hidden

Participating in Science Outreach is a Win-Win For Everyone

Last month I wrote about the January is for Advocacy AHA initiative and discussed the importance of physicians and scientists getting involved in science advocacy. Since I mentioned I wanted this New Year’s resolution to stick, I am continuing this theme for February because there are so many different ways to get involved with our communities and advocate for change.

One way I personally enjoy engaging with my community is by participating in science outreach activities. Now, the best part about this type of extra-curricular community engagement is that it comes in a variety of different forms, whether it be judging a local science fair, visiting an elementary classroom to talk about your science and do an experiment (my favorite is isolating DNA from strawberries with them), or even Skyping with a classroom of students through the fantastic Skype A Scientist program (you don’t even have to leave work!).

Before I highlight a fantastic cardiology outreach program that just recently happened, I want to take a moment to discuss why science outreach programs are so critical for our both our local and scientific communities. We are all busy, so finding time to fit something like this into our schedules feels like a scary game of Tetris. However, science and particularly the cardiology field, has diversity/inclusivity issues that need attention. Even though this is an issue that some may feel like has “been addressed,” women still make up around only a third of scientific researchers across the world. While this varies across disciplines, only around 13% of cardiologists are women – even though roughly 50% of medical students are women. All of these numbers are even lower for people of color.

While I understand that these issues are insanely complex and speak to the need of a re-vamp of how our scientific and medical institutions are structured, we need to continue to flame the excitement for science in students of every background, gender and race. The easiest way to do this is by getting involved and not just in your neighborhood, but also underserved communities. I highlighted a variety of ways to get involved in science outreach in last month’s post. The STEM ecosystem is a particularly good resource for getting in contact with underserved communities you may have not been aware of before.

I mentioned before that I completely understand that getting involved or organizing a science outreach event feels overwhelming. However, working with other colleagues within your network who are also passionate about this issue is the key to really making an impact. Just like with everything else in science, you don’t have to do this alone!

This is exactly the approach Dr. Kathryn Berlacher and Diana Rodgers took to organize their recent She Looks Like A Cardiologist event last month in Pittsburgh. Both women took their passion for increasing the diversity in cardiology into creating a fantastic event where 28 female high school students interested in becoming cardiologists got to meet with local women in cardiology. The day was filled with a mix of lectures, group discussions and some simulation, as well as one-on-one lunch with paired mentors. The best part of this event is that it’s not over – the organizers didn’t want this to be a “one and done” day, so every girl got paired with one of the mentors who will help answer college application questions, advise on jobs and summer experiences, and just be a resource for them in the future. You can find a great breakdown of the day on Dr. Berlacher’s twitter page (@KBerlacher). Seeing this event on Twitter is actually what inspired me to write this blog post and I emailed Dr. Berlacher right away to talk about it. I asked her if she thinks outreach activities are valued within our field and I loved her response:

Definitely – many of my colleagues do it and love it. Almost all of my fellows do it. The fellows who came on Saturday raved about the event afterwards, saying they thought it was going to be a great event for the high school girls, but at the end of the day they felt inspired and invigorated too.  Things like this (and all our other volunteering), keeps us grounded and really provides perspective. I honestly think it’s a great way to bond – AND to combat burnout in the field, which is another hot topic. If you feel valued and feel that what you’re doing is making a difference, then you’re much less likely to get burnt out at your job.”

I hope this event inspires you to get involved in science outreach within your community as much as it inspired me. Here’s to seeing many more events like this in the future.

 

 

 

hidden

Why Advocacy is Critical for the Future of Cardiovascular Research & Medicine

As researchers and physicians, many of us got in to our professions to push the scientific enterprise further to ultimately help others. We’ve all trained for an insane amount of years and collectively we work as a unit to uncover the intricacies of the cardiovascular system, develop therapeutics and treat patients. We traditionally think of ourselves as researchers or physicians first, but obviously we are all so much more than our jobs. We are also citizens within a really complex system that has been continually struggling to serve all of its citizens equally. It’s no secret that access to affordable health care is currently not equitable within our society. Similarly, there are also large diversity & inclusivity issues within our training institutions for both researchers and physicians.

However, something we don’t think about enough is that our intensive training and experience within these systems has also prepared us to be effective advocates for these issues. We have the opportunity to promote tangible change and some might argue it’s even our responsibility.

One of the things I really appreciate about being apart of the American Heart Association (AHA) is that this is something the organization doesn’t shy away from. During his presidential address at AHA Scientific Sessions 2018, Dr. Ivor Benjamin gave a heartfelt and determined talk about what the future of the AHA’s advocacy mission looks like. He discussed how supporting local and federal advocacy, early careers and mentoring is key to supporting the future of the AHA – but only 3% of cardiac professionals are African American men and this is something the AHA wants to help change. To help solve the diversity and inclusivity issues within the cardiac field, the AHA is expanding major undergraduate initiatives to fix the leaky pipeline. My favorite part of Dr. Benjamin’s talk was when he urged everyone at AHA18 to get involved in advocacy, not just for our field, but also for our communities. Because this is the key point: in order for our work to have meaning and to be effective, we need to ensure our communities are healthy. We also need to put value to advocacy efforts in our field – this is an essential part of our profession.

Well, this is all great, but how can you get involved? We are all insanely busy; I know adding advocacy efforts can seem daunting. Luckily for all of us, one of the focuses of the AHA for January is Advocacy. Since over 7 million Americans with cardiovascular disease are currently uninsured, advocating for the protection of the Affordable Care Act is something we can all do from our computers right now.

How can you help? (Provided by the AHA newsroom)

https://www.heart.org/en/get-involved/advocate/state-issues

 

Looking for more ways to help on other issues?

  • The AHA has a great advocacy resource page for to get involved with efforts at the federal, state and community levels with issues regarding health care, tobacco prevention, and healthy lifestyles for kids.
  • Sign up here to become part of the AHA’s grassroots network, You’re the Cure, which is focused on advocating for heart-healthy and stroke-smart communities.
  • There are many great non-profits around the country focused on promoting science funding, literacy, inclusion, diversity & advocacy – finding the right one for you is key and many of them have already done the legwork by developing toolkits for you to get started in your community.
  • Interested in STEM outreach as a way to get involved in your community? The great Marian Wright Edelman said, “You can’t be what you can’t see.” Participating in local educational initiatives is one of the best ways to expose kids to what scientists and physicians actually look like (in addition to getting them excited about science). The STEM Ecosystem is a great way to get started; there are local chapters all over the country.

I recently watched the brilliant documentary (I highly recommend it!) about Mr. Rogers, “Won’t You Be My Neighbor”, where I was reminded of his advice many of us take comfort in during intense times.

“When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.” – Mr. Rogers

We are the helpers. Its time we use our power to advocate for equity within our field and communities.

 

 

hidden

AHA18 Reminded Me We Need to Do More for Women

On the surface, it doesn’t really seem that surprising men and women develop heart disease differently or experience different symptoms for the same types of cardiac episodes. However, even though heart disease is the number one killer of both men and women, women have traditionally been omitted from clinical trials and female animals have either not been included in preclinical research studies or the two sexes have been combined1. We just simply weren’t taking half of the population into account at every level of cardiovascular disease (CVD) research for quite some time. I spent my graduate career focused on understanding the baseline differences in the heart between the sexes, and was extremely passionate about this work. Since I spent most of my scientific career working in this field, I wanted to switch it up as a postdoctoral fellow and am currently not researching sex differences. However, when I went to AHA sessions this year, I made it a point to go to any events focused on sex differences and women to get updated on what I’ve been missing this past year. Luckily the “State of the Heart For Women: Top Ten Advances in Gender-Specific Medicine” session provided the perfect summary. After ten great talks focused on a variety of gender specific concerns ranging from heart failure to pregnancy, the take home message was clear: women are still very much at risk, more likely to be misdiagnosed, and are still under-represented in clinical trials. These issues are also worse for women of color.

 

While this is a widespread issue across disciplines, the cardiovascular field has been particularly biased with regard to including women in clinical trials for drug development, leading to drugs being either not as effective in women or causing different side effects2. The good news is, things are changing. In the early 1990’s, reports from the Food and Drug Agency (FDA) demonstrated that less than 20% of participants in clinical trials were women and recent studies reveal that this number is steadily increasing – even in the cardiovascular field3. Fixing this imbalance is the result of the tireless work from many dedicated researchers over the past several decades. One of the main advocates this field has is Dr. Nanette Wenger, who was the first speaker of this session and actually let me ask her a some questions later during the conference while we were both in the Women in Science and Medicine Lounge. When I asked Dr. Wenger about her strategy for making this issue a priority in our field she explained the key steps to creating change:

  1. Investigate — people can’t ignore what the data is clearly telling them
  2. Educate — teach your peers & patients
  3. Advocate for the change
  4. Legislate — it took a long time, but we’re slowly transforming the strategic plan of the NIH

Dr. Wenger also stressed that since the emphasis in our field now is personalized care, many researchers and physicians are more supportive of including sex in their experiments and/or trials, but we need to move forward by not assuming that women are a homogeneous group. Other factors such as race are also important and must also be considered.

While progress has been made we still have a long way to go on many accounts. While there are more women in clinical trials than in the past, women still only make-up about 34% of the total participants in cardiac clinical trials3. Hopefully, with the passing of the 21st Centuries Cures act and the NIH policy mandating sex be included as an biological variable in basic research studies in 2016, these numbers will progressively increase. At the session before the talks even began, I immediately noticed that all but one of the ten panelists were women (which is awesome, but strange for the cardiac field) and the majority of people in the audience were also women. We will need to continue to advocate for this issue and we need men to join us and take it seriously for real change to be made. Additionally, while I really enjoyed this unique session, the speakers were only given ~10 minutes each to summarize their extraordinarily complex topics, which just wasn’t enough time. It would be great if gender-specific cardiovascular issues were given more time at AHA Scientific Sessions as well as other conferences in the future. This session reminded me just how pressing making CVD treatment equitable for all truly is and thankful for the researchers making it happen.

 

References

  1. Blenck CL, Harvey PA, Reckelhoff JF, Leinwand LA. The Importance of Biological Sex and Estrogen in Rodent Models of Cardiovascular Health and Disease. Circ Res. 2016;118(8):1294-312.
  2. Regitz-Zagrosek V. Therapeutic implications of the gender-specific aspects of cardiovascular disease. Nat Rev Drug Discov. 2006;5(5):425-38.
  3. Pilote L, Raparelli V. Participation of Women in Clinical Trials: Not Yet Time to Rest on Our Laurels. J Am Coll Cardiol. 2018;71(18):1970-2.

 

hidden

The Future of Wearable Technology & Detecting Atrial Fibrillation at AHA18

Like many of us, I have several family members who experience atrial fibrillation (AFib) regularly, as between 2-6 million people in the United States have this disorder. My father-in-law in particular has experienced difficultly with AFib recently and because he knows I study the heart, he often asks me about different treatment options and advice for handling his disease. Of course since I’m a basic research scientist, I always remind him that I’m not that kind of doctor and gently recommend he talk about it with his medical doctor and receive second opinions. However, when I got the chance to attend the AHA’s Scientific Sessions 2018 for the first time as an AHA Early Career Blogger, I knew I wanted to attend some sessions about AFib so I might have a little more to say for the next time I see my family. As a basic researcher, I don’t often get the often opportunity to hear from physicians about the day-to-day AFib issues they encounter with their patients.

Naturally, I jumped at the chance to attend the “Hey Doc, My Wristband Says I Have AF What Do I Do?” session yesterday afternoon. I was initially drawn to this particular event because my husband and I actually bought my father-in-law a wearable device last year for Christmas when he expressed interest in counting his steps and also keeping an eye on his heart rate, based on a comment from his doctor. Surprisingly though, the gift backfired since my father-in-law’s anxiety about his heart rate skyrocketed after he started wearing the device, because anytime it gave him an “abnormal” heart rate alert, he would get nervous and eventually ended up just staring at the device all day. So we all agreed it would be best if he just stopped wearing it. During this time, I kept wondering how accurate these devices actually are, and if my father-in-law actually was experiencing AFib that regularly, or maybe these were just false positives? Luckily, medical researchers primed to study this question were already on it, because the Apple Heart Study was initiated last November.

This collaboration between Apple and Stanford, spearheaded by Dr. Marco Perez, is a progressive clinical trial that uses data from Apple Watch devices from over 400,000 participants. The main purpose of this unprecedented study is to examine if AFib can be reliably diagnosed from irregular pulse notification data from wearable devices. In this session, Dr. Perez outlined how easy it is for participants for to sign up for the study and how a single reminder email from Apple actually doubled the amount of study participants almost over night, highlighting the power of these types of collaborations. One of the most interesting aspects of this study is how it is all done remotely. Interested participants just have to download the application, where they consent to study and then the algorithm monitors them. If an individual receives an irregular heart rate alert, they are recommended to a local doctor who can then prescribe them a patch monitor, which is mailed to the participants. After the monitor period, the participants simply mail the patch monitor back to Stanford where the scientists analyze the data. If AFib or other cardiac disorders are identified from this data, the participants are then referred to a doctor to get treatment. The clinical trial scientists never even meet the participants.

Dr. Perez mentioned that they are hopeful to have all of the data analyzed by the end of January as they are still collecting data everyday. Some of the most pressing questions this study hopes to answer is how accurate are these irregular heart rate alerts in diagnosing AFib? False positive rates are particularly of interest since many in the community think these devices could be causing alert when none is needed. Also an important thing to consider is how does the user’s behavior change after the alert? I know my father-in-law’s anxiety increased after getting these alerts, but I’m sure some people might find these devices as a comfort, particularly if this study reveals them to be accurate. Since many physicians here at the AHA 2018 Sessions have expressed that their patients are coming into their office with irregular alert data from their wearable devices, I’m sure doctors and users alike are excitedly awaiting the results of this powerful study – I know I am. The most important take home from this study truly has to be the actual size and manner in which it has been conducted. The results of this study have the potential to impact the future of clinical trials in general, since a trial of this magnitude run completely virtually has never been done before.

Picture source: https://www.apple.com/newsroom/2017/11/apple-heart-study-launches-to-identify-irregular-heart-rhythms/