#331

Date: Tue, 20 Feb 2001 09:16:25 -0600
From: "Mark J. Kittleson, PhD, FAAHB" <kittle@SIU.EDU>
Subject: Bob Russell

** The University of Alabama Distance Education
** Master of Arts Program in Health Studies
** http:// www.ches.ua.edu/health
**
** Sr Level Minority Position at Texas A&M;
** http://hlknweb.tamu.edu/Employment (3-18)

For those of you who know Bob Russell I wanted to let you know that he recently had surgery in Carbondale. Around thanksgiving he injured the bottom of his feet and he required a skin graft to allow him to maintain his mobility. I believe these grafts will require that he stay off his feet for several weeks--not real good for a person as active as Bob. For those who would like to contact him he can be reached at either of the following:

Carbondale Memorial Hospital
Room 400, Bed 1
Carbondale, IL 62901
618-529-0721

or home at:

RR2, Box 765
Cobden, IL 62920





Mark J. Kittleson, Ph.D., FAAHB
Professor & Director of Graduate Studies
Southern Illinois University
Home Page: http://www.kittle.siu.edu
HEDIR: http://www.hedir.org
IEJHE: http://www.iejhe.org

------------------------------
#332
Date: Tue, 20 Feb 2001 11:09:04 -0600
From: Nancy Bates <nbates@AMERITECH.NET>
Subject: Soda pop and obesity

** The University of Alabama Distance Education
** Master of Arts Program in Health Studies
** http:// www.ches.ua.edu/health
**
** Sr Level Minority Position at Texas A&M;
** http://hlknweb.tamu.edu/Employment (3-18)

Michael,

As a registered dietitian, I am always frustrated by the media spin on
nutrition and health!

I have only heard about this article briefly on the radio and I don't know
the details of the article (research design and conclusions). It is
unlikely that consuming soda pop or any other food will cause children (or
adults) to gain weight. You are right when you say "The emphasis probably
should have been: "these data suggest that people aren't compensating for
the extra calories by cutting back on eating...," or, "these are estimates
and the study doesn't tell us the importance of soft drinks relative to the
other factors that contribute to obesity....." (quotes from David Ludwig)"

Soft drinks are a very concentrated source of calories that provide only
energy - no other nutrients (about 120 calories per can). Soft drink
manufacturers are giving a lot of money to schools to be able to put pop in
schools so it is much more accessible to kids. In addition, consider the
"up-sizing" of pop at fast food restaurants and 7-11 type stores where it
is promoted as more value for the money. It is easy to see how calories
from soda pop easily add up.


>Is it me, is it a media problem, or a health educator's problem to clearly
>report and/or correct the media?

It's definitely a media problem, but I think health educators need to know
what the media says and have the expertise to understand whether it's
accurate or not and present accurate information in their programs,
newsletters, work, etc.


>If the data is dead on and "an extra soft drink a day gives a child a 60
>percent greater chance of becoming obese...." Do I need to re-learn
>obesity fundamentals. If it is a media problem, how can we get to them,
>get them to state it clearly, and get them, in turn, to get the basic idea
>of calories in/calories out to the public...if in fact that is still valid.

I would caution that obesity is far more complex than calories in/calories
out. As with all illnesses, it is extremely rare to have a complete
understanding of what cause the disease. In fact, it is unusual to explain
more than 40% or so of the occurrence of disease by risk factors/health
behavior theories. While we know that calories in/calories out and
genetics are clearly known risk factors, it is unlikely that reduction of
calories and increased exercise will guarantee weight loss or prevent
further weight gain. Note, however, that I believe strongly that eating a
healthy balanced diet with regular physical activity is important for all,
because of the protective nature of these health behaviors against most
diseases.

> (Hold the information hostage and allow an interview only if they get it
> right!?)

I like this one a lot!!!


>I had a meeting last week with a team and had to swallow hard as the
>recommendation to teach children not to drink soda pop came up as part of
>an obesity lesson for our curriculum (Nurse Rosy Goodhealth's Visiting
>Nurse Program). Reducing soda pop and other sugary/sticky foods that have
>no nutritional value, as a part of an overall overview of nutrition (we
>use the Food Guide Pyramid), is already part of the curriculum, as is
>physical activity (not exercise).

I'm not sure what I'd do about the recommendation not to drink soda pop,
given the better approach in the second sentence about the food guide
pyramid. I don't do nutrition counseling any more, but the kids I know
drink way too much pop and eat candy on a daily basis. Pop in particular
(and candy too) are filling, reducing appetite and replace foods with more
nutritients.


>Of course if I am wrong and the data presented in the media correct, I
>will be gulping hard as I write a new K-5 ancillary health lesson, as well
>as learn new obesity fundamentals.

You are right! Don't rely on the media for accurate health information,
but for what your clients are learning about health (or pseudo-health
recommendations as the case may be!)

>Any ideas?

You might also read nutrition newsletters such as those from Tufts
University <http://www.navigator.tufts.edu> or University of California at
Berkeley <http://www.wellnessletter.com> which routinely address nutrition
issues such as this that come up in the media or are current topics among
the general public. No doubt the soda pop/obesity issue will be discussed
shortly!

Finally, one article does not nutrition policy make!!!! Use these media
indiscretions as a conversation starter to get around to talking about 1) a
healthy diet and that all foods can fit in a healthy diet, 2) point out
that the media is not always accurate in health reporting and 3) that one
research study should not be the basis for a healthy lifestyle.

If health information in the media is confusing to us, think about what it
does to the general public!

Good luck! Nancy Bates



Nancy Bates, MS, RD, CHES, DrPH candidate
Project Coordinator
Center for Research on Women and Gender
University of Illinois at Chicago
(708) 672-8573
nbates@ameritech.net

------------------------------
#333
Date: Tue, 20 Feb 2001 12:59:18 -0500
From: Andrew BILLS <abills@CRITPATH.ORG>
Subject: Sexual Hlth. overview for clinic workers

** The University of Alabama Distance Education
** Master of Arts Program in Health Studies
** http:// www.ches.ua.edu/health
**
** Sr Level Minority Position at Texas A&M;
** http://hlknweb.tamu.edu/Employment (3-18)

Hey Folks, here is a summary of the responses I got to this question:

Hey folks -- I am Looking for a workshop outline on sexual health issues
in clinical practice. We will be doing a training for medical and
nursing students on working with clients in a community clinic setting.
The goal of the training will be two fold: first to increase their
comfort in talking with clients about sexual health and second to
increase their general knowledge base on sexual health issues. Anyone
have ideas of where to look?

Summary of the responses

Training manual - "Developing Peer Leaders to Prevent the Spread of
HIV". It is put out by the Wisconsin Clearinghouse, 1-800-322-1468.
Although it isn't for clinic workers, it gives great ideas for
activities to do to increase comfort levels of participants in
discussing issues related to sexuality.

STI slide show that is available from ACHA. It's pretty technical and
has lots of pictures of different STIs.

Glass' Office Gynecology (5th edition, published by Williams and
Wilkins; edited by
Curtis and Hopkins) in 1998, and it speaks specifically to this
population of health care professionals, about recognizing sexual
functioning issues in a clinical ob/gyn setting. Included are thoughts
on how and what questions to ask a patient, co-occurrence of dysfunction
with other issues such as sexual assault, infertility, sexual
functioning after surgery and cancer treatment; pharmacological effects
on sexual functioning; and the impact of a man's sexual
function/dysfunction on a woman's sense of her of functioning. I think
it might be useful, as it also has a healthy and current reference
section.

I would suggest teaching the information and skills of proper condom
knowledge.

You may want to try SIECUS and the AMA, as well as people at
NYU-Sexuality Division. Also, University of Minnesota SAR Program, or
Sandra Cole at U of Michigan.

At this time I can only point you the literature for suggestions.
References

Boekeloo, B. O., Marx, E. S., Kral, A. H., & Rabin, D. (1991). Frequency
and thoroughness of STD/HIV risk assessment by physicians in a high-risk
metropolitan area. American Journal of Public Health, 81, 1645-1648.

Carter, W. B. Belcher, D. W., & Inui, T. S. (1981). Implementing
preventive care in clinical settings: An analysis of barriers.
Preventive Medicine, 16, 1-12.

Centers for Disease Control and Prevention, (1994). HIV prevention
practices of primary-care physicians-United States, 1992. Morbidity and
Mortality Weekly Report, 42, 988-992.

Elster, A. (1992). Guidelines for adolescent preventive services.
Chicago: American Medical Association.

Kotte, T. E., Brekke, M. L., & Solberg, L. I. (1993). Mayo Clinic
Proceedings, 68, 785-791.

Lief, H. I. & Reed, D. M. (1972) Sex Knowledge and Attitude Test (2nd
ed.). Center for the Study of Sex Education in Medicine, Philadelphia:
University of Pennsylvania.

Millstein, S. G. (1996). Utility of the Theory of Reasoned Action and
Planned Behavior for predicting physician behavior: A prospective
analysis. Health Psychology, 15. 398-402.

Oppenheim, M. (1980). Healers. New England Journal of Medicine, 303,
1117 - 1120.

Rosen, D. S., Xiangdang, M., & Blum, R. W. (1990). Adolescent health:
Current trends and critical issues. Adolescent Medicine. 1, 15-29.

Scott. C. S., Neighbor, W. E., Brock, D. M. (1992). Physician's
attitudes toward preventive care services: A seven-year prospective
cohort study. American Journal of Preventive Medicine, 8, 241-248.

U. S. Preventive Services Task Force. (1989). Guide to clinical
preventive services. Baltimore: Williams & Wilkins.

GLICHE (Great Lakes Institute for Community Health Educators).GLICHE is
a skill based training for sexuality educators. The model of the
training has been implemented nationwide, each region of the country has
its own training: example) SWICHE (Southwest institute), NICHE
(Northwest). GLICHE is organized by Health Care Education and Training,
Inc. (HCET). Their contact info is: 2346 S. Lynhurst Dr., Suite A201
Indianapolis, IN 46241 317/247-9008 Fax: 317/247-9055 The training was
divided into Modules. They are as follows:
Module I: Affirming our Sexuality
Module II: Effective Sexuality Education
Module III: Planning Your Program
Module IV: Celebrating our Differences
Module V: Putting it all Together

------------------------------
#334
Date: Tue, 20 Feb 2001 17:18:53 -0600
From: "Mark J. Kittleson, PhD, FAAHB" <kittle@SIU.EDU>
Subject: Wrong Phone Number

** The University of Alabama Distance Education
** Master of Arts Program in Health Studies
** http:// www.ches.ua.edu/health
**
** Sr Level Minority Position at Texas A&M;
** http://hlknweb.tamu.edu/Employment (3-18)

Correct...the hospital phone number where Bob Russell is at is 618-549-0721...Sorry.
This is twice in three days I've made a major error disseminating information. I must need a vacation.


Mark J. Kittleson, Ph.D., FAAHB
Professor & Director of Graduate Studies
Southern Illinois University
Home Page: http://www.kittle.siu.edu
HEDIR: http://www.hedir.org
IEJHE: http://www.iejhe.org

------------------------------