Tuesday, December 18, 2012

Our Graying World and Wisdom on Living in It

By Jeffrey Weisbord, Adelphi sophomore

In the days of the Soviet Union, my grandmother was the assistant principal of a prominent English language school in Moscow. Many of her students became leaders in business, politics and medicine, and one—Mikhail Prokhorov—even went on to rank among the wealthiest people in the world and own the NBA’s Brooklyn Nets.

My father was one of her students, and grew up seeing his own mother as an authority figure for hundreds of Moscow’s most gifted youths. This image has changed drastically over the last few years, as my grandmother—now in her late 80s—relies on her immediate family simply to survive. Despite various ailments (dementia being the most noticeable), she still lives by herself, albeit with a house attendant who stays with her until 9:00 every night. I make a nightly trip to her apartment to ensure that she’s ready for bed, and my father visits her every day during his lunch break. Her day-to-day life has become very difficult, but it may be even harder for my father to witness his hero fade to a shell of her former self.

My story is just one among millions. Within the next five years, the number of people who are 65 or older will, for the first time, exceed the number of children on our planet. Aging is an issue that touches all of us. Fittingly, faculty members from Adelphi’s Gordon F. Derner Institute of Advanced Psychological Studies are using their expertise to address the issues surrounding aging and caring for the aged. Their work and that of other Adelphi professors and alumni is covered in the feature story of the Fall 2012 issue of Adelphi University Magazine, “Everyday People, Extraordinary Challenges—A Look at Growing Older in the New Millennium.”

From the Derner Institute, Professor Robert Bornstein, Ph.D., who co-wrote When Someone You Love Needs Nursing Home, Assisted Living, or In-Home Care: The Complete Guide with his wife, psychologist Mary Languirand, offers guidance on not only finding a good nursing home for yourself or a loved one, but also budgeting for elder care before it’s too late.

Assistant Professor Katherine Fiori, Ph.D., has researched the effects social networks have on seniors’ mental and physical health. She comments on the differing effects of networks—with family and with friends. She has found that friend-focused networks are particularly beneficial for mental health, while family-focused ones tend to be better for physical health than mental health.

Associate Professor Francine Conway, M.S. ’92, Ph.D. ’99, has studied grandparents who care for their grandchildren—a growing trend. She has found that the grandparents’ disposition and outlook play crucial roles in their health outcomes. “If they’re able to see this as a benefit to them, then it will be,” she told Adelphi University Magazine.

Whatever your age or outlook on aging, you’ll find credible and valuable faculty and alumni expertise in this Adelphi University Magazine article. 

Jeffrey Weisbord, a biology major, is part of Adelphi’s Early Assurance Program with NYU College of Dentistry. He is an avid writer and contributes to various University publications, including Adelphi University Magazine. He has always stayed active by exercising and playing sports, but has recently taken the next step by severely limiting the amount of unhealthy food that he consumes.

Monday, December 17, 2012

Hold the Applause

by Philip Alcabes, Ph.D.

Last week, the Think About It blog’s Weekly Health Roundup (14 Dec.) moved too fast. 

Our bloggers applauded the behavioral policing of NYC’s Bloomberg administration as a factor in two pieces of news:  the decline in New York City’s child obesity prevalence and an increase in life expectancy.

The Dec. 14th TAI blog post specifically mentioned four Bloomberg-era innovations:  bans on smoking in restaurants, bars, and parks; the ban on trans fats in restaurants; the requirement to post calorie counts at chain restaurants; and the new ban on the sale of sugar-sweetened beverages in large-size cups.
Our bloggers didn’t consider two big problems, though. 

First, there has been no convincing evidence that any one of the Bloombergian innovations has led to a reduced rate of disease.  The city’s Department of Health and Mental Hygiene has indeed made such claims – but they were based on circumstantial evidence.  For instance, evaluators found that people who order lower-calorie options at fast-food restaurants say they had read the posted calorie counts (the NYC health commissioner, Thomas Farley, might well believe that such correlations are evidence of cause-and-effect relations – but intelligent people know better).

Second, the data don’t support the conclusion that obesity prevalence has declined, nor the inference that the increased life expectancy demonstrates reduced risks of dying.

The obesity data are based on what are called “serial cross-sections.”  That is, investigators weigh and measure a bunch of children to determine the distribution of BMI, body-mass index.  Two years later, they do the same to a new bunch of children.  To find that the second batch contains fewer high-BMI kids than did the earlier group tells us nothing about whether the children who were obese the first time around have now slimmed down.  Because we don’t know if the children in the first batch even appeared in the second batch, and no individual child is observed at multiple times to track BMI increase or decrease. 

These data don’t allow us to conclude anything at all about whether children are getting fatter or slimmer.

And life expectancy, it’s important to know, is just an average age at death.  Life expectancy in a population will go up if people live longer, which is the point of measuring life expectancy in the first place.  But L.E. will also go up if more wealthy people move into a region (because wealthy people live longer than poor people).  And it will go up simply if more older people move in (because adding 70- and 80-year-olds to the population makes the average age at death go up – even though nobody’s chances of dying have changed at all).

In fact, over a short term and with the high rates of in- and out-migration that NYC has, the most likely expectation for the longer life expectancy in NYC isn’t lower risk of dying – it’s that the wealthy have bought up properties that the lower and middle classes can no longer afford. 

So there’s no reason to think that the trans fat ban, smoking bans, or big-cups-of-soda ban have made New Yorkers healthier.  It’s more likely that Mayor Bloomberg has simply made the city more hospitable to the rich.

Which doesn’t seem to merit applause at all.

Philip Alcabes is a professor in the Adelphi University School of Nursing and director of the Public Health Program. He is an epidemiologist and has studied the history, ethics, and policy of public health.

Friday, December 14, 2012

Weekly Health Roundup

Three cheers for New York City!

The Bloomberg administration’s longterm focus on public health appears to be paying off, as a pair of reports released this week suggests. The childhood obesity rate in New York declined more than 5% in recent years, and made significant strides in other U.S. cities, including Miami and Philadelphia, as well. The positive news comes with a caveat, as the decrease in New York was less significant among minority and low-income children.

Mayor Bloomberg’s office announced all-time high life expectancy and all-time low infant mortality figures in conjunction with the Health Department this week. Babies born in 2010 have a life expectancy of 80.9 years—more than two years longer than the national average. And New York City’s infant mortality rate fell in 2011 to an all-time low of 4.7 deaths per 1,000 live births, this time with improvements seen across all ethnic groups.

The mayor’s office is quick to claim the positive news as a result of their commitment to public health. Over the span of Bloomberg’s decade-long mayorship, the Big Apple has benefited from several much-imitated health initiatives, including:
  • Smoking ban in most restaurants and bars, and in outdoor public places
  • Trans-fat ban in restaurants
  • Calorie count posting requirement at chain eateries
  • Ban on sugary beverages over 16 oz.

While New York City has made significant strides toward healthier living under Bloomberg’s mayorship, a new report from the ocean conservatory group Oceana details fish mislabeling in restaurants and stores in NYC and other cities across the country.  Aside from the “bait and switch” economic issue of patrons paying for higher-priced fish than they are consuming, the mislabeling can create significant health hazards for pregnant women, those with food allergies, or for anyone seeking to lower their consumption of mercury and other toxins.

Friday, December 7, 2012

Weekly Health Roundup

This week saw significant changes announced to the upcoming edition of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) , the comprehensive guide produced by the American Psychiatric Association.  The headline-grabber involved the elimination of a separate Asperger’s syndrome and its envelopment into a broader autism spectrum diagnosis. While this was the noisiest change generated, other note-worthy shifts announced include:
  • expansion of post-traumatic stress definition
  • inclusion of binge-eating disorder and hoarding
  • addition of disruptive mood dysregulation disorder for children
  • elimination of gender identity disorder, to be replaced by gender dysphoria
  • dropping the bereavement exclusion from major depressive disorder, or more simply, permitting grief to be categorized with depression.
Controversy surrounds many of these changes, and for those that expand the current guidelines for diagnosis, there is apprehension surrounding the potential for overmedicating of what some would consider “normal” life chapters (i.e. grief as part of the bereavement process; temper tantrums as part of a child’s development).

And while overmedication is certainly a hazard, a new study published in The Lancet this week reveals that the breast cancer drug tamoxifen has been largely underutilized in post-breast cancer treatment. The study finds that prolonged (ten-year) use of tamoxifen further reduces the risk of breast cancer recurrence, as opposed to the current five-year tamoxifen protocol.

For royal bump watchers, good news from Buckingham Palace came this week in the form of an official announcement of the Duchess of Cambridge’s pregnancy. The happy news came with the more sobering footnote of Kate’s severe morning sickness for which she had been hospitalized, shining light on a rare pregnancy side effect that is generally benign but can produce serious health risks.

And finally, as we close out National Influenza Vaccination Week, we urge you to get the flu shot if you have not done so already. The CDC warned just days ago that this year’s flu season may be a particularly nasty one, having started earlier than usual. If you missed this week’s Flu Clinic, you can still get your flu shot through Health Services (Monday through Thursday from 5:00-7:00 p.m., and Tuesday through Friday from 8:30-10:30 a.m.).

Friday, November 30, 2012

Weekly Health Roundup

As November winds down, we are turning our focus this week to December 1 and World AIDS Day.

In the days leading up to December 1, The New York Times published a piece exploring how expanding technology has changed the nature of India’s sex industry. Women are experiencing both increased autonomy and financial benefits, since they no longer have to rely on brothels. However, this autonomy may pose long-term problems for a country who was once predicted to ultimately become the “focal point” of the AIDS epidemic, and to see 25 million people with AIDS by 2010. Targeted outreach to high-risk groups, including prostitutes were hallmarks of the country’s success. In addition, foundations such as the World Bank and the Bill and Melinda Gates Foundation, provided ample financial resources in support of these efforts. Today, India is dealing with approximately 1.5 million cases of AIDS, a staggeringly different number from what was predicted. However, Gates foundation funding is poised to stop in the coming months. In addition, the fear is that technology will disperse one of the country’s most vulnerable populations, and make education and prevention almost impossible.

But that doesn’t mean groups will stop trying. Yesterday, US Secretary of State Hillary Clinton released the “PEPFAR Blueprint: Creating an AIDS-free Generation”. The plan’s overall vision is that while “smart investments based on sound science and a shared global responsibility” will be key if we want to “save millions of lives and achieve an AIDS-free generation. The plan sees a path to this vision through five over-arching goals:
  • Make strategic, scientifically sound investments to rapidly scale-up core HIV prevention, treatment and care interventions and maximize impact.
  • Work with partner countries, donor nations, civil society, people living with HIV, faith-based organizations, the private sector, foundations and multilateral institutions to effectively mobilize, coordinate and efficiently utilize resources to expand high-impact strategies, saving more lives sooner.
  • Focus on women and girls to increase gender equality in HIV services.
  • End stigma and discrimination against people living with HIV and key populations, improving their access to, and uptake of, comprehensive HIV services.
  • Set benchmarks for outcomes and programmatic efficiencies through regularly assessed planning and reporting processes to ensure goals are being met.

We have reason to hope. The PEPFAR blueprint comes on the heels of “Results”, a November 20 report released by UNAIDS that finds, among other things, that “between 2001 and 2011, HIV incidence in 25 countries declined by more than 50 percent and decreased by 20 percent worldwide. Since 2005, the number of AIDS-related deaths has declined by almost one-third.” 

Friday, November 16, 2012

Weekly Health Roundup

A message from Adelphi’s Center for Health Innovation

More than two weeks have passed since the devastation caused by Superstorm Sandy swept through the area. As the region begins to repair and rebuild our altered landscape and tattered neighborhoods, we pause to acknowledge the emotional toll imprinted on the survivors. The superstorm, nor’easter, and their aftereffects damaged more than our powerlines and buildings; they further battered an already hardened New York collective psyche. Yet for many, the most fulfilling path to inner healing is to extend a hand outward to aid our neighbors who have lost so much of their livelihoods.

Adelphi is assisting in disaster relief efforts in many ways, from blood and donation drives that address physical needs, to counseling services to address the psychological aftereffects. The University is coordinating volunteer efforts at hard-hit sites on Long Island and Queens, including Long Beach, Oceanside, Island Park, and Breezy Point (visit the link above, then click How You Can Help, then Volunteering at Disaster Locations for more information).

As we prepare for Thanksgiving next week, many area organizations and businesses are working to bring Thanksgiving meals to many still without power, as well as those displaced by the storm. There are bountiful other opportunities to help our neighbors in need throughout the affected areas.

Wishing you the gifts of health, love, and gratitude this holiday season.

Wednesday, November 14, 2012

Training health professionals for a new normal

by Philip Alcabes, Ph.D.

The public policy scholar Robert Puentes (a Senior Fellow at the Brookings Institution) has advised that we look at extreme weather events — like last month’s Hurricane Sandy — as part of the “new normal.”  To which we can add last year’s Hurricane Irene, the derecho of summer ‘12, a devastating drought in the middle of the country, paralyzing snowstorms in both October 2011 and last week that felled trees and branches that were still in leaf, and so on.

But the new normal – extreme weather, rising sea levels in the Northeast, higher storm surges, and, as the National Aeronautics and Space Administration (NASA) reported, ecosystem change – isn’t just a matter for transportation and land-use planners. 

It means that we need new norms for health – and new ways of protecting the gains in human capacity and longevity won in the course of the previous century.

How will we train a generation of health professionals to be capable of taking on dire problems of tomorrow whose outlines are only beginning to be perceptible today?

Here are five issues to consider in training future health professionals to confront the New Normal:
  1. Ecosystem alteration will both accelerate and alter the evolution of microbes.  Microbes outnumber humans (by a lot!) and they can adapt far more readily to changed circumstances.  What will ecosystem change mean for infectious diseases of humans?  What sorts of responses will replace antibiotic therapy – already hopelessly out of date?
  1. The great gains in life expectancy of the past 150 years were partly attributable to improvements in waste management and water purification.  How will our leaders protect those gains – when infrastructure is imperiled by rising sea levels, harmed by extreme weather, or out of power?  How will waterborne illness be kept at bay?  What sorts of microbial adaptions will create health concerns even outside of emergency situations?
  1. Energy shortages will exacerbate food insecurity – already a serious problem in our region and a pressing one worldwide.  When poverty limits people’s access to nutritious food and failures of refrigeration or shipping curtail the availability of those foods that are (or were) accessible, we can anticipate new forms of debility.  What will our leaders to do guarantee nutritional stability – and how will they do it without amplifying the damage to ecosystems already under way as a result of industrialized agriculture?
  1. Communities are challenged not only to develop new structures to prepare for dire events and respond to the unexpected, but especially to promote the solidarity necessary to respond collectively to trauma – both individual level trauma and that experienced by the community itself.  What kind of leadership will be needed?  Who will cultivate such solidarity at the same time as providing services?
  1. Finally, leadership itself is at stake.  We can already see that some leaders hear cries for help while others simply preach to the victims about altering their risk-inducing ways. 
A cautionary tale on leadership: 

Two weeks after Hurricane Sandy, 55,000 NYC residents were still lacking power, many of them in buildings that also lacked running water.  The New York City Commissioner of Health and Mental Hygiene, a leader in banning large servings of sugar-sweetened beverages and promoting bicycling, has done almost nothing to mobilize aid for threatened food and water supplies or provide warmth or medical care.  Instead, the Department of Health and Mental Hygiene addresses suffering residents solely with warnings:  “Never use stove burners or ovens for heat,” “Dry ice: safety tips,” “Hypothermia after Hurricane Sandy,” and other messages populate the website

Effective leadership in the New Normal will mean being proficient technically, of course.  But it will also mean not wasting time and resources preaching about behavioral “improvement.”  It will mean recognizing the enormity of suffering and the depth of human needs.  And it will mean being able to plan and respond in ways that are both smart and humane.

Acknowledging, with the advent of Sandy, that the New Normal has arrived, we who train health professionals are challenged to produce the right kind of leaders for the future.

Philip Alcabes is a professor in the Adelphi University School of Nursing and director of the Public Health Program. He is an epidemiologist and has studied the history, ethics, and policy of public health.

Tuesday, November 13, 2012

Superstorm Sandy: An energy wake-up call

by Meghan McPherson, MPP, CEM

In the days leading up to Superstorm Sandy making a direct hit on the New York region, emergency management officials made warning after warning that this was a storm not to take be taken lightly.  This storm was destined to be an outlier from recent memory in terms of the amount of heavy damage it would cause.  Yet, Long Island Power Authority COO Michael Hervey continues to assert that LIPA had no way of knowing that the effects of the storm would be this catastrophic, with over one hundred thousand still without power 14 days after the storm.  One could contend the exact opposite.  LIPA certainly did know the likelihood of this type of paralysis, even without the dire warnings from emergency management and public officials. 

There have been a lot of comparisons between Hurricane Katrina and Superstorm Sandy in the past two weeks.  I personally saw the aftermath of both storms, and I can speak to their similarly devastating impacts on the many sectors critical infrastructure.  But from an energy perspective, there is no comparison.  The population density and critical infrastructure needed to support that population is second to none in the New York area, and especially on Long Island.  The interdependencies of energy sector critical infrastructure and the cascading consequences when the energy sector collapses could be seen coming as a menacing wave long before our homes were flooded. 

The concept of energy assurance focuses on this specific issue.  The US Department of Energy, Office of Electricity Delivery and Energy Reliability defines energy assurance as “Improving the ability of energy sector stakeholders to prevent, prepare for, and respond to threats, hazards, natural disasters, and other supply disruptions.”  With 85% of the national critical infrastructure privately owned, it is crucial for our energy sector stakeholders to develop redundant systems and protocols that will reduce the impact of a major storm and will speed the recovery of the entire region.  Long Island’s residents have suffered long enough from the inexcusable power outages and the resulting impact on health care, gasoline availability, heat for our homes, school closures, and business losses. Let this be a wake up call to our region and to energy officials all over the country.  The energy infrastructure is old and is being relied upon much beyond its original determined lifetime.  If we continue to ignore this issue in light of increasing severity and frequency of major weather events, we will continue to see our entire way of life screech to a grinding halt while power officials tell the public, “It was beyond the magnitude of what anyone expected.”

Meghan McPherson is the Coordinator of Adelphi University’s Center for Health Innovation and the Program Manager of Adelphi University’s Graduate Emergency Management Programs. Before joining Adelphi University in the fall of 2011, Ms. McPherson spent four years as both a grants manager and the Energy Assurance (energy emergency management) Program Manager in the Governor’s Office of Energy and Planning at the State of New Hampshire. Click to read more about Ms. McPherson’s experience.

Friday, October 26, 2012

Weekly Health Roundup

It’s Friday—time to check in on what’s happening in health!

We’ve seen our share of health news this week—from a malaria outbreak in Greece, thought to be exacerbated by their economic depression, to the roller coaster/soap opera that is Europe’s battle against tobacco.

On the new research front, a recent study from the University of Toronto published in the Proceedings of the National Academy of Sciencefinds that adversity during childhood can yield positive results later in life in the form of persistence and self-control; while a British study soon to be published in Social Indicators Research, finds that fruits and vegetables may not just good for your body, but also for your soul.

But today, we’d like to focus on preparing you and your family for a weather event that is heading up the east coast. Hurricane Sandy is projected to start affecting our area early next week—and we want to make sure you have what you need.

Earlier this year, we shared the results of the inaugural Adelphi University Center for Health Innovation Poll, which found that we just aren’t that prepared for emergencies—mostly because we don’t think we’ll be impacted. According to our poll, 84% of Americans don’t think it’s very likely they will be affected by a disaster. You can hear more from the CHI team about our poll on this podcast.

However, it looks like we may, in fact, be impacted by a weather event in the next few days. We urge you to act upon the poll’s findings and use the time ahead of the storm to prepare yourself and your family.  To assist you, here are some important resources from ready.gov: How to build a basic disaster kit for your family ; Creating a Family Emergency Plan; and What to do Before, During, and After a Hurricane.

Friday, October 19, 2012

Weekly Health Roundup

It’s Friday…which means it’s time for the Center for Health Innovation’s Weekly Health Roundup.

The U.S. presidential debate dominated media coverage this week, with healthcare taking a backseat to foreign policy, the economy, job creation, and other contentious topics Tuesday night.  Nonetheless, you may have caught the candidates’ brief exchanges on women’s health issues, health insurance premiums, and Medicare in between the jabs and hooks.

In honor of World Food Day this week, and at the intersection of food and politics, did you savor Michael Pollan’s article on the political implications of the burgeoning food movement in the New York Times Magazine’s annual Food and Drink issue? Foodies and health-minded individuals will surely pay close mind to California this November as it votes on Proposition 37, requiring genetically modified foods to be appropriately identified and labeled. And speaking of labels, Mark Bittman’s exercise in reimagining a more useful and streamlined food label distills food worthiness down to a numerical score and a traffic light color-coded system. Is this an oversimplification or a step in the right direction?

Peeking ahead to next week, Adelphi relishes National Food Day on October 24 with a series of on-campus events to highlight the need for sustainable, affordable, and healthy food for all. Free events include the Long Island premiere of The Harvest/La Cosecha, the story of migrant child workers working on U.S. farms; a Farmers Market; Iron Chef Competition; and an interactive food memory project.  To kick off National Food Day, famed celebrity chef and motivational speaker Chef LaLa brings her cooking show to Adelphi on Tuesday, October 23. Make sure to check out all of our Food Day-related events.

If an apple a day keeps the doctor away, it seems a vitamin may be a worthy substitute.  Encouraging news for men who take daily multivitamins came from a paper presented at the American Association for Cancer Research conference.  Men taking a daily multivitamin were diagnosed with 8% fewer cancers than their placebo counterparts. 

Saturday, October 13, 2012

Some thoughts about “Homeland” from a clinical psychologist’s point of view interested in epistemology

by Dr. Jacques Barber

There is a first time for everything.  This will be the first time that I blend my interest in psychology with my interest in a TV series.  The series Homeland, which just won several Emmys awards, has many interesting aspects, including many psychological ones.  In fact, there are so many psychological angles to focus on that I will have to be selective. I will focus on Carrie and her psychological struggles.  At the end of the first season, her bipolar disorder is exacerbated by the stress and complexity of the situation that she is trying to solve.  Solving complex problems is stressful; stress and lack of sleep are detrimental to individuals with a tendency to have difficulties maintaining a stable state of mind and emotional balance.  My focus on this blog is to discuss her “disease,”  how her disease leads Carrie to be mistrusted, and how it is easy for “normal” people to dismiss the views of individuals different from themselves.   Furthermore, I will touch on the topic what is “truth” and how do we know it.

The viewer knows that Carrie is onto something when she is suspicious of Brody.  Because her behavior is somewhat erratic and her theories are quite unusual if not “crazy,” her colleagues begin to distrust her.  In fact, it is heartbreaking to see how easily dismissed somebody who sounds crazy can be.  It is easier for those around her to distrust her and to dismiss her Ideas or “hypotheses” than to take them seriously, or even ponder, what she was suggesting.  How can an American hero, a Marine, who has survived hardship during years of captivity, betray his country?  How could he really plan to murder the Vice President of the USA and his entourage (e.g., the defense secretary)?

Many psychologists and psychiatrists have tried to find deep meaning in human behavior, including abnormal behavior.  One of the first was Freud, the father of psychoanalysis, who attempted to explain hysterical symptoms (e.g., hysterical hand paralysis which is a phenomenon that is not consistent with what we know about the neurology of hand function) with a far-reaching theory of the mind.  His psychoanalytic theory of the mind, which some people consider quite farfetched, has recently received some support from neuroscience findings.  This is happening at a time when the popularity of Freudian therapy is declining around the world.  Watching “Homeland” the viewers, however, do not need to understand the deep causes of Carrie’s delusions.  This is not necessary as we know that her views are not delusional.  This is reminiscent of the non trivial saying “Just because someone is paranoid, it doesn’t mean he’s not being followed.”  The viewer knows enough to understand that Carrie’s theories are not off the wall; they are close to reality.  Keep in mind also that the reality is evolving as Brody becomes more involved in what could be called anti-American activities (e.g., collecting secret information from the CIA) than he actually planned initially.

If we stick with what is known, are Carrie’s hypotheses farfetched?  Is she delusional?  Delusions are not a typical feature of bipolar disorder.  Systematic delusions like Carrie’s are more a characteristic of paranoia (now called delusional disorders) or to a lesser extent of schizophrenia.  But we do not need to be too technical here; after all, it is a TV series.  So let’s discuss delusions.  Following the work of Fried and Agassi (1976), I will surmise that in paranoia the delusion is very systematic. How do we know when a systematic delusion is true or when is it false?  Can we even know when a scientific theory is delusional, or when it is true, for that matter?  For example Copernicus was initially dismissed as irrational.  Although much has been written about how, and whether, the validity and truth value of scientific theories can be corroborated, there is little work that takes seriously the question, how do we decide that a delusion is indeed delusional?  Is it when it does not correspond to reality or to the facts? Do we ever have all the facts? These are very basic questions that mental health experts and epistemologists should grapple with but, for the most part, they have not (exception includes Fried and Agassi). Early in my life these questions occupied much of my thinking, and intellectual energy.  The question is: What distinguishes a delusional theory from any kind of theory, including a scientific one?  How do we know that a scientific theory is valid while Carrie’s is not?

She is dismissed. It is also interesting that when, as she is going to receive her first ECT, she remembers that Brody knew Abu Nazir’s son and she asks her sister and the nurse to remind her of that after the ECT. However, the nurse dismissed her.  Yes, it is common for patients under anesthesia to say things that make no sense.  And even if what they express is logical and sensible, how can a nurse or doctor hearing those fragments of thoughts understand them without the context?   Furthermore, the anesthesia nurse has heard many depressed patients (depression is one pole of the bipolar disorder spectrum) saying all kinds of things related to their own lives. Likely she long ago stopped trying understanding what the patients are saying, or meaning. 

I will bet that most viewers feel sympathy towards Carrie; she cares about her country, and she is extremely dedicated.  In fact, she is willing to follow her views in the face of ridicule and adversity.  But in the end she gives up.  She comes to believe she is wrong, and she feels badly (depressed) about having caused harm to Brody and his family.  Is it a coincidence that she is a woman, and that as a woman with mental health issues she is dismissed?

How do we increase tolerance and respect for people who are different from us?  I think the first step is to listen to them and not dismiss them automatically.  I know that this is hard; it’s hard to listen to somebody from the extreme right, or the left, etc.  But one message I take away from the show , even if the writers didn’t intend it, is that it is worth listening to people like Carrie and perhaps even to Brody (note that how his daughter listens to him and the impact it had on him when he decides not to detonate the explosive vest in the bomb shelter). If we listen, we open up the possibility of learning something new. 

Fried, Y. & Agassi, J. (1976) Paranoia: a study in diagnosis.  Boston Studies in Philosophy of Science, Volume 50.  Dordrecht:  D. Reidel Publishing Company

Jacques P. Barber, Ph.D., ABPP is the dean of the Derner Institute of Advanced Psychological Studies at Adelphi University and Emeritus Professor, Perelman School of Medicine, University of Pennsylvania and Adjunct Professor of Psychiatry, New York University Medical School.

Friday, October 12, 2012

Weekly Health Roundup

Another Friday means another Weekly Health Roundup!

We’re starting off this week in Kenya, where researchers at the Harvard School of Public Health spent a year collecting data from the 15 million cell phones used in the country. Why? To map how malaria spreads through the country. The results reveal some surprising information. First—and perhaps most distressing—is that mega-cities, like Nairobi, are seeing increased malaria cases, meaning mosquitoes are learning to adapt to big cities. However, the data also provide encouraging opportunities for better focusing malaria control efforts, as well as dispersing outbreak and treatment information to large groups of people at once.

State-side, the US continues to deal with more reported cases of the rare but non-contagious fungal meningitis thought to be caused by contaminated drugs administered via spinal injection. This interactive map from the New York Times  provides updated information on reported cases. As the number of cases has risen, media coverage has turned its focus, in part, on exploring spinal injections’ big-picture risks, ones that existed well before this recent outbreak.

And before you start thinking that the news is entirely grim this week, a new report by the Centers for Disease Control might make you feel better. Their data indicate that while the average overall life expectancy in the U.S. has remained the same (78.7 years), death rates overall reached a record low. But the most positive finding was that death rates for five of the top 15 causes of death dropped in 2011. Even more encouraging are the declines in death rates from cancer and heart disease, which together, accounted for close to 50% of all deaths in the United States in 2011. Although HIV is not in the top 15 causes of death, it saw a 7.7% in death rate, but researchers warned that it is still a public health concern particularly among the 15-64-year-old populations.

Monday, October 8, 2012

Abortion: From Contentious Debate to a Non-Issue?

by Philip Alcabes, Ph.D.

There hasn’t been much hope in the past few years that concord will calm America’s no-holds-barred struggle over abortion.  But what if abortion were to become a rare event? There’s reason to hope that a new policy approach might make abortion a non-issue, or at least a less inflammatory one.

This week, the Associated Press reports on a study in St. Louis showing that when women have access to a variety of contraceptives at no cost, abortion rates fall dramatically.  In the study of nine thousand women, many of them lacking health insurance, who were given contraceptives of their choice at no cost, only 0.4 to 0.8 percent had abortions per year – far less than the 2 percent per year that, according to the Guttmacher Institute, is the average for women aged 15-44 nationally.

Why does one study signal hope? Because the rules for women’s health services under the new Affordable Care Act (ACA) – the so-called Obamacare law – require that insurance companies cover contraceptive services for women at no out-of-pocket cost

According to the US Health Resources and Services Administration, insurance plans, except for those sponsored by religious organizations, must cover:

“All Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.”

For roughly the past decade, there have been about 1.2 million induced abortions each year in the US. The percentage of women who need to end a pregnancy with abortion has not declined much during the decade, according to Guttmacher.

The St. Louis study suggests that widespread access to free contraception – which the ACA should help extend – might decrease the need for abortions dramatically.

There are caveats, of course. There’s the religious-insurance-plan exemption, which will allow contraception to remain financially out of the reach of some women. There’s the chance that opponents of women’s health within Congress could push through an amendment removing the free-contraceptive-access provision of the ACA. 

And there’s the problem of correct use of contraceptives. In surveys of women seeking to terminate unwanted pregnancies in the early 2000s, a high percentage said they had used contraception during the month in which they became pregnant. That is, access to contraceptive methods doesn’t necessarily translate into effective use of those methods. Effective use of contraception has probably improved since the surveys were done – but it’s not clear by how much.

And, it’s possible that the struggle over abortion – embodying as it does a fundamental disagreement as to whether America’s search for justice should be based on deeply held beliefs about good and bad behavior, or on widely shared principles of individual rights – can’t be resolved even if abortion becomes a rare event.

Still, it’s worth wondering whether access to contraception, by dramatically reducing need for abortions, might just allow for the abortion fight to turn into an abortion conversation.

Philip Alcabes is a professor in the Adelphi University School of Nursing and director of the Public Health Program. He is an epidemiologist and has studied the history, ethics, and policy of public health.

Friday, October 5, 2012

Weekly Health Roundup

It’s Friday…which means it’s time for the Center for Health Innovation’s Weekly Health Roundup.

This week brings some encouraging news from the world of epidemiology, where NPR’s health blog reports that scientists recently discovered three new human viruses. What’s so good about that? In these three cases, the viruses were found before impacting more than two or three people. The most recent wide-spread viruses, such SARS—which in 2003 spread to over 8,000 people and caused over 750 deaths—followed a trend of a virus emerging in one location then quickly spreading across the globe. What has changed? In addition to new World Health Organization guidelines on information sharing and advances in genetic sequencing, Dr. John Brownstein of Children’s Hospital in Boston believes that with the social media and communications tools available, that “it’s very difficult to imagine…an important public health event where that information isn’t getting out in some form …I think there’s very few places on Earth where we’re not able to get citizen reporting and information.” He and his colleagues are using tools like HealthMap to keep up-to-the-minute information flowing about outbreaks.  

The United States is dealing with outbreak concerns this week, as a form of rare meningitis continues to spread. The New York Times reports that patients are thought to have become ill from a contaminated steroid. This particular form of meningitis does not spread from person to person, although, infection disease professionals do expect additional cases due to where the contaminated drugs have been shipped.

In more domestic news, the Centers for Disease Control reported that in 2011, close to 1 million teens drove drunk. Their report also showed that drunk driving has gone down by 54% since 1991, which seems like an encouraging trend. However, a Los Angeles Times article is quick to point out that this may simply be a function of increased gas prices coupled with fewer opportunities for teens to drive due to drops in employment opportunities for them. The CDC’s report also offers tips on how parents and teens can work together to further decrease rates of drunk driving and the curb behaviors that influence it.

But what really does help when you are trying to modify your behavior? Rewards? Punishments? How can we truly impact behavioral change? Dr. Kent Bottles, a Senior Fellow at The Thomas Jefferson University School of Population Health in Philadelphia, explores a rise in new web tools designed to help us meet our goals. Sites like Stikk have an “anti charity” option that takes money away from you if you don’t stick to your goals, while Aherk exploits user-supplied embarrassing photos as motivation and GymPlant tracks your workouts via smartphone. Could these tools become commonplace, and potentially helpful, for the next generation of teen drivers?

Friday, September 28, 2012

Weekly Health Roundup

Welcome to the Center for Health Innovation’s Weekly Health Roundup, where we’ll take a look at what’s making news in the world of health.

Autism appeared on the international agenda this week when the United Nations 67th General Assembly heard a resolution that “calls for greater participation of the U.N. in recognizing autism as a public health crisis and encourages Member States to tackle developmental disorders at the local, national and international levels.” World leaders also attended Autism Speaks Fifth Annual World Focus On Autism, and further emphasized the importance of raising awareness.

Meanwhile, collection sites across the United States are getting ready for Saturday’s National Take Back Drugs Day, which helps in the safe disposal of expired prescription drugs. The improper disposal of expired or unused medications can pose health risks to children and pets.Adelphi will have a collection site open on Saturday, September 29, from 10:00 am to 2:00 pm in the Ruth S. Harley University Center Lobby, and has an early drop off box available today, in the Public Safety Office, Levermore Hall, lower level.

If you are catching up on the latest fall TV premieres, you may be interested to know that a new study in the Journal of Communication finds that “social bullying is common on TV, even in shows made for kids.” Researcher Nicole Martins, PhD, used Nielsen Media Research data to determine the 50 most popular shows for viewers aged 12 and younger, and watched 3 episodes of each show. Dr. Martins found that “a total of 92% of the viewed episodes included incidents of social aggression, with verbal aggression accounting for about four out of five of these incidents.” She identified this as an opportunity for parents to talk about social bullying with their children.

And finally, we all know it’s rude to “eat and run,” but this week, researchers at the University of Copenhagen discovered that there may be benefits to people who “learn and run.” They asked a group of healthy males to repeatedly complete a complicated motor skill task on a computer, with some of the men exercising before they began, others after they had tried the task several times, and others still not at all; all participants came back a week later to repeat the task. Researchers found that the group who had exercised after learning the task “were noticeably better at remembering the task…which suggests…that physical exercise may help the brain to consolidate and store physical or motor memories.”

See you for next week’s Roundup!

Thursday, September 27, 2012

Adelphi University Pioneers Aphasia Group in Suffolk County

by Bonnie Soman, D.A., CCC-SLP

In September, the Hy Weinberg Center for Communication Disorders (Adelphi University’s Speech and Hearing Center) started a program for individuals with aphasia at our Hauppauge Center. The Center now offers a weekly communication group run by graduate students in the department of Communication Sciences and Disorders under the supervision of Dr. Bonnie Soman, clinic director and licensed speech-language pathologist. This is the first group of its kind in Suffolk County.

Aphasia is a communication disorder resulting from some type of brain injury. Oral communication (speaking and understanding of  language), as well as written language (reading and writing) may be affected. Although most typically caused by stroke, aphasia may result from traumatic brain injury or brain tumor. Although more common in older adults, aphasia may occur in individuals of any age. Each year, more than 100,000 people in the United States acquire aphasia.

There are three goals in running our aphasia group:
  • Therapeutic – to assist participants in communicating with one another, as well as with the clinicians;
  • Support – to offer the support of others who have had similar experiences;
  • Social – to provide the opportunity and the assistance so that participants can interact with one another in a relaxed and enjoyable setting.
Aphasia affects not only the individual who acquires this disorder but family members as well. Serving as a caregiver may interfere with work and other family responsibilities. The caregiver often neglects his/her own needs to care for the person with aphasia. To address this, the Hy Weinberg Center in Hauppauge is running a weekly support group for family members.

Enrollment is ongoing. For information, contact Dr. Bonnie Soman:
  • (tel) 516-877-4845
  • (email) soman@adelphi.edu

Dr. Bonnie Soman is a speech-language pathologist and Director of the Hy Weinberg Center for Communication Disorders on campus. Her work involves supervising students as they engage in clinical practice coursework. She has worked with clients across the lifespan, but has a particular interest in working with adults with communication problems and their families.

Thursday, September 6, 2012

Working Together for a Healthier World

by Caroline T. Roan

When I was invited to post on Think About It, I was reminded of a recent article by Paul Klein on the Forbes CSR Blog, “Defining the Social Purpose of Business.”  I was included in interviews he did with business leaders on social purpose and its relationship to a company’s approach to corporate responsibility.

Mr. Klein believes that “every corporation has an overarching social purpose that transcends the operations of corporate social responsibility and, when well understood and effectively integrated, can have profound business and social results.” At Pfizer, we agree with him. The social purpose of our business is to discover and develop new and innovative medicines that prevent and treat disease, allowing individuals to live longer and healthier at every stage of life. That is why my colleagues and I come to work every day.

Corporations have a responsibility to provide value to their shareholders. But these days, the definition of value is expanding. It is more than just monetary. In exchange for providing companies with a license to operate, society has great expectations. Companies are, rightfully, judged on issues far beyond just the profits they make.

Pfizer is one of many companies that now reports on both financial and non-financial performance indicators. Two years ago, we began combining our Annual Report with our Corporate Responsibility Review into a single review. Our web site www.pfizer.com, and our annual integrated report highlight our financial, environmental and social performance.  Additionally, we voluntarily participate in various sustainability questionnaires, such as those offered by Carbon Disclosure Project (carbon, water), Bloomberg (Climate Innovation Index), and Newsweek (Green Rankings).  We are committed to improving our transparency through reporting.

In order to address current and future public health challenges, everyone involved in the health care dialogue will need to listen with an open mind and commit to working together for a healthier world. That isn’t just our tagline, it is the purpose of our business.

Caroline T. Roan is Vice President of Corporate Responsibility & Reputation at Pfizer Inc, the world’s largest biopharmaceutical company headquartered in New York.  She is also President of The Pfizer Foundation. Under Ms. Roan’s leadership, Pfizer continues to be a top corporate donor and has received local, national and international awards and recognition for its corporate responsibility programs. She will be speaking at the Adelphi University President’s Series on Critical Issues on Thursday, September 13, 2012, 8:30 a.m. – 10:00 a.m. 

Monday, July 30, 2012

What Does Not Kill You Makes You Stronger

by Roni Berger, Ph.D., LCSW

Most of us heard about the German philosopher’s Nietzsche statement in the title; however, until quite recently, we heard much more about the devastating effects of struggling with highly stressful events.
As communication advances, media and social networks make all of us in the global village involved witnesses to traumatic experiences inflicted on individuals, families and communities around the world as soon as they occur. Natural disasters such as flood, hurricanes, bushfires and earthquakes, as well as human made catastrophes like wars, terrorist attacks, the failure of atomic reactors, and personal assault including rape and abuse, all take their toll in lives, injuries, devastation, psychological, health, social and financial outcomes.

Both those directly exposed and those close to them such as family members or professional service providers are affected. However, while the idea was around for a long time, only in the last three decades, we have reliable evidence that together with negative effects, traumatic exposure may also lead to benefits called posttraumatic growth (PTG). PTG has been documented in different cultural contexts followingdiverse stressor events. While its nature and manifestation are culture-specific, universally, growth may include different combinations of the core elements of interpersonal relationships, values, and beliefs, attitudes to life and view of self.

It is important to remember several basic facts:
  1. It is the struggle with the traumatic event rather than the occurrence itself that may lead to growth;
  2. Negative and positive outcomes of the struggle are two separate rather than opposite processes and may occur simultaneously;
  3. Not everybody experiences posttraumatic growth and thus, not getting benefits from the struggle is NOT a failure;
  4. Many factors determine if growth occurs such event, personal, and environmental characteristics;
  5. Growth, if it occurs, happens later in the process. No good comes of expecting it or pushing for it.

Dr. Roni Berger is a professor in the Adelphi University School of Social Work. She teaches courses in quantitative and qualitative research methods and practice with individuals, families and groups in the M.S.W. and D.S.W. programs, as well as a course on practice with immigrants and refugees. Together with Tzipi Weiss, Roni Berger co-authored the book Post-Traumatic Growth and Culturally Competent Practice.

Friday, July 27, 2012

Ready…or not?

Hurricanes, thunderstorms, extreme heat, power outages–it seems disasters are popping up daily, bringing us new challenges to think about and plan for. While we can’t control when emergencies happen, at the very least we can use them to prepare ourselves: or can we?

A new Adelphi University Center for Health Innovation poll finds that most Americans are not only unprepared for emergencies, but also incorrectly assume that they are ready for whatever comes their way.

USA Today’s ”Healthy Perspectives” blog  and the Centers for Disease Control’s “Public Health Matters” blog provides a summary of the results as well as a link to a more detailed report of the results. The poll has already ignited debate and discussion among people who are trying to make sense of how to be as prepared as possible for the unexpected.

Visit the Center for Health Innovation’s poll section for information, resources, and stories from people who have first-hand experience about the impact of disasters and the importance of being prepared. 

The Adelphi Natural Disaster Survey was conducted by Wakefield Research among 1,003 American adults, ages 18 and older, between May 15th and May 23rd, 2012, using a random-dialing telephone survey. Quotas have been set to ensure reliable and accurate representation of the U.S. adult population ages 18 and older.

Monday, July 23, 2012

Supreme Court Upholds Health Care Law: Good, Bad, or a Bit of Both?

by Philip Alcabes, Ph.D.
Although the Justices were expected to strike down the Affordable Care Act, the Obama administration’s health-care financing law passed in 2010, the Supreme Court upheld it in a 5-4 ruling today.

The law has a number of favorable effects, as Josh Levs at CNN cogently explained today.

Most important for students, Americans may now be covered on their parents’ health-insurance policies up to the age of 26. Important for everyone, it will no longer be permissible for insurance companies to refuse to cover young people with so-called pre-existing conditions or, beginning 2014, to refuse to cover anyone with a pre-existing condition.

The most vexatious provision of the law, the mandate that everyone not covered by either Medicaid or Medicare buy an insurance policy, stands for now.

To enforce the mandate, a family can be fined $285 or 1% of income, whichever is greater, if it doesn’t have health insurance in 2014. And the fine would go up to $2085 or 2.5% of income by 2016.

The Obama administration had argued that this financial penalty is okay under the Constitution: it’s a way to force more people to buy health insurance, the administration said, and that is the best way of making insurance less expensive for everyone–the more people who pay premiums to an insurance company, the cheaper the premiums can be. Congress has the right to regulate interstate commerce so, for the administration and its supporters, the Affordable Care Act is constitutional.

Others, including some private companies and 26 states’ attorneys general, had said that the mandate amounts to the federal government forcing citizens to buy a product, and therefore unconstitutional.

The big surprise is that Chief Justice Roberts, who usually sides with Court conservatives, cast the deciding vote and wrote the upholding opinion. The second big surprise is that Roberts’s opinion upholds the law not because Congress can regulate commerce – as Obama had wanted. Instead, he says it’s okay because the mandate is really a tax. And of course Congress is allowed to levy taxes.

What should we make of this? Surely it’s a good thing to make health insurance more available to more Americans. And especially good to stop insurers from refusing to indemnify people who are already sick or injured.

But if the mandate is a tax, then it seems that it’s okay for Congress to tell you to pay a tax either to the federal government (the fine for not having insurance) or to a private company (in the form of insurance premiums).

Wait–is it really okay to have to pay taxes to a private corporation?

Another problem today: the ACA’s expansion of Medicaid–the state-based programs that provide health insurance for the poor–has been questioned by the Supreme Court’s decision.

The Affordable Care Act has lots of good things in it. But it isn’t really health care reform–it’s more of a health care financing law. It doesn’t apply to everyone. And it might not work to create more insurance coverage for the poor.

Plus, the high court’s decision upholding the law seems to break new ground in giving private corporations the power to determine how Americans should look after our health and how much we should pay.

Some people think that’s better than letting governments make those decisions.

Others disagree.

What do you think?

Philip Alcabes is a professor in the Adelphi University School of Nursing and director of the Public Health Program. He is an epidemiologist and has studied the history, ethics, and policy of public health.

Wednesday, June 6, 2012

The super size soda ban: public health or public relations?

by Philip Alcabes, Ph.D.

New York’s mayor Michael Bloomberg announced last week that he is going to ban serving soda or other sweet beverages in large sizes in New York City. The order would limit servings to no more than 16 ounces, basically wiping out the Big Gulp and its super-size friends. It would not affect the sale of big bottles of soda in grocery stores, but would limit consumption in movie theaters, ball parks, and so forth.

Bloomberg is not asking for a new law – since it might not pass, given that a NY1-Marist poll finds that about half of New Yorkers oppose the idea. Instead, he will make it an executive order, which needs only a go-ahead from the city’s eleven-person Board of Health — all appointed by the mayor. And the courts aren’t likely to find it onerous or unjust – since if a New Yorker really, really wants to drink 32 ounces of, say, Mountain Dew all at once, she can just buy two 16-ounce cups.

It’s true that Americans drink a lot of soda. As of 2000, it was estimated that 15% of the average American diet comprised added sugars (i.e., not naturally occurring in foods, like the fructose in apples) – and that about half of the added sugar came from soft drinks. And it’s also true that Americans are heavier now than a generation ago.

So the NYC super-size-soda ban (shall we call it the SSSBan?) is pitched as a public health victory. For instance, Barry Popkin, a professor of nutrition at the UNC-Chapel Hill School of Public Health and a longstanding anti-obesity crusader, says that “controlling sugary beverage portions sizes is critical for reducing weight gain and [the] risks of diabetes in the U.S.”

And Ellen Rautenberg, CEO of Public Health Solutions (a private, nonprofit research firm associated with the NYC Department of Health) points out that limiting portion size is “…one important approach to this multifaceted problem [i.e., obesity] and applying this to sugary drinks, particularly those with no nutritional value, is an excellent place to begin. We went from happily accepting bottles of soda that were 6.5 fluid ounces and have now come to expect that a “regular” drink is 32 ounces.”

(I’m not sure Rautenberg is right that most people think of a quart as a regular-sized portion of soda. But she makes the point about the need for adjusting the landscape of consumption, if we want people to be slimmer.)

And Walter Willett, chair of the nutrition department at the Harvard School of Public Health, says that “New York City’s plan to limit the serving size of soda and other sugar-sweetened beverages sold in restaurants is well-justified by solid evidence. High intakes of these beverages increase the risks of obesity and diabetes and are clearly unsafe for anyone.”

There’s a big problem with the public health argument for the SSSBan, though: it’s probably false.
First, a comprehensive meta-analysis published in 2008 in the American Journal of Clinical Nutrition summarized studies examining consumption of sugar-sweetened beverages in relation to childhood obesity — and found no relationship of sugary-beverage consumption with body mass index.
Willett and his Harvard colleague Frank Hu did their own meta-analysis of studies relating sugary-beverage consumption in children, reporting (Am J Clin Nutr, Jan. 2009) that the average kid who adds one 12-ounce soda to his diet every day would gain 29 kg (64 lbs) per year compared to the same-sized child who does not. But the Willett and Hu results were based only on studies that failed to adjust for total dietary intake. Doing a good analysis of bad science (even at Harvard) doesn’t make the results any more valid.

At the very least, there’s reason to question whether it’s soda that makes obese children obese, or general caloric intake, or lack of exercise, or a combination of all of those.
Second, even if the evidence that soda consumption is associated with weight gain is correct, there has never been evidence that limiting soda consumption to 16 ounces (as opposed to 8 ounces, or 6 ounces, or zero!) can prevent or undo obesity.

Third, if soda is a public health enemy, as Popkin and Willett imply, then it’s hard to see how anything is to be gained by getting McDonald’s to sell sodas only in smaller sizes while large bottles are still available in the supermarket or the bodega down the block.

So here are some questions to think about:
  • Is the proposed SSSBan just a publicity ploy? Or, as Mayor Bloomberg insists, is it a small step in the right direction?
  • If soda is really toxic, should it be banned outright? If it’s not banned outright, should it be like alcohol — sold only to adults, and only if they haven’t already had too much?
  • Everyone agrees that government should protect the public’s health – where would we be without a supply of clean water, or sewage disposal, or air-pollution controls? But should government be in the business of nudging us toward better, healthier behavior?
So far, the SSSBan is only planned for NYC. But it could go further. How should you decide if it’s the right thing for your community?

Philip Alcabes is a professor in the Adelphi University School of Nursing and director of the Public Health Program. He is an epidemiologist and has studied the history, ethics, and policy of public health.

Friday, May 11, 2012

Who wins the mommy wars?

by Sarah Eichberg, Ph.D.

The recent media firestorm over the ‘mommy wars,” shows just how socially relevant and significant the debate remains. Yet, as in previous disputes over the contributions of working and stay-at-home mothers, white, affluent women were rhetorically privileged and the varied interests and experiences of all other women ignored.

In their arguments, most politicians and pundits routinely presented a false binary of “choice,” as if mothers act independently of social context and are free to remain at home or in the labor force. But the simple fact is that most American women do not have the luxury to choose.

As they are framed, the mommy war debates deny the multiple constraints women face daily –in and out of the home–which restrict autonomy and create challenges to caring for their families’ economic, psychological and physical well-being.

Today, 70.8% of mothers are in the labor force, either working for pay or looking for a job. The reality is that in most two parent households, it takes two incomes to thrive or even survive. As real wages for men have declined over the past 30-40 years, women’s earning have become critical to even approximating a middle class existence. For many women, it’s either work or lose your home or forego healthcare or endure food insecurity.

What’s more, the “decision” to stay at home is not necessarily born out of a desire to leave a job. Many women are forced out by unfriendly work environments– low pay, inflexible parental leave – and a societal apathy toward affordable childcare that makes it impossible for women to earn a living and care for their children at the same time. As of 2009, there were 5.7 million married stay-at-home mothers in America. Rather than suburban soccer moms, the greatest concentration of married stay at home moms was young, Hispanic, foreign-born and without high school or college degrees. It is quite likely that many of these women need to work but lack the education and skills to find the high wage jobs that cover childcare costs.

The recent conversation about motherhood and choice becomes even more perverse when juxtaposed with current attacks on federal benefits, like the Supplemental Nutrition Assistance Program (SNAP) or Food Stamps, which offer low-income women, married or not, a key means to maintain some degree of economic self-sufficiency, by helping them put food on the table. With the dismantling of welfare in the 1990s, SNAP has become the first-line of defense against poverty. Even reducing these benefits would make millions of mothers and their children vulnerable to hunger, chronic health conditions, and mental distress.

As recent events show, this country remains conflicted about working mothers but not because of a quarrel over choice. Instead, we still have not become reconciled–in belief or in policy–to shifting gender roles (where are the fathers in all these discussions?) or the nation’s profound gap between the haves and the have-nots. As long as we – men and women – accept false narratives of equality and allow politicians and pundits to cynically frame our real life experiences as simple expressions of free-will, we will forever find ourselves trapped in rhetorical mommy wars, while the real issues of gender and economic justice are ignored.

Dr. Sarah Eichberg is the Director of Community Research of Adelphi University’s Institute for Social Research and Community Engagement (iSoRCE), whose mission is is twofold to generate actionable knowledge through collaborative social research, and to use that knowledge to better understand and address Long Island’s critical and enduring social issues.

Wednesday, April 4, 2012

A Canine Connection

by Chris Gasiewski

With students aligning the walls of room 228 in Alumnae Hall on March 30, Bridget and Delilah—two Darlington Great Pyrenees—were providing instant gratification to one corner of the room. Orion, their counterpart, was resting comfortably underneath the arm of freshman Brian Hamel.

It wasn’t your typical classroom setting. Instead, it was a glimpse into Dr. Diane Dembicki’s Healing and the Arts course, which is housed in the School of Nursing. The class teaches several different types of therapies, including art, music, dance and drama treatments. And the latest healing demonstration displayed how therapeutic dogs can provide a slice of happiness to hospital patients.

“You don’t get that experience often. Seeing these dogs changed my thinking,” said Brian, a self-proclaimed cat lover. “People were calling me the dog whisperer.”

Maybe so, but the Great Pyrenees were actually trained by Susie Wong, who has raised and specialized in Great Pyrenees for more than 20 years. Primarily, she visits North Shore-Long Island Jewish University Hospital two-to-three times a week, bringing the cuddly canines to several floors and units in the hopes of bringing a smile to the faces of the patients.

“They touch their souls,” said Ms. Wong, who recruited her children, Michael (21), Lauren (19) and Michelle (15) into the family business. “It’s just incredible. People in general forget how lucky we are. Going into the hospital and meeting all kinds of people from all walks of life, it’s just incredible.”

Ms. Wong witnesses the overwhelming joy that her dogs bring almost daily. She’s most fond of the palliative care unit, where her work has been rewarded with seeing great responses out of patients. She also tells the story of a little girl who suffered from a bone disease that resulted in pain when she made facial expressions. However, Ms. Wong’s dogs changed that.

“There were days she would come in and eat, and she would smile,” Ms. Wong said. “She said to me that ‘you are the only one who has ever made me smile.’”

Spring 2012 marked the third straight semester that Dr. Dembicki hosted Ms. Wong and the therapy dogs. Reviving the course after a brief hiatus, Dr. Dembicki has provided her students with an experiential learning experience like no other.

She assigns projects that include viewing various art pieces and sculptures around campus to observe their therapeutic characteristics. On Wednesday, April 4, the class will perform music therapies outdoors. There’s a social commentary component on contemporary arts and healing, as well as folk healing and shamanism. The class also did a community service project and made a voluntary contribution to the Pet Therapy Program, which was founded by Ms. Wong, at North Shore-LIJ Hospital.

“It looks at various therapies in healthcare,” Dr. Dembicki said of the course. “It is an interdisciplinary class, and we have faculty come in from the art department and psychology department. We make use of the computer technology at the University on Moodle, where the students have a weekly discussion forum.”

Mostly, Dr. Dembicki said, the class is popular because it allows students an opportunity to decompress from the rigors of academia. Her students, including Brian, agree.

“This class is really important for everyone to take,” Brian said. “If anything, it’s an escape from the daily stress and you can stimulate your mind in a different way. It’s really, really useful.”

For behind-the-scenes pictures and to find out when our therapy dogs video is ready, follow Adelphi University on Facebook.

Tuesday, February 28, 2012

Wading through the aftermath

Traumatic events bring with them a host of reactions—shock, fear, anger, and an insatiable quest to understand “why here, why now?”. Residents of Chardon, Ohio, are experiencing that range of emotions this week as they grapple with a school shooting that has claimed the lives of three students and wounded two others.

Dr. Jessie Klein, assistant professor in sociology and criminal justice at Adelphi was on CNN this morning to discuss the Ohio shooting incident. Author of the upcoming book The Bully Society: School Shootings, and the Crisis of Bullying in America’s Schools, Dr. Kleinfocused on the increasing isolation and fear that plague many school-aged children. She advised us to avoid looking for “red flags” in individual students and instead to look for “red flag” schools, whose cultures may promote mistreatment among students. Dr. Klein was also a guest on the Brian Leher show on WNYC, where she offered additional insight into the evolution of bullying and school shooting incidents in the United States, the impact of bullying on children, and schools’ roles in prevention.

The next few weeks will shine an increased spotlight on issues of bullying and violence in schools, as friends, family, and the public-at-large are searching for answers. But is our search helping us prevent future tragedies? Only time will tell.

Tuesday, February 14, 2012

Valentine’s day and your health: a lifelong relationship

Have you noticed that things seem a little more pink, cheerful, and flowery lately? That’s because today is Valentine’s Day, a holiday that is as loathed as it is loved. If you’ve turned on a TV or been anywhere online today, you’ve likely come across the most common complaint of day: it’s yet another “Hallmark Holiday” invented as a way to sell trinkets and candy and cards. (If you feel strongly about the day but can’t quite find the right words for your own Facebook or Twitter posts, consider getting some help from trusted status experts.)

There does, however, appear to be at least some historical record of Valentine’s Day. If you want to delve into day’s murky past, The History Channel offers a rather comprehensive explanation of the holiday—while also sharing that approximately 150 million greeting cards are exchanged on the day.
The Rebel Yell, the award-winning official student newspaper of the University of Nevada, Las Vegas offers a different perspective on the holiday. Columnist Doc Bradley says we shouldn’t blame Hallmark for just continuing the tradition of Valentine’s Day as a scam, and advises us to remember “that truth and romance are not necessarily the best of friends.”

Feeling happy and lovey-dovey yet?

Whether created or historic, Valentine’s Day is a holiday you simply can’t escape. Media coverage takes a certain delight in drawing the single vs. non single battle lines, painting each side as worthy of both envy and pity. There are online survival guides that encourage those without a partner to proactively ward off the negative impact of Valentine’s day by making plans, and not defining themselves by their relationship status. A recent counter to Valentine’s Day is Singles Awareness Day. If you’re not sure how to celebrate properly, you can get a quick primer here on all things S.A.D.

If you think being in a couple makes Valentine’s Day all roses: think again. CNN contributor and comedian Dean Obeidallah provides perhaps this year’s most comprehensive perspective on why couples are the big losers on Valentine’s Day. The pressure of the day makesValentine’s Day “the bully of love,” writes Kelli Forsythe, relationship therapist with Psychological Counseling Services, Ltd. It can also shine an unwelcome spotlight on issues within a couple.

But the recipe for couples’ success on Valentine’s Day is no different from any other day. As renown psychologist Esther Perel notes, “love flourishes in an atmosphere of mutuality and reciprocity.” Later this month, Dr. Perel, an international authority on couple therapy, cross-cultural relations, and culture and sexuality, will be a guest of the Adelphi University School of Social Work Continuing Education and Professional Development program. Her all-day workshop on February 24 will focus on “The Psychology of Erotic Desire in Couples.”

Whether you’re single, paired up, or somewhere in between, perhaps today we should just take a tip from family mental health blogger Erica Krull, and embrace a day that is “about sharing and showing love.” After all, the love of family, friends, and yes, partners is good for us—mentally, physically, and emotionally. Love can keep our blood pressure low, it can reduce stress, and it can bring an added level of fulfillment to our every day lives.

See? No flowers or candy necessary.