go back in time to learn about the origin of one tremendous contemporary advance in the treatment of malignant melanoma -- immunotherapy -- and learn about a new development coming for patients diagnosed with melanoma.

Dr. William Coley (1862-1936) was a bone surgeon and cancer researcher who spent his career at the New York Cancer Hospital. At the time, cancers were commonly treated with amputation. Coley’s young patient, 17 year old Elizabeth Dashiell, presented with an aggressive sarcoma in her hand. Despite an amputation, her cancer had metastasized and she died ten weeks later. Coley began to comb through hospital records, and found a patient who had had four recurrences of an inoperable sarcoma, whose disease had gone into remission when he developed a superficial streptococcal infection of the skin. Coley managed to locate the patient, who did not present with any clinical evidence of malignancy. He also found a number of observational publications connecting this particular skin infection with positive outcomes for sarcoma patients.

Cover of a medical monograph from 1914
The Treatment of Malignant Inoperable Tumors, by William B. Coley, MD (1914)

Coley began intentionally inducing this skin infection in his cancer patients, despite the fact that antibiotics were not yet available to help control infections. His practice is of course shocking and unethical in the light of our contemporary understanding of medical ethics. Additionally, the specific infection, erysipelas, was difficult to induce in patients, some of whom never developed the infection, and some of whom were injected repeatedly in the attempt to induce it. Having achieved some results with his initial attempts, Coley began using a heat-killed version of the infection, combined with one other toxin (which is known to us today as Serratia marcescens) to increase the virulence, and in turn, patients’ immune responses. This combination came to be known as “Coley’s toxins.” A summary of the patients treated with Coley’s toxins prior to 1940 shows that 22 soft-tissue sarcoma patients and 8 lymphoma patients were found to be free of clinical evidence of disease for a period of at least 20 years. (Starnes, 1992). Results for other types of cancers varied, but were not nearly as dramatic. You can read Coley’s 1914 report on his treatment of patients with toxins in its entirety online.

The concept of inducing an immune response in patients to address malignancies also underlies the pioneering work done by contemporary researcher James Allison, for which he shared the 2018 Nobel prize with Tasuku Honjo, for their work on immunotherapy. Allison’s work is chronicled in the documentary Breakthrough, which is available to stream on a number of platforms. Immune checkpoint therapy stimulates the patient’s immune system by blocking inhibitory checkpoints, in order to enable T cells to attack the tumor. Currently, immune checkpoint inhibitors which target the molecules CTLA4, PD-1, and PD-L1 are approved. The very first immune checkpoint therapy, ipilimumab, was approved in 2011 for the treatment of melanoma; since then, seven additional immune checkpoint inhibitors have been approved for use in the treatment of an ever-increasing number of cancers.

Research is ongoing towards the development of melanoma vaccines, which also build on the basis of activating patients’ own immune systems. The April 2024 issue of Cancer Research contains a brief comment on the growing body of evidence for vaccines tailored to specific tumor mutations, noting that progress has accelerated and increased during the past five years. (Fritsch & Ott, 2024) 

While the ultimate goal is to prevent patients from developing melanoma in the first place, the results of research are leading to exciting and unprecedented outcomes for patients who have the disease. Dr. Coley’s early work with the immune system of cancer patients reminds us that pioneering ideas may come before their time and before the technology exists to support them, but may nonetheless lead to unimaginable and positive outcomes centuries later.

References

Coley, W. B. The Treatment of Malignant Inoperable Tumors with the Mixed Toxins of Erysipelas and Bacillus Prodigiosus : With a Brief Report of 80 Cases Successfully Treated with the Toxins from 1893 to 1914 / by William B. Coley. M. Weissenbruch, 1914; 1914.

Fritsch, E. F., & Ott, P. A. (2024). Personalized Cancer Vaccines Directed against Tumor Mutations: Building Evidence from Mice to Humans. Cancer research, 84(7), 953–955. https://doi.org/10.1158/0008-5472.CAN-24-0565

Starnes C. O. (1992). Coley's toxins in perspective. Nature, 357(6373), 11–12. https://doi.org/10.1038/357011a0

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Picture of a medical student of Asian decent taking a history from a patient with long, curly red hair.
Photo by EdTech Stanford University (CC BY-NC-ND-2.0 DEED license)

It’s officially clerkship season! Third-year medical students started clerkships during the past few weeks, so this is a great time to remind you that Himmelfarb Library has some great sources to help you get through clerkships!

A great place to start is our MS3 Clerkship Guide! This guide is packed with resources to help you during each of the six 3rd-year clerkships: medicine, OB/GYN, pediatrics, primary care, psychiatry, and surgery. Each clerkship tab includes:

  • Best Bets: The top 2-3 full-text resources for your searches
  • Key Textbooks: The best textbooks for education and study
  • Mobile/Handheld: Apps for your phone or tablet so you can access information 24/7
  • Recommended Resources: Additional sites and tools recommended by clerkship directors
  • Research Articles: Links to PubMed and MEDLINE
  • Shelf Prep Materials: Books and question banks to help you prepare for the shelf exam
  • Clerkship Contacts: Names and contact information for clerkship directors and clerkship coordinators.

You’ll also find information about the Electronic Health Record systems used at your clerkship sites.

Are you looking to find specific types of resources that you can count on during each clerkship? Check out the following list of resources!

Drug Information - Choosing the right medication, dosage, drug interactions, contraindications, and drug coverage:

  • LexiDrug (aka LexiComp): Clinical drug information with integrated access to multiple drug databases plus access to Trissel's IV Compatibility, drug interaction checker, drug I.D., patient education, calculators, and additional clinical tools. Includes access to adult, pediatric, and neonatal drug information, pharmacogenomics, lab tests and diagnostic procedures, toxicology, and drug allergy and idiosyncratic reactions.
  • NatMed Pro (aka Natural Medicines): Supports evidence-based alternative therapy decision-making including 1,400+ natural ingredient and alternative therapy monographs, and 185,000+ commercial products. Searchable by scientific, common, or brand name; includes interactive tools for safety, effectiveness, and interactions. 
  • ClinicalKey: Search the Drug Monographs section for drug and dosing information to guide treatment.
  • DynaMed Drugs A-Z: Click on Drugs A-Z or the Drug Interactions in the top menu. 
  • Epocrates+: Click on the Briefcase + Icon on the left side of the screen to find tools including Drugs, Interaction Check, Pill ID, etc.

Differential Diagnosis - Creating your Ddx using reputable sources:

  • DynaMed: When looking at a condition in DynaMed, there is a Differential Diagnosis area in the Diagnosis area (on the left side menu).
  • Epocrates+: Like DynaMed, there's a Differential Diagnosis area in the Diagnosis area on the left side menu.

Evidence-Based Guidelines - Finding current practice guidelines to drive your assessment and plan:

  • DynaMed: Check out the Guidelines & Resources area towards the bottom of the left-side menu.
  • Epocrates+: Check out the Guidelines area (under References) towards the bottom of the left-side menu.
  • PubMed: If you use Himmelfarb's link to PubMed, you can use our filters on the left side of the search results page to limit your results by Practice Guidelines.
  • ClinicalKey: Click on the "Guidelines" area to search for clinical guidelines from leading organizations.

As you move into your fourth-year clerkships, remember our MS4 Clerkship Guide! This guide has the same great information as the MS3 Clerkship Guide but is specific to anesthesiology, neuroscience, emergency medicine, and pediatric emergency medicine clerkships.

Access Note:

On Monday, May 20, 2024, Himmelfarb Library, in partnership with GW Libraries and Academic Innovation, changed the underlying system that provides access to our online collections (including ebooks, databases, and journals). We’ve worked hard to make this transition seamless with only minor changes. However, if you experience issues accessing any of the resources mentioned above, please let us know so we can fix the issue. To let us know about a problem with a resource, or if you have questions about access, reach out to himmelfarb@gwu.edu or Ask A Librarian. If you’d like to learn more about this change, read our recent blog post.

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Going to the doctor can be an anxiety-inducing experience. Regardless of how comfortable one is with their medical provider, the prospect of test results bearing bad news can make a routine visit understandably nerve-wracking. 

But what if one’s apprehension regarding medical care was due to other reasons? What if going to the doctor meant being called the wrong name and pronouns for the entire visit? What if your visit led to being grilled about your life and hobbies as if they’re to blame for whatever ails you? What if you had to change how you looked or dressed to get treatment?

Sadly, these experiences are not uncommon for adults who identify as LBGT. According to a new survey out of the Kaiser Family Foundation (KFF), one third of adults who identify as LBGT have experienced discrimination when they are treated by a health care provider. Negative experiences included but were not limited to:

  1. A provider assuming something about them without asking (1).
  2. A provider implying or suggesting they were to blame for a health problem (1).
  3. A provider ignoring or rejecting a request or question (1).

These negative experiences make patients less likely to seek care and can impact their health as a result. Even when LBGT adults continue to seek care despite these negative experiences, discrimination can lead to increased levels of anxiety or distress, which in turn can contribute to mental health conditions like depression or anxiety. Given that 46% of  LBGT adults report being unable to receive mental health services when they needed them in the last three years, this only worsens existing issues (1). 

LBGT patients are people, just like anyone else. Thankfully, there are things practitioners can do to provide a more welcoming attitude to  LBGT patients. 

  • Don’t assume one’s legal name and gender markers are what they use. Ask patients what they wish to be called by and what pronouns they want you to use. 
  • Don’t make assumptions: Never assume something about a patient just because they are LBGT. 
  • Have material in your office or medical facility that identifies your practice as a safe space. This can include patient materials about health concerns that disproportionately impact LBGT individuals, having a private policy on display, and showcasing rainbow stickers or signs that state the area is a safe space (4). 
  • Ensure your intake forms are inclusive. There are examples online one can use as templates like those available from Queering Medicine (3). 
  • Explicitly use inclusive language and images both in the office and on all social media. 

As pride month approaches, let’s work to ensure medicine is welcoming to all our patients, regardless of who they are. 

1.Survey: LGBT Adults Are Twice as Likely as Others to Say They’ve Been Treated Unfairly or with Disrespect by a Doctor or Other Health Care Provider. KFF. Published April 2, 2024. Accessed May 20, 2024. https://www.kff.org/racial-equity-and-health-policy/press-release/survey-lgbt-adults-are-twice-as-likely-as-others-to-say-theyve-been-treated-unfairly-or-with-disrespect-by-a-doctor-or-other-health-care-provider/

2. Queering Medicine - Intake Form Guidance for Providers. Queering Medicine. Published July 8, 2021. Accessed May 20, 2024. https://www.queeringmedicine.com/resources/intake-form-guidance-for-providers

3.  Daniel H, Butkus R. Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians. Ann Intern Med. 2015;163(2):135-137. doi:10.7326/M14-2482

4. Bourns A, Kucharski E, Peterkin A, Risdon C, eds. Caring for LGBTQ2S People : A Clinical Guide. Second edition. University of Toronto Press; 2022.

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GW graduates throwing graduation caps in the air with the Washington Monument in the background.

Congratulations to the Class of 2024! This weekend, GW Commencement will celebrate the Class of 2024 in ceremonies and celebrations spanning the entire weekend! The staff of Himmelfarb Library would like to extend our heartfelt congratulations to GW Nursing, GWSPH, and SMHS graduates! It has been an absolute joy to work with you and watch you learn, grow, and navigate your academic and research interests during your time at GW! We wish you the best as you transition into the next phase of your careers or future educational pursuits.

Even if this is the end of your GW journey, don’t forget that we’re still here for you! Be sure to check out GW’s E-Resources for Alumni! 

We hope that as you look back at your time at GW and Himmelfarb you’ll remember us fondly, take pride in all that you learned, and cherish the bonds of friendships you made here. We are proud of all you’ve accomplished! We wish each of you the best in your future endeavors! 

Congratulations, Class of 2024!

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Fingers with arthritis resting on a blue cushion
Fingertip arthritis - DIP joint, by handarmdoc on Flickr, licensed under Creative Commons

May was designated as Arthritis Awareness Month by Congress and the President in 1972. An estimated 53.2 million US adults (21.2%) reported being diagnosed with some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia, in response to the CDC’s National Health Interview Survey (Fallon et al., 2023). There are numerous types of arthritis. Because of its prevalence, as well as the financial impact of the various forms of arthritis – for the year 2017, the CDC estimated that osteoarthritis was the second most costly condition treated at US hospitals. Let’s look at a couple of recently published articles examining the impacts of arthritis on population health.

When we consider a condition that is as common within the population as arthritis, and as costly to treat, health disparities are a concern. In a brief report in the July 2023 issue of Arthritis Care & Research, researchers examined healthcare utilization by patients diagnosed with rheumatoid arthritis (RA) or osteoarthritis (OA), focusing on whether these patients live in rural/isolated, largely rural, or urban locations (Desilet et al., 2023) The study was based on questionnaires filled out by over 37,000 RA patients and over 8200 OA patients. A majority of the RA patients responding (74.5%) lived in a rural area, and this proportion was similar for OA patients. By analyzing questionnaire responses indicating healthcare utilization over six months, the research team found that among RA patients, urban residents were more likely to utilize healthcare provided by some type of professional than their rural counterparts. The same was true for OA patients. Patients with both types of arthritis fare better under the care of a rheumatologist, and in rural areas, access to this expertise is more limited. The findings of this study suggest the importance of extending access to rheumatology care in rural communities that are not currently well-served.

A forthcoming article in the journal Rheumatology (d'Elia et al, 2024) reports on a study of symptoms in a primary care database, which tracked prodromal (early) symptoms for the 24 months prior to diagnosis, in over 70,000 RA patients, over a period of 18 years. When analyzed demographically and socioeconomically, the findings were that symptoms were reported differently in new-onset RA across ethnic groups. While some of this may be accounted for due to the way symptoms are reported by patients, delayed diagnosis and treatment is another potential factor. 

Another interesting finding of this study was the fact that of the symptoms reported, there was a discrepancy between the most common symptoms of RA (e.g. painful small joints of the hands, present in over half of RA patients) and the percentage of patients in the database who were reporting this symptom (10.2%). This may point to under-coding of symptoms, which would have an impact on treatment. Future studies may build on these findings delving more deeply into the differences in RA symptoms among different ethnic groups, including their underlying causes and their clinical implications.

Arthritis affects a large proportion of the population in the US and worldwide, and the burden falls more heavily on those who struggle to access care, as well as those who are not served equitably within healthcare settings. This Arthritis Awareness Month, consider how you might be able to contribute to our understanding of these disparities and help to cure them.

References

Fallon, E. A., Boring, M. A., Foster, A. L., Stowe, E. W., Lites, T. D., Odom, E. L., & Seth, P. (2023). Prevalence of Diagnosed Arthritis - United States, 2019-2021. MMWR. Morbidity and mortality weekly report, 72(41), 1101–1107. https://doi.org/10.15585/mmwr.mm7241a1

Desilet, L. W., Pedro, S., Katz, P., & Michaud, K. (2023). Urban and Rural Patterns of Health Care Utilization Among People With Rheumatoid Arthritis and Osteoarthritis in a Large US Patient Registry. Arthritis Care & Research (2010). https://doi.org/10.1002/acr.25192

d'Elia, A., Baranskaya, A., Haroon, S., Hammond, B., Adderley, N. J., Nirantharakumar, K., Chandan, J. S., Falahee, M., & Raza, K. (2024). Prodromal symptoms of rheumatoid arthritis in a primary care database: variation by ethnicity and socioeconomic status. Rheumatology (Oxford, England). Advance online publication.

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Image of a peach background with white scrabble tiles spelling out the word "Login" in the center of the image.
Photo from Pexels by Miguel Á. Padriñán 

On Monday, May 20, 2024, Himmelfarb Library, in partnership with GW Libraries and Academic Innovation (GW LAI), will change the underlying system that provides access to our online collections including our ebooks, databases, and journals. This change will be seamless for most users as the new system (OpenAthens) uses the same GW Single Sign-On login method used by our current system (EZproxy).

Changes you can expect to see when accessing Himmelfarb’s e-resources include:

  • When accessing a subscription resource through the library, you may be prompted to log in with your GW UserID and password, even if you are on campus or connected to the VPN.
  • If you’ve recently logged in to another resource via GW’s Single Sign On, you may be able to access resources without logging in again.
  • Many publishers offer direct OpenAthens login from their resources by providing an interface that allows users to choose their institution and select a Single Sign On option for access (for example: JAMA’s OpenAthens access)

For GW faculty, instructional designers, and staff who maintain links to course materials in Blackboard and other course management systems, links that use the older EZproxy system will need to be updated. However, additional time is available to make this transition. 

Here are some key points to know:

  • EZproxy links continue to work and users will be forwarded directly to the linked resource.
  • Link forwarding will remain in place for one year to allow for time to update links to OpenAthens. 
  • Most Blackboard links will be updated automatically via a GW LAI project.
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For additional support related to access and durable linking, see the following resources:

Published on
An image from NAMI (the national alliance on mental illness) that says "small steps can lead to big progress in mental health"

When we talk about illnesses, one of the many things that might first come to mind is symptoms. A friend complains about a sore throat, a fever and white patches on the tonsils? We might advise them to go see a doctor about a strep test. A child complains of a headache and starts sporting a rash made of tiny red dots? It wouldn’t be outrageous to consider chicken pox the culprit. Of course, disease presentation can vary and many illnesses share symptoms, but at the end of the day, many illnesses provide a visible clue that something is wrong. 

Mental illness is far less visible to the naked eye. There is no rash that accompanies depression, nor is there a wheezing cough that comes with anxiety. The symptoms of mental illness, as the name implies, are often found in thought patterns and behaviors of those who have them. And while these thought patterns and behaviors can be observed, it often far more than a passing glance to properly diagnose someone. The average delay in treatment after a person starts showing symptoms of a mental illness is 11 years (1). 

Just because the symptoms of mental illness might not be as clear as other illnesses, they are just as debilitating. 

While mental illness may be hard to spot, that doesn’t mean it isn’t common. While one in five adults in the United States experience mental illness, only half of them receive treatment (1). The statistics for children are even more dire: nearly 70% don’t receive treatment (2).  

Treatment in itself is often difficult to access, with long wait lists to see a provider and spotty insurance coverage among other issues. 

To help raise awareness about mental illness, May is Mental Health Awareness Month. The National Alliance on Mental Illness (NAMI) is celebrating with the campaign “Take the Moment” which aims to highlight programs NAMI provides for patients and their loved ones dealing with mental illness, as well as working to erase stigma around mental health. Here at GW, our Resiliency and Well-Being Center has its own list of topics it will be discussing both this month and the month of June.

  1. Mindfulness and Stress Management (May 8-21)
  2. Healthy Eating (May 22 - June 4)
  3. Restorative Sleep (June 5-18)
  4. Physical Activity: Improving Movement  and Exercise (June 19 - July 2)

The center will also be offering classes about practicing mindfulness both online and in person. 

Here are some ways you can decrease stigma around mental illness: 

  • Language really matters. Terms like “bipolar” and “OCD” can be thrown around as slang for being “moody” or “neat” respectively, despite being terms for serious mental conditions. Don’t perpetuate stigma and stereotypes about these conditions: use different words rather than conditions to describe what you mean. 
  • Reach out to others: It’s okay to need help. If you haven’t been feeling well, you can find help. The school’s Resiliency and Well-Being Center provides resources to support those who are coping. There are also plenty of national resources one can use: NAMI offers a variety of resources in-house and also curates outside resources for those who either need help or want to help someone else.
  • Know mental health is for everyone: stigma about mental health implies that those who have mental illness are simply “not trying hard enough” or “seeking attention.” This couldn’t be further from the truth: mental health conditions are caused by a variety of factors including genetics and environment.  

1. Mental Health Awareness Month. NAMI. Accessed May 6, 2024. https://www.nami.org/get-involved/awareness-events/mental-health-awareness-month/

2. House TW. A Proclamation on National Mental Health Awareness Month, 2024. The White House. Published April 30, 2024. Accessed May 6, 2024. https://www.whitehouse.gov/briefing-room/presidential-actions/2024/04/30/a-proclamation-on-national-mental-health-awareness-month-2024/

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