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6 Healthcare Action Items for the LGBTQIA+ Community
© Niyazz via Canva.com Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs. Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health. PrEP and PEP Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months. Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days. PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location. HPV Immunization All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime. The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never! STI Testing Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year. Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you. Prostate Exams Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old. These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened. Pap Tests and Pelvic Exams Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer. Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings. Mammograms and Breast Exams People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual. The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project. Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.
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Steve Shell se une a Renown para dirigir el Stacie Mathewson Behavioral Health & Addiction Institute
Under Steve Shell's leadership, the Institute will continue to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. Renown Health is excited to announce Steve Shell is joining the Stacie Mathewson Behavioral Health & Addiction Institute at Renown as its vice president. In this role, Shell will oversee the Institute, which provides intensive outpatient treatment, partial hospitalization programs and medication-assisted treatment to serve those struggling with mental illness and addiction in our community. “We are pleased to welcome such an experienced and talented leader like Steve to our organization,” said Tony Slonim, MD, DrPH, president and CEO, Renown Health. “As vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown, Steve will continue the Institute’s work to change the status of mental health and addiction in northern Nevada.” Shell llega a Renown luego de inaugurar y dirigir los dos hospitales de salud conductual más nuevos de Nevada desde 2013. Fue fundamental en la creación del Reno Behavioral Healthcare Hospital en 2016 y ayudó a diseñar, establecer y gestionar las operaciones de este centro de tratamiento psiquiátrico y de adicciones con 124 camas para personas de todas las edades. También inauguró en 2013 el Desert Parkway Behavioral Healthcare Hospital, en Las Vegas, un centro de tratamiento psiquiátrico y de adicciones que cuenta con 152 camas para personas de todas las edades. “Nevada has the highest prevalence of mental illness and substance use in the nation combined with limited access to treatment and a shortage of care providers,” said Steve Shell. “I am passionate about improving the health of our community and have dedicated my career to advocating for mental health, working diligently to further elevate the care offered in our state.” Renown Health and Charles N. and Stacie L. Mathewson established the Stacie Mathewson Behavioral Health & Addiction Institute at Renown in to expand community access to prevention and intervention services for mental health disorders and alcohol and drug addiction. The Institute is working to expand intensive outpatient treatment, partial hospitalization programs and medication-assisted treatment to better serve those struggling with mental illness and addiction and is working to decrease stigma and encourage more people to seek help. “Moving the needle and improving the heartbreaking statistics of our state is a key focus for the Institute,” said Stacie Mathewson, executive director at the Stacie Mathewson Foundation. “I believe Steve’s leadership will have a positive impact on our efforts to improve the care and treatment of mental illness and addiction.” About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®.
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Takesha Cooper, M.D., Appointed Chair of Psychiatry & Behavioral Sciences
Takesha Cooper, MD, has joined the University of Nevada, Reno School of Medicine and Renown Health as Department Chair of Psychiatry and Behavioral Sciences. Dr. Cooper comes to the area from the University of California, Riverside School of Medicine where she served for seven years as clinical associate and then full professor in the Department of Psychiatry and Neurosciences, and associate training director for Child and Adolescent Psychiatry. Dr. Cooper previously served as associate medical director for the Riverside University Health System and Riverside County Department of Mental Health providing clinical and operational oversight for four regional psychiatric county clinics, and as an adjunct instructor of psychiatry at Stanford University School of Medicine. As a double board-certified child, adolescent, and adult psychiatrist, she also established a successful solo private practice serving patients from diverse backgrounds. At UC Riverside, Dr. Cooper held significant academic and leadership roles including vice chair of education, residency program director, chair of the Admissions Committee and equity advisor. Dr. Cooper will now build on the strong foundation established by Dr. Josh Fitzgerald, interim chair of the department, who will now serve as director of research for the department. Dr. Cooper will be responsible with Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown Health, for leading the Behavioral Health Program at the Institute where a team of nine psychiatrists, nurse practitioners and licensed professionals and counselors provide intensive outpatient treatment, partial hospitalization programs, Transcranial Magnetic Stimulation, Esketamine, hospital-based assessment and medication-assisted treatment to serve those struggling with mental illness and addiction across northern Nevada, Lake Tahoe and northern California. “We are delighted to have Dr. Cooper join the UNR Med/Renown team,” said Paul J. Hauptman, MD, dean of UNR Med and chief academic officer for Renown Health. “She brings a wealth of experience in multiple clinical settings, and we are confident that she will have a significant impact at a time of great need for mental health services, education, and research in northern Nevada. Dr. Cooper will do much to advance the mission of UNR Med which includes a commitment by the Department of Psychiatry to train the next generation of psychiatrists through a Psychiatry Residency and Child & Adolescent Psychiatry Fellowship training program. Education and training are provided in both urban and rural areas of northern Nevada.” Dr. Cooper earned her Doctor of Medicine Degree from the Keck School of Medicine at the University of Southern California and completed her residency at San Mateo County and fellowship at Stanford University. Prior to medical school, she obtained a Master of Science degree in Biochemistry and Molecular Biology from UC Riverside and her bachelor’s degree in Biochemistry and Molecular Biology from UC Santa Barbara. Dr. Cooper’s research explores the impact of Adverse Childhood Experiences on mental health outcomes in children and adults. She served as a clinical co-PI on a U54 funded grant aimed at reducing health disparities by engaging in community-based participatory research partnerships. “Dr. Cooper is an energetic, collaborative physician, researcher and mentor who cares deeply about improving the mental health and well-being of adults and children,” said Brian Erling, MD, MBA, President and CEO, Renown Health. “This is an exceptionally exciting time to advance health equity and to help improve mental health outcomes for people and communities across northern Nevada. We are excited that Dr. Cooper is joining our team. I know her talent, energy and leadership will further elevate our mission of outstanding care, exceptional training, innovative research, impactful advocacy and innovative community partnerships in mental health and addiction medicine.” Dr. Cooper is recognized for her passion for high-quality patient care and supports future practitioners through rigorous and culturally informed undergraduate and graduate medical education, research, and community collaboration. A 2022 graduate of the Executive Leadership in Academic Medicine (ELAM) program offered through Drexel University, she also maintains active involvement in national and state committees and journal editorial boards. The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Desde 1969, UNR Med ha capacitado a más de 3,900 estudiantes, residentes y becarios. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu. Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Visite renown.org para obtener más información.
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Renown Now Offering rTMS Treatment for Major Depression
Treatment offers patients safe, non-drug and non-invasive repetitive transcranial magnetic stimulation (rTMS) therapy to treat symptoms of major depression. Renown Health is committed to improving access to vital mental health services in northern Nevada. Today, clinical leaders at the Stacie Mathewson Behavioral Health & Addiction Institute at Renown announced they will offer repetitive transcranial magnetic stimulation (rTMS) therapy for people experiencing Major Depressive Disorder (MDD) under the guidance of a Renown psychiatrist. According to the National Institute of Mental Health, major depression is one of the most common mental disorders in the U.S. The disease causes people to experience sadness and helplessness, and in some cases, may prevent people from carrying out their daily routines. “We at Renown are proud of our national reputation as an innovator in implementing new models, technology and systems of care for our community,” said Tony Slonim, MD, DrPH, President and CEO. “We are working to transform care and demonstrate value in a way that appeals to patients and helps clinicians improve outcomes and reduce costs. There is now a sufficient body of evidence to accept the analgesic and antidepressant effect of high-frequency rTMS, and we are pleased to offer this promising therapy.” rTMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. It is typically used when other depression treatments haven't been effective. This treatment for depression involves delivering repetitive magnetic pulses, so it's called repetitive TMS or rTMS. “Depression can be treated; however, for some people, medications and talking with a behavioral health expert may not be enough,” said Renown’s Division Chief of Behavioral Health, Richard A. Charlat, M.D., M.P.H. “We are pleased to offer rTMS therapy for people looking for a new way to fight depression and for whom other treatments may not have given them relief. We are committed to working closely with our patients to find the treatment that works best for them, so they can live their best lives.” “Nevada has the highest prevalence of mental illness and substance use in the nation,” said Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute. “Combine that with the added stress and isolation many are feeling with the COVID-19 pandemic, and we know that offering patients safe, non-drug and non-invasive treatments- as well as essential mental health and addiction services are more important than ever.” How rTMS Works During an rTMS session, an electromagnetic coil is placed against the person’s scalp near their forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of the person’s brain involved in mood control and depression. It's thought to activate regions of the brain that have decreased activity in depression. Though the biology of why rTMS works isn't completely understood, the stimulation appears to impact how the brain is working, which in turn seems to ease depression symptoms and improve mood. There are different ways to perform the procedure, and techniques may change as experts learn more about the most effective ways to perform treatments. En promedio, los pacientes se someten a tratamientos de EMTr durante cuatro a seis semanas, cinco días a la semana, durante unos 40 minutos al día. In all cases, a patient’s doctor will determine a treatment plan that’s best for the patient. This video shows what patients can expect during rTMS therapy. What Does rTMS Feel Like? rTMS therapy is an easy, in-office experience designed to be positive for patients. During treatment, people are awake, alert, and comfortably reclined in a spa-like chair. Los primeros tratamientos pueden causar molestias en la zona de tratamiento o cerca de ella; sin embargo, es poco probable que esto dure más allá de la primera semana de tratamiento.1, 2 “Los efectos de la depresión pueden ser devastadores para las personas que luchan contra ella, así como para sus seres queridos”, afirmó Stacie Mathewson. “No importa cuán oscura pueda parecer la vida, siempre tenga en cuenta que hay increíbles expertos en salud conductual en Renown dispuestos a apoyarlo y empoderarlo mientras busca la ayuda que se merece”. Charles N. y Stacie L. Mathewson crearon el Stacie Mathewson Behavioral Health & Addiction Institute en Renown en 2018 para ampliar el acceso de la comunidad a los servicios de prevención e intervención de los trastornos de la salud mental y la adicción al alcohol y las drogas. Renown is working to expand intensive outpatient treatment, partial hospitalization and medication-assisted treatment programs to better serve those struggling with mental illness and addiction. The Renown team is also passionate about prevention, mental wellness and is actively working to decrease stigma and encourage more people to seek the help they need. TMS therapy is cleared by the FDA and available by prescription only. It is commonly covered by most insurance plans. Patients must be referred by a behavioral expert to seek rTMS treatment. Para obtener más información y para referir a un paciente, llame al Stacie Mathewson Behavioral Health & Addiction Institute al 775-982-5318. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Health, Neurosciences and Robotic Surgery. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. Sources Trivedi MH, et al. (2006). Evaluation of Outcomes with Citalopram for Depression Using Measurement-Based Care in STAR*D Implications for Clinical Practice. Am J Psychiatry, 163(1):28-40 Rush AJ, et. al. (2006) Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry, 163(11):1905-1917.
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Programa de vida infantil
Providing emotional support for your children, and you. It is undeniable that hospitals can be a daunting experience for all, but when a child is faced with a difficult diagnosis or staying in the hospital, it can be especially overwhelming. Fortunately, Renown Health has a team of experts called the Child Life team to help. This group of devoted healthcare providers collaborate with kids who have been admitted to the hospital, as well as children whose family member is a patient at Renown, to ensure they understand every aspect of their visit, while also letting them be kids. Child Life Specialists provide support to children and their families by: Assessing patients developmental level and tailoring interactions to each individual family need Helping children cope with worries, fears and/or separation Making doctors, needles, and tests a little less scary by creating coping plans Organizing activities in the playroom and at bedside Addressing parent and caregiver concerns Preparing patients and families for what to expect Fostering a therapeutic environment through play opportunities Offering a hand to hold during tests, procedures, and tough stuff Offering services like art, music and pet therapy Creating special memories and mementos for children and families in times of grief and loss The Child Life Program is available seven days a week at Renown Health and the team can be reached at 775-982-5173.