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Health & Fitness 2020


Runners can keep going in winter months with preparation By Rob Zolman / Valley Journal

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any running enthusiasts avoid the cold weather and choose to stay toasty in a warm gym on a treadmill rather than venture outdoors to pound the pavement for a few miles once the snowdrifts and the frigid wind starts to howl. Lou Brenner is a veteran marathoner and member of the Polson Running Club, which is a nonprofit organization that hosts races and promotes running throughout the year in the Mission Valley. Brenner offers a few tips concerning winter running. “Getting out the door is by far the hardest part of the run,” said Brenner. “The hardest step is the first one. No matter how cold, wet or windy, find ways to trick yourself to get out the door and get moving. Pretty much, without fail, no matter how bad you don’t want to go, within 15 minutes of starting, you are feeling good and having fun.” In cold weather, it takes longer to get your body temperature up and muscles warm to reach their maximum efficiency, so a pre-run warm-up indoors before you head outside is suggested. Warming up inside loosens your muscles, gets your blood flowing, increases your heart rate and reduces the shock to your system when you open the door to head out on your run. It’s difficult to give a one-temperature-fits-all guide for clothing because how much you wear depends a lot on your internal thermometer and factors like your body shape and size. The basic guidelines are to keep as 14 - January 22, 2020

warm as possible. Start with a snug-fitting, moisture-wicking base layer, which holds heat close to your body and transfers moisture away. Wear a jacket that’s windproof in front and breathable in back. If you’re a little cold at the beginning but sweating by the end of your run, you’ll know you’re doing it right. If you’re running outside in the snow and ice regularly, you might want to invest in a pair of lightweight trail running shoes, which often have weatherproof uppers and the added benefit of traction on the outsole. The old running adage “there is no such thing as bad weather, only bad gear” comes into play said Brenner. “I thought it absurd, but in time, I came to realize much truth in the phrase. If you have the right gear, it is fun to exercise in inclement weather.” Cover up as much as possible. Make sure that most of your exposed skin is covered, including ankles, neck, fingers and head. Fingers stay warmer when not separated by fabric. “Mittens work way better than gloves for keeping hands warm,” said Brenner. If you like logging your miles during early morning or dusk hours, it’s important to make yourself more visible. “Wear lights or reflective gear so you are visible,” said Brenner. “It’s surprising how invisible you are when running in the dark.” Staying properly hydrated even if you don’t feel thirsty is also important in cold weather. “You need to hydrate just as much in the winter as you do in the summer,” explained Bren-

PHOTOS BY ROB ZOLMAN / VALLEY JOURNAL

ner. “Don’t short yourself on water.” Without visual cues like dripping sweat, you don’t always realize you’re thirsty in cold temperatures. As soon as you stop running, your metabolic rate drops, meaning your body’s internal furnace cranks down its heat production. Putting on dry layers and sipping on a warm drink, like tea or coffee, will help. A warm shower or bath is a good way to defrost. “After your run, get out of your sweaty clothes fast and put on some warm clothes,” said Brenner. “You go from feeling great and warm to absolutely freezing pretty quickly after a run.”

Runners keep going through winter months by participating in the Sorry ‘Bout That race in Polson.

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Right: expert runners recommend a good pair of running shoes to keep runners going during the winter months.

The old running adage “there is no such thing as bad weather, only bad gear” comes into play said Brenner.


Training on overdose-reversing medication available By Mary Auld for the Valley Journal

ST. IGNATIUS – Physical therapist Jason Krumbeck leaned over a mannequin on a table and fitted a small nasal spray container into its plastic nostrils. He pushed the spray button, which was a move that could have saved its life had the mannequin been a living human overdosing on opioids. Krumbeck was demonstrating the proper administration of Naloxone. The medicine can be used to revive people who have overdosed on opioids. The medication can bring people back from the brink of a fatal overdose. Krumbeck, a physical therapist with Confederated Salish and Kootenai Tribal Health, is certified to train community members on how to administer the medication. He provides free trainings through a Department of Health and Human Services program intended to reduce the number of deaths caused by opioid overdoses. Overdoses cause people to stop breathing. Naloxone completely stops the effects of opioid medications and can immediately help people start breathing. Naloxone is available over the counter at some

Jason Krumbeck with CSKT Tribal Health estimates that he's trained about 40 people so far on how to administer the opiod overdose medication Naloxone.

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Overdose medication training from page 15

pharmacies, but it is costly. The training prepares community members to use the medication and provides the medication free of cost. Those who go through the training are given two free doses of the medication to carry in case they encounter a person going through an overdose. If the trained administrator uses their doses, the program will replace them. According to Krumbeck, the training is especially valuable in rural areas where emergency response times are longer. The medication can ward off the overdose for 30 to 45 minutes so emergency professionals can arrive. A dose of Naloxone can determine whether a person who overdoses survives. Krumbeck estimates he’s given eight trainings to about 40 people. Krumbeck has trained the team at Tribal Health. He will be training CSKT law enforcement. He’s also trained teachers, school nurses, and community members who want to be able to help. He recommends the training for anyone but especially those who spend time with people who use opioids, either prescribed by a doctor or improperly. Those who use opioids themselves should also be trained. Krumbeck also recommends the training for people whose work brings them to strangers’ homes - like social workers or plumbers. Those interested in being trained and receiving free doses of Naloxone can contact Krumbeck at jason.krumbeck@cskthealth. org or 406-745-3525 ext. 5012 for training in St. Ignatius or Aaron Sparks at aaron.sparks@ cskthealth.org or 406-745-3525 ext. 7339 to schedule training in Polson.

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State health officials raise awareness of rising STD rates News from DPHHS

State health officials report the upward trend over the past several years of sexually transmitted diseases in Montana are now reaching record highs. Gonorrhea rates have been increasing over the past seven years and are now projected to reach nearly 1,500 cases in 2019. Department of Public Health and Human Services STD/ HIV program manager Dana Fejes said the gonorrhea numbers haven’t been this high in 40 years. Other STDs like syphilis and chlamydia has also been increasing, despite the availability of free prevention supplies and information on safe sex. Cascade and Yellowstone County have been impacted the most by gonorrhea and syphilis in 2019. “This is very concerning,” Fejes said. “And the reason we’re concerned is because of the serious health consequences that can occur to an individual with an STD if left untreated. Some people are at greater risks for complications, such as those who have a suppressed immune system and pregnant women. Sometimes, there are no symptoms and the infection is spread to others unknowingly.” In addition, people with an STD may be at an increased risk of getting HIV. This is because the same behaviors and circumstances that may put someone at risk for getting an STD

The reason we’re concerned is because of the serious health consequences that can occur to an individual with an STD if left untreated.” - Dana Fejes, DPHHS STD/HIV program manager

also puts them at greater risk for getting HIV. Having unprotected sex, with multiple or anonymous partners, increases the likelihood that someone might get infected. Fejes notes the increase is not unique to Montana. According to the Centers for Disease Control and Prevention, syphilis and gonorrhea reports are the highest nationwide since 1991. Public health officials said social media is also playing a role. Social media platforms and anonymous sex have further complicated the ability to reach partners to get them tested and treated. This is a necessary step to stop further infections. To keep up with the increase of online dating, local and state partners are reaching out on social media to urge sexually active persons to get tested for STDs and stay safe. Local disease trends are posted on the DPHHS website at STDFree. mt.gov to remind the public that STDs

are not a thing of the past. A new public health campaign was created to raise awareness about the rising STDs in Montana. Free awareness materials are being provided to various local STD clinics and through HIV outreach contractors. Fejes reminds everyone that STDs are entirely preventable and even though some activities can pose greater risks, there are things that everyone can do to stay healthy: Talk to your health care provider about STD testing. Take charge of your own health, get tested and treated correctly. Find free or low-cost testing locations at GetTested.MT.gov Learn about STDs and how to avoid them at STDFree.MT.gov. The most reliable way to avoid infection is to not have sex. Reduce your number of partners and talk about sexual health with your partners. Use protection correctly every time. Synthetic non-latex condoms can be used for those who have latex allergies. Visit your local STD clinics, outreach workers or health departments to learn more, grab some free stuff and get the conversation started with friends. Visit DPHHS on Facebook, like and share our Public Health in the 406 #GetTestedMT messages. It only takes simple steps to stop STDs from spreading. Many local resources are available with little to no cost.

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Children felt their relationships with a pet were more supportive than that with a sibling. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY

Studies show pet ownership can improve health By Kathi Beeks / Valley Journal

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et owners instinctively know pets make life better. With roughly half of all households in the United States owning at least one dog, (the most popular pet), science has undertaken the task of proving what pet owners already know. Researchers in Sweden, Germany, the United Kingdom, Canada and the United States continue to expand public understanding about the health benefits of pet ownership - benefits that can begin prenatally and extend over an entire lifespan. A 13 percent decrease in asthma has been found in children exposed to a dog during the first year of life. Exposure to furry pets early in infancy (and even prenatally), increases two gut bacteria, Ruminococcus and Oscillopira. Ruminococcus has been linked to fewer allergies in children while Oscil-

lopira is associated with a decrease in a risk for obesity. The simple act of early exposure to pets might mitigate a lifetime of suffering. Pets don’t argue or disagree. They provide unconditional affection and are loyal, non-judgmental companions. In the “Journal of Applied Developmental Psychology,” researchers discovered that children felt their relationship with a pet was more supportive than that with a sibling. Pets provide fewer emotional upsets, commonly experienced in human interactions. Young people dealing with the trauma of a deployed parent may especially benefit from a strong connection with a pet. Teens reported their pets provide solace and consistency when dealing with stressors such as moving from one school or one home to another. Pet-owning teens were also found to be more

empathetic and socially connected. Clinical depression in people aged 60 and older is less likely for those who have a pet. A wagging tail and a happy bark can be fun to come home to. Seniors with pooches were even found to make fewer doctor visits. Mental health issues of many kinds are better managed by pet owners who receive encouragement and companionship from their furry friends. Pets provide distraction from troubles and provide the need for a predictable routine. Buffalo University conducted a study that showed people are less easily stressed and recover more quickly from work-related stress when their pets are with them. The American Heart Association produced research that showed physical benefits associated with pet ownership included less risk of cardiovascular disease. According to the Cen-

ters for Disease Control and Prevention, some of the health benefits of owning a pet include decreased blood pressure, cholesterol levels, triglyceride levels, feelings of loneliness and increased opportunities for exercise and outdoor activities as well as socialization. Owning a pet can be an excellent ice-breaker for shy or isolated people. There is evidence to suggest that people are more likely to trust someone who cares for and owns a pet. Author Shanna Johnson described life-lessons she’s learned from her tiny dog; lessons most any one could benefit from. Her one-eyed mutt, adopted after being injured and abandoned, enthusiastically embraces his challenges, regardless of the number of depth-perception caused mishaps he has. He doesn’t let his past failures get in the way of trying again.

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Each day he wakes up and engages in activities identical to those of previous weeks, months and years, never letting what some might consider mundane to diminish his attention to the current moment. He excitedly greets Johnson with affection, re-

gardless of whether she’s been gone three minutes or all day. Johnson said she has learned from her little friend, that previously endured hardships are in the past and that each new day is worth investing in with eagerness and a heart full of love.

January 22, 2020 - 17


Preventable deaths higher in rural areas News from the CDC

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otentially preventable deaths from the five leading causes of death occurred more often among people in the most rural counties than in the most urban counties during 2010–2017, according to a new study released in CDC’s Morbidity and Mortality Weekly Report. The gap in the percentages of preventable deaths between rural and urban counties widened over the eight-year study period for deaths from cancer, heart disease, and chronic lower respiratory disease. This rural/urban gap remained relatively stable for stroke and decreased for unintentional injuries; however, the decrease in the gap for preventable deaths from unintentional injuries wasn’t due to improvements in rural counties but to the sharp rise in urban areas, due in large part to the opioid crisis. The study also found that while potentially preventable cancer deaths fell to less than 10 percent of all cancer deaths in 2017, more than half of deaths due to unintentional injury were potentially preventable. Percentages of preventable deaths were generally higher in the southeastern United States for most causes than in other regions. “We are encouraged to find that preventable deaths from cancer have gone down overall, yet there is a persistent and striking gap between rural and urban Americans for this and other leading causes of death,” said CDC Director Robert R. Redfield, M.D. “There are proven strategies for Health & Fitness

reducing health risks like cigarette smoking and obesity and we need to redouble our prevention efforts to reach those living in rural areas, where risks tend to be higher.” CDC researchers used mortality data from the National Vital Statistics System to calculate potentially preventable deaths for the five leading causes of death among people under 80 years old. Previous studies placed counties into two categories — urban or rural — but this new study breaks counties down further into six categories: large central metropolitan (the most urban), large fringe metropolitan, medium metropolitan, small metropolitan, micropolitan and noncore (the most rural). This gave the researchers a more detailed look at health differences among these communities. Main findings In 2010, 28.7 percent of deaths from cancer in the most rural counties were potentially preventable, compared with 17.9 percent in the most urban counties. By 2017, 21.7 percent of cancer deaths in the most rural counties were potentially preventable, compared with 3.2 percent in the most urban counties. In 2010, 45.1 percent of deaths from heart disease in the most rural counties were potentially preventable, compared with 24.1 percent in large fringe metropolitan areas. By 2017, 44.9 percent of deaths from heart disease in the most rural counties were potentially preventable, compared with 18.5 percent in large fringe metropolitan areas. In 2010, 60.9 percent of deaths from unintentional

injury in the most rural counties were potentially preventable, compared with 25.4 percent in the most urban counties. By 2017, 64.1 percent of deaths from unintentional injury in the most rural counties were potentially preventable, compared with 47.8 percent in the most urban counties. In 2010, 54.3 percent of deaths from chronic lower respiratory disease (such as COPD) in the most rural counties were potentially preventable, compared with 23.4 percent in the most urban counties. By 2017, 57.1 percent of deaths from chronic lower respiratory disease in the most rural counties were potentially preventable, compared with 13 percent in the most urban counties. In 2010, 41.6 percent of deaths from stroke in the most rural counties were potentially preventable, compared with 22.7 percent in large fringe metropolitan areas. By 2017, 37.8 percent of deaths from stroke in the most rural counties were potentially preventable, compared with 17 percent large fringe metropolitan areas. How to reduce deadly health risks in rural America More than 46 million Americans live in rural areas, and these residents tend to be older and sicker than those living in urban areas. Rural Americans tend to have higher rates of cigarette smoking, high blood pressure, and obesity, and to report less leisure-time physical activity and lower seatbelt use than their urban counterparts. They also have higher rates of poverty, less access to healthcare and are less likely to have health insurance.


An emerging health threat can lead to type 2 diabetes 1 in 5 adolescents and 1 in 4 young adults now living with prediabetes News from the CDC

Nearly one in five adolescents aged 12-18 years, and one in four young adults aged 19-34 years, are living with prediabetes, according to a CDC study. Prediabetes is a health condition in which blood sugar levels are higher than normal, but not yet high enough to be diagnosed as type 2 diabetes. The condition also increases the risk of developing type 2 diabetes, chronic kidney disease, heart disease and stroke. Monitoring the percentage of adolescents and young adults with prediabetes can help determine the future risk of type 2 diabetes, so CDC researchers used data from the National Health and Nutrition Examination Survey covering the years 2005-2016. “The prevalence of prediabetes in adolescents and young adults reinforces the critical need for effective public health strategies that promote healthy eating habits, physical activity and stress management,” said CDC Director Robert R. Redfield, M.D.  “These lifestyle behaviors can begin early in a child’s life and should continue through adolescence and adulthood to reduce onset of type 2 diabetes.” Key study findings: Nearly one in five (18 percent) adolescents (those aged 12-18) and one in four (24 percent) young adults (aged 19-34 years) were living with prediabetes. The percentage of adolescents and young adults

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living with prediabetes was higher in males and participants with obesity. Hispanic young adults had higher rates of prediabetes compared to white young adults. Adolescents and young adults with prediabetes had significantly higher cholesterol levels, systolic blood pressure, abdominal fat and lower insulin sensitivity than those with normal glucose tolerance, which increased their risk of type 2 diabetes and other cardiovascular diseases. “We’re already seeing increased rates of type 2 diabetes and diabetes-related complications in youth and young adults, and these new findings are evidence of a growing epidemic and a tremendously worrisome threat to the future of our nation’s health,” said Ann Albright, Ph.D., director of CDC’s Division of Diabetes Translation. “Additional research is needed to support the development of interventions for youth and increasing access to programs that we know work for young adults, like the CDC-led National Diabetes Prevention Program.”

What can be done? Research shows that adults with prediabetes who take part in a structured lifestyle-change program, including weight management and exercise, can cut their risk of developing type 2 diabetes by 58 percent (71 percent for people over 60 years old). Participation in the CDCled National Diabetes Prevention Program lifestyle change program can help prevent or delay type 2 diabetes in those at high risk. The program, available to those aged 18 and older, is taught by trained lifestyle coaches, and encourages healthy, whole-life changes to help participants address barriers to improved nutrition, increased physical activity and coping mechanisms for stress reduction. Parents can also help turn the tide on prediabetes by encouraging healthy eating and increased physical activity. They can aim for their children to get 60 minutes of physical activity a day. To find tips on how to encourage children to eat healthy and stay active, visit CDC’s Healthy Weight site. There are several ways

state and local organizations can create a supportive environment to promote healthy weight and help prevent diabetes related to obesity. States and communities can: support mothers who choose to breastfeed; work with early care and education centers and schools to improve healthy food and beverage offerings and opportunities for physical activity for children; increase access to healthy and affordable foods; and make it easier and safer to walk and bike where families live, learn, work and play. To learn more about diabetes or the National Diabetes Prevention Program, visit cdc.gov/diabetes. CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

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January 22, 2020 - 19


MSU study shows promising results of internet-based program used to reduce depression symptoms 2017 and reached 464 people in more than 100 communities. The Thrive program used in Schure and his colleagues’ study is a culturally adapted version of Waypoint’s original program. The Thrive for Montana research project has been supported by a $221,000 grant from the state of Montana after the 2017 Legislature passed, and Gov. Steve Bullock signed, a bill to provide $1 million for suicide prevention in Montana. It also later received an additional $90,000 in continuing funds from the state. “The success of these large-scope evaluation projects is largely due to partnerships established early on with MSU’s Center for Mental Health Research and Recovery, MSU

and in conjunction with other studies that confirm the effectiveness of internet-based cognitive behavior therapy programs, digital mental health options such as Waypoint’s Thrive will be adopted by employers and healthcare systems and that health insurers will provide reimbursement,” Schure said. The Thrive for Montana research project is a collaboration between MSU and Waypoint Health Innovations. The MSUled research project is not affiliated with the nonprofit, Bozeman-based, social service corporation named “Thrive.” More information about Thrive by Waypoint Health Innovations is available at montana.edu/cmhrr/ ccbt.html.

Extension and One Montana, a local nonprofit organization,” Schure said. Alison Harmon, dean of the College of Education, Health and Human Development, said the results are promising. “We need to use every tool we have to address depression, anxiety and the frequency of suicidal thoughts in rural Montana,” Harmon said. “Results from this study indicate that Internet-based care can be effective. I look forward to an expansion of this work and increased access to Thrive in additional populations.” Schure said he hopes Waypoint’s Thrive program will eventually be available to any Montanan to access. “We hope that, based on our research findings

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clinical measure known as the Patient Health Questionnaire. Researchers also measured participants’ anxiety symptoms, work and social adjustment, resilience and frequency of suicidal thoughts. Outcomes were compared between the group receiving Waypoint’s Thrive program over the eight-week period to those who had not yet received the program. The group using the Internet-based cognitive behavior therapy program reported significant reductions in depression symptoms over those who had not used the program. In addition, researchers found that using Thrive had moderately positive effects on participants’ anxiety symptoms, work and social functioning and resilience. The Thrive group was also 45 percent less likely than the control group to experience increased suicidal thoughts, Schure said, findings that he called encouraging. Schure said the researchers are currently evaluating whether the positive impacts they found are lasting. They are also replicating the research with a larger sample of 1,000 adult Montanans and working to develop a similar program for adolescents. “We have heard from many community members that youth also need a program like Waypoint’s Thrive, so, with the success of our research and this need that has been communicated, we are now developing a youth version of the program and will pilot it thereafter with Montana youth,” Schure said. Schure said delivery of Waypoint’s Thrive was launched in Montana in

MONTANA – A program delivered entirely online that aims to reduce depression and anxiety symptoms has shown promising results in a new Montana State University study. The findings by MSU researcher Mark Schure suggest that an Internet-based interactive platform known as Thrive was effective in reducing the severity of depression and anxiety symptoms and improving functioning and resilience among a mostly rural community population of U.S. adults. The findings were published Nov. 18 in the Journal of Medical Internet Research. “This research is the first known of its kind to rigorously evaluate the impact of an Internet-based cognitive behavior therapy program to help reduce depression and anxiety symptoms among a U.S. general rural population of adults,” said Schure, assistant professor in the College of Education, Health and Human Development’s Department. “We’re hopeful that these results indicate the usefulness of these types of Internet-based programs to effectively teach individuals positive skills to manage their depression and anxiety, which could be especially valuable in rural areas where mental healthcare services can be hard to access.” Waypoint Health Innovations, a Seattle-based technology company, developed and owns the Thrive program, which primarily uses video to deliver confidential, evidence-based care to any-

one with Internet access, Schure said, adding that Thrive’s algorithms allow it to tailor to the needs of the person using it. The program’s responses are based on participants’ answers to a series of questions aimed at determining how much they are being impacted by depression and which aspects of the program would benefit them most. The program is further personalized in response to evaluations as participants continue using the program. Because Waypoint’s Thrive program is delivered via the Internet, it can reach individuals in nearly all areas of the state, including rural communities where it may be difficult to access mental health services. Another benefit is that costs of Internet-based care are considerably less than traditional face-to-face care, Schure said. Cognitive behavior therapy – a form of psychotherapy that aims to boost happiness by focusing on behaviors and thoughts – has been shown to effectively reduce depression symptoms, which can increase risk for suicidal thinking and suicidal behaviors, Schure said. Schure’s study examined the effects of Waypoint’s Thrive program on nearly 350 adults in the state who reported at least mild symptoms of depression. The study evaluated participants’ self-reported mental health before they used the program, after using the program for four weeks and again after using the program for eight weeks. The study’s main outcome of interest was the severity of participants’ depression symptoms, Schure said, as measured by the common

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By Anne Cantrell, MSU News Service

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