Third-hand smoke.

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I’ve learned about the new term ‘third-hand smoke’ in my classes at UWF so now I thought I’d share it with you! This is an excerpt from Women’s Health magazine that I came across. Enjoy 🙂

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Day 33: (03/22/13)

It’s Friday! And boy has it been a good week! Actually, this week may have been the best so far of my internship. I feel like I am finally feeling comfortable at what I do and have a better idea of how things operate around the hospital. I’ve definitely met a lot of people too which has broadened my resources and comes in hand when I need something. So the first half of the internship, I feel like most of my time was spent meeting folks, shadowing them, learning the system of both the hospital and specifically deployment health, and now I am doing more hands on stuff (which is obviously more interactive and BUSY!). So many projects have come up lately and I don’t know if it’s an answer to my prayers or if this is part of the learning experience. I’d like to think both 🙂

So on to the details.. Friday, I went into the office to meet again with Mr. Sherrard. I gave him the finalized powerpoint (since I had made some corrections on Wednesday) and we printed out a copy for both him and I. The presentation is on Monday, so it’s crunch time! We did a walk through of it as well as printed all of the handouts we created. One of them is the Mifflin St. Jeor equation which calculates your BMR (or how many calories your body needs each day). Here is a PDF copy of that: MifflinStJeor. The next handout we have is on portion size and the way it has changed over time. We now live in a “bigger is better” society. Attached is a photo I took of that handout. The third handout is about “ChooseMyPlate” which is a government organization on Nutrition & Health. Another photo is attached of that handout as well. Last, we went over and printed the pre & post tests, which I created that morning. This was my idea to do and basically just for my benefit. It’s only 5 questions and it is used to assess their knowledge. I will pass it out at the beginning and then collect it when they are done. At the end of the presentation, I will pass them all back out because on the back side is the post test for them to take it again. Stay tuned Monday for the results and to see how much they learned. In health education, evaluation is a tool that we use to measure and review the process, possibilities, and problems of our programs. Now since this was just a presentation and not necessarily a “program”, I didn’t go all out with the evaluation method but instead a simple pre/post test. Here are the questions I asked:

Proper nutrition can help lower the risk of which health condition?
a) High blood pressure
b) Type II Diabetes
c) Some cancers
d) Osteoporosis
e) All of the above
Which food group is least consumed among military personnel?
a) Grains
b) Dairy
c) Fruits & Vegetables
d) Lean Meat
Which macronutrient has the highest kilocalorie per gram?
a) Carbohydrates
b) Protein
c) Fats
How long should you wait to re-fuel after a workout?
a) Immediately
b) 30 minutes
c) 45 minutes
d) 1 hour
I should eat every ________ hours and consume about ________ meals per day.
a) 4, 3
b) 1-2, 6-8
c) 2-3, 4-6
d) 3-4, 2-4

After Mr. Sherrard and I organized all of the materials needed for Monday’s Nutrition brief, we discussed our next project. The last I wrote on her about the “Family, Fun, & Fitness” event was that it was cancelled. Tara Rettig had called me when this happened and asked if Naval Hospital Pensacola (and specifically Deployment Health) would like to put on our own health fair at the hospital. I thought that was a great idea and kept forgetting to tell Mr. Sherrard about it because we’ve been so busy with this nutrition thing. So, I brought it up today and after calling Tara and discussing the logistics, we decided to do it!! I’m super excited, hence why I was saying this is the best week ever in the beginning. 🙂 So basically, we need to create a flyer and email/invite the participants AGAIN that were originally going to attend the Family Fun & Fitness event at the NEX. Stay tuned into my next blog for all the details with that, along with how the presentation went!

Thanks y’all ❤ Breanne

Daily hours: 8

Total hours: 224

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Day 32: (03/20/13)

Well, this is LAST Wednesday’s blog… I am a bit behind on my blogging, I apologize! But that is actually a good thing because that means I have been BUSY!!

So last week, I had the Diabetes Ed. class on Mon & Tues, which I already blogged. On Wednesday, I woke up, finalized the Nutrition powerpoint, then headed to Mr. Sherrard’s office to review it. He really enjoyed the powerpoint I created and gave me many kudos for all of the hard work I put into it, which was nice! He also said that it was a big project and gave me lots of great experience, which it did. From this, I learned a couple of things. First, a LOT about Nutrition. Not so much the material, but the extent and quantity of material that goes into the general subject. It’s quite difficult educating a crowd on Nutrition when you don’t know their health literacy level. I did the best I could at targeting military personnel within their age group and given limitations when it comes to eating. Second thing I learned from this experience is working under a supervisor and completing the tasks they give you. One of the key things to management I think is giving someone a project and trusting that they will do it and do it well. Mr. Sherrard gave me feedback on a couple of things as we went over each slide together and I took notes so that I could go home and make corrections. I enjoyed working with him and the trust he had in me to create this project on my own.

We shall see how the Army likes it on Monday, so stay tuned! 😉

I’ve attached the powerpoint, “Tactical Nutrition Brief” if you would like to look at it. Beware- it’s 70 something slides! But good general info.. thanks!

Tactical Nutrition Brief

Daily hours: 8

Total hours: 238

Day 30 & 31: Living Well with Diabetes

Hello! Well, today I am posting on a Diabetes Education class that I attended on Monday & Tuesday of this week (3/18-19) at Naval Hospital Pensacola. The class was taught mainly by Joyce Robinson and LaNora Glaze whom are both registered nurses and CDE (Community Diabetes Educators). However, guest speakers also played a big part in the program by educating the participants and other important areas of concern regarding Diabetes. The target audience was for pre-diabetic or diabetic patients with type I and type II.

Monday’s agenda:

0800-0815 Welcome & Overview by Joyce

0815-0905 What is Diabetes? by Joyce

0915-1000 Monitoring & Short Term Complications by LaNora

1015-1100 Medications by pharmacist LT Meaghan Horrigan

1110-1200 The Wellness Center by Bob Thomas, MWR Director

Tuesday’s agenda:

0800-0920 What Should I Eat? by Shelley Pino, Registered & Licensed Dietician

0930-1015 Quality of Life by Rikki Vidak, Social Worker at NHP

1030-1120 Long Term Complications by Joyce

1130-1200 Wrap Up/Evaluations by Joyce

If I explained in detail what all I learned, I’d be writing for 8 hours, so instead I will just give you the basics and some of my favorite parts of the training. On Monday, we covered the basics on Diabetes. A lot of these patients were clueless about their disease and so Joyce explained what happens and what is diabetes? Here is a good photo to describe diabetes:

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Understanding Diabetes

The food you eat is digested to be used as fuel. This fuel supplies energy to your body’s cells. When you have Diabetes, the fuel has a hard time entering most cells.

In Depth

The digestive system breaks down food, resulting in a variety of nutrients including a sugar called glucose. Some of the glucose is stored in the liver. Most of it enters the bloodstream and travels to cells to be used as fuel. Glucose needs the help of a hormone (chemical messenger) called insulin to enter most cells. Insulin is made in the pancreas. It is released into the bloodstream in response to meals and the presence of glucose in the blood. Think of insulin as a key. When insulin reaches a cell, it unlocks a doorway into the cell that allows glucose to enter the cell.

Diabetes: Your body may not make enough insulin, or may make none at all. And/or your cells may not respond the right way to insulin in the blood. Either way, this means that glucose ha trouble entering the cells. If it can’t enter the cells, it builds up to a harmful level in the blood stream. This is called high blood glucose or hyperglycemia.

Discussing the Types

When you have type 1 diabetes, the pancreas is not making any insulin at all. Type 1 diabetes most often develops in children. But adults at any age can also get it. People with type 1 usually must take insulin every day in order to get fuel into most cells.

When you have type 2 diabetes, the pancreas may still be making some but not enough insulin. And the cells may not respond to insulin the way they should. This is called insulin resistance. The pancreas may try to overcome resistance by making more insulin. But the pancreas can’t provide the extra insulin needed. People with type 2 diabetes may also need to take insulin, but more importantly- monitor their diet and exercise! Which falls into the next topic of Monitoring your Diabetes…

We went over the symptoms associated with Diabetes and what all it can do to your body. Typically those with Diabetes also have other existing issues such as high cholesterol, nerve problems, food allergies, etc. One thing they placed a big emphasis on was self-care and that only you are in charge of how you deal with your Diabetes. It’ all about choices.

Monitoring

Well, most people with diabetes SHOULD have a monitor or reader. This tells them their blood glucose levels. The goal is to keep your blood glucose levels within target range throughout the entire day. You also want to monitor your blood glucose levels after eating certain foods to discover whether or not they spiked your levels so that in the future you can avoid or limit those items from your diet. The target range for pre-meal blood glucose is 70-130mg/dL and <180mg/dL post-meal (or up to 2 hrs after you finish eating). This is helpful when trying to maintain in a healthy target range. While there’s hyperglycemia, there’s also hypoglycemia which means your blood sugar level is dropping too low. This can happen when consuming alcohol and not eating (which is not advised for diabetics because it is hard to diagnose whether they are drunk or having negative symptoms from the diabetes.. very dangerous!).

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I’m going to skip over some and talk more about my favorite parts of the class which included of course Nutrition & Fitness 🙂

So, Bob Thomas (who actually did my CPR certification) came and talked to the group on exercise and the important role it plays in controlling your diabetes. Exercise actually helps to lower your blood glucose levels because it burns some of that excess glucose and uses it for energy. He told them all about the different classes available at MWR on base and at the end, he talked to me a little more on shadow/job opportunities. We set up a time to meet and talk more on Friday, so I look forward to that. If I was in desperate need of a job, I would resort to becoming certified in fitness coordinating and taking the ACE exam to do so.

Anyway, moving onto Nutrition. Being that I have been working on a Nutrition Brief for the Army folks the past week, I was anxious to hear Shelley Pino’s lecture on Nutrition. She’s the RD at the Naval Hospital, ex-air force and super fun. She brought all her food demos and we had a good time. Basically, she covered the importance of carbohydrates in the diabetic diet. Carbs are the main source of glucose, therefore it needs to be limited and controlled. She gave them alternatives and healthy food options as well as resources to find diabetic recipes.

Well, that is all I’m going to say for now. I could go on and on about Diabetes! Oh wait, reminds me of one last important thing! 🙂

The A1C is a test that gives an average of the patient’s blood glucose levels over a period of time. Basically, it is advised that the diabetic has an appointment with their doctor every 6 months to review their A1C score and make sure that it is below 7%. Pre-diabetics are considered to be at 6%. The risks for diabetes include: being overweight, a sedentary lifestyle, age (although with the obesity epidemic, children are now being diagnosed), genetics or family history of diabetes, and race (typically the darker skin tones).

Ok, I think that is it. We covered tons of information (actually everything there is to know about Diabetes) in this class. The pharmacist talked about the different medications for diabetes and side effects of each, etc. The social worker gave a good analogy on diabetes by comparing it to a new born baby. When you first have a baby, it’s ALL about the baby. But after a while, it dies down. That’s like being diagnosed with Diabetes. At first, it’s all about the diabetes and you think your life is ruined, however it DOES and WILL get better with control and self-care!

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Daily hours: 14

(When I got home, I worked on the Nutrition Brief  each day for a total of 6 hours)

Total hours: 230

SPRING BREAK WEEK (03/11-03/17)

Hello bloggers! With it being Spring Break, I have spread my hours throughout the week and been working on the General Nutrition via my home computer. Due to military restrictions, I am not given access to the internet when at the Hospital. The power point has been fun but also hard work. I’ve learned a lot with creating it and trying to ensure that the message and learning material is appropriate for my target audience (Army soldiers). I’m covering general nutrition info with some helpful tips along with some physical activity info in relation to nutrition and recovery.

In this past week, I was supposed to attend a Maternal & Infant Nutrition meeting with Mr. Sherrard on Wednesday at the hospital, however it was postponed last minute. Hopefully they will reschedule soon because I am interested in attending! Tomorrow I will be attending a Diabetes Training at the hospital, so I am excited about that! I haven’t done anything yet with Diabetes, so I feel that it will be a good learning experience for me.

Unfortunately, we got some bad news this week in regards to the Family Fun & Fitness event. Andrea Beck (the NEX events coordinator) contacted me with regrets that the event has been cancelled due to budget cuts. She thanked me for all my hard work in contacting and coordinating participating vendors. However, now I need to contact those who confirmed that they would participate and let them know that the event has been cancelled. Before doing this, I want to meet with Mr. Sherrard and discuss any further opportunities we can partake in. Tara Rettig called me on Friday and she is the event/marketing manager at the Naval Hospital. We discussed the event being cancelled and she actually gave me the idea of creating our own health fair instead at the hospital. So, I am waiting to contact the vendors because we may just be changing the location/event…

By Wednesday, I will have the Nutrition PowerPoint complete and plan to meet with Mr. Sherrard so that he can review what I’ve done and revise as needed. After this, I will be uploading the document so that bloggers can view what I have done 🙂 So, stay tuned!!

Weekly hours: 23

Total hours: 216

Day 29: NOFFS

On Thursday, March 7th, I attended the NOFFS training with MWR. The Command Fitness Leaders need this certification to help educate Navy sailors on the importance of fitness and health while deployed on a submarine ship. I was one of the only female/civilians in a group of 20 Navy guys in PT gear. I was a little bit nervous at first, however they made me feel very welcomed which I was thankful for! And later, I even made a friend 🙂

We spent the morning inside a racquet ball room learning many fitness exercises with the use of resistance bands and lots of plyometrics. The instructor, Brian Hannah, did a great job of making it realistic to the life on a submarine ship. Being in a tight space with a large group makes it limited as to what exercises you can perform. We were given a training book showing how to do each exercise. It also had a chart showing how long you plan to work out 20 min, 40 min, or 1 hr and the correlating number of reps for each time frame and exercise which makes it easy to use to sailors. I was very impressed with the program and got some great ideas/experience for my future career. I’ve posted some pictures of the booklet and our group performing the exercises. Brian would first demonstrate each exercise, next we would perform the exercise, and then teach it to someone else in our group to help us to recall or remember each skill. These exercises were targeted at enhancing muscle strength.

 

After lunch, we went outside and did the cardio/running portion of the training program. Again, since space is limited when out at sea, sailors have to do short distance but fast paced exercises. Brian set up some cones and we learned different sprinting techniques to enhance speed and agility. We then went back inside the racquet ball room to do stretches. Last, we covered the nutrition portion of the program. This was my favorite part. I learned some new & interesting things which made it beneficial and fun. I loved the way it was organized. Their mission statement is “Eat Clean. Eat Often. Hydrate. Recover. Mindset.” It included a “10 Nutrition Tips to Live by” outline which reminded me of the one on ChooseMyPlate. If you go to this website, it gives you all of the information and program material: http://www.navyfitness.org/nutrition/noffs_fueling_series/rules_to_live_by/. Again, great information and very resourceful!
I particularly liked their Fueling Series which includes a virtual meal builder. Given someones age, gender, and current weight, you can build meal plans from a precise food selection menu. It tells you the number of servings per food group that you should eat for breakfast, lunch, & dinner based on whether you want to lose, maintain, or gain weight. Very simple and cool! Here’s the website for that: http://www.navyfitness.org/nutrition/noffs_fueling_series/interactive_mealbuilder/Overall, a great day and learning experience! I could definitely see myself doing something like this in my future and would love working with Morale, Wellness, and Recreating (MWR).

*Another neat feature is the NOFFS app that you can download on your smart phone. A took a screen shot and the photo is below! Enjoy
Daily hours: 8
Total hours: 193

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Day 28: (03/06/13)

Topics….

I went into the office this morning and Mr. Sherrard got called into a last minute meeting at NHP, therefore I started brainstorming some discussion topics for the General Nutrition Lecture/Powerpoint Presentation. After Mr. Sherrard got out of his meeting, he also gave me some topic discussion ideas. But before I get into those, let me go over some of the basics with you! So, the target population is fresh, young, enlisted Army soldiers. With this being said, it is important to remember: what their job is, where they live, what kind of activities they are involved with, where they do their shopping (commissary) etc., when creating the program material. The dates for this training (as of today) have changed to 25 March at 1100 & 1500, each session will be 1 hour.

Here is a list of potential topic areas up for discussion:

  1. Eating healthy and staying fit (normal nutrition intro)
  2. Healthy choices while eating in the galley (shopping list & blueprints, male & female)
  3. Making convenience healthy (supplementing with sound nutrition – high protein bars, etc)
  4. Identifying ‘eat this, not that’
  5. Sugar cube demo
  6. Supplementation can be healthy (identifying the dangers of wrongfully supplementing your diet *supplement wisely)
  7. Alcohol and drugs (tobacco) don’t constitute a healthy diet
  8. How to incorporate “Choose My Plate” into a healthy eating/fitness plan
  9. Military programs to offer-NOFFS, MISSION NUTRITION, EAT HEALTHY/BE ACTIVE (what is it and how will it help me)
  10. Eat a rainbow often
  11. Choose high octane carbs, proteins, & fats versus low (and show list)
  12. List of the Top 5 Carbs/Proteins/Fats
  13. Come back to Earth (basically eating natural foods, outside parameters of the commissary)
  14. Portion Distortion
  15. The less legs the better
  16. Eat breakfast everyday (crank up your metabolism!)
  17. Three for Three
  18. Stay Hydrated (show pee chart & recommended amount per body weight)
  19. Don’t waste your workout (pre & post meals)
  20. Sleep (8hrs)

So, as you can see, I have a pretty long list. I plan to organize & condense the material, as it is in no order here. However, the powerpoint will be close to 40 slides and there is a lot of information to cover regarding Nutrition… Good thing we aren’t getting into Physical Activity/Fitness!
Stay tuned for more on the Nutrition Lecture 🙂

Daily hours: 7

Total hours: 185

 

Day 27: (03/04/13)

On Monday morning, I sent some emails and updated the list of confirmations for the family fun and fitness event. At 11, I had lunch at Cactus Flower with Mr. Sherrard and Tara Rettig (marketing manager at NHP). Besides the amazing California style Mexican food, the meeting was great! We discussed the family fun and fitness event. Tara Rettig is the one who initially told me about the event and gave me Andrea Beck’s contact info months ago. Basically, we met with Tara to ensure that we are all on the same page and to fill her in on what all we have done so far for this event. She is the one who has to run everything by the CO involving NHP. I gave her the list of participants that I have this far and we also discussed some of the logistics for the event (i.e. tables, chairs, etc).

Since Family Fun & Fitness is not our event, Naval Hospital is just participating, we are limited as to what we can do and what is our responsibility. We all decided at lunch that it would be best for us all to meet with Andrea and tell her our ideas and what we have to offer. From what I understand, the NEX is putting on another event on March 16th for spring including lawn care, etc. so I think it is best if we recoup after she finished with that. This is good for Mr. Sherrard and I as well because we need to get started on the Nutrition Power Point.

When I got home, I sent Andrea the following email:

Andrea,

I’m sorry it’s been a while since we’ve chatted. I understand you have an event coming up on 16 March and don’t want to get in the way with that. However, I wanted to keep you updated on a couple of things.

First, I had lunch yesterday with my supervisor and department head of Deployment Health, Jim Sherrard, and also Tara Rettig from NHP. We discussed the Family Fun & Fitness event a little bit and wanted to ensure that we are all on the same page.

Second, we’d all like to meet you and just discuss the details and bring any further ideas to the table for you. Is there sometime toward the end of March/beginning of April that we could get together?

Third, I have gotten confirmations from about 5 of the organizations that I invited to participate at the event.

I hope you are doing well and having a great week! Looking forward to hearing from you as well.

V/R,

Breanne Michelle Watts
Community Health Education,
University of West Florida
(678) 386-8254
Bmk7@students.uwf.edu

Daily hours: 8
Total hours: 178

Day 26: MIDTERM

Hello! Well, I’ve made it to the midterm point, hooray! So, Friday did not get off to a good start, but it turned out to be yet another learning experience and a great day.

I showed up to the office around 8:30am and had a planned meeting with my supervisor, Mr. Sherrard. Upon arriving, I discovered that Mr. Sherrard was having some car trouble and would be late. So, I went to my office and started gathering my thoughts and ideas for our meeting. I felt a little discouraged, especially after receiving a negative phone call in regards to an email that I sent. This is what turned into a learning experience for me. I’ve learned that things are not always going to be ‘peachy’ in the workplace. I will face some road blocks or a dead end, but that doesn’t mean that I did something wrong. I have been limited as to what I can do so far this semester with Mr. Sherrard being gone on temporary additional duty, etc.. I was only trying to accomplish the tasks that he provided me with.

So, at around 1:15pm, after lunch, I had a meeting with Mr. Sherrard in his office. He went over the midterm evaluation with me (which is basically a grade sheet for my internship that he fills out and is required by UWF). I received all above averages and a score of 5 (being the highest) in all areas. His feedback was very positive and I was pleased with the evaluation overall. I explained to Mr. Sherrard my concerns and explained that since I have now shadowed the majority of various health professionals at Naval Hospital Pensacola, I am interested in doing more hands on tasks for the remainder of the semester.  He agreed.

So, some things have changed. We decided that the “Eat Health, Be Active” curriculum was too difficult for me to change and target toward youth. Mission Nutrition is an existing program at NHP which we would build our program off of and the material is targeted toward the adult population. Since this didn’t work out, we decided to engage in something else. Mr. Sherrard received an email from an Army Captain requesting a presentation on Nutrition to her initial entry training students (fresh soldiers) in March. Mr. Sherrard and I called the Captain in charge to discuss in detail what all she wanted for this presentation. She has 120 soldiers and thinks it’d be best to split them into 2 groups and teach 2 sessions at an hour long each. We will be going over the general principles of nutrition and ways to improve their food selection at the Commissary, etc. Mr. Sherrard told Captain Gonzalez that we would be happy to participate and we set the event date to Wed, March 20th. He explained to her that I would be helping to create and teach this presentation.

So, Mr. Sherrard and I decided that it would be best to use powerpoint for our presentation. He wants me to create the powerpoint as well as a handout/flyer to send out to all participants before hand. I am very excited to have this hands on experience and look forward to helping Mr. Sherrard with the Nutrition class!

After discussing my evaluation and then the nutrition class, we went over some more details for the Family Fun and Fitness event. I shared with him the confirmations that I received and what all I was working on with that. We called Tara Rettig who is the event coordinator/marketing manager for Naval Hospital Pensacola. She works with Andrea Beck (the NEX event coordinator) when they have events like this. Because there is a lot of material to go over, Mr. Sherrard planned a lunch meeting with Ms. Rettig for Monday at 11am. We will talk more on this event at that time.

Well, those are all the updates I have (as of now at least)!  Stay tuned for Part II of the internship 🙂

Daily hours: 7

Total hours: 170