Rotary International District 6290
March 2014 Report
Nathan Reynolds
Dear Rotarians of District 6290,
March turned out to be an extremely busy month. There were two assignments due from the first semester.
The group project I worked on in my Control of Communicable Disease class is attached. It is a national
proposal to eliminate cholera from the Republic of Haiti. There are still two classes that have not recorded
grades from the first semester, but among the 25 credits that are reported, my cumulative grade is currently
87.5%.
I’ve been working hard on projects for courses in the second semester as well. One of the courses I am
taking is called Community Oriented Primary Care, whereby we characterize a community, prioritize health
concerns or burdens, identify intervention programs, implement the programs, monitor and finally reevaluate. Unfortunately this is a virtual exercise, but it is an important opportunity to learn how to analyze
data that is often incomplete, conduct literature reviews from peer-reviewed journals, government archives
and non-governmental organizational websites. Furthermore, it provides another opportunity to learn how
to work in teams, which is essential in today’s integrated, team-oriented and multi-faceted work
environment. In terms of the community we have been assigned, one of my classmates completed a
residency in community medicine in a remote village in Guatemala and, with the approval of the lead
physician at that clinic, brought vital statistics data and data on the various morbidity causes among the
2800 residents being serviced by the clinic. The 22 members of my class split into three groups and selected
three health concerns based on death certificates and a general morbidity chart. The health concerns are:
cardio-vascular disease, chronic malnutrition, and acute respiratory disease. I am in the group focusing on
the prevention of acute respiratory diseases and I will be sending you our final write-up once we’ve
completed it in May or June. Furthermore, I am taking an Aging class and part of the curriculum requires
a report on health issues that predominantly burden the aging or elderly. As a result, I have selected working
on iatrogenic diseases, which represents the third most fatal category of diseases among Americans. I am
in the early phases of the assignment, and am eager to share it with you once it’s finished in a month or
two.
In terms of my Master’s thesis, I was unable to collect data on women with and without BRCA mutations.
There were confidentiality issues and, although it was never explicitly said, I think my professor’s contact
with the data wanted to keep the analysis in-house, without involving my school and institution. That being
said, I was able to find data for another interesting topic. The research question of my thesis is: Is there a
parent-of-origin effect (POE) on the change in BMI from adolescence to adulthood among 1400 young
adults selected from the Jerusalem Perinatal Study? Some background on the Jerusalem Perinatal Study
(JPS) is that it was a cohort study of 92,408 births in Jerusalem from 1964 to 1976. The team working on
the project took many anthropometric measurements, blood work, etc. We have a sub-set of 1400 offspring
from this study with 168 sequenced cardio-metabolic and adiposity associated genes. Furthermore, we have
physical evaluations from when they entered military service at 17 and a physical evaluation at 35, from
which we can determine a longitudinal change in BMI. The data will be stratified according to adiposity
genes and known cardio-metabolic risk factor genes to assess if there is a parent-of-origin effect. This study
is one in a sequence that needs to be done with this data. Initially, the professor I am working with identified
that maternal weight gain during gestation is an independent risk factor for weight gain in the child. That
posed the question of my POE study. After this study is completed and depending on what we find, more
information will be required in terms of the mechanistic expression of the genes we’ve identified
(methylation, deacylation, in-utero metabolic environment). However, I’m looking forward to running this
analysis for my thesis.
On the Rotary front, this was also a busy month. I attended the 85th anniversary party of the Jerusalem Club
on the 11th. There were many people there and it was interesting to learn about its charter from the Rotary
Club of Cairo back in 1929. A few weeks later, the four Rotary Scholars studying in Jerusalem presented.
I presented on the BRCA mutation. After contacting the Israel Cancer Society, I found out that genetic
counseling and testing for the mutation is included in the Israeli health insurance package if the woman has
a family history of breast and ovarian cancer. As a result, I relayed that information to the members of the
Jerusalem Club. An important issue was raised that demonstrated the need to be vigilant of what is said
when presenting on risk factors for certain diseases. A woman who was 70+ said that she and three of her
daughters had been diagnosed with breast cancer and none of them had a BRCA mutation. I used that
opportunity to explain that BRCA mutations are not the only risk factor for developing breast cancer and
there were numerous other etiologies. During the presentation, I also discussed the possibility of having a
youth exchange student come to our district, specifically the Traverse City Club. One of the members is
associated with St. George’s School here in town, which has many Arab Christians and Muslims who would
be excellent candidates for RYE. As soon as Steve Alexander gets back to me on how to proceed, I will let
you know. Classes are out of session until the 28th of April due to the Passover vacation, so I am trying to
schedule club visits to Ramallah in the West Bank and Tel Aviv.
Finally, I want to wish all of you a Happy Passover and Happy Easter.
Thank you,
Nathan