Antimicrobial Resistance (AMR)

By Vincent Man

Antibiotics, also known as antibacterials, are types of medications that are used to treat infections by killing or inhibiting the growth of bacteria. For the most part, our immune system is highly competent of destroying the bacteria and naturally fighting off the infection on its own. However in some cases, when there is all too much, then there is a need for the use of antibiotics.

Although antibiotics play a fundamental role in treating infections, it must be used correctly and appropriately. Over the past decades, the widespread use of antibiotics has posed a threat to the health and safety of the community. Antimicrobial resistance (AMR) is the resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive. Every now and then, people become sick with a sore throat, cold, fever, or a cough. They typically purchase some OTC (over the counter) medications from the Pharmacy in hopes of a speedy and successful treatment. When OTC medications fail, patients ultimately believe they need antibiotics. Many patients pressure their doctors to write prescriptions for antibiotics when the reality is, the patient do not have an infection but a virus. For example, a disease caused by bacteria is strep throat and an ailment caused by a virus is the flu. In fact, most infections present in the upper respiratory tract are generally caused by viruses. As mentioned, antibiotics target only microorganisms such as bacteria, fungi and parasites, but are ineffective against viruses. If given antibiotics to treat a virus, it is not only futile but can also be detrimental such that when an infection arises in the future, our body will not respond as effectively due to AMR. Once these infections become acquired, there are only a handful of last-line antibiotics capable of undertaking these superbugs, increasing the chances of death. Better yet, let it alone for the immune system to combat these viruses.

Bacteria, unlike humans, evolve and replicate themselves exponentially in their lysogenic cycle to produce the millions that dwell inside our bodies. These bacteria and other microbes that cause infections are remarkably resilient and have developed ways to resist antibiotics and other antibacterial drugs. Antibiotic overuse is one of the factors that have contributed towards the growing number of bacterial infections, which are becoming resistant to antibacterial medications. According to the ECDC (European Centre for Disease Prevention and Control), antibiotic resistance continues to be an increasing public health threat worldwide. In a statement issued in 2012, the ECDC reported that an estimated 25,000 people die each year in the European Union from antibiotic-resistant bacterial infections. In addition to the misuse of antibiotics, antibiotic-resistant bacterial infections can also be caused by a patient’s incompletion of the medication course used to prevent the infection from coming back. If a course is not completed, there is a higher risk the bacteria may become resistant to future treatments- because the ones that survive have had exposure to the antibiotic and may therefore have built up a resistance to it.

A solution to this public health concern is to better educate our patients and more importantly our health care professionals regarding the use of antibiotics. Rather than succumbing to the use of antibiotics, health care professionals should act logically and prescribe medications in interest of the long-term care for the patient. In recent years, programs such as the Antimicrobial Stewardship was created to slow the spread of antimicrobial resistance. The program aims to make rational approaches to the use of antimicrobial agents in order to accomplish optimal success. Actions must be taken now to prevent antibiotic resistance from proliferating. As bacteria become resistant to antibiotics, it is possible for previously treated infections to resurface and become ever more so lethal.

About the Author: Vincent is a 3rd year intended molecular toxicology major and planning on applying for Pharmacy School. Vincent is also doing research on protein crystallography at Lawrence Berkeley National Laboratory. He is part of the Pre-Pharmacy Club (PILLS) on campus as well as the pharmacy facilitator for the Pre-Health Decal. Some of his hobbies include playing basketball, tennis, puzzle-solving, and biking.

The Mediterranean Diet

by Nisha Sarla Chandra

A new study published in the New England journal of medicine in early February 2013 definitively shows the effect that diet can have on one’s cardiovascular health. The 5-year long study, which took place in Spain, used participants who were at high risk for heart disease. Each of the 7,447 people had at least one risk factor, such as smoking, being overweight, or having diabetes. They were then separated into three groups; one group was assigned a low-fat diet and the two others followed different variations of a traditional Mediterranean diet.

The Mediterranean diet is one that has been followed by the people of the region for hundreds of years. The diet has moderate amounts of fat in the form of olive oil and nuts. It also involves multiple servings of fish each week, lots of fresh fruit and vegetables, and a daily glass of wine. Those who adhere to the Mediterranean diet stay clear of red meat, dairy, and store-bought bakery goods. Researchers in the past have noticed a slightly lower incidence in heart disease for people who live in the Mediterranean. However, without definitive proof, it was hard to ascribe this lower prevalence to diet, rather than other factors like genetics or lifestyle. In fact, many leading experts in cardiovascular health have long recommended either low-fat diets or veganism to those with heart issues.

But it seems that a low-fat diet is not the solution. The group assigned to a low-fat diet had a hard time sticking to it, despite intensive nutritional counselling. As a result, the study ended up comparing the Mediterranean diet with a modern, moderate-fat diet. The end result was astonishing – a 30% decrease in heart attacks, strokes, and deaths from heart disease in those following the Mediterranean diet. In fact, the study was supposed to run for a longer period of time, but researchers could not in good conscious allow a study to go on that showed such a large health disparity between groups.

Of course, as with any study, there are detractors. But the majority of experts are impressed with the parameters researchers used and the ensuing results. The study only explored the effects on the diet on those with risk factors for heart disease, but it is expected to have preventative benefits for those at low risk.

Adderall Abuse

By Karen Louie

What is supposed to be a prescription drug for individuals with attention deficit hyperactive disorder (ADHD) is now being touted as the miracle that college students have been looking for. Adderall – it’s the small capsule that’s making big news across the nation as finals approach.

For non-ADHD students who are using Adderall, the common effect seems to be prolonged periods of concentration. Superficially, it seems like a win-win. Students are cranking out those papers and don’t seem to experience any side effects -- sounds too good to be true. Let’s get real. The moment an individual without ADHD ingests an Adderall capsule, the chemistry of the brain is being manipulated. The amygdala, the regulating sector of your emotions, can be altered leading to heightened aggression, depression, and generally feelings of being on edge.

It is becoming more apparent to public health officials that Adderall abuse is now a social norm. No longer is there a taboo of discussing illicit usage in public. Walking around campus, you can hear conversations of extraordinary late-night cramming sessions thanks to Adderall. The risks are forgotten or unconcerned as the usage of this drug becomes standard among the college population.

In the spirit of finals week, here is a brief, informative Adderall study guide:

1.)Adderall is a mixture of different ingredients, one being amphetamine salts. Another amphetamine drug? Speed.

2.)It’s listed as a Schedule II drug by the FDA, meaning it has a high potential for abuse and said abuse can lead to severe dependence.

3.)Possible psychotic effects of Adderall abuse: bipolar disorder, insomnia, Tourette’s

4.)Possible physical effects of Adderall abuse: unintentional weight loss, impotence, digestive issues, hives, strokes

The academic pressure is high here in Berkeley. We are prompted to evolve into the leaders of tomorrow, innovators, and cancer-curers. With academic pressure and competition high, it is understandable why so many students succumb to using illicit resources to aid our studies. However, It is important to look at our experience here at Cal, or any university and college, with perspective. Do not gamble away your mental and physical well-being just for an A on that exam.

For more information:
1.) http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm111441.htm
2.) http://www.cdc.gov/media/pressrel/2010/r100603.htm

PH 113: A Review

Public Health 113 is a course offered at UC Berkeley that focuses on developing and implementing community health promotion strategies.  This course is a great opportunity for Public Health students to apply what they have learned in their theoretical Public Health classes.  This course applies skills covered in Epidemiology, Community Health and Environmental Health courses.

What does this class entail?  For the Spring of 2012, Public Health 113 required students to create a community action project focused on the sexual health of the Berkeley community.  You can create projects using strategies such as behavior change, harm reduction and social norms amongst others.

For example, one student evaluated the sexual health of a premedical organization on campus.  The student found that around 36% of members of this organization do not use condoms consistently once in a monogamous relationship.  In response, the student developed a program to address this sexual health issue.

How to identify a problem?
This student used an anonymous online survey to assess the sexual health practices of the defined community.  The survey results indicated that consistent condom use was a problem within the community.

Why is consistent condom use important?

1. Mutual Monogamy is not an objective form of protection - you can never objectively guarantee that your partner is honoring the commitment.  There is still a risk of contracting an STI if there has been any infidelity.

2. STI Status may be unclear - many people are unaware of their STI status.  People may assure their partners that they are STI free while in actuality they are putting their partner at risk.  Why the confusion?  People may not have been tested.  People may had been tested but are confused about their results and what they were actually tested for.  For example, many women think that their annual pelvic exam includes a check for STIs when in actuality it does not.  Many people think that HIV screenings telling you if you are clear of all STIs.  Finally, some STIs go unnoticed (like recurring genital herpes) or undiagnosed due to long latency periods.

3. Unwanted pregnancy - there is always a risk of unwanted pregnancy even if a person is tang oral contraceptives.  They are not 100% effective and lose effectiveness if not taken correctly.

How to address the problem?
In this action project, the student used the model of behavior change to try to improve the sexual health practices of the community.  The student developed a comic strip displaying the issue of consistent condom use and distributed this comic during an information session about sexual health.

If you are interested in engaging in public health activism then sign up for Public Health 113.  The class offers students the opportunity to make a difference in their community and practice the skills taught by the Public Health courses at Cal.








-Anonymous

HPV and CA

The HPV Vaccine and California
By Kevin Yuan


Genital human papilloma virus, also called HPV, is by far the most common sexually transmitted infection, especially in the United States. There are more than a hundred strains of the virus, where less than half cause some form of genital infection, or something far worse, such as cervical cancer. In the span of 5 years, initial results suggest the vaccine has been found to prevent nearly 100 percent of precancerous cervical cells that would have been cause by two specific HPV strains (16&18). For some time, California has considered requiring the vaccine.  Vaccine but noting the success of the vaccine based on voluntary terms, California should not mandate or require young girls to have the HPV vaccine before entering middle school. Instead, it should only be a recommendation for this vaccine.


Despite the initial minor side effects associated with the vaccine, it is still too new to discount possible adverse side-effects in a 10 or even 20 year span. Ultimately, guardians of those young girls should make the decision themselves, after researching the benefits and consequences associated with the vaccine. Guardians can make an educated decision as to whether or not to have the vaccination for their children.


Even though cervical cancer is a serious issue, the HPV vaccine is extremely expensive. When we look at the different types of cancers in the United States, cervical cancer accounts for about 0.006 percent and the annual incidence count in California is only 1,488 according to the National Cancer Institute from time period 2004-2008. In addition, as of now, there are already effective treatments and screenings for cervical cancer. When a mandate is in order, things have to go into motion, and insurance companies will have to cover it in the states. Health care money is then prioritized in this one specific area, even though resources are limited. According to LA Times on March 16, 2010, nearly 1 out of 4 people in California under the age of 65 lack health insurance, and mandatory measures for this vaccine will shift already limited health care dollars towards only one asset involving HPV infections. Resources have to go into low socioeconomic areas where people are having trouble even having access to care, and getting better delivery of health where they could get screened and covering for not only cervical cancer but also a variety of health issues.


Although many advocates who wish to require the HPV vaccine by law may argue it will achieve widespread protection of the disease, we have to look at people’s liberty concerns. Understandably, universal protection is ideal but forcing little girls to have a government injection through a junction such as an executive order is wrong. The NPR reported on September 11, 2011 that the executive order mandating the HPV vaccine in Texas was overturned. Even Governor Rick Perry considers his decision a mistake and confers that “If I had to do it over again, I would have done it differently.” The fact that this law was proposed infringes on the people’s rights to make their own decisions. This is a liberty that cannot be overlooked despite the universal protection the vaccine might offer. However, the law was overturned, showing that the concern for the individual’s rights remains.

In conclusion, the HPV vaccine represents a significant breakthrough for women’s health. But, required immunization in California is a gesture that is unreasonable given the premature state of the vaccine, the decisions guardians have over their children and also the strain it will have on health care dollars. Instead, the vaccine should be available for those who want to be the vaccinated.

Housing and Homelessness: A Call for Public Health Action

By Marvin So

As Berkeley students, it’s easy to go about our daily lives rife with midterms, clubs, exercise, and maybe even social activities, and ignore the ubiquitous homeless individuals occupying the curbs and nooks of Telegraph. There are about 280 chronically homeless individuals living in Berkeley on any given night, along with 680 others who live in  streets, shelters, or transitional housing programs. Furthermore, due to the recent economic downturn, the Berkeley population of people living in temporary situations or close to being evicted has increased ten-fold. Much has been done by the City of Berkeley to support these individuals in accessing services and developing self-sufficiency, though it is by far insufficient to account for all people in the area experiencing homelessness.

The prevalence of homelessness in Berkeley provides an excellent illustration that there is not enough being done to mobilize action in light of an array of complex factors including income inequality, reduced government support for the poor, and decreased affordable housing units all over the country.

Examining homelessness from a public health perspective, a question of temporality arises. Does poor health contribute to being homeless, or does homelessness moreso contribute to ill health outcomes? Understanding the health issues of the homeless is a vastly important issue to consider, as reduced funds towards emergency departments means greatly reduced emergency care access for low-income individuals. Moreover, since low-income communities are more likely to require emergency care, trauma closures act to further exacerbate inequalities in health among the very poor.

Common health issues among homeless communities can include mental health problems, substance abuse problems, bronchitis/pneumonia, and skin infections. Conversely, a serious illness or debilitating disease can trigger a downward spiral from losing one’s job, to deterioration of savings to pay for treatment, and eventual eviction. Lack of access to affordable care results in minor issues turning into major disabilities; in turn, the tax burden of lack of access to care for these individuals is greater than if they were to receive primary or preventive services earlier on. This is the philosophy that operates many community-based clinics and organizations aiming to act as a safety net for people who cannot access services due to economic barriers.

Addressing homelessness offers public health professionals a key opportunity to address an enormous social determinant of health – lack of safe, adequate housing. If we can work, through service, advocacy, and policy to slowly erode the discrimination and barriers imposed upon the homeless, we can make impactful change towards more equitable health outcomes for all communities.

If you’re interested in learning more about homelessness, poverty, and social justice, UC Berkeley provides a variety of opportunities to do just that. Check out the following resources and find a program or organization that you like – it’s going to take an enormous effort to begin to solve a problem as multifactorial as homelessness. What better place to mobilize this grassroots movement at Cal, the mecca of impassioned students acting for social change? With this information, what will you do to make a difference in the community?

1. Cal Corps Public Service Center, publicservice.berkeley.edu
2. The Suitcase Clinic, suitcaseclinic.org
3. The Berkeley Free Clinic,
4. Cal Habitat for Humanity, habitat.berkeley.edu

PHA Goes Green!

UC Berkeley offers a certification program to encourage student organizations to be environmentally friendly.  The program consists of a training program, requirements and certification.  PHA decided to go green and successfully completed the program and requirements.

The certification program suggests strategies for being smart when it comes to the environmental impact a campus group may have.  In addition to reviewing the basics of recycling e.g. what types of plastics and papers can be recycled and what cannot, the program suggests strategies for club and event promotion that does not requirement paper flyers.

PHA felt it was necessary to seek certification because the health of the environment is inextricably linked to public health for many reasons.  First, the quality of the environment determines what populations are exposed to.  many negative health outcomes can be explained by exposure to toxic environments, whether that be occupational or residential.  Second, in order for the health of populations to prosper we need a sustainable habitat that can produce nutritious foods.  Promoting and protecting the health of our environment is a pre-requisite to promoting and protecting public health.

If you are a student organization at UC Berkeley, consider getting certified!  Making campus organizations environmentally savvy will have an important impact on our coal environment and the campus's environmental footprint.

For more information about how to make your club green, click here