Category: Uncategorized

Potato & Peas Stew

In the heat of June you wouldn’t expect to crave a warm stew. The summer storming we had last week, though, got me thinking about my mom’s comforting potato and pea stew. It’s warm, just a tad spicy, filling, and pretty healthy! Try it out next time the clouds look gloomy:

Ingredients:

4 tbsp oil

1 tbsp cumin seeds

3 large potatoes

1 12 oz bag of frozen peas

3 medium tomatoes

4 cloves garlic

2-4 oz water

Seasoning: turmeric, coriander powder, salt

Fresh cilantro, for garnish

 

Heat oil, then add in cumin seeds and minced garlic. Saute until golden brown. Add in cubed potatoes, and some water. Then cover and let cook until potatoes are almost done. Add in chopped tomatoes, mushing and mixing until well combined. Add in frozen peas. Season with salt, turmeric, and coriander powder, to taste.

When potatoes are cooked through, garnish with chopped cilantro.

Serve over rice or with naan/roti.

Enjoy 🙂

What’s Ruining Healthcare, Again?

Forbes published an article earlier this week titles “10 Ways Lack of Communication is Ruining Healthcare”. If you’ve been following healthcare at all since January, “ruining healthcare” is not an unfamiliar term to hear tossed around, but wouldn’t you think that was all due to politics.

It may or may not be surprising to you that the tragedy they’re referring to is lack of communication–between hospitals, between health care workers, between patients and providers, between institutions…..gaps, all around!

If you need a little inspiration after reading that article, check out this TED talk by Eric Dishman, on why and how healthcare is a team sport:

Switchpoint Conference-2017

Switchpoint is an annual conference brought to North Carolina by IntraHealth.

With a massive stage that hosted a diverse array of speakers and presenters, the energy in the Haw River Ballroom last week was almost tangible last Thursday and Friday, for the 7th annual conference.

The day I attended was filled to the brim–speakers ranging from behavioral economics to digital epidemiology to “Artivism”, break-out sessions with hands-on activities, and live music. One of the main goals of the conference was to allow speakers of similar mindsets, from across the country, to network and connect. That’s a cool thing to see happen before your eyes.

I’ll leave it to you to check out the speakers’ profiles and the microlab sessions made available to participants, form your own opinions or get inspired as the case may be. But I will say that as a Health Communication student, it was a nifty experience and definitely provided some food for thought. I’d highly recommend it to other students in this field or in public (especially global) health.

And on that note, to the other students: good luck finishing of the semester strong!

 

 

Summer Tanning

With summer just around the corner, the beach calls: sun, sand, and a chance to get the long-awaited tan. Carefree, however, doesn’t mean careless. It’s important to remember that, as our first defense against the outside world, the skin is subject to a lot of damage. About 90% of melanoma cases are caused by UV exposure (which can occur with indoor tanning or unprotected exposure to the sun).

The Journal of Health Communication reported in a March 2017 article that one way to more effectively convey the long-term negative impact of tanning beds was by pairing them with images of skin cancer or wrinkles. The study showed that these messages were more effective than images depicting short term effects. A 2008 study reports a 75% increase in risk for melanoma with use of artificial tanning devices, and a higher risk when first UV exposure via indoor tanning is in the teenage years. Looking at two decades of targeted campaigns, it attributes, in part, an increase in indoor tanning to a failure of messages to influence tanning attitudes.

The CDC defines indoor tanning as using a tanning bed, booth, or sunlamp–all of which expose users to UVA and UVB rays. This may lead to increased risk for melanoma, basal cell carcinoma, squamous cell carcinoma as well as cancers of the eye and cataracts. Their site also cites a 2014 article that estimates more than 400,000 of indoor tanning related cancer cases per year in the United States.

This is a significant burden–in fact, the FDA proposed a rule that would restrict minors from participating in indoor tanning.

Sources:

http://www.news-medical.net/news/20170425/Images-showing-impacts-of-indoor-tanning-may-be-effective-in-communicating-health-risks.aspx

Robinson JK, Kim J, Rosenbaum S, Ortiz S. Indoor Tanning Knowledge, Attitudes, and Behavior Among Young Adults From 1988-2007. Arch Dermatol. 2008;144(4):484-488. doi:10.1001/archderm.144.4.484

Sontag, J. M., & Noar, S. M. (2017). Assessing the Potential Effectiveness of Pictorial Messages to Deter Young Women from Indoor Tanning: An Experimental Study. Journal of Health Communication, 1-10.

Wehner, M. R., Chren, M. M., Nameth, D., Choudhry, A., Gaskins, M., Nead, K. T., … & Linos, E. (2014). International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA dermatology, 150(4), 390-400.

 

 

Naming Flu Viruses-Nothing to Sneeze At!

By Arshya Gurbani

I’m sorry about the title, too. I heard a pretty ridiculous pun today, and I guess they’re just contagious…much like the flu.

That’s right–sure as the sun rising each morning and the certain as the pride every Tarheel felt following last week’s momentous basketball victory…flu season is back again. In the US, flu season tends to peak somewhere between December and March. A highly variable virus, influenza strains are often different than the previous years’, which leads to the need to constantly update and refine  recommended vaccines for the year. It’s why you have to go back to get a flu shot every year.

Of course, it’s important to know what you can do to prevent getting ill. If you need a refresher, quick shout-out to a fellow UpstreamDownstream blogger from the past: Surviving Flu Season.  But I thought it’d be kind of fun to talk about the influenza virus itself. (You may roll your eyes at “fun” but you’re still reading…)

There are 4 types of the influenza virus, A-D. Influenza A and B are the most common causes of the seasonal epidemic known as the flu that afflicts the US. The A viruses has hemagglutinin and neuramidase surface proteins, also called H and N subunits. That’s where the name of a particular strain comes from. Remember the H1N1 pandemic in 2009? That’s right–the H1 refers to 1 of 18 known H subtypes, and N1 refers to one of 11 known N subtypes. Both of these proteins live on the outside layer of the virus, also known as the viral envelope. They act sort of like bridges, connecting the virus to our cell membranes by latching on to one of the sugars in our cell membranes, sialic acid–H helps the virus enter our cell, and N helps it leave. Pretty nifty, right? Here’s a helpful visual from David Goodsell’s “Molecule of the Month” blog featuring H and N:

 

 

As mentioned earlier, the strain of influenza virus most prevalent in any given season can change. Now that we have a vague idea of the naming system, let’s talk about which strains vaccines recommended for the 2016-2017 season protect against. There are 3-component and 4-component vaccines:

  • A/California/7/2009 (H1N1)pdm09-like virus
  • A/Hong Kong/4801/2014 (H3N2)-like virus
  • B/Brisbane/60/2008-like virus (B/Victoria lineage)
  • B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage) –only in 4 component vaccines

So far this season, according to a Morbidity and Mortality report looking at data from Oct-Feb, the A(H3N2) virus has been the most prevalent. Around 94% of infections were caused by Influenza A, and 98% of these were attributed to the H3N2 strain. Overall, the report says, it’s been a pretty moderate season.

I hope you enjoyed that brief dip into biology–who knows, if enough of you did, maybe this post can go, you know ….viral.

References:

https://www.cdc.gov/flu/about/viruses/types.htm

https://www.cdc.gov/flu/about/season/flu-season-2016-2017.htm

http://blog.h1n1.influenza.bvsalud.org/en/2009/09/10/molecule-of-the-month-presents-hemagglutinin-and-neuramidase/

 

 

Promoting Healthy Habits? Tell a Story

Researchers at the University of Southern California have been studying how narrative influence health behavior. They wonder if it might not be more effective to present information as a story. Their results thus far show that, in fact, this may be the case.

Narrative communication has been defined “any cohesive and coherent story with an identifiable beginning, middle, and end that provides information about scene, characters, and conflict; raises unanswered questions or unresolved conflict; and provides resolution”.

A recent article published by the Contributor and re-published by US News  discusses a study that attribute the greater success of narrative-driven presentation to 2 key factors: 1) identification with characters and 2) transportation to and absorption in the story. Both of these psychological processes assist with retaining information. Harnessing this to create characters that are identifiable role models is the key, the author says, to reducing health disparity.

Not surprised by this finding? It does seem somewhat intuitive that something with a story-line is more appealing. The point is, it’s not necessarily how we think to present a message with a scientific or health-rooted concern. We tend to rely on facts, or on recommendations. The article suggests that collaboration across disciplines is important in reaching the most beneficial results.

Utilizing narrative can be tricky, however. A 2016 article on the subject, published in Health Affairs, notes some possible limitations to incorporating narrative into clinical practice. For instance, it may be hard to generalize data that is based on narrative–it may not appeal widely nor have equal effect in diverse populations. Confidentiality may be another barrier. These make it difficult, the authors say, to translate good narrative into practice. They do offer some recommendations on how to address the problem. However, it’s clear that there is a gap to be bridged.

It’s a good reminder that sometimes data collected is only a glimpse of the human it represents.

References:

Dohan, D., Garrett, S. B., Rendle, K. A., Halley, M., & Abramson, C. (2016). The importance of integrating narrative into health care decision making. Health Affairs, 35(4), 720-725.

Hinyard, L. J., & Kreuter, M. W. (2007). Using narrative communication as a tool for health behavior change: a conceptual, theoretical, and empirical overview. Health Education & Behavior, 34(5), 777-792.

https://www.usnews.com/news/healthcare-of-tomorrow/articles/2017-03-03/stories-are-better-than-lectures-at-teaching-us-about-health

 

GOP Proposal for the American Health Care Act in the works

The Huffington Post reported this morning that the American Medical Association (AMA) is joining other big names in health and patient advocacy to push back against the GOP proposed health bill to replace The Affordable Care Act.

The AMA has historically been a key voice in health care, often opposing national level reform in order to protect clinical practice. However imperfect the 2010 roll-out of the Affordable Care Act (ACA/ObamaCare was), they agree that certain aspects of the ACA should not be rolled back now. In particular, they agreed that the ACA allowed for Medicaid expansion to cover more lower income individuals. They make the argument that the newly proposed bill provides government subsidies based on age, rather than income, which would be  problematic and cause loss of coverage and higher costs.

Other groups that are pushing back against this reform include the American Health Care Association, the American College of Physicians, the American Hospital Association, the National Center for Assisted Living, and the National Health Council. So who actually agrees with the proposed bill? The medical device industry, who claim that cutting taxes on medical devices will allow for growth in innovation that will eventually lead to better care. The counter argument to this claim, it seems, is that though quality of care must indeed improvement, this is irrelevant if people who need it cannot even afford coverage.

If you’d like to read up more on the proposal, the American Health Care Act, and how it differs from what is currently in place, check out Kaiser Health News’ article on the subject. They explain the funding changes the proposal suggests: how tax credits for insurance will change, the addition of caps to the current Medicaid funding, benefits fort he wealthy, penalties for those who have gaps in coverage, and a change to a free market system.

As expected, much is still unclear, but the calls to slow down the repeal process while details are ironed out appears to be quite loud.

Sources (linked in text): The Huffington Post, Kaiser Health News, U.S. Department of Health and Human Services

Nothing but Nets-Challenges to Inspiring Behavior Change

GUEST BLOGGER: Carolyn Windler

Carolyn Windler is a member of The United States Peace Corps, currently serving in Togo, West Africa as a Community Health and Malaria Prevention Volunteer

National Eating Disorder Awareness Week

By Arshya Gurbani

Feb 26th-March 4th is National Eating Disorder Awareness Week 2017. Whether you or someone you know is affected by an eating disorder or you just want to learn more about them, the National Eating Disorders Association has a lot of helpful toolkits to help jump start important conversations.

The most common and identifiable eating disorders are Anorexia Nervosa, Binge Eating Disorder, and Bulimia Nervosa, though there are other eating disorders not otherwise specified.

The role of the media in discussing body image, weight, and eating disorders is powerful. “Media stories about obesity and eating disorders often create images that bear little resemblance to the scientific, clinical, and even lived realities of these conditions” begins one 2014 book on the subject (citation below). Another researcher discusses the role of Facebook in increasing anxiety around weight  or shape . This is not to say that media cannot have a positive impact or generate positive dialogue, but just to recognize that how we talk about eating disorders matters.

If nothing else, we can use this week as an opportunity to intentionally speak about body image and eating in a healthy way. One cool initiative here at UNC’s Campus is done in conjunction with our Campus Recreation facilities; group fitness instructors and coaches will incorporate the theme of NEDA throughout classes and training this week, through actions such as “Mirror-less Monday”, for which mirrors at the gym will be covered, encouraging participants to think about how they feel (as opposed to how they look).

At the end of the day, we all eat. ( Well, hopefully at the beginning of the day too…they still say breakfast is the most important meal!) It has to be incredibly difficult when a daily activity is a major cause of stress.

Eli, K., & Ulijaszek, S. (2014). Obesity, Eating Disorders, and the Media . New York : Ashgate Publishing .

Equity vs Equality: Understanding the Difference in Health Communications

GUEST BLOGGER: Julie Potyraj

In any type of communication, choosing the right words makes a big difference—and this is especially true when it comes to health. Unfortunately, some terms are often interchanged that don’t have the same meaning. That’s why MPH@GW, the online MPH program from The Milken Institute School of Public Health at The George Washington University , worked with an illustrator to visualize commonly confused terms in public health. Two of these, equity and equality, are particularly important in health communications. Here we’ll examine why that’s the case.

Defining the Difference

In the context of education, The Education Trust says that “making sure all students have equal access to resources is an important goal. All students should have the resources necessary for a high-quality education. But the truth remains that some students need more to get there.” This perspective demonstrates that while an equal approach ensures that all parties receive the same resources—an equitable approach considers which resources most effectively support the unique needs of each party.

According to the World Health Organization (WHO), such equity is “the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically.” The WHO highlights the fact that health inequities involve more than a lack of equal access to needed health resources, “They also entail a failure to avoid or overcome inequalities that infringe on fairness and human rights norms.”

Why It Matters

Understanding how health equality and health equity are different is essential to ensuring that consumer needs are adequately assessed and met. When issues of equity are addressed, then resources can be directed in the most effective manner to optimize health outcomes. Providing equal resources to all isn’t the answer to reducing the health disparities gap. Instead, the underlying issues and individual needs of underserved and vulnerable populations must be effectively addressed, as well.

As the Boston Public Health Commission notes, “Achieving health equity requires creating fair opportunities for health and eliminating gaps in health outcomes between different social groups. It also requires that public health professionals look for solutions outside of the health care system, such as in the transportation or housing sectors, to improve the opportunities for health in communities.”

Implications for Health Communications

Health communications play a critical role on a variety of fronts—including those which touch consumers, providers, public health advocates and those involved in policy development and implementation. As such, it’s essential that equity and equality be discussed in the correct contexts to help ensure the effective assessment and delivery of appropriate resources. According to the CDC, “Effectively making the case for health equity requires an understanding of the community context and intended audiences, an appropriately framed message that appeals to core values, and increased awareness of existing health inequities among stakeholders.”

Equity and equality not only affect the messages themselves, but also the way they are delivered and received. Issues such as language, literacy, and access to electronic communications impact the meaning and effectiveness of health communications. If communication equality takes priority over communication equity, too many will fall through the gaps—unable to access the information they need the most.

 

Julie Potyraj is the community manager for MHA@GW and MPH@GW, both offered by the Milken Institute School of Public Health at the George Washington University. She is currently an MPH@GW student focusing on global health and health communications.