Faculty Development for Education for Sustainable Health Care: A University System-Wide Initiative to Transform Health Professional Education.

Health professionals (HPs) are increasingly called upon to care for patients experiencing the health impacts of climate change, while working in the high eco-footprint health care system, which is starting to embrace a culture of sustainability. HPs are uniquely positioned to drive health care culture toward ecological responsibility and, consequently, improve patient care, health equity, and public health. Education for sustainable health care (ESHC or ESH) is the first step in developing health care practitioners able to think critically about and act upon the health impacts of the climate crisis. University of California Education for Sustainable Healthcare (UC-ESH) Faculty Development Initiative was developed to address the following goals: educate faculty on eco-medical literacy, empower faculty to build community and lead ESH at their institutions, and expand coverage of ESH to reach students beyond those for whom sustainability is already a focus. The initiative provided training to faculty across health professions and 6 health science campuses to integrate ESH into their courses using the train-the-trainer model, key knowledge and pedagogical skills, and longitudinal guidance and networking opportunities. Using a survey, questionnaire, and interviews, the initiative was evaluated using the process/elements and product/outcomes steps of the Context, Input, Process, and Product evaluation model. The UC-ESH educated over 100 faculty members and led to ESH integration into 99 existing and new courses that subsequently reached over 7,000 learners. The UC-ESH increased empowerment, awareness, and knowledge about the climate crisis, and built an ESH community of practice. Initiative elements that contributed to these outcomes included engaging training; creation of supportive group dynamics; helpful resources and activities; ongoing support; and integration approaches to ESH. This university-system-wide initiative provides a transferable model to institutions, schools, and departments seeking to develop eco-medical literate faculty who educate their students about the climate, ecosystem, and health crisis.

A Case Report of Scrupulosity Presenting as Catatonia in a Patient With Both OCD and OCPD.

We present the case of a woman in her 40s with a history of hypothyroidism, a differential diagnosis of major depressive disorder with psychotic features versus bipolar I disorder, catatonia, and anorexia nervosa. The patient was admitted to the hospital for poor oral intake, mutism, and social withdrawal. Administration of lorazepam successfully treated these presenting symptoms. However, on subsequent days, she was found to be reading the Bible almost constantly during waking hours, at the expense of engaging in treatment or interacting with others. The patient's history and presentation supported the idea that her hyper-religiosity stemmed not from bipolar disorder or psychosis, as previously thought, but rather from a subtype of obsessive-compulsive disorder referred to as scrupulosity. This report summarizes the characteristics of scrupulosity and discusses this potentially deceptive mimic of more commonly seen conditions.

A rare case of Wernicke encephalopathy in stage IV gastric cancer.

A 38-year-old male with stage IV gastric adenocarcinoma presented with abdominal pain, nausea, bilious non-bloody vomiting, and lethargy. He was found to have an ileus and was treated appropriately with bowel rest and nasogastric tube decompression. However, the patient was also noted to have confusion and nystagmus. While he was abstinent from alcohol for 20 years, he was found to have Wernicke Encephalopathy (WE) as a result of malnutrition from the underlying malignancy.

Sexually Predatory Behavior in an Adolescent Female.

This report describes a rare case of an adolescent female with a history of unspecified depressive disorder, disinhibited social engagement disorder, and significant history of sexual trauma at an early age, who initially presented with suicidal ideation. During the initial evaluation, the patient was found to have engaged in sexually predatory behavior toward younger boys, including solicitation and inappropriate sexual behavior. This report discusses relevant literature on the prevalence, risk factors, and treatment for this behavior among female adolescent sexual predators, as sex offenders are primarily thought to be men. General recommendations for health care professionals caring for female sexual offenders are addressed as well as the importance of early treatment and appropriate training for professionals. The patient has been deidentified.

Community-engaged sustainable health care education.

BACKGROUND: Climate and ecological changes substantially impact human health. Sustainable health care education (SHE) teaches health professions students about the interdependence of ecosystems and human health, the health sector's impact on the environment, and sustainable solutions for both ecosystems and human health. Yet little is understood about the methods used to facilitate SHE learning within the local context. Community-engaged medical education (CEME), a concept used in medicine and other health professions, underscores the relationship between the community served and education, which is both interdependent and reciprocal. Our objective was to characterise how SHE could be made relevant to the local context and the health of the community. METHODS: Qualitative content analysis was used to explore the perspectives of faculty members, community experts and health professions students on the relationship between SHE and CEME. Semi-structured interviews were conducted with 51 participants between March 2016 and May 2017. RESULTS: Participants highlighted that it was vital for students to become familiar with real-world, locally relevant issues by collaborating with community members and identifying opportunities for engagement. For optimal learning, CEME experiences should be accompanied by relevant curricular changes. Educational partnerships with local organisations, societies and activists provide continuing opportunities for dialogue about, and integration of, SHE. DISCUSSION: The integration of SHE through CEME will draw the community voice into the curriculum and will compel students to connect CEME SHE learning to their continuing education. The credible and respected role of the health professionals and health professions institutions provide a foundation for the development of community partnerships and the promotion of SHE. The integration of SHE through CEME will draw the community voice into the curriculum and will compel students to connect CEME SHE learning to their continuing education.