Category: Uncategorized

Next Level Data Presentation

By Arshya Gurbani

It’s probably safe to guess that lot of people studying Health Communication feel strongly about data, how it’s presented, and the “story” it has to tell. I thought it was about time to re-watch this, one of my favorite TED talks, about using statistics effectively. Hans Rosling presents data on child mortality, but in doing so he layers it with context and bias and paints a picture that is remarkably clear and moving.  It’s good stuff–seriously, get some popcorn and a handkerchief before you watch/re-watch it!

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/

 

 

Meditation and Stress Relief

By Arshya Gurbani

Earlier this semester, I heard about Transcendental Meditation (TM) for the first time. It’s defined as a technique that trains one to turn “attention inwards towards the subtler levels of a thought until the mind transcends the experience of the subtlest state of the thought and arrives at the source of the thought” (Mahesh Yogi, 1969). A distinguishing characteristic of this form of meditation is the carefulness with which the pedagogy is preserved–requiring a training process to certify preservation of fidelity to the method. (Wallace, 1970).

An early and foundational study noted physiological changes attributed to practicing TM.  These included decreased heart rate and oxygen uptake, and changes in EEG frequency (Wallace, 1970). Generally, as we’ve heard in class from various individuals who practice, these manifest themselves as lower stress levels, in creased focus, and increased clarity and decision-making power.

Other positive benefits have been described in a variety of populations. TM has been suggested to facilitate decreased drop-out rates from urban schools, improve quality of life in children living with Autism Spectrum Disorder ,  boost immunity levels , and generally improve mental health and well-being.

This New York Times article chronicles the experiences of schools implementing TM in classrooms around NY, largely featuring success stories, while still noting that research on the use of TM in an academic setting is not yet conclusive.

There is room to speculate whether TM is radically different form other forms of inward reflection. Surely, there are many ways to reduce stress and enhance productivity, of which TM is just one. With TM on my radar, I look forward to seeing if research can discern TM as a distinctively beneficial.

 

Non-linked References:

M. Mahesh Yogi, The Science of Being and Art of Living (International SRM, – London, rev. ed., 1966), pp. 180-209.

Wallace, R. K. (1970). Physiological effects of transcendental meditation. Science, 167(3926), 1751-1754.

*credit for articles/reference guidance to EPID799c course resources made available to students

Dining with Dysphagia

GUEST BLOG, By Colleen O’Day

Dysphagia is a swallowing disorder that can affect patients of all ages under a variety of medical conditions. According to the ASHA, one in 25 adults in the United States experience swallowing problems. However, since the disorder spans across ages and medical conditions, research indicates that its prevalence may be underestimated.

When working with patients with dysphagia, the role of a speech-language pathologist (SLP) is to diagnose and manage patients’ dysphagia. However, a recent project from Speech@NYU – NYU Steinhardt’s online master’s in speech-language pathology – sheds light onto not only how SLPs can do more for patients with dysphagia, but also how patients with dysphagia don’t have to let their medical condition impact their eating experience.

Dining with Dysphagia: A Cookbook is a collection of recipes that are both easy to follow and easy to swallow. Based on the NYU Steinhardt’s annual Dysphagia Iron Chef Competition, the goal of these recipes is to make eating an enjoyable experience for individuals with all levels of dysphagia.

Colleen O’Day is a Community Manager for Speech@NYU, the online master’s in speech-language pathology from NYU Steinhardt. You can find her on Twitter @ColleenMODay.

 

 

 

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.

Kaiser Health News covers the Repeal of ACA

You couldn’t really make the case that the American health care has ever been easy to follow. Maybe, though, it’s more on your radar now, with the Trump administration’s promise to repeal the Affordable Care Act and impending changes on the horizon. With a very uncertain political climate, the need for effective health communication is evident because transparency and comprehension are key for informed decision-making.

One source that may prove informative is Kaiser Health News. They’re open to would-be health communicators sharing and spreading their stories (for free, so long as you credit them), and they’ve been especially attuned to changes in health care policy of late. In fact, their beat Repeal & Replace Watch monitors the progress of the new administration, providing policy updates peppered with analysis and data to explain them. Some pieces are originals, and others link to reputable sources, allowing for breadth as well as depth of coverage.

Well, so I bet you’re wondering, “What did the cover today?” A lot! But here’s what I read: In an article on the individual health insurance market, they explain legislation discussed in Congress today.  We’ve been hearing for a while that the Trump White House has no concrete plan to roll out a new health care infrastructure, but this is the first tangible sign of what might lie ahead. Basically, as explained by KHN author Julie Rovner,  insurers thought that consumers were taking advantage of the market by only buying coverage when needed it—which makes them a high risk population. The new rule makes it harder to buy coverage for only short periods of time, and gives insurers more flexibility. However, Rovner notes, there is concern as to whether the rule can be implemented in time for 2018 roll-outs, because insurers would need to decide by early may where they will opt to sell insurance for next year.

She goes on with details on how key market players, representing insurers as well as patients, and politicians responded this news (mixed responses, of course).