The Development of a Master of Public Health Program with an Initial Focus on Urban and Immigrant Health at the State University of New York,Downstate Medical Center

The State University Downstate Medical Center initiated a Master of Public Health (MPH) degree program in July 2001 following planning efforts that began in 1995. Twelve Students entered the program in June 2002. Currently, eighty students are enrolled in the program and eighteen have graduated from it in 2004 and 2005. With an initial focus on urban and immigrant health, the program aims to train public health professionals who can assist in addressing through population-based interventions the health issues of Brooklyn’s 2,465,326 people, of whom 38.5% are immigrants to the United States. Starting with four courses in the summer 2002 semester, the program now offers twenty-four courses over the three semesters of the academic year. The program is housed in the Department of Preventive Medicine and Community Health of the College of Medicine and is part-time in nature for most students. In addition to completing required course work, students must also complete a 250-hour practicum experience in which they apply theoretical knowledge in a public health practice setting. Student practicum experiences play a vital role in linking the program to communities and serve as conduits for the initiation of further community based collaboratives. This article describes the challenges encountered in initiating an MPH program in an academic medical center, the importance of both intramural and community support to its success, and the vital role it plays in addressing the health issues of various communities. The program became a leading priority of the Strategic Plan of the Downstate Medical Center in 2000, and received the full support of Downstate’s then new president, Dr. John C. LaRosa. This prioritization and support proved essential to the rapid development of the program. The Downstate MPH program offers a concurrent degree to medical students who are able to complete both degrees in a four year period. The Alumni Fund of the College of Medicine provides each MD/MPH student with a one-time scholarship which covers a quarter of the MPH tuition. Concurrent MPH degrees are also offered for graduate students enrolled in occupational therapy, nursing, and several other health programs. The Council on Education for Public Health (CEPH) conducted an accreditation site visit of the Downstate MPH program in December 2004. On June 10, 2005, the CEPH Board accredited the program for 5 years. Pascal James Imperato, MD, MPH & TM is Distinguished Service Professor and Chair, Department of Preventive Medicine and Community Health and Director of the Master of Public Health Program, SUNY Downstate Medical Center; Judith H. LaRosa, PhD, RN is Professor of Preventive Medicine and Community Health and Deputy Director of the Master of Public Health Program, SUNY Downstate Medical Center; Leslie Schechter, MA is the Administrator for the Department of Preventive Medicine and Community Health and the Master of Public Health Program, SUNY Downstate Medical Center.     

Rapid loss of nicotine-cholinergic receptor binding activity in the deafferented avian optic lobe

The levels of alpha-bungarotoxin (alpha-BuTX) sensitive receptor sites were investigated in the optic lobe after optic deafferentation in the neonatal and adult chicken. Within two days a 30% loss of alpha-BuTX binding sites per optic lobe is observed in the neonatal chick after enucleation. The results are similar with the adult chicken in experiments where the receptor binding activity is measured in the optic lobe and in the optic tectum after enucleation. The possibility that acetylcholine is a neurotransmitter in the vertebrate retinotectal pathway is discussed.     

Air in gallbladder: a frequent finding in gallstone ileus.

A retrospective assessment of the presence of air in the biliary tract is presented, based on plain film findings in 16 proven cases of gallstone ileus. In addition to five cases that demonstrated air in the biliary radicles, four cases exhibited air exclusively in the gallbladder and duodenal bulb. A clearly identifiable radiographic appearance composed of two adjacent small air-fluid levels in the right upper quadrant is described. This radiographic feature represents the air- and fluid-filled duodenal cap adjacent to the visualized shrunken gallbladder. Recognition of this combination of findings helps in establishing a prompt preoperative diagnosis in cases of gallstone ileus.     

Early-stage visual processing and cortical amplification deficits in schizophrenia

BACKGROUND: Patients with schizophrenia show deficits in early-stage visual processing, potentially reflecting dysfunction of the magnocellular visual pathway. The magnocellular system operates normally in a nonlinear amplification mode mediated by glutamatergic (N-methyl-D-aspartate) receptors. Investigating magnocellular dysfunction in schizophrenia therefore permits evaluation of underlying etiologic hypotheses. OBJECTIVES: To evaluate magnocellular dysfunction in schizophrenia, relative to known neurochemical and neuroanatomical substrates, and to examine relationships between electrophysiological and behavioral measures of visual pathway dysfunction and relationships with higher cognitive deficits. DESIGN, SETTING, AND PARTICIPANTS: Between-group study at an inpatient state psychiatric hospital and outpatient county psychiatric facilities. Thirty-three patients met DSM-IV criteria for schizophrenia or schizoaffective disorder, and 21 nonpsychiatric volunteers of similar ages composed the control group. MAIN OUTCOME MEASURES: (1) Magnocellular and parvocellular evoked potentials, analyzed using nonlinear (Michaelis-Menten) and linear contrast gain approaches; (2) behavioral contrast sensitivity measures; (3) white matter integrity; (4) visual and nonvisual neuropsychological measures, and (5) clinical symptom and community functioning measures. RESULTS: Patients generated evoked potentials that were significantly reduced in response to magnocellular-biased, but not parvocellular-biased, stimuli (P = .001). Michaelis-Menten analyses demonstrated reduced contrast gain of the magnocellular system (P = .001). Patients showed decreased contrast sensitivity to magnocellular-biased stimuli (P<.001). Evoked potential deficits were significantly related to decreased white matter integrity in the optic radiations (P<.03). Evoked potential deficits predicted impaired contrast sensitivity (P = .002), which was in turn related to deficits in complex visual processing (P< or =.04). Both evoked potential (P< or =.04) and contrast sensitivity (P = .01) measures significantly predicted community functioning. CONCLUSIONS: These findings confirm the existence of early-stage visual processing dysfunction in schizophrenia and provide the first evidence that such deficits are due to decreased nonlinear signal amplification, consistent with glutamatergic theories. Neuroimaging studies support the hypothesis of dysfunction within low-level visual pathways involving thalamocortical radiations. Deficits in early-stage visual processing significantly predict higher cognitive deficits.