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Cardiology andHealthy Living
Mini-Med School, Feb 2019Wednesday, February 20th , 2019
Mini-Med Lecture 3
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Cardiology and Healthy LivingPatient Centered Medicine Topic: Cultural HumilityMini-Med Spring 2019
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Patient Centered Medicine Topic:
Cultural Humility
Cardiovascular Anatomy and
Physiology
Common Illnesses
Healthy Habits for Cardiovascular
Health
Part 1 Part 2 Part 3
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● Muscular organ located between the lungs
● Pumps blood throughout the body via blood vessels○ Takes ONE minute to pump all
your blood!● Pumps blood out via aorta and
pulmonary arteries● Receives blood via vena cava and
pulmonary veins
Heart
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The ‘highways’ of the circulatory system
Systemic Arteries● oxygenated
from the heart● Transports nutrients
and hormones to tissues
● High pressure maintains blood flow
Systemic Veins● Carry deoxygenated
blood to the heart● Transports waste
materials from tissues
● Low pressure
Capillaries● Network of vessels
connecting arteries and veins
● Site of oxygen, nutrient and waste exchange
● Highly branched to increase blood diffusion
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Exception!
● pulmonary arterydeoxygenated
● pulmonary vein oxygenated
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Questions?
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Cardiovascular Disease in the United States
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(Not so) Fun Fact...
●
●○○○
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Atherosclerosis
High Blood Pressure
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What is blood pressure?●
●
●○ Systolic ≤
○ Diastolic ≤
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Hypertension● ≥ 130/80 mmHg●●
○○
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●
●
●
Case: Cardiovascular Emergency 1
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Stroke ●
● permanent damage
○ Brain cells do not regenerate →
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Types of Stroke
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Hemorrhagic Stroke
Ischemic Stroke
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Detecting a Stroke
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●
●
●
Case: Cardiovascular Emergency 2
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Myocardial Infarction●●
●
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The road to a heart attack...
●
coronary circulation
●
● coronary artery disease
●
Myocardial Infarction (Heart Attack)19
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Risk Factors for Cardiovascular Disease
GENETICS●●
○○
○
●
COMORBIDITIES●●
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Modifiable Risk Factors
● Smoking
● High sodium diets
● Excess alcohol intake● Stress● Obesity
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Questions?
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So how can we remain healthy?
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A healthy dietEat more of:
● Complex carbs:
● Protein:
● Mono/polyunsaturated fats
●
●●
Eat less of:● Simple carbs
● Saturated/trans-fats
●
●
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Aerobic exercise
●
●
●
●
●
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But let’s be real...
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● Don’t do it alone ○○
● Have cheat days○○
● Read nutritional labels on groceries
● Exercising
○
○
○
So what can you do?
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Questions?
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Cultural Humility in Healthcare
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“
30Prasad SJ, Nair P, Gadhvi K, Barai I, Danish HS, Philip AB. Cultural humility: treating the patient, not the illness. Med Educ Online. 2016;21:30908. Published 2016 Feb 3. doi:10.3402/meo.v21.30908
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What is Cultural Humility in Healthcare?• A set of tools, not a set of stereotypes,
••
••
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A Meeting Of Experts
•
ask, listen, and learn •
•
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An example of why cultural humility matters: Najma’s Story
Najma’s Story, https://www.youtube.com/watch?v=L_9R_MtZ6bA
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Exercise: Najma’s Story
1.
2.
3.
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Some examples of how the providers’ lack of cultural humility negatively affect Najma.
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Najma’s Understanding American Healthcare Team’s Understanding Impact on Najma’s Care
Only sick individuals need to see the doctor Healthy patients should have regular check ups Najma does not understand why she needs to schedule doctor’s appointments/follow up
No set appointment times: the doctor will see you when you get there and when they are free
Appointment times are rigid and can be cancelled if patient is late
Receptionist was angry with Najma and called her selfish. Furthered Najma’s confusion and negative experience.
Medical records are not usually kept – forms are unusual.
Healthcare forms must be filled out to gather relevant patient information
Najma thought these questions may be for the police and might lead to trouble. Left Najma feeling isolated since she has no one to help her, especially since her husband’s death.
Patients see the doctor. Other healthcare team members are unusual.
Patients interact with many different parts of the healthcare team, and typically with the doctor the least
Najma was confused as to who her actual doctor was, believing it may be the nurse because they spent the most time together.
Doctors in America purposely keep patients waiting as the “powerful often keep subordinates waiting”
Lag between patients for physicians is common Najma felt disrespected and an unequal power dynamic between her and her doctor
Bloodletting is sometimes a treatment in Somalia for illness
Physicians order blood draws and labs to diagnose various conditions and as part of wellness exams
Najma thought the doctor must believe she is sick because she was taking her blood. She did not feel comfortable asking more questions.
For a healthy person, a good Somalian diet does not need to be changed.
To treat anemia, having a diet high in iron is beneficial. Food examples provided to patients typically involve foods consumed in American diets
Najma throws away the food card as all the foods on it were foreign and she had no idea to cook them. Since she also “felt well and ate good food already”, she felt she did not need it.
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Answer: How could the providers have worked with Najma to give her the care she deserves?
• ASKED, LISTENED, LEARNED
•
they just need to ask her!
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Answer: What could have been done differently?•
•
•••
••
••••
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After acting with cultural humility, Najma’s care-team was able to learn how to better care for her….
Najma’s Story, https://www.youtube.com/watch?v=L_9R_MtZ6bA
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Take Away•
•lifelong
•
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Questions?
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References
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• DallaPiazza, M 2018, Cultural Humility and the Patient’s Perspective of Illness, lecture notes, Health Equity and Social Justice, New Jersey Medical School, delivered August 28 2018.
• Prasad SJ, Nair P, Gadhvi K, Barai I, Danish HS, Philip AB. Cultural humility: treating the patient, not the illness. Med Educ Online. 2016;21:30908. Published 2016 Feb 3. doi:10.3402/meo.v21.30908
• Cultural Competency- For Providers, https://www.youtube.com/watch?v=L_9R_MtZ6bA
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Overview of Oro-Facial Pain and Puzzling Pain
Mini-Med School, Feb 2019Wednesday, February 20th , 2019
Mini-Med Lecture 2
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Stanley Markman, DDS
After I completed my dental training at NYU, School of Dentistry, I spent several months at the
Triboro Division of Queens General Hospital where I treated TB patients for their dental needs.
Thereafter, I spent two years in the United States Air Force treating pilots who were in the
Tactical Air Command. (The US Air Force did not want their pilots to have toothaches while
chasing enemy aircraft.) After I completed my 2 year tour of duty, I opened a dental office, and
have been in private practice ever since. I moved several times as my practice matured.
During my career, I received an appointment as an attending dentist in Newark Beth Israel
Hospital in New Jersey and later was appointed to the staff at NYUCD as an Assistant Clinical
Professor in the Special Care unit. As an advocate of continuing dental education, I obtained
three fellowships: a Fellowship in The Academy of General Dentistry in 1978, a fellowship in The
American College of Dentists in 2006, and a specialty Fellowship in Oro-Facial Pain in 2007. I am
a past president of the Bergen County Dental Society and have been active for many years in the
local and state dental society activities.
As I further perused my educational endeavors, I was awarded a Diplomate of the Board of
Orofacial Pain and a 4th fellowship relating to that same discipline.
Currently, I am a Clinical Associate Professor at Rutgers School of Dental Medicine, instructing
post graduate dental students on the subject of orofacial pain and dental sleep medicine. Part of
my duties is to provide lectures to the post graduate residents relating to subjects of orofacial
pain.