Author: Arshya Gurbani

Physiology and Space Travel

Next week will mark the 48th anniversary of the first manned moon landing, conducted by Apollo 11 on July 20th, 1969. It marked a momentous and patriotic moment for the United States, which remains the only country to have successfully accomplished this task, and for the field of aeronautics as a whole. Indeed, “a giant leap for mankind”! (more information about the landing itself here).

Long space missions like Apollo 11 are also a huge physiological feat. Conditions on Earth aren’t the same as they are in space, or on other celestial bodies. Microgravity and radiation effects, just to name two, are really different on the moon than they are here at home. When you go on a mission to Mars, for instance, your body goes through three separate gravity fields. And when you are in the spacecraft, you are exposed to a very contained and unique ecosystem. Scientists back home monitor saliva, urine and blood content to ensure latent viruses, like herpes or Epstein-Barr, are not reactivated.  Astronauts are also subject to about ten times more radiation than normal when they visit the space station, which can have immediate as well as longer term effects on the central nervous system.

As one article published in the Canadian Medical Association Journal sums it up, “astronauts are people with normal physiology who live in an abnormal environment”. Here are some changes the body makes in order to adapt, or acclimatize, to space travel (summarized from this nifty table here):

  • Fluid re-distribution (a temporary in-flight decreased flow to the legs, and increased flow to the head and torso)
  • Neurovestibular effects (the motion sickness astronauts can expect to feel when traveling)
  • Muscle mass changes (mass will decrease up to 30% and will regain/recover post-flight)
  • Bone demineralization (a loss of almost 60-70% in calcium, as well as decreased thyroid activity and Vitamin D production, which recovers upon returning to Earth)
  • Psychosocial effects (Weariness and emotional effects)
  • Immune dysregulation

There are some measures that can be taken to counter these effects, including the following: exercise, negative pressure space suits, anti-nausea medication, resistance training, diet supplements, and exposure to artificial gravity during flight.

Curious to learn more? Here are a few more fascinating reads to get you started from Harvard, the Smithsonian, and StatNews.

Side Note–if you’re a local NC reader, I hope you’ve visited Morehead Planetarium, on UNC’s Chapel Hill campus! Apollo mission astronauts Neil Armstrong, Buzz Aldrin, and Michael Collins all trained here–as well as other space giants.

 

Turmeric’s Health Benefits

To this day, if I’m feeling a little under the weather, my parents will prescribe a healthy dose of turmeric. Sore throat? Teaspoon of turmeric in warm milk. Acne acting up? Make a turmeric paste. Feeling weary? Add some more turmeric in your veggies when you cook.

Turmeric is a naturally bitter spice, but my ma and pa are right–it’s somewhat of a super food! It’s an anti-oxidant as well as an anti-inflammatory agent. It’s also been known to have anti-fungal and anti-cancer properties.

Curcumin, the phytochemical that gives turmeric it’s trademark yellow color, makes up about 2-5% of turmeric, but is responsible for most of its recognized therapeutic effects. It was first extracted from turmeric in the early 1800s and since then has been used extensively in Asian cooking, religious ceremonies, and for medicinal purposes. It works by regulating transcription factors (proteins that are important in converting DNA to RNA, which then codes for genes). It is also thought to bind to cellular proteins, and to be able to help stop the growth of tumor cells.

But wait, there’s more! With that strong yellow color, it makes a very effective natural food coloring, and can function as a preservative of sorts. All in all, not a bad spice to throw in the mix every now and again.

I think I may just roll my eyes a little less the next time my mom tells me drink a warm cup of haldi (Hindi for turmeric) milk before bed.

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 🙂

Transparency during Outbreaks-a Balancing Act?

Communicating about a potential public health concern can put a national voice in a tricky position. This was the situation the Indian government found itself in earlier this year when isolated cases of Zika broke out in the state of Gujarat.

Some argue that it is absolutely essential for the government to keep the public aware of even threats deemed low, as a step towards increased preparedness in the event of an outbreak (Scroll.In). The New York Times cites Dr. Swaminathan, the director-general of the Indian Council of Medical Research, as justifying the lack of communication as rooted in a need to prevent undue panic. Similarly, the Wire interviewed Dr. Ravindran, the director of emergencies in the Ministry of Health and Welfare , who reports that as the WHO did not declare ZIKA as a continued PHEIC (Public Health Emergency of International Concern), the government was not obligated to report these cases, as noted in the International Health Regulations. The cases were reported after being further investigated.

Which brings us back to a question of responsibility: What guides risk communication?

A document published in March 2016 by the WHO provides some guidance. They define risk communication as “the real-time exchange of information, advice, and opinions between experts, community leaders, or officials and the people who are at risk”. It goes on to identify who the at-risk populations are, the best channels for communication, and guidelines on content. By and large, it stresses the point that risk communication has the goal of empowering, above and beyond informing.

Social media have had a significant positive impact in real-time health communication in recent years. For instance, SMS/Tweets were used to identify vaccination locations during the 2009 H1N1 outbreak. On the other hand, such a large volume of information can be difficult to manage. An example of this chaos was witnessed in the Fall of 2014, when the United States saw an Ebola outbreak (Ratzan, 2014).

All to say…risk communication requires deliberation and thoughtful consideration. While the Zika cases in India continue to be a story that sparks a lot of push-back, rightfully so, it’s important to see the flip side of that coin.

 

 

 

 

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.

 

 

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/

 

 

Why our perception of beauty is skewed

My friend asked me last night, seemingly out of the blue, “Do you ever wonder why stores separate their plus size clothes?”

The truth is, it didn’t cross my mind until she asked it. But I haven’t stopped thinking about it since because, really,  it seems like a classic microagression–a small, perhaps mundane but not insignificant–manner by which to separate people who lie outside of what, at some point, became considered the norm. Not that it should matter, but a 2016 VCU article cited data claiming that over 60% of women in the US wear clothes that are plus or extended sized. Another article notes that plus size women account for 28% of the clothing market (Binkley, 2013). With an affected population that substantial, it’s even more glaring how insensitive we can be.

A 2016  article published in Body Image links anti-fat attitudes, body shaming, self-compassion, and fat-talk in female college students. They found that internalizing body-shaming led to engaging in fat-talk, among other negative anti-fat attitudes. They found the converse to be true as well–that self-compassion leads to better psychological well-being and less engagement with objectification and self-denigration. The health education and communication implication of all this, is to promote self-compassion (Webb, 2016).  It isn’t hard to imagine that segregated stores don’t play into a healing cycle very well.

Though there has been a recent movement for models to that match all body types, the retail industry still largely caters to a frankly thinner than average body type. Consider the last mannequin you saw that wasn’t unrealistically proportioned. I can’t recall a single one…

One article says these social pressures, among others like harsh lighting and narrow spaces in dressing rooms,  are driving plus-sized women to opt towards online shopping (Money, 2017).  Despite some small successes, Money says, men and women of size “are clearly tired of limited options and unwelcome shopping experience”.

The thing is, it wasn’t a question out of the blue. She had gone shopping with her cousin. It should have been a fun  outing– bonding, enjoying rare time together, catching up and picking out clothes for each other. Instead, they parted ways near the entrance of the store.

References:

Binkley, Christina (2013, June 12), “On plus side: New fashion choices for size 18,” The Wall Street Journal, Retrieved from http://online.wsj.com/news/articles/SB100014241278873 23949904578540002476232128.

Money, C. N. (2017). Do the Clothes Make the (Fat) Woman: The Good and Bad of the Plus-Sized Clothing Industry. Siegel Institute Ethics Research Scholars, 1(1), 1.

Webb, J. B., Fiery, M. F., & Jafari, N. (2016). “You better not leave me shaming!”: Conditional indirect effect analyses of anti-fat attitudes, body shame, and fat talk as a function of self-compassion in college women. Body image, 18, 5-13.

http://www.hercampus.com/school/vcu/problems-womens-plus-size-clothing