Week 8 - Body Systems + Medical Terms Directions and Positions ● Anterior (front side) vs Posterior (back side) ● Cranial (forehead) bvs Caudal (back of head) ● Flexion (arms in) vs Extension (arms out) ● Internal vs External ● Medial (hands to chest) vs Lateral (hands to side of body) ● Distal (fingertips) vs Proximal (shoulder) ● Superior (top half) vs Inferior (bottom half) ● Prone (sleeping) vs Supine (head down sleeping) Planes of Movement ● Frontal ○ Anterior / Posterior ○ Adduction / Abduction ● Sagittal ○ Right / Left ○ Flexion / Extension ● Transverse ○ Superior / Inferior ○ Rotation Body Systems Integumentary System ● Organ system that protects the body ● Largest cell in the entire body ● Provides cushioning ● Helps with temperature regulation ● Attachment site for sensory receptors ● Provides vitamin D synthesis (skin, hair, nails) Digestive System ● Mechanical & Chemical breakdown of food into smaller components that can be easily absorbed (catabolism) ● Mouth (Mastication) ○ Saliva digests starch → Bolus - soft mass of chewed food ● Esophagus ○ Peristalsis - a series of muscle contractions and relaxations that occur along the course of the intestinal tract to push food and waste products through ● Stomach - Gastric Juice (hydrochloric acid & pepsin) digests protein (+mucus) ○ Chyme (1-2 hours) - is partially digested mass of food that is forced into the small intestine. It has a low pH balance that is countered by the production of bile, helping to further digest food. Chyme combined with bile ultimately is secreted from the body in the form of bowel movements ● Intestines ○ 95% of Digestion takes place in the small intestine ○ Colon - water & minerals reabsorbed Respiratory System ● Airways - nose vs mouth ● Lungs - alveoli ● Respiratory Muscles ○ Diaphragm ■ Separates thoracic & abdominal cavities ■ Contracts = air drawn into the lungs ■ GAS exchange = diffusion of O2/CO2 Cardiovascular System (the heart) Nervous System ● CNS - brain & spinal cord ● PNS - nerves that connect CNS to body ● Cranial Nerves - 12 pairs of nerves control signals to and from the brain, muscles, glands, internal organs, heart & lungs ● Central Nerves - the CNS is composed of the brain and spinal cord. Your brain and spinal cord serve as the main “processing center” for the entire nervous system, and control all the workings of your body ● Peripheral Nerves - they are the ones outside your brain & spinal cord. Like static on a telephone line, PN disorders distort or interrupt the messages between the brain and the rest of the body ● Autonomic Nervous System - “involuntary nervous system” (HR, digestion, RR, perspiration, sexual arousal) Genitourinary System (Reproductive organs & urinary system) (High # of nerve endings) Males Females Eyes and Ears ● Auditory System (EARS) ○ Detect sounds ■ The CNS actually ‘hears’ ■ Sound waves changed to a signal of nerve impulses sent to the brain ○ Aids in balance & body position (8th Cranial Nerve - Vestibular Nerve) ● EYES ○ Detect light & convert it to electro-chemical impulses to create images Musculoskeletal System ● 206 bones in body ○ Adult Skeleton: 28 skull bones (8 cranial, 14 facial, 6 ear) ○ horseshoe-shaped hyoid bone of the neck which is the only bone that does not articulate (connect via a joint) to another bone ○ 26 vertebrae (7 cervical or neck; 12 thoracic; 5 lumbar or loins; the sacrum, which is five fused vertebrae; and the coccyx, which is four fused vertebrae) ○ 24 ribs plus the sternum or breastbone ○ the shoulder girdle (2 clavicles, the most frequently fractured bones in the body, and 2 scapulae) ○ the pelvic bones (3 fused bones called the coxal bone, or Os Coxae) ○ 30 bones in each of the arms and legs (a total of 120) ○ a few partial bones, ranging from 8-18 in number, which are related to joints ● 639 skeletal muscles (some sources say 640) // 40% body weight is muscle Endocrine System ● Different organs secrete different hormones ○ Metabolism ○ Growth / Development ○ Mood ○ Tissue Function Medical Terminology Abduction - to draw away from the midline of the bod Adrenomegaly - enlargement of the adrenal gland Alopecia - baldness; hereditary or caused by chemotherapy Amputation - removal of a limb or other appendage of the body Anesthesia - loss of feeling or sensation Angioplasty - surgical or percutaneous reconstruction of blood vessels Anorexia - lack or loss of appetite for food Anoxia - without oxygen Aphasia - loss of the ability to speak owing to injury or disease of the brain centers Arrhythmia - variation form normal heart rhythm Aspirate - removal of fluid from a lump, often a cyst Ataxia - failure of muscle coordination AU - both ears Audiometer - a device for testing the hearing Biopsy - removal and examination, usually microscopic, of tissue from living body, performed for diagnosis Body cavities - hollow spaces containing body substances for recycling or excretion Bradycardia - slowness of the heartbeat, as evidenced by slowing of the pulse rate to <60 Bradypenia - abnormally slow breathing Cachexia - malnutrition, wasting and emaciation Cardiovascular system - heart and blood vessels; blood pumped and circulated through the body Cerebrum - main part of the human brain, occupying the upper part of the crania cavity Cirrh/o orange-yellow Cl Liq - clear liquids only; ginger ale, tea, broth, jell-o, 7-up, coffee Clavicle - a long, curved, horizontal bone just above the first rib (collar bone) Constriction - making something arrow; to contact; to close (an opening) Contracture - permanent contraction of a muscle Cornea - transparent anterior part of the eye Cyanosis - a bluish discoloration of skin and mucous membranes caused by insufficient oxygen in the blood Debridement - removal of contaminated or devitalized tissue from a traumatic or infected lesion Decagram - a weight of 10 grams Dermatology - the medical specialty concerned with the diagnosis and treatment of skin diseases Diaphoresis - profuse perspiration Diffusion - state or process of being widely spread Dysphagia - difficulty swallowing Embolism - the sudden blocking of an artery by an embolus Endometriosis - cells of the lining of the uterus spreading into the pelvis (peritoneal cavity) Epidermis cuticle - the outermost, non vascular layer of the skin; composed of, from within outward; 5 layers; basal layer, prickle cell layer, granular layer, clear layer, and horny layer Epithelial tissue - the skin and lining surfaces that protect, absorb, and excrete Exfoliation - a falling off in scales or layers FF - push fluids Fistula - an abnormal passage between two internal organs, or leading to the body surface Formen - a natural opening or passage, especially one into or through a bone Gangrene - death of tissue from lack of circulation and consequent loss of nutrients Gastritis - inflammation of the stomach lining; a common stomach disorder Geriatrician - a physician who specializes in the diagnosis and treatment of the diseases of the aging and elderly Gestation - period from conception of birth Hemorrhage - the escape of blood form the vessels; excessive bleeding Hg++ - mercury Infarction - a localized area of ischemic necrosis owing to occlusion of the arterial supply Ischemia - deficiency of blood in a part; due to spasm of blood vessel, temporarily reducing blood flow Laparotomy - incision through any part of the abdominal wall Laryngoscopy - visual examination of the interior larynx with an instrument called a laryngoscope Mantoux or PPD - a test for tuberculosis Meatus - urinary passage or opening Meconium - dark green mucilaginous material in the intestine of a full term fetus, expelled at first stool Mega - one million times the size of unit Meningitis inflammation - of the meninges caused by bacterial viral, or viral infection Metabolism - sum of the body's physical and chemical processes that convert food into elements for body growth, energy, building body parts and degrading body substances for recycling or excretion Morgue - units for autopsies/holding the deceased Neuropathy - any functional disturbances and/or pathologic changes in the peripheral nervous system; a complication in some diabetic patients npo no food or fluid by mouth Nullipara - a woman with no children Occlusion - obstruction, a closing off of the coronary arteries, leading to a heart attack Opthalmology - the branch of the medicine dealing with the eye Paresis - slight or incomplete paralysis pc after meals Perforation - a hole in something e.g., perforation of the stomach wall by a gastric ulcer Peritoneum - membrane lining abdominal walls and pelvis, cavities, and investing the contained viscera, the peritoneal cavity Pharmacist - one who is licensed to prepare, sell, or dispense drugs, compounds, and prescriptions PO - by mouth Podiatrist - a specialist who deals with the study of care of the foot Polyp - a growth that protrudes from a mucus membrane Postpartum - 6 week period following childbirth prn as needed Prognosis - a forecast of the probable course and outcome of a disorder Pruritus - itching Psychiatrist - a person who specializes in the diagnosis and treatment of mental disorders Ptosis - drooping of upper eyelid qd - once a day qid - 4 times a day Quadriplegic - paralysis of all four limbs Respiratory system - nose, pharynx, larynx, trachea, bronchi, and lungs. Furnishes oxygen, removes carbon dioxide Sinus - one definitions is a recess, cavity, or channel, such as one in bone ss one-half Stoma - artificial opening established by colostomy, ileostomy, and tracheostomy Strabismus - deviation of the eye from normal (cross-eyed) Subluxation - partial dislocation Submerged - under the surface Superior - situated above, or directed upward Sweat test - examines the presence of Cystic Fibrosis Syncope - a faint, temporary loss of consciousness Syndrome - a set of symptoms occurring together Tendonitis - inflammation of tendon Tinea - ringworm; a name applied to many different fungal infections Tinnitus - a noise (ringing) in the ears Toxemia - a group of pathologic conditions, essentially metabolic disturbances, occurring in pregnant women, manifested by hypertensions, edema, etc. May be preclampsia or eclampsia Transverse - a plane that divides the body into superior and inferior sections (top and bottom) Uremia - the retention of toxic body waste in blood Ventricle - a small cavity or chamber, as n the brain or heart Vertigo - a sensation of rotation or dizziness Week 9 - PA Program, Pharmacy, Physical Therapy Amanda Kulesza (PA Program) ● Was a student at LIU --> major in HS --> PA program ● Graduated 19 years ago (undergrad) --> graduated PA program in 2014 ● PA's are independent providers who provide medical services ● Works for CityMD --> urgent care provider ● Sees patients for covid testing to like chest pains, lacerations, able to prescribe medicine and referrals, etc. ● Started in specialty of urology (chronic UTI, etc.) --> labor/delivery at NYP (in patient care) ● You can work in different specialties (lateral mobilization) ○ Urology (was a MA urology assistant) ○ L/D ○ Level 1 trauma (MVA, emergency, etc.) ○ PA education ○ Different admin positions in hospitals (NYS Society of PA's) ● At LIU ○ 28 months, 86 credits, masters program ○ Pre-requisites: bio, chem, stats, general ed, a few other sciences ○ Depending on the school you apply to, each school requires 'different' pre-requisites ○ REQUIRE: having patient hours - direct patient care (CBA, PT assistant, MA, EMT, Scribes) ○ Shadowing a PA (currently difficult) ○ 1st year called the didactic year (basics: A/P, chemistry, for clinical medicine) ■ Based on the medical model (unlike NP) --> refer to it as drinking from a fire hose ■ 8 hours a day at school, the rest is studying ■ 3 semesters ○ 2nd year: Clinical Year (rotations) ■ LIU has exceptional clinical rotations ■ First PA programs of NY (a lot of prestigious hospitals, NYP, Bellevue, VA, NYU Langone, MSK, the Brooklyn Hospital, HSS) good clout ■ Most PA schools require 7 rotations --> LIU gives 10 rotations (internal medicine, obgyn, surgery, psychiatry, plastics, bariatrics, orthopedics, etc.) ■ Write a master's thesis ● Strong applicants: a few different types of patient care hours (variety), Q/A ● ● ● ● Every student is assigned an advisor --> talk about everything Open Door Policy: students are encourages to come to any faculty --> but will always be followed up by advisor Some students need more assistant, gladly show them where/who to get help from Do you need to major in anything specific to get into PA: commonly bio or HS majors, fashion and accounting majors Portal for Application: CASPA ● CASPA will take transcript, see GPA of science and GPA of overall ● Will look at grades, not exactly look at major ● MUST TAKE GRE TO APPLY , equivalent to the SAT but for masters ● MCAT for med school If you graduate May 2022, you can apply December 2021 and submit spring transcript once its ready to start September 2022 (instead of taking a gap year) https://www.liu.edu/brooklyn/academics/school-of-health-professions/academic-programs/MS-physicia n-assistant Dr. Sara Grossman (Pharmacy / Pharmacist) ● Working at College of Pharmacy for 15 years ● Interprofessional team ● What does it take to be a pharmacist? ○ Most trusted health professional (also most accessible) ○ Caring for others / compassion (a lot of demands in community setting: CVS) ○ NO ROOM FOR ERROR --> a mistake in dosage calculation can kill someone ○ Good studying habits: exams on a weekly basis, can't just study for one ○ Things change over time (must be on top of changes --> take CE classes) ○ Foundational skills: math skills need to be sharp ● Education ○ About 140 pharmD schools ○ 3 in NYC: LIU, St Johns, Touro ○ Typical program is 6 years (2 years of 'preprofessional' and 4 years of 'professional') ○ 1st 3 years are didactic classes --> IPES (getting feet week, intern at CVS, hospital, community pharmacy) ○ Final year is completely rotations (APES --> 5 week rotations in XYZ practice settings) ■ This is where they learn the hands on skills ○ Courses: math, ethics & law, economics, series of pharmacology courses ○ The MOST sequence are very hard --> kinds of diseases they see and how to treat it (DB, CHF, etc.) ● Licensing and Registration: ○ Licensing ■ Part 1: NAPLEX ■ Part 2: Law exam (depends on the state) ■ NY used to have Part 3 (compounding exam --> prior to covid) ○ Registration ■ 3-year period ■ CE credit requirements (45 credits, LIVE/VIRTUAL, need to be able to interact) ■ Certification (immunizer, BLS, etc.) ● Post-Graduate Training/Education ○ Residency: hospital based (clinical pharmacist --> rounds with the medical team) / PGY1 is one year program / PGY 2 is specialty program ○ Fellowship: 1-2 years, pharmaceutical industry (clinical trials, medication administration trials) ○ Graduate degrees: MS, MPH, PhD, MBA, JD ● Practice Setting ○ Typically Community Staff positions ○ Hospital Clinical = rounds with dr ○ LTC = nursing type facilities (will need to review every pt info once every month) ○ Academia --> aka LIU ○ Industry: specialty compounding Question/Answer ● ASHP Residency (similar to Match Day for Drs) ● Laws being passed for pharmacists? Lobby Day (Albany Day) pharmacists go to the capital of NY and go to legislature offices and express our needs --> NY lacks innovation to do more/help more. One of the last states to pass immunizer pharmacists ● Getting rid of Part 3 Compounding exam? Right now its been deferred because of COVID but it doesn't seem to be going away in NY ● Attention to detail? No Room for Error? Protocol? --> Checks and Balances (pharmacist is not the only person looking and giving the medication --> pharmacist has the final look before sending it away --> want to stop errors before it happens // Each company has their own protocol (everyone has to acknowledge it) ● Student LIABILITY Insurance? LIU covers this, but as a pharmacist its suggested to take out their own insurance Dr Lisa Bradley (Physical Therapy) ● Been a PT since 1996 ● Was a bachelors program back then, later earned doctorate ● Now only the doctorate program is available ● Education since 2010, was in the clinical setting prior to that ● ● Measure ROM, joint problems, pain in LE but it could be coming from your back (via sciatica) She works with Pat from the YouTube video - you can be me (APTA) ● More common setting is the Hospital (acute care, inpatient rehab, outpatient rehab) ● According to Wikipedia: PT is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout a lifespan Quality of Life via Physical Wellness: ○ Has an established theoretical base ○ Widespread clinical applications ○ Aims to preserve, develop, and restore and promote optimal function APTA says that PTs are movement experts who optimize quality of life through prescribed exercise, hands-on care, and patient education Diagnose and treat all ages PT also cares for people who want to become healthier / prevent future problems PT examines person --> develops treatment plan to improve their ability to move, reduce or manage pain, restore function, and prevent disability PT can help people achieve fitness goals, regain or maintain their independence, and lead active lives How do PTs provide Physical Therapy ○ HOLISTIC APPROACH --> uses BIOPSYCHOSOCIAL MODEL (body, mind, and social context in which the patient lives) ○ SYSTEMATIC APPROACH --> establish a diagnosis and prognosis starting with.. ■ PT Session: ■ (1) Examination: what is the presenting problem, medical history, what else is influencing what's happening ■ (2) Evaluation: measure ROM, look at balance, special tests to determine what structures are causing the problem ■ (3) Interventions: exercise, balance training, depends on the problem ■ (4) Reassessment: 'quick', see if interventions provided made a difference (if it did --> continue \\ if it didn't --> search through literature YOUTUBE VIDEO: you can be me Practice Settings ○ Hospital: acute care, inpatient / outpatient rehab ○ Private Practice: clinics or offices ○ Subacute Facilities: skilled nursing facility ○ Patient / Client Home (Dr. Bradley's Favorite) ○ Schools (DOE) ○ Academic Institutions (Dr. Bradley is an edcuator) ○ Research Centers / Facilities ○ Workplace, Industrial, Occupational Environments ○ Fitness Center and Sports Training Facilities ○ US ARMY Board Certified Specialties ○ Cardiovascular & pulmonary ● ● ● ● ● ● ● ● ● ● ○ ○ ○ ○ ○ ○ ● ● ● ● ● ● ● Clinical electrophysiology Geriatrics Neurology Orthopedics Sports Pelvic health - woman who delivers a child (pelvic floor muscle is weak can cause incontinence) \\ men too just not pregnant part Support Personnel (PTA --> associates degree, national licensing exam, works under PT Requirements for becoming a PT ○ Education = up to Doctorate Degree ○ Licensure = by state Job Market: increase employment 21% from 2020-2030 \ median annual wage is 91K or 44/hr ○ Home healthcare (highest 97.6k) ○ Nursing homes (95.3k) ○ Hospitals (93k) ○ Offices of PTs (85.7k) Upward mobility in the PT profession ○ Staff --> Senior PT --> Chief PT / Clinical Director ○ Some PTs open their own clinic Applying for PT school ○ Requirements vary among schools ○ PTCAS ○ Common Requirements: bachelors degree, LIU is 2.75 in science/math GPA, Cumulative GPA 3.0, GRE 290 (verbal and quantitative), volunteer/work experience in PT setting LIU Doctor of PT APTA: American Physical Therapy Association Cadaver lab? Interprofessional Team? --> OT, Speech T, nurses, dieticians, physicians, podiatrists, Recreational T, psychiatrists, social workers Week 10 - OT, HS, RT Dr Renee Ortega (OT) A Career in Occupational Therapy Slide 1: What is Occupational Therapy ● OT - is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations) ● OT's work with people of all ages by helping them promote health, and prevent - or live by better with - injury, illness, or disability Slide 2: What are the Qualities of a Good Occupational Therapist? Slide 3: Personal Qualities or Traits ● Enjoy helping people ● Strong communication skills ● Strong interpersonal skills ● Good problem solver ● Enjoy working with others ● Creative ● Flexible Slide 4: Al Roker Video Slide 5: Where Do Occupational Therapists Work? Slide 6: Occupational Therapists Work In… ● Hospitals ● Nursing homes ● Home health ● Mental health facilities ● Community health organizations ● Schools ● Outpatient clinics ● Sensory gyms ● Academics & research ● Specialty areas like hand therapy, design & accessibility services, wheelchair seating & positioning, assistive technology. Slide 7: Pediatrics, Physical Rehab, Mental Health Slide 8: What is the Job Outlook? ● OT employment expected to grow by 24% through 2026 ○ US Bureau of Labor Statistics, 2019 ○ 130,400 - Current Employment ● Best Jobs in America ○ US News & World Report, January 2019 ○ The 25 best jobs of 2019: OT is No. 13 ○ The best medical jobs that don't require medical school Slide 9: Occupational Therapist Degree ● Masters in OT ● Occupational Therapy Doctorate (OTD) ● To practice as a OT therapist in the US, you must: ○ Earn a master's or doctoral degree from a program accredited by the American Commission on Occupational Therapy Education (ACOTE) ○ Pass a national certification exam and state registration Slide 10: About LIU OT ● BS/MS Program ○ Student WITH and WITHOUT a degree are eligible ○ All students regardless of a degree status participate in the same 3 year curriculum Slide 11: LIU OT ● ● Science and inquiry-driven 1st year 4 Level I FW Experiences ○ Geriatrics, Adult Physical Disabilities, Mental Health/Community-Base Practice, Pediatrics ● 3 Level II Experiences ○ Adult Physical Disabilities ○ Pediatrics ○ Mental Health/Community-Based Practice Slide 12: Application Process ● Due to competitive nature of the program unfortunately only eligible students will be invited for an interview. The following criteria will be considered to determine eligibility for an interview: ○ Meeting application deadline ○ Cumulative GPA as well as Science GPA ○ Volunteer experience and extracurricular activities ○ Writing competency (personal statement, curriculum vitae) ○ Letters of recommendation ○ Leadership positions/Research participation ○ Resume Slide 13: Questions ● Email BLKN-OT@LIU.EDU ● Email EFEKONA.NUWERE@LIU.EDU ● VISIT LIU OT ON INSTA/FACEBOOK Dr Lisa Shultis (HS and RT Director) // Dr Minerva ● Graduated from RT school at LIU ● Known Rawls since 2008, graduated in 2010 RT are intensive care specialists ● Provide airway help (breathing) ● Vital signs will be affected if there is ineffective breathing ● Not breathing for a few minutes can be fatal ● Provide patients different type of therapists to help him ● Assessing and treating patient with breathing supportive devices (invasive and noninvasive) Got COVID 2 weeks after COVID began, was down 6 weeks, almost died ● 14 patients intubated, 6 dead by morning (40 to 60 years old) RT is basically the Rapid Response Team Anything below the waist is not your job, you aren't feeding people or picking them up. AIRWAYS ● 5-10K increase yearly until plateu ● Make more than nurses ● ● When you graduate and licensed, you call the shots and pick where you want to work Not easier than Nursing, about the same --> just concentrated in Cardiovascular Even during COVID (not during the 3 month shutdown) --> Still had clinicals LIU has a good reputation with all the NY hospitals, stamp on forehead, immediate good connections 2 clinicals per semester since Junior Year (8 clinical sides in 4 years) ● Residency?? ● Respiratory technician jobs but not licensed and way below RTT HS 3rd floor M/W Health Science ● State area of interest, they will find a site to place you ● See the profession and if you like it ● HS 490 Practicum - needed to graduate / 190 hours Week 11 - Athletic Trainer Jayne Ellinger - Athletic Trainer Masters Program? Hofstra ● LIU person - Blackbird, undergraduate in Athletic Trainer ● Graduate Assistant for dept Athletic Trainer - St Peters University ● 1st professional job at LIU (8 years) --> work with Professor Rawls-Martin ● Provide High quality services/education -- urban community Slide 1: Master of Science in Athletic Training Slide 2: What is an Athletic Trainer ● A certified and licensed health care professional who practices in the field of sports medicine ● ● Provide behind the scenes (prevent injuries, physical examination on injuries, diagnosis, treatment (short-term, immediate, rehabilitation), advocate mental health, coordinate health care with other HCP Slide 3: Practice Settings ● College/university ● Performing arts ● Professional sports ● Secondary schools (HS) ● Armed forces/military ● Physician practice (organizations like IBM, etc.) ● Industrial health care ● Community sports programs ● Health care administration ● Teaching & research ● Public safety (police, fire fighters) Slide 4: Interprofessional Collaborations AT: team physicians, nutritionist, athletic directors, sports psychologist, school nurse & medical director, strength & conditioning coaches, sports coaches, specialty physicians ● None of us work alone Slide 5: Job Outlook in AT ● Employment of athletic trainers to grow 23% by 2030 ● Faster than any other health occupation ● 3,100 jobs openings are projected to be open each year ○ Private industry is looking for people Slide 6: It's a great time to become an AT Slide 7: Our Alumni are EVERWHERE! ● Northwell Health Orthopedics ● Northwell STARS Physical Therapy ● Orlin & Cohen Physical Therapy ● High Schools / School Districts ● Professional Sports Teams ● NCAA Collegiate Sports Medicine ● Performance Enhancement, Recovery and Rehabilitation Centers ● Sports Medicine Sales ● Athletic Training Administration ● Military Health Care Slide 8: Starting Salaries (all Nassau County) ● Direct hire for High School: 67,000 ● Shared time High School & Clinic: 57,000 ● Collegiate Sports Medicine: 52,000 ● Industrial Setting: 67,000 Slide 9: Preparing to become an AT ● Classroom Education ● Clinical Education ● Simulations ● Professional Development ● Certifications Slide 10: Program Mission & Values ● To educate future Athletic Training professionals through competency-based didactic and clinical instruction ● The program strives for academic excellence and aims to provide a quality education to its students in an environment that encourages, nurtures, and supports learning ● Core Values ○ Leadership ○ Collaboration ○ Respect ○ Innovation ○ Professionalism Slide 11: MS in Athletic Training Curriculum ● 2-year plan of full-time study ● 53 credits ● Clinical experiences during all terms of enrollment ● Wide variety of clinical experience settings ● Opportunity to earn multiple certifications Slide 12: Potential Certifications ● Earn 3+ professional certifications ○ BOC Certification as an Athletic Trainer (upon graduation) ○ NY State Emergency Medical Technician (end of first summer) ○ ISSN Certified Sports Nutritionist (end of year 1) ○ NSCA Certified Special Population Specialist (upon earning BOC certification) Slide 13: First-Year Focus ● Develop knowledge, skills and abilities in~ ○ Injury and Illness Prevention and Wellness Promotion ○ Physical Examination, Assessment and Diagnosis ○ Immediate and Emergency Care ○ Professional Responsibilities Slide 14: Second-Year Focus ● Develop knowledge, skills and abilities in~ ○ Therapeutic Interventions ○ Healthcare Leadership and Administration ○ Development of scholarly activity/research project Slide 15: 3 Program Laboratories ● Classroom learning is applied & expanded through structured and interactive AT Simulation Lab experiences Slide 16: Clinical Education - Preceptors/Sites ● Six clinical education experiences ● 800 clinical hours (spend some time initially with EMT) ● 3 on-campus NCAA Division I Athletic Training Facilities ● Clinical affiliations with high schools, colleges, physician offices/surgical facilities, rehabilitation and performance enhancement clinics & professional sports Slide 17: Professional Development ● Iota Tau Alpha Athletic Training Honor Society ● Hofstra Athletic Training Society (HATS) ● Professional AT Conference Attendance ● Interprofessional Education Events ● BOC Approved Provider for Continuing Education ● Alumni Networking Events (aka LIU Brooklyn and Friends) Slide 18: Slide 19: Why YOU at Hofstra ● YOU-Centered Learning ● Attentive & Supportive Faculty ● Cutting-Edge Laboratory Facilities ● NCAA Division I Sports Experiences ● Diverse Clinical Facilities and populations ● In-demand certifications Slide 20: Admission Requirements ● Prerequisite Coursework ○ Biology, chemistry, psychology, physics, human anatomy, human physiology, exercise physiology, kinesiology or biomechanics, statistics ● Other Requirements ○ Bachelor degree with GPA of 3.00 ○ Prerequisite coursework GPA of 2.75 ○ Personal statement ○ 50 hours of healthcare experience (waived right now due to COVID) ○ Two letters of recommendation ○ Current resume ○ Interview with AT Program faculty ○ CPR/AED and First Aid Certification ● Scholarship and Fellowship Opportunities Slide 21: Week 12 - Speech Pathology, Public Health, Social Work Intro to Health Professions Speech-Language Pathology by Carol Slingerland Norman ● Clinical supervisor of SLP program for 7-8 years Slide 2: American Speech-Language-Hearing Association (ASHA) Making effective communication, a human right, accessible and achievable for all. ● SO WHAT EXACTLY DOES A CSD (Communication Science and Disorder) PROFESSIONAL DO? ○ You can make a real impact in your community and beyond as an audiologist or speech-language pathologist ○ Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids ○ Speech-language pathologists (SLPs) identify, assess, and treat speech, language, and swallowing disorders Slide 3: ● You want a competitive salary ○ Salaries and job opportunities are increasing for both audiologists and speech-language pathologists, according to the BLS ○ The need for professionals in the career is expected to grow over the coming decade ○ Demand for candidates who use two or more languages is high - no wonder our professions offer so much potential and so many choices ● You want job flexibility ○ CSD careers offer a diverse range of environments, extended breaks, less evening and weekend work, and ample paid leave and holidays - as well as flexible work schedules to accommodate your lifestyl Slide 4: ● You have a range of talents: ○ You have many talents and are good at more than one thing ○ ● ● You can handle yourself in science, you're great with people, and you're intellectually curious ○ A career that allows you to tap into your different interests and allows you to put all your skills to work is a great fit You want to make a positive difference: ○ Whether you provide clinical services, conduct research, supervise, or manage services, you will have the opportunity to improve others quality of life - all with empathy and compassion You like to solve problems: ○ You like finding creative solutions to complex problems. ○ You are a lifelong learner and enjoy being challenged - you don't back down when facing complex issues ○ You want to get to the root of the problem and you won't stop until you're there Slide 5: ● You want to serve your community: ○ It is important for clients to see themselves represented in their service providers ○ You want to represent your community and respect the values and practices of the people you serve ○ You are passionate about improving communication and self-advocacy skills, and you understand the need for diverse clinicians based on changing demographics - and the need for representation ● You are bilingual and/or bilterate: ○ If you use another language and take pride in using your languages to connect with others, CSD professionals will allow you to use your bilingual superpowers for good Slide 6: Where do Audiologists and SLPs work? **this likely doesn't include teletherapy, which has become much more widespread during the pandemic Slide 7: Terminal Degrees in SLP and Audiology ● SLPs need to complete a Master's Degree (MS or MA) ● Audiologists need to complete a doctoral degree (AuD) ● SLP assistants: recognized in only some states ○ Some states (e.g., California, Florida, and Texas, among others) allow the use of SLP-As and the terminal degrees vary by state (AS or Bachelors in speech) ○ All require observation and practicum experience plus a specified amount of coursework ○ More information on the ASHA website Slide 8: NYC-DOE Starting Salary for SLP (MA C2 + PD) Slide 9: 2017 CCCs, Jobs, & Careers Mini-Survey Summary Report: Numbers and Types of Responses: Job and Career Satisfaction: Overall, how satisfied are you with your career choice so far (percentages): Satisfaction All CCC-A CCC-SLP CCC-Dual Cert. 1.8 1.0 1.8 2.7 0.5 1.6 0.5 1.5 5.9 8.6 5.7 5.8 33.7 39.6 33.3 25.5 58.1 49.2 58.7 64.5 Very Dissatisfied Dissatisfied Neutral Satisfied Very Satisfied Slide 10: Speech-language Pathologist Overview (From US News & World Report) ● Overall Score 7.4/10 ○ #3 in Best Health Care Jobs ○ #10 in 100 Best Jobs ● How Much Does a Speech-Language Pathologist Make? ○ ○ ○ SLPs made a median salary of $80,480 in 2020 The best-paid 25% made $101,110 that year, while the lowest-paid 25% made $62,790 25% = $62.790 50% = $80,480 75% = 101,110 Week 13 - Healthcare Debate Teams 1 & 3 Team 1: Healthcare Debate - Abortion ● ● Intro Pros ● ● ● ● ● ● ● Cons: ● ● ● ● ● Pro-Choice Pro-Life Mental and physical takeaways Right of health, life and non-discrimination Privacy (Clinic, pills) Companies paying for expenses (Citibank, Bumble, etc.) Pregnant woman have the right to say what they can and cannot be put into or taken out of her body Protecting oneself is the most important (healthy) Big market companies don't suffer the consequences Abortion is killing Getting and abortion can be pricey, especially for those without health There are health risk for the mother when getting an abortion Can become an ethical dilemma, goes against a person's religious values Some companies have been threatened (Texas) if they help their employees go out of state to get an abortion essentially stopping the company from making money Court Cases Roe v Wade ● 7-to-2 vote it was unconstitutional ● Conflicts 14th amendments ● Change was denied 4 times Woman's Health v Jackson ● Doctors that help with procedure can be sued ● No exemptions for pregnancy (doesn't matter if it is rape) Conclusion ● ● Abortion should not be in the hands of the government Refer to the quote, abortion is a human right Team 3: Maternal Mortality Rate in Minorities in the US Introduction ● Pros ● Hear Her Campaign ● Perinatal quality collaboratives (PQCs) ● CDC LOCATe - web based tool to help states/others create standardized assessments ● ACOG - guidance for postpartum care ● Cons ● Minority racial and ethnic groups are 2-3x more likely to die from pregnancy-related causes Statistics ● Very recent, shows disproportionate rates Testimonials ● Someone with ectopic pregnancy got different care because of their skin color Conclusion ● Health disparities Week 14 - Healthcare Debate Teams 2 & 4 Team 2 ● Pro: increase access to women of marginalized communities, decreases abortion rates, effectiveness seen in other countries ● Cons: long time for approval, adverse reactions, misuse of birth control pill, women responsible for their health ● Conclusion: for it but needs guided restriction (OTC but behind pharmacist) Team 4 ● Healthcare Debate - Abortion Group 1 - Marisa Pero, Jonathan Timal, Maya Arazi, Indianna Low, Jeneil Jack Intro - Marisa Pero Women have had to fight for personal autonomy all over the world. In 2022 in the US, did anyone expect to be having to take a step backwards? The Controversy: - Pro-Choice - Pro-Life ● Individual stances ○ ○ ● Societal controversy ○ ○ ● Political ammunition Legal battles Affected by Covid-19 ○ ○ ● A personal choice A devious practice New laws against Increased access Large companies take their stance ○ ○ Citigroup, Bumble, Uber, etc. Abortion providers sue Pros - Jonathan Timal ● Mental and Physical takeaway ● Right of health, life and non-discrimination ● Privacy (Clinic, Pills) ● Companies paying for expenses (Citibank, Bumble, etc.) First Point ● ● ● The pregnant person has the right to say what can and cannot be put into or taken out of her body, such as abortion pills or removal of the fetus. Protecting oneself is the most important part to assure they’re alive and healthy with or without the pregnancy. Permission from doctors for pills, mental stability and physical health. Support by big market companies helps bring attention to what pregnant woman want to do without suffering consequences of their own body. Cons - Maya Arazi ● Abortion is killing ● Getting an abortion can be pricey, especially for those without health insurance ● There are health risk for the mother when getting an abortion ● Can become an ethical dilemma, goes against a person's religious values Second Point ● ● Some states have been enforcing laws against abortion and are getting involved with businesses. For example, in Texas a company called Citigroup pays their employees if needed to go out of state to get an abortion, the Texas lawmaker has threatened to create a bill that stops the company from making any deals with the state, which in a sense is stopping the company from making money. Court Cases - Jeneil Jack Roe v. Wade: ● Governed state restrictions on abortion are unconstitutional ● Conflicted with the 14 Amendment ● Supreme Court denied appeal to prohibit abortion past 6 weeks ● Fourth time court denied changes Court Cases - Jeneil Jack Woman’s Health v. Jackson: ● Criminalizes those who help with abortions ● Offers no exemptions for pregnancies Conclusion - Indianna Low Whether women truly have the right of life, Liberty, and property is challenged as many overpowering forces in the government try to hold them back from choosing what happens to their own bodies. It is undeniable that abortion is a human right, but some people and cultures view the act as defying the God of their religion. What society fails to see today is the reason why people terminate pregnancies and that reason is because of the many factors such as economic instability, unsafe environments, and etc. Final point When it comes to the realities of pregnant women and what they have to endure, abortions should not be in the hands of the government that is blinded by ignorance. “Incorporating measures to ensure safe abortion services into state pandemic responses and eliminating barriers to abortion is not just a matter of harm reduction – it is a human rights imperative.” - Jaime Todd-Gher & Payal K. Shah Every person should be able to choose what happens or does not happen to their bodies References Belluck P., (2021, December 16). F.D.A. will permanently allow abortion pills by mail. The New York Times. https://www.nytimes.com/2021/12/16/health/abortion-pills-fda.html Encyclopedia Britannica, inc. (2021, December 10). Roe v. Wade. Encyclopædia Britannica. Retrieved March 23, 2022, from https://www.britannica.com/event/Roe-v-Wade Kendall. (2012, August 28). When is it Too Late to Get an Abortion. Planned Parenthood. https://www.plannedparenthood.org/learn/ask-experts/when-is-it-too-late-to-get-an-abortion Liptak A., (2022, January 20). Supreme Court lets Texas abortion law stay in effect, for now. The New York Times. https://www.nytimes.com/2022/01/20/us/politics/texas-abortion-law-supreme-court.html Marcos, C. M. (2022, March 19). Texas lawmaker warns Citigroup against paying for out-of-state abortions. The New York Times. Retrieved March 20, 2022, from https://www.nytimes.com/2022/03/18/business/citigroup-abortion-texas-warning.html?searchResultPosition=1 Miller C. C., & Sanger-Katz M., (2022, January 22). On abortion law, the U.S. is unusual. without roe, it would be, too. The New York Times. https://www.nytimes.com/2022/01/22/upshot/abortion-us-roe-global.html References Nguyen, L. (2022, March 17). Citigroup will pay travel costs for employee abortions in response to the Texas law. The New York Times. Retrieved March 18, 2022, from https://www.nytimes.com/2022/03/17/business/citigroup-texas-abortion.html?action=click&amp;module=RelatedLinks&amp;pgtype=Article Pendergraft, D. J. S. (n.d.). How Much Does an Abortion Cost? Orlando Women's Center. https://www.womenscenter.com/2022/02/how-much-does-an-abortion-cost-in-2022/ Press, E. (2022, January 21). Opinion | Why the Medical Establishment Shied Away From Abortion. The New York Times. Retrieved March 23, 2022, from https://www.nytimes.com/2022/01/21/opinion/roe-v-wade-abortion-doctors-violence.html Pro and Con: Abortion. (2019, May 9). Encyclopedia Britannica. https://www.britannica.com/story/pro-and-con-abortion#:~:text=Abortions%20cause%20psychological%20damage.,as%20a%20form%20of%20co ntraception Todd-Gher, J., & Shah, P. K. (2020). Abortion in the context of covid-19: A human rights imperative. Sexual and Reproductive Health Matters, 28(1), 28–30. https://doi.org/10.1080/26410397.2020.1758394 Thanks! Any questions? Should Birth Control Be Made Over-The-Counter Group 2: Kayla Rendon, Helen Tang, Ryan Zheleznyak, and Kim Lee SLIDESMANIA.COM SLIDESMANIA.COM HS 300- 001 Professor Rawls-Martin Table of Contents.01 - Introduction 02 - Pros for Birth Control made OTC 03 - Cons for Birth Control made OTC 04 - Conclusion SLIDESMANIA.COM 01 Introduction “Should oral contraceptives be made available over the counter rather than requiring a prescription?” (Kelly, 2021). ● The right to the access of birth control has been a long debated topic since the conception and invention of the pill itself. SLIDESMANIA.COM SLIDESMANIA.COM ● Firm push to make birth control pills available without prescription. Did you know? ● Earliest form of birth control was around since 3000 BCE . ○ Crete and Egypt began developing condoms from animal and fish bladder/intestine and linen shreaths ● Evolution of birth control and the ability of contraceptives have changed. ● There are several national groups advocating for birth control SLIDESMANIA.COM SLIDESMANIA.COM ○ Birth Control Federation of America is now known as Planned Parenthood (Khan, F., Mukhtar, S., Dickinson, I. K., & Sriprasad, S. (2013) 02 1. Pros for Birth Control Made OTC Increase access to marginalized communities of women 2. Politics’ role on banning abortion increases favoribility for birth control pill 3. The effectiveness of OTC birth control seen in other countries around the world. SLIDESMANIA.COM (ACOG, 2019) 03 Cons for Birth Control Made OTC 1. The Amount of Time for Approval 2. Adverse Reactions & Misuse of Birth Control Pill -Rare reactions may occur even after trial phases -Not reading the label & Polypharmacy 3. Women’s Responsibility of Their Health -No doctor’s consultation needed -Greater risk on those who have high blood pressure & clotting issues SLIDESMANIA.COM (FDA, 2022) (Halli-Tierney, 2019) Conclusion Overall, if the FDA approves the OTC birth control pill, it will be a historical contribution to women’s reproductive health movement! We as a group agree that the birth control pill should be made available SLIDESMANIA.COM SLIDESMANIA.COM OTC. Introduction ● ● Rates of maternal preterm birth, mortality, and ● morbidity have been rising in the United States of approximately one-third occur during pregnancy while approximately America. 56 percent occur during labor or within the first week postpartum. Minorities are at an increased risk for poor and ● various factors that contribute to health disparities such ● ● Black minorities have pregnancy-related mortality rates that are about 2-3 times higher when compared to white women (Petersen EE, et. Al). correlate to the kind of health care that is obtained for various types of demographics. Approximately 700 women die in the U.S each year from pregnancy complications. as socio-economic issues, disabilities, poor education, lack of jobs, etc., and all of those factors directly Between six weeks and one year, another 13 percent of maternal deaths occur. detrimental health outcomes. ● Maternal deaths are deaths that occur within one year of pregnancy and ● Figuratively, 40.8 versus 12.7 per 100,000 live births (Samantha Artiga, 2020). Pros ● ● ● ● ● ● The Hear Her campaign is a national campaign created in support of the CDC’s efforts to prevent pregnancy-related deaths by sharing potentially life-saving messages about urgent maternal warning signs. National pregnancy-related mortality surveillance has been introduced to better understand the risk factors and causes of pregnancy-related deaths in the United States. Collected data is released regularly throughout scientific works and on the CDC Web site. Perinatal quality collaboratives (PQCs) are state or multi-state networks of teams working to improve the quality of care for mothers and babies. PQC members identify health care processes that need to be improved and use the best available methods to make changes as quickly as possible. CDC Levels of Care Assessment Tool (CDC LOCATe) is a web-based tool to help states and other jurisdictions create standardized assessments of levels of maternal and neonatal care. Enhancing Reviews and Surveillance to Eliminate Maternal Mortality supports agencies and organizations that coordinate and manage Maternal Mortality Review Committees to identify, review, and characterize maternal deaths; and identify prevention opportunities The American College of Obstetricians and Gynecologists (ACOG) has issued guidance for postpartum care that recommends shifting from a single visit at one point in time to a comprehensive set of visits customized to a woman's needs ● ● ● ● The CDC's Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) Program supports 25 states and provides funding to their Maternal Mortality Review Committees (MMRCs) to identify and review maternal deaths and develop recommendations to prevent future deaths. The CMQCC has developed quality improvement toolkits focused on hemorrhage and preeclampsia and implemented targeted quality improvement projects that continue to have a substantive effect. The Health Resources and Services Administration (HRSA) initiated the remote pregnancy monitoring challenge to support innovative technology-based solutions that help providers remotely monitor the health of pregnant women and empower women to make informed decisions about their care, remote monitoring increasing virtual access to quality care for low-income pregnant women and benefits women who live in rural and medically underserved areas who have limited access to on-site prenatal care. The MOMMIES Act from Sen. Cory Booker is co-sponsored by several other 2020 contenders, including now VP Kamala Harris, and focuses heavily on Medicaid. It would promote more state coverage of doula services through the program. Doula support has been associated with better birth outcomes and greater satisfaction with care, and has been touted as a way to address racial disparities in maternal health. Cons ● Women in minority racial and ethnic groups are 2-3 times more likely to die from pregnancy-related causes than white women. ● Cardiomyopathy, thrombotic pulmonary embolism, and hypertension disorders of pregnancy, contributed more to pregnancy-related deaths among black women than among white women ● Preeclampsia/eclampsia and embolism were the leading cause of death among African American women. Hospitals that serve predominantly African American women have shown to have higher rates of maternal complications than other hospitals. Records also show they perform worse on 12 out of 15 birth outcomes, including elective deliveries, non-elective cesarean birth, and maternal mortality ● ● The elevated risks for African American women alone reflect the impact of structural racism on health and healthcare in structural racism on health and healthcare in the United States. Common Factors with the Highest Risk Ratios for SMM for Women Overall ( BCBS) Maternal mortality in the US by race and ethnicity (per 100,000 live births) America is Failing Black Mother (hsph.harvard.edu) Testimonial A friend’s mother had an ectopic pregnancy. Her OB-GYN sent her to the emergency room to get methotrexate to terminate the rapid growth of the cells. They had run multiple tests and done an ultrasound but they never listened to her abdomen or did a pelvic exam. She was instructed to return to the hospital again two days later to check if what she had was an ectopic pregnancy. She spoke to the resident on the phone but they still had not given her methotrexate. As per her OB-GYN’s advice, my friend’s mother went to a different emergency room the next day. She had an ultrasound and tests run again. There was a heartbeat and she was bleeding into her abdomen. Only after the persuading of the OB-GYN consultant did the hospital take her for emergency surgery. In the procedure of the surgery, her fallopian tube was in the process of rupturing. Thankfully she had survived, healed well, and got back to normal activities. My friend’s mother said, “It made me realize how lucky I am. The truth is I was lucky because I am a white woman, had access to an alternative hospital, and had my OB-GYN call. If I did not go to the second emergency room the next day I would not be able to tell you this story” Although this is not the case for everyone, especially minorities. https://youtu.be/uWQXjkKB4Jc Conclusion ❏ Mortality rates have been increasing in the United States due to many causes while an individual woman is pregnant. ❏ The causes are cardiovascular diseases, hypertension, pulmonary emboli, and cardiomyopathy. Embolism and preeclampsia/ eclampsia have been leading many women that are pregnant to maternal death. ❏ Many African American women have ectopic pregnancy which is when a fetus develops outside of the uterus in the fallopian tube. ❏ Health disparities such as poor education, disabilities, and lack of jobs lead to the kind of healthcare an individual woman may have. ❏ Maintaining a better education and job are more likely to have better coverage and a better lifestyle due to having more options for their health. ❏ Many women have many symptoms such as pain in the abdomen, nausea, vomiting, and abdominal bleeding while having an ectopic pregnancy which leads to mortality rate to increase. Mental Health Promotion and Education on Social Media Patrick Diaz, Kaila Roker-White, Rebecca Adaia, Esmiana Xhafa HS 300 SECTION 02 | AWESOME TEAM 4 APRIL 2022 Why promote Mental Health on Social Media? Mental Health • Mental Health Awareness is growing • Affects how we see and feel about ourselves • Affects how we cope with stress and various situations • Affects our view of the world around us HS 300 SECTION 02 | AWESOME TEAM 4 Social Media • Necessary in our personal, social, and professional lives • Has the power to Influence who we are and how we see ourselves in society • A valuable source of information and connection • Reaches a massive audience and is constantly growing APRIL 2022 72% Humans are social creatures of the public uses some type of social media Usage by Age Most Commonly Used Platforms 13-17 = 97% YouTube = 81% 18-29 = 84% Facebook = 69% 30-49 = 81% Instagram = 40% 50-64 = 73% Pinterest = 31% 65+ = 45% LinkedIn = 28% (PEW RESEARCH CENTER 2021) (PEW RESEARCH CENTER 2021) HS 300 SECTION 02 | AWESOME TEAM 4 APRIL 2022 Negative Impacts of Social Media on Mental Health ● One of the biggest issues is overuse and overstimulation. This leading young adults and children develop poor habits. ● Most significant factor against mental health is the pressure to conform to societal norms and expectations • Affects self-esteem • Influences perceptions of one's self • Fear of missing out (FOMO) ● Misinformation spreaders manipulate content to cause harm and could often lead to: • Rumors, Hate Speech, Cyberbullying ⚬ Increases risk of mental health issues, depression, self-harm, and suicide NEGATIVE IMPACT IS OFTEN OVERSTATED! HS 300 SECTION 02 | AWESOME TEAM 4 APRIL 2022 Benefits of Social Media to Mental Health ● Social media can be seen as a safe haven, comfort, and sweet escape for many individuals ● Brings people together and builds new connections ● Provides a place for people to practice and enhance social and professional skills ● Social media is advantageous to learning the issues that may affect mental health • Education and promotion can destigmatize the mental health conversation ● Source of information and discovery including many mental health resources • Support/Focus groups • Telehealth and Mental health apps (BetterHelp, TalkSpace, etc.) BENEFITS OUTWEIGH THE NEGATIVES! HS 300 SECTION 02 | AWESOME TEAM 4 APRIL 2022 So why not promote Mental Health on Social Media? Social Media and Mental Health go hand-in-hand. ● ● Mental health promotion and education is needed to combat the negative impacts of social media ○ Destigmatize the conversation ○ Break down societal norms and expectations Social Media is necessary and reaches a massive audience ○ Bring awareness to mental health issues ○ Positive messaging influences outlook on social media and mental health MENTAL HEALTH IS WHO WE ARE! HS 300 SECTION 02 | AWESOME TEAM 4 APRIL 2022 The Importance of Mental Health ● ● ● ● Good physical and mental health go hand in hand to ensure your wellbeing and help you live a long and fulfilling life. Poor mental health can lead to violence and crime. Good mental health boosts your overall productivity and financial security. Hard to start a family or achieve goals in life. “Mental health… is not a destination but a process. It’s about how you drive, not where you’re going.” — Noam Shpancer HS 300 SECTION 02 | AWESOME TEAM 4 APRIL 2022