DiversityNursing Blog

By KAREN KAPLAN

Another influenza season is in the books, and overall it caused less sickness and death than flu seasons in the recent past, according to a new report from the Centers for Disease Control and Prevention.

Between Sept. 29, 2013, and May 17, 2014, a total of 53,471 specimens sent to U.S. labs tested positive for a flu virus. Among them, 87% were influenza A viruses, and the most common of these were versions of the H1N1 virus that prompted the swine flu epidemic in 2009. The other 13% of the confirmed specimens were influenza B viruses.

The CDC findings, which were published Thursday in the Morbidity and Mortality Weekly Report, did not estimate a total number of flu deaths for the 2013-14 flu season. But based on records kept by doctors and hospitals, researchers concluded that flu activity in the last year resulted in “lower levels of outpatient illness and mortality” compared with years when the predominant strains were versions of the H3N2 virus.

At least 96 children died of the flu in the last year, laboratory tests confirmed. Those deaths were reported in 30 states, New York City and Chicago. In about half of these cases, the patients had at least one preexisting condition, such as a neurologic disorder or a pulmonary disease, that may have made them more vulnerable to the flu.

The most striking statistic in the report is the rate of hospitalization among people between the ages of 50 and 64. Over the course of the entire flu season, the cumulative hospitalization rate for these adults was 54.3 per 100,000 people. In the previous four years, that figure has been as low as 8.1 and it never topped 40.6.

The report noted one human case of a H3N2 virus that was first spotted in pigs in 2010 and was identified in a dozen people the following year. The new case was a child from Iowa who had direct contact with pigs. The patient fully recovered, apparently without spreading it to relatives or anyone else, according to the CDC.

The vaccine for the 2014-15 flu season will be based on the same four viruses, the CDC said.

Source: latimes.com

By KATE MURPHY

PITTSBURGH — Trauma patients arriving at an emergency room here after sustaining a gunshot or knife wound may find themselves enrolled in a startling medical experiment.

Surgeons will drain their blood and replace it with freezing saltwater. Without heartbeat and brain activity, the patients will be clinically dead.

And then the surgeons will try to save their lives.

Researchers at the University of Pittsburgh Medical Center have begun a clinical trial that pushes the boundaries of conventional surgery — and, some say, medical ethics.

By inducing hypothermia and slowing metabolism in dying patients, doctors hope to buy valuable time in which to mend the victims’ wounds.

But scientists have never tried anything like this in humans, and the unconscious patients will not be able to consent to the procedure. Indeed, the medical center has been providing free bracelets to be worn by skittish citizens here who do not want to participate should they somehow wind up in the E.R.

“This is ‘Star Wars’ stuff,” said Dr. Thomas M. Scalea, a trauma specialist at the University of Maryland. “If you told people we would be doing this a few years ago, they’d tell you to stop smoking whatever you’re smoking, because you’ve clearly lost your mind.”

At normal body temperatures, surgeons have less than five minutes to restore blood flow before brain damage occurs. CreditUniversity of Pittsburgh Medical Center

Submerged in a frozen lake or stowed away in the wheel well of a jumbo jet at 38,000 feet, people can survive for hours with little or no oxygen if their bodies are kept cold. In the 1960s, surgeons in Siberia began putting babies in snow banks before heart surgery to improve their chances of survival.

Patients are routinely cooled before surgical procedures that involve stopping the heart. But so-called therapeutic hypothermia has never been tried in patients in which a penetrative wound has already occurred, and until now doctors have never tried to replace a patient’s blood entirely with cold saltwater.

In their trial, funded by the Department of Defense, doctors at the University of Pittsburgh Medical Center will be performing the procedure only on patients who arrive at the E.R. with “catastrophic penetrating trauma” and who have lost so much blood that they have gone into cardiac arrest.

At normal body temperatures, surgeons typically have less than five minutes to restore blood flow before brain damage occurs.

“In these situations, less than one in 10 survive,” said Dr. Samuel A. Tisherman, the lead researcher of the study. “We want to give people better odds.”

Dr. Tisherman and his team will insert a tube called a cannula into the patient’s aorta, flushing the circulatory system with a cold saline solution until body temperature falls to 50 degrees Fahrenheit. As the patient enters a sort of suspended animation, without vital signs, the surgeons will have perhaps one hour to repair the injuries before brain damage occurs.

After the operation, the team will use a heart-lung bypass machine with a heat exchanger to return blood to the patient. The blood will warm the body gradually, which should circumvent injuries that can happen when tissue is suddenly subjected to oxygen after a period of deprivation.

Dr. Tisherman and his colleagues plan to try the technique on 10 subjects, then review the data, consider changes in their approach, and enroll another 10. For every patient who has the operation, there will be a control subject for comparison.

The experiment officially began in April and the surgeons predict they will see about one qualifying patient a month.

It may take a couple of years to complete the study. Citing the preliminary nature of the research, Dr. Tisherman declined to say whether he and his colleagues had already operated on a patient.

Each time they do, they will be stepping into a scientific void. Ethicists say it’s reasonable to presume most people would want to undergo the experimental procedure when the alternative is almost certain death. But no one can be sure of the outcome.

“If this works, what they’ve done is suspended people when they are dead and then brought them back to life,” said Dr. Arthur L. Caplan, a medical ethicist at New York University. “There’s a grave risk that they won’t bring the person back to cognitive life but in a vegetative state.”

But researchers at a number of institutions say they have perfected the technique, known as Emergency Preservation and Resuscitation, or E.P.R., in experimental surgeries on hundreds of dogs and pigs over the last decade.

As many as 90 percent of the animals have survived in recent studies, most without discernible cognitive impairment — after the procedure, the dogs and pigs remembered old tricks and were able to learn new ones.

“From a scientific standpoint, we now know the nuts and bolts and that it works,” said Dr. Hasan B. Alam, chief of general surgery at the University of Michigan Medical Center, who has helped perfect the technique in pigs.

“It’s a little unsettling if you think of all the what ifs, but it’s the same every time you push into new frontiers,” he added. “You have to look at risk and balance it against benefits.”

Trauma accounts for more years of life lost than cancer and heart disease combined, and it is the leading cause of death in people up to age 44, according to the Centers for Disease Control and Prevention. Surgeons are eager for new techniques that would help better the odds in emergency situations. Black males are disproportionately victims of homicide, especially gun violence, and most of the patients likely to fit the study criteria in Pittsburgh are African-American males, according to officials at the medical center.

In order to obtain an exemption to federal informed consent rules, the hospital held two town hall meetings on the university campus, placed advertisements on buses, and made sure the news got in newspapers catering to minority readers.

Officials posted information about the study on a website,acutecareresearch.org, and conducted a phone survey in the neighborhoods most at risk for “involuntary enrollment” in the trial. Still, a taxi driver, grocery clerk and security guard — all African-American men approached at random — said they had never heard of the trial, though they work within a couple of miles of the hospital.

They also did not object. “I don’t have a problem with it, if it saves lives,” said Charles Miller, a 52-year-old security guard.

Just 14 people have so far requested “No E.P.R.” bracelets, according to the medical center.

Nearly a half-dozen trauma hospitals may join the trial and begin testing the hypothermia procedure on dying patients, including the University of Maryland Medical Center in Baltimore.

Dr. Scalea, who will head the effort there, said he hoped to receive final regulatory approval by the end of the year.

He recalled a recent stabbing victim who died on his operating table.

“He might have lived if we could have cooled him down,” Dr. Scalea said.

Source: nytimes.com

By LAUREN SILVERMAN

In the emergency department at Children's Medical Center in Dallas, pharmacists who specialize in emergency medicine review each medication to make sure it's the right one in the right dose.

It's part of the hospital's efforts to cut down on medication errors and dangerous drug interactions, which contribute to more than 7,000 deaths across the country each year.

At Children's in Dallas, there are 10 full-time emergency pharmacists, more than anywhere else in the country, and they are on call 24 hours a day. The pharmacists provide a vital safety net, according to Dr. Rustin Morse, chief quality officer and a pediatric ER physician.

"Every single order I put in," Morse says, "is reviewed in real time by a pharmacist in the emergency department prior to dispensing and administering the medication."

That may sound obvious, but Morse says doctors like him, are used to jotting down a type and quantity of drugs and moving on. If there's a problem, a pharmacist will hopefully catch it and get in touch later. But later won't work in the emergency room.

The extra review is particularly important at Children's because medication errors are three times more likely to occur with children than with adults. That's because kids are not "just little adults," says Dr. Brenda Darling, the clinical pharmacy manager for Children's Medical Center.

"They have completely different metabolic rates that you have to look at," Darling says, "so you have to know your patients."

On any given week, pharmacists at Children's review nearly 20,000 prescriptions and medication orders, looking at things like the child's weight, allergies, medications and health insurance.

There are also automatic reviews by an electronic medical record system designed to essentially "spell check" orders to prevent errors. You need both, says Dr. James Svenson, associate professor of emergency medicine at the University of Wisconsin, because the electronic medical record doesn't catch all errors.

Svenson co-authored a study in the Annals of Emergency Medicine that found that even with an electronic medical record, 25 percent of children's prescriptions had errors, as did 10 percent of adults'. Now his hospital also has a pharmacist in the emergency department 24 hours a day.

So why doesn't every hospital do this? The main reason, Svenson says, is money.

"If you're in a small ER, it's hard enough just to have adequate staffing for your patients in terms of nursing and techs, let alone to have a pharmacist sitting down. If the volume isn't there, it's hard to justify."

Hiring pharmacists is expensive, but Morse points to research showing prescription review can reduce the number of hospital readmissions, thereby saving money and lives.

"People do make mistakes," Morse says, and you need to make sure "a patient doesn't get a drug that could potentially stop them breathing because it's the wrong dose."

Source: npr.org

BY LINDA CARROLL

Want a healthy baby? You may want to roll her around in dirt.

For decades, parents have shielded infants from bacteria and other possible triggers for illness, allergies and asthma.

Interestingly, contact with bacteria and dander after age 1 was not protective — it actually increased the risk.

“It was the opposite of what we expected,” said Dr. Robert Wood, chief of the division of allergy and immunology at the Johns Hopkins Children’s Center and co-author of the study in the Journal of Allergy and Clinical Immunology. “We’re not promoting bringing rodents and cockroaches into the home, but this data does suggest that being too clean may not be good.”

 The new findings may help explain some contradictions in research on the so-called hygiene hypothesis, which suggested that kids growing up in a super clean environment were more likely to develop allergies.

“This doesn't completely resolve the controversy, but it does add a big piece of the puzzle,” said Dr. Jonathan Spergel, a professor of pediatrics and chief of allergy at the Children’s Hospital of Philadelphia.

“We’re not promoting bringing rodents and cockroaches into the home, but this data does suggest that being too clean may not be good.”

The theory “is that as we clean up our environment, our immune system moves away from being geared toward fighting bacteria and parasites,” said Dr. Maria Garcia Lloret, an assistant clinical professor of pediatric allergy and immunology at the Mattel Children’s Hospital at the University of California, Los Angeles. “It then has nothing to do and starts to react against things that are normally not harmful, like dust mites, or cat dander or cockroaches or peanuts.”

A chink in the hygiene hypothesis seemed to be the high rates of allergy and asthma in inner-city environments. But the new study may help explain the contradictions by showing that early exposure is crucial.

“It’s all about being exposed to the right bacteria at the right time,” Spergel said.

Wood and his colleagues followed 467 newborns for three years, screening them for allergies annually and testing the dust in the houses where they lived for allergens and bacteria. To the researchers’ surprise, kids who were exposed before their first birthday to mouse and cat dander along with cockroach droppings had lower rates of allergies and wheezing by age 3, compared to those who were not exposed so early on.

 In fact, wheezing was three times as common among children who had less exposure to those allergens early in life.

The protective effect of early exposure to allergens was amplified if the home also contained a wide variety of bacteria.

The reason may be that “a lot of immune system development that may lead someone down the path to allergies and asthma may be set down early in life,” Wood said.

Researchers aren’t ready to try to translate the new findings into practical advice for parents. But, Lloret said, we now know that “strict avoidance of allergens from the beginning does not protect you, and early exposure in the right context may make the difference between disease and tolerance. You could say that this is the downside of cleanliness.”

The new findings may upend advice experts have been giving to parents on the topic of pets and newborns.

“Twenty years ago we used to tell parents to get the cats and dogs out of the house,” Wood said. “This shows that the younger the child is when you get a pet, the better.”

Source: nbcnews.com

By AGATA BLASZCZAK-BOXE

Do men and women feel pain differently? A new study finds an unexpected gender divide.

Researchers found that men tend to report feeling more pain after major surgeries than women, whereas women tend to report experiencing more pain after minor surgical procedures than men.

In the study, researchers found that men were 27 percent more likely to report higher pain ratings after a major surgery such as a knee replacement, while women were 34 percent more likely to report experiencing more pain after procedures that the researchers labeled as minor, such as biopsies. (The researchers differentiated between "major" and "minor" procedures depending on the intensity of pain that people typically expect to feel after a particular procedure.)

To conduct the study, the researchers interviewed 10,200 patients from the University Hospitals of the Ruhr University of Bochum, Germany, following an operation, over more than four years. About 42 percent of the patients were male and 58 percent were female.

Initially, the study authors didn't find significant differences between the genders in people's overall experience of postoperative pain. However, that changed when the researchers distinguished between different kinds of surgeries.

The researchers are not sure where these differences stem from; however, they speculate that a lot may depend on the kind of surgery a person is undergoing. For instance, procedures such as cancer-related biopsies or an abortion may take a particularly serious emotional toll on women, and therefore exacerbate their individual perceptions of pain.

"It could be anxiety," study author Dr. Andreas Sandner-Kiesling of Medical University of Graz, Austria, told CBS News.

"This is a very interesting study," Dr. M. Fahad Khan, an assistant professor in the Department of Anesthesiology at NYU Langone Medical Center, told CBS News. "Ten thousand patients in any type of study is a huge number, and it is really great to see studies on that number of patients because it can limit a lot of the bias that some studies have."

Khan noted he found it interesting that in women, even smaller procedures "can be fraught with the development of pain problems after the procedure," which many people may not expect when they go to the hospital for a simple biopsy, he said.

Sandner-Kiesling said he did not think the findings should change the way men and women are treated for pain. "Clinically, there is no relevance," he said.

According to certain popular cultural stereotypes, women are often considered to be tougher about dealing with pain than men, but is this really the case?

"Anecdotally, people will say that women have a higher threshold for pain and they are more tolerant to pain, just because of their life experience. And perhaps, emotionally, maybe they are stronger than men," Khan said. "However, medically, in my experience, we haven't really noticed much of a difference with regard to men and women in the development of problems with dealing with severe and chronic pain."

The new study is presented at this year's Euroanaesthesia meeting in Stockholm.

Source:cbsnews.com

BY JAMIE DAVIS

First up in this week’s news is a look at an article on humor and the mental health of senior citizens I found over at healthday.com. A new study from researchers at Loma Linda University in California looked at the effects of the stress hormone cortisol on aging patients’ memory and mental acuity. They studied the possibility that laughter might lower the effects of cortisol on the seniors.

Healing Power of Funny Videos

Two groups of senior citizens were shown a funny 20 minute video and then were tested on their memory and mental acuity as well as cortisol levels. This was then compared to tests on a group who did not see the video. The subjects who saw the funny video were found to score better on the memory tests and had lower cortisol levels suggesting that regular exposure to funny and humorous things can improve memory and mental state of seniors.

The study was presented recently at the Experimental Biology conference in San Diego. One of the authors summed up the research saying, “it’s simple, the less stress you have, the better your memory.” This doesn’t mean that we need to be comedians in the midst of our care for patients but it does point to the core nursing tenet that when we treat the whole patient we manage their overall health better.

Make sure your hospitals have access to humorous videos and movies in their in-house TV system. Maybe even share a suggested funny YouTube video of the day with your patients who wish to view it. When appropriate, you could even open up your patient interactions with a simple joke. Maybe “why did the chicken cross the road” will be a precursor to better patient interactions in the future.

Source: nursingshow.com

By Melissa McGlensey

Melvyn Amrine, of Little Rock, Ark., may not remember the details of his life since his Alzheimer's diagnosis, but he recently proved that his love for his wife transcends memory.

Melvyn was diagnosed with Alzheimer's disease three years ago and since then it hasn't been easy for his wife, Doris, CBS News reported. Melvyn at times doesn't remember details like whether he proposed to his wife, or vice versa. However a recent holiday prompted Melvyn to remember the most important thing.

On the day before Mother's Day, Melvyn went missing. Considering he normally requires assistance to do any walking, his family was alarmed and notified the police.

When police found Melvyn, he was 2 miles from his house and he was resolute in his goal, according to Fox 16. He was going to the store to buy flowers for his wife for Mother's Day, just like he had done every year since they had their first child.

Sgt. Brian Grigsby and Officer Troy Dillard were touched by Melvyn's determination, and decided to help the elderly man complete his mission by taking him to a store and even paying for the flowers.

"We had to get those flowers," Grigsby told CBS News. "We had to get them. I didn't have a choice."

Melvyn's flowers made a very sweet surprise for his wife of 60 years, Doris, as well as a reminder to the rest of us that love knows no obstacles.

"When I saw him waking up with those flowers in hand, it just about broke my heart because I thought 'Oh he went there to get me flowers because he loves me,'" Doris told Fox 16.

She added to CBS News: "It's special, because even though the mind doesn't remember everything, the heart remembers."

Source: Huffingtonpost.com

By Ilene MacDonald

Despite new technology and evidence-based guidelines, medical mistakes happen too frequently and may lead to as many as 400,000 preventable deaths each year.

But two new programs, launched at the University of Virginia Medical Center, offer a new approach to patient safety that may prevent medical errors, WVTF Public Radio reports.

This year the organization introduced a simulation lab in the pediatric intensive care unit. The "Room of Errors" features high-tech infant mannequins attached to monitors. When doctors and nurses enter the lab, they have seven minutes to determine what is wrong.

As part of a recent exercise, a doctor-nurse team worked together to spot 54 problems with the scenario, including the fact the ventilator wasn't plugged into the correct outlet, the heat wasn't turned on and the potassium chloride was programmed at the wrong concentration.

The interpersonal, team-based learning approach helps doctors and nurses improve their ability to make decisions together and communicate with one another, Valentina Brashers, M.D., co-director of the Center for Interprofessional Research and Education, an effort headquartered at UVa's Schools of Nursing and Medicine, told WVTF.

"Knowing that there are others that you can work to think with you and share with you their concerns as you work through difficult problems makes care provision a much more enjoyable and rewarding activity. It reduces staff turnover. It creates an environment where we feel like we're all in it together with the patient," she said.

The pilot proved so successful that the medical center intends to roll it out to the entire hospital.

In its quest to eliminate medical mistakes at the organization, UVa also launched a second patient safety initiative that calls for hospital administrators to meet each morning to talk about any problems that occurred in the previous 24 hours, according to a second WVFT article.

The "Situation Room" features white boards and monitors, where administrators review every new infection and unexpected death and then visit the places where the problems took place.

Sometimes the solutions are easy fixes, such as a receptionist who removed a mat that caused patients to trip at the entrance of an outpatient building. Others, caused by communication problems, are more complicated, Richard  Shannon, M.D., executive vice president for health affairs, told the publication. To address it, Shannon wants to shake up the medical hierarchy where the physician sits at the top.

"The physician may spend 20 minutes at the bedside a day. The nurse is there 24/7 and has about 13 times more direct contact with the patient than does the physician," he told WVFT. "You can't have someone at the head of the pyramid who is absent a lot of the time."

Finally, to encourage better communication among caregivers, patients and families, Shannon now encourages healthcare professionals to make rounds in the afternoon, when visitors are on premises.

Source: fiercehealthcare.com

By: Alice Park

People who speak more than one language tend to score higher on memory and other cognitive function tests as they get older, but researchers haven’t been able to credit bilingualism as the definitive reason for their sharper intellects. It wasn’t clear, for example, whether people who spoke multiple languages have higher childhood intelligence, or whether they share some other characteristics, such as higher education overall, that could explain their higher scores.

Now, scientists think they can say with more certainty that speaking a second language may indeed help to improve memory and other intellectual skills later in life. Working with a unique population of 853 people born in 1936 who were tested and followed until 2008-2010, when they were in their 70s, researchers found that those who picked up a second language, whether during childhood or as adults, were more likely to score higher on general intelligence, reading and verbal abilities than those who spoke one language their entire lives. Because the participants, all of whom were born and lived near Edinburgh, Scotland, took aptitude tests when they were 11, the investigators could see that the effect held true even after they accounted for the volunteers’ starting levels of intelligence.

Reporting in the Annals of Neurology, they say that those who began with higher intellect scores did show more benefit from being bilingual, but the improvements were significant for all of the participants. That’s because, the authors suspect, learning a second language activates neurons in the frontal or executive functions of the brain that are generally responsible for skills such as reasoning, planning and organizing information.

Even more encouraging, not all of the bilingual people were necessarily fluent in their second language. All they needed was enough vocabulary and grammar skills in order to communicate on a basic level. So it’s never too late to learn another language – and you’ll be sharper for it later in life.

Source: Time.com

Maya Angelou was born Marguerite Annie Johnson in St. Louis, Missouri. Her parents divorced when she was only three and she was sent with her brother Bailey to live with their grandmother in the small town of Stamps, Arkansas. In Stamps, the young girl experienced the racial discrimination that was the legally enforced way of life in the American South, but she also absorbed the deep religious faith and old-fashioned courtesy of traditional African American life. She credits her grandmother and her extended family with instilling in her the values that informed her later life and career. She enjoyed a close relationship with her brother. Unable to pronounce her name because of a stutter, Bailey called her "My" for "My sister." A few years later, when he read a book about the Maya Indians, he began to call her "Maya," and the name stuck.

At age seven, while visiting her mother in Chicago, she was sexually molested by her mother's boyfriend. Too ashamed to tell any of the adults in her life, she confided in her brother. When she later heard the news that an uncle had killed her attacker, she felt that her words had killed the man. She fell silent and did not speak for five years.

Maya began to speak again at 13, when she and her brother rejoined their mother in San Francisco. Maya attended Mission High School and won a scholarship to study dance and drama at San Francisco's Labor School, where she was exposed to the progressive ideals that animated her later political activism. She dropped out of school in her teens to become San Francisco's first African American female cable car conductor. She later returned to high school, but became pregnant in her senior year and graduated a few weeks before giving birth to her son, Guy. She left home at 16 and took on the difficult life of a single mother, supporting herself and her son by working as a waitress and cook, but she had not given up on her talents for music, dance, performance and poetry.

In 1952, she married a Greek sailor named Anastasios Angelopulos. When she began her career as a nightclub singer, she took the professional name Maya Angelou, combining her childhood nickname with a form of her husband's name. Although the marriage did not last, her performing career flourished. She toured Europe with a production of the opera Porgy and Bess in 1954 and 1955. She studied modern dance with Martha Graham, danced with Alvin Ailey on television variety shows, and recorded her first record album, Calypso Lady in 1957.

She had composed song lyrics and poems for many years, and by the end of the 1950s was increasingly interested in developing her skills as a writer. She moved to New York, where she joined the Harlem Writers Guild and took her place among the growing number of young black writers and artists associated with the Civil Rights Movement. She acted in the historic Off-Broadway production of Jean Genet's The Blacks and wrote and performed a Cabaret for Freedom with the actor and comedian Godfrey Cambridge.

In New York, she fell in love with the South African civil rights activist Vusumzi Make and in 1960, the couple moved, with Angelou's son, to Cairo, Egypt. In Cairo, Angelou served as editor of the English language weekly The Arab Observer. Angelou and Guy later moved to Ghana, where she joined a thriving group of African American expatriates. She served as an instructor and assistant administrator at the University of Ghana's School of Music and Drama, worked as feature editor forThe African Review and wrote for The Ghanaian Times and the Ghanaian Broadcasting Company.

During her years abroad, she read and studied voraciously, mastering French, Spanish, Italian, Arabic and the West African language Fanti. She met with the American dissident leader Malcolm X in his visits to Ghana, and corresponded with him as his thinking evolved from the racially polarized thinking of his youth to the more inclusive vision of his maturity.

Maya Angelou returned to America in 1964, with the intention of helping Malcolm X build his new Organization of African American Unity. Shortly after her arrival in the United States, Malcolm X was assassinated, and his plans for a new organization died with him. Angelou involved herself in television production and remained active in the Civil Rights Movement, working more closely with Dr. Martin Luther King, Jr., who requested that Angelou serve as Northern Coordinator for the Southern Christian Leadership Conference. His assassination, falling on her birthday in 1968, left her devastated. With the guidance of her friend, the novelist James Baldwin, she found solace in writing, and began work on the book that would become I Know Why the Caged Bird Sings. The book tells the story of her life from her childhood in Arkansas to the birth of her child. I Know Why the Caged Bird Sings was published in 1970 to widespread critical acclaim and enormous popular success.

Seemingly overnight, Angelou became a national figure. In the following years, books of her verse and the subsequent volumes of her autobiographical narrative won her a huge international audience. She was increasingly in demand as a teacher and lecturer and continued to explore dramatic forms as well. She wrote the screenplay and composed the score for the film Georgia, Georgia (1972). Her screenplay, the first by an African American woman ever to be filmed, was nominated for a Pulitzer Prize.

Angelou was invited by successive Presidents of the United States to serve in various capacities. President Ford appointed her to the American Revolution Bicentennial Commission and President Carter invited her to serve on the Presidential Commission for the International Year of the Woman. President Clinton requested that she compose a poem to read at his inauguration in 1993. Angelou's reading of her poem "On the Pulse of the Morning" was broadcast live around the world.

Since 1981, Angelou has served as Reynolds Professor of American Studies at Wake Forest University in Winston-Salem, North Carolina. She has continued to appear on television and in films including Poetic Justice (1993) and the landmark television adaptation of Roots (1977). She directed numerous dramatic and documentary programs on television and directed a feature film,Down in the Delta, in 1996.

The list of her published works includes more than 30 titles. These include numerous volumes of verse, beginning with Just Give Me a Cool Drink of Water 'Fore I Die (1971). Books of her stories and essays include Wouldn't Take Nothing For My Journey Now (1993) and Even the Stars Look Lonesome(1997). She continued the compelling narrative of her life in the books Gather Together in My Name (1974), Singin' and Swingin' and Gettin' Merry Like Christmas (1976), The Heart of a Woman (1981), All God's Children Need Traveling Shoes(1987) and A Song Flung Up to Heaven (2002).

In 2000, Dr. Angelou was honored with the Presidential Medal of the Arts; she received the Ford's Theatre Lincoln Medal in 2008. The same year, she narrated the award-winning documentary film The Black Candle and published a book of guidance for young women, Letter to My Daughter. In 2011, President Barack Obama awarded her the nation's highest civilian honor, the Presidential Medal of Freedom.

Maya Angelou participated in a series of live broadcasts for Achievement Television in 1991, 1994 and 1997, taking questions submitted by students from across the United States. The interview with Maya Angelou on this web site has been condensed from these broadcasts.

Source: achievement.org