Category: Uncategorized

Go NapSACC: A Nutrition And Physical Activity Self Assessment for Child Care

Last week, former Interdisciplinary Health Communication master’s graduate Stephanie Lane came to talk to the members of Upstream about Go NapSACC, a program she worked on at her time as a project manager at the UNC Center for Health Promotion & Disease Prevention.

The Nap SACC program, created in 2002, began when a group of researchers came together and developed a set of self-assessment, action planning, and educational tools to help early care and education programs set goals and make improvements to their nutrition and physical activity practices. Over the last decade, the program was  adopted in child care centers around the United States and recognized for it’s success.

Go Nap SACC is the next generation of the Nap SACC program, featuring new tools on an interactive website. Now, those who run early care and education programs can go online and take assessments in areas such as: child nutrition, infant feeding & breastfeeding, infant & child physical activity, outdoor play & learning, and screen time. The program uses five steps to guide program directors through making improvements. These steps are:

  1. Assess- take the self-assessment online
  2. Plan- use the action planning tool
  3. Take Action- use tips and materials to put plan into action
  4. Learn More- take a training and learn new skills
  5. Keep It Up- celebrate your progress and plan your next move.

Go Nap SACC can also tailor tools and recommendations for different child care settings, and all resources online are free to use. For more information about the program, or to use the resources and take assessments, visit





Do I have a UTI? How do I get rid of it?

Week 11 Blog

The first time I ever heard of a urinary tract infection (UTI), it was my freshman year of college and my suite mate was doubled over in pain crying. The group girls from our hallway who assembled to help out in her time of need were convinced that we needed to call an ambulance. This was during the dark ages before smartphones and Wi-Fi in our dorm, so after tracking down the graduate student that lived in our hallway, she told us that it was probably a UTI and that our suite mate should go to the doctor or urgent care as soon as possible.

A few years later, when I was experiencing the same symptoms for the first time and was also doubled over in pain, it was only because of that experience that I had any idea of what was happening to me. I knew to get to a doctor immediately even though many of the websites I was frantically searching told me that my UTI could be cured by drinking lots of pure cranberry juice and resting.

My health classes in middle and high school didn’t talk about UTIs at all, and I have heard that same story from others as well. Here are some tips for detecting, treating, and preventing UTIs.

What are the symptoms of a UTI?

  • It burns when you pee
  • You feel like you need to urinate constantly, but when you go not much comes out
  • When you do pee it is cloudy, strangely colored, and/or smells bad
  • You feel sleepy and achy

How do I treat a UTI?

  • If you think you may have a UTI, make an appointment with a health care provider right away. They will have you pee in a cup and if you test positive for a UTI, you will soon be on your way home with antibiotics to rest and get better very quickly.
  • Your friend or the internet may tell you that you can cure a UTI at home, but most things like drinking cranberry juice or taking over the counter medicine are either preventative or meant to minimize your symptoms until you are able to see a healthcare provider.

How can I prevent getting a UTI?

  • Pee after sex!
  • Never hold it
  • Always wipe from back to front
  • Keep it clean down there with water in the shower or bath (no soap!)
  • Drink real cranberry juice (with no added sugar) to prevent future UTIs. There are also cranberry pills available at any pharmacy.
  • See a healthcare provider if you are getting frequent UTIs

Do you really need that sports drink?

As the weather warms up and we begin to get back into our exercise routines, concerns about proper and adequate hydration have many people turning to sports drinks in addition to water. But do you really need that sports drink?

Are you…

Doing intense sustained exercise for 90 minutes or more?

An athlete competing in an intense endurance event?

If your answer to these questions is “No,” then you don’t need to be consuming sports drinks. Here are some of the reasons why:

Extra calories

Most sports drinks contain added sugar to provide energy. Sports drinks have been linked to obesity in children and adults and could be counterproductive if you’re exercising to lose or maintain your weight.

Extra sodium

An average sports drink has 1/5 the maximum daily allowance of sodium recommended by the American Heart Association which puts you at risk for high blood pressure, stroke, and heart disease over time. For regular levels of recreational exercise, you probably aren’t sweating enough to lose dangerous amounts of electrolytes (such as sodium).

Enamel erosion

Like many acidic fruit flavored beverages, regular consumption of sports drinks has been linked to significant erosion of tooth enamel.

Artificial colors and flavors

These additives are unnecessary and potentially harmful.

Vitamins or minerals

If you’re eating a healthy and well-balanced diet, you’re getting plenty of vitamins and minerals from your food so there’s no need to supplement unless your doctor has recommended that you do so based on some other medical condition.


Thirst is still the most reliable signal for fluid needs, and if you exercise recreationally, water is still the best way to satisfy that need.  If the flavors of sports drinks are what encourages you to consume the necessary amounts of fluid, try infusing water with fruits like lemon, lime, or berries; vegetables like cucumber; or herbs like mint.

Women Share Stories to Warn Others of Skin Cancer Risk

Last year, 27-year-old Tawny Willoughby shared a graphic selfie showcasing her skin cancer scars on Facebook to warn others about the dangers of indoor tanning. The viral post received thousands of responses and illustrates the success of Willoughby sharing her story online.

Just last week, another woman, Judy Cloud, is now also sharing graphic selfies which also feature the resulting damage of her two-year battle with skin cancer.

While indoor tanning is a clear cause of both these women’s development of the most common cancer in the United States, not practicing basic sun safety can also contribute to the development of basal or squamous cell carcinoma, or even melanoma. In fact, in addition to indoor tanning, Cloud also admits to getting multiple bad sunburns as a child.

Both these women, who have suffered multiple surgeries and long recovery periods, are hoping that by sharing their stories, people will begin to take the warnings of skin cancer more seriously. I am also hopeful that more men and women who have similar stories will follow both Willoughby and Cloud’s lead. In the meantime, especially with spring break this week, remember to follow these simple sun safety tips:

  • Use sunscreen, and reapply every two hours in the sun.
  • Wear protective clothing and hats when out in the sun for long periods of time.
  • Reduce time in the sun by seeking shade every so often.
  • Wear sunglasses to also protect your eyes from UV rays.

So We Need Another YouTube Video on How to Use Eye Drops?

Eye drops

Scott A. Davis is a doctoral student in the Division of Pharmaceutical Outcomes and Policy at the University of North Carolina Eshelman School of Pharmacy.

Given the estimated 1 billion videos currently on YouTube, one might think that every important medical topic must be covered many times over. Thus I wasn’t surprised that my dissertation idea of testing a new online video to improve patients’ eye drop technique was met with some skepticism. Existing YouTube videos feature famous names from the likes of Johns Hopkins, Mayo Clinic, and the UK National Health Service. Why, then, am I proposing another one?

Health literacy: To reach the people who most need educational videos, roughly a fifth-grade reading level is recommended. Thirty-five percent of Americans have a basic or below basic health literacy level, and these are likely the population that need video instruction the most. That means avoiding difficult medical terminology such as “systemic absorption”.

Evidence-based coverage of all steps: Several videos did not mention blocking the tear ducts, hand washing before instilling eye drops, or even avoiding contamination of the bottle by not touch the eye or face. These are crucial steps to avoid eye infections from agents that can grow on the bottle.

vCultural appropriateness: An important study in the glaucoma literature found that their video intervention was less effective in African Americans, who are more likely to become blind from glaucoma than Caucasians. By incorporating the feedback that African American patients have provided in our past studies, we believe we can create a video that actually has the ability to reduce racial disparities in eye drop technique and adherence.

By incorporating these important principles, as well as the most advanced health behavior theory available, I believe our new video will enhance eye drop instillation skills and make much greater impact on the unfortunate burden of glaucoma. What do you think?

GamerGate: a case study of internet harassment


Photo Caption: Zoe Quinn, the original victim of GamerGate, is now an outspoken advocate for victims of internet harassment.

This post was written by Marjorie Margolis. Marjorie is Doctoral student in Health Behavior at the Gillings School of Global Public Health

****TRIGGER WARNING This article or section, or pages it links to, contains information about sexual violence which may be triggering to survivors.****

On August 27, 2014, a feminist advocate for women in the tech industry received the following message via Twitter: “I’m going to go to your apartment at [redacted] and rape you.” This message was part of a larger controversy sweeping the gaming community. At the center of the controversy lay Zoe Quinn, a female game developer whose former boyfriend had explicitly blogged about his allegations of Ms. Quinn’s transgressions during their relationship. Over the next several months, Ms. Quinn and those who spoke in her defense were mercilessly bombarded with violent threats and insults. In a Washington Post article, Zoe Quinn describes how her accounts were hacked, her address and phone number posted online and death threats caused her to flee her house. This incident, dubbed “GamerGate” led to a heated debate about inclusion in the gaming community, internet safety, and freedom of speech.

Some assert that the central issue of GamerGate is an allegation that Ms. Quinn attempted to further her career through intimate relationships and that attempts to publicize these allegations were suppressed. Within social media discussions of GamerGate, arguments about ethics in journalism and whether and when to curtail free speech are interspersed with blatant insults branding Ms. Quinn as sexually promiscuous, manipulative, and lying. Some claim that while they do not condone threats toward Ms. Quinn, they feel that the more pressing issue is the ethics of how games are created and marketed.

This case illustrates a severe example of a disturbing trend on the Internet toward acceptance of violence. In youth, cyberbullying has been associated with increases in depression and suicidal ideation. As people increasingly rely on the internet to create and maintain social connections, understanding how to prevent and address violence that occurs in this channel is an imperative public health concern.

Further complicating the situation is the fact that many people gain valuable support and acceptance from online communities. An underlying thread in GamerGate discussions is the sense of companionship found in the gaming community. Given the strong ties within the gaming community, I find the dismissal of violence in favor of “more pressing issues” to be incredibly disappointing. By shifting the conversation away from the violence occurring in their community, they allow it to perpetuate. Compromising the safety of one member of a community threatens not only that person but the entire group. By turning a blind eye to threats and viscous insults, members of the gaming community not only fail to protect Zoe Quinn but fail to protect themselves.

Additional links:

You may be all grown up, but your brain isn’t.

When you turn 18, you are legally considered an adult, so you can do things like not have to get parental consent to be treated by a doctor, buy lottery tickets, or get arrested and tried for a crime as an adult. When you’re 21, the government declares you old enough to buy and consume alcohol responsibly.

However, just watch any episode of HBO’s Girls to see the blunders and high jinx twentysomething women get up to, and you might understand why the show isn’t called Women. Psychologist Jeffry Arnett has coined the term “emerging adulthood” for those over the hormonal frenzy of adolescence, but have not quite achieved the stability of adulthood. Are  “emerging adults” a product of the bad economy and an overall privileged society, or are there actual differences in our brains?

Research in neuroscience would support the argument for emerging adulthood, at least somewhat. Even though the peak of brain development is in the adolescent years, quite a bit is still happening in your early-to-mid twenties. There is a large increase in dendrites (part of the neuron that receives information) observed during childhood and adolescence, but interestingly, this process still occurs well into our twenties, finally leveling off in our thirties (1). So for those of you who are still in college, take advantage of this unique time; now is the time to form healthy habits. You have the maturity of many older adults in resisting impulses, but still have the “neural flexibility” of learning new things easily. Of course, it’s not too late if you’ve survived the tumultuous twenties; old dogs can learn new tricks (literally), but it just takes a little longer. Learning how to stick to an exercise regime or enjoy healthy meals early in adulthood might help set you up for better health behaviors down the road.

This post is part of the Psy-Friday series; every Friday Zan talks about findings in psychology, and how knowing the mind can influence health and well-being.

(Image credit: “object” by Evan / Flickr / CC BY-NC-ND 2.0)

Warning: E-Cigarette Advertising Increases Urge to Smoke

While controversy surrounds the fact that e-cigarettes are often promoted as a safe alternative to tobacco cigarettes, a recent study shows their advertising may be more dangerous than the products themselves. Researchers at the Annenberg School for Communication University of Pennsylvania found that visual depictions of e-cigarettes in advertisements actually increase daily smokers’ urge to smoke cigarettes and may lead to an increase in actual smoking behavior.

Although tobacco advertising has been banned from television and radio in the United States since 1971; electronic cigarettes, because they don’t use tobacco directly, are not subject to this same restriction. As a result, advertisements promoting e-cigarettes have increased substantially in the last five years.

Given the visual similarities of vaping e-cigarettes and smoking tobacco cigarettes, researchers set out to find out whether visual depictions of vaping would serve as smoking cues, and create a greater urge among daily, intermittent, and former smokers to smoke tobacco cigarettes.

Participants in the study were randomly assigned to either view three e-cigarette advertisements containing visual smoking cues, three without visual smoking cues, or no advertisements at all. They then answered questions about their urge to smoke, their belief that they have the ability to quit smoking, and their attitudes and intentions to quit smoking. What they found was not surprising.

Results not only showed that visual depictions of vaping in commercials increased smoking urge among daily smokers, but also that former smokers exposed to vaping cues reported lower intentions to continue to abstain from smoking. While intermittent smokers did not show any significant differences, researchers attribute this to the fact that their smoking is more situation specific, therefore the ads did not affect them.

While it is clear that more research needs to be done in this area, this study is one of the first of it’s kind to prove the harmful affects of vaping cues and is a big step in the movement towards a ban on e-cigarette advertising.



No Doctor’s Visit Required


As of January 1, 2016, women over 18 in Oregon can now access oral contraceptives without the hassle of a visit to the doctor. Pharmacists can now prescribe the pill after a quick screening process with no extra trip to the doctor’s office required. This new law aims to make the pill more accessible especially for minority, low-income, and young women ages 18–24 that have the highest rates of unintended pregnancies.

This law does not make the pill truly over-the-counter, and the American Medical Association, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians all support making oral contraceptives available without a prescription. However, this will require the cooperation of drug manufacturers and the Food and Drug Administration, and will certainly involve additional testing and more waiting.

While increased access to the pill through this law has the potential to lower unintended pregnancy rates, some worry that it will stall continuing efforts to make the pill available without a prescription. Eliminated need of a doctor’s office could make women less likely to pursue more efficient contraceptive methods such as intrauterine devices and the hormonal implant, and may dissuade women from going to the doctor for essential screening tests. Additionally, the pharmacist screening can potentially cost about $25, creating another barrier to access.

A similar law passed in California in 2013, should become effective on March 1, 2016.

Setting S.M.A.R.T. Resolutions

The New Year is here and we all want to make 2016 our best year yet. This could mean many different things to different people. Some people want to live healthier or happier. Some want to accomplish something tangible, like bike across the country. Some want to finish what they’ve started, like getting that PhD. While others want to try something new, like photography. We all have hopes and aspirations for ourselves. The beginning of the year, a time to reset, always prompts us to make, and often remake, plans to achieve these goals. But why can’t we seem to follow through and attain these dreams?

Perhaps you need to think SMARTER and make a S.M.A.R.T. resolution this year. S.M.A.R.T. goals, or resolutions, are defined as specific, measurable, achievable, results-focused, and time bound (the University of California at San Diego has created a worksheet to help you create your own and be sure to watch the video above). Often we fail to meet goals because they are vague, difficult to measure, unrealistic, abstract, and have no deadline. Because there are so many other obligations in life that are demanding our attention and effort, we push aside abstruse goals in favor of productivity and livelihood. However, if we establish specific actions to take that will help us achieve our larger dreams, we can prioritize time and energy better and hopefully get to where we want to be.

Using apps and social media can help you stay on track. Check out these suggestions from AppAdvice.

Happy New Year and good luck with your S.M.A.R.T. resolutions!