Led by Eric Song, an associate research scientist and resident physician at the School of Medicine, the researchers found that injecting vaccines directly into the eyes of mice can activate an immune response, potentially protecting mice from brain infections caused by the herpes simplex virus. According to Song, their findings demonstrate that physicians could use the eye’s immune response to help fight bacteria and tumors. 

“We hear this phrase a lot: ‘the eye is like a window to the brain,’” Song told the News. “That’s kind of centered around this idea that the eye is central nervous system tissue, like the brain.” 

Song explained that when diseases affect the neurons, they are often observable in both the brain and the eye’s retina. His study demonstrated that immune reactions in the retina mirror those in the brain. His team discovered that stimulating the immune system in the retina can also protect the brain against diseases and tumors. 

“I think it’s important because this opens up a new anatomical avenue that hasn’t been described before,” Song said. “Our paper is the first to really show that there’s functional lymphatic vessels.” 

Song and his team primarily study “immune privilege,” a concept initially proposed in the 1940s which suggests that immune responses are significantly reduced in the brain and eyes. For a long time, the scientific community believed that these organs were immune-inactive, Song said. However, infections and autoimmune diseases still occur in these sites, which indicates that there is a present immune response distinct from other parts of the body. 

Song and his team previously discovered that the brain and eyes lack traditional lymphatic vessels, which help drain proteins and fluids. However, they identified that the membrane tissues surrounding these organs do contain lymphatic vessels, and physicians can manipulate these vessels to enhance immune responses.

The eye’s anterior and posterior compartments have different drainage systems to the lymph nodes, parts of the immune system that filter substances in the lymphatic fluid and contain white blood cells to help the body fight infections. 

In this study, Song and his team found that the posterior compartment drains through the optic nerve, which can be enhanced or inhibited to affect immune responses. Lymphatic vessels at the back of the eye and those surrounding the brain are interconnected and drain into the same lymph node, which facilitates a coordinated immune defense.  

They also discovered that blocking the lymphatic system’s communication in the optic nerve can reduce the immune system’s reaction to adeno-associated virus. This virus is often used in gene therapy, a technique that modifies a person’s gene to treat or cure a disease. 

They found that when the herpes vaccine is injected into the eye, it induces an immune response. By blocking this response, gene therapy could be more effective, as the vector viruses will not be attacked by the immune system, enabling the modification of genes. 

Ellen Foxman, a professor of immunobiology at the School of Medicine, noted that one of the initial FDA-approved gene therapies for a genetic eye disease had little effect because the body created an immune defense against the virus used to deliver the gene therapy. But now, Song and his team’s study offers a method to suppress this immune response, potentially enhancing gene therapy’s effectiveness. 

“It’s really exciting because there’s sort of a lore that the eye is an immunologically privileged site,” Foxman said. “It’s just that you don’t have any immune responses against things in the eye and the brain. But this challenges that dogma and says, ‘Well, let’s see, is that really true?’”

According to Akiko Iwasaki, Sterling Professor of Immunobiology at the School of Medicine, certain individuals have mutations or deficiencies in gene expression that lead to eye diseases. But gene therapy can compensate for these missing genes and introduce them to the body via viral vectors. While previously these vectors were quickly eliminated from the eye, Song’s findings suggest that scientists could obstruct this draining and prevent an immune response that would typically flush out this vector. 

“It’s significant because [the study] has many clinical implications,” Iwasaki said. “Now that we understand this new lymphatic drainage system, and [Song] manipulated it to enable gene therapy more efficiently. Other drugs can also benefit from this new knowledge and strategy of either blocking or enhancing the posterior eye drainage.”

Iwasaki also said that Song’s technique could be leveraged to use for gene therapy in the eye. 

The discovery opens up new avenues for treating a variety of eye-related diseases. Currently, Song and his team are investigating how their findings could be useful for treating other diseases that affect the eye, such as glaucoma and macular edema. He said that he will continue to look at other features of the nervous system and if there are other barriers to allowing effective immune responses.

“I think there’s still a lot of work to be done in order for anything to be translational,” Song said. “It should be our job and other labs to really focus down on specific diseases of the eye or the brain and see how this applies in those settings.”

Iwasaki also said scientists should conduct clinical trials to ensure the techniques are both effective and safe before applying their discoveries to human therapies. Nevertheless, Iwasaki said he is optimistic for its use in future clinical practice. 

“I suspect that translation of this finding is relatively straightforward,” Iwasaki said. 

The concept of gene therapy first arose in the 1960s. 

The post Yale researchers discover new immunological capabilities of the eye appeared first on Yale Daily News.

The alliance, known as CARE, is a joint partnership between the School of Public Health and Southern Connecticut State University that uses community-engaged research to help improve the health of low-income and marginalized communities. This is the second consecutive five-year grant from the CDC’s Racial and Ethnic Approaches to Community Health program, which funds various initiatives that target health disparities across different racial groups. 

According to Alycia Santilli, the director of CARE at SCSU, the alliance hopes to use this new funding to expand access to healthier foods, support breast-feeding accommodations and strengthen transportation infrastructure.  

“In New Haven’s low-income neighborhoods — predominantly communities of color — we see wealth disparities that are staggering; 34 percent of residents live below the federal poverty threshold, compared to 26 percent across New Haven and 10 percent in [Connecticut],” Santilli wrote in an email to the News. “More than 30 percent of [households] in these neighborhoods experience food insecurity. Wealth disparities drive health disparities.” 

CARE directs multiple initiatives that address different health issues, including vaccine outreach, chronic disease prevention and health education in New Haven Public Schools. In 2019, CARE founded Supporting Wellness at Pantries, or SWAP, a health advocacy program that seeks to improve the community’s overall nutrition by increasing the selection of healthier food options at New Haven food pantries.  

Sofia Morales, a program manager of research and evaluation at CARE, said the program hopes to expand to 12 additional food pantries across the city.  

“If we really want to increase the access to healthy foods at food pantries, we need to change the system,” Morales said. “We need to work with the regional food bank and others at the policy level to make healthy food accessible so pantries can procure more nutritious options for community members.” 

The new grant will also allow CARE to form a working group to help identify and implement policy changes in the food access system. Morales said members of the working group will include food pantry workers, leaders from community-based organizations, representatives from regional food banks and those with lived expertise of food insecurity.  

Along with SWAP, CARE hopes to expand two other initiatives. The first is the ​“Support Breastfeeding Anytime, Anyplace” campaign, which seeks to provide more breastfeeding accommodations in community spaces. The second is the “Roots of Racial Inequities in Breastfeeding” program, which offers healthcare providers cultural competence training to target breastfeeding disparities among Black and Brown patients.  

Further, CARE hopes to reinforce its “Safe Routes For All” active transit plan, which, in collaboration with the New Haven government, seeks to expand the city’s walking, biking and transit infrastructure. The plan also is looking to promote road safety measures to make New Haven safer for walkers and bicyclists.  

Jackson Higginbottom, a program administrator for health and vaccine communications at CARE, pointed to how CARE listens to community members who have advocated for greater support for maternal care and road safety. 

“I really hope that as long as we are continuing to support and listen to our community, and our priorities are in alignment with theirs, we will have the impact that we are hoping for,” Higginbottom said. 

Morales emphasized that CARE prioritizes input from community members who have endured socioeconomic inequities to inform their approaches to current health disparities in New Haven.  

To expand its outreach and impact, CARE relies on the partnerships it has formed across different cities to help provide input on pertinent local issues, Santilli said.  

“This work should not ever be done in a vacuum,  but in close collaboration with folks on the ground who are deeply tied to — and experiencing — health inequities every day,” Santilli wrote to the News. 

CARE was founded in 2007 at the School of Public Health. 

The post Yale and SCSU community health program awarded grant to fight health inequities appeared first on Yale Daily News.

The Yale Internal Medicine Residency Writers’ Workshop recently celebrated its 20th anniversary. Initially established by physician-writer Abraham Verghese as a one-off event, the workshop has gained prominence within the School of Medicine for training new doctors across specialties to hone the craft of writing.

“We teach medicine as stories,” said Lisa Sanders, the co-director of the workshop and a professor at the School of Medicine. “It’s not like medicine is just science. It’s always about that intersection between human beings, sickness or death, and science. And if you just focus on the science, you’re missing a lot.”

The Internal Medicine Residency Writers’ Workshop is open to all medical residents at Yale’s internal medicine department and other fields, including psychiatry, surgery and emergency medicine. A few months before the workshop, residents submit a 1200 maximum creative or personal essay as part of their application, said Anna Reisman, a professor at the Yale School of Medicine and the co-director of the program.

Selected participants bring those pieces to a two-day workshop where they refine and revise each others’ pieces. The residents also learn writing techniques under the guidance of the program directors, who themselves are physician-writers and creatives. Reisman is also co-director of the program for humanities in medicine, and Sanders created and authors the New York Times Magazine’s “Diagnosis” column — the inspiration for the television show House M.D.

At the end of the program, the writers read aloud their final pieces to students and faculty. Their essays are published in an online zine titled “Capsules.”

“The objective really is for us to teach the craft of writing,” said Reisman. “We teach residents who take part to learn some of the elements of writing, learn how to tell a story and learn how to write a personal essay. We talk about good verbs, writing with precision, all the basic craft lessons, and we spend time doing some writing exercises.”

This experience has proved integral for residents like Effie Johnson, a workshop participant and editor for “Capsules,” who felt tentative about her writing abilities as a medical student.

“I had a lot of impostor syndrome,” said Johnson. “The opportunity to just talk about writing, get feedback on my writing, and have the opportunity to grow is something that really attracted me. Writing is part of the way that we can solidify what is important to us, using it as motivation, especially those emotional experiences.”

Justin Dower, another resident who participated in the program, said he was also excited at the prospect of working with the workshop leaders and the other participants. Learning about the diversity of experiences that each of the new doctors wrote about, he added, was informative.

As a healthcare provider, Dower said he also believes that studying the medical humanities has improved his ability to connect with his patients.

“The humanities gives us a way to get better … by studying the experiences of writers in the past, writers in the present, learning from patients, and also other practitioners,” Dower said. “By reading what they have written, we can really get a better understanding of how to meet the people that we’re trying to serve and how to connect with them.”

The News interviewed several additional participants in the workshops, many of whom spoke about how the workshops helped them reflect on their experiences as physicians and healthcare providers. 

Morgan Goheen, an infectious diseases fellow in the School of Medicine’s division of infectious diseases who participated in the workshop, said she plans to spend most of her time as a physician-scientist in the lab. As an academic researcher, she said she hopes that improving her writing will allow her to communicate her research more effectively.

Writing has also been a tool to better connect and communicate with her patients, Goheen added. 

“It’s a way to express and appreciate what lies before me, whether it’s an individual patient or discussion of a global disease burden like malaria,” said Goheen. “Having the skills to notice and appreciate things that are affecting my day-to-day work has been an important part of letting me process and be better at working with people that are really different from me.”

Not every writer’s piece in the workshop centered around medicine. Caroline Raymond-King, for instance, wrote about her partner, their chickens and their dog.

“It’s hard in residency, but when you have a story to tell, it’s nice to have the skills to be able to write it,” Raymond-King said. “Writing really gives me the space and time to think about what I really care about.”

That space to reflect has been critical for some of the participants to reflect on challenging experiences they’ve encountered during their medical training, several told the News. In her piece for the workshop, Lara Rotter wrote about her experience treating a victim of domestic violence while still in medical school. 

Rotter said she believes that many people in the medical field harbor stigma around experiencing hardship during clinical practice. Doctors, she said, are often expected to remain emotionally unperturbed, even when encountering traumatic cases like domestic violence and abuse. 

“In medicine, we often fall into the trap of connecting professionalism with being unemotional and not encountering any difficult situations,” she said. “Often when difficult situations are encountered, we think this means we are too vulnerable or not perfect enough.” 

But through her writing, Rotter said she hopes to open up about doctors’ emotional and mental well-being as they navigate challenging patient experiences.

“We just really want to share stories to normalize things that are happening, that we all experience these things, and that we all have these difficult encounters with patients,” said Rotter.

For Matthew Morrison, an emergency medicine physician in New York City and a lecturer of medical humanities at Yale College, the quality of a physician’s writing might not even matter. Rather, he said he believes that having a creative outlet is a necessity for doctors.

“Doctors, who are occasionally ourselves human, need artistic and creative outlets for what we experience,” Morrison wrote in an email to the News. “The vast majority of us will write abominable poetry, and that is perfectly fine. But we need to remember that we are entitled to our experiences. Only a human — and not an algorithm, not a computer, not an LLM — can see the gestalt.”

The Yale Internal Medicine Residency Writers’ Workshop was established in 2003.

The post Yale Internal Medicine Residency Writers’ Workshop celebrates 20th anniversary appeared first on Yale Daily News.

But there’s one problem: Berger said she doesn’t actually remember much from the show. When she thinks back, she said that she blanks on the specifics, like the outfits, the dances and the speeches. 

“If I didn’t have the set list beforehand, I would’ve had no idea what she actually said,” Berger said. “In the moment, it was like having an out-of-body experience.”

Berger is not the only Swiftie to report lapses in memory during the singer’s performances, with many fans documenting mysterious memory gaps during shows on social media and in the press. But Nathan Carroll SPH ’24, a resident psychiatrist at Jersey Shore University Medical Center and a second-year student in the School of Public Health’s Executive Master of Public Health program, might have an answer. 

In a pre-published literature review titled “Here And Then Swiftly Gone: Taylor Swift-Induced Amnesia,” Carroll and a team of researchers investigated the scientific basis behind those reports of memory gaps among concertgoers. While Carroll’s report is not yet peer-reviewed and does not include real participants, it compares reported memory loss symptoms to existing scientific research on short-term amnesia.

Behind Swifties’ memory loss, the researchers believe, could be a type of amnesia linked to heightened emotion and excitement.

Carroll’s team focused specifically on post-concert amnesia associated with Swift’s Eras Tour, which debuted on March 17, 2023. Anticipation for the tour was palpable from the onset: Following Swift’s announcement that she was going on tour for the first time in five years, Ticketmaster’s website experienced unprecedented demand, leaving many fans unable to snag tickets in time.

Carroll recounted watching his fellow residents trying to secure tickets on Ticketmaster when the platform crashed. While they were eventually able to get tickets and attend the concert, Caroll said he noticed that they returned with gaps in their memory for portions of the concert.

“I remember trying so hard to remember everything because I spent a lot of money and a lot of time,” said Gabriela Mendoza Cueva SPH ’24. “I think I just had so much adrenaline from being hyped up that I don’t remember a lot of things.”

Swift fans’ loss of memory sparked Carroll’s interest. How was it possible, he recalled thinkimg at the time, that people could forget concerts they’d been so passionate about?

But that passion, Carroll and his colleagues now hypothesize, might be behind fans’ lapse in memory — a phenomenon that Carroll said he believes shares similarities with a condition called transient global amnesia, or TGA.

TGA is a type of short-term memory loss often triggered by highly emotional experiences, such as physical exertion, emotional stimulation, high-stress events and migraines. While the condition involves an inability to form new memories, it does not result in a loss of consciousness or self-awareness, and memory issues last for less than 24 hours. Individuals experiencing TGA may also encounter symptoms like disorientation around people and places, agitation and anxiety, and occasionally, headache, dizziness or nausea.

Though TGA has been well-documented in scientific research among older individuals between the ages of 50 and 80, post-event amnesia has not been as extensively studied in younger people, Carroll said — making the process of finding published literature on TGA in younger populations challenging. 

“The overlap between the Taylor Swift concertgoer population and the traditional population seen with TGA don’t share a tremendous number of characteristics,” he said. 

But Taylor Swift’s shows might fit the bill for an emotional, TGA-linked event. For fans, Carroll described the event as a “three-hour concert of non-stop excitement.”

During highly emotional or strenuous events, Carroll said, the body begins to release the stress hormone cortisol, a natural chemical that alters heart rate and blood pressure. Researchers believe that, in TGA, those changes in blood pressure affect the brain’s hippocampus, a portion of the brain that plays a major role in learning and memory. 

“These fluctuations in blood pressure are thought to affect the ability of your brain to record episodic memory, giving rise to transient global amnesia,” Carroll said.

Carroll and his team note in their review that, given that the number of young people with TGA in scientific literature is small, it’s an important and unexplored area of research. And since TGA symptoms are temporary, many who experience it don’t report memory loss to health professionals.

“Since the memories do come back, a lot of people don’t seek treatment for it either, so it’s missed all the time,” he said.

However, not all researchers think that Carroll’s theory about Swifties’ amnesia and TGA answers the question.

According to Philip Corlett, an associate professor of psychiatry at the School of Medicine, memory loss at concerts is not a brand-new phenomenon.

“I worry that we scientists try a little too hard to be current sometimes,” Corlett said. “I think the phenomenon itself is perhaps not so novel — people have been having extreme emotional responses to pop stars since Elvis, the Beatles and the Rolling Stones.” 

Corlett also questioned whether Swift fans were experiencing TGA at all since many typically didn’t end their night in a characteristic “fugue state” — where people become temporally or spatially disoriented. 

But that doesn’t diminish the impact that music can have on the brain, said Corlett.

“We remember music because it is a really potent combination of stimulus features that render it very memorable,” Corlett said. “It is characteristically structured like a story.” 

For concertgoers, Carroll and his team’s review recommends some prevention mechanisms to avoid amnesia, including staying hydrated, being mindful of breathing and excitement levels and avoiding recording the concert while watching.

Those recommendations resonated all too well with some Taylor Swift fans. 

A few months after Madelyn Dawson ’25 saw Swift’s Red Tour in 2013, she said she couldn’t remember any details. Dawson chalked up the lapse to the show’s overwhelming nature and competing mental priorities between experiencing and documenting the show.

“It’s hard to both live in the moment and experience shows while you’re there and also trying to have an archival collection of them,” she said. 

But for Shivesh Shourya SPH ’25, who went to an Eras Tour concert twice and saw the tour’s film, avoiding his phone helped him remember more of the performance. By the time he watched his second show, a new mindset improved how he remembered moments from the experience.

“I remember most of the concert simply because I wasn’t … trying to capture every moment on video and being more present,” said Shourya. “When I went to go see the Eras movie, I had great memory at that point.”

The Eras Tour set the record as the first tour to gross over one billion dollars. 

The post ‘Blank Space’ in memory? Researchers investigate Taylor Swift-induced amnesia appeared first on Yale Daily News.

Researchers at the School of Medicine, Brown and the University of Washington analyzed a nationwide database with data from 4,888 hospitals between 2016 and 2020. They found that less than two percent of patients who were diagnosed with both stroke and cardiac interventions were treated with endovascular thrombectomy, or EVT — the only effective treatment for patients dealing with cardiac malfunctions. 

“I’ve always felt that we weren’t able to offer as many stroke treatments to those patients [in cardiac intensive care units],” Adam de Havenon ’01, a professor of neurology at the School of Medicine and the lead author of the study, told the News. “But in medicine, there’s a huge gap between something you anecdotally experience and demonstrating that in a data set, which is what we did in this study.” 

According to de Havenon, cardiac interventions, after neurosurgical procedures, are the second leading surgical procedure that causes stroke. During cardiac interventions, surgeons can accidentally knock debris off of the aortic arch, causing clots and plaque to travel upstream to the brain, increasing the likelihood of stroke, specifically ischemic stroke.

Fabio Ramponi, a professor of cardiac surgery at the School of Medicine, the risk of stroke varies for different cardiac interventions. For minor surgeries, like valve replacement, the risk of stroke is roughly two percent. For patients who need multiple cardiac interventions, the risk of stroke increases to 10 percent. 

The researchers first analyzed patients’ billing codes and identified those who received EVT, the most effective stroke treatment for patients with ischemic strokes. During EVT, a surgeon inserts a thin catheter through a limb into the patient’s brain and uses a stent retriever to remove the clot. EVT is only effective within 24 hours of stroke symptoms. The team also determined the exact dates patients were diagnosed with a stroke and when they were treated with EVT. 

The researchers then identified the presence and timing of cardiac intervention among the patients treated with EVT. Of the 630,000 stroke patients, more than 12,000 patients also had a cardiac procedure, which they defined as including both cardiac surgeries and other interventions, such as catheter-based stent placement and inserting cardiac pacemakers. 

“What we found was that individuals who had their stroke after cardiac procedures were less than half as likely to get [EVT] within three days after the cardiac surgery,” de Havenon said. “And that was consistent with our hypothesis and my personal experience.”

According to Kevin Sheth, a professor of neurology at the School of Medicine and a co-author of the study, patients who had both a cardiac intervention and ischemic stroke — and were then treated with EVT — were twice as likely to be discharged home. Many patients who weren’t treated with EVT had to endure long-term care, Sheth said.

Ramponi noted that some patients may not receive EVT because it is harder to detect stroke among cardiac patients. While it can help doctors guess if there is decreased blood flow on one side of the body, doctors can’t always be sure.

“When the patient gets to intensive care, it’s hard to make a full neurologic exam because the patient is still under some sort of sedation,” Ramponi told the News. “The anesthesia is still lingering, so it’s hard to assess in a very systematic way.”

Further, de Havenon argued that it’s difficult to determine if EVT will be useful for patients — especially if doctors observe stroke symptoms hours after the patient wakes up from sedation — because the treatment is only effective for a short amount of time. Some cardiac procedures force patients to be sedated for days, making stroke detection even more difficult, according to de Havenon. 

Still, many doctors differ on how to help identify strokes in patients following cardiac interventions. For de Havenon, medical workers ought to monitor these patients more closely. For example, nurses could wake patients out of sedation to identify potential signs of stroke. They could also use bedside tests, such as an electroencephalogram, or EEG, to help determine the onset of stroke, he said. 

Still, Ramponi argued that doctors should focus more on preventing strokes altogether. 

“In my opinion, the focus has to be more on prevention,” Ramponi said. “Even if you detect [the stroke] early, the prognosis for the patient won’t be as good as if they never had a stroke.” 
The National Institute of Health estimates that roughly 795,000 people experience strokes in the United States per year.

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Led by Sarah Lowe, a professor of public health in social behavioral and sciences at the School of Public Health, in collaboration with researchers from the Harvard T.H. Chan School of Public Health, the University of Chicago and Oxford University, the researchers reviewed the scientific literature on the connection between chronic climate change and mental health issues. The study reported that the existing research is sparse — and scientists ought to do much more to help inform specific public health interventions. 

“Climate change is already harming human health, including growing mental health impacts,” Anthony Leiserowitz, the director of the Yale Program on Climate Change Communication, who was not involved in the study, wrote in an email to the News. “This paper underscores the critical need for more research on these impacts and investments in providing mental health support for individuals and communities struggling with the issue of climate change and the aftermath of climate change disasters.”

There is substantial evidence that natural disasters caused by climate change, such as hurricanes — which many scientists consider to be acute climate change — can directly impact mental health.

During a recent Climate Change and Trauma Webinar with the International Society for Traumatic Stress Studies, Betty Lai, a professor in counseling psychology at Boston College who was not involved in the study, highlighted this connection. 

“Disasters are directly linked to potential mental health distress symptoms,” Lai said.

Lai said that climate disasters especially affect children, recalling one study that demonstrated that one in four children who witnessed Hurricane Ike in 2008 were still reporting anxiety and PTSD symptoms 15 months later. 

In the webinar, Lowe noted that much of her research typically centers on the long-term mental health consequences of traumatic events. Her doctorate began with a study on how Hurricane Katrina exacerbated socioeconomic and racial disparities. 

However, after joining the School of Public Health in 2019, Lowe said, she realized that the bulk of research on climate change and mental health focuses only on acute climate change and not on the effects of long-term climate change. 

“[I]t seemed obvious that climate change could influence mental health in other ways, and I was hearing a lot from young people and in the media about how the threat of climate change escalation was leading to significant anxiety,” Lowe wrote in an email to the News. “We decided to embark on this systematic review to see what work had been done on the topic, knowing that there was likely to be research outside of our specialties.”

In the study, the researchers analyzed qualitative, quantitative and mixed-methods studies that examined the effects of slow-onset climate change on mental health indicators, which, according to Lowe, ended up being a “huge undertaking.” After screening over 10,000 abstracts, they included only 57 in the final review. 

They found that there is a lack of research on the specific link between chronic climate change and PTSD and post-traumatic stress symptoms. Most studies, they claimed, tended to focus on how the climate affects anxiety and depression symptoms and negative emotions, such as sadness, fear and anger. In addition, they noted that low and middle-income countries, the places most likely to feel the effects of chronic climate change, have less research output.

Lowe said she was especially surprised by how small the body of literature is on chronic climate change and mental health.

“As a point of comparison, I conducted a review of studies published in 2018 on PTSD and depression symptoms after disasters; in that single year, without using gold-standard systematic review methodologies, and focusing on only two outcomes, my colleagues and I identified 100 peer-reviewed articles on the topic,” Lowe wrote. 

For Lowe, because this body of research is so small, it is too early to determine the main differences between chronic climate change and acute climate change. Still, the preliminary evidence suggests that acute natural disasters may have more consistent negative impacts and are more likely to cause PTSD-related symptoms. 

Lowe emphasized the importance of conducting more qualitative and quantitative research across different disciplines to clarify the effects of chronic climate change. She also noted that longitudinal cohort studies, combined with interviews and focus groups, could help researchers learn more clearly how climate change affects overall well-being. 

Joan Monin, a professor of public health at the School of Public Health, who was not involved with the study, praised the call for more climate change research, noting how it could impact future policy. 

“This work is so important because it suggests that policymakers can implement changes to mitigate the effects of climate change,” Monin wrote in an email to the News. “This can have far-reaching effects on the mental health of large communities.”

According to the National Institute of Mental Health, it is estimated that one in five adults in the United States live with a mental illness. 

The post Yale researchers call for more studies on chronic climate change and mental health appeared first on Yale Daily News.

Heilpern is the former chief operating officer of the Weill Cornell Division at NewYork-Presbyterian Hospital and worked for 12 years as chair of the department of emergency medicine at Emory University School of Medicine. She will assume the position at Yale New Haven Hospital, the system’s flagship facility, on March 11. On Tuesday, the YNHH system announced that it will promote Pamela Sutton-Wallace SPH ’97, who previously served as interim president of YNHH, to president of the entire system. 

“I’ve had leadership positions that have served on both sides of the academic healthcare coin,” Heilpern said. “Having practiced emergency medicine for about 28 years, [this] gives me the opportunity to really understand life at the frontline, and the care that’s being delivered by the providers and how it feels on the side of patients and families.” 

Prior to Wallace’s interim appointment in 2023, Keith Churchwell was president of the hospital. Before Churchwell, Richard D’Aquila served as both the president of the hospital and for the entire YNHH system for nearly 15 years. 

For Arjun Venkatesh, chair of emergency medicine at the hospital, Heilpern’s appointment represents an important transition in YNHH’s leadership. Heilpern will be one of the few women running a hospital of YNHH’s size — the hospital is one of the largest in the United States. 

“There are not many women who lead hospitals among that top 10 or 20 list,” Venkatesh said, referring to specifically large hospitals. 

Heilpern will assume the role amid many ongoing developments at YNHH. Last week, the News reported on parents’ disapproval of YNHH’s plans to close one of its daycare locations in order to cut costs. 

Last fall, the YNHH system signed a preliminary agreement to acquire three hospitals from Prospect Medical Holdings — Manchester Memorial, Rockville General and Waterbury Health, which has prompted concerns about the system’s expansion, as the Connecticut healthcare giant’s expanding reach could decrease competition and increase patient costs. Amid such concerns, the deal has stalled.

Heilpern said that she is unaware of the charged response to the daycare closures and regards the acquisitions as beyond her role as YNHH president. 

Nevertheless, many YNHH officers expressed optimism about Heilpern and her new position. According to Venkatesh, many medical workers believe Heilpern’s history as an emergency physician will bring an important perspective. 

Venkatesh noted that many hospital presidents do not have a clinical background. However, he said that physician presidents could offer a more well-rounded perspective when determining how to best serve patients.

“I believe that physician-literate leaders can bring their clinical experience and lens of taking care of patients to [the] business leadership and organizational leadership skills you need to be … president of the hospital,” Venkatesh said.

Alan Friedman, the chief medical officer at YNHH, works closely alongside Ena Williams, the chief nursing officer at YNHH, and the president to improve patient care. For Friedman, the new YNHH president’s background could enhance patients’ experiences. 

“Having a president who is so clinically attuned to the day-to-day operations in the critical need to provide high quality, safe care to each and every patient in the most equitable ways, is what we seek to do,” Friedman said. 

Venkatesh also specifically highlighted that Heilpern’s perspective as a physician could help the hospital solve overcrowded hospitals. Her experience in emergency medicine may also help her tackle the wide range of issues in the healthcare system. 

“If you look anywhere in the news today, you’ll see hospitals crumbling,” Venkatesh said. “Having a president who has experience, with the full lens of hospitals and how they operate, and experience working in those kinds of capacity issues is  good for both the hospital and the community.”

In an interview with the News, Heilpern said that her goal is to deliver more accessible and convenient care to patients, especially to develop an efficient care continuum — from a pre-hospital setting, to the hospital and back home again.   

Heilpern also described her goal to deliver quality care through, “the force multiplier,” a collaboration between the School of Medicine, the School of Public Health and the School of Nursing.

“There aren’t too many places in the country, for that matter, in the world, that can pull together the talent that exists in the system, and in the schools,” Heilpern said. 

Yale New Haven Hospital employs over 5000 medical personnel and almost 15,000 staff members.

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The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 988. 

Crisis Text Line is a texting service for emotional crisis support. To speak with a trained listener, text HELLO to 741741. It is free, available 24/7 and confidential.

To talk with a counselor from Yale Mental Health and Counseling, schedule a session here. On-call counselors are available at any time: call (203) 432-0290.  Appointments  with Yale College Community Care can be scheduled here.

Students who are interested in taking a medical leave of absence should reach out to their residential college dean.

Additional resources are available in a guide compiled by the Yale College Council here.

In a Yale-led study published earlier this month, researchers investigated the impact of Generalized Anxiety Disorder — a mental health condition characterized by persistent and excessive anxiety that can disrupt daily life and functioning — on military veterans. 

The study was led by Grace Macdonald-Gagnon, a former psychiatry research assistant at Yale and current clinical psychology doctoral student at the University of Illinois at Chicago, alongside Robert H. Pietrzak, a professor of psychiatry at the School of Medicine and a researcher at the U.S. Department of Veterans Affairs National Center for PTSD. They found that 7.9 percent of veterans screened positive for probable Generalized Anxiety Disorder, or GAD, while only 2.9 percent of the general United States adult population experiences GAD. The researchers also found that almost one in four veterans experience mild anxiety disorders. 

The researchers noted that veterans with GAD or mild anxiety were more likely to have been deployed multiple times and to be young, female and from a racial or ethnic minority. Notably, those with probable GAD were more likely to have combat experience and had higher rates of past-year suicidal ideation and lifetime suicidal attempts compared to both mild anxiety and no-GAD groups. For Macdonald-Gagnon, this has profound implications. 

“Importantly, we found that even mild anxiety symptoms, which do not meet the level indicative of a positive screen on commonly used measures, are associated with elevated rates of co-occurring psychiatric and functional difficulties, as well as suicidal thoughts and behaviors,” Macdonald-Gagnon wrote in an email to the News. 

The researchers analyzed data extracted from the 2019-2020 National Health and Resilience in Veterans Study, a comprehensive survey of a cross-section of U.S. military veterans. The Yale researchers studied multiple sociodemographic and military factors — such as trauma burden, experiences of military sexual trauma, PTSD symptoms, substance use, mental health resources and thoughts of suicide — and how they are linked to anxiety symptoms.

Macdonald-Gagnon acknowledged that because the study’s data collection predated the onset COVID-19 pandemic, the study may not represent the full impact GAD symptoms have on veterans. 

According to Macdonald-Gagnon and Pietrzak, the results suggest that there is a linear correlation between the severity of anxiety symptoms and its negative effects on other psychiatric and daily functions. They argued that brief screening measures that assess both mild and severe anxiety symptoms could increase access to care for veterans. 

“Our study suggests that brief screening measures may help identify veterans who are experiencing anxiety symptoms, which are associated with other psychological problems such as depression and suicidal thoughts and behaviors, as well as functional difficulties,” Pietrzak wrote in an email to the News. 

Pietrzak suggested that these screenings should be delivered in primary care settings, such as those of the Veterans Health Administration, in order to increase access for veterans, many of whom Pietrzak said don’t actively seek mental health care. Further, Macdonald-Gagnon said that anxiety screenings could occur in primary care settings not specifically designed for veterans, such as college mental health clinics. 

“Screening for psychological symptoms in primary care settings could allow veterans to access education and support who maybe are not be actively seeking mental healthcare or may not know where/how to seek available resources,” Pietrzak wrote.  

Macdonald-Gagnon noted that while awareness of veterans’ mental health issues, such as PTSD, TBI, depression and substance abuse has grown, many challenges, including stigma, access barriers and service deficits, remain.

Still, she said that many existing organizations seek to improve veteran mental health care. She added that initiatives like the U.S. Preventative Services Task Force, which encourages adults to be screened for anxiety disorders, could be applied to veterans more broadly. 

For United States military veterans on college campuses like Yale, Macdonald-Gagnon recommended that they refine their mental health resource referral processes and help them transition to campus life. 

“Colleges can ensure that students and faculty/staff who are Veterans are provided with appropriate referrals and resources for mental healthcare, whether that be within the university healthcare systems or assisting individuals in locating resources outside of the university,” Macdonald-Gagnon wrote. “For example, The Department of Veterans Affairs has a VetSuccess on Campus program that provides support to individuals transitioning from the military to college.”

Jason Hug JGA ’27 LAW ’27 is a professional student at both the Jackson School of Global Affairs and Yale Law School. Before arriving at Yale, he worked for five years as a United States Army intelligence officer. 

Hug emphasized the importance of limiting the number of obstacles veterans have to face when transitioning to college. In particular, he said that having veteran representation on campus and bolstering institutional support to aid veterans during their transition is crucial.

“When applying to Yale, it was clear that the institution emphasized veteran representation within the current and incoming cohorts,” Hug wrote in an email to the News. “The institutional support in helping Veterans transition from military service and use their VA Benefits (i.e., Post 9/11 GI Bill, Veteran’s Readiness & Employment) has truly been unmatched.”
In November 2023, Yale News estimated that there are over 200 student veterans across the college and graduate schools.

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The daycare center currently operates out of two locations, each located around 10 minutes away from the other by car. Both provide childcare services to employees of the Yale New Haven Hospital, though the daycare located at 110 Davenport St. is larger and operates with greater child enrollment.

On Feb. 13, however, families enrolled at the Yale New Haven Hospital Day Care Center received an email announcing that the Davenport Street location would be closing permanently on June 28, 2024. 

At a Feb. 15 town hall meeting for parents, YNHH administrators informed parents that the remaining YNHH daycare center, on 501 George St., would not have the capacity to include all children currently enrolled at the Davenport Street facility.

“We recognize that there will not be a spot for everyone,” said Melissa Turner, senior vice president and chief human resources officer at YNHH, during the town hall. 

YNHH did not immediately respond to the News’s request for comment on Sunday afternoon.

The closure is occurring amid record losses for the hospital system during the COVID-19 pandemic: for the fiscal year 2023, the Yale New Haven Health system budgeted for a $250 million deficit.

As a cost-saving measure, administrators plan to outsource daycare operations to Bright Horizons, a national organization that provides childcare services, YNHH leaders announced to parents in January. The shift has sparked concern among parents about prospective tuition hikes at the YNHH daycare, which previously cost far less than local comparable daycare facilities due to YNHH subsidies. 

The prospective partnership with Bright Horizons has also prompted alarm about daycare educators’ futures at the center. During a staff meeting with daycare educators, Turner and other YNHH administrators announced that current daycare employees would have to be rehired for their current positions. 

At the town hall, administrators at the YNHH Daycare Center and Bright Horizons attempted to address some of the parents’ concerns about the consolidation of the daycare centers and the new YNHH-Bright Horizons partnership.

Turner reassured parents that YNHH’s partnership does not indicate that the hospital is “selling our daycare and daycare services.”

She also clarified that all teaching staff in good standing would be offered employment at the George Street daycare center. There would be no application and interview, she added — “simply a background check.”

However, Turner announced that there would be limited capacity at the consolidated daycare location, meaning that not every family could be promised a spot.

Parents will be required to complete a “Needs Assessment Survey,” which daycare administrators will use to determine which families will receive spots at the consolidated center. The survey will also be used to determine new hours of operation and tuition rates. 

“No surprise to all of you, we had a pretty substantial subsidy in place up to this point,” said Jodie Boldrighini, the vice president of human resources at YNHH. “We first need to understand the needs assessment and understand the volume of children and teachers at the center and do a market assessment of where rates are.”

The News was able to acquire the survey from parents. Other than family information and demographics, the survey includes two questions. The first asks whether the children currently enrolled at the center are interested in staying, have plans to leave or would be graduating in the fall. The form then asks for “hours needed” from families. It does not include any questions or information about tuition rates. 

The closure and re-assessment process has generated new frustration among parents at the center. Deborah Greig, an educator in New Haven who has two children at the daycare, believes that the daycare consolidation process has broken old promises of a guaranteed spot until they reach the age for kindergarten.

She chose the YNHH Daycare Center in part because it is one of the few facilities that allows children to stay until they are 5 years old without switching locations, she said.

“It is something we intentionally looked for, we want them to feel comfortable at a place,” said Greig. 

Because her child is at a specific age threshold that some childcare systems do not support, the YNHH Daycare Center may be Greig’s only option, she added. 

“I was talking to some daycare places and they said ‘He’s 2 years and 7 months old in August, and he needs to be 2.8,” Greig said “So we just can’t have a spot for him in our Pre-K because he doesn’t make the cut off.’”

Meanwhile, public preschools are not an option for Greig’s family because the cutoff is even higher, at 3 years of age. In addition, most public preschools end at 3 p.m. and do not provide after-school care until she finishes her workday. 

Another daycare parent, a YNHH medical staff administrator who requested anonymity from the News over concerns of employer retribution, described concerns over the consolidation’s impact on her daughter’s sense of emotional stability.

After moving to New Haven two years ago with her daughter, the employee tried other daycare locations where her daughter experienced “a lot of behavioral and emotional difficulties adjusting.” 

However, her child had a smooth transition to the Davenport location of the daycare, she said. The center was also conveniently located for her. 

“I don’t have to worry about finding a place that opens before I go to work,” the employee said. “I don’t have to worry about getting to work on time. The commute is just very seamless.” 

Her biggest fear is that her daughter will not be able to transition into a new environment. 

“I am worried that she would relive the emotional changes or behavior changes just due to the changes of people, routine, or how this other center may run their operations,” she added.

The parents also expressed skepticism about the continued affordability of the daycare center. 

One of the other parents of a child at the YNHH daycare center is an employee at a Bright Horizons center in Connecticut, she said. 

However, because he couldn’t afford Bright Horizons tuition, he opted to send his daughter to the cheaper YNHH center instead.

The current closest Bright Horizons daycare center is located at Yale West Campus at 230 West Campus Dr. in Orange.

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Researchers at the School of Medicine and the University of Pennsylvania fine-tuned genetic prediction models for opioid dependence by considering a combination of factors, including genetics, socioeconomic level and mental health history. 

Their latest study, based on 1,958 volunteers and published last week in the journal Psychological Medicine, found that genes alone were weak predictors of opioid use disorder. Instead, they improved their ability to predict volunteers’ susceptibility to opioid dependence by factoring in personal experiences, such as a prior diagnosis of post-traumatic stress disorder, or PTSD. 

Their study helps clarify a larger dilemma facing physicians as they attempt to treat pain with opioids: How do doctors know which patients who need painkillers are at risk of developing opioid dependence? 

“Some people may blame the genes, some people might blame the social environment, but I would say both are important,” said Peter Na, one of the investigators and an assistant professor of psychiatry at the School of Medicine. 

This study is a part of a larger effort by the Yale-Penn research team that has recruited more than 14,000 participants to investigate substance use disorders. Since 1999, they have interviewed and collected genetic samples from these volunteers, building a repository of biological and background data on substance use disorders. 

In previous research, Joseph Deak, a member of the Yale-Penn team and an associate research scientist in psychiatry at the School of Medicine, analyzed whether any common genetic differences between individuals carried an increased risk for opioid use disorder. Looking at 7.5 million sites in the human genome, Deak identified 19 high-risk genetic locations that were common across individuals with opioid use disorder.

Still, Deak found that the genetic differences at those locations explained only a small fraction of different individuals’ risks for opioid use disorder: in other words, genes alone were not an effective predictor of opioid misuse, he said. 

Na said that experts consider opioid use disorder through a “biopsychosocial model,” considering how biology, psychology and social circumstances converge to explain addiction.

But scientists do not know how much of the vulnerability to opioid use disorder is due to genetic risks compared to other social and psychological factors, like income level, psychiatric diagnoses or childhood trauma. 

In their most recent study, the scientists re-ran Deak’s prior genetic analysis while factoring in participants’ non-genetic information — including partnered status, household income, sex and exposure to trauma — to see how non-genetic risk factors might explain the development of opioid use disorder. To do so, they examined interview data and genetic information from 1,958 patients who had enrolled in a prior Yale-Penn study. 

After correcting for non-genetic differences, the researchers found that genes, on their own, continued to be a small yet informative predictor of opioid use disorder diagnosis. 

But participants’ education levels and mental health histories were more closely tied to opioid dependence risk, they found. Patients with less than a bachelor’s degree and a previous PTSD diagnosis had a higher risk of developing opioid dependence, regardless of their genes, according to their research. 

“Not only does genetic risk of opioid use disorder increase the risk of developing the disorder, as one would expect, but it interacts with other features, such as educational level and post-traumatic stress disorder,” said Henry Kranzler, a professor of psychiatry and the director of the Center for Studies of Addiction at the University of Pennsylvania’s Perelman School of Medicine, who co-founded the Yale-Penn collaboration. “It’s a gene-by-environment kind of interaction.” 

The finding that non-genetic risks to opioid use disorder can overwrite genetic predispositions is a new insight. A better understanding of risk factors for opioid dependence could create a future where physicians can better weigh the risks of prescribing opioids. 

As it stands, however, the model is far from accurate enough to be a clinically useful tool, Na said. 

Kristen Brennand, professor of psychiatry and genetics at the School of Medicine who was not involved in the research, suggested that the study’s data was not large enough to draw conclusions from. In the future, larger genetic studies with more target gene locations will be key, she said. 

Brennand also highlighted the limitations of the researchers’ risk assessment — a method called polygenic risk score. The scores can be a useful tool to understand how common gene variants are tied to the probability of disease, but they are not a rock-solid diagnostic, she said.

“It’s just a math problem — polygenic risk scores are mediocre at predicting disease,” Brennand said. “You would never use them in a fertility clinic. You could barely use it in an adolescent high-risk clinic.”

In the paper, the scientists caution against kits that claim to predict opioid dependence risk based on genetics alone. The FDA, for instance, approved a genetic test in December though researchers found that its analysis was inaccurate.

“The level of genetic prediction is so low at this point that we can’t really use it for identifying people at risk in the population,” said Dr. Kranzler. “But it’s only a matter of time — using things like the environmental factors we looked at — before you can come up with a profile of risk.” 

Other experts also pointed out what they said was a limited diversity of the study’s participants. The researchers only had enough data to look at individuals from European ancestry. It’s a shortcoming that led Sterling Elliott, a pharmacist and assistant professor of orthopedic surgery at the Feinberg School of Medicine at Northwestern University who specializes in post-surgery pain management, to question whether these findings were “generalizable enough to the American population.”

But Brennand agreed that further research on the links between genetics and substance use disorders, like this one, will be critical for doctors to better understand how addiction can pass through generations.

“So many people just don’t even think about the heritability of addiction,” Brennand said. “And what we actually know from genetic studies is not only is addiction heritable, but the type of drug of choice actually seems to be in the genetics too.” 

According to the Centers for Disease Control and Prevention, more than 1 million people have died since 1999 from a drug overdose.

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