Tuesday, July 29, 2014

CHI takes on the topic of substance addiction and treatment trends

Adelphi University’s Center for Health Innovation continues to tackle some of the toughest issues of today. In 2012, 1.2 million people age 12 and older on Long Island and our immediate surrounding area were classified as living with a substance use disorder according to the Substance Abuse Mental Health Services Administrations, National Survey on Drug Use and Health. For this reason, gaining insight into how mental health professionals understand and treat addiction is a critical health need for our community and the nation.

On July 29, Adelphi’s Center for Health Innovation (CHI) released the results of a poll on addiction and treatment trends. Adelphi has a long standing interest in how we can assist local communities in dealing with substance abuse and mental health. We were the first institute of higher education in New York State designated as a disposal site for National Take-Back Drug Day, a day designed to provide a responsible means of disposing of prescription drugs, while also providing education to the public about potential for the abuse of medication. Through such efforts Adelphi University is taking an active and leading role in bringing together communities and providing data about an often stigmatized, deliberating condition effecting patients, families and communities.

Utilizing the knowledge and expertise from faculty, students and alumni, CHI seeks to find innovative ways of creating a culture of health by providing insight and data focused on both our communities; our most pressing needs and our greatest strengths. CHI’s research and practice is focused on strengthening what works well in communities on a daily basis and addressing social, educational, physical, emotional and economic health. CHI’s mission is to provide a foundation for creating community partnerships and leadership—with the goal of meeting current and emergent healthcare needs. We seek to ask and answer questions that help us understand how we can contribute to a culture of health in our communities and across the nation, we hope this type of commitment to our families and communities can help move the conversation forward and find solutions.

Written by
Elizabeth Cohn, Ph.D., RN, Director
Center for Health Innovation
Adelphi University

Monday, July 28, 2014

Caring for children 0-3, what's a working family to do?

President Obama’s recent White House Summit on Working Families raises awareness of the fundamental inadequacy of U.S. child care policy.  However, the President needs to do more to ensure that the federal government develops and funds universal policies to address U.S. child care needs.   The most recent regulations from the Department of Health and Human Services which are designed to improve the quality of child care in agencies receiving federal dollars will, in the absence of greater resources, do little to address the needs of many of the families they are supposed to help.

Parents across the economic spectrum have trouble finding safe, affordable, stimulating child care that is provided during their work hours.   Most parents, be they single or two parent families,  are working and struggle with family care, particularly, child care.  Sixty one percent of women with children younger than three are in the paid workforce.  The average child spends approximately 27 hours a week in child care in the first 4 ½ years of his or her life.  Approximately half of all children under 3 spend at least 25 hours a week in care with someone other than their parents.  The President noted, paid leave and flexible work conditions can help parents to care for their children but history has shown us that corporate America will not provide these benefits to many workers, particularly non-professional workers, without the inducement of law.

At present, we have a patchwork of public child care policies, providing subsidies for only a minority of those who technically qualify for them and some limited tax benefits.  By addressing this as a universal problem, President Obama is taking a huge step in re-framing the public discourse around child care policy which, since Nixon’s 1971 veto of the Child Care Development Act, has been largely limited to providing more extensive funding for existing poverty based programs. 

Investing in early education reaps huge economic benefits to society, more than those designed for school age children, by reducing the likelihood that these children will be involved in the justice system or be involved with other social benefits programs.  There is currently limited state and federal funding for early childhood education leaving many of those who are supposedly eligible without actual benefits.  In addition, much "high quality" care is not available during the hours that are needed by parents who do shift work or work non-traditional hours.  Kindergarten and universal pre-K are often limited to half day programs which, though they may meet some children’s educational needs, do not address the care needs that their working parents have.

Policies addressing early childhood education have historically been separated from child care policies designed to meet the needs of working parents and parental leave has not been viewed as child care policy, despite the fact that parents who can take leave need not hire someone else to care for their children.   Given the number of working parents who need 8-10 hours of care for their children each day, the separation between policies designed to meet early education and care needs is no longer viable.  Both the needs of working parents and the educational needs of their children have a lasting impact on our society. 

I commend President Obama and his Summit on Working Families for re-framing child care from an isolated policy issue designed only to address the needs of the working poor to a broader universal issue that affects all working Americans and one that is intimately linked with paid leave, flexible work and early education.  We need to do more than say that this is a problem.  First, we need to develop universal policies to educate in-home caregivers so that they can improve the quality of care they provide.  We also need to develop a universal system of center and home based care that models what is already available in much of the industrialized world and use tax dollars to fund it.  Finally, we need paid parental leave and sick leave for all workers, not only those with high status professional jobs. Caring for our children well will provide the US with more than simply economic benefits; it is simply the right thing to do.

Submitted by Elizabeth Palley, an associate professor of social work at Adelphi University, is the author of In Our Hands: The Struggle for US Child Care Policy.

Wednesday, June 11, 2014

Aging Family Members and Hidden Mental Health Issues

Associate Professor of Social Work Richard Francoeur first became interested in hidden mental health issues early in his career, as a medical social worker at a Veteran’s Administration hospital in Pennsylvania. He went on to compare the financial strain-related coping processes of patients over 65 who were undergoing outpatient palliative radiation for cancer with those of younger patients undergoing similar treatment.

Dr. Francoeur’s study revealed that older patients were more concerned about not having enough resources for the future, while younger patients were more concerned with difficulty meeting their current obligations. “Most screening for financial vulnerability and stress focus on present issues [like] paying bills,” says Dr. Francoeur, “so clinicians can miss older patients who are struggling, but who frame the issue differently.”

Similarly, in research with epidemiological data from an inner-city outpatient population receiving palliative care, Dr. Francoeur has found that screens for depression often miss older minority men. “Older adults are less likely to say that they feel sad, and yet they very much may be depressed even though they don’t use those kinds of terms,” Dr. Francoeur explains.

As an outgrowth of his work on hidden mental health issues, Dr. Francoeur’s research has more recently turned to symptom clusters. In his latest study, the experience of pain predicts depressive affect more strongly when pain occurred with fatigue and weakness or with sleeping difficulties, but only in patients reporting fever. When pain and either of these symptoms manifest together, interventions to relieve fever could reduce pain sensitivity and sickness malaise, which are concerns to multidisciplinary healthcare teams and smoking cessation programs.

Dr. Francoeur’s recent work has also focused on methodological advancement, in particular statistical innovations in moderated regression that make detecting and analyzing symptom clusters easier. Using his new methods, he plans next to look at symptom clusters in nonmalignant conditions that are related to the abuse of prescription drugs.

This piece appeared in the Erudition 2013 edition.

Thursday, May 29, 2014

Substance Abuse, Internet Abuse and Family Intervention

Errol Rodriguez, Ph.D., Gordon F. Derner Institute of Advanced Psychological Studies assistant dean and director of the master’s program in general psychology and mental health counseling, has spent much of the last decade studying families who have been affected by addiction. “Somewhere between four and five significant others are affected by one person’s addiction,” explains Dr. Rodriguez. “We know that somewhere around 23 million people are substance abusers annually, so that’s about one-third of the country each year that’s affected.”

One way Dr. Rodriguez hopes to reach more of the people affected by substance abuse is through Community Reinforcement and Family Training (CRAFT) interventions. Rather than the traditional model of intervention, which involves a surprise confrontation with the addict, the CRAFT model is a strategically planned intervention where family members first discuss their role in enabling abuse and then determine what they can do so the using person begins to feel the consequences of his or her substance abuse.

“It’s a powerful behavioral therapy approach,” Dr. Rodriguez says. “With over 80 percent of the people who begin the CRAFT model, their significant other enters treatment.”

“That doesn’t mean they stop using,” Dr. Rodriguez clarifies, “but family members often feel a great sense of relief knowing that their loved one has started to get help.”

Dr. Rodriguez’s most recent research focuses on a new type of abuse: Internet addiction, particularly among adolescents.

“Some young adults are really glued to their phones, to the Internet, in a way that becomes problematic for their lives and their families,” Dr. Rodriguez says. “It’s different from other teenagers who enjoy their phones but don’t seem obsessed with them.”

Dr. Rodriguez is examining vulnerabilities to this type of compulsivity. “Is it similar to other addictions, like alcohol or marijuana?” Dr. Rodriguez wonders. “Are some of the same markers that put teens at risk for other behaviors, things like low self-esteem and eagerness to fit in, involved in compulsive Internet use?” In the coming year, he’ll begin to find out.

This piece appeared in the Erudition 2013 edition.

Thursday, May 15, 2014

Pioneering Conservation Physiology

by Ela Schwartz

From tiny arthropods, we travel up the food chain to the large, marine mammals known as pinnipeds, which include the seals and sea lions studied by Heather Liwanag, Ph.D., assistant professor of biology.

Unlike smaller animals, such as the geckos Dr. Liwanag also studies, these long-lived mammals “are not going to adapt or evolve as rapidly, and a lot of them are in trouble. So we need to figure out how to keep them with us, and not just in zoos,” she says.

Dr. Liwanag is active in what she calls the “upand- coming” field of conservation physiology, which looks at how animals physiologically respond to environmental changes. “The common thread in my research is critical temperature,” she says, meaning the maximum and minimum temperatures organisms can tolerate before having to adjust their physiology.

Another question she seeks to answer is: “How fast does a seal’s fur grow back?” Why? Because researchers glue data tags to the seal’s fur, then cut the seal’s fur to remove the tag. “No one has looked at how the loss of fur may compromise the seal’s ability to insulate itself, including when it dives for food into higher pressures,” she says. Dr. Liwanag raised the funds to purchase a small hyperbaric chamber that re-creates the higher pressures that occur underwater so that she and her students can insert pelts and measure the amount of water that can penetrate the fur under pressure.

Dr. Liwanag is also collaborating with Linnea Pearson, a Ph.D. candidate at the University of Alaska Anchorage, to study insulation in harp seals from birth to adult and how this relates to environmental temperature changes. She explains that baby seals are born on the Arctic sea ice and nurse for only 12 days before they are abandoned by their mothers. They fast on the ice for another four to six weeks. “When they are first born, they have very little blubber and instead rely on thick, fluffy fur to keep warm,” Dr. Liwanag explains. “As the blubber develops, their fur changes from the thick pelage they had at birth to a thin, more streamlined…pelt like the adults have.” If there isn’t enough ice for these seals to sit on while they develop, they’ll be forced to venture into the water before they’re physiologically ready to withstand the icy temperatures.

In addition, if the waters seals inhabit become warmer and the sea ice continues to recede, these creatures may need to maintain their body temperatures by raising their metabolism, which requires them to increase food intake. If food sources are no longer plentiful, they must expend energy to forage. “So it’s a downward spiral,” she says.

In the future, Dr. Liwanag hopes to apply her research on critical temperatures to polar bears. “The ice is receding at rates not predicted in even the most liberal of climate models,” she says. “Polar bears are spending more time swimming, and we have no idea what their thermal capabilities are in water. I’m hoping to work with captive polar bears in zoos to look at lower critical temperatures in water and acquire data that will help us understand how [climate] changes are going to affect them.”

This piece appeared in the Erudition 2013 edition.

Thursday, May 8, 2014

Biodiversity and Heavy Metals in the Salt Marshes

by Ela Schwartz

What do you envision when you hear the word “shore”? Most likely a sandy beach with splashing waves, not a salt marsh. But look through the eyes of Matthias Foellmer, Ph.D., associate professor of biology, and you’ll see that these areas are the homes of a myriad of life forms: marsh grasses stirred by breezes, mussels exposed in the low tide and migratory birds stopping by to grab a meal before continuing on their way inland. Look closer and you’ll see the many species of what Dr. Foellmer refers to as “small animal biomasses you can hardly see, like crabs, insects and spiders.”

Known as arthropods, these creatures are a specialty of Dr. Foellmer, who is leading students in research that examines the influences of humans on invertebrate populations in wetlands along the South Shore of Long Island.

He explains that what makes Long Island’s salt marshes unique is that they are “isolated and disturbed.” Suburban sprawl has decimated the swaths of salt marshes once prevalent on our coasts. The result is secluded patches where these tiny creatures cannot travel from one habitat to another. Concurrently, these patches are being damaged by pollution due to their proximity to densely populated urban/ suburban developments.

One of Dr. Foellmer’s undergraduate students, Carolyn Trietsch ’12, extensively surveyed three isolated salt marsh patches still attached to the mainland. She and Dr. Foellmer used pitfall traps, beat sheets and sweep nets to whisk insects from vegetation. In Summer 2011, Ms. Trietsch even received a stipend from Adelphi’s McDonell Fellowship to pursue this research with Dr. Foellmer. “We are still in the process of identifying these creatures in the lab,” he says. After this phase is completed, Ms. Trietsch, now a master’s candidate at Adelphi, will analyze the data. Hypotheses to explore include the possibility of differences in genetic structure in populations or identifying ones that are extinct in one patch but not in others.

Another of Dr. Foellmer’s students, Andrew Vacca, M.S. ’12, analyzed the effects of heavy metal bioaccumulation in invertebrate food webs consisting of plants, small insects and wolf spiders. “What he found is that wolf spiders heavily accumulate methylmercury, which is highly toxic,” Dr. Foellmer explains. Toxicity can lead to neurological, behavioral and reproductive impairments. Despite his own fascination with spiders, he is well aware that they don’t make the best poster children to inspire most of us to be more environmentally conscious. But what about the birds who prey upon the spiders? “The accumulation of mercury in spiders is a threat to them as well as the animals that eat them,” he says, “and other studies have shown that semi-aquatic wolf spiders are the means by which aquatic methylmercury can move up to terrestrial food webs.”

This piece appeared in the Erudition 2013 edition.

Monday, May 5, 2014

Adelphi’s M.S. in Nutrition Program

by Charity Shumway

College of Nursing and Public Health Clinical Associate Professor Diane Dembicki’s interest in nutrition began when she was an anthropology graduate student, examining skeletal material from prehistoric Native Americans. “You could see evidence of diet and disease in the bones,” she says, marvel still in her voice. She followed up her anthropology degree with a Ph.D. in Nutrition and found her niche in teaching nutrition to students in the health professions. Dr. Dembicki has since gone on to study subjects from companion-animal influences on health and behavior to healing in the arts; but her latest research has taken her all the way from prehistory to the cutting edge of training and technology.

Over the last two years, Dr. Dembicki has been studying best practices in knowledge and technology as part of the College of Nursing and Public Health and the Center for Health Innovation’s efforts to develop a new M.S. in Nutrition program. Starting fall 2013, drawing on Dr. Dembicki’s research, Adelphi will begin educating its first class of M.S. in Nutrition students in a new fully online program, with Dr. Dembicki serving as director.

“Over two billion people in the world are malnourished,” Dr. Dembicki says. “Right away, we think undernourished, but that number also includes the overnourished. The world, but also locally and nationally in our own communities, needs more nutrition experts. That means properly educated and credentialed people with a specialization in nutrition.”

Adelphi’s new program is aimed at college graduates who are interested in health and nutrition. While course materials will be available 24/7, with integrated social media, sections will be kept small so that students will still receive individualized faculty attention. “Many students may be locals initially,” says Dr. Dembicki, “but because it’s online, the program has a potential global reach.”

Soon, a whole new cadre of Adelphi educated nutrition experts will be working to ensure that the bones of the future have healthy stories to tell.

This piece appeared in the Erudition 2013 edition.