The purpose of the competition is to stimulate and demonstrate the ability of future healthcare executives to identify and describe important issues and developments in their chosen profession. ACHE invites eligible students to submit high-quality essays with a focus on health management topics such as:.
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Program faculty must select and submit one essay to represent their program in the competition. Essays may be up to 15 pages, excluding executive summary, endnotes and bibliography. The executive summary should be to words and follow the title page. Essays selected to be submitted to ACHE will be subjected to a thorough review by panels composed of practitioners and faculty.
The panels employ five equally-weighted criteria:.
Only one entry per program will be accepted. Program faculty must select and submit the student essay entered into the competition. Schools with both graduate and undergraduate degree programs may submit separate entries for each. Cash prizes will be awarded to the first-place, second-place, and third-place essayists in both the graduate and undergraduate divisions.
Awards will be presented at the Leon I. Gintzig Commemorative Lecture and Luncheon. Here is my entry for the competition that was awarded a highly commended distinction on the topic of cancer immunotherapy. Certificate of Achievement.
At the Winship Cancer Institute in Atlanta, Georgia, a year-old man was suffering from metastatic melanoma that first spread to his liver and soon after reached his brain. He was former US president Jimmy Carter, and he rightly believed at the time that he had months to live as no patient with the same initial metastases for Stage IV melanoma survived even a year Figure 1.
However, the doctors came to him with a treatment plan, combining radiation therapy and surgery with a new drug, pembrolizumab , which was approved less than a year earlier by the FDA for the treatment of metastatic melanoma. Within months, he was entirely cancer free. The first response, known as the innate immunity, uses non-specific physical and chemical barriers to prevent the entry of offending agents. If the threat bypasses or is not subdued by these barriers, the more specific and efficient second response, known as the adaptive immunity, rounds up and eliminates the offending agent through antibodies and cell-mediated pathways.
Cancers are sometimes not stopped by either the innate or adaptive immunity though. Checkpoints meant to prohibit unrestrained cell growth fail. Then, the cancer further evades the immune system by reducing its own antigen expression to make itself less detectable or by deactivating the immune cells through targeting receptors like PD Thus, the cancer is able to immortally proliferate, dividing at an immense rate for a considerable amount of time.
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With the immune system not functioning as it should, the human body is defenseless against the cancer. What if you could prevent the cancer from evading and deactivating the immune system in the first place? In seeking an answer to this question, Dr.
William B. Coley utilized the power of the immune system to fight cancer in By injecting cultures of the bacteria to cause erysipelas, an infection of the surface of the skin, Dr. Coley discovered that patients with cancers like sarcomas and lymphomas could achieve full remission. Given its excellent track record in clinical trials thus far, immunotherapy may reach that milestone much sooner. Enthusiasm for cancer immunotherapy drugs flooding the field is justified when one examines what they have to offer.
The drug works by specifically targeting the PD-1 checkpoint protein, which is located on the surface of immune T cells, and its complementary PD-L1 ligand, which is located on host cells Figure 2. Additionally, the PD-1 and PD-L1 interaction triggers the increase of regulatory T cells Tregs function, further suppressing the immune system to the advantage of the cancer.
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Pembrolizumab , a PD-1 inhibitor, occupies and blocks the PD-1 receptor on the T-cell, preventing this interaction with PD-L1 and thus exposing the cancer to a T-cell attack. No longer is it a question of where the cancer is located. It is a question of what biomarker the cancer has; one immunotherapy drug can be used treat a myriad of cancer types.
For patients with advanced cancer, hope is something that they covet and so desperately need. Immunotherapy is there to provide that hope. It is not limited by cancer type nor its progression.
As mentioned before with pembrolizumab , what works for one cancer works for another as long as the cancer shares the same biomarker. Moreover, successful therapy can happen at any time during the course of the cancer progression. Once a drug has activated and mobilized the immune system, then theoretically no matter how far the cancer has spread, the immune system can get to it and kill it with impressive precision and speed.
Hektoen International Medical Humanities essay competition
Scientists are now adapting and tailoring immunotherapy to cancer with chimeric antigen receptor CAR T-cell therapy by infusing genetically modified T-cells, designed to recognize and destroy particular cancer cells by binding to cancer-specific antigens Figure 3.
The ability to flood a patient with personalized white blood cell soldiers not only solves the immediate cancer problem but also is able to prevent the cancer from recurring since these cells will continue to multiply and will circulate in the bloodstream indefinitely.
Transformative advances such as CAR T-cell therapy, which has been approved by the FDA and widely utilized recently, is what makes cancer immunotherapy so promising.
With over cancer immunotherapy clinical trials on the horizon, these combinations will likely be found and will likely revolutionize cancer treatment forever. If so, cancer immunotherapy will be the vanguard of the silver bullet that destroys cancer once and for all. Bucco, Danielle.
Last modified October 20, Accessed February 10, Buchbinder, Elizabeth, and Anupam Desai. Last modified CAR T-cell Therapy.