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Welcome to this bonus episode of the MDedge Psychcast. In this episode, as a tribute to the late Carl C. Bell, MD, we would like to replay highlights from the interview that Lorenzo Norris, MD, did with him last year at the annual IPS (Institute on Psychiatric Services) Mental Health Services conference in Chicago. Dr. Norris, host of the MDedge Psychcast, is assistant professor of psychiatry and behavioral sciences at George Washington University, Washington. Dr. Bell, who died Aug. 1, was a psychiatrist at Jackson Park Hospital in Chicago and an emeritus professor of psychiatry at the University of Illinois at Chicago. He spoke with Dr. Norris in episodes 26 and 27 about identifying and preventing fetal alcohol spectrum disorders. Conceptualizing intellectual disabilities in children In the late 1960s, African American children had twice the rates of mild intellectual disabilities as did white children. Some clinicians thought that the intellectual disabilities they were seeing among African American children were the result of social-cultural mental retardation, but that conclusion did not make sense to Dr. Bell. Julius B. Richmond, MD, former surgeon general, cocreated Head Start as a way to address some of the educational disadvantages faced by low-income children. African American psychologists began to suggest that standardized tests were biased against certain racial and low-income groups. Bell thought some African American and low-income children might have knowledge that their counterparts in other communities might not have. Fetal alcohol exposure emerges as an explanation A few years ago, Dr. Bell was talking with a woman patient with three children in the Illinois Department of Children and Family Services. The children had poor tempers, social/emotional skills. And when he looked at their mother, he saw fetal alcohol facies. After talking with the patient longer, he learned that she had not gotten far in school. She also had problems with simple subtraction. At that point, he thought that the patient might have had fetal alcohol exposure. He then began looking at family medicine patients at Jackson Park Hospital in Chicago. The question at that time was: “Were you drinking while you were pregnant?” That question did not explain why patients had children who could not do basic subtraction and had ADHD, for example. Bell realized that the right question was: When did you realize you were pregnant? In many cases, they would say that they had learned they were pregnant at 4-6 weeks. Choline deficiency and fetal alcohol exposure The Institute of Medicine recommended that pregnant women consume 450 mg/day of choline each day. Robert Freedman, MD, and his colleagues found that higher amounts of choline as a prenatal supplement are tied to more self-regulation among infants who had common maternal infections during gestation. Bell began giving choline to patients. In one example, a patient’s ability to relate to others improved dramatically after taking choline over an 18-month period. The American Medical Association passed a resolution supporting the addition of adequate amounts of choline to prenatal vitamins. References Freedle RO. Correcting the SAT’s ethnic and social-class bias: A method for reestimating SAT scores. Harvard Educ Rev. 2003. 73(1):1-42. Bell CC and J Aujla. Prenatal vitamins deficient in recommended choline intake for pregnant women. J Fam Med Dis Prevent. 2016. 4(2):1-3. Wozniak JR et al. Choline supplementation in children with fetal alcohol spectrum disorders: A randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2015 Nov;102(5):1113-25. Wozniak JR et al. Choline supplementation in children with fetal alcohol spectrum disorders(FASD) has high feasibility & tolerability. Nutr Res. 2013. Nov;33(11):897-904. Zeisel SH and KA da Costa. Choline: An essential nutrient for public health. Nutr. Res. 2009. Nov;67(11):615-23. Freedman R et al. Higher gestational choline levels in maternal infection are protective for infant brain development. J Pediatr. 2019 May. 208:198-206. Velazquez R et al. Maternal choline supplementation ameliorates Alzheimer’s disease pathology by reducing brain homocysteine levels across multiple generations. Mol Psychiatry. 2019 Jan 8. doi: 10.1038/s41380-018-0322-z. Wilhoit F et al. Fetal alcohol spectrum disorders: Characteristics, complications, and treatment. Community Ment Health J. 2017 Aug;53(6):711-8. For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych
Top officials from the Mount Sinai Health Systems and Jackson Park Hospital talk with Craig Dellimore about the difficulties and the victories in providing health care in economically challenged neighborhoods. It’s a learning process about what works, and doesn’t when it comes to Government and Medicine.
Jackson Park Hospital and Medical Center announced it will close its obstetrics unit in August, leaving many African American women in the area with few options for prenatal care.The news came as a shock to the all-female, all-black staff of nurses and doctors that run the unit and the community at large, and it comes in a time of need.Black women in the United States are three to four times more likely to die in childbirth than white women, and the situation in Illinois is even worse than the national average.The U.S. is also the only developed nation in the world where the overall maternal mortality rate is on the rise.Morning Shift talks with a nurse and an organizer about the black maternal health crisis and what this move at Jackson Park will mean for women and their families.
Has the NFL peaked? The TV ratings aren’t climbing like they used to. The NFL still dominates baseball and hockey and those know-it-alls at the NBA, but the inertia is concerning. Some of your brethren assume the TV networks will keep lining up to pay billions—and, if not the networks, the nerds at Facebook or Amazon—but you’re not so sure. Media is volatile. Sports betting could make up some of the difference, but who knows? You’re even having issues with attendance. You see empty seats on Sunday—you never used to see empty seats. Stupid HDTV—it’s nicer to watch a game in your living room, and a lot cheaper, too. You tried lowering the price of parking, and you did that hot dog-and-a-beer promotion for $25. Twenty-five dollars for a hot dog and a beer! It’s a steal! Five people were wounded in a shooting after a softball game Sunday night in the South Shore neighborhood. Police said someone in a black van opened fire near 75th and Dante shortly before 11 p.m., striking four men and a woman. A 30-year-old man shot in the ankle, a 40-year-old woman shot in the calf, a 42-year-old man shot in the arm, and an adult male shot in the chest all were being treated at the University of Chicago trauma center. The man shot in the chest was in serious condition, the other three were not seriously hurt. A 26-year-old man who was shot in the leg was stabilized at Jackson Park Hospital & Medical Center. The other mass shooting happened Friday night in the Englewood neighborhood. Police said six of the people were out in front of a home near 65th and Marshfield, enjoying a summer evening, when they heard gunfire and realized they had been shot. The victims included a 3-year-old boy. A seventh person was struck by a stray bullet in her back yard.
Keeping up with the RN’s from National Nurses United—Registered nurses at Jackson Park Hospital and Medical Center on Chicago’s South Side reached an agreement with hospital officials on their first ever collective bargaining contract that includes significant improvements in patient care protections. We’ll talk with RN Monica Lloyd from the great city of Chicago about this and more. And did we say Monica is on fire about this good news!?! And later in the show, if you haven’t found this great app called iTriage, look no further than the Nurse Talk website. iTriage is an amazing resource for everyone. Have a symptom? Go to the iTriage symptom checker. Need information about a disease? You’ll find complete clinical descriptions from A-Z. Is your medical issue an emergency or do you need to find a clinic or hospital near you? Yip, you guessed it; a complete directory of everything in your area including WAIT times. Read more...
Keeping up with the RNs from National Nurses United—Registered nurses at Jackson Park Hospital and Medical Center on Chicago’s South Side reached an agreement with hospital officials on their first ever collective bargaining contract that includes significant improvements in patient care protections. We’ll talk with RN Monica Lloyd from the great city of Chicago about this and more. And did we say Monica is on fire about this good news!?! Read more...
This last week of May our own Rev. Wesley Sun reads from Matthew 8:18-22. As Rev. Sun has taken a new position as the resident Chaplain at Jackson Park Hospital under the direction of the Hyde Park Union Church he won't be attending First Baptist Regularly. It's our hope from time to time they will allow him to come back as we have greatly benefited from his time with us. Please join us in congratulating Rev. Sun on his new position as he grows and moves where the Lord directs him. Thanks to everyone listening to our podcast. Please drop us a Note at fbcpreacher@fbcpreacher.com or submit your comments here on the web page about anything you might hear in this ministry. We enjoy hearing your comments about our ministry or anything you might think of to improve this ministry. Again thank you all for listening and have a blessed week from the pastoral and technical staff at First Baptist Church of Chicago.