How Honeybees May Infect Bumblebees

Many species of wild bumblebees are in decline—and new research shows that diseases spread by domestic honeybees may be a major culprit.

Several of the viruses associated with bumblebees’ trouble are moving from managed bees in apiaries to nearby populations of wild bumblebees—“and we show this spillover is likely occurring through flowers that both kinds of bees share,” says Samantha Alger, a scientist at the University of Vermont who led the new research.

“Many wild pollinators are in trouble and this finding could help us protect bumblebees,” she says. “This has implications for how we manage domestic bees and where we locate them.”

The first-of-its-kind study was published June 26 in the journal PLOS ONE.

Virus hunters

Around the globe, the importance of wild pollinators has been gaining attention as diseases and declines in managed honeybees threaten key crops. Less well understood is that many of the threats to honeybees (Apis mellifera)—including land degradation, certain pesticides, and diseases—also threaten native bees, such as the rusty patched bumblebee, recently listed under the Endangered Species Act; it has declined by nearly 90%  but was once an excellent pollinator of cranberries, plums, apples and other agricultural plants.

The research team—three scientists from the University of Vermont and one from the University of Florida—explored 19 sites across Vermont. They discovered that two well-know RNA viruses found in honeybees—deformed wing virus and black queen cell virus—were higher in bumblebees collected less than 300 meters from commercial beehives.  The scientists also discovered that active infections of the deformed wing virus were higher near these commercial apiaries but no deformed wing virus was found in the bumblebees they collected where foraging honeybees and apiaries were absent. 

Most impressive, the team detected viruses on 19% of the flowers they sampled from sites near apiaries. “I thought this was going to be like looking for a needle in a haystack. What are the chances that you’re going to pick a flower and find a bee virus on it?” says Alger. “Finding this many was surprising.” In contrast, the scientists didn’t detect any bee viruses on flowers sampled more than one kilometer from commercial beehives.

 The UVM scientists—including Alger and co-author Alex Burnham, a doctoral student—and other bee experts have for some years suspected that RNA viruses might move from honeybees to bumblebees through shared flowers. But—with the exception of one small study in a single apiary—the degree to which these viruses can be “horizontally transmitted,” the scientists write, with flowers as the bridge, has not been examined until now.

Taken together, these results strongly suggest that “viruses in managed honeybees are spilling over to wild bumblebee populations and that flowers are an important route,” says Alison Brody, a professor in UVM’s Department of Biology, and senior author on the new PLOS study. “Careful monitoring and treating of diseased honeybee colonies could protect wild bees from these viruses as well as other pathogens or parasites.”

Just like chicken?
Alger—an expert beekeeper and researcher in UVM’s Department of Plant & Soil Science and Gund Institute for Environment—is deeply concerned about the long-distance transport of large numbers of honeybees for commercial pollination. “Big operators put hives on flatbed trucks and move them to California to pollinate almonds and then onto Texas for another crop,” she says—carrying their diseases wherever they go. And between bouts of work on monoculture farm fields, commercial bees are often taken to more pristine natural habitats “to rest and recover, where there is diverse, better forage,” says Alger.

“This research suggests that we might want to keep apiaries outside of areas where there are vulnerable pollinator species, like the rusty patched bumblebees,” Alger says, “especially because we have so much more to learn about what these viruses are actually doing to bumblebees.”

 Honeybees are an important part of modern agriculture, but “they’re non-native. They’re livestock animals,” Alger says. “A huge misconception in the public is that honeybees serve as the iconic image for pollinator conservation. That’s ridiculous. It’s like making chickens the iconic image of bird conservation.”

Source: UVM News

Are commercial honeybees making wild bees sick?

A first of its kind study in PLOS One by Samantha Alger, a research affiliate in the Plant & Soil Sciences Department, showed that viruses may be spilling over from commercial honeybee colonies into wild bumblebee populations, with the potential for significant harmful consequences to crop pollination. Read the PBS NewsHour story.

The research was also covered by Earth.com, Grist, and Inverse, among others.

 

Source: UVM News

Video Games Offer Clues to Help Curb Animal Disease Outbreaks

Strengthening biosecurity is widely considered the best strategy to reduce the devastating impact of disease outbreaks in the multi-billion-dollar global swine industry, but successfully doing so all comes down to human decision-making, a University of Vermont study shows.

The study, published June 25, 2019 in Frontiers in Veterinary Science, is the first of its kind to include human behavior in infectious disease outbreak projections – a critical element that has largely been ignored in previous epidemiological models. Incorporating theories of behavior change, communications and economic decision-making into disease models gives a more accurate depiction of how outbreak scenarios play out in the real-world to better inform prevention and control strategies.

“We’ve come to realize that human decisions are critical to this picture,” said Gabriela Bucini, a postdoctoral researcher in UVM’s Dept. of Plant and Soil Science and lead author of the study. “We are talking about incredibly virulent diseases that can be transmitted in tiny amounts of feed and manure. Ultimately, controlling these diseases is up to the people in the production system who decide whether or not to invest and comply with biosecurity practices.”

Seeking to understand the role of human behavior in animal disease outbreaks, the researchers designed a series of video games in which players assumed the roles of hog farmers and were required to make risk management decisions in different situations. Observing how players responded to different biosecurity threats provided data used to simulate the spread of Porcine Epidemic Diarrhea virus (PEDv) – one of the most severe infectious diseases in the U.S. swine industry – in a regional, real-world hog production system.

The number of pigs that contracted PEDv was shown to be highly dependent on the risk attitudes of the farmers and producers in the system and a relatively small shift in risk attitudes could have a significant impact on disease incidence. According to the study, getting just 10 percent of risk tolerant farmers to adopt a risk averse position with stronger biosecurity measures reduced the total incidence of PEDv by 19 percent. Keeping the disease under control required at least 40 percent of risk-takers to change their attitudes.

Disease dynamics in a simulated hog production system in North Carolina showed disease incidence to be highly dependent on risk attitudes and behaviors. 

“The risk attitudes and human decisions that we’re incorporating in the model are really powerful,” said Scott Merrill, co-author and researcher in the Dept­. of Plant and Soil Science and Gund Institute for the Environment. “If we can change the way people behave, then we have a chance to make some dramatic impacts and avoid a devastating outbreak.”

Getting Serious About Games

Merrill and Bucini are part of a team of researchers in UVM’s Social Ecological Gaming and Simulation (SEGS) Lab who are designing interactive “serious” games and computational models to understand complex systems. Developed by Merrill, along with Chris Koliba and Asim Zia in the Dept. of Community Development and Applied Economics and Gund Institute for the Environment, the SEGS Lab places research subjects in a virtual world where researchers can monitor their behavior – an approach that may help eliminate some of the biases that can occur with traditional surveys.

Their work in the area of animal disease biosecurity is part of a $7.4 million multi-institutional biosecurity initiative led by UVM animal science researcher Julie Smith that’s aiming to inform policies that collectively reduce the impact of pests and diseases on food-producing livestock in the U.S.

The PEDv outbreak model is grounded in data derived from the biosecurity video games, which found that people behaved differently depending on the type of information they received and how it was presented. In one game, players were given several different risk scenarios and had to decide whether to maximize their profit or minimize their risk. Players presented with a 5 percent risk of their animals getting sick if they ignored biosecurity protocols complied only 30 percent of the time. However, when the risk level was presented visually as “low risk” on a threat gauge with some built in uncertainty, rather than numerically, players complied over 80 percent of the time.

Images from biosecurity video games showing two different risk scenarios

“A simple thing like going out the wrong barn door can have a huge impact,” said Merrill. “With the game data, we can see big differences in the economic and disease dynamics as we change the type of information we’re delivering, and the way it’s delivered.”

Rising Global Threat

Infectious diseases like PEDv pose a continuous risk to U.S. hog producers, one that is increasing with the consolidation and globalization of the industry. The diseases are highly contagious and the effects can be catastrophic. PEDv was first detected in the U.S in 2013. Within one year, it spread to 33 states and wiped out as many as 7 million pigs, or 10 percent of the nation’s agricultural swine population.

Since then, U.S. producers have ramped up biosecurity measures, but PEDv remains endemic in the U.S. and new and emerging pests and diseases are on the rise. An ongoing outbreak of African swine fever in Asia has decimated pig herds across China, the world’s largest consumer of pork, and pork prices are expected to hit record levels in 2019.

“Biosecurity efforts are often voluntary, but are critical to prevention, especially when there are no vaccines or treatments available,” said Smith, principal investigator of UVM’s animal disease biosecurity project. “We have to understand where people are on the risk continuum, their barriers and challenges, and their ability to act. That information is critical to the response.”

The Animal Disease Biosecurity Coordinated Agriculture Project is funded with a National Institute of Food and Agriculture (NIFA) grant from the U.S. Department of Agriculture, under award number 2015-69004-23273. Collaborating research and extension faculty are based at the University of Central Florida, Iowa State University, Kansas State University, Montana State University and Washington State University.

Source: UVM News

UVM Extension Receives $599,124 Grant to Expand Program Aimed at Reducing Risky Behavior in Vermont Youth

University of Vermont Extension will expand a program proven to reduce risky behavior in youth, including substance misuse, called PROSPER to schools in St. Johnsbury, Newport and Derby. The program is currently in place at three Vermont schools.

PROSPER, for Promoting School-Community-University Partnerships to Enhance Resilience, was developed jointly at Iowa State University and Pennsylvania State University in 2001 and has been implemented in communities around the country since then. Its effectiveness has been demonstrated in nearly 80 published research studies.

The two-year program targets sixth and seventh graders.

“We’re honored and pleased to be able to expand the PROSPER program to three communities in the Northeast Kingdom,” said Chuck Ross, director of UVM Extension. “The program has generated impressive results nationally and in the three Vermont schools where it’s in place. We have every reason to expect similar success in St. Johnsbury, Newport and Derby.”

The PROSPER expansion to St. Johnsbury and Newport will be funded with a $599,124 Children, Youth and Families at Risk (CYFAR) grant from the National Institute of Food and Agriculture (NIFA) within USDA. Funding for the Derby expansion is coming from Iowa State. 

The program will be implemented at St. Johnsbury School in St. Johnsbury, Newport City Elementary School in Newport, and Derby Elementary School and North Country Union Junior High School in Derby, which serves both Newport and Derby.  

The PROSPER programs in St. Johnsbury and Newport will launch July 1, with Derby following three months later. UVM Extension expects that the programs in all three communities will be up and running in early 2020. 

The PROSPER Model

The PROSPER program builds competency and confidence in sixth and seventh graders and improves family functioning as bedrock strategies for preventing behavior problems in youth. 

In sixth grade, PROSPER engages families in an after-school program called Strengthening Families Program: For Parents and Youth Ages 10-14. The program shifts to an in-school focus during seventh grade with delivery of Lifeskills programming. During both years, teachers and counselors in the school deliver a set curriculum that research has shown to be effective.

Critical to the program’s success is the work of a team of eight to ten community members, including parents, teachers and other school personnel, Department of Health representatives and community members. The community team helps fine-tune the messaging of the program to the specific needs of the school, does fundraising to ensure the program is sustainable after the five-year grant expires, conducts outreach to the community about PROSPER and oversees the program’s implementation via monthly meetings.

The new PROSPER programs will be enhanced by a partnership with 4-H that will engage students in variety of leadership training programs.

Strong research results

According to research conducted by Iowa State and published in  the journal Preventive Medicine in 2013, teens involved with PROSPER program had significantly reduced rates of drug and alcohol use compared with teens not in the program.  Teens and young adults who had been through the program also had better relationships with parents, improved life skills and fewer problem behaviors in general.

According to a different study conducted by Penn State, students who participated in PROSPER had reduced initiation rates for marijuana and meth. If the findings were to generalize, about 61 students in a PROSPER community would try marijuana, as compared to 100 students in a non-PROSPER community.

The PROSPER program also has a continuing effect. One study showed it reduced alcohol use by an average of 32 percent for 10th grade students who had participated in the program compared with peer who hadn’t. 

The principal investigator on the grant is UVM Extension’s Sarah Kleinman, the state director of 4-H. Other members of the UVM Extension team are Ellen Rowe, community and leadership development specialist and co-principal investigator/evaluator; Anthony Willey, 4-H educator and PROSPER team leader; and Kara Bissonnette, technology coordinator.Through an earlier CYFAR grant awarded to UVM Extension in 2017, PROSPER programs are in place at Lyndon Town School in Lyndonville and Otter Valley Union High School, where the program is delivered to sixth and seventh graders from five rural middle schools in the Rutland Northeast Supervisory Union. The program, with a different funding source, has been in place at Camel’s Hump Middle School in Richmond since 2013.

More information about UVM Extension’s PROSPER program can be found at https://www.uvm.edu/extension/prosper.

Source: UVM News

UVM Ranks Among Northeast’s Top LGBTQ-Friendly Schools

The University of Vermont ranks among the Northeast’s “Best Colleges for LGBTQ Students,” according to a new ranking from Campus Pride.

Campus Pride, in partnership with BestColleges.com, ranked “the most LGBTQ-friendly college in each state,” placing UVM first among Vermont schools. The Campus Pride Index is the premier national benchmarking tool that self-assesses LGBTQ-friendly policies, programs and practices.

Each school listed “has been hand vetted by our panel of experts from Campus Pride for their inclusion features to ensure that they represent the most positive option for LGBTQ youth in each state,” according to the ranking.

The ranking highlights resources available to LGBTQ+ students at UVM, including health and wellbeing services, academic offerings, housing options, gender-inclusive restrooms, and the Prism Center, which “builds an inclusive environment through education, advocacy, and community building.”

UVM currently has a 4.5/5-star rating on the Campus Pride Index, “an overall indicator of institutional commitment to LGBTQ-inclusive policy, program and practice.”

The “Best Colleges for LGBTQ Students in the Northeast” include:

Bowdoin College

Dartmouth College

Princeton University

Tufts University

University of Connecticut

University of Delaware

University of Maryland

University of Rhode Island

University of Vermont

See the complete list of Best Colleges for LGBTQ Students by state.

Source: UVM News

Former VP and General Counsel Bazluke to Be Honored with Life Membership Award

Francine “Fran” T. Bazluke, former vice president and general counsel at UVM, will be honored with the National Association of College and University Attorney (NACUA) 2019 Life Membership Award, granted after an individual’s retirement from the regular practice of higher education law, in recognition of outstanding service and substantial contributions to the association.

Bazluke served as a member of the NACUA Board of Directors from 1996-1999 and as its president from 2003-2004. She has also been a member of numerous committees, including chairing the Committee on Program for the Annual Conference, the Committee on Nominations and Elections and the Committee on Honors and Awards. In 2006 she co-wrote an article in the Journal of College and University Law, titled “Because of Sex: The Evolving Legal Riddle of Sexual vs. Gender Identity” with Jeffrey J. Nolan. In 2008, she was a recipient of the NACUA Distinguished Service Award.

In the words of her colleagues, Bazluke’s “decades of outstanding service, leadership and devotion to NACUA are extraordinary and substantial. She exemplifies all of NACUA’s core values and has inspired countless higher education attorneys. Fran has contributed so much to NACUA and the higher education legal profession in so many ways.”

Awards for this year’s honorees will be presented on Sunday, June 23 at the 2019 Honors & Awards Ceremony, held as part of the NACUA 59th Annual Conference in Denver Colorado.

Source: UVM News

Why Noah’s Ark Won’t Work

A Noah’s Ark strategy will fail. In the roughest sense, that’s the conclusion of a first-of-its-kind study that illuminates which marine species may have the ability to survive in a world where temperatures are rising and oceans are becoming acidic.

Two-by-two, or even moderately sized, remnants may have little chance to persist on a climate-changed planet. Instead, for many species, “we’ll need large populations,” says Melissa Pespeni, a biologist at the University of Vermont who led the new research examining how hundreds of thousands of sea urchin larvae responded to experiments where their seawater was made either moderately or extremely acidic.

The study was published on June 11, 2019, in the Proceedings of the Royal Society B.

Rare relief

Pespeni and her team were surprised to discover that rare variation in the DNA of a small minority of the urchins were highly useful for survival. These rare genetic variants are “a bit like having one winter coat among fifty lightweight jackets when the weather hits twenty below in Vermont,” Pespeni says. “It’s that coat that lets you survive.” When the water conditions were made extremely acidic, these rare variants increased in frequency in the larvae. These are the genes that let the next generation of urchins alter how various proteins function—like the ones they use to make their hard-but-easily-dissolved shells and manage the acidity in their cells.

But maintaining these rare variants in the population—plus other needed genetic variation that is more common and allows for response to a range of acid levels in the water—requires many individuals.

“The bigger the population, the more rare variation you’ll have,” says Reid Brennan, a post-doctoral researcher in Pespeni’s UVM lab and lead author on the new study. “If we reduce population sizes, then we’re going to have less fodder for evolution—and less chance to have the rare genetic variation that might be beneficial.”

In other words, some organisms might persist in a climate-changed world because they’re able to change their physiology—think of sweating more; some will be able to migrate, perhaps farther north or upslope. But for many others, their only hope is to evolve—rescued by the potential for change that lies waiting in rare stretches of DNA.

Rapid adaptation

The purple sea urchins the UVM team studied in their Vermont lab are part of natural populations that stretch from Baja, California to Alaska. Found in rocky reefs and kelp forests, these prickly creatures are a favorite snack of sea otters—and a key species in shaping life in the intertidal and subtidal zones. Because of their huge numbers, geographic range, and the varying conditions they live in, the urchins have high “standing genetic variation,” the scientists note. This makes purple urchins likely survivors in the harsh future of an acidified ocean—and good candidates for understanding how marine creatures may adapt to rapidly changing conditions.

It is well understood that rising average global temperatures are a fundamental driver of the imminent extinction faced by a million or more species—as a recent UN biodiversity report notes. But it’s not just rising averages that matter. It may be the hottest—or most acidic—moments that test an organism’s limits and control its survival. And, as the UVM team writes, “the genetic mechanisms that allow rapid adaptation to extreme conditions have been rarely explored.”

Currency in the current sea

The new study used an innovative “single-generation selection” experiment that began with twenty-five wild-caught adult urchins. Each female produced about 200,000 eggs from which the scientists were able to extract DNA out of pools of about 20,000 surviving larvae that were living in differing water conditions. This very large number of individuals gave the scientists a clear view that purple urchins possess a genetic heritage that lets them adapt to extremely acidic ocean water. “This species of sea urchin is going to be okay in the short term. They can respond to these low pH conditions and have the needed genetic variation to evolve,” says UVM’s Reid Brennan. “So long as we do our part to protect their habitats and keep their populations large.”

But coming through the ferocious challenge of rapid climate change may come at a high cost. “It’s hopeful that evolution happens—and it’s surprising and exciting that these rare variants play such a powerful role,” says Melissa Pespeni, an assistant professor in UVM’s biology department and expert on ocean ecosystems. “This discovery has important implications for long-term species persistence. These rare variants are a kind of currency that urchins have to spend,” she says. “But they can only spend it once.”

Source: UVM News

Calling the Shots

An observer of the sophomore seminar course “Vaccines on Trial” would likely mistake it for a class on constitutional law or American history. With arguments from prosecution and defense teams, testimony from historical figures and shouts of “objection!” and “order in the court!” it’s not the typical course taught by faculty in the Department of Biomedical and Health Science.

“Vaccines on Trial,” HCOL 186, explores the pros and cons of a universal vaccination mandate for all citizens of the United States. The course plays out like a trial set in the year 2222, a hypothetical future where a continued rise in the global population contributes to increased rates of influenza, smallpox, rotavirus, diphtheria and measles, threatening the stability of human life. In this imagined scenario, U.S. health leaders and politicians assembled a team of experts to comprehensively investigate and decide on the issue of a national vaccine mandate by way of legal debate.

Eyal Amiel, assistant professor at the University of Vermont Biomedical and Health Sciences Department in the College of Nursing and Health Sciences, developed and teaches the course for Honors College sophomores to help them discover their own areas of interest and develop the necessary research skills to complete an independent thesis their senior year. 

At the start of the course, students learned about the history of communicable diseases, vaccine efficacy, health policies and concepts including public good versus individual rights, vaccine cost and liability and herd immunity — the resistance to the spread of a contagious disease within a population that results when a majority of individuals become immune to the disease through vaccination.

The students divided into teams for defense (supporting the vaccine mandate) and prosecution (opposing the mandate). They worked together building their cases, brainstorming topics for research, developing witness lists and outlining argument strategies. The course culminated in a fully enacted mock trial, with faculty members serving as jurors and Amiel presiding as judge. 

“I feel like I was given the perfect opportunity to defend an idea that I am passionate about, although it turned out to be more difficult than I thought going into this class,” said Clara Sarantopoulos ’21, who took the course as an environmental science student focusing on conservation biology and biodiversity. “I grew up in a family full of lawyers and thought this would be a fun way to explore the research around vaccines.”

As a real epidemic of measles currently threatens Americans’ health, this course has particular relevance. Measles cases are at a 27-year high in the U.S., according to the U.S. Centers for Disease Control and Prevention, with more than 1,000 cases so far in 2019, and more likely as unvaccinated people become exposed to this highly contagious disease.

“The debate about vaccines is extremely present in our lives right now, so I wanted to learn more about the different sides to his argument,” said Abby Goldman ’21, who took the course as a health sciences major and plans to attend medical school. “Not only have I learned more about infectious diseases, but also lots about vaccines in our society today — and the scientific, legal and ethical aspects of vaccinations. This class will help me make educated decisions and educate others going forward.” 

More than Medicine 

But this class was not about epidemics or vaccines, or even public health policy. While the students — whose majors included biochemistry, political science, psychological sciences, English and elementary education — learned about small pox and Spanish flu pandemics, early inoculations, forced quarantines and the U.S. Constitution, they gained skills in gathering, analyzing and critiquing evidence, working interprofessionally and creating a compelling academic argument. 

“The point is to introduce students to the research process to prepare them for their honors theses,” said Amiel, an expert on cellular molecular biology and disease immunity. Amiel’s research focuses on mechanisms of molecular control of cellular metabolism in response to pathogenic stimuli. “When you do research, you have to read everything on your topic and condense it into a clear argument. But answers are never completely clear — there’s always more than one side. I chose a paradigm that is difficult. Vaccines pose moral, ethical and personal liberty issues, and both sides have reasons that they feel are legitimate.”

He developed the course prior to the current measles outbreak, basing the format on his own experiences as a student.

“I had a course in high school where we put Julius Caesar on trial. It struck me as a great way to learn, as a semi-competitive game, to inject a sense of pressure in a fun way to know what you’re talking about,” said Amiel. “Education is about empowering students to get answers to their questions in life, and strategies for getting information and how to incorporate that into their lives. When we do it as a trial, research happens by accident because you are playing a game. There’s an element of competition, pride and performance.” 

Court in Session

Before going into the trial, the students agreed that they were not arguing for or against the idea of vaccination in general, but rather about a government-enforced national vaccine mandate.

To make their case, the prosecution team called witnesses including Antonin Scalia, the late justice of the U.S. Supreme Court, who discussed Tenth Amendment protection of states’ rights to sovereignty and testified that a federal vaccine mandate undermines democracy. Prosecutors also called to the stand former directors of the U.S. Centers for Disease Control and Prevention and the Alliance for Health Policy, whose testimonies elicited arguments about the inequity of vaccines for people who lack health insurance or access to clean water, which is necessary for treating disease outbreaks.

“A national vaccine mandate heightens inequality among American people,” argued the prosecution. “It is unjust and an infringement on human rights…People forced into quarantine are poor, vulnerable citizens with few resources…We must fix environmental issues and economic inequities, rather than force vaccinations.”

Countered the defense team: “Is liberty worth the price of life?…Those who are most vulnerable will be impacted the most by the spread of disease…Climate change puts a greater strain on clean water resources…The cost of a vaccine is much less than a trip to the emergency room. By the time the ambulance is called, it’s usually too late…Poverty should not be a death sentence in preventing diseases.”

The defense referenced Abraham Lincoln’s restriction on civil liberties during the Civil War, and called to the stand Supreme Court Justice Clarence Thomas as well as the smallpox virus — represented by a student wearing a nametag declaring “HELLO, my name is Smallpox!” — who focused on the dangers of diseases and efficacy of vaccines. 

At the trial’s conclusion, the jury voted 2-1 in favor of the defense. Sure, as biomedical and health sciences professors, the jurors may have held some biases, but the courtroom experience gave everyone pause for thought.

“This active approach to learning challenged the students to become experts in the subject matter and explore the issue from diverse perspectives that were perhaps not in line with their own. The result was a very informative and engaging trial, where the students really showcased their knowledge,” said Biomedical and Health Sciences Senior Lecturer Deborah Hinchey, who served as a juror. 

“Everyone gets to learn about both sides of the argument, not just their own, which I think is really beneficial as I am able to form my own opinions even though I have to argue one side,” said Goldman. 

Sarantopoulos added, “Having so many people in a group working on a topic that wasn’t necessarily in their field of study was really cool, and everyone had something unique to bring to the group.”

Source: UVM News

Mind over Medicated

David Tomasi didn’t reinvent the wheel with his latest research on exercise; in fact, he’s well aware that the core concept has been common knowledge for centuries. “The Romans used to say: ‘Mens sana in corpore sano,’” he recites in his native language, Italian, “which means ‘healthy mind, healthy body.’” But what he is proposing is a new application for the tried-and-true wheel.

A lecturer at UVM and inpatient psychotherapist at UVM Medical Center, Tomasi notes that the number of psychiatric patients seeking acute, inpatient treatment has steadily increased since the ’90s at the start of the opioid crisis. A majority of the patients he treats at UVMMC are young adults suffering from dual-diagnoses of a mood disorder and addiction, typically to opioids. According to Mental Health Care America, Vermont is ranked the sixth most prevalent state for mental illness and substance disorders.

“There aren’t enough beds. We have struggles with opioid addiction and suicidality, and it’s a crisis we’ve never seen before on a national level in the United States. Especially in the northeast, especially in New England, but even more so in Vermont. We are really struggling,” he says. 

In Tomasi’s line of work, inpatient facilities across the nation are often crowded, acute settings where patients experience severe distress and discomfort. When patients display symptoms like mania, angry outbursts, anxiety, or disruptive behavior, practitioners primarily prescribe psychotropic medications or rely on classical psychotherapeutic and pharmacological frameworks. To keep the revolving door in motion for the next patient, practitioners determine if or when patients are ready for discharge once their symptoms subside.

At UVMMC, where Tomasi and his colleagues Sheri Gates and Emily Reyns treat patients suffering from a range of mood and mental health disorders like dual-diagnoses, critical anxiety, depression, schizophrenia, suicidality and acute psychotic episodes, a new idea surfaced: What if practitioners prescribed patients exercise as part of their treatment plans?

To explore the potential of this mind-body connection, Tomasi, Gates and Reyns were awarded an inaugural University of Vermont Medical Center Fund grant that supported their study and enabled them to build a gym, exclusive to patients in UVMMC’s inpatient psychiatry unit. For roughly 100 patients in the unit, treatment plans included new 60-minute nutrition education programs and structured exercise classes that featured a combination of relaxation, stretching, and exercise techniques recommended by the American College of Sports Medicine, “all monitored by psychotherapists — that’s the key. We were always there to support the emotional background as well,” Tomasi says. They surveyed patients on their mood, self-esteem and self-image both before and after the exercise sessions to gauge their effects on mood.

Given that benefits of exercise have long been known and studied, Tomasi admits that he and his team anticipated positive results. But what they found surprised even them: a whopping 95 percent of patients reported that their moods improved after doing the structured exercises. While nearly all patients reported an improvement in their general mood, an average of 63 percent of patients reported being happy or very happy after the exercises, as opposed to neutral, sad or very sad, and an average of 91.8 percent of patients reported that they were pleased with the way their bodies felt after doing the structured exercises. Overall, patients reported reduced levels of mood disorder symptoms like anger, anxiety and depression and higher levels of self-esteem and improved moods.

“The general attitude of medicine is that you treat the primary problem first, and exercise was never considered to be a life or death treatment option. Now that we know it’s so effective, it can become as fundamental as pharmacological intervention,” Tomasi says. “The fantastic thing about these results is that, if you’re in a psychotic state, you’re sort of limited with what you can do in terms of standard psychotherapy. It’s hard to receive a message through talk therapy in that state, whereas with exercise, you can use your body and not rely on cognitive or emotional intelligence alone.”

Unfortunately, Tomasi estimates that only a handful of inpatient psychiatric hospitals in the United States provide psychotherapist-supported gym facilities exclusively for these patients or incorporate structured exercise classes into patient treatment plans. In the midst of a national opioid epidemic, Tomasi argues that there’s never been a better time to try and reduce patients’ potential reliance on prescription psychotropic medications and promote a more balanced, integrated sense of self.

A Look Inside the Brain

As Tomasi points out, even the ancient Romans knew that exercise makes both our bodies and minds feel better. But what he, Gates and Reyns have found helps lay the groundwork for further evidence-based research about exercise’s ability to treat mental health and mood disorder symptoms naturally. While this phase of their study relied on self-reporting and evaluation by patients themselves — which Tomasi argues is one of the most important factors in psychiatry, to hear a patient say they’re feeling better — the next phase of their research will incorporate brain scans and MRI analysis to confirm what they expect is happening: exercise is balancing the brain’s chemicals naturally.

“You experience a level of neurofeedback, in which the thing you are doing makes you feel that you’re doing the right thing and so the body, in turn, secretes neurotransmitters and makes you feel happier about it,” Tomasi explains.

Prior research has proven that when exercise occurs, the brain stimulates the nervous system — which releases neurotransmitters like serotonin and dopamine, targeted in the treatment of depression — as well as the endocrine system, which regulates hormones that impact everything from mood to metabolism. The specific combination of neurotransmitters and hormones released during exercise can reduce symptoms of anxiety, depression, anger, psychomotor agitation and muscle tension.

“We definitely overmedicate folks in this country, period. No doubt about it. Then on top of that, the medication that we put into the brain — neurologically speaking — is already produced by the brain. So, it’s not that patients would be opting out of medication, they’d be increasing the level of those same neurotransmitters naturally, through exercise, as opposed to chemically,” he explains.

Finding Balance 

Tomasi understands that medication is necessary for some patients. By no means is he advocating for practitioners to replace their prescription pads with gym memberships. Instead, what he hopes patients and practitioners alike will consider are the ways in which the mind and body work in tandem, as well as holistic approaches to maintaining mental and physical health that reduce reliance on psychotropic medications alone. 

“For instance, in Italy when I’m from, there is no psychiatric hospital. By law, there is no inpatient psychiatry, period,” he says, illuminating the stark contrasts in approaches to mental health. “There, mental health is considered to be a social issue, so if you’re experiencing a psychotic episode, the community, the town or the city is responsible for your wellbeing. In Scandinavia, they have this open dialogue model in which the patient is part of every decision-making meeting, giving calls and providing feedback.”

In Vermont, Tomasi notes that a balanced and integrated approach to mental health is very much in the DNA of the state and could be just what the doctor ordered. Based on the study’s positive results, Tomasi believes that incorporating American College of Sports Medicine-approved exercises into inpatient treatment would not only improve patients’ symptoms faster than classic pharmacological intervention alone could — thus increasing facilities’ bed and patient turnover rates — but would also offer patients an alternative, holistic, and cost-effective approach to maintaining their mental health after discharge.

“It’s something that we know, deep inside, to be effective, and the time is ripe for that,” he says. “I think Vermont, especially UVM, is going to be a leader in this field.”

Source: UVM News

From Soldier to Doctor

When Jose Calderon was six years old, his mother began exhibiting symptoms of schizophrenia. As he watched her cycle in and out of psychiatric units – sometimes enduring run-ins with law enforcement and negative encounters with neighbors and members of their church – he came to understand how the stigma associated with mental illness can devastate a family already struggling to cope with a brutal disease.   

Years later, fresh out of high school, he joined the U.S. Marine Corps and went on to serve two tours of duty, one a combat mission in Afghanistan. Peers were killed in action, and others returned home only to suffer through post-traumatic stress disorder. 

These two seminal experiences helped to propel him on a career path that led to UVM’s Larner College of Medicine. “I’m a first-generation college student, first-generation medical school student,” he says. “I came here fresh and with an open mind, willing to adapt and overcome.” 

It wasn’t an easy path: Growing up in a low-income neighborhood in Houston touched by crime and gang violence, there weren’t many role models. His father instilled in his three children a love of learning and a strong work ethic, despite his own education in El Salvador ending at the third-grade level.

“I remember him expecting us to have our homework done by 8 p.m,” he says. “It was a matter of being accountable to ourselves. He really valued education.”

Calderon’s father came to the U.S. from El Salvador as a teenager, desperate to escape the vicious civil war unfolding in that country. He found work as a construction worker and met Calderon’s mother, also a native of El Salvador, in Houston. Calderon’s first language was Spanish; he learned English when he entered elementary school. His older twin brothers helped to keep Calderon focused on achieving his goals. 

“It was a challenging childhood,” he says. “I owe a lot to them being on the right path, and me trying to emulate them.”

Calderon’s decision to enter the Marine Corps was a tough one for his father, who, after witnessing the devastation war brought to his home country, struggled to understand why his youngest child would volunteer to put himself in harm’s way. 

But Calderon says his military service gave him courage and confidence. On his first tour of duty, he traveled around the world, improving military training and tactics while also conducting humanitarian missions in far-flung locations like East Timor, Thailand, Djibouti, and Kuwait. As he painted primary schools alongside local residents and helped to distribute potable water, he realized just how much he had to contribute, especially in communities with the greatest need. 

Serving in Afghanistan strengthened his resolve to make a difference. 

“I think you’re forced to mature at a young age,” he says. “You learn to value life differently than others at that age. It’s a powerful experience, being there and doing your best to handle stressful situations.”

His time in a combat zone also gave him a window into the medical field. He remembers a time when his unit was being hit particularly hard by enemy fire, and personnel were asked to gather at a medical site to give blood. As he waited, an injured Marine arrived by helicopter. A roadside bomb had exploded while he was on patrol with his platoon; he had suffered traumatic injuries including three amputated limbs. Calderon remembers the seamless communication and sharp decision-making of the surgical team as they saved the Marine’s life. Watching those surgeons work was key to sparking his interest in medicine, he says. 

After his four years of military service, Calderon studied psychology at the University of Southern California. A minor in healthcare studies, an assistantship in USC’s Culture and Mental Health Research Lab and volunteer work in the emergency department at L.A. County General Hospital in East Los Angeles all helped him prepare for the career he envisioned.

The decision to come to UVM’s Larner College of Medicine was based in part on the school’s mission statement and emphasis on active learning in medical education, but even more on the sense of community he experienced when he visited the campus and Burlington.

Although he has yet to decide on a specialty – he’s considering psychiatry, family medicine and emergency medicine – Calderon is committed to serving where he is needed the most. “I want to work in an underserved, low-income, urban community, and I want to work with a Spanish speaking population,” he says. “I think I can make the biggest impact there.”

Source: UVM News