‘Changing Sports Changing Lives’ symposium includes Upstate pediatrician

Participants in the unified wheelchair basketball event held at Nottingham High School.

Participants in the unified wheelchair basketball event held at Nottingham High School.

An adapted sports documentary that premieres at Syracuse University April 28 includes footage from a unified wheelchair basketball event involving Upstate caregivers.

Admission is free to the “Changing Sports Changing Lives” symposium at 4 p.m. April 28 at SU’s Watson Theater in Watson Hall. After the film, a panel will field questions. Upstate developmental pediatrician Nienke Dosa, MD, is part of the panel, along with Peyton Sefick, a graduate assistant at SU. Dosa and Sefick gave an interview about adaptive physical education recently on Upstate’s HealthLink on Air radio program.

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Three governors, one hospital, three cheers

Gov. Nelson Rockefeller and his wife, Happy, tour the new Upstate hospital in 1964. Behind them is are Drs. Carlyle and Cookie Jacobsen.

Governor Nelson Rockefeller and his wife, Happy, tour the new Upstate hospital in 1965. Behind them are Drs. Carlyle and Cookie Jacobsen. Collection of Upstate’s Health Sciences Library.

In our April 3 blog, we described the personal experiences that prepared Upstate President Carlyle “Jake” Jacobsen, PhD to oversee the building of our state-funded hospital at 750 East Adams Street in downtown Syracuse. His Minnesota childhood helped, and so did Jacobsen’s ability to work effectively with three New York State governors: Thomas E. Dewey (served 1943-1954), W. Averell Harriman (served 1955-1958) and Nelson A. Rockefeller (served 1959-1973).

In 1950, Jacobsen was executive dean for medical education at the State University of New York. He met with then-Governor Dewey to discuss the development of SUNY, in particular the development of its medical centers. In 1955, Jacobsen was a guest at the governor’s mansion, then occupied by Averell Harriman, at which time the important decision was made to proceed with construction of the medical center at Syracuse. By 1961, Nelson Rockefeller was in the governor’s office, and Jacobsen invited him to travel to Syracuse to inspect the site for the new state university hospital. Rockefeller returned in 1965 to tour the completed hospital and wrote the following note:

From Nelson Rockefeller: “It affords me the greatest pleasure to be able to congratulate you…on… the dedication of the Upstate Medical Center…the largest single construction enterprise of the State University of New York to be completed so far. You and your associates may well be proud of your leadership and your tenacity in consummating plans for this teaching center…you have rendered services beyond praise for the people of our state.”

And his predecessors sent their congratulations:

From Thomas E. Dewey: “In developing the concept and persuading others to join you in its achievement, you have earned the gratitude of all of us. I congratulate you and the Upstate Medical Center most warmly on this great occasion….I am so happy to know that your great hospital is now open for patients and congratulate you once again on this wonderful achievement and opportunity for service.  With warmest personal regards and every good wish.”

From Averell Harriman: “Your vision, your plans, and your leadership….I am happy to share with you, your faculty colleagues and the citizens of our state, the sense of accomplishment and pride which all of us have in the State Medical Center at Syracuse.”

Signatures of Govs. Dewey, Herriman and Rockefeller. From letters of congratulation written about the opening of Upstate University Hospital.

Signatures of Govs. Dewey, Herriman and Rockefeller. From letters of congratulation written about the opening of Upstate University Hospital.

Special thanks to Patricia Numann MD for providing access to the personal papers of Drs. Carlyle (Jake) and Ellen Cook (Cookie) Jacobsen.

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Chaplain interns graduate noon Thursday

Interns from Upstate’s Clinical Pastoral Education program will graduate at noon, Thursday, April 10 in the Interfaith Chapel of the downtown hospital. The ceremony is open to the public.

Upstate is one of 350 nationally accredited training centers by the Association for Clinical Pastoral Education that offers experiential theological education for seminarians, clergy and qualified laypersons. This group of chaplain interns has been at Upstate since September, serving on inpatient oncology, neurology, orthopedics and pediatric surgery.

 

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50 years ago, air conditioning was a draw for new recruits

This newspaper advertisement is framed and hanging at the Upstate University Hospital at Community campus.

This newspaper advertisement is framed and hanging at the Upstate University Hospital at Community campus.

Spring Career Fair- College MailerThe “entirely new” 300-bed Community Hospital of Greater Syracuse is “completely air conditioned” and “designed for maximum satisfaction of patient and nurse,” says a recruiting advertisement from 1964. It offers nursing salaries ranging from $4,400 to $5,400.

Of course pay rates have risen in 50 years. And, instead of recruits sending in coupons to learn about job opportunities, people interested in working at Upstate are invited to career fairs, such as the one taking place from 10 a.m. to noon Saturday, April 12. Jobs openings are available now for registered nurses, nurse practitioners, physician assistants, surgical technicians, medical office assistants and physical, speech and occupational therapists, and there are positions open in clinical pathology, pharmacy, radiology, respiratory, utilization review, tele-health nursing and the transitional care unit.

Learn about the 50th anniversary of Upstate University Hospital

If you have memories or artifacts related to the construction of Upstate’s downtown and community campus hospitals, please contact the hospital anniversary committee through Susan Keeter at keeters@upstate.edu, 315-464-4834.

 

 

 

 

 

 

 

 

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Centering on diabetes in pregnancy

Obstetrician Unzila Nayeri, MD of Upstate's Regional Perinatal Center (center) talks with patients at a recent Centering Pregnancy class.

Obstetrician Unzila Nayeri, MD of Upstate’s Regional Perinatal Center (center) talks with patients at a recent Centering Pregnancy class. Photo by Susan Kahn.

Pregnant women, some with their partners, gather in a circle with their obstetrician, midwife, a nurse and nutritionist. A chime sounds. The Centering Pregnancy group begins. 

Centering Pregnancy is a program offered in a variety of medical practices throughout the country, bringing together women with similar due dates for group visits. The Regional Perinatal Center at Upstate used grant money from the March of Dimes to launch Centering Pregnancy specifically for pregnant women with diabetes.

“This is a time for us to help women with diabetes meet the challenges of pregnancy and possibly  make some big changes in their lives,” certified nurse midwife Kathleen Dermady says, this includes mothers living with with diabetes and those diagnosed during pregnancy. Diabetes increases the risk in pregnancy, requiring frequent medical visits and close monitoring. Pregnancy hormones decrease the body’s sensitivity to insulin, the hormone  that helps the body process glucose, so that even women who have experience living with diabetes can become frustrated in pregnancy.  

Listen to interview

The moms-to-be who choose to participate attend 10 two-hour Centering sessions before their babies are born. Blood work, sonograms and other tests are scheduled before or after each session. “Moms tell us they learn so much more than they would in an office visit,” Dermady says. The support they feel from other women is important, too.

The sessions include bursts of laugher, some education and warm cups of tea.

Unzila Nayeri, MD talks about the A1C blood test. Because glucose leaves its mark on the red blood cells, this test reveals the average glucose in the last three months. She reminds the women, still in the early months of pregnancy, of the importance of stability. Dermady explains it this way: A car that drives down a bug-infested highway may arrive at its destination — but the imprint of all those bugs will remain on its windshield.

Women with diabetes are at high risk of having difficult labors and deliveries, partly because they are liable to have large babies. This may mean they require a Cesarean section or other interventions. “If we do a good job taking care of sugar levels, we can really reduce these risks,” Nayeri says.

Registered dietitian, Julie Mellen speaks about proper portion sizes and weight gain, saying that the desirable pregnancy weight gain is based on a woman’s pre-pregnancy weight. “What if you are gaining 1 to 2 pounds per week?” she asks before answering: “Your baby is getting too big, too fast.”

Centering leaves time for questions, too, an efficient way of addressing common issues, Dermady says. “Many of the questions they have are questions that all the moms have.” Learn more about Centering Pregnancy by contacting the Regional Perinatal Center Program Coordinator Karen Davis at 315-464-5702.

Listen to an interview with Kathleen Dermady on HealthLink on Air

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Listen to lectures on public health topics all week for National Public Health Week

Celebrate National Public Health Week this week by participating in these activities and events that are open to the public. The lectures on Tuesday through Thursday will be available on line.

* Monday, April 7  from noon to 12:30 p.m. walk a “Monday Mile,” starting in front of Hendricks Chapel on the Syracuse University Campus.

* Monday, April 7  from 12:30 to 1 p.m. registered dietitian Lisa Thomas speaks about Mindful Eating at SU’s Bird Library

* Tuesday, April 8 from 12:30 to 1:30 p.m. Dr. Kaushal Nanavati speaks about “Wellness and Self Care” in room 2231 of Weiskotten Hall on the Upstate campus. (Webinar link: https://www1.gotomeeting.com/register/404465625 ) Nanavati is an assistant professor of family medicine and the director of integrative medicine at Upstate.

* Wednesday, April 9 from noon to 1 p.m. Dr. Donna Bacchi provides “Tips for Keeping Your Food Safe and Yourself Healthy.” She is an associate professor and chair of public health and preventive medicine and the director of the master’s in public health program. Her talk is in room 2510 of Setnor Academic Building on the Upstate campus. (Webinar link: :  https://www1.gotomeeting.com/register/341492769 )

* Thursday, April 10 from 12:15 to 1:15 p.m. Martha Wojtowycz, PhD speaks about “The Affordable Care Act: What Does the Evidence Say?” in room 2231 of Weiskotten Hall. She is an associate professor in obstetrics and gynecology and public health and preventive medicine. (Webinar link: https://www1.gotomeeting.com/register/560303585 )

* Friday, April 11 from noon to 1:15 p.m., try NIA, a mind, body and spirit exercise that incorporates yoga, dance, Tai Chi and martial arts. Instructor Elin Adams leads the class in rooms 3509 and 3510 of the Setnor Academic Building.

* Friday, April 11 from noon to 1 p.m., a panel of local public health leaders will have a discussion in the 9th floor auditorium of Weiskotten Hall.

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Drugs you rub into your skin can be dangerous, too

iStock_000008122420LargeWhen a previously healthy 18-month-old child developed a diaper rash, the toddler’s mother reached for some pain-relieving cream. What she grabbed was a prescription her husband used for neck pain. She rubbed a small amount onto her son’s rash and put him down for a nap.

Within 20 minutes, the child was gasping for breath and unresponsive. An ambulance rushed him to Upstate University Hospital’s pediatric emergency department, where he continued to deteriorate. His heart rate and blood pressure dropped. Doctors inserted a tube in his windpipe to help him breathe.

lessonsThis case was shared in the November issue of the journal, Pediatric Emergency Care. The authors, all health care providers from Upstate, expressed concern that as compound preparations gain popularity, people mistakenly assume they are safer than pills. “This perception and the fact that these are not dispensed in child-proof containers and are often mailed to the patients without pharmacist counseling can lead to increased inadvertent exposures in the pediatric population,” wrote authors, Drs. Ross Sullivan, MD, Michael Holland, MD and Jeanna Marraffa, a doctor of pharmacy at the Upstate Poison Center. Matt Ryzewski, MD was also a co-author; today he is completing a fellowship in neonatal intensive care in Massachusetts.

The skin’s epidermal layer absorbs substances such as pain-relieving cream through diffusion, the speed of which varies depending on the chemical makeup and amount of the substance as well as the condition of the skin.

Poison Center toxicologists Michael Holland, MD, Ross Sullivan, MD, and Jeanna Marraffa, PharmD.

Poison Center toxicologists Michael Holland, MD, Ross Sullivan, MD, and Jeanna Marraffa, PharmD.

The toddler in this case was at particular risk because of his size and his rash. Any open wound on the skin can greatly increase absorption of anything applied to the skin.

“The smaller the child is, the larger the surface area, relative to body weight ratio. As a human grows in volume, so does the surface area, but at a much slower rate,” the authors write. Adults have a small skin surface area-to-weight ratio, compared to infants, who have a large surface area in proportion to size and weight. “Because absorption depends on the amount of surface area exposed to a topical drug, a child will absorb a higher dose per kilogram than an adult.”

The prescription in this case was a compound of several potent drugs known to cause central nervous system depression. Even a small amount was highly toxic to the little boy, who improved over the next 12 hours in intensive care and eventually recovered.

 

Skin is a barrier that exists to keep body water in and microorganisms and noxious chemicals out. The skin consists of three main layers: the epidermis, the dermis and the subcutaneous tissues. The epidermis actually has multiple layers, the most superficial of which is the stratum corneum, which provides almost all the skin’s protective properties. The stratum corneum is made up of keratin, which consists of dead skin cell remnants and fibrous proteins that overlap in layers. Transdermal absorption occurs via a passive diffusion through the epithelial cell layer, in a concentration-dependent process. The magnitude and speed of diffusion depends on the integrity and also physical properties of the applied drug. Drugs with low molecular weight with a high water and lipid solubility show the greatest penetration. Source: “Compounded Ointment Results in Severe Toxicity in a Pediatric Patient,” Pediatric Emergency Care, November 2013

Skin is a barrier that exists to keep body water in and microorganisms and noxious chemicals out. The skin consists of three main layers: the epidermis, the dermis and the subcutaneous tissues. The epidermis actually has multiple layers, the most superficial of which is the stratum corneum, which provides almost all the skin’s protective properties. The stratum corneum is made up of keratin, which consists of dead skin cell remnants and fibrous proteins that overlap in layers. Transdermal absorption occurs via a passive diffusion through the epithelial cell layer, in a concentration-dependent process. The magnitude and speed of diffusion depends on the integrity and also physical properties of the applied drug. Drugs with low molecular weight with a high water and lipid solubility show the greatest penetration.                                                                                          Source: “Compounded Ointment Results in Severe Toxicity in a Pediatric Patient,” Pediatric Emergency Care, November 2013

 

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Jake’s take on how to build a hospital

Carlyle "Jake" Jacobsen laying the cornerstone for Upstate's downtown hospital, 1963

Carlyle “Jake” Jacobsen laying the cornerstone for Upstate’s downtown hospital, 1963

More than 50 years ago, Upstate President Carlyle “Jake” Jacobsen PhD (1902-1974) began working on the creation of Upstate University Hospital in downtown Syracuse. As a seasoned college administrator, brain researcher and professor of medical psychology, “Jake” had impressive credentials for the job. But, in a 1964 interview at Columbia University, Jake credited his Minnesota childhood for giving him the real tools he needed.

Here’s what Jake said made him an adept hospital-builder:

1) Delivering newspapers.

As a boy, Jake had a paper route that included  hospitals, and he delivering newspapers directly to patients. This early, close contact with the sick and injured gave Jake a deep appreciation for health care, and his ability to navigate hospital hallways prepared him to finesse the design of Upstate hospital’s physical plant.

2) Drawing maps.

In middle school, Jake created maps for his school district and remembers drawing the intricate streets and road patterns on drafting paper. Jake credits his art classes and map drawing for giving him the ability to “fight with the architects about what was wrong with what they were doing.”

3) Watching wheat.

Jake’s uncles were North Dakota farmers. He saw that, no matter how hard they worked, outside forces (mother nature, chiefly) left them with a sickly wheat crop three seasons out of four. Those were lean years for his uncles, and that was before they were hit by the Great Depression. According to Jake, observing their hardships helped mold his social philosophy—useful for a guy who’d someday lead a public hospital.

4) Running trains.

Jake was only 7 when he told his Dad, “I want to make an invention.” They got together and created a belt-driven, 6-volt generator that powered Jake’s toy train set.

Later, as a college kid who’d run out of money, Jake worked for the railroad. His boss saw he had a knack for the business, and encouraged Jake to make the railroad his career. (Jake chose to finish his education instead.)

Jake’s  boyhood desire to create something new and his young man’s ability to understand a complex business prepared him well for his job at Upstate.

5) Learning Latin and selling trees.

During high school, Jake studied Latin, oratory and debate. After school, he worked at a dry goods store with a nursery. Days feeding his intellect and evenings shoveling dirt gave Jake, as he described it, the “diffuse interests” that made him good at his job as a hospital builder and university president.

6) Pulling taffy.

Jake’s summer job after high school was making taffy. It was hot and involved lots of precise steps — boiling sugar, kneading, twisting, cutting — and he did it all under the scrutiny of impatient customers. It was an early experience in navigating public perception.

7) Studying in public schools.

While Jake was on the faculty of several prestigious private universities – Yale, Harvard, Cornell – prior to joining Upstate, he attended public schools throughout his childhood and earned his bachelor’s and doctoral degrees at a state school: the University of Minnesota.

“I have a strong feeling for public education, whether it is grade school, or on through a PhD,”  he said in the 1964 interview.

Those strong feelings, and his own experiences as a public school kid, made Jake an ideal leader for the newly created State University of New York.

Special thanks to Patricia Numann MD for sharing Dr. Jacobsen’s personal papers with the hospital anniversary committee.

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Urge to smoke begins in utero

Pregnancy and smoking issueBabies born to mothers who smoke during pregnancy are four times more likely to begin smoking in adolescence.

Scientists at Upstate recently showed that nicotine, the most addictive of more than 4,000 chemicals in tobacco, modifies part of the brain responsible for smell and changes the neural sensitivity of the olfactory cells in the noses of the babies in utero. This is what leads them to develop a preference for the sweet, warm and spicy odor of nicotine, according to Nicole Mantella, a graduate student in the lab of professor Steven Youngentob, PhD.

Youngentob’s lab in the Department of Psychiatry and Behavioral Sciences explores what drives kids to have that first cigarette, or that first drink. He has done similar work showing how alcohol exposure in the womb can create a craving in adolescence. 

He is alarmed that with all we know about the dangers of smoking, 25 percent of smoking women who become pregnant continue to smoke during pregnancy. Not only does this put babies at risk for stillbirth or prematurity, but they are also more likely to have behavioral problems such as hyperactivity and impulsivity and defects in learning, memory and attention – and to become smokers, themselves.

Listen to the HealthLink on Air radio interview with Dr. Youngentob

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Roasted delicata squash with mushrooms and thyme

WinterFood

Delicata squash stars in this wintery dish, which is equally happy in a supporting role next to meat or stealing the show as a vegetarian centerpiece. This gourd is called delicata because its skin is delicate enough to eat without peeling.

Ingredients

1 pound fresh delicata squash

10 ounces crimini mushrooms

3 tablespoons olive oil

2 teaspoons minced garlic cloves

1 tablespoon minced thyme

½ teaspoon kosher salt

¼ teaspoon ground black pepper

 Preparation

Preheat oven to 350 degrees Fahrenheit. Wash delicata squash. Cut squash in half lengthwise, scoop out seeds and discard. Slice ½ inch thick and place in a bowl. Remove stems from mushrooms and place caps in a bowl. Divide into each bowl olive oil, garlic, salt and pepper. Place the squash on the pan and the mushrooms on another pan. Roast in the oven until tender, about 10 to 15 minutes. When cooked through, combine vegetables and toss with fresh thyme leaves.

Nutritional information

93 calories

1.7 grams protein

7.5 grams carbohydrates

7 grams total fat

1 gram saturated fat

0 milligrams cholesterol

200 miligrams sodium

2 grams fiber

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