Health Beat MAGAZINE
A PUBLICATION OF THE RICHMOND REGISTER
FEELING THE BURN WITH BURNS:
TIME TO MAKE MY FAT
still common in the wild
As long as rabies is circulating among wildlife populations, our best protection against this fatal disease is to keep dogs and other pets vaccinated annually.
How many steps are enough? DEALING WITH THE
2 Richmond Register
Tiny preemies get a boost from live music therapy By Lindsey Tanner AP Medical Writer
CHICAGO — As the guitarist strums and softly sings a lullaby in Spanish, tiny Augustin Morales stops squirming in his hospital crib and closes his eyes. This is therapy in a newborn intensive care unit, and research suggests that music may help those born way too soon adapt to life outside the womb. Some tiny preemies are too small and fragile to be held and comforted by human touch, and many are often fussy and show other signs of stress. Other common complications include immature lungs, eye disease, problems with sucking, and sleeping and alertness difficulties. Recent studies and anecdotal reports suggest the vibrations and soothing rhythms of music, especially performed live in the hospital, might benefit preemies and other sick babies.
AP PHOTO/M. SPENCER GREEN
Music therapist Elizabeth Klinger, left, quietly plays guitar and sings for Henry Buchert and his mother Stacy Bjorkman, in the Pediatric Intensive Care unit at Ann & Robert H. Lurie Children’s Hospital in Chicago. Research suggests that music may help those born way too soon adapt to life outside the womb. Recent studies and anecdotal reports suggest the vibrations and soothing rhythms of music, especially performed live in the hospital, might benefit preemies and other sick babies. Many insurers won’t pay for music therapy because of doubts that it results in any lasting medical improvement. Some doctors say the music works best at relieving babies’ stress and helping parents bond with infants too sick to go home. But amid beeping monitors, IV poles
and plastic breathing tubes in infants’ rooms at Chicago’s Ann & Robert H. Lurie Children’s Hospital, music therapist Elizabeth Klinger provides a soothing contrast that even the tiniest babies
Turn to MUSIC THERAPY, page 7
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Richmond Register 3
Rabies still common in the wild As long as rabies is circulating among wildlife populations, our best protection is to keep dogs and other pets vaccinated annually.
READ CHRISTIE GREEN’S COLUMN ON PAGES 8-9
GROWING UP: Dealing with the terrible temper tantrums . . . . . . . . . . . . . . . . . . . . . . .page 4 FEELING THE BURN WITH BURNS: Time to make my fat cry . . . . . . . . . . . . . . . . . . . . . . .page 5 THE BREAKING POINT: Defeating bullies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 6 DR. JACK RUTHERFORD: How many steps are enough? . . . . . . . . . . . . . . . . . . . . . . . . .page 10 RECIPE FOR A HEALTHY LIFE: A lighter take on barbecued chicken . . . . . . . . . . . . . . . . .page 11 MENTAL MORSELS: Defining your terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 12 MEDICAL MINUTE: Best workouts for good health . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 13
Health Beat is an official publication of the Richmond Register
CHIROPRACTIC CORNER: Try chiropractic for help with migraines . . . . . . . . . . . . . . . . .page 14
Study questions how sharply U.S. should cut the salt WASHINGTON (AP) — A surprising new report questions public health efforts to get Americans to sharply cut back on salt, saying it’s not clear whether eating super-low levels is worth the struggle. Make no mistake: Most Americans eat way too much salt, not just from salt shakers but because of sodium hidden inside processed foods and restaurant meals. The report stresses that, overall, the nation needs to ease back on the sodium for better heart health. But there’s no good evidence that eating very low levels — below the 2,300 milligrams a day that the government recommends for most people — offers benefits even though national guidelines urge that certain high-risk patients do just that, the Institute of Medicine concluded. Also, there are some hints, albeit from studies with serious flaws, that eating the lowest levels might actually harm certain people — those who are being aggressively treated for serious heart failure, the report added. The prestigious group, which advises the govern-
ment about health, urged more and better research to settle the best target range. “We’re not saying we shouldn’t be lowering excessive salt intake,” said Dr. Brian Strom of the University of Pennsylvania, who led the IOM committee. But below 2,300 mg a day, “there is simply a lack of data that shows it is beneficial.” The average American consumes more than 3,400 mg of sodium a day, equivalent to 1 1/2 teaspoons. Current U.S. dietary guidelines say most people should limit that to 2,300 mg a day, while certain people — those older than 50, African-Americans, and people with high blood pressure, diabetes or chronic kidney disease — should aim for just 1,500 mg. The report sparked an immediate outcry from health organizations that have long battled to lower the nation’s salt consumption. The American Heart Association said it stood by its own recommendations, stricter than the government’s, that everyone eat no more than 1,500 mg of
Turn to SALT, page 15
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Dealing with the
TERRIBLE TEMPER TANTRUMS
he mother could tell it was about to begin. She had just told her 2-year-old that she could not have a cookie. The 2-year-old’s face was beginning to turn red. She was starting to open her mouth where a howling, high-pitched screech came out with the words, “I want it!” The girl proceeded to continue screaming and
stomping her feet. The mother is beginning to wonder if these frequent temper tantrums are normal and if so, will they ever go away? Temper tantrums are never easy to deal with, especially when it is your darling little one that is throwing the tantrum. The good news is that temper tantrums in
well-being with every step
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young children is a normal part of development and will typically go away in time. Temper tantrums are a sign that toddlers are becoming more independent and they want the world to know it. However, they only have limited ways of displaying their wants and needs. This usually consists of basic words like “no” and behavioral outbursts. Temper tantrums tend to start around 18 months of age, worsen between the ages of 2 to 3 years old, and then lessen by the age of 4. By the age of 4, most children have sufficient language skills so that they are better able to communicate their wants and needs through words versus actions. While it is comforting to know that temper tantrums will eventually fade, there are still a couple of years in which parents need to deal with them. When a tantrum does occur, it is important to stay calm and see how the tantrum progresses as they are often short-lived. Ignoring minor displays of anger such as crying, screaming, and kicking can also shorten the duration of the tantrums. Other times distraction like changing the child’s location can prevent a tantrum. However there are some behaviors that are not okay and should not be ignored. This includes hitting or kicking people, throwing things that might hurt others, or
DAN FLORELL, PH.D. AND PRAVEENA SALINS, M.D.
screaming or yelling for long periods of time. If any of these behaviors occur, take the child away from the problem and say firmly, “No hitting” or “No yelling” to ensure the child knows the behaviors are not okay. Of course prevention can be the most satisfying approach to temper tantrums. One technique is to encourage the child to use words to tell how he is feeling. Another technique is to set reasonable limits and not expect the child to be perfect. A third technique is to keep a daily routine as much as possible so the child knows what to expect. Finally, give the child choices such as asking whether they want to eat their goldfish or drink their juice. It is harder for the child to get upset when they have some choices. There are some children who continue to tantrum regularly past 4 years old. If the tantrums are severe or happen too often, it could be a sign of early emotional problems. If this is the case, consult with a pediatrician or child psychologist about the issue.
Dan Florell, Ph.D., is an assistant professor at Eastern Kentucky University and has a private practice, MindPsi (www.mindpsi.net). Praveena Salins, M.D., is a pediatrician at Madison Pediatric Associates (www.madisonpeds.com).
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TIME TO MAKE MY FAT If
every time I wrote this column I talked about how great I was doing with my weight-loss efforts, you would know I was lying to you. I almost didn’t want to start this column because I knew if I hit a snag, I would feel crappy about reporting it to the people who are holding me accountable. Although I want to be happy for other people who make and achieve weightloss goals, I find myself shutting them out, mostly because I’m jealous that I’m not getting the same results. None of this is Neil’s fault. He’s constantly encouraging. He kicks my butt during workouts to maximize my calorie burn. And most importantly, he never gives up on me. I’ve not given up on myself, by no means, but I’m currently searching for ways to recommit myself to this journey in light of a work/home schedule that has become increasingly crushing. Let me tell on myself. Here’s what I do: I don’t eat breakfast. I work all day and grab some food when I can (most of the time it’s a notso-healthy choice). When I get home, I’m starved and am usually inclined to eat whatever is easiest to consume. I go to sleep late, wake up early, and repeat. Neil always says if you get your eating right, the rest will fall in line. I know that’s true because I’ve kept up the same intensity during workouts, but have strayed (far)
from my calorie goals (either too much or too little). I have to remember it’s not always about eating less, but eating right. During January, the first month of my weight-loss journey, I lost more than 10 inches and almost 10 pounds. But once I stopped keeping an eye on calories and eating the right foods at the right times, I stopped losing. I was asked to include in my column a numbers update on pounds and inches lost, but I don’t have one. I’ve not lost anymore weight. But I still have hope. When I lost 70 pounds before my pregnancy, I thought I would NEVER see those pounds again. I swore I would never gain them back. I couldn’t even fathom it. But I know of others who have gotten closer to their weightloss goals than I, but suddenly found themselves right back where they started. For example, Neil said one time he lost more than 100 pounds. But he got injured somehow, gained every bit of it back and then some. It’s a familiar story for anyone who has tried to lose weight. I don’t know the answers right now. To some, losing weight seems as simple as calorie-watching and exercising, but it’s the most difficult thing to actually do. Being discouraged about the progress of my weight loss has stopped me from continuing before – but not this time. Quoting redneck extraordinaire Joe Dirt: “You gotta
THE BURN WITH
Editor’s note: The Register featured Richmond native Neil Burns three times over the course of his incredible weight-loss journey. In 2010, Burns was a 680pound backhoe operator who began to lose weight “the old-fashioned way” through healthy eating and exercise. Today, Burns is a personal trainer at CRYSTAL WYLIE First Step Fitness and is helping others make FEELING THE BURN their own incredible weight-loss stories. WITH BURNS
keep on keepin’ on.” Regardless of my slow progress, I’m getting in regular workouts, I’m building fat-burning muscles, and I’m elevating my heart-rate during cardio exercise. I look at Neil, who just celebrated his three-year anniversary since he started the journey to lose 400
pounds, and I know I don’t have nearly as far to go. I can be at the weight I want to be within a year if I could just get this right. I have to get this right. In a recent Facebook status update, Neil wrote it was “time to make my fat cry.” I agree Neil; that’s what time it is.
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THE BREAKING POINT
ave you or your child ever had to deal with bullies? When most people think of bullies they think of the old school-yard, but that isn’t always the case. Bullies come from all walks of life. They come in different shapes, sizes and all ethnic backgrounds. In the end, for the most part, bullies are who they are because of low self-esteem. Maybe they were treated that way and believe that everyone must go through it. Or their lives are so bad and uneventful that they feel the need to share it with you. A person has two options when it comes to bullies. Either stand up for yourself or back down and continue to take the punishment. Now standing up means many things, and only one aspect is physical. It also happens to be the last option. You’ve probably heard the saying, “The worst thing about war is war itself.” So it is with physical altercations because there are so many uncontrollable variables that can go wrong during a fight. While they may be necessary from time to time, more often than not they can easily be avoided with a little brains. There are a few basic prepare strategies to defeat a bully nonviolently. One is to simply walk away. This is usually very easy to do and it takes some guts or moxie to do. Now when you walk away, keep your head up and walk away no matter what the bully or bullies say. Above all, don’t mouth back or say or do anything that would raise tensions. Be humble and walk slowly and confidently. This is usually the best
approach. MASTER WILL It’s safe, SCHNEIDER easy to do,and has little to no drawbacks. Plus while walking away you could tell a teacher or supervisor about what happened. Parents, teachers and coaches can teach this technique and others quickly and safely. A second tactic is to make a joke out of a taunt and make light of it or agree with the bully. For example, let’s say a bully makes fun of your neon-orange with blue, pink and purple stripe shirt. An easy response would be to agree with the bully that the shirt is ugly and that you’re wearing it as a bet. Another easy one is to blame it on your mom or wife for picking out such a bad selection. If you notice these don’t require a lot of thought, and it quickly calms down the situation., especially if the bully has lots of friends around and feels he or she has to look good in front of their buddies. Usually this tactic works very well. Just be sure to look the bully in the eye when you say it and stand up straight with good posture and speak in a confident, nonaggressive voice. More on this next time ...
Master Will Schneider is the CEO of Elite Martial Arts & Fitness, Martial Arts Global, and the Elite Martial Arts Challenge. He is a 1996 World Martial Arts Hall of Fame Inductee and a popular speaker on self-defense, leadership skills and child protection skills. He can be reached at Was8189@gmail.com.
Music therapist Elizabeth Klinger, right, quietly plays guitar and sings for Augustin as his mother, Lucy Morales, sits next to him in the newborn intensive care unit at Ann & Robert H. Lurie Children’s Hospital in Chicago.
Continued from page 2 seem to notice “What music therapy can uniquely provide is that passive listening experience that just encourages relaxation for the patient, encourages participation by the family,” Klinger said after a recent session in Augustin’s hospital room. The baby’s parents, Lucy Morales and Alejandro Moran, stood at the crib and whispered lovingly to their son as Klinger played traditional lullabies, singing in Spanish and English. “The music relaxes him, it makes him feel more calm” and helps him sleep better too, Lucy Morales said. “Sometimes it makes us cry.” Some families request rock music or other high-tempo songs, but Klinger always slows the beat to make it easier on tender ears. “A lot of times families become afraid of interacting with their children because they are so sick and so frail, and music provides them something that they can still do,” Klinger said, who works full time as a music therapist but her services are provided for free. Music therapists say live performances in hospitals are better than recorded music because patients can feel the music vibrations and also benefit from seeing the musicians. More than two dozen U.S. hospitals offer music therapy in their newborn intensive care units and its popularity is growing, said Joanne Loewy, a music therapist who directs a music and medicine program at Beth Israel Medical Center in New York. Preemies’ music therapy was even featured on a recent episode of the hit TV show “American Idol,” when show finalist Kree Harrison watched a therapist working
Richmond Register 7
with a tiny baby at Children’s Hospital Los Angeles. “Music is such a huge part of our lives and to do something like this, make it a sort of healing process, is a cool thing,” Harrison said on the April 25 episode. Dr. Natalia Henner, a newborn specialist at Lurie hospital, said studies in nursing journals show music therapy for preemies “does help with promoting growth. And there’s some good literature ... saying that the time to discharge is a little bit shorter in babies who’ve been exposed to more music therapy.” She said it “definitely facilitates bonding” between parents of preemies and other babies too sick to go home. Loewy led a study published last month in the journal Pediatrics, involving 11 U.S. hospitals. Therapists in the study played special small drums to mimic womb sounds and timed the rhythm to match the infants’ heartbeats. The music appeared to slow the infants’ heartbeats, calm their breathing, and improve sucking and sleeping, Loewy said. Soozie Cotter-Schaufele, a music therapist at Advocate Children’s Hospital-Park Ridge near Chicago, says soothing rhythmic sounds of music can mimic womb sounds and provide a comforting environment for preemies.
She sings and plays a small harp or guitar, and says the sounds help calm tiny babies while they’re undergoing painful medical procedures. Cotter-Schaufele said she recently heard from a woman whose daughter was born prematurely at her hospital six
years ago. She had played the 1960s folk song “Today” for the infant. The mother reported her daughter “’still loves that song,” She said ‘She didn’t learn that song from me, she learned it from you,’” CotterSchaufele said.
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M A D I S O N C O U N T Y H E A LT H D E P A R T M E N T
Rabies still common in the wild As long as rabies is circulating among wildlife populations, our best protection is to keep dogs and other pets vaccinated annually. Rabies is such an uncommon disease in our society today that we may only think of it when our veterinarian reminds us to get our pets’ annual vaccinations. However, on closer inspection one finds that this disease is not as uncommon as it appears.
Rabies has been with us a long time The name rabies comes from the Latin revere, which means to rage or rave. The Greeks gave the human form of rabies the name hydrophobia. This means “fear of water,” which is a symptom shown by rabies victims.
With animal bites being the most common form of transmission, and with maddening symptoms ending in death, the disease has held our attention for millennia. Its incidence has been documented throughout history, with records as far back as the Babylonians describing symptoms and deaths from rabies more than 4,000 years ago. Rabies occurs in outbreaks, and the number of cases in a region will rise and fall over time. During the Middle Ages, officials in cities sometimes ordered mass slaughter of stray dogs to try to stop rabies outbreaks. The majority of rabies cases happen in wildlife, such as raccoons, foxes,
CHRISTIE GREEN, MPH MCHD
skunks and bats. However, most cases in humans are from being bitten by a domestic animal. Dogs are the most common transmitter of rabies to humans because they are the most common link to infected wildlife. Rabies is more common in developing countries that lack canine vaccination programs than in industrialized countries. The World Health Organization Reports that globally, approximately 35,000 to 50,000 individuals die of rabies each year.
Rabies is fatal if not treated BEFORE symptoms show Rabies is a viral disease that affects the central nervous system. It can take a long time for rabies symptoms to appear, but the course is quick and fatal once symptoms develop. Early symptoms include anxiety, confusion or agitation. As the disease progresses, victims experience delirium, hallucinations, abnormal behavior and insomnia. Paralysis typically occurs, and death comes from cardiac arrest as the victims’ systems shut down. To date, less than 10 documented cases of human survival have been reported. After developing symptoms, victims typically live only 10 days or less. For thousands of years, no hope existed for someone bitten by a rabid animal. Then Louis Pasteur and Emile Roux created a vaccine
Richmond Register 9
Prevent rabies have your dogs, cats,
ferrets properly vaccinated
Each year MCHD, in partnership with several local veterinarians, provides rabies vaccination clinics
Madison County Health Department 2013 Rabies Clinic Schedule June 8th
Cost: $5 per vaccination.
10 a.m.- 2 p.m. Madison County Health Department* 216 Boggs Lane, Richmond
10 a.m.- 2 p.m. Madison County Health Department* 216 Boggs Lane, Richmond
Clinics will be held regardless of weather conditions.
Sponsors: Skipworth Veterinary Clinic; Town & Country Veterinary Clinic
Sponsors: Central Madison Veterinary Clinic; Barnes Mill Animal Hospital
12 -2 p.m. ByPass Animal Clinic 1401 Lexington Rd, Richmond Sponsor: ByPass Animal Clinic
12-2 p.m. Advanced Animal Care 201 Pauline Dr., Berea Sponsor: Advanced Animal Care
for humans that successfully prevented a case of rabies in 1885. Scientists now use a PEP (postexposure prophylaxis) treatment made up of immune globulin and a series of rabies vaccines to prevent the disease. However, the PEP treatment is only effective if given quickly, before symptoms begin.
Rabies is tricky In the United States, public health departments began offering rabies vaccination clinics for domestic pets in the 1940s. Thanks to success at getting a good portion of the dog population vaccinated, rabies incidence has changed dramatically over the last 80 years. Before 1960, the majority of rabies cases were in domestic animals. Now most documented cases are in wild animals.
Currently, there are less than 10 deaths per year because of rabies in the U.S. The few fatalities that do occur are in people who failed to get immediate medical attention after a bite, usually because they were not aware that they had been exposed to rabies. We can’t rest on our laurels with rabies, however. It is still common in the wild, and parts of the world where canine vaccinations are not widespread still see several deaths from rabies each year. As long as rabies is circulating among wildlife populations, our best protection is to keep dogs and other pets vaccinated annually. We shouldn’t forget our companions, either. Rabies is also deadly for our pets. Vaccinating them annually helps keep them protected, too.
* Clinics held at the Madison County Health Department will be located in the shelter at the back of the property at 216 Boggs Lane, Richmond.
Rabies can be kept in check The fatal madness of rabies captures our attention. Once a person or animal shows symptoms, death is nearly certain. This is why Kentucky law requires that all dog bites be reported to the Environmental Services programs at local health departments. Once they get notice of a bite, the environmentalists work with the dog owner to identify whether the bite victim might be at risk of rabies. If there is risk for rabies, the bite victim needs to get the PEP treatment quickly. Even though we had ZERO confirmed cases of rabies in Madison County in 2012, it remains a priority that we vaccinate our domestic pets. Because rabies is still common in the wild, it is an ongoing public health concern. That’s why the health department and local veterinarians partner to offer convenient, low-cost rabies vaccination clinics for pet owners. Each summer, they work together to host clinics at various dates and locations. The vets donate their time, and the vaccine is given for only $5 per pet.
10 Richmond Register
JUNE 2013 ON
H E A LT H & F I T N E S S
How many steps are enough? P
hysical activity guidelines for the promotion of better health and fitness are typically written in terms of frequency, intensity and duration parameters, essentially trying to answer the question of “how much is enough?” However, with the increasing popularity of pedometers and accelerometers, simple stepcount guidelines are needed to provide a reasonable approximation of daily physical activity. So how do step counts translate to the more commonly used FIT guidelines? The answer needs to be provided in the context of one’s age. For purposes of this discussion, the FIT guidelines will be described in terms of daily minutes of moderate-to-vigorous physical activity (MVPA). The steps per day guidelines are shown in Figure 1. Children are recommended to accrue at least 60 minutes of MVPA per day. This equates to 13,000 to 15,000 steps per day in primary/elementary school boys and 11,000 to 12,000 steps/day in girls. For adolescents (both boys and girls), 10,000 to 11,700 steps/day is associated with 60 minutes of MVPA. In adults, estimates range between 7,000 and 11,000 steps per day, to obtain minimal amounts of MVPA. Given that 100 steps per minute represents a reasonable floor value indicative of moderate intensity walking, a 30 minute brisk walk would then generate 3,000 steps of MVPA. It is important to recognize that a 30minute walk comprises less than 50 percent of the total number of daily steps recommended for good health. Much of the remainder can be achieved through occupational activities, walking to and from vehicles, chores and other activities. Nevertheless, one should realize that even the minimum step value normally will not be reached through obligatory activities and that at least a 30-minute workout above and beyond daily activity is needed to provide health benefits. Some activities, like swimming and bicycling, are healthy physical activities that do not lend themselves to tracking with pedometers.
Turn to HOW MANY, page 15
DR. JACK RUTHERFORD
Richmond Register 11
F O R A H E A LT H Y L I F E
A lighter, foolproof take on barbecued chicken By Sara Moulton Associated Press
Barbecue chicken is one of my favorite summertime dishes. I like every part of it — the tomato-based sauce (the spicier the better), the crispy skin, even the bones. And taste aside, it's also relatively healthy, at least as compared to such sundry first cousins as grilled and/or smoked ribs, brisket or pulled pork. It's chicken, after all, and it wears that lean protein halo. Unfortunately, when it's prepared with its skin and bones, and slathered with a sugary sauce, barbecue chicken is very nearly as caloric as its brethren. Know why chicken skin is so delicious? It's high in fat. So I set myself the task of coming up with a recipe for a leaner version of barbecue chicken that somehow still boasted the most lovable aspects of the classic version — a mouth-watering sauce and an element of crunch. I started by enlisting the usual lean poultry suspect, the boneless, skinless chicken breast. Chicken breasts come in all different sizes and thicknesses. Generally, if it's labeled "cutlet," it's fairly thin. If it's labeled "chicken breast," it's rather thick. But there's a range of thickness within these categories, too. I tried both and opted for the latter because the thicker breasts were simply harder to overcook. The breasts also are covered for two-thirds of the cooking time, which helps keep them moist, further ensuring perfectly cooked barbecue. By the way, the internal temperature of the cooked breasts should be 165 F. And be sure when you take the temperature to insert the thermometer sideways into the center, and not straight down from the top. That way
you'll get a more accurate reading. Also, don't forget to let the chicken rest for a few minutes after you pull it out of the oven. It's another way to maximize the juiciness.
EASY BAKED BARBECUE CHICKEN BREASTS This barbecue sauce can be as flavorful as you like. For the adobo sauce and garlic, start with the lower amounts, then taste and adjust to your preference. Start to finish: 40 minutes (10 minutes active) Servings: 4 1/2 cup ketchup 1 to 2 tablespoons adobo sauce (from a can of chipotles in adobo) 2 teaspoons packed dark brown sugar, or to taste 2 tablespoons cider vinegar 2 tablespoons Dijon mustard 1 to 2 cloves garlic, minced Kosher salt and ground black pepper, to taste 1 pound boneless skinless chicken breasts without the filet (a total of 2 to 3 breasts, each about 3/4- to 1-inch thick) 1 tablespoon extra-virgin olive oil 1/2 cup panko breadcrumbs 2 teaspoons chopped fresh thyme Heat the oven to 350 F. In a small bowl combine the ketchup, adobo sauce, brown sugar, vinegar, mustard and garlic. Season with salt and pepper. Line a shallow baking dish with foil, leaving enough excess to generously overhang the sides. Spread half of the sauce on the foil in an area just the size of the chicken breasts. Arrange the breasts on top of the sauce and spoon the remaining sauce over them. Bring the edges of the foil up and over the chicken and fold it to
enclose them. Bake the breasts on the middle shelf of the oven for 20 minutes. Meanwhile, in a small skillet over medium, heat the oil. Add the breadcrumbs, thyme, a pinch of salt and some pepper. Saute until light golden, 2 to 3 minutes. Set aside.
After the chicken has baked for 20 minutes, open up the foil and spoon any sauce that has fallen off the chicken back on top of it. Sprinkle the crumb mixture evenly over the chicken. Continue baking, uncovered, until the chicken is just cooked through, another 8 to 10 minutes. Let stand for 5 minutes. Carefully slice the chicken, then divide between 4 serving plates, spooning any sauce and crumbs that have fallen off over the chicken slices.
Nutrition information per serving: 240 calories; 45 calories from fat (19 percent of total calories); 5 g fat (1 g saturated; 0 g trans fats); 65 mg cholesterol; 20 g carbohydrate; 0 g fiber; 9 g sugar; 28 g protein; 750 mg sodium.
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12 Richmond Register
M E N TA L M O R S E L S
Defining your terms S
ince 1949, the profession of psychology has most often trained its practitioners under what came to be called the â€œBoulder Model.â€? This philosophy, first formalized in Bolder, Co., establishes a scientist-practitioner expectation of aspiring graduates into the profession. That is, those who seek to apply psychological knowledge to help others must have a firm background in the principles of scientific theory and research. The rationale is that the profession needs to protect the public from quackery or otherwise unproven treatments. The reality, of course, is
that most of us REALLY dreaded the experimental and research methods classes when we were in school. I well remember the long lectures over dense material about Bell Curves, probabilities, null hypotheses and then the mind-bending study of the squiggly-looking Greek characters used to denote complex statistics that seemed designed for an age of Spartans in spaceships. We really just hoped to squeak through those courses, so we could keep our eyes on the â€œrealâ€? training in counseling, hypnosis and abnormal psychology.
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Years later, however, I have developed a whole new appreciation for the utility of the scientific perspective, whether in clinical work or just in conversations with people. It amazes me how useful it can be, and yet how alien it can still seem to the general public. Consider one little illustration: the operational definition. Without going into too much detail, an OD is basically a measurement for something. For example, you might measure how tired you are by counting the number of minutes you were awake past your bedtime last night. Why is an OD useful? Letâ€™s take a closer look and see. Often in intimate relationships or friendships, communication has broken down because neither side is defining their terms. Instead, they are reacting. Finger-pointing, accusations and expressions of hurt. We see only our own feelings, and not what the other person is actually doing that bothers us so much. Here is where we observe people calling each other â€œjerkâ€? or â€œinconsiderateâ€? or in the worst circumstances, â€œevil.â€? But how helpful are such adjectives? Once youâ€™ve called someone a name, what options have you left them except to bristle and respond defensively? The role of counseling is often to get hurting people in a relationship to define their terms rather than emoting about them. What is the problem with the other personâ€™s behavior? What behavior would you like to see them decrease or increase? If the other person
THOMAS THORNBERRY is a â€œjerk,â€? is it because they wonâ€™t wipe their feet when the weather is wet? Because they forget birthdays? Chew with their mouth open? You see, once you have measurable behavior, you can negotiate from a position of neutrality and objectivity, rather than hurt, aggressiveness or defensiveness. It gets better. When you focus on behavior, you can make a constructive plan for how to increase or decrease it. Think about sensible eating plans, for example, where the operational definition for physical attractiveness or self-esteem is usually in pounds or waistline inches. You know if your plan is successful by changes in the scale or the tape measure. Now, learning how to think in terms of operational definitions can be challenging. How, for example, do you measure feelings like jealousy? Low self-esteem? Positive thinking? With the help of a counselor, however, each one of these terms can indeed be defined in behavior. Even the journey of a thousand miles is measured in footsteps, right?
Thomas W. Thornberry, M.A., is a mental health professional who has worked extensively with those suffering lifestyle stress and communication issues. His interest is in language and the power of words to create change. Thomas welcomes your feedback: email@example.com.
Richmond Register 13
Best workouts for good health Some exercises are better than others for certain health conditions
workout a day will not necessarily keep the doctor away, but it is probably the best thing you can do for your health. What are the best workouts for good health? There is no clear answer that is right for everybody; it all depends on your physical and mental makeup and what you enjoy doing. Some exercises are better than others for certain health conditions, though.
HEART HEALTH When Kenneth Cooper, M.D., MPH, used the term “aerobic” in the late 1960s, he was referring to vigorous exercise that gets the heart beating at a training rate–60 to 90 percent of capacity. These workouts are primarily running, biking, swimming and aerobic dance. There is no question that they are effective at strengthening the heart, improving the health of blood vessels and controlling cholesterol, blood pressure and weight. Because of their intensity, however, they also increase the risk of soft tissue injuries, particularly when the athlete has biomechanical issues or tries to push training a bit too rapidly. Walking is less hazardous, but leisurely strolling–while healthy–does not qualify as aerobic exercise and does not build increased cardiovascular fitness. It does, however, improve circulation and help control weight. Brisk walking is aerobic; for most indi-
viduals, this means a pace of about 4.0 mph or faster.
HEALTHY JOINTS The best exercises for your joints are those that improve the strength and flexibility of your muscles. Contrary to what you may have heard, running does not cause arthritis. It can, however, damage your joints if you already have arthritis. For persons with stiff, aching joints, warm water exercise is often recommended, along with supervised stretching and strengthening routines. Yoga and tai chi are good options.
TARA LONG OTR/L DIRECTOR, REHAB SERVICES
BAPTIST HEALTH RICHMOND
STRONG BONES are important at any stage of life. During youth, it’s important to lay down bone density as a reserve for later in life when loss of bone density puts seniors at risk of falls and fractures.
even highly competitive swimmers and cyclists have lower-than-expected density, according to studies. That led to the theory that bones benefit from weight-bearing exercise. Recently, researchers have begun to re-think that theory. Exercise that’s too prolonged or too intense may be detrimental to bone health, leading to excessive calcium loss through sweat. What’s most
Runners and walkers tend to develop strong bones; but
Turn to WORKOUTS, page 15
that some degree of power is also important for everyday activities–from starting a lawn mower to preventing a fall.
POWERFUL MUSCLES are not just for showing off at the beach; they are necessary to maintain a good metabolism, keep joints working properly and to prevent falls and fractures. Virtually any exercise benefits the muscles, but strength and endurance are best obtained from resistance training. The basic principle is to overload the muscles, lifting to the point of fatigue through progressively increasing weights or repetitions. Generally, endurance is built through lower weights and more repetitions; strength, through higher weight and fewer repetitions. Power involves speed and explosiveness as well. The professional athlete ultimately requires power–whether swinging a bat or running the 100 meter dash. And it’s now believed
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Try chiropractic for help with
igraine headaches are severe headaches that can incapacitate the person having it. There are many types of migraines. We will discuss some of the types of migraines and treatments. Signs and symptoms of a migraine: • Severe or moderate pain with more than half of the sufferers feeling the pain on one side of the head. • Pain is described as throbbing or wavelike pain and the pain increases with activity. • Nausea with or without vomiting may occur as well as loss of appetite. • Very sensitive to light and or noise. Most of these migraines run a course within three days. The frequency of migraines depends on the individual. Heredity seems to play a large part in migraine sufferers. I believe, at last guess, about 80 percent of sufferers had some family tie. Studies range from a 50/50 percent occurrence in men to women up to three times as many women as men. Two categories of migraines are common migraine and classic migraine. The basic difference between these is an aura. Classic migraines have a neurological precursor that may show in the form of starlike or flashing light in your visual field, hazy vision or lines, or temporary vision loss. This primarily occurs 10 to 30 minutes prior to the onset of the migraine. Both types of migraines can be as frequent as daily or
as infrequent as once every few years. The pain of a migraine is classified by intense throbbing or pounding pain that starts on one side of the head and can settle to both sides and often settles behind one or both eyes. An episode can last for minutes or days; the intensity is usually constant and eases with being as motionless as possible in a dark, quiet room. Symptoms prior to a common migraine are fatigue, mood swings and vague thinking or memory lapses. Nausea, vomiting with abdominal pain and/or water retention may also occur. Migraines can be triggered by food such as cheese, chocolate, nuts, some fruits, dairy products, grain that include gluten, processed foods, MSG or shellfish. Certain odors like perfume and smoke can certainly trigger a migraine. Migraines may also be initiated by increased stress levels, hormonal changes, lack of sleep, prescription drugs, alcohol and caffeine. In my practice I see about twice as many women for migraines and seem to reduce or stop the migraines in about 75 percent to 80 percent of my patients who suffer from them. Upper thoracic and cervical adjustments seem to be the most effective areas for treatment. However there are several areas in the lower back that can also cause migraines. Many of my patients who suffer from migraines have a precursor sign their migraine is about to start, symptoms
such as visual problems, aura, etc. as discussed previously. If my patient can come in for an adjustment during the early stages, many times the migraine can be avoided. If adjustment occurs during the migraine, then the duration is reduced. Usually with these headaches taking an aspirin is like hunting an elephant with a pea shooter, and it isn’t going to touch it. Some medications, however, do seem to help. But some medications can cause migraines so if you have recently changed prescriptions and started having migraines tell your doctor. Try chiropractic first. The most conservative approach should be tried. Relaxation and elimination of environmental, emotional and physical stress should be attempted. Keep a diary to track foods, stressors, frequency and duration of migraines. This could prove to be invaluable in stopping the migraines. One of my patients came in with torticollis (neck in spasm on one side), so I
adjusted for that and incidentally reduced the number of migraines experienced as reported during the 30-day re-exam. The patient hadn’t had a migraine in 30 days, after suffering with two to three per month. I asked why the patient hadn’t written that down on the history form and was told, “I didn’t think you guys (chiropractors) could do anything about that.” Well, as I say, we return the body to as close to normal as possible allowing the body’s inner intelligence to heal the body. Get to a chiropractor and see what they can do for you. Keep the diary to assist in assessing the trigger of the migraines. Include time of day, how long, intensity and what you did for relief. Check with your family for others that suffer from migraines. Communicate with your chiropractor to help him or her to give you the best care possible.
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Richmond Register 15
beneficial, it’s believed, are large forces released in a relatively big burst, as in hopping or skipping rope. If you already have weak bones, of course, jumping is not recommended as it could result in a fracture. And, if you are over age 60, a safer and more practical workout may be brisk walking–the faster the pace, the better.
Likewise, a number of sports may be categorized as vigorous activities that are not easily translated into MVPA by pedometers. These activities should of course be acknowledged and count towards one’s daily MVPA total. However, the largest segment of the population does not regularly engage in any sport or exercise apart from walking. These step count ranges then are in line with public health’s guidelines for time spent in MVPA. Older adults and special populations (living with disability and/or chronic illness that may limit mobility) may also benefit from a more active lifestyle that involves higher levels of MVPA. Step-counting devices such as pedometers offer a chance to monitor daily ambulatory activity. However, a translation of public health guidelines in terms of steps/day is currently unknown. Some research data suggest that healthy older adults average between 2,000 and 9,000 steps/day and special populations average 1,200 to 8,800 steps/day. Using the adult cadence of 100 steps/minute to demark the
Continued from page 13
MENTAL HEALTH To relieve or prevent stress, anxiety and depression, research indicates that exercise is often as effective as medications. And it’s faster–all you have to do is step on the treadmill or hit the pavement and your therapy starts to work. Physical activity releases tension, of course, and it also increases the production of neurochemicals that lead to a feeling of well-being. The best exercises are continuous and rhythmic such as walking, swimming, dancing and cycling. Yoga and tai chi have a mind/body element that is specifically intended for healing. Whatever your health needs, the best workout for you is one that you most enjoy doing; otherwise, you won’t keep at it, day after day, year after year.
Continued from page 10
Continued from page 3 sodium a day. Studies make clear that eating less sodium helps lower blood pressure, and lower blood pressure in turn leads to less heart disease, said heart association spokesman Dr. Elliott Antman, a cardiologist at Boston’s Brigham and Women’s Hospital. “We’re sticking where we have the most solid evidence,” Antman said. What to study is key to the debate:
lower value of the range of moderate intensity, multiplying it by 30 minutes gives a guiding value of 3,000 steps. This cadence may be unattainable in frail or diseased populations. However, if public health guidelines are to be strictly translated, these steps should be taken above and beyond activities of normal daily living. They can be accumulated in smaller bouts (e.g. 10 minutes) of moderate intensity and should add up to at least 30 minutes a day. In studies involving direct measurement of MVPA and background activities, the evidence suggests that 30 minutes of brisk walking, in addition to habitual daily activities in healthy older adults, is equivalent to 7,000 to 10,000 steps/day. By now it is clear to you that current public health guidelines for physical activity call for 30 minutes or more of moderate intensity activity be performed on most, preferably all, days of the week. More recent guidelines recommend at least 150 minutes/week of moderate intensity, 75 minutes/week in vigorous intensity physical activity, or a combination of both. If you have taken to wearing a pedometer or accelerometer during the day, now you can see how your daily step counts compare to age-related guidelines.
The IOM committee was asked to examine whether eating less salt directly affects longer-term outcomes such as heart attacks and death.That’s harder to prove, especially since the panel stressed many of the studies it reviewed had quality problems. Among those problems, Antman said, was including some patients too sick for diet to matter. Debating how little salt is too little is a moot point, added nutritionist Bonnie Liebman of the Center for Science in the Public Interest. “The average American is still in the
red zone, the danger zone,” she said. The salt industry, in contrast, has long opposed the push for sharp sodium reductions and welcomed the report. “There is no scientific justification for population-wide sodium reduction to such low levels, and the recognition by the IOM experts that such low levels may cause harm may help steer overzealous organizations away from reckless recommendations,” said Morton Satin of the Salt Institute. Some salt is necessary for good health, although it’s not clear exactly how much.
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