Neck Injuries

Pictured: Hannah Wastyk/Background by Nicole Bean for BioSpace Hannah Wastyk was born in Jiangxi, China, and grew up with her adoptive parents in a small town in Pennsylvania. She grew up wanting to be a doctor, and had her first job in a cancer research lab during high school. That experience led to her being the first student at her high school to participate in a regional science fair, which she won. She took her project to an international fair, winning first prize in the molecular biology category and third overall. As a result, she was able to attend the Nobel Prize conference in Sweden in 2013, an experience that solidified her burgeoning desire to work in biological research. She got her undergraduate degree in biochemistry at the University of Delaware, then headed to Stanford for graduate school. During her third year in graduate school, a fellow PhD candidate, Will Van Treuren, asked Wastyk to start a company with him. That was the beginning of what is now known as Interface Biosciences, which is building an AI-enabled, metabolomics-based drug discovery engine for inflammatory disease. Wastyk didn’t know anything about startups at the time, so she borrowed the book Zero to One: Notes on Startups, or How to Build the Future and read it over winter break. She had always envisioned herself going into academia, but that winter, she reconsidered the impact she wanted to have. At Stanford, Van Treuren was building the very tools Wastyk had been waiting to use to find out how the microbiome and chemical language of its bacteria can be used to develop next-generation therapeutics. “It really was a perfect marriage there . . . his tools and then my vision," Wastyk said. "With the company, we could really go out there and try to make these therapeutics [and] use this technology for an application that would change the world. And I felt like we had a better chance of that in going out and start[ing] a company than staying in academia.” But stepping out of the lab at Stanford and into the biotech venture capital world, Wastyk, a 28-year-old queer Asian-American woman, had to learn quickly how to command rooms where middle-aged white men predominated. The Heavy Weight of Representation In 2023, companies founded solely by women garnered just 2% of the total capital invested in venture-backed startups in the U.S., according to a Pitchbook report, while startups with both female and male co-founders—like Interface Biosciences, of which Wastyk is CEO—doing only slightly better at 20.7%. “There’s a lot of women at Stanford, and there’s a lot of Asian women at Stanford,” Wastyk said. “I didn’t feel like a minority in that way as acutely as I did in pitch rooms and with venture capitalists.” In a January 2023 Substack post, Wastyk documented the pressure she felt: I was overwhelmingly surrounded by white men whose sole job was to judge me on the validity of my ideas and ability to make them money. Every day I feel the weight of representing women and proving we have what it takes to be successful. Every day I feel the weight of representing Asian Americans and proving we have what it takes to be successful. Every day I feel the weight of representing queer folks and proving we have what it takes to be successful. Every day I feel the weight of representing adoptees and proving we have what it takes to be successful. “There were times when I would pitch the entire company and then all of the questions would be directed to my co-founder, who’s a white man,” Wastyk said. “That was challenging. I had to learn very quickly to command respect.” Biotech venture capital, and venture capital as a whole, is a largely relationship-focused industry, Wastyk said. Having things in common, including shared identities like race and gender expression, can make it easier to form those relationships. Wastyk recalled a time when she pitched to a group of women venture capitalists and said she wondered why it felt so easy. Then it hit her: This is probably how it feels for white men pitching to other white men. “That rapport just comes really, really quickly,” she said. “That doesn’t necessarily mean it always translates to deals. . . . But being able to create that rapport so quickly with almost every single meeting that you’re in—the chances of it converting to a deal is much higher.” A Business Chameleon Wastyk thinks of herself as a chameleon. And while she said that identity grew out of necessity, she sees it as giving her an edge in business. “This is something that I’ve had to do my entire life,” she said. “Being in spaces where I’m pretty much always the minority, [I’m] good at adapting and can adapt to the mannerisms and the values that people are speaking to.” After delivering as many as eight pitches a day over Zoom to investors during the pandemic, she learned firsthand the truth of the age-old saying “confidence is key.” In graduate school, she noted, the approach is to look at the world as if you don’t know the answer to a research question and refrain from making blanket statements. But in business, investors want to hear sureties, a change in presentation style she described as “whiplash.” Yet she sees that confidence as earned, since “Really, when you come out of your PhD, you kind of are the expert in that domain, at least for a couple of years, because no one goes as deep as you go.” Wastyk said she conducts herself with command in every pitch she delivers, and it’s a practice that has paid off. As CEO she helped win $3 million in seed funding for Interface Biosciences in late 2023 despite a tough investing environment. “You want to have the confidence that what you’re doing is going to change the world, and that you are the only people that can do it,” she said. But her attitude has shifted a bit since last January’s Substack post. While she used to be afraid of failing, Wastyk said she now views failure as the expectation, as successful drug development is not the usual outcome. This gives her freedom to do good science, she said, because now she’s not afraid to try things that she thinks will work and adjust from there. “Business is the most tolerant to failure field in the world,” she said. “Failure doesn’t mean you’re going to be a failure forever.” For now, her priorities in building her company are defining her values, focusing on building up her employees and “protecting these people so that we can do the best science possible for as long as we possibly can.” Mollie Barnes is a freelance science writer based in Los Angeles. Reach her at mollie@100yearsco.com. Follow her on Threads and Instagram @shejustlikedtogo and see more of her work at molliebarnes.contently.com.

Dire shortage of subacute mental health beds has severely impacted Los Angeles General's acute psychiatric unit, jeopardizing staff safety. Shortages result in long lengths of stay and higher rates of restraint and seclusion for extremely violent patients. LOS ANGELES, Oct. 12, 2023 /PRNewswire/ -- The leadership at Los Angeles General Medical Center – Los Angeles County's largest safety-net hospital – was honored to host Governor Gavin Newsom today as he signed AB-531 into law. AB-531, which would fund the development of 10,000 new behavioral treatment beds and supportive housing units throughout CA, will help safety-net hospitals like LA General find appropriate placements for complex patients with severe mental illness in need of subacute care and long-term support outside of the hospital setting. LA General's psychiatric facility is an acute care center designed to stabilize patients experiencing mental health crisis over a short-term stay. Under normal circumstances, a patient stabilized at LA General's acute psychiatric facility would promptly transfer to a subacute facility equipped to provide longer-term care. However, due to the severe shortage of subacute psychiatric beds, some LA General patients remain in the hospital's acute care facility for months to years on end as they await transfer. A 2019 report by the Los Angeles County Department of Mental Health examined the dire shortage of mental health beds in Los Angeles County and its impact on area residents. The report identified a shortage of 3,000 subacute mental health beds in Los Angeles County. Lacking placement option availability, combined with the reality that LA General often cares for patients with a history of violence, has contributed to higher rates of restraint and seclusion. Without timely availability of sub-acute beds that offer an appropriate long-term therapeutic setting, patients grow frustrated with the feeling of being "stuck" in an acute psychiatric setting. This results in violent outbursts that require restraint to protect fellow patients and staff alike. Despite wide agreement that more beds are needed, relief has not come. In 2020, LA General's rate of restraint and seclusion was 32.38 and 23.07 respectively1 – the highest in the state – underscoring the unique complexities faced by LA General staff in caring for particularly violent patients for extended lengths of time. Yet an overall parroting of these numbers masks the truth: a very small number of actively violent patients with extremely long lengths of stay, who await sub-acute placements, account for the vast majority of the restraint use. Specifically, only five of these patients accounted for 67 percent of restraint usage at LA General's acute psychiatric unit. These patients all had repeated episodes of violent assaults on staff and even on other patients, which required the use of restraints or seclusions to de-escalate the patients and prevent acts of violence to others. On average, these patients stayed at LA General for 13 months each due to the ongoing shortage of subacute mental health beds, which is even more pronounced for patients with histories of violence. When accounting for the small number of violent patients waiting for lower level of care, as well as removing the hours for restraints used when transferring patients between facilities, the rate of restraints falls to within the average for safety-net hospitals. LA General's Psychiatric facility was recently praised as one of the best-run facilities in the state of California by the Joint Commission. The facility consistently meets and exceeds regulatory oversight requirements and inspections by individuals with expertise in the management of psychiatric patients, including thorough review of its use of restraints. Hospitals such as LA General should not have to choose between restraining patients in the wrong care setting and protecting fellow patients and staff. AB-531 is a critical step in the right direction to correct this fundamental injustice. LA General applauds the California legislature and Governor Newsom for their work to rectify long-standing mental health bed shortages in California. The investments made through AB 531 will enhance LA General's ability to appropriately care for patients, will protect patients and staff who expertly and compassionately provide care, and will connect patients to care in settings appropriate for their unique clinical needs and circumstances. However, the crisis of bed shortages not only affects patients who desperately need appropriate long-term placement but have nowhere to go, it also affects hospital staff, as staff are frequently subject to assault. LA General's acute psychiatric staff have suffered injuries and traumas due to assaults by patients, including physical injuries that require ongoing care and treatment. Los Angeles General leadership offer the following comments on the signing of AB-531: "Los Angeles General provides compassionate, high-quality care to Los Angeles County's most vulnerable communities. Because of our location in the heart of Downtown Los Angeles, and our proximity to Skid Row and the Twin Towers Correctional Facility, our acute psychiatric unit is the primary facility in LA County caring for highly complex patients, including some who are extremely violent. These patients are often the most difficult to place, given their unique needs and the severe shortage of mental health beds. AB 531 would provide some desperately needed relief to our staff and hope for our patients and their families. I want to thank Governor Newsom for his support in addressing these pressing issues," said Jorge Orozco, CEO, Los Angeles General Medical Center. "Tragically, the patients that are the most challenging to place are often the ones with the highest need for long-term, customized care. This includes patients with histories of incarceration – sometimes for violent crimes. Unfortunately, patient violence directed at our staff, or even at other patients, is a common occurrence. Often this violence grows out of the frustration our patients experience due to being 'stuck' in an acute care setting, which is the most restrictive clinical setting. It is imperative, both for our staff and our patients, that we take steps to address these issues. We are grateful to Governor Newsom for signing this bill into law," said Dr. Brad Spellberg, Chief Medical Officer, Los Angeles General Medical Center. Los Angeles County Board Supervisor, Hilda Solis, who oversees the district where LA General is located, also offered her voice in support the Governor's mental health package: "In Los Angeles County, we are experiencing crises of homelessness, mental health, and substance use – the effects of which we are seeing in crowded emergency departments, in our jails, and on our streets. One of the main causes is a significant lack of beds to meet the growing level of need. That is why I want to thank Governor Newsom, Secretary Ghaly, and Assemblymember Irwin for their leadership in passing the Behavioral Health Infrastructure Bond Act. If passed by the voters, this important program would help fund some of the most desperately needed projects in the County, including the rehabilitation of Historic General Hospital and the construction of a Restorative Care Village at the Los Angeles General Medical Center. I am proud to lay the foundation for these developments which will bring much needed housing, treatment facilities, and beds that our most vulnerable residents need, and because of this legislation, we are now one step closer to making this a reality," said LA County Board Supervisor Hilda Solis. Additional information can be found below. For questions, or to request an interview with a representative from Los Angeles General, please contact [email protected] Fast Facts about Psychiatric Services at Los Angeles General Overview As a safety-net facility, Los Angeles General provides compassionate, high-quality care to LA County's most complex psychiatric patients, many of whom have histories of homelessness, substance abuse, and incarceration. LA General's psychiatric facility is an acute care center designed to stabilize patients experiencing mental health crisis over a short-term stay. Under normal circumstances, a patient who has been stabilized at LA General's acute psychiatric facility would transfer to a subacute facility that is equipped to provide longer-term care. However, due to the severe shortage of subacute psychiatric beds, some LA General patients remain in the hospital's acute care facility for months to years on end as they await transfer. This dynamic has also contributed to higher rates of restraint and seclusion at LA General, due to the extended admissions of a small number of extremely violent patients and the lack of available placement options for long-term care. LA General's service area and safety-net status leads to the admission of violent psychiatric patients, including justice-involved patients who have been previously incarcerated for severe crimes including rape, assault, and other convictions. LA General has one of the few inpatient psychiatric facilities in Los Angeles County that will admit patients with a history of violence, homelessness and from jails and the justice system. Other hospitals often do not accept these patients due to the risk of violence and the severe shortage of psychiatric beds in Los Angeles County and the state of California. LA General receives a disproportionate number of patients from the jails and Skid Row because over the years, many private hospitals in LA County have carved out both the jails and Skid Row from their respective "zones" or service areas from which they take patients. Given LA General's proximity to both Skid Row and the Twin Towers Correctional Facility, patients from these locations are brought to LA General in higher proportions, as other hospitals often will not admit patients from these locations. The dire shortage of subacute mental health beds has had severe impacts on Los Angeles General's acute psychiatric unit, resulting in long lengths of stay and high rates of restraint and seclusion due to the lack of available options for long-term care and the need to maintain a safe environment. A 2019 report by the Los Angeles County Department of Mental Health examined the dire shortage of mental health beds in Los Angeles County and its impact on area residents. The report identified a shortage of 3,000 subacute mental health beds in Los Angeles County. In 2020, LA General's rate of restraint and seclusion was 32.08 and 23.07 respectively – the highest in the state, underscoring the unique complexities that LA General faces as its staff care for particularly violent patients for extended lengths of time. In 2020, 4% of patients accounted for 67% of restraint usage at LA General's acute psychiatric unit. These patients stayed at LA General for an average of 13 months each due to the ongoing shortage of subacute mental health beds, which is even more pronounced for patients with histories of violence. More details on these patients are provided here: Patient #1 – 7 month hospitalization: A patient previously in a sub-acute mental health facility for 3 years with over 100 psychiatric encounters, demonstrated persistent violent behaviors, assaulted staff with bodily fluids and violently assaulted another Los Angeles General patient who was disabled. Patient #2 – 17 month hospitalization: A patient with schizophrenia was unresponsive to medication and assaulted eight other patients, a maintenance worker, and seven staff members over the course of a 17-month hospitalization. Placement was difficult to find due to the patient's violent behavior, which was a major factor in the patient's long length of stay at Los Angeles General. Patient #3 – 12 month hospitalization: A physically imposing patient, with a history of multiple incarcerations and polysubstance abuse, presented persistent aggressive behaviors and assaulted staff and other patients multiple times. Patient #4 – 14 month hospitalization: A young patient with a history of physical and sexual abuse frequently responded to hallucinations with aggression, threatening to kill staff, using racial slurs, and physically assaulting staff and other patients, as well as demonstrating self-harming behaviors over the course of a 14-month hospitalization. Placement was difficult to find due to the patient's violent behavior, which was a major factor in the patient's long length of stay at Los Angeles General. Patient #5 – 15 month hospitalization: A patient with an early schizophrenia diagnosis had recurrent violent outbursts, resulting in persistent attempts to assault both staff and patients over a 15-month hospitalization. Patient was referred to a state psychiatric hospital, but placement could not be found due to the patient's violent behavior. Without the availability of sub-acute beds, patients often grow frustrated with the feeling of being "stuck" in a setting like Los Angeles General, resulting in violent outbursts that require restraint. Psychiatric Staff at Los Angeles General are routinely subject to assault by patients, suffering injuries and traumas including psychical injuries that require ongoing care and treatment. A short summary of a few stories of assaults suffered by staff at Los Angeles General is provided here: Nurse Attacked by Schizophrenic Patient: A nurse was slammed to the wall and punched by a schizophrenic patient in 2021 and has been in physical therapy and on medication for a chronic injury ever since. Social Worker Punched in Face: A social worker assigned to a particularly aggressive patient was punched in the face when intervening as the patient chased other patients and staff. Brutal Attack on Psychiatrist: A psychiatrist was punched in the head and slammed to the ground by a patient coming down from meth, resulting in physical trauma and spurring facility wide security changes. Attack on Social Worker: A social worker was violently thrown against a concrete wall by a patient that was sent to Los Angeles General directly from jail, resulting in serious physical injuries and necessitating an extended leave to recover mentally and physically. Security is consistently one of the top priorities for LA General psychiatric residents in contract negotiations, and LA General has undergone several changes to its security protocol because of the increasingly violent behaviors of psychiatric patients. Several staff have had to take leave from work following an assault by patients, including to recover from head, neck, and back injuries. Staff also report significant, long-lasting mental harm due to the trauma of being attacked by a patient. 1 Rate per 1,000 patient hours. SOURCE Los Angeles General Medical Center

TUESDAY, June 6, 2023 (American Heart Association News) -- As rainbow flags flutter in the June breeze for Pride Month, many LGBTQ+ people will feel tension in the air. "It's been a really rough go for LGBTQ Americans" of late, said psychiatrist Dr. Natalia Ramos, an assistant clinical professor at the David Geffen School of Medicine at the University of California, Los Angeles. In the wake of universal stressors such as the COVID-19 pandemic and the economy, the news has been full of anti-gay and anti-transgender actions from the highest levels of state and local governments. "I think even for those of us that are not based in states that are directly impacted right now, it's hard to miss out on the extremely negative discriminatory messaging that's going on against LGBTQ people," Ramos said. Which means this year's pride celebrations could be an opportunity for LGBTQ people and those who love them to get a much-needed mental health boost from social companionship and public affirmation. But fittingly for an event that is associated both with exuberance and defiance, there's a spectrum of ways to approach it, experts say. Jessica Halem, senior director of Eidos, the LGBTQ+ health initiative at the University of Pennsylvania in Philadelphia, calls today's social and political climate the best of times and the worst of times. "I've been in LGBT health for 20 years," she said. "We've never had so much momentum, interest, support and public recognition," even as states enact laws that target LGBTQ people and some pride events are being shut down. "That's the part that gives us a little bit of whiplash," Halem said. "And of course, none of this is good for my heart health." Ramos, who is medical director of UCLA's EMPWR clinic, which emphasizes well-being and resilience in LGBTQ+ people, said toxic stress of the type caused by homophobia and discrimination can indeed be a health risk. "It's a weighty thing to be experiencing constant stigma and messaging against you and/or people you love." A 2020 scientific statement from the American Heart Association emphasized that stress is thought to be a significant factor in health disparities for LGBTQ people. They also are at higher risk for social isolation, which has been linked to issues with mental and heart health. Pride Month celebrations might, therefore, be healthy, Ramos said. "In general, we know that social connectedness, social cohesion and finding meaning in your identity and your values are all very positive experiences for our mental well-being and our physical well-being as well." Halem, who was the first LGBTQ director at Harvard Medical School, said "being isolated breeds shame. And shame is the internalization of stigma." It's impossible for an LGBTQ person to avoid hearing negative messages and absorbing their toxicity. "But you have to actively release it. That is why we dance. That is why we listen to loud music. That is why we sing. That is why we wear wacky clothes. We have to release that shame." Pride Month traces its roots to the 1969 Stonewall Uprising for gay rights in New York City. Over the years, it's been celebrated in ways both serious and silly. "You know, it's funny, because some of us old-timers probably started to take pride celebrations for granted," Halem said. "We were a little like, 'Oh God, not one more party. Not one more rainbow boa.'" Now, she's tuned in to the way those celebrations are a way to witness "the huge diversity of experience, expression and lives within the community." Halem, who has performed as a standup comic at pride events nationwide, said she'd felt the power of such gatherings firsthand. At pride celebrations large and small, she said, "you will always see an incredible range of bodies, couples, hairstyles and clothes. I mean, just to see how people live in their queer bodies, just to see people embody queer joy, to see transgender people, to see old gay people. It's just … "It heals," Halem said. Ramos said "there's an immense potential positive effect on well-being for folks that are marginalized" if they experience a sense of community. "Seeing ourselves in public discourse and public media in positive ways also is very helpful for mental health, even if you're not directly experiencing the pride events in person." But she said it would be naïve to assume that a pride month, week or weekend could counterbalance all of the negative social and political stressors people are encountering right now. People might also have safety concerns about large gatherings. "Realistically, a lot of folks think there's a kind of performative aspect of pride where it's confined to one weekend or one month, while all of these life stressors are never-ending," Ramos said. Some pride parties end up centered on alcohol in unhealthy ways, she said. Others focus on family and community or emphasize activism. So, in some areas, people can pick and choose the most comfortable setting for celebrating. Social connectedness doesn't have to involve marching in a parade, Ramos said. "Hanging out with friends, chosen family, in small get-togethers – whatever floats your boat – can be really meaningful." Halem said LGBTQ events, like LGBTQ people, come in all varieties. "Back in the day, we only had smoky bars and a couple of softball leagues. Today, you can find meetups in parks. You could find Dungeons & Dragons gay night. I'm going to a trivia night at a church basement." If your favorite type of event doesn't exist, it's easy to start something over social media, she said. Go to an online forum such as a local LGBTQ-oriented Facebook group, Halem said, and say, "'I'm looking for other introverts to do a gay puzzle night.' I guarantee you, you'll have 20 people show up." Pride activities also are a great way for friends and family to show support, Ramos said. People who aren't sure how to best be an ally can always ask. But, she said, "you don't want to just reach out to your LGBTQ friends during Pride Month. You want to be maintaining the relationships, checking in, being mindful and thoughtful year-round, especially when there's a lot of stuff going on around us." LGBTQ allies who want to show their support in person need to be thoughtful in choosing an event, Halem said. "You should go to a pride parade and cheer people on and hold a sign saying, 'Another mom for gay rights! I love my transgender kid!'" But after that, "you don't have to go to the dance club." Overall, she said, even small validations of LGBTQ people – including self-validations – matter. The world is full of loud, cruel voices, Halem said. "For me, the antidote, and the way to celebrate this month, is to practice love, joy and affirmation towards ourselves and others." Pride, she said, "sounds like an event I go to. But it's a feeling that I can cultivate in myself first." American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. By Michael Merschel, American Heart Association News Posted June 2023