Category: Uncategorized

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).

Along for the (Fluo) Ride

By Arshya Gurbani, M.A. candidate 2018

Fluoridated water, at the right amounts, is beneficial for our dental care. In fact, the Centers for Disease Control and Prevention says it’s one of the ten greatest public health achievements of the 20th century! So why was it necessary for the Orange Water and Sewer Authority to shut down after a fluoridation leak (and water main break) last week? If you’re a resident of Chapel Hill or Carrboro wondering about the risks of “contaminated” water, questioning whether the closing of businesses and workplaces was a necessary loss of income, or if you’re just interested in the water you drink…look no further.

Here are 5 things you should know about the fluoridation of drinking water:

  • Fluoride has proven to be very effective in reducing tooth decay, in children and in adults (Centers for Disease Control)
  • It works by making your tooth enamel stronger which slows decay; it can also help reverse early tooth decay When you consume fluoride, it hangs out in your saliva and is bathes your pearly whites! (American Dental Association)
  • Recommended amounts of fluoride in drinking water are around 0.7 mg/liter—well below the identified danger zone of 2-4 mg/liter (Centers for Disease Control)
  • There’s no evidence that water at recommended levels in drinking water worsens or causes cancer (National Cancer Institute)
  • As of 2012, 75% of the U.S. Population had access to safe fluoridated water (American Dental Association).

On the other hand, there are some who believe that fluoride has no real benefits to adding fluoride to our water, and that in fact it may harm some populations, such as young infants. They note that most developed countries do not add any fluoride to their water, though some counter this by saying speculating that salt or other foods are supplemented.

So there is a bit of a debate on the subject. All things said, I’d be interested in knowing just how high fluoride levels got last week.

OWASA’s website posted this announcement, in case you’re local and are interested as well:

Customers are invited to receive information and to comment and ask questions about the water emergency in the OWASA Board of Directors’ meeting on Thursday, February 9th at 6 PM in the Chapel Hill Town Hall, 405 Martin Luther King Jr. Boulevard.

 

 

Hope for Rare Cancers with the Moonshot Program

by Emily Walsh, an advocate of the Mesothelioma Cancer Alliance

January 12th marks the one year anniversary since the start of the Cancer Moonshot Initiative under President Obama and headed by Vice President Joseph Biden. Similar to the “moonshot” that put a man on the moon in 1969, this plan hopes to achieve the seemingly insurmountable by finding a cure for cancer by the year 2020.

Since it was announced, companies and governmental organizations around the country have begun to form partnerships that will be critical to the Cancer Moonshot in the years to come. In September, the Blue Ribbon Panel, a group formed from industry professionals including cancer research, doctors, and patient advocates from both sides of the red tape came together and released their guidelines for the Cancer Moonshot. Their recommendations will pave the way for this initiative moving forward, and rare cancers like mesothelioma stand to benefit more than they usually would.

With an increased focus on immunotherapy, those who suffer from rare cancers that don’t typically react as favorably to traditional treatments will have more windows of opportunity to not only help themselves, but help others. As it stands, more funding for research, and volunteers for clinical trials are critical. Without the cross-organization improvements in communication fostered by the moonshot, this likely wouldn’t be possible.

Already, $4.8 billion has been promised over the next ten years for the National Institutes of Health, much of which will help support the drive for high-risk high-reward cancer research. As a rare disease, mesothelioma receives very little funding. Currently, 95% of rare diseases have no FDA approved treatment or cure. Any cancer, rare or common, stands to gain just as much from the continual support and drive of the Cancer Moonshot Initiative.

We look forward to what 2017 will bring for cancer patients and their families.

Meso Shield

 

 

 

 

 

 

 

The Mesothelioma Cancer Alliance is dedicated to sharing valid and up-to-date information with those whose lives have been affected by all types of cancer. Learn more about cancer treatments and potential advancements at their site here.

Take a Hike!

by Arshya Gurbani, M.A. candidate 2018

I know, I know—you don’t need a blog post to tell you that hiking comes with health benefits. No surprises there. Sometimes, though, it’s good to get a reminder to get outdoors and get moving! Consider this your friendly reminder, complete with serene photos, to lure you back outside as the weather warms up.

somewhere in North Carolina (courtesy of Unsplash)

somewhere in North Carolina (courtesy of Unsplash)

Hiking is essentially walking—a low impact sport that improves cardiovascular health, helps fight obesity and anxiety, and improves bone strength, as detailed by this nifty handout by the American Hiking Society.  Plus…you can challenge yourself on nature’s obstacle course of rocky surfaces, steep inclines, and slippery slopes. Just in case you’re not a walk in the park type of person.

A healthy mind is equally as important as a healthy body–being outdoors is restorative to mental and emotional health. When outdoors, you are exposed to fresh air, daylight, and beneficial organic compounds.  In fact, some say that outdoor activity should be medically prescribed!

Stone Mountain, Roaring Gap NC

Stone Mountain, Roaring Gap NC

So, if you can, here are a few suggestions to get hiking:

-Join a MeetUp—it’s a great option if you enjoy hiking in company, are terrified of getting woefully lost (yours truly), or are willing to car pool to a scenic location

-Plan a day out with friends—it’ll keep you accountable, and is a great way to catch up and enjoy the local beauty, without emptying your wallets

-Pack some water and snacks, walk out the door, and just keep walking—you don’t need to go far, chase high mountains or trudge through dense forests…just get outside and let your feet take you somewhere new.

Thanks for reading—now get outta here. Take a Hike!

somewhere near Jordan Lake, NC

somewhere near Jordan Lake, NC

Additional references:

Ewert AW, Mitten DS, Overholt JR. Natural Environments and Human Health. Wallingford, England: CABI; 2014.

Gatterer, H., et al. “Effect of weekly hiking on cardiovascular risk factors in the elderly.” Zeitschrift für Gerontologie und Geriatrie 48.2 (2015): 150-153.

Mitten, Denise, et al. “Hiking A Low-Cost, Accessible Intervention to Promote Health Benefits.” American Journal of Lifestyle Medicine (2016): 1559827616658229.

Wolf, Isabelle D., and Teresa Wohlfart. “Walking, hiking and running in parks: A multidisciplinary assessment of health and well-being benefits.” Landscape and Urban Planning 130 (2014): 89-103.