From the Stacks
There are literally thousands of journals published around the world that relate to the disability community. It is virtually impossible to capture even a fraction of them. HELEN receives "stacks" of journals and selectively earmarks what we feel are "must read" articles of interest for our readers. It's a HELEN perk.
Med school enrollment is up
More than 100,000 people are enrolled in M.D. programs for the 2025-2026 academic year, according to data released yesterday by the Association of American Medical Colleges. It’s the first time total enrollment has been that high, after a 5.3% increase in applicants from the previous year.
Some experts worry that action by the Trump administration, including a new caps on federal loan assistance and increased scrutiny around international students, could lead to drops in medical school enrollment. Any potential effects likely won’t be seen until next year or the year after, as people typically commit to school far ahead of time. In the meantime, here are more data from this year:
Women made up 55% of newly enrolled students, making this the seventh year in a row that women have been the majority of applicants, matriculants, and total enrollment. But it’s the third year in a row that the increase in matriculants has been larger for men than women. (Read: They’re catching up!)
For the fourth year in a row, there was a decrease in applicants and matriculants with parents who have less than a bachelor’s degree or who have jobs categorized as “service, clerical, skilled, or unskilled.”
AAMC changed its methodology for collecting race and ethnicity data, so the group did not compare this year’s data to previous years. But as former STAT reporter Usha Lee McFarling wrote in January, there was, at least initially, a steep drop in enrollment of Black and Hispanic students after the Supreme Court banned the consideration of race in admissions in 2023.
The Dignity Index
Tim Shriver
Last week, I got the flu. Influenza A, to be exact. I’m one of those people who has been extraordinarily lucky with my health over the years and have rarely been sick. Lucky me. But this time, I got the full flu. Bed for days. Sweats. Aches. Hacking cough. Throbbing head. The full works.
During the week, it felt like the flu was robbing me of my dignity, but it turns out, it was just the opposite.
Let me explain.
I sometimes confuse dignity with strength. I love having the strength to work hard for the causes I believe to be important. I love championing the athletes of Special Olympics and championing the dignity movement that they’ve inspired. I love riding my bike around town and participating in events and gatherings of inspiring people and friends. I love everything that having energy and health make it possible for me to do.
But when I confuse energy and health for dignity, I make a big mistake.
Being sick gave me a chance to listen for the message of how dignity is often revealed in illness, not distorted by it. My daughter Kathleen, for instance, reminded me that being bedridden was a “real experience of consent, Dad. You’re really practicing what it feels like to have to let go of your will.” I was taken aback by her comment, not because it didn’t make sense but because it felt so surprising. I had simply felt sick: she saw me feeling like I was relinquishing control. Does dignity grow when we relinquish control?
Later that same day, my daughter Rose asked me about what my body was telling me. “It’s telling me it doesn’t have the ability to do anything,” I replied. “Are you listening to that?” she asked. “Of course not” was my initial reply. But then I realized I actually had no choice but to “listen to my body.” I would prefer to overrule my body than listen to it, but maybe listening to the capacity and limits of one’s body can deepen one’s sense of dignity? I had never thought of it that way.
Finally, as the week wore on, I tried to get up to help my wife Linda clean up our house that had been turned upside down by Thanksgiving and parties and dozens of family. I put on clothes and haltingly walked downstairs to move furniture and organize the kitchen and more. By the time I got to the first task, she looked at me like I was crazy. “You don’t have the energy, do you?” she said. “I, uh, well, kind of, I’m trying to…” “Go to bed, Timmy. You’re sick. I’ve got this.”
I looked at her and couldn’t believe that I couldn’t even help a little. I was embarrassed. Incredulous. But I could barely stand up, so I stumbled back upstairs and back to bed. I so wanted to be able to carry my weight. Instead, I had to realize she was carrying me, and I needed to be carried.
Humiliating? In some ways. But as I crawled back to bed, I was almost in tears with how much Linda was caring for me, how much my children were guiding me, how I could do almost nothing, how everyone around me was picking up from my weakness. And slowly, a version of my dignity emerged, not predicated on my abilities but on my capacity for gratitude for the gifts of others.
What does all this have to do with our dignity movement? A lot. At least to me.
Dignity is a lot about humility. Realizing that we don’t have the means to solve problems ourselves is humbling, but a reminder that treating others with dignity should never be arrogant. We can all learn from each other.
Dignity is a lot about relationships. We have each been given dignity at birth, but we need each other to protect our dignity. In my days of need, I needed others. No one protects their dignity alone. We need each other.
Finally, dignity shines through when we care for one another. We don’t need a politician or a scholar to show us how to care. We just need people who care, and people who care are ambassadors of dignity. It may seem small to care for another person who happens to be a little sick, but it meant the world to me. And that care preserved and even strengthened my dignity in a moment of need. Dignity means caring.
Last week, the news was often horrible. Violent attacks in the Caribbean replayed for the world. Persistent violence in the Middle East. Brutality in Ukraine. And more name-calling at home. A friend told me his son said to him, “Dad, look at what hatred and contempt are doing. They’re winning.”
In some ways, of course, that’s true. But you have to choose what side you’re on. Contempt might win power for a time, but at the times that matter, it's humility and listening and caring that carry the day.
I don’t wish illness on anyone—even a minor illness like mine. But I do wish for everyone the lessons my illness taught me.
Tim Shriver is co-creator of The Dignity Index. Learn more about Universal Dignity at TimothyShriver.com.
Fostering empathy: Gamified approach to address health care disparities
Po Ling Pauline Luk, Michelle Che Yan Lam, Yat Chun Lim, Mei Li Khong
First published: 26 June 2025 https://doi.org/10.1111/medu.15755
Funding information This was supported by the Teaching Development Grant (TDG) of the University of Hong Kong.
WHAT PROBLEMS WERE ADDRESSED?
Health care disparities pose a significant challenge in modern medical practice, including urban settings where social determinants of health have context-specific effects on access to care. At the Li Ka Shing Faculty of Medicine, The University of Hong Kong (HKUMed), a critical issue identified was the lack of understanding and empathy among medical students regarding the experiences of vulnerable populations. Traditional medical education often emphasizes clinical knowledge and skills, neglecting the social contexts in which patients live. Consequently, future health care practitioners may lack the insights necessary for compassionate care, leading to poor patient outcomes and distrust in patient-provider relationships.1 Recognizing this gap, the Health Seekers Project is a game-based simulation developed through student–educator partnership and supported by the university's Teaching Development Grant.
WHAT WAS TRIED?
The project was co-created by two educators, one research assistant and 17 student co-designers from second to final year medical, nursing, and global health and development programs. At its core is a board game developed to simulate challenges faced by underprivileged groups, such as ethnic minorities and low-income families. Participants assume roles to navigate context-specific scenarios based on real-life barriers of patients in Hong Kong when seeking health care. These obstacles include transportation issues, financial constraints, or discrimination, forcing participants to make decisions that may impact their character's health and well-being. The content is based on secondary research, interviews with community members and iterative plays with community partners for continuous improvements.
The board game, paired with an introduction to health care inequality themes and debriefings, became a workshop that was integrated into the medical humanities curriculum, reaching 32 second-year medical students. During gameplay, participants engaged in decision-making and reflection based on the real-life scenarios. This was followed by a debriefing where students reflect on the complexities of the experience, confront their own biases and engage in discussion with community members who shared their stories. With modifications, the workshop also reached over 40 exchange medical students from other universities and 120 secondary school students as an extracurricular activity.
WHAT LESSONS WERE LEARNED?
Several lessons emerged from the Health Seekers Project. First, the effectiveness of experiential learning was evident. Feedback indicated significant improvements in empathy and understanding after engaging with the board game and participating in outreach. Pre- and post-intervention assessments showed a 30% increase in self-reported empathy scores, highlighting the positive impact of interactive simulation learning integrated with real-world context.
The strength of the project is built upon the interactions between students and community members through interviews for game content curation and organized game sessions together which fueled discussions. The engagement of student co-designers from various health care disciplines also created a rich learning environment that allows for diverse perspectives. These collaborations enhanced the authenticity of the game and deepened students' understanding of health care disparities. Each game play also served as an evaluation stage for stakeholders such as health professional learners and community members to provide feedback which informs continuous improvements. Through this project, we aim to create a lasting impact in fostering empathy in the next generation of health care professionals.
AUTHOR CONTRIBUTION:
Po Ling Pauline Luk: Conceptualization; data curation; funding acquisition; methodology; investigation; project administration; supervision; resources; writing—original draft; writing—review and editing. Michelle Che Yan Lam: Conceptualization; data curation; formal analysis; writing—original draft; writing—review and editing. Yat Chun Lim: Conceptualization; formal analysis; writing—original draft; writing—review and editing. Mei Li Khong: Conceptualization; investigation; project administration; resources; supervision; writing—original draft; writing—review and editing.
CONFLICT OF INTEREST STATEMENT:
There is no conflict of interest.
ETHICS STATEMENT:
This project was approved by the Human Research Ethics Committee (HREC) at the University of Hong Kong. The HREC's reference number is EA230415.
DATA AVAILABILITY:
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
More Than Half Of US Population Affected By A Nervous System Disorder, Study Finds
Reports a study found “that nervous system disorders impact more than half of the U.S. population, with neurologic and cognitive conditions the leading causes of disability and health loss.” A cross-sectional study “of the Global Burden of Disease 2021 data for nervous system health between 1990 and 2021 yielded 180.3 million individuals impacted by nervous system-related disorders in 2021, or 54.2% of the population. Data included analysis of 36 unique nervous system-related conditions that contribute to health loss, specifically 15 neurological conditions linked to mortality.” Researchers highlighted that “nervous system disorders were the top cause of disability, with 16.6 million DALYs. The most prevalent neurological-based conditions were tension-type headache (121.9 million); migraine (57.7 million); and diabetic neuropathy (17.1 million).” The study was published in JAMA Neurology.
Research Study Highlights Racial Disparities In Neuropsychological Functioning Following Brain Injury
Neurology Advisor reports a study found that “after brain injury, Black patients demonstrate significantly lower absolute neuropsychological scores than White patients across nearly all measures, yet no race-based differences were found in relative decline.” Researchers observed that “across measures of absolute functioning, Black patients scored significantly lower, with medium to large effect sizes, on premorbid estimates, intellectual functioning, memory, and executive functioning. The researchers emphasize that these differences likely reflect systemic inequities and test bias, not greater neurologic injury. The only nonsignificant measure was DKEFS Condition 2.” However, they noted that “when scores were interpreted using relative decline, comparing current performance to individualized premorbid expectations, there were no significant racial differences, and impairment categories were similarly distributed across groups.” The article was published in Brain Injury.
Longer Puncture To Recanalization Times During Thrombectomy In Patients With Acute Ischemic Stroke Tied To Worse Outcomes, Greater Acute Care Costs, Study Finds
Neurology Advisor reports a study found that “patients with acute ischemic stroke who experience longer puncture to recanalization (PTR) times during thrombectomy have worse outcomes and greater acute care costs.” Researchers observed a “significant association between PTR and discharge disposition. Each 15-minute increase in PTR was linked to a 2% to 4.6% higher likelihood of death or hospice discharge and a 1.5% to 2.5% lower likelihood of being discharged home or home with PT. In adjusted analyses, longer PTR was independently associated with greater odds of death or hospice disposition.” Furthermore, from an economic standpoint, every 15-minute increase in PTR was associated with an average increase in direct acute care costs of $190.04 per stroke episode. When extrapolated to an estimated 39,000 annual thrombectomies nationwide, the researchers estimated a $7.4 million annual increase in acute stroke care costs for each 15-minute increase in mean PTR.” The study was published in Stroke: Vascular and Interventional Neurology.
Adherence To Mediterranean, MIND Diets Associated With Cognitive Benefits In Patients With MS, Study Suggests
Multiple Sclerosis News Today reports a study suggests that “adherence to either the Mediterranean or the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets was associated with better performance in certain areas of thinking and memory among people with multiple sclerosis (MS).” Study results indicate that “people whose eating habits most closely matched the Mediterranean or MIND diets scored higher in specific cognitive areas, but not in overall cognition. Higher Mediterranean diet scores were associated with faster information-processing speed and better verbal reasoning and knowledge.” In addition, higher MIND scores were “associated with faster information-processing speed and better word memory and problem-solving performance. In particular, moderate adherence to the MIND diet was linked to better short- and medium-term verbal recognition memory.” Also, “connections between MIND diet scores and cognitive performance were stronger and more consistent in people with progressive MS than in relapsing MS.” The study was published in Nutrients.
Drug & Device Update
Most Patients With MS Find Disease-Modifying Therapies Do Not Affect Their Pain, Study Suggests
Multiple Sclerosis News reports a study suggests that “for most people with multiple sclerosis (MS), the use of disease-modifying therapies, or DMTs, does not affect their perceived pain.” Researchers observed that among patients with MS “who had ever used a DMT in their lifetime, 30% said that one or more of the DMTs had reduced or increased pain severity or frequency. One-third (33%) believed DMTs had no effect, and the remaining 37% said they didn’t know.” Furthermore, of the patients who reported that DMTs affected their pain, 99% provided data on the severity or frequency of pain associated with one or more DMTs. More than one-fourth (29%) reported a reduction in pain severity, while nearly one-fourth (23%) reported pain worsening. Similar results were seen for pain frequency.” Injectable DMTs “were more likely to be reported to increase pain severity and frequency,” while infusion DMTs and certain other DMTs “were more likely to be reported to decrease pain severity and frequency.” The study was published in Multiple Sclerosis and Related Disorders.
Wrist-Worn Sensor Can Reliably Track Tremor In Patients With Parkinson’s Disease, Study Suggests
Parkinson’s News reports a study found that a “wrist-worn device may provide a clearer and more consistent picture of tremor in Parkinson’s disease than what can be seen during a single clinic visit or recalled from memory alone.” Study participants “wore the wrist-worn movement sensor for one week. It was placed on the arm most affected by tremor, or on the non-dominant arm for healthy controls and those with symptoms on both sides. The device continuously tracked wrist movements, including movement speed and rotational motion. After three days of recording, the movement sensor produced highly reliable and repeatable results.” Results suggest that “tremor volume measured by the device agreed with patients’ own reports, even when clinicians did not observe tremor during the visit. This indicates that a wrist-worn sensor can capture tremor episodes that might otherwise be missed. Overall, the findings show that wearable sensors can provide accurate, consistent, and detailed insights into Parkinson’s tremor.” The study was published in NPJ Parkinson’s Disease.
Robotic Arm: Assistive Technology for Independent Feeding
D Petrikic, R F F Dos Santos, G V Sipoli, K M M Santos, G N Nogueira Neto, P Nohama
PMID: 41335671 DOI: 10.1109/EMBC58623.2025.11253161
Abstract
Disabilities, such as those caused by spinal cord injury, stroke, cerebral palsy, amyotrophic lateral sclerosis and amputations, can impair upper limb function and limit eating autonomy, requiring third-party assistance. Thus, assistive technologies have emerged as viable alternatives for promoting greater independence and social inclusion. This article presents the development of an educational robotic arm with 5 degrees of freedom for use as a meal-assist robot. A 3D printer was used for the utensils and wood for the base. To receive user commands, a voice recognition module was implemented to identify the five programmed commands. To verify the effectiveness of the proposed method, several tests were conducted, including a water transfer test and execution time measurement. The assistive device successfully transported more than 75% of the water and completed each feeding cycle in 21 s, demonstrating its effectiveness in aiding the feeding process.