Author: Chris Noronha

October is Health Literacy Month!

Founded in 1999 by Helen Osborne, Health Literacy Month is all about promoting understandable health information. This information is critical in order for individuals to make appropriate health decisions.

Health literacy is the ability to obtain, process, and understand basic health information and services. This includes reading, writing, and numeracy of health information. Sometimes, health information can be difficult to understand and communicate among different audiences. This can make navigating the healthcare system challenging.

According to the U.S. Department of Health and Human Services, 77 million U.S. adults have basic or below basic health literacy. Low health literacy can lead to poor health outcomes, such low uptake of preventive health services and/or greater use of treatment health services. This can lead to high healthcare costs.

There are many factors that can affect health literacy. Some of these factors include: education, age, language, and culture. Culture can play a key role in how one understands and responds to health information. Culture involves certain beliefs, values, communication styles that all can affect how one processes health information. Therefore, it is important that health information is communicated in a way that is culturally appropriate for the individual or audience.

One key setting for health literacy is that of patient and health care providers. Patients may have difficulty understanding complex medical information, while providers may have difficulty communicating complex medical information. It is important for providers and patients to work together in order to ensure that health information is understood and communicated effectively, so that the best health care decisions are made for the patient.

Interested in learning more about health literacy? Check out the following resources from the Centers for Disease Control and Prevention:

Additional resources from the U.S. Department of Health and Human Services:

References:

Kindig, D. A., Panzer, A. M., & Nielsen-Bohlman, L. (Eds.). (2004). Health literacy: a prescription to end confusion. National Academies Press.

National Institutes of Health. (2017, May 31). Health Literacy. Retrieved from https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/health-literacy

U.S. Department of Health and Human Services. (2008). America’s Health Literacy: Why We Need Accessible Health Information. Retrieved from https://health.gov/communication/literacy/issuebrief/

U.S. Department of Health and Human Services.  (N.d.). Quick Guide to Health Literacy: Fact Sheet – Health Literacy Basics. Retrieved from https://health.gov/communication/literacy/quickguide/factsbasic.htm

U.S. Department of Health and Human Services.  (N.d.). Quick Guide to Health Literacy: Fact Sheet – Health Literacy and Health Outcomes. Retrieved from https://health.gov/communication/literacy/quickguide/factsbasic.htm
U.S. National Library of Medicine. (N.d.). Health Literacy: Definition. Retrieved from https://nnlm.gov/initiatives/topics/health-literacy

Student Develops Jelly Drops to Support Dementia Patients Like his Grandmother

As we age, we naturally lose our sense of thirst, increasing our risk of dehydration. This risk is even greater among older individuals living with dementia. Individuals with dementia may experience trouble swallowing thin liquids as well as memory loss. This was true for Lewis Hornsby’s grandmother, Pat, who struggled with dehydration. After an unexpected rush to the hospital, Lewis found his grandmother had been severely dehydrated, and it took 24 hours on IV fluids for her to return to her normal state.

Recognizing his grandmother’s struggle with dehydration, Lewis, an innovative engineering student at the Imperial College of London, developed “Jelly Drops.” These colorful, jelly-like treats contain over 90% water as well as other ingredients that give it its solid state. This solid state allows the body to slowly break down the Jelly Drop, maximizing hydration. But Lewis’  innovation does not end with the Jelly Drop alone. The Jelly Drops are stored in a clear box so that you can see the colorful treats. The box also contains a booklet with talking points to encourage social interaction between care home residents and their caretakers. Lewis’ innovative Jelly Drops is a result of thoughtful research. Some of this research involved living in his grandmother’s care home and observing the behaviors of residents as well as meeting with dementia psychologists and doctors.

Lewis has already received two awards for his Jelly Drops invention: the Helen Hamlyn Design Award – Snowdon Award for Disability as well as the Dyson School of Design Engineering DESIRE Award for Social Impact. According to his Facebook page, Jelly Drops are not available for purchase at this time as he is conducting further research and trials using the product.

What an exciting, real-life example of public health innovation! – To read more about Lewis’ Jelly Drops project, visit his project page on The James Dyson Award website.

References

Nelson, Elizabeth. (N.d.). Young Man Invents “Water You Can Eat” to Help Dementia Patients Like His Grandma Stay Hydrated. Retrieved from https://blog.thealzheimerssite.com/jelly-drops/

Royal College of Art. (N.d.). Lewis Hornsby. Retrieved from https://www.rca.ac.uk/students/lewis-hornby/

The James Dyson Foundation. (2018). Jelly Drops. Retrieved from https://www.jamesdysonaward.org/2018/project/jelly-drops/

Tuchtan, Vicki. (2016). Dehydration: how it affects the elderly and what to do about it. Retrieved from http://www.sageagedcare.edu.au/blog/dehydration-how-it-affects-the-elderly-and-what-to-do-about-it/

Dr. Leana Wen Selected as New President of Planned Parenthood

Last week, it was announced that Dr. Leana Wen, Baltimore City Health Commissioner, will serve as the new president of Planned Parenthood Federation of America, an organization that provides vital sexual and reproductive health care and education to millions of people around the world. Dr. Wen will be the first physician in almost 50 years to serve in this role. She will succeed Cecile Richards, who has served as president of Planned Parenthood for the past 12 years.

Dr. Wen, an emergency medicine physician, has led the Baltimore City Health Department since January 2015. She is a passionate public health leader and active champion for communities and patients. During her tenure as Baltimore City Health Commissioner, Dr. Wen led a lawsuit against the Trump administration after its abrupt decision to cut funding for teen pregnancy prevention programs, resulting in $5 million of funding being restored to two of these programs in Baltimore. Additionally, Dr. Wen has fought to preserve Title X in Baltimore, which funds a variety of health care services for low-income women.

Dr. Wen is no stranger to Planned Parenthood. After she and her family immigrated to the U.S. from China, they depended on Planned Parenthood for their health care. Dr. Wen also volunteered at a Planned Parenthood health center in St. Louis during medical school.

In a recent statement posted on the Baltimore City Health Department website, Dr. Wen wrote:

“A core principle in public health is to go where the need is. The single biggest public health catastrophe of our time is the threat to women’s health and the health of our most vulnerable communities.”

She continues, in referring to Planned Parenthood, writing:

“I have seen firsthand the lifesaving work it does for our most vulnerable communities. As a doctor, I will ensure we continue to provide high-quality health care, including the full range of reproductive care, and will fight to protect the access of millions of patients who rely on Planned Parenthood.”

Dr. Wen’s last day as Baltimore City Health Commissioner will be Friday, October 12th, where she will then begin her new role as President of Planned Parenthood.

References:

Planned Parenthood. (N.d.). Dr. Leana Wen. Retrieved from  https://www.plannedparenthood.org/about-us/our-leadership/dr-leana-wen

Planned Parenthood. (N.d.). Cecile Richards. Retrieved from  https://www.plannedparenthood.org/about-us/our-leadership/cecile-richards

Zernike, Kate. (2018, September 12). Planned Parenthood Names Leana Wen, a Doctor, Its New President. Retrieved from https://www.nytimes.com/2018/09/12/us/politics/planned-parenthood-president-wen.html?rref=collection%2Fsectioncollection%2Fpolitics

Wen, Leana S. (2018, July 6). Trump’s family planning dystopia. Retrieved from http://www.baltimoresun.com/news/opinion/oped/bs-ed-op-0708-wen-dystopia-20180703-story.html

Baltimore City Health Department. (2018, September 12). Statement from Baltimore City Health Commissioner, Dr. Leana Wen. Retrieved from https://health.baltimorecity.gov/news/press-releases/2018-09-12-statement-baltimore-city-health-commissioner-dr-leana-wen

Faculty Spotlight: Dr. Maria Leonora “Nori” Comello

Our IHC Colloquium class was recently joined by none other than Dr. Maria Leonora “Nori” Comello, Associate Professor in the School of Media and Journalism at The University of North Carolina at Chapel Hill.  Dr. Comello spoke with our class about her research and work at UNC, describing her path to research and academia.

Dr. Comello’s research involves the intersection of strategic communication, health, and identity. Some of her most recent research (1) has focused on the role of intrinsic motivation in recreational videogames and its effect on psychological outcomes among cancer survivors. Dr. Comello and her team found that cancer survivors were motivated to play videogames for “intrinsic rewards” such as stimulation and having a sense of accomplishment, as well as for development of self and a sense of community.

Outside of her research, Dr. Comello has also taught several courses in the UNC School of Media and Journalism, including: PR Campaigns, Advertising & PR Research, and the Interdisciplinary Health Communication Seminar.

Dr. Comello completed her M.S. degree in Technical Communication and Ph.D. in Communication at Colorado State University and The Ohio State University, respectively. She joined the UNC School of Media and Journalism in 2010.

References:

1. Comello, M. L. G., Francis, D. B., Marshall, L. H., & Puglia, D. R. (2016). Cancer    survivors who play recreational computer games: Motivations for playing and associations with beneficial psychological outcomes. Games for health journal, 5(4), 286-292. DOI:10.1089/g4h.2016.0003

The Keto Diet: Healthy or Unhealthy?

It seems like every couple of years a different diet fad takes the world by storm, often touting weight loss and/or a host of health benefits, and the ketogenic “keto” diet is no exception. This latest diet trend has produced quite the buzz in recent years for its potential weight loss benefits, but the verdict seems mixed on just how healthy this diet may be.

The keto diet is a low-carbohydrate, high-fat diet. This includes eating foods such as meats, cheeses, eggs, fish, and oils, and avoiding foods such as breads, fruits, starchy vegetables, and sugars.  Carbohydrates provide our bodies with glucose that gives us energy. By consuming less carbohydrates, our bodies are forced to turn to fats as a source of energy, placing our body in a state of “ketosis.”

While the keto diet has only recently made headlines, it has actually been used for nearly a century as a sort of last medical resort for treating individuals with epilepsy, particularly children. However, while beneficial for these individuals, it may not necessarily benefit those with other health conditions. Further, it is still  unknown what the long-term effects of a ketogenic diet are.

In an interview with Plant Based News, Dr. Kim Williams, former President of the American College of Cardiology, claimed that, while it may offer short-term weight loss, the keto diet offers limited health benefits. Furthermore, in a recent study by Seidelmann et al. (2018), researchers found that low-carbohydrate diets that relied on animal proteins and fats were associated with greater risk of death. As Dr. Marcelo Campos, lecturer at Harvard Medical School, describes, the keto diet can include heavy red meat and unhealthy foods that are fatty and processed. Further, the keto diet may lead to nutritional deficiencies given its high-fat diet. Ultimately, Dr. Campos suggests that individuals engage in long-term, sustainable change, consuming a balanced, unprocessed diet as opposed to a short-term diet like the keto diet.

What are your thoughts on the keto diet? Let us know in the comments below!

References

Belluz, Julia. (2018, June 13). The keto diet, explained. Retrieved from https://www.vox.com/science-and-health/2018/2/21/16965122/keto-diet-reset

Campos, Marcelo. (2017, July 27). Ketogenic diet: Is the ultimate low-carb diet good for you? Retrieved from https://www.health.harvard.edu/blog/ketogenic-diet-is-the-ultimate-low-carb-diet-good-for-you-2017072712089

Chiorando, Maria. (2018, August 24). ‘No One Should Be Doing Keto Diet’ Says Leading Cardiologist. Retrieved from https://www.plantbasednews.org/post/no-one-should-be-doing-keto-diet-leading-cardiologist

Epilepsy Society. (2016, March). Ketogenic Diet. Retrieved from https://www.epilepsysociety.org.uk/ketogenic-diet

Harvard T. H. Chan School of Public Health. (N.d.). Diet Review: Ketogenic Diet for Weight Loss. Retrieved from https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/ketogenic-diet/

Seidelmann, S. B., Claggett, B., Cheng, S., Henglin, M., Shah, A., Steffen, L. M., … & Solomon, S. D. (2018). Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. The Lancet Public Health.

WebMD. (2017, February 1). What’s a Ketogenic Diet? Retrieved from https://www.webmd.com/diet/ss/slideshow-ketogenic-diet

 

 

Revised Cervical Cancer Screening Guidelines Offer Women More Options

New recommendation guidelines for cervical cancer screening were published this month in the Journal of the American Medical Association (JAMA). These guidelines are an update to the U.S. Preventive Services Task Force (USPSTF) 2012 recommendations on cervical cancer screening. The new screening guidelines now offer women more options and longer screening intervals when it comes to their preventative care. One of the most notable guideline changes is that women aged 30-65 can now get an HPV test alone every 5 years instead of just a Pap smear alone every 3 years, or in combination with a Pap smear every 5 years.

According to the guidelines:

  • Women aged 21-29 years should get a Pap smear every 3 years
  • Women aged 30-65 years can get:
    • A Pap smear alone every 3 years
    • An HPV test alone every 5 years
    • A combination of a Pap smear and HPV test every 5 years

The USPSTF does not recommend screening for women younger than 21 years as well as women older than 65 years who have received adequate screening before and are not at high-risk for cervical cancer.

Cervical cancer was once a major cause of death among women. However, with the advent of screening tests, such as Pap smears, cervical cancer rates have fallen considerably over the years. Still, the American Cancer Society estimates 13,240 women will be diagnosed with cervical cancer in 2018.

Almost all cervical cancers are caused by the human papillomavirus (HPV), a common sexually transmitted infection. There are many types of HPV, some low-risk and some high-risk. Low-risk HPV types can cause warts that can be treated. High-risk types, however, can cause cancer. While the body can often fight off HPV infection, this is not always the case. Some HPV infections can become chronic, and chronic infections with high-risk HPV types can lead to cancer in both men and women if left untreated. However, there are vaccines that can prevent cancers, like cervical cancer in women, caused by HPV. The Centers for Disease Control (CDC) recommends that all children get vaccinated against HPV at age 11 or 12. For young women in particular, the CDC recommends they get vaccinated through age 26.

Because it can take years for cancer caused by HPV to develop and for symptoms to appear, the CDC encourages women to regularly screen for cervical cancer. This includes both women who have and have not vaccinated against HPV, as the HPV vaccine does not protect against all types of HPV that can cause cancer.

References

U.S. Preventive Services Task Force. (2018). Cervical Cancer Screening. Retrieved from  https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening2

Centers for Disease Control and Prevention. (2017, December 16). The Link Between HPV and Cancer. Retrieved from https://www.cdc.gov/hpv/parents/cancer.html

National Institutes of Health. (2018, June 30). Cervical Cancer. Retrieved from

https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=76

American Cancer Society. (2017, November 1). What Are the Risk Factors for Cervical Cancer? Retrieved from

https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/risk-factors.html

U.S. Preventive Services Task Force. (2012). Archived: Cervical Cancer: Screening. Retrieved from

https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening

Centers for Disease Control and Prevention. (2018, August 23). HPV Vaccines: Vaccinating Your Preteen or Teen. Retrieved from

https://www.cdc.gov/hpv/parents/vaccine.html

American Cancer Society. (2015, February 19). HPV and Cancer. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

American Cancer Society. (2017, October 9). HPV and Cancer. Retrieved from

https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-cancer-info.html

Coffee… Good or Bad for Health?

I recently read an article that was published a few days ago in The BMJ regarding coffee consumption and health. I was curious to learn what the findings were, considering that I have heard mixed reviews over the years about the health benefits of coffee.

After conducting an umbrella review of over 200 meta-analyses regarding coffee consumption and health outcomes, Poole et al. (2017) found that drinking three to four cups of coffee a day was associated with lower risk of a variety of health outcomes. According to the article, researchers found that drinking three cups of coffee a day lowered risk for death and cardiovascular disease, compared to non-coffee drinkers. Coffee consumption was also found to lower risk of various cancers, as well as neurological, liver, and metabolic diseases. In women who are pregnant, however, high levels of coffee consumption were associated with higher risk of low birth weight, pregnancy loss, as well as preterm births. Additionally, coffee consumption was found to be associated with an increased risk of fracture in women.

A note that this study mentions is that current evidence on the topic of coffee consumption and health is mainly observational and of lower quality in nature. That said, researchers recommend that randomized controlled trials be used in future research to better understand causal associations between coffee consumption and various health outcomes.

Eliseo Guallar, professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health published an editorial in response to Poole et al. (2017). Dr. Guallar comments that while coffee drinking is generally safe, people should not start drinking coffee for health reasons. Dr. Guallar continues in stating that “some population subgroups may be at higher risk of adverse effects” of coffee consumption. Additionally, Dr. Guallar expressed the importance of the amount of coffee consumption, asserting that there remains uncertainty regarding the effects of higher levels of coffee consumption. However, Dr. Guallar expressed that moderate coffee consumption is safe and can be a part of a healthy diet.

References:

Poole, R., Kennedy, O.J., Roderick, P., Fallowfield, J.A., Hayes, P.C., & Parkes, J. (2017). Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ 2017; 359:j5024. doi: https://doi.org/10.1136/bmj.j5356 

Guallar, E. (2017). Coffee gets a clean bill of health. BMJ 2017; 359:j5356. doi: https://doi.org/10.1136/bmj.j5356 

Research Spotlight: Dr. Noel Brewer

Last week, Upstream Writers were joined by Noel Brewer, PhD, professor of Health Behavior in the UNC Gillings School of Global Public Health and affiliated scholar with UNC’s Interdisciplinary Health Communication program. Dr. Brewer gave an interesting and informative talk about his recent tobacco research involving the effect of cigarette pack messages. His findings showed that pictorial cigarette pack warnings increased smoking quit attempts and 7-day quitting. Additionally, the pictorial warnings were found to work better than text warnings, as they led to more attention, negative affect, social interactions and thinking about the warnings. Finally, because the study’s findings did not fit existing models of health behavior, Dr. Brewer developed the new Tobacco Warnings Model.

Dr. Brewer received his PhD in psychology from Rutgers University and joined the faculty in the Department of Health Behavior at the University of North Carolina at Chapel Hill in 2004. He studies how people make risky health decisions, and he currently directs the UNC Health Cognition & Behavior Lab where he conducts his research. Furthermore, in addition to Dr. Brewer’s tobacco research involving smoking risk communication, his work also focuses on HPV vaccine communication and increasing HPV vaccine uptake, and he currently serves as Chair of the National HPV Vaccination Roundtable. More information about his research can be found here.

In the spirit of Public Health Thank You Day, thank you, Dr. Brewer, for the work that you do to promote and protect public health! 

Practice Gratitude

Thanksgiving is just right around the corner, and while I often try to practice gratitude in my everyday life, I especially find myself during this time reflecting on the opportunities and the experiences that I have had, as well as the people in my life that I appreciate and am grateful for.

I find that when I practice gratitude I feel happier and more confident in my ability to manage any stress I may be experiencing. In a recent study, Mills et al. (2015) examined the relationship between spiritual wellbeing, gratitude, and mental health in heart failure patients. They found that gratitude was associated with better mood, sleep, as well as less fatigue among these patients, demonstrating a positive effect of gratitude on well-being.

Gratitude is free and requires little effort to do, and I believe that it is something that we can all cultivate and practice—not just during the Thanksgiving season, but in our everyday lives. When practicing gratitude, I often reflect on the value that the people in my life have, the value of the experiences that I have had, as well as the opportunities that I have been given. I will document this reflection in my journal, making note of my feelings and thoughts. It is a humbling but rewarding process, and one that I think we can all benefit from.

How do you practice gratitude? What are you grateful for?  

References:

Mills, P. J., Redwine, L., Wilson, K., Pung, M. A., Chinh, K., Greenberg, B. H., … & Chopra, D. (2015). The role of gratitude in spiritual well-being in asymptomatic heart failure patients. Spirituality in Clinical Practice2(1), 5-17. http://dx.doi.org/10.1037/scp0000050

 

November is American Diabetes Month

Diabetes is a chronic disease in which the body is unable to properly process blood sugar levels due to an inability to either produce or use insulin properly. There are more than 30 million Americans living with diabetes, and 7.2 million of those individuals are undiagnosed.

There are three main types of diabetes:

 Type 1 diabetes. With type 1 diabetes, the body does not produce insulin, and as a result, individuals living with type 1 diabetes require insulin injections in order to survive.

 Type 2 diabetes. This is the most common type of diabetes. With type 2 diabetes, the body is unable to produce or use insulin properly. Those living with prediabetes are at an increased risk for developing type 2 diabetes. Approximately 84.1 million adults ages 18 years or older have prediabetes, and 90% of those individuals do not know they have it.

 Gestational diabetes. This type of diabetes can occur in women during pregnancy. Women with gestational diabetes are at an increased risk for developing type 2 diabetes.

While there is no cure for diabetes, it can be managed with the proper medication, by monitoring blood sugar levels, managing stress, and/or with lifestyle changes to diet and exercise. And for people living with prediabetes, type 2 diabetes can be prevented with weight loss, physical activity, and/or healthy eating.

To learn more about diabetes, check out the following resources:

American Diabetes Association

Diabetes – Centers for Disease Control

References

About Diabetes. (2017, June 1). Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html

Diabetes [PDF]. (N.d.) Retrieved from https://www.cdc.gov/media/presskits/aahd/diabetes.pdf

Diabetes Statistics. (2017, September). Retrieved from https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics

Facts about Type 2. (2015, October 27). Retrieved from http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html

Living with Type 1 Diabetes. (2016, November 21). Retrieved from http://www.diabetes.org/living-with-diabetes/recently-diagnosed/living-with-type-1-diabetes.html

Managing Diabetes. (2016, November). Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes

Prediabetes. (2017, July 25). Retrieved from https://www.cdc.gov/diabetes/basics/prediabetes.html

Preventing Type 2 Diabetes. (2016, November). Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-type-2-diabetes

What is Diabetes? (2016, November). Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes