John Rafael, MD MBA (He/Him/Siya)

PGY-2 @TheBCRP | #tripleboard TB-2 @BostonChildrens @TuftsMedicalCtr | @ttuhscmed '23 | @Stanford '17🌲| 🇵🇭🇺🇸 | | #BLM✊🏾 | Stairmaster guru 🪜 | Views=mine

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

#MedTwitter #PsychTwitter, interested to see how a #tripleboard physician uses his training?

Join my @TheBCRP @The_BMC Health Equity Rounds team this Friday at noon where we and two awesome panelists discuss the #inequity of the #ClimateCrisis.

DM me for the Zoom link!

[Chris Aiken, MD @chrisaikenmd]

Asians have more side effects to antidepressants.

On reason: 20-40% metabolize them slower in the liver.

Desvenlafaxine (Pristiq) isn't metabolized there, which may explain why it was better tolerated than duloxetine (Cymbalta) in this large 2023 trial from China:
https://t.co/NVo1o4AVQz

Here's more on ethnicity, genetic testing, and antidepressant response:
https://t.co/UNacEvG66k

[American Psychiatric Association @APApsychiatric]

Election Jitters! 70% of us feeling the pulse. Let's support each other during times of heighted anxiety. #MentalHealthMatters

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

⏰⏰⏰⏰⏰⏰⏰⏰⏰!!!!!!

[American Psychiatric Association @APApsychiatric]

Surviving a hurricane or wildfire can be traumatic. And people who are displaced from their homes may suffer anxiety, PTSD, or depression. https://t.co/TuqQ0VfRbt

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

https://t.co/HkPhqJMXv6 now have never been more excited to finish the part of residency that involves overnights and 24 hr call 😵‍💫

[Rebecca Brady, MD, PhD @rebeccagbrady]

Crime negatively affects teens, but what about toddlers?

In a new paper out in @JAACAP, we found that toddlers living in high crime neighborhoods had more externalizing symptoms at 1 & 2yrs, especially aggression. @wunder_lab

But how does crime influence toddlers?!

🧵 1/

[American Psychiatric Association @APApsychiatric]

The holiday season often brings with it beer, wine, or other adult beverages — all of which can spell trouble for people who have problematic relationships with alcohol.
https://t.co/KKuwSYu7N4

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

Someone in childhood shot me down when an former coach told me walking faster is healthier for you, but now I feel justified 😃 #getyoursteps

Associations of Daily Steps With Cancer, Cardiovascular Disease, and Mortality https://t.co/LpwJznjJYg

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

anecdotally and statistically this is still the norm, whether or not it's related to stigma towards mental health 🥲 https://t.co/y2jvwzzpXJ

[Meg Quint (they/them) @meg_quint_]

Just a friendly reminder that even a $10 -20 prescription can be cost prohibitive. "Affordable" is a relative term that has a very different meaning to many of our patients. #medtwitter #medicine

[American Psychiatric Association @APApsychiatric]

Celebrating World Kindness Day with a reminder: small acts of kindness can make a big impact on mental well-being. Let's spread compassion and create a world where kindness is the norm. 💙✨ #WorldKindnessDay #MentalHealthMatters #APAKindness

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

My implicit biases for any physical activity as a former personal trainer confirmed!

Always an advocate for any form of physical activity, and happy to have this article for reference!

@JAMAPsych just wished the infographic was not so ableist in its exercise image

[JAMA Psychiatry @JAMAPsych]

This randomized clinical trial investigates whether a 12-week application-based exercise intervention has an effect on depressive symptoms, burnout, and absenteeism among health care workers. https://t.co/j2MIXoO4AV

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

On this #WorldMentalHealthDay I am reminded of my 'why', and the work I need to put in everyday to instill hope in the young people and their caregivers get the #MentalHealth and support they need.

A long, fulfilling career of maintaining this discipline awaits.

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

Intriguing to hear this statistic as a resident 👀👀

[World Health Organization (WHO) @WHO]

1 in 10 people worldwide work long hours & the trend is increasing.

Compared to working 35-40 hours, working 55 or more hours per week is associated with an est.:
🧠 35% higher risk of a #stroke
🫀 17% higher risk of dying from ischemic heart disease

[American Academy of Pediatrics @AmerAcadPeds]

Pediatricians: #CivicHealthMonth is the perfect time for a civic health “checkup”!
✅ Double-check your voter registration.
⏰ Set up election reminders.
🗳 Preview what will be on the ballot in November.
Everything you need for your check-up is at https://t.co/94rVSGnGJP

[American Psychiatric Association @APApsychiatric]

Today is #InternationalOverdoseAwarenessDay, a day to remember all those lost to a drug overdose and an opportunity to reflect on practical ways to prevent overdoses in our community. #EndOverdose #Addiction #psychtwitter

[Scott Hadland, MD @DrScottHadland]

Breaking public health news: After a long wait, Narcan is finally going over-the-counter next week

It's currently being shipped to major retailers: CVS, Walgreens, Rite Aid, Walmart

Key considerations on this:
🧵 1/

[National Harm Reduction Coalition @HarmReduction]

🧵We applaud @samhsagov as the 1st federal agency to release a “Harm Reduction Framework” w/ requests for feedback, & call on SAMHSA to make necessary changes to save lives.

Read our full comments: https://t.co/Bf9pWHDkEw

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

#MedTwitter, Let's make sure anyone can cast their ballot in the upcoming election!
I just ordered a free, nonpartisan voter badge from @vot_er_org to offer patients the opportunity to register to vote or view their ballot in the clinic. Get yours ⤵️ https://t.co/5nNgmTuB8I

[John Rafael, MD MBA (He/Him/Siya) @johnersz]

Come join me at #AACAP23! Will also be a monitor. Would love to connect with all my current and future #Psychiatry #tripleboard #CAP colleagues!

[American Academy of Child & Adolescent Psychiatry @AACAP]

Medical Students and Residents can attend AACAP's Annual Meeting in #NYC for FREE when they sign up for the monitor program and assist in running the meeting. For further information visit https://t.co/DfJJES9IZz. #Mentalhealth #Medtwitter #AACAP23