Category Archives: Integrative Medicine

Editors note: This is the first of a weekly series The Longevity Project, a collaboration betweenThe Aspen TimesandPost Independent.

Many individuals who experience traumatic brain injuries (TBI) undergo what is called perseveration, where they often repeat words or phrases. For Carbondale resident Darryl Fuller, 52, the word he clings to is nature.

Sometimes he calls me nature, Darryls wife, Susan Jordan, said. Sometimes he calls other people nature. Sometimes he just uses it to fill in.

In the early stages following Fullers TBI, the word clung to was determination. These words choices seem to be in line with the kind of person Darryl Fuller is.

He and Susan have been living in Carbondale for over 20 years. They moved here in 2000, when Darryl took a job at Colorado Rocky Mountain School as the outdoor programming director, a title hes held since he moved here.

Before the accident that led to Darryls TBI, on a typical weekend, Darryl and Susan would spend it biking or skiing, enjoying all the things living in the mountains has to offer.

A love of nature seems to have carved out a career and lifestyle for Darryl.

On May 21, 2022, Darryl was in a backcountry skiing accident on Cathedral Peak. He was with a friend, trying to enjoy one of the last snow storms of the season.

While walking up the peak, Darryl slid on a patch of rocks and lost a ski. He was not injured at this point. After he fell the first time, he and his friend decided to descend the peak, making their way back down the way they had come up.

They were both being cautious and wearing protective gear, including helmets. Darryl is an experienced skier and outdoorsman, given his long career as an outdoor program director. Still, accidents can happen to the most experienced outdoor adventurers, even those who make safety a priority.

It was on their way back down the peak that Darryl fell again, sliding an estimated 1,000 feet.His friend found him lying unconscious.

Before Darryls friend was able to make it to him safely, others who witnessed his fall were able to reach him.

The miracle was that there were two people, a father and a son hiking at the Cathedral Lakes Trail on May 21. Like, who does that? said Susan. Even locals dont really do that.

Darryl was airlifted to Aspen Valley Hospital, then transferred to St. Marys Medical Center in Grand Junction. According to Susan, he almost didnt make it.

He was covered with blood, his eyes were slow and he was intubated. He couldnt talk. He was not conscious, Susan said about her first time seeing her husband.

Darryl had broken his leg, tore the upper side of his left eye, and endured a traumatic brain injury.

He moved from St. Marys Medical Center in Grand Junction to Craig Hospital in Denver, where he and Susan have been since July 6.

Darryl is one of 1.5 million people diagnosed with a TBI this year, according to estimates from theCenters for Disease Control and Prevention.

The number of people living with TBIs in the United States nearly equals the entire population of Colorado. According to Aspen Valley Hospital, an estimated5.3 millionadults and children living in the United States are suffering from permanent brain injuries. TheU.S. Censusfrom 2021 estimates the population of Colorado at 5.8 million.

Each year, Aspen Valley Hospital sees anestimated 2,000 peoplewho come in with concerns of brain injuries. Concussion is the most frequent diagnosis for those patients, but even a mild concussion can lead to lasting impacts.

Austin Colbert, the sports editor and lead photographer forThe Aspen Times, endured a mild concussion a handful of years ago and still has lingering symptoms.

I had a very light, insignificant knock on the head, and Im still dealing with symptoms five years later. Colbert said. It impacts your life.

Dr. John Hughes, who owns Aspen Integrative Medicine, described a TBI as a bomb that explodes in the brain. This bomb often goes undetected on CT or MRI scans, which makes the treatment for TBI all the more challenging.

Themost common eventsthat lead to TBIs are falls, car collisions, combative injuries or sports-related injuries. People living in rural or mountainous regionsare more likely to experience a TBIthan those who live in urban or eastern regions.

With this, Colorado ranks ninth in the country for TBI-related fatalities and 13th for TBI-related hospitalizations, according toBrain Injury Alliance of Colorado.

Astudy from Craig Hospitalestimates that Region 12 of Colorado, which consists of Pitkin, Eagle, Summit, Jackson and Grand counties, ranks No. 1 for TBIs when adjusted for the population.

Like the severity of TBIs, treatment and recovery for TBI patients varies.

I tell my patients, its still going to be a six- to nine-month process, even a year before they might get back to some resemblance of normal and can say, Hey, I have my identity back, said Dr. Hughes.

I think everybody has to have those kinds of kind of long-term expectations.

For Darryl Fuller and Susan Jordan, every day seems to get a little better.

Every little thing is just like this little golden nugget of hope, said Susan.

He can read, write, do math problems and more signs that Darryl is recovering. Conversing and walking are still challenging.

He and Susan pass the time between his treatments playing games or rolling around the hospital.

Both of them are currently not able to work. This, along with the cost of medical treatment, is why Darryls sister started aGoFundMepage that is still taking donations.

Susan also started a blog on Caringbridge in which she writes journal updates on his progress. She considers the blog a good way to keep people informed and hopes that it is something they can look back on in the future, when Darryl gets better.

For now, they are still in Craig Hospital. The release date always seems to change, depending on the fluctuating recovery process.

Susan hopes Darryl will be treated in more of a residential-style treatment facility soon.

As much as wed like to get home, hes not ready to go home, said Susan. So, I am super hopeful that were going to get Darryl back to a very high level.

Whatevers left, well just continue to work on whatever that is.

To reach Kristen Mohammadi, call 304-650-2404 or email kmohammadi@aspentimes.com.

Excerpt from:
The Longevity Project: Traumatic Brain Injuries in the High Country - Glenwood Springs Post Independent

Doctors say vaccine fatigue may lead to higher flu numbers.

ATLANTA If you're tired of being pricked, boosted, and the plethora of medical information, it's what experts call vaccine fatigue. Health officials say that's what many Georgians are feeling right now and they're choosing to not get the flu shot as a result.

Vaccine fatigue can be defined as: Peoples inertia or inaction towards vaccine information or instruction due to perceived burden and burnout.

11Alive spoke to Dr. Brent Harris of US MedClinic and Dr. Dana Neacsu of Medical Creations Integrative Medicine. Both say at least half their patients who received the flu shot last year, haven't or don't plan to this year.

"Its about the frequency of the immunizations. Weve had a number of those -- weve had COVID, weve had the flu shot, and now monkeypox," Dr. Neacsu said. She says the continuous stream of information can be overwhelming not just for patients, but also for medical professionals too.

"This is a problem and we need to work on it because guess what? All these vital illnesses arent going anywhere," she said.

Dr. Harris says one part of vaccine fatigue has to do with misinformation.

He says so many people thought vaccines prevented COVID-19-- and then after getting the shot-- they either got the virus or experienced side effects. He says that confusion from the beginning still lingers today.

Dr. Neacsu also says some people think the COVID booster is strong enough to protect them from the flu, but she says that's not the case.

"Having specific immunization for special illnesses is important," Neacsu said. "COVID vaccines are not going to cover you or help you prevent the flu and vice versa."

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Many Atlantans say they're skipping out on this year's flu shot - 11Alive.com WXIA

Pioneering concierge medicine management company Specialdocs and physician clients to offer compelling perspectives at the Concierge Medicine Forum October 20th 22nd

CHICAGO, Oct. 13, 2022 /PRNewswire/ -- Terry Bauer, CEO of Specialdocs Consultants, a 20-year pioneer in concierge medicine transitions and management, and several of the company's affiliated physicians will offer insights on the extraordinary growth of this dynamic and enticing practice model at the upcoming Concierge Medicine Forum (CMF) in Atlanta. Reflecting the surging demand for personalized care, the industry's signature event is on track in 2022 to be the most well-attended conference to date, according to organizers.

"What we're seeing is a genuine recognition of the pillar stone of concierge medicine - the tremendous value of a long-term physician-patient relationship," says Bauer. "The impact of the pandemic made that crystal clear and has inspired thousands of people to thoughtfully reconsider how they chose to deliver and receive care." He cited a doubling in the number of physicians converting to the Specialdocs concierge medicine model in the last few years, as well as a 10% average annual industry growth rate of the U.S. concierge medicine market over the next 8 years, as forecast by Grand View Research.

Bauer will lead key sessions covering qualities necessary for success as a concierge physician, and how to communicate the enhanced level of care to concierge patients inside and outside the exam room. He'll also discuss the expanding plethora of paths to becoming a concierge physician. "The options go well beyond traditional conversions from fee-for-service models to acquiring a practice from a retiring physician, transitioning from hospital employment or within a group practice, or joining a successful local concierge practice," he said.

In addition, Specialdocs-affiliated physicians will be featured at the conference, sharing expert perspectives that include:

"Sharing our passion for concierge medicine at CMF with insightful, long-time collaborators like Specialdocs and others is a privilege we look forward to each year," Michael Tetreault, CMF organizer and editor of Concierge Medicine Today."We're all thrilled to see the soaring interest in membership medicine practices which continue to bring balance to physicians' lives and elevate the care offered to the patients and communities they serve."

A pioneer in concierge medicine since 2002, Specialdocs is celebrating two decades of transforming physicians' professional lives, empowering them to deliver exceptionally personalized patient care.

CONTACT:[emailprotected]

SOURCE Specialdocs Consultants

Link:
Concierge Medicine's Continued Rise Illuminated by Specialdocs Consultants at the Industry's Leading Event - PR Newswire

image:Of the 10 richest countries in the world, the U.S. ranks last in vaccination rates and first in both numbers and rates of COVID-19 deaths, view more

Credit: Alex Dolce, Florida Atlantic University

The United States Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA), which was immediately endorsed by the U.S. Centers for Disease Control and Prevention (CDC), for new booster shots created to combat the most recent and highly prevalent omicron variants of COVID-19, specifically BA.4 and BA.5. Fortunately, these most recent and very highly prevalent variants, while more communicable, are less lethal.

In a commentary published in The American Journal of Medicine, researchers from Florida Atlantic Universitys Schmidt College of Medicine and collaborators, provide the most updated guidance to health care providers and urge how widespread vaccination with these boosters can now avoid the specter of future and more lethal variants becoming a reality.

Of the 10 richest countries in the world, the U.S. ranks last in vaccination rates and first in both numbers and rates of COVID-19 deaths, said Charles H. Hennekens, M.D., Dr.PH, senior author, first Sir Richard Doll Professor of Medicine and senior academic advisor, FAU Schmidt College of Medicine. The dedicated health care professionals in communities and hospitals across the nation continue to try to address existing and new challenges of COVID-19. We must redouble our efforts to promote evidence-based clinical and public health practices, which should include vaccination of all U.S. adults and eligible children based on the most recent FDA and CDC guidance.

The authors point out that, compared with influenza, the mortality rate from COVID-19 is about 30 times higher. Further, a positive COVID-19 patient is likely to transmit to about six people compared with one or two for influenza. Finally, the boosters will reduce the risk of dying and hospitalization by more than 90 percent.

The most simple and straightforward newest guidance we can now offer to health care providers is that all individuals ages 5 and older should receive a booster shot, said Alexandra Rubenstein, first author, clinical research coordinator, Department of Neurology, Boston Medical Center, and an aspiring physician. Specifically, based on the recent EUAs issued by the FDA and CDC, those 5 and older may receive Pfizer bivalent boosters, and those ages 6 and older may receive bivalent boosters from Moderna. While the absolute risks of severe COVID-19 are low in youths, the benefit-to-risk ratio was deemed to be favorable in a 13-to-1 vote of independent external advisers to the FDA.

According to the authors, vaccines to prevent common and serious infectious diseases have had a greater impact on improving human health than any other medical advance of the 20th century. Nonetheless, since 2019, the percentages of children in the U.S. vaccinated against common and serious childhood diseases has decreased.

In the U.S., diphtheria-pertussis-tetanus or DPT immunizations have decreased from 85 percent in 2019 to 67 percent in 2021, said co-author Sarah K. Wood, M.D., professor of pediatrics and interim chair, Department of Womens and Childrens Health and vice dean for medical education, FAU Schmidt College of Medicine. Recently, a young adult unvaccinated against polio in a neighborhood in Rockland County, New York, contracted a paralytic disease raising concerns that the loss of herd immunity may portend new epidemics of avoidable serious morbidity and mortality in the U.S. and worldwide.

Ironically, the authors note, virtually all Americans would seek effective and safe therapies for any communicable diseases. Most individuals routinely accept major surgery, toxic chemotherapy and/or radiation therapy for cancer, which result in a far greater number of side effects than are caused by vaccinations. The authors encourage health care providers to recommend a COVID-19 booster vaccine to all eligible patients to protect individuals and communities.

Other co-authors are Vama Jhumkhawala, a first-year FAU medical student; and Mark DiCorcia, Ph.D., associate professor of obstetrics and gynecology and assistant dean for medical education, FAU Schmidt College of Medicine, as well as Dennis G. Maki, M.D., Ovid O. Meyer professor of medicine, director of the COVID-19 Intensive Care Unit and an internationally renowned infectious disease clinician and epidemiologist from the University of Wisconsin School of Medicine and Public Health.

Maki and Hennekens served together for two years as lieutenant commanders in the U.S. Public Health Service as epidemic intelligence service (EIS) officers with the CDC. They served under Alexander D. Langmuir, M.D., who created the EIS and epidemiology program at the CDC, and Donald A. Henderson, M.D., chief of the virus disease surveillance program at the CDC. Langmuir and Henderson made significant contributions to the eradication of polio and smallpox using widespread vaccinations and public health strategies of proven benefit.

- FAU -

About the Charles E. Schmidt College of Medicine:

FAUs Charles E. Schmidt College of Medicine is one of approximately 156 accredited medical schools in the U.S. The college was launched in 2010, when the Florida Board of Governors made a landmark decision authorizing FAU to award the M.D. degree. After receiving approval from the Florida legislature and the governor, it became the 134th allopathic medical school in North America. With more than 70 full and part-time faculty and more than 1,300 affiliate faculty, the college matriculates 64 medical students each year and has been nationally recognized for its innovative curriculum. To further FAUs commitment to increase much needed medical residency positions in Palm Beach County and to ensure that the region will continue to have an adequate and well-trained physician workforce, the FAU Charles E. Schmidt College of Medicine Consortium for Graduate Medical Education (GME) was formed in fall 2011 with five leading hospitals in Palm Beach County. The Consortium currently has five Accreditation Council for Graduate Medical Education (ACGME) accredited residencies including internal medicine, surgery, emergency medicine, psychiatry, and neurology. The colleges vibrant research focus areas include healthy aging, neuroscience, chronic pain management, precision medicine and machine learning. With community at the forefront, the college offers the local population a variety of evidence-based, clinical services that treat the whole person. Jointly, FAU Medicines Primary Care practice and the Marcus Institute of Integrative Health have been designed to provide complete health and wellness under one roof.

About Florida Atlantic University: Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University serves more than 30,000 undergraduate and graduate students across six campuses located along the southeast Florida coast. In recent years, the University has doubled its research expenditures and outpaced its peers in student achievement rates. Through the coexistence of access and excellence, FAU embodies an innovative model where traditional achievement gaps vanish. FAU is designated a Hispanic-serving institution, ranked as a top public university by U.S. News & World Report and a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. For more information, visitwww.fau.edu.

The American Journal of Medicine

Literature review

People

Newest guidance and evidence for health care providers: COVID-19 and other vaccines

3-Oct-2022

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

See more here:
Needs and challenges for COVID-19 boosters and other vaccines in the US - EurekAlert

Accountants arent the only ones who go by the numbers. Increasingly, doctors gauge your health by your numbers as well. Better numbers mean better health and a lower risk of heart attacks and strokes.

You can make healthy choices that add up to better numbers every day. To do it, keep LDL cholesterol numbers in mind and choose smaller portions of high-fat foods like hamburgers, cheese, and French fries.

The two faces of cholesterol:According to the American Heart Association, an acceptable total cholesterol reading is 200 milligrams per deciliter (mg/dl) or lower. Above 200, you should take some steps to lower it. The number includes two kinds of cholesterol.

The bad: Low-density lipoproteins, the LDLs: This is the stuff that clogs arteries. You need some, but too much is bad news. Shoot for an LDL reading of less than 100.

If your total cholesterol level is high, you have two choices: You can pay more attention to eating a low-fat diet and getting some exercise, or you can get your doctors advice about cholesterol-lowering drugs.

According to the University of Kentucky College of Medicine, eating high amounts of soluble fiber from sources like oat bran and beans can also help lower cholesterol. In the colon, fiber may interfere with the bodys production of LDL.

The good: High-density lipoproteins, the HDLs: The minimum good reading here is 35 mg/dl. If you have an HDL as high as 80, despite high total cholesterol levels, you may not have to worry about heart disease.

To increase good cholesterol in your blood, eat more fruits and vegetables. Aerobic exercise can raise levels of the protective HDL and may also help to lower LDL.

If the names HDL and LDL confuse you, remember that, in most areas, high is better than low!

Read more from the original source:
What you need to know about mammograms - Royal Examiner

One Health may be a new term to many when applied to veterinary science, but the LSU School of Veterinary Medicine is working to put the idea at the forefront of its work.

One Health is the integrative effort of multiple disciplines working locally, nationally and globally to attain the optimal health towardanimal, environment and human health.

Rebecca Christofferson,an associate professor in the vet school's Department of Pathological Sciences since 2015, said for many in the LSU Vet School, the concept of One Health has been second nature for years, but naming the initiative of working toward improvinghas elevated the effort of working locally, nationally and globally of attaining optimal health across the board.

"It's why when we solve one problem, we have to make sure that that Rubik's cube is not too disturbed," Christofferson said.

The One Health approach is important because historically, using Christofferson's metaphor, there were instances of disturbing the Rubik's cube.

Take, for example, cow dipswhich were often used to treat and eradicate ticks on cattle in Louisiana and other Southern states through much of the first half of the 1900s. Farmers would dig large holes in the ground and fill them with an arsenic and pesticide-filled sludge. The farmers would then guide the cows through the sludge, which killed the ticks. The problem was the arsenic sludge was left in the ground to potentially infiltrate the water table an approach that helped the health of the cows but left what became a long-term environmental hazard, which led to problems for some humans.

With One Health, researchers like Christofferson have the opportunity to take a more global approach to solving these kinds of problems. Even still, scientists are able to bring in their personalities into their approach to research.

On a personal level, Christofferson loves how her research for the vet school contributes to the overall health of the community in the same way sheloves incorporating little nods to her passion for jazz into her veterinary science work. In her work to collect mosquitoes, she sometimes makes special trips to Roselawn Memorial Park on Baton Rouge's North Street where legendary jazz pianist Bill Evans is buried. Christofferson is a big Evans fan.

Rebecca Christofferson, right, an associate professor in the LSU School of Veterinary Medicine's Department of Pathological Science stands in her lab area with graduate assistant Erik Turner, who works with Christofferson in researching pathological diseases carried by mosquitos.

"A graveyard is a really good place to catch mosquitoes," Christofferson said. "And since I love jazz and Bill Evans, we sometimes catch them at his grave. It's just our way of including him in our work."

True, there's no feasible connection between jazz and mosquitoes. But in Christofferson's world, the idea of integration and connecting the dots between the environment, humans and animals, even the mosquito, work hand in hand.

Rebecca Christofferson, an associate professor in the LSU School of Veterinary Medicine's Department of Pathological Science, watches an adult mosquito captured inside a trap. Christofferson applies her findings not only to animals but humans and the environment through the school's One Health initiative.

Christofferson has been an associate professor in the vet school's Department of Pathological Sciences since 2015. Her main field of study is mosquitoes and the diseases they carry. She's aided by graduate assistant Erik Turner.

Their individual field of study contributes to the overall One Health mission instituted by the school's dean, Oliver Garden.

He's the first to say the idea of One Health isn't anything new. It's common knowledge that a circle of life continually rotates among humans, animals and the environment. When one is affected, all are.

Rebecca Christofferson, an associate professor in the LSU School of Veterinary Medicine's Department of Pathological Science, watches an adult mosquito captured inside a trap. Christofferson applies her findings not only to animals but humans and the environment through the school's One Health initiative.

Though the vet school primarily focused on animals in the past, Garden looks at the school's work through a different lens.

"Clearly, diseases that threaten humans involve an animal as a host and vice versa," Garden said. "We are linked, and many of the diseases that our veterinary patients suffer are very similar to those of human beings. And we at the vet school do at least as much research on human as we do veterinary health, because we regard them as inextricably linked."

Rebecca Christofferson's graduate assistant, Erik Turner, checks a mosquito trap for larvae.

Garden added, One Health is a key concept that defines 21st century living, medicine and healthy existence.

"We at LSU Vet Med embrace One Health in everything that we do, whether it's through areas of teaching, healing, discovering and protecting," Garden said.

Garden calls these areas "missions."

Graduate assistant Erik Turner, left, and associate professor Rebecca Christofferson check on a mosquito captured in a trap in the LSU School of Veterinary Medicine. The duo researches mosquito transmitted diseases and apply their findings not only to animals but people.

"These missions pervade everything that we do," he said. "And part of that is we're able to do human testing, as well as animal testing, including surveillance for such trans-boundary diseases as classical swine fever, African swine fever and Newcastle disease. We're also participating in the poultry health program, and we're the state diagnostic testing lab for rabies."

Garden also highlights Christofferson's work, pointing out her study of pathogens, along with how those pathogens are cultivated in the environment, have a direct impact on both human and animal health.

Rebecca Christofferson removes a mosquito trap from a shelf within her lab inside the LSU School of Veterinary Medicine. This trap is designed as an attractive place for pregnant female mosquitoes to lay their eggs.

"For example, Dr. Christofferson, who does work on viruses and emergency infectious diseases, has been doing work on sarcoidosis and is instrumental now in articulating the university response to monkeypox," he said.

Of course, that doesn't have anything to do with jazz. Not officially, anyway. But for Christofferson, Evans adds something personal in her own One Health mission when she sets her mosquito traps next to his grave.

The water-filled trays provide a breeding ground for fertile females, which are the only mosquitoes that bite. Males and females who aren't pregnant actually feed off pollen.

Graduate assistant Erik Turner removes a mosquito larva from a trap set buy Associate Professor Rebecca Christofferson. The duo researches how diseases are transmitted by mosquitoes.

"Yes, they're pollinators," Christofferson said. "The females only need protein from blood when they're carrying eggs."

That's one fact she shares when taking the One Health mission into high schools and other areas of the community. She also teaches her audiences how to tell the difference between male and female mosquitoes.

"The male mosquito has fuzzy antennas," she said. "Those are just some things they're interested in, and we can use them to talk about other things we're doing."

Christofferson and Turner step into their lab to check on a mosquito trap.

Graduate assistant Erik Turner removes a mosquito larva from a trap set buy Associate Professor Rebecca Christofferson. The duo researches how diseases are transmitted by mosquitoes.

This particular trap, designed to capture adult mosquitoes, has imprisoned two male and one female, which doesn't have fuzzy antennas.

"Yeah, the males get the prettier antennas," Christofferson said, laughing. "We'll trap more and bring them into the lab to study."

And what are they looking for? Zoonotic viruses, which are viruses that infect both humans and animals.

"Most of my viruses are zoonotic," she said. "So for example, some of the viruses I'm working with right now are called bunya viruses or ortho bunya viruses, and they affect cattle as well as humans, and they're transmitted by mosquitoes."

Christofferson's work focuses on the dengue virus, including such variants as Zika and West Nile, which cause fever, headache, vomiting, muscle and joint pains for people living primarily in tropical environments.

"In Louisiana, we have the environmental factor for mosquitoes carrying this virus, so we can study these mosquitoes and how the environment interacts with the mosquitoes to transmit the virus," Christofferson said.

Through it all, Christofferson keeps her eye on how she can apply her findings to the One Health initiative.

Rebecca Christofferson, right, an associate professor in the LSU School of Veterinary Medicine's Department of Pathological Science stands in her lab area with graduate assistant Erik Turner, who works with Christofferson in researching pathological diseases carried by mosquitos.

Garden is determined to do more by spreading this message through community outreach.

"We're increasingly engaging with the community through outreach programs," Garden said. "We provide key services to the community and basic veterinary needs, but in that, we'll also be educating."

Garden added that the school also is scheduling monthly community outreach programs in its library.

The LSU School of Veterinary Medicine's logo for its One Health initiative.

Garden said getting the message of One Health out using different means is important, like the culmination of the recent artist-in-residence program. He added that the school is incorporating a program for students to earn bachelor's and master's degrees in the One Health program.

In the end, the One Health initiative is a reminder of the importance of looking at the bigger picture and connecting the dots, even if the dots include a love for jazz and mosquitoes.

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One Health: LSU Vet School uses integrative approach to help people, animals and the environment - NOLA.com