Nadia Adjoa Sam, MD, CTropMed @NASAdoc

CONGRATULATIONS to Ghana🇬🇭's @EdemWosornu on her appointment as Assistant High Commissioner for Protection, @Refugees She is among three senior leaders appointed yesterday to help guide UNHCR's work. AYEKOO👏 Read more: ▶️press.un.org/en/2026/sga242…

The U.S. World Cup in one horrible photo:

I never want to hear a single soul say ‘keep politics out of sport’ because this World Cup disaster has shown that is exactly what they are not doing. FIFA and America should be embarrassed.

Pediatrics is one of the lower paying physician specialties out there. Do people genuinely think pediatricians are rolling in money because they recommend vaccines? Like… You think pediatricians are getting secret PayPal notifications every time they vaccinate a child? Meanwhile… Do people apply this same skepticism to: Supplement sales? Affiliate links? Brand deals? Paid memberships? Coaching programs? Interesting how financial conflicts only seem to matter when it fits a bias…..

Physicians are not burned out because medicine is hard. Medicine has always been hard. That is not new. We are burned out because the things making it harder have nothing to do with medicine. Fix the system. Keep the physicians.

I'm a cardiologist. A 42-year-old mother of two came to my office complaining of jaw pain and crushing fatigue. She ran half-marathons. Her EKG was normal. Another doctor had sent her home with anxiety medication. When I got her into the cath lab, I found severe microvascular disease — plaque choking the tiniest vessels of her heart, the ones standard angiograms routinely miss. Her heart had been starving in silence while everyone told her she was stressed. She is alive today. Too many women like her are not. Heart disease kills more women than every cancer combined. And medicine is still diagnosing it through a male lens. 84% of cardiologists report having patients in the past year whose heart disease was misdiagnosed by another physician. Women with a STEMI heart attack have a 59% greater chance of being misdiagnosed compared to men. Women with an NSTEMI — 41% greater chance. The reason is structural. For decades, we screened, tested, and treated women using a template built for men. Men's heart attacks announce themselves — the crushing chest pain, the clutched fist, the Hollywood collapse. Women's hearts whisper. Crushing fatigue that feels like wearing a lead vest. Jaw pain written off as TMJ. Nausea blamed on a stomach bug. An ache between the shoulder blades blamed on a long week. Shortness of breath blamed on being out of shape. For years, medicine called these "atypical" symptoms. They are not atypical. They are female-typical. Half of humanity is not a variant. And the biology runs deeper than symptoms. Women have smaller hearts and narrower coronary arteries. Plaque doesn't only clog the big highway vessels — it hides in the microvasculature, the tiny branches feeding the heart muscle itself. A woman can have a heart attack with a completely "clean" standard angiogram. SCAD — spontaneous coronary artery dissection — occurs 90% of the time in women. Often young, fit women with zero traditional risk factors. It's the leading cause of heart attack in women under 50, accounting for roughly one quarter of all cases in that age group. Most doctors have never diagnosed one. And some of the most dangerous cardiac risk factors are hidden in women's medical histories where no one thinks to look: Preeclampsia or gestational hypertension doubles to quadruples lifetime heart disease and stroke risk. Pregnancy is the body's first cardiac stress test — and these complications are early warning sirens, not closed chapters. Autoimmune disease — lupus, rheumatoid arthritis, psoriasis — far more common in women, turbocharges inflammation and plaque formation at any age. Cardiovascular disease in women aged 20-44 is projected to surge nearly 50% by 2050. The youngest patients in my practice keep getting younger. What every woman should ask her doctor — and what every doctor should be asking: "Given my pregnancy history, autoimmune status, and family history — what is my full cardiovascular risk?" If they don't ask about preeclampsia or gestational diabetes, volunteer it. "Should I have an Lp(a) test and a coronary calcium score?" Standard cholesterol panels miss too much. Lp(a) is genetic, one-time, and most women have never been tested. "My tests came back normal but my symptoms haven't stopped — what's next?" Normal stress tests and angiograms can miss microvascular disease, spasm, and SCAD. Persistent symptoms warrant coronary CT angiography or cardiac MRI. And if something feels wrong — say these exact words to your doctor: "I am concerned this could be my heart." That single sentence changes the workup. Do not soften it. Do not apologize for it. 80% of heart disease is preventable. But the playbook has to be built for female biology. Two decades ago, I wrote one of the first books warning that heart disease was the number one killer of women and that medicine was diagnosing it through a male lens. It was recognized by First Lady Laura Bush at the White House during the early years of the national conversation about women's heart health. I'm haunted by how much of that book I could republish today unchanged. The science has advanced. The awareness has grown. But the gap between what we know and what happens in the exam room is still costing women their lives. Share this with every woman you love — and every doctor who treats them. READ MORE: open.substack.com/pub/afshine/p/…

It’s so crazy that we have medicine that literally protects you from HIV when just 40 years ago it was a death sentence, science is amazing

You cannot spend years breaking a child's spirit and then expect a few words in adulthood to repair what took years to destroy. You cannot teach a child to fear your footsteps, your voice, your moods, and your anger, then expect them to see you as a source of comfort later in life.

"Critical Thinking in Qualitative Research: A New Compilation" — A selection of 9 articles appearing from 2017-2025 emphasizing the essential role that critical thinking — from the human mind — plays in the quality and integrity of qualitative research. bit.ly/CriticalThinki…

everyone who is saying ‘parents need to be prepared for a disabled child for the rest of their lives, if they want to have a baby’ are being euphemistic. They mean mothers. Every severely disabled child I know is being taken care off primarily by their mom.

Looking for the an assessment tool for your #implementation initiative? The Assess section of the D&I Models Webtool lets you: ✅Learn strategies for selecting & using tools ✅Explore diverse qual & quant measures ✅Search by keywords & key constructs dissemination-implementation.org/tool/assess/

A Nigerian nurse approached me for advice this week regarding her son who is in Year 10 and due to sit his GCSEs next year. She had attended parents’ evening and was worried about the possibility of him not achieving the grades he needs for college. As she described him, it became clear that he was struggling with much more than academic pressure. She spoke about him becoming overwhelmed in busy environments, struggling to socialise with his peers, flapping his hands when dysregulated and finding it difficult to communicate his ideas effectively in writing despite being academically very capable. As we talked, she told me something that stayed with me. When her son was in primary school, teachers raised concerns that he may be autistic and sought her consent to make referrals for further assessment. She declined she regrets that decision now. I do not judge her for it. In fact, I think many parents, particularly those who did not grow up hearing terms such as ADHD, autism, neurodiversity or EHCPs, would have made the same decision. Many parents worry about their child being labelled. They fear stigma. They hope their child will simply grow out of the difficulties. But a diagnosis does not create a difficulty. It simply helps us understand it. The behaviours were there when he was 7 years old. They are still there now at 15. The difference is that years have passed during which support could have been explored and implemented. I advised her to speak to the school about initiating an EHCP needs assessment and to explore the Right to Choose pathway through her GP rather than waiting years for an NHS assessment. What I often say to parents is this: it is not the label that determines a child’s future. It is the support. You cannot beat ADHD/Autism out of a child. A child with speech delay needs speech and language therapy! And not every child who struggles with communication, routines, emotional regulation, sensory processing or social interaction is simply being stubborn. I understand that many immigrant parents may never have heard of ADHD or autism before moving to the UK. However, these conditions exist whether we acknowledge them or not. If your child regularly walks on their toes, flaps their hands, becomes overwhelmed by noise, struggles to make friends, has intense reactions to changes in routine or finds it difficult to regulate their emotions, please speak to their school or your GP.

Just saying.

Her husband told a court she was too strong to be a wife. The judge agreed and stripped Wangari Maathai of everything, her family, her job, her home. She looked around and noticed women walking miles every single day just to collect firewood. So she handed them seeds instead. The government responded with arrests, beatings, and a padlocked office door. 30,000 women trained. 51 million trees planted across Kenya. Nobel Peace Prize in 2004. They handed her destruction. She turned it into an entire forest.

What is a family? In Africa, family is the grandma who raised you,the aunt who paid your school fees, the uncle who housed you when things got tough, and the older sibling who became a parent overnight. Family has never been one-size-fits-all. #RejectTheCharter #RaiseYourVoice

A unilateral anteroposterior sutural cataract in a 39-year-old patient ultimately revealed asymptomatic hypoparathyroidism—demonstrating how subtle ocular signs can point to underlying endocrine disorders. Read the case: …l-medicine.panafrican-med-journal.com/content/articl…

We can't keep being perpetual immigrants. Not with the current climate of the world.

thousand. @oneman1000_

6 days ago

i understand why you want to leave the country permanently. with every passing day, it gets clearer and clearer.

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@Jairo_I_Funez Just read Chapter 26 on "Towards a Transdisciplinary Decolonial Praxis: Insights from Using Decolonial Theory in Collaborative Research." This was work done with First Nations people in Canada. I have learned so much. THANK YOU to you and your colleagues! This textbook is a gem!

It's actually so wiłd that people don't see that “raising the minimum wage to a true living wage would cause businesses to close” is an indictment of capitalism.