This Fellowship takes on a key challenge: the reality that professionals are not well prepared to deal with or talk about death, dying, and grieving families, especially during an era of COVID-19. The Fellowship allows participants to learn, confront, and discuss the legal, medical, social, cultural, familial, and spiritual aspects of death and dying within a multi-disciplinary group in a low-pressure environment. The sessions include opportunities to practice conversation skills, facilitated conversations, and virtual site visits.

The home for the 2019 Salk Health Activist Fellowship.

We are going to use this platform to be able to communicate effectively, collaborate, and build each other up for this fellowship. Activism starts here. Let us learn and use each other's strengths to the best of our ability. 

Together, we can change the world. 

Pregnant women, no matter their socioeconomic status, should have equal rights and access to the best care. We hope to narrow down the potential causes of increased mortality rates and design unique solutions to address gaps in quality and access to care. 

The aim of this project is to establish a maternal care collaborative similar to and modeled after the California Maternal Quality Care Collaborative (CMQCC). This collaborative will differ in that it will be run for and by hospitals that primarily service neighborhoods with a large black population (there is evidence that points to the quality of care at hospitals where a disproportionate number of black women deliver as a contributing factor as to why black mothers are dying at a rate that is higher than white moms). 

Key elements of the collaborative:

- All hospitals in the collaborative will work to submit data to the MMRIA (Maternal Mortality Review Information Application) a free data system that allows users to develop quality improvement plans based on the reports generated by MMRIA (CMQCC has their maternal data center. This collaborative will utilize an existing free one to cut costs at least in the beginning). 

- Create and share development of evidence-based quality improvement toolkits that address the leading causes of preventable complications and deaths 

- Physician education: provide patient first continuing medical education for providers that address the common issues black women face in their pregnancies; physician and hospital administration education on new protocols for rare situations

- Use of predictive analytics to develop a risk score for pregnancy related complications and maternal mortality that will be available for all providers to see in the patient's EHR. (Major difference between this collaborative and CMQCC). 

- Development or outsourcing of a doula program similar to the use of case/disease managers for women who were identified as high risk through the risk score analysis mentioned above 

- Development and distribution of a patient satisfaction survey. Dedicated Committee to review all surveys and address issues 

The home for the 2018 Salk Health Activist Fellowship.

We are going to use this platform to be able to communicate effectively, collaborate, and build each other up for this fellowship. Activism starts here. Let us learn and use each other's strengths to the best of our ability. 

Together, we can change the world. 

Vitiligo (vit-ih-LIE-go) is a disease that causes the loss of skin color in blotches. The extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair and the inside of the mouth. The main reason and cause of vitiligo is the fact that the body itself decides to destroy its skin pigment. Without a doubt, this is an irregularity of the system. However, the main culprit for this setback is the immune system. Doctors currently can’t predict whether the Vitiligo on a person will spread, and  how fast. Currently, there is no known cure for Vitiligo, but treatment may be able to make skin tone appear more even. However, treatments can be time consuming and expensive, and often not covered by health insurance.  Because Vitiligo affects a person’s appearance, it is considered as a “cosmetic problem.” However, it is more than a “cosmetic problem.” It is a medical condition. People who have Vitiligo have a higher risk of getting some other medical conditions – such as hearing loss; painful sunburns; develop other autoimmune diseases; changes in vision/eye problems; anxiety and depression. Vitiligo is not contagious, and it is not life threatening. However, it is life-altering. Some people develop low self-esteem. They may no longer want to hang out with friends. They can develop serious depression. Most people have Vitiligo for life, so it’s important to develop coping strategies. Researchers have found that many people who have vitiligo often feel anxious and embarrassed around others. It’s easy to understand why. People often stare and make rude remarks. Some people are obviously frightened. Facing this day in and day out can take a toll on a person’s overall wellbeing. 

Vision: 

- Raise awareness about vitiligo and the dermatological and psychological impact the disease has on those affected by it.

- Partner with healthcare professionals, educational institutions and social workers and activists to work diligently toward securing grant funding and increase sponsors and donors.

- Encourage governmental agencies to make vitiligo research and advocacy efforts a high priority.

- Improve the care of patients with vitiligo by providing medical professionals with the best available information about vitiligo and its treatment.

- Improve teacher and staff training in schools so they are prepared to provide support to parents and students cope with this disease. 

We are going to use this platform to be able to communicate effectively, collaborate, and build each other up for this fellowship. Activism satrts here, let us learn and use each other's strengths to the best of our ability. 

We are here to help, and are open to any and all questions that you may possess. If we don't know the answer, we will do our best to find someone who does. Together, we can change the world. 

According the a recent study in the New England Journal of Medicine, 96% of executives, clinical leaders, and clinicians agree that physician burnout is a serious problem in health care. More than 50% of all physicians including residents suffer from burnout. Coupled with a projected shortage of 50,000 physicians by 2020, this degree of burnout will continue to impact quality, access to care and  patient safety. There have been many studies that have linked physician stress to medical errors (3^rd leading cause of death in the U.S.). Decreased quality of care has been cited as the leading reason to address physician burnout.

Despite the recognition that physician burnout is a serious and growing threat to our health care system, there is very little that is being done to mitigate this problem. The answers include both organizational changes that allow physician to function at the top of their licensure as well as personal strategies targeting increased resilience and better stress management.

Mindfulness-based interventions can be a powerful tool for decreasing physician burnout and improving overall health and well-being, with a positive effect on patient safety and quality of care. Mindfulness refers to the ability to pay attention to the present-moment with acceptance and receptivity and mindfulness interventions have been shown in initial studies to reduce stress and burnout.

What is particularly exciting is that we have collaborated with David Cresswell from Carneige Mellon University whose lab is one of the first groups to show that mindfulness interventions can improve brain stress resilience circuits and biomarkers of stress-related disease in multiple patient populations (Creswell et al., 2016). This work has had substantial impact and resulted in well-publicized coverage in fora such as the New York Times, the Los Angeles Times, and the Today Show.

We have formed Pittsburgh based initiative that focuses on physician wellness and patient safety. This initiative includes a unique collaboration between Carnegie-Mellon researchers and UPMC physicians. We will conduct a landmark study investigating the effects of a brief mindfulness based intervention to improve brain stress resilience circuits and biomarkers of inflammation among a high-stress physician population. We hope to publish the results in top journals and more importantly promote our region as a leading innovator in improving physician wellness and patient safety. Given the vast expertise of healthcare, research and medical education in Western PA, our study will have significant local and national impact for both physicians and patients.