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Is Your Child Afraid of Getting a Shot From the Doctor? Here’s How to Help Them

Nov 9, 2021 | Children's Health, COVID-19, Featured, Vaccines, Your Health

A trip to the doctor is a common childhood fear. But when kids are afraid of needles, even a simple checkup can cause problems for children and their parents or guardians alike. With the proper preparation and planning, you can help make your next doctor’s visit as smooth as possible, and that’s more important than ever for those getting a COVID-19 vaccine.

In this Q&A, C. Anthoney Lim, MD, the Director of Pediatric Emergency Medicine for the Mount Sinai Health System and the Medical Director of the Pediatric Emergency Department and Pediatric Short Stay Unit at Mount Sinai Beth Israel, explains how you can help calm your child’s fears and ease their anxiety about the doctor’s office and needles. And if needed, how you can talk with your doctor in advance about key issues, including medications that can help reduce the pain. Certified child life specialists and music therapists will also be present at the Mount Sinai vaccination pods to help support children of all ages using play, preparation, distraction and relaxation strategies.

“We have plenty of experience with children who are afraid of injections, so we can work with you and your child to ensure they get immunized in a safe and comfortable manner,” says Dr. Lim, who recently gave his own seven-year-old son the vaccine. “We are creating a very family-friendly space for the COVID-19 vaccine because you will need to bring them back in three weeks for their second shot, so it’s especially important that your child has a positive experience.”

How common is it for kids to be afraid of needles?

It is a very common fear. We see it among children who may have been hospitalized or have chronic illnesses and are in the doctor’s office a lot. But a healthy child without any medical problems is equally prone to needle-phobia.

How can I talk to my child who is afraid of needles?

There are many things you can do to help normalize the process, and it’s important to prepare. A lot of it is knowing your child and if they are at an age that we can talk about their fears. Then, prepare them by having a conversation in advance, letting them know what is going to happen at the doctor’s office and explaining what the process may look like. It can help quite a bit. Not all kids want to talk about it. But they are generally pretty smart, and they will know they are going to the doctor and what they are going for. It’s also worth remembering: Kids will often follow your lead. So if you are prepared and calm, your children will more likely be prepared and calm

Anything more specific?

For younger kids, play can be a really helpful way to prepare for a doctor visit. It provides children the opportunity to approach the event with a sense of control while creating a safe environment to express feelings and to practice coping strategies. One option for younger kids is showing them with their stuffed animal or having them play doctor to get used to what happens when you get your vaccine. For instance, when we were teaching kids how to use masks, we had them make a mask or put a mask on their teddy bear so they can see what it looks like. This is a similar process.

What about bringing something to distract my child?

You can bring a toy to distract them or a doll or plaything they can squeeze really hard. Tablets or smart phones are fine, so make sure your devices are charged. You can bring a cold pack because sometimes that will numb the area a little bit and that is often helpful. There are special cold packs for kids that also include a vibrating tiny bee that can help soothe and distract young children.

Any other techniques?

There are many relaxation strategies that children of all ages can use when feeling anxious and worried. One example is deep breathing—taking deep breaths right before the shot, and then breathing out as the shot is being delivered, can help minimize the discomfort. For younger kids, there are specific positioning techniques you can use, basically a big hug that exposes their arm for the nurse to administer the shot.

What about medications?

Most of the time, approaches that do not involve medications work really well in kids. Prescription medications require a visit or a discussion with your doctor beforehand. There are prescription products, like EMLA or ELA-Max, which are creams that contain a local anesthetic we sometimes use for children for some injections and vaccines. You put the cream on your child’s arm before you go to the doctor’s office because it takes about an hour to kick in. Over-the-counter topical creams are also available.

Is it okay to take over-the-counter pain relievers?

We recommend pain relievers like Motrin or Tylenol but only if your child experiences muscle pain or fevers after they receive the shot, and not beforehand.

How is Mount Sinai helping to make the vaccination process easier for young kids?

At our hospitals, we are setting up special areas for vaccinations for young children. We want to make it a child-friendly, family-friendly environment. We want to make sure that they have a great experience

What should I do if I have more questions?

There are some great resources online, such as from the American Academy of Pediatrics and from the Meg Foundation, an organization that helps families with pain management. A conversation with your pediatrician is very valuable.

Get more information about COVID-19 Vaccination, Appointments and Resources

Mount Sinai Neuroscience Student Earns NIH Fellowship to Study Substance Use Disorders

Oct 29, 2021 | Diversity and Inclusion, Featured, Research

Can the bacteria in your gut influence addictive behavior? That is the question that Katherine Meckel is studying and trying to answer. Currently a fifth-year PhD candidate in neuroscience at the Icahn School of Medicine at Mount Sinai, Ms. Meckel is one of 31 young scientists from across the country to be honored with the National Institutes of Health (NIH) Blueprint Diversity Specialized Predoctoral to Postdoctoral Advancement in Neuroscience (D-SPAN) Award.

The award will provide Ms. Meckel with a six-year, $447,000 fellowship to fund the remaining two years of her PhD studies, as well as four years of postdoctoral research. The D-SPAN Award recognizes outstanding trainees from historically underrepresented communities in the sciences.

Working in the lab of Drew D. Kiraly, MD, PhD, Ms. Meckel is drawing upon her background in gastroenterology and neuropharmacology to study the effects of the gut microbiome on gene expression and behavior in a rodent model of cocaine use disorder.

“When we look at human patients and also animal models of substance use disorders, we see highly altered gene expression in response to cocaine and other drugs of abuse,” she explains. “This seems to emerge from long-term adaptations or ‘molecular scars’ which affect the ability of gene sequences in the DNA to be accessed and expressed. My work seeks to understand how gut bacteria and the metabolites they produce regulate the structure and accessibility of the DNA, influencing gene expression and ultimately drug-seeking behaviors.”

Dr. Kiraly, her dissertation advisor, praises her tenacity in establishing a new line of research within the field of neuroscience. “Katherine has generated a tremendous amount of exciting data, which provides insight into the mechanisms of gut-brain communication,” says Dr. Kiraly, Assistant Professor of Psychiatry, and Neuroscience, at Icahn Mount Sinai. “Her work holds potential to uncover novel pathways for drug development, which may one day lead to much-needed treatments for patients with substance use disorders.”

Trusting Her Gut Intuition

As an undergraduate, Ms. Meckel pursued a rigorous five-year dual degree program in Voice Performance and Biochemistry at Lawrence University in Appleton, Wisconsin. There, she conducted neuropharmacology research under Bruce Hetzler, PhD, studying the effects of methylphenidate (Ritalin) on rodent behavior and visual processing.

After graduating, she joined the Section of Gastroenterology at the University of Chicago, working under Joel Pekow, MD, and Marc Bissonnette, MD, to study the effects of diet and metabolism on inflammatory bowel disease and colorectal cancer.

Ms. Meckel credits her time in gastroenterology for encouraging a more integrative physiological approach, which now informs her studies. “Often times in neuroscience, we study the brain in isolation,” she says. “But it’s important to consider that the brain exists in communication with the other peripheral organs throughout the body, and they influence each other’s activity.”

Building Community for Students With Disabilities

Ms. Meckel has also emerged as a leader in disability rights since joining Icahn Mount Sinai. Together with classmates Jessica Pintado Silva and Marisa Goff, she co-founded Disability Rights, Education, and Awareness at Mount Sinai (DREAMS), which provides peer mentoring and support to graduate students with visible and invisible disabilities.

“As a queer, disabled individual, I often compare living with invisible chronic illness to ‘being in the closet.’ If you didn’t know me well, you probably wouldn’t realize I am disabled,” she says. “But much of my life outside of lab is characterized by managing chronic health flares.”

Ms. Meckel expressed gratitude to her advisors and the National Institute of Neurological Disorders and Stroke for supporting her training. “I hope that my experience inspires disabled and chronically ill trainees to continue in the sciences,” she says. “So we can share our unique perspectives and bring new innovation to STEM.”

Eleven Medical Schools Join Mount Sinai’s Project to Eliminate Racism and Bias From Medical Education

Oct 28, 2021 | Diversity and Inclusion, Featured

The Icahn School of Medicine at Mount Sinai has selected 11 medical schools to join a newly launched collaboration to eliminate racism and bias in medical education.

The project—called Anti-Racist Transformation in Medical Education (ART in Med Ed)—will engage these schools in using training modules and tools that were developed at Mount Sinai to foster and manage anti-racist cultural change. The new collaboration was made possible by a generous grant from the Josiah Macy Jr. Foundation.

Last summer, Icahn Mount Sinai invited medical schools throughout North America to send proposals to join this effort. Forty-eight schools, or approximately one-third of all accredited medical schools, responded. Eleven were chosen based on their commitment to implementing a transformational-change strategy and willingness to build a diverse team of leaders, faculty, students, and staff that would be able to participate over three years. Mount Sinai sought to include private and public schools, as well as MD and DO programs, from a broad geographic range.

Leona Hess, PhD

One of the participating schools is the David Geffen School of Medicine (DGSOM) at the University of California, Los Angeles. According to Julian McNeil, DGSOM’s Racism Program Manager, the medical school had committed $5 million to anti-racism efforts in the wake of the police killing of George Floyd, Black Lives Matter demonstrations, and inequities exacerbated by the COVID-19 pandemic. The ART in Med Ed program, he says, will provide DGSOM with a framework to guide these efforts.

“It was clear that Mount Sinai had given considerable thought to how organizational science and change management could be applied to advancing anti-racism efforts in a medical school context, and that is what we loved about the project,” Mr. McNeil explains. “This is a model for change that is grounded in theory that has been tested and refined, and that provides us with best practices to guide our work.”

The University of the Incarnate Word School of Osteopathic Medicine (UIWSOM), based in San Antonio, Texas, is also participating in the ART in Med Ed project. UIWSOM graduated its first class in May 2021, and was motivated to participate in ART in Med Ed for several reasons, says Linda Grace Solis, PhD, Assistant Professor of Applied Humanities, Department of Clinical and Applied Science Education.

Students had expressed an interest in exploring ways in which the school was perpetuating ideas that could lead to inequities, she says, and had voiced concerns over elements of the curriculum, such as the predominant use of imagery of white people in dermatology classes.

Jennifer Dias, a rising third-year medical student at the Icahn School of Medicine, is devoting a scholarly year to helping run the Art in Med Ed project.

“What appealed to us about ART in Med Ed was the project’s structure and its focus on change management,” Dr. Solis says. “I see that as the secret sauce that is missing from most diversity, equity, and inclusion work because it helps people understand why this change matters so that they get on board.”

The Columbia University Vagelos College of Physicians and Surgeons is also part of the ART in Med Ed project. “It is helpful to be part of a group that is moving in the same direction, and to have an external partner guiding us, because it takes some of the weight off our shoulders in figuring out how to do this,” says Todd A. Bates, PhD, MSEd, MA, Education and Learning Specialist with the Center for Education Research and Evaluation at Columbia University, who is working with Mount Sinai. “There is also a degree of hopefulness that comes with participating in a project that has a proven track record in this area. All these elements are a huge benefit in making progress and achieving more equity for our students, faculty, and staff.”

Leona Hess, PhD, Director of Strategy and Equity Education Programs at Icahn Mount Sinai, who helped create and now leads the ART in Med Ed project, says ongoing feedback from the participating students, staff, and faculty at each school will help Mount Sinai improve the project.

“We want to see whether the schools are able to use our learning strategy, content, design, and support to build capacity and address and dismantle racism regardless of their location or demographics,” Dr. Hess says. “As we gather that information, we will refine our learning modules and tools and look at the possibility of bringing more schools on board.”

The goal, she says, is for all medical schools to ultimately dismantle racism and bias from their learning environments so that all patients receive health care that is just, equitable, and free of racism and bias.

The following is a list of all 11 schools that will be part of Mount Sinai’s ART in Med Ed project:

College of Medicine, University of Saskatchewan

Columbia University Vagelos College of Physicians and Surgeons

David Geffen School of Medicine at the University of California, Los Angeles

Duke University School of Medicine

East Carolina University Brody School of Medicine

The George Washington University School of Medicine & Health Sciences

The Ohio State University College of Medicine

University of Arizona College of Medicine – Phoenix

University of Minnesota Medical School

University of Missouri-Columbia School of Medicine

University of the Incarnate Word School of Osteopathic Medicine

Phillips School of Nursing Announces Scholarship for Students From Underrepresented Groups

Oct 21, 2021 | Community, Diversity and Inclusion, Featured

The Phillips School of Nursing at Mount Sinai Beth Israel has granted nursing scholarships to eight students who belong to racial and ethnic groups that are underrepresented in nursing.

Funded by the U.S. Health Resources and Services Administration, the scholarships are part of the agency’s Nursing Workforce Diversity Program, which strives to encourage diversity in an inclusive and equitable environment.

This year’s recipients are Maria Colon, Paola Coronel, Jeefry De La Cruz, Jessica Guaman, Autumn Johnson, Julissa Lorenzo, Thayshamarie Rodriguez, and Adenike Strachan.

“These scholarships build on our efforts to recruit and graduate a diverse group of students,” Todd F. Ambrosia, DNP, MSN, APRN, FNP-BC, FNAP, Dean of the Phillips School of Nursing, says of the program. “We are proud to help these students acquire the skills necessary to excel in today’s demanding health care environment.”

The Phillips School of Nursing has received a grant of more than $1.8 million over the next four years to continue distributing the scholarships. It expects to help fund the education of 10 to 12 students from underrepresented groups each year.

According to the American Association of Colleges of Nursing, nursing students from minority backgrounds represent only 32 percent of students enrolled in baccalaureate programs. The scholarships will enable these students to enter and graduate from the nursing program, covering the student’s entire time in the program, which lasts for 15 months, or four semesters. It will provide 70 percent of tuition as well as a small stipend to help with living expenses.

Once students are accepted into the Phillips School of Nursing, they are automatically considered for the scholarship. To qualify, students must be educationally or economically disadvantaged and come from a minority background that is underrepresented in nursing. This includes those who are American Indian or Alaska Native, Black or African American, Native Hawaiian or other Pacific Islander, or Hispanic of any race.

In addition to scholarship funds, the program provides academic and support services to all nursing students. Services include group and individual tutoring sessions, mentoring, a writing center, and career readiness workshops.

Seven Mount Sinai Hospitals Receive Quality Awards From the American Heart Association

Oct 20, 2021 | Featured

Seven Mount Sinai hospitals have received quality achievement awards from the American Heart Association (AHA) for ensuring that patients with stroke, heart failure, and heart attacks receive the most appropriate and safe treatments to strive toward the best possible outcomes.

Mount Sinai was recognized for its commitment to ensuring that stroke patients receive the most appropriate treatment according to nationally recognized research-based guidelines based on the latest scientific evidence. The Get With The Guidelines® Stroke quality improvement initiative aims to decrease readmissions and lower mortality rates.

The following hospitals received Get With The Guidelines®-Stroke Gold Plus Quality Achievement Awards, and many were recognized for additional care they provide in special populations like those with type 2 diabetes or needing advanced therapy.

Mount Sinai Beth Israel
Mount Sinai Brooklyn
The Mount Sinai Hospital
Mount Sinai Morningside
Mount Sinai Queens
Mount Sinai South Nassau
Mount Sinai West

The AHA also acknowledged several Mount Sinai hospitals for their efforts in heart failure care and implementing specific quality improvement measures with the goal of speeding recovery and reducing hospital readmissions for heart failure patients. Numerous published studies demonstrate that the Get With The Guidelines®-Heart Failure programs have achieved significant improvements in patient outcomes including reducing 30-day readmissions.

Mount Sinai hospitals received these following awards:

Get With The Guidelines®-Heart Failure Gold Plus with Target: Heart Failure Honor Roll and Target: Type 2 Diabetes Honor Roll

The Mount Sinai Hospital
Mount Sinai South Nassau

Get With The Guidelines®-Heart Failure Gold with Target: Type 2 Diabetes Honor Roll

Mount Sinai Beth Israel

Get With The Guidelines®-Heart Failure Bronze

Mount Sinai Morningside

Mount Sinai was also recognized for coordinating STEMI and non-STEMI heart attack care for our communities. ST-elevated myocardial infarction (STEMI) is the deadliest type of heart attack. To prevent death in STEMI heart attacks, it is critical to restore blood flow as quickly as possible, either by mechanically opening the blocked vessel or by providing clot-busting medication. The AHA’s Mission: Lifeline program’s goal is to improve prompt treatment for heart attacks, beginning with the 911 call, to EMS transport, and continuing through hospital treatment and discharge. The following hospitals were recognized:

Mission: Lifeline® Receiving Gold for STEMI Care

Mount Sinai Beth Israel
The Mount Sinai Hospital
Mount Sinai Morningside

Mission: Lifeline® Receiving Gold Plus and Mission Lifeline® NSTEMI Silver

Mount Sinai Morningside

Click here to see the full list of awards for all GWTG programs across the country organized by state.

Mount Sinai leaders expressed their thanks to the teams that provide this care. The leaders are: Valentin Fuster, MD, PhD, Director of Mount Sinai Heart, Mount Sinai Health System, and Physician-in-Chief, The Mount Sinai Hospital; Beth Oliver, DNP, RN, Chief Nurse Executive and Senior Vice President, Cardiac Services, Mount Sinai Health System; Barbara Vickrey, MD, MPH, Chair, Department of Neurology, Mount Sinai Health System and Henry P. and Georgette Goldschmidt Professor of Neurology, Icahn School of Medicine at Mount Sinai; and Joshua B. Bederson, MD, Leonard I. Malis, MD / Corinne and Joseph Graber Professor and Chair, Department of Neurosurgery, Mount Sinai Health System.

“These awards are evidence of the vital care our Mount Sinai family provides to our patients in their greatest moments of need,” they said in a statement. ”We are grateful to the multidisciplinary teams who—through these valuable programs and daily actions of compassion and agility—save thousands of lives each year.”

Mount Sinai Researchers Describe a Novel Approach to Harness Fecal Microbiota Transplantation That Could Be Safer and More Precise

Oct 8, 2021 | Featured, Research

In a study published in Nature Microbiology, researchers at the Icahn School of Medicine at Mount Sinai address unanswered questions about how fecal microbiota transplantation (FMT) can effectively restore a patient’s microbiome.

Ari Grinspan, MD

FMT involves transferring processed stool collected from a healthy donor into the intestinal tract of a patient in order to replace the existing microorganisms in the intestinal tract and treat Clostridioides difficile infection (CDI). FMT helps to restore the balance of “good” and “bad” bacteria in the colon, which can help patients fight off infections.

“This is big news for patients and providers. While FMT is effective for CDI, it is a crude treatment, fraught with challenges including access and safety concerns. We have identified a select group of bacteria in a real-life human study that can serve as an ideal starting point for a synthetic FMT product–without the ‘fecal’ component,” says Ari Grinspan, MD, Associate Professor of Medicine, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, a co-author of the study.

Studies have shown how a healthy patient’s gut microbiota after transplantation resembles that of a healthy donor. However, these studies have failed to answer a very basic question: Which individual bacterial strains are actually transferred to the recipient’s gut microbiota and for how long?

Jeremiah Faith, PhD

“Knowing which bacterial strains are transferred to the recipient gut microbiota is critical to our understanding of why some patients respond to FMT and others do not,” says Jeremiah Faith, PhD, Associate Professor, Precision Immunology Institute and the Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, senior author of the study.

Dr. Faith and his team of researchers isolated and sequenced the whole genomes of 2,987 bacterial isolates representing 1,008 unique strains from 9 FMT healthy donors and 13 recurrent CDI FMT recipients, while also developing an algorithm to track sequenced bacterial strains and metagenome, thus allowing them to pinpoint strains that will be most effective in treatment.

They rigorously validated and benchmarked the algorithms and showed that most FMT donor strains (more than 70 percent) and a minority of recipient strains (less than 25 percent) are retained for at least five years after FMT in non- relapsing patients.

Several U.S. Food and Drug Administration (FDA) advisories have recently reported severe adverse events from FMT, increasing safety concerns around undefined FMT, which uses the entire stool. Isolating and identifying the strains that are transferred from FMT donors to recipients could lead to a potentially safer alternative to FMT, according to the researchers.

The study received funding support from the Crohn’s & Colitis Foundation; the National Institutes of Health; and a SUCCESS philanthropic award funded by the Bacchetta Foundation.