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Rollin FG, Lee-Rey S, Wong-Serrano E, Habert S, Tejani M. The Importance of Naming Structural Racism as a Root Cause of Racial Inequities in Breast Cancer Outcomes. Clin Breast Cancer 2024; 24:261-262. [PMID: 38246834 DOI: 10.1016/j.clbc.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Affiliation(s)
- Francois G Rollin
- Department of Medicine, Emory University School of Medicine, Atlanta, GA.
| | | | | | - Sydney Habert
- Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Mehul Tejani
- Department of Medicine, Emory University School of Medicine, Atlanta, GA
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Ghosh AK, Azan A, Basu G, Bernstein J, Gillespie E, Gordon LB, Krishnamurthy S, LeFrancois D, Marcus EN, Tejani M, Townley T, Rimler E, Whelan H. Building Climate Change into Medical Education: A Society of General Internal Medicine Position Statement. J Gen Intern Med 2024:10.1007/s11606-024-08690-1. [PMID: 38424345 DOI: 10.1007/s11606-024-08690-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
Building expertise in climate and planetary health among healthcare professionals cannot come with greater urgency as the threats from climate change become increasingly apparent. Current and future healthcare professionals-particularly internists-will increasingly need to understand the interconnectedness of natural systems and human health to better serve their patients longitudinally. Despite this, few national medical societies and accreditation bodies espouse frameworks for climate change and planetary health-related education at the undergraduate (UME), graduate (GME), and continuing (CME) medical education level. As a community of medical educators with an enduring interest in climate change and planetary health, the Society of General Internal Medicine (SGIM) recognizes the need to explicitly define structured educational opportunities and core competencies in both UME and GME as well as pathways for faculty development. In this position statement, we build from the related SGIM Climate and Health position statement, and review and synthesize existing position statements made by US-based medical societies and accreditation bodies that focus on climate change and planetary health-related medical education, identify gaps using Bloom's Hierarchy, and provide recommendations on behalf of SGIM regarding the development of climate and planetary health curricula development. Identified gaps include (1) limited systematic approach to climate and planetary health medical education at all levels; (2) minimal emphasis on learner-driven approaches; (3) limited focus on physician and learner well-being; and (4) limited role for health equity and climate justice. Recommendations include a call to relevant accreditation bodies to explicitly include climate change and planetary health as a competency, extend the structural competency framework to climate change and planetary health to build climate justice, proactively include learners in curricular development and teaching, and ensure resources and support to design and implement climate and planetary health-focused education that includes well-being and resiliency.
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Affiliation(s)
- Arnab K Ghosh
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 E 70th St, New York, NY, 10065, USA.
| | - Alexander Azan
- Division of General Internal Medicine, Department of Medicine, NYU Grossman School of Medicine, 550 1ST Ave, New York, NY, 10016, USA
| | - Gaurab Basu
- Department of Medicine, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge Street25 Shattuck Street, CambridgeBoston, MAMA, 0213902115, USA
| | - Joanna Bernstein
- Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Elizabeth Gillespie
- School of Medicine, University of Colorado Anschutz Medical Campus, Leprino Building, 4th Floor, 12401 East 17th Avenue, Aurora, CO, 80045, USA
| | - Lesley B Gordon
- Department of Medicine, Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA
| | - Sudarshan Krishnamurthy
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA
| | - Darlene LeFrancois
- Division of General Internal Medicine, Department of Medicine, Montefiore Medical Center, 111 East 210th St, Bronx, NY, 10467, USA
| | - Erin N Marcus
- Division of General Internal Medicine, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL, 33136, USA
| | - Mehul Tejani
- Division of General Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30332, USA
| | - Theresa Townley
- Division of General Internal Medicine, Creighton University School of Medicine Omaha, 7500 Mercy Road, Omaha, NE, 68124, USA
| | - Eva Rimler
- Division of General Interval Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA
| | - Heather Whelan
- Division of Hospital Medicine, Department of Medicine, San Francisco VA Medical Center, University of California San Francisco, San Francisco, CA, 94121, USA
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Weppner WG, Tejani M. Improving Health Care Systems' Publicly Available Plans to Address Climate Change. JAMA Netw Open 2023; 6:e2321370. [PMID: 37338909 DOI: 10.1001/jamanetworkopen.2023.21370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Affiliation(s)
- William G Weppner
- University of Washington, Seattle, Washington
- Department of Veterans Affairs Medical Center, Boise, Idaho
| | - Mehul Tejani
- Emory University School of Medicine, Atlanta, Georgia
- Grady Health System, Atlanta, Georgia
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Azzi G, Tavallai M, Aushev V, Koyen Malashevich A, Botta G, Tejani M, Hanna D, Krinshpun S, Malhotra M, Olshan P, Jurdi A, Aleshin A, Kasi P. 90P Feasibility of using tumor-informed circulating tumor DNA (ctDNA)-based testing for patients with anal squamous cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Fakih M, Tejani M, Ren X, Landes D, Werneke S, Curtis K, Hecht J. 439TiP A phase II (ph2), randomized study of magrolimab with bevacizumab and FOLFIRI in previously treated patients with advanced inoperable metastatic colorectal cancer (mCRC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Titanji BK, Tejani M, Farber EW, Mehta CC, Pace TW, Meagley K, Gavegnano C, Harrison T, Kokubun CW, Negi SD, Schinazi RF, Marconi VC. Cognitively Based Compassion Training for HIV Immune Nonresponders-An Attention-Placebo Randomized Controlled Trial. J Acquir Immune Defic Syndr 2022; 89:340-348. [PMID: 34879006 PMCID: PMC8837678 DOI: 10.1097/qai.0000000000002874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Chronic inflammation is associated with increased morbidity and mortality for people with HIV (PWH). Psychological stress is an important contributor to this chronic inflammation. We hypothesized that a cognitively based compassion training (CBCT) approach could reduce inflammation and psychological stress in immune nonresponder PWH. DESIGN An attention-placebo randomized controlled trial design to evaluate the acceptability of CBCT among PWH and its effects on key aspects of stress and immune function compared with an active-attention control group (NCT02395289). METHODS This study was conducted at an HIV clinic in Atlanta, Georgia. Eligible individuals determined by (1) adherence to antiretroviral therapy for at least a year, (2) virologic suppression; and (3) stable CD4+ T-cell counts <350 cells/μL were randomized in a 2:1 ratio to either CBCT or control in 2 study periods: April-May, 2016, and September-December, 2016. Psychological measures and inflammatory biomarkers associated with HIV disease progression (IL-1β, TNF-α, sCD14, IL-6, and IL-10) were obtained for all study participants at baseline and at the time of study completion. RESULTS We found a significant association between CBCT practice time engagement and fold reduction in IL-6 and TNF-α levels. There was no association between CBCT practice time and other biomarkers markers assessed (IL-1β, sCD14, and IL-10). These changes were coincident with significant increases in self-reported psychological well-being and HIV disease acceptance and in benefits for CBCT participants. We also observed fewer instances of virologic failure for those in the CBCT arm compared with controls. CONCLUSIONS CBCT is a novel and feasible nonmedication-based intervention that could reduce inflammation and psychological stress in PWH.
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Affiliation(s)
- Boghuma K. Titanji
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA
| | - Mehul Tejani
- Division of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Eugene W. Farber
- Emory University School of Medicine Department of Psychiatry and Behavioral Sciences, Atlanta, GA
| | - C. Christina Mehta
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta GA
| | - Thaddeus W. Pace
- Community and Systems Health Science Division, University of Arizona, Tuscon, AZ
| | - Kathryn Meagley
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA
| | - Christina Gavegnano
- Department of Pathology and Laboratory Medicine, Emory School of Medicine, Atlanta, GA
| | - Timothy Harrison
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Caroline W. Kokubun
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Satya Dev Negi
- Center for Contemplative Science and Compassion-Based Ethics, Emory University, Atlanta, GA
| | - Raymond F. Schinazi
- Center for AIDS Research, Laboratory of Biochemical Pharmacology, Department of Pediatrics, Emory School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA
| | - Vincent C. Marconi
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA
- Department of Global Health, Rollins School of Public Health, Emory University Atlanta
- Emory Vaccine Center, Emory University, Atlanta, GA
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Klempner S, Sirard C, Chao J, Chiu V, Mahalingam D, Uronis H, Kagey M, Baum J, Dayyani F, Song J, Wang J, Iqbal S, Tejani M, Sonbol M, Scott A, Wainberg Z, Ajani J. 1384P DKN-01 in combination with tislelizumab and chemotherapy as a first-line therapy in unselected patients with advanced gastroesophageal adenocarcinoma (GEA): DisTinGuish trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Tang CC, Draucker C, Tejani M, Von Ah D. Symptom experiences in patients with advanced pancreatic cancer as reported during healthcare encounters. Eur J Cancer Care (Engl) 2018; 27:e12838. [DOI: 10.1111/ecc.12838] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 01/09/2023]
Affiliation(s)
- C.-C. Tang
- National Taiwan University; Taipei Taiwan
| | - C. Draucker
- Angela Barron McBride Endowed Professorship in Mental Health Nursing; Indiana University School of Nursing; Indianapolis IN USA
| | - M. Tejani
- University of Rochester Medical Center; Rochester NY USA
| | - D. Von Ah
- Department of Community & Health Systems; Indiana University School of Nursing; Indianapolis IN USA
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Egyud M, Jackson J, Yamada E, Ståhlberg A, Filges S, Krzyzanowski P, Nielsen G, Tejani M, Zhou Z, Pennathur A, Luketich J, Litle V, Stein L, Godfrey T. F-044DETECTION OF TUMOUR-SPECIFIC MUTATIONS IN PLASMA DEOXYRIBONUCLEIC ACID: A POTENTIAL OESOPHAGEAL ADENOCARCINOMA BIOMARKER. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yang X, Tejani M, Jiang X, Elder E, Dhabaan A. SU-F-T-446: Improving Craniospinal Irradiation Technique Using Volumetric Modulated Arc Therapy (VMAT) Planning and Its Dosimetric Verification. Med Phys 2016. [DOI: 10.1118/1.4956631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Park P, Roper J, Fox T, Schreibmann E, Elder E, Tejani M, Curran W, Crocker I, Dhabaan A. SU-E-T-513: Probabilistic Approach to Plan Evaluation in Linac-Based Stereotactic Radiosurgery: A Patient Specific Uncertainty Analysis. Med Phys 2014. [DOI: 10.1118/1.4888846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Betzel G, Tejani M, Dhabaan A. SU-E-T-307: Susceptibility of SBRT to Delivery Uncertainties Using RapidArc Or Dynamic IMRT. Med Phys 2014. [DOI: 10.1118/1.4888639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Park P, Schreibmann E, Fox T, Roper J, Elder E, Tejani M, Crocker I, Curran W, Dhabaan A. TH-C-BRD-06: A Novel MRI Based CT Artifact Correction Method for Improving Proton Range Calculation in the Presence of Severe CT Artifacts. Med Phys 2014. [DOI: 10.1118/1.4889604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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