LAS VEGAS, Nev. -- The University of Nevada-Las Vegas (UNLV) will graduate its very first class of 50 medical students today, marking a milestone in a fight to attract more doctors to the Silver State.

A report from the University of Nevada Reno found the state ranks 45th in the country for its number of active physicians per 100,000 people, so it's not uncommon in some areas to wait months for appointments for non-emergency care.

Dr. Marc J. Kahn, dean of the Kirk Kerkorian School of Medicine and UNLV vice president for health affairs, said a little more than one-third of this year's graduates have committed to doing their medical residencies in Nevada.

"Part of the issue is, we need to expand the number of residency training positions in our state," Kahn asserted. "We rank 46th when you look at number of residents per capita. We have to improve that."

Kahn noted right now, the state doesn't have training programs for certain sub-specialties, so procedures like liver and bone-marrow transplants have to be done elsewhere.

Part of the solution, he suggested, is the new $150 million UNLV medical education building under construction. The university received a $3 million grant from UnitedHealthcare to support an integrated training program and diversify the workforce.

Until now, the state had to rely entirely on the University of Nevada Reno School of Medicine, built in 1969, which will graduate about 75 medical students next week.

John Packham, associate dean for the office of statewide initiatives at the University of Nevada Reno School of Medicine, said the lifestyle and the unmet demand for medical care make Nevada an attractive place to start a new practice.

"We have a really high retention rate," Packham observed. "Typically, between 50% and 60% of physicians every year who complete their residencies and fellowships in Nevada, stay in Nevada to practice."

Packham added he's keeping an eye on budget negotiations, and hopes to see full funding for higher education, for the Governor's Task Force on Graduate Medical Education, and for the Nevada Health Service Corps, which pays off student loans for doctors who agree to practice in medically underserved areas.

California has shattered heat records left and right this month and temperatures are forecast to be 10 degrees above normal this weekend, so the state wants to remind workers of their right to shade, free cold water and rest breaks.

Employers are required to train workers on how to prevent heat illness.

Charlene Gloriani, senior safety engineer for the California Division of Occupational Safety and Health, said employers must provide shade when the temperature climbs to over 80 degrees.

"When temperatures exceed 95 degrees, a buddy system should be in place and employees must be monitored for signs of heat illness," Gloriani pointed out. "Also, cool-down rest periods are required every two hours."

She added new workers must be watched for their first two weeks on the job, to make sure they are acclimatized to the heat. In June, the Occupational Safety and Health Standards Board passed new regulations regarding excessive heat in indoor workplaces, which are expected to take effect in the next few months.

Gloriani noted indoor rules come into play when it is at least 82 degrees inside.

"The indoor heat regulation requires employers to assess the indoor temperatures," Gloriani explained. "Generally, if it's above 87 degrees, cool the workplace or implement other engineering controls."

Workers who see abuses of heat policies are encouraged to file a complaint with Cal/OSHA. You can enter your ZIP code on the agency's website to find the office nearest your work site.


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More than 85,000 people are admitted each year in New Jersey to treatment programs for alcohol and drug addiction, and experts say language can be a major barrier to getting services.

According to the state Department of Health, New Jersey is home to more than 2 million immigrants and more than one-third said Spanish is the primary language in their home. It means a growing demand for addiction treatment professionals who are multilingual and multicultural.

Marlene Lao-Collins, executive director of Catholic Charities-Diocese of Trenton, which operates an intensive addiction recovery program, said a multicultural approach helps reach more people.

"Sometimes you may be able to speak the language but not really understand the culture," Lao-Collins pointed out. "The language barriers make it difficult to appropriately deliver the services that we have to deliver, and for people to really understand."

Lao-Collins noted her agency uses federal Certified Community Behavioral Health Clinic funding to hire, recruit and train bilingual staff to best serve its patient population. Catholic Charities is primarily an outpatient program, while other facilities use an inpatient approach to addiction recovery.

Lao-Collins emphasized it is challenging for treatment programs to find the appropriate staff to work with them. She added the number of people requiring treatment is growing.

"Absolutely, (by) leaps and bounds," Lao-Collins observed. "We don't have enough clinicians or folks -- whether they're psychiatrists, nurses -- that speak multiple languages, or even just English. The demand is huge and the supply is very slim."

Elsa Candelario, professor of professional practice in the School of Social Work at Rutgers University, director of the "Latino Initiatives for Service, Training, and Assessment" program, said they train social workers to interact with multiple constituencies and many are employed by groups like Catholic Charities.

"My program trains individuals in cultural competency," Candelario explained. "The majority of our students are Spanish-speaking or bilingual and they are interested in working with a non-English-speaking population."

Support for this reporting was provided by The Pew Charitable Trusts.


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Summer is usually a fun time to enjoy the outdoors with family and friends, but experts said Missourians should be taking precautions to keep a day of fun in the sun from causing serious health concerns.

With climate change, summers have been measurably hotter in the Midwest than in previous years.

Dr. Peter Panagos, professor of emergency medicine and neurology at Washington University-Saint Louis, said if you are going to be outside, choose the right time of day.

"Typically in the Midwest this time of year, it's quite hot with ambient temperatures above 90," Panagos pointed out. "If you can avoid the hottest part of the day, with often can be around noon, between, like, 10 and 2 p.m. or 3 p.m., where the sun is at its highest and its hottest."

Panagos noted it is best to plan activities for early morning or early evening. If you are exercising or hiking, he suggested you go around 7 or 8 in the morning. He advised hikers and runners to take plenty of water and a wide-brimmed hat or baseball cap to help keep your face shaded and your head cool.

Even if you take precautions, being outdoors in the summer can lead to dehydration and sometimes, heat-related illnesses. Panagos emphasized knowing the signs of heat stress can help you deal with it before it becomes a serious matter.

"You may notice things such as dry mouth, kind of all of a sudden shutting down or lack of sweating, dizziness, confusion, headaches, muscle ache," Panagos outlined. "That is your body's way of telling you that it's advancing from just heat exposure to potential heat exhaustion."

Kids love the outdoors, and favorite summer activities include playing their favorite sports, bike riding or going to the pool to cool off. But children are often more susceptible to injuries than adults.

Dr. Donna O'Shea, chief medical Officer of population health for UnitedHealthcare, said a video chat with your doctor can help you decide whether to treat a problem at home or seek medical help.

"Virtual care can help you determine how much, how long to wait, before you go to the emergency room," O'Shea recommended. "Same thing even for sunburns, or for bike safety: 'Do I need to go in?' 'Do you think I need stitches?' And we don't think about that."