2023 Edition
“As women achieve power, the barriers will fall. As society sees what women can do, as women see what women can do, there will be more women out there doing things, and we'll all be better off for it.”
Ruth Bader Ginsburg
The Editor's Take: February Newsletter
Welcome back AMWA, to your February Edition of the Newsletter! We hope your Valentine’s day was as splendid as ever!
In this edition, your writers bring to you articles on the Turkey and Syria Earthquake, Investments in Developing Cures, Medicalization of Obesity, Menopause Awareness, Misdiagnosis of ADHD, and a submission by an AMWA UTD member, Aaliyah Sherfuddin, on upgrading your workplace. As always, don’t forget to check out our Study Playlist for this month!
If you have any topics, ideas, or pieces of writing that you would like to submit, please feel free to email me at Tanya.Baiju@utdallas.edu.
- Tanya
The Turkey and Syria Earthquake Disaster
By: Hafsa Mohammed and Janavi Mehta
Trapped under rubble, exposed to freezing temperatures, and with no way out, one family faced these horrifying circumstances for 13 days in the aftermath of the 7.8 magnitude earthquake that struck Turkey and Syria. In the end, only the mother and father survived, while their three children passed away. This story is still a miracle considering that most of the rescue efforts have been winding down in parts of Turkey and Syria at this point. The rescue teams continue their efforts only in the hardest hit areas like the Kahramanmaraş and Hatay provinces of Turkey. Since the disaster struck on February 6th, the death toll has surpassed 46,000, with many more permanently injured or disabled for life. Beyond that, millions of people have been displaced from their homes and have become refugees. In the wake of this natural disaster, many countries acted and contributed to the humanitarian crisis. Yet sending aid is no simple task due to the unique situations of Turkey and Syria.
Internationally, Turkey has received $1.78 billion from the World Bank and the US has pledged to provide 100 million dollars in funding to support the relief efforts. Although the fallout for Turkey has been catastrophic, another problem that has been buried under the relief efforts sent to Turkey is more troublesome. Syria is on the verge of collapse. More than five million people have been displaced within the country. Moreover, before the earthquake, the ongoing civil war within the country had already displaced millions of refugees and destroyed the healthcare system. Providing emergency aid and relief to Syrians poses unique issues due to political instability.
After an earthquake, one of the most imminent issues that arise is the inundation of the healthcare system as efforts are redirected to impacted regions and populations. The sheer magnitude of the earthquake brings devastating effects to the region that not even the established emergency efforts and protocols that Turkey has in place can rectify. Recent efforts have been focused on search-and-rescue, which have now been closing to an end after two weeks. The situation is still developing, but eventually, public health crises will come to light which will prove debilitating to the recovery efforts. Common problems that result include access to clean water and sanitation, overpopulation of shelters, population displacement, etc. All of which are ideal breeding grounds for disease and will most likely hinder progress.
According to a paper published by the Chinese CDC, a Rapid Public Health Needs Assessment framework must be established after major earthquakes to effectively handle the situation. Five objectives were identified within the paper:
Estimating casualties and injuries
Identifying damaged medical facilities
Estimating drinking water needs
Identifying areas at risk of disease
Identifying temporary settlement sites.
The assessment establishes a basis for public health recovery efforts and dealing with the developing situation.
In the end, a lot of relief can still be provided by individuals as well. Organizing fundraisers for charities helping in Turkey and Syria, as well as simply donating to a charity like Doctors Without Borders or the Syrian American Medical Society Foundation can make that first ripple in the pond. Other efforts include volunteering for one of the relief organizations or spreading awareness. Even among the tragedies, everyone needs to keep their heads up and remember that they are not alone.
Investments in Developing Cures
By: Zoe Du
“Side effects are rare but include headache, vomiting, nausea, death…” and the narrator drones on and on about the potential side effects associated with a drug. Sound familiar? That’s because it probably is. If you have turned on the TV anytime recently, you most likely got at least a few drug commercials trying to sell you drugs you may never have even heard of. The pharmaceutical industry in the United States is so big that it seems like we have medicines for almost any ailment you can think of. Have a sore throat? Take your pick of the dozens of options in the pharmaceutical aisle. Experiencing hair loss? Not to worry, there are several options to choose from. What you might have a harder time finding are effective treatments or vaccines for diseases like Zika or HIV/AIDS.
To some degree, the absence of effective treatments and vaccines for diseases can be attributed to science, with some pathogens simply eluding scientists. However, the bigger issue, and one for which resources exist, is the lack of investment in research and development (R&D). R&D is an expensive and time-intensive process - the estimated cost to develop a new drug or vaccine is $1-2 billion over the course of several years - and pharmaceutical companies are profit-motivated, as evidenced by the barrage of advertisements they release. As a result, pharmaceutical companies prioritize drugs that will have a high return on investment, meaning minimal investment in treatments and prevention for diseases that primarily affect poor populations. The resultant disparities in R&D investments are astounding: only 10% of investments were directed towards diseases affecting 90% of the population. Treatments for baldness exist while R&D on a vaccine for Ebola was halted before the 2014 outbreak because treating baldness is more profitable; in fact, 10 times as much was spent on developing treatments for male baldness than the cost of curing malaria.
In 2021, nearly $14 billion was spent on digital drug advertisements, outpacing investments in R&D for neglected diseases, which fell short of $4 billion in 2020. Of those $4 billion, a majority was directed towards only three diseases: HIV/AIDS, TB, and malaria. It is clear that the status quo leaves too many people behind. While there is no easy or perfect solution, there are policies that have the potential to change how investments are made. For instance, a group established by the WHO that analyzed R&D needs proposed an alternative model in which a pooled global fund maintained by 0.01% of each nation’s GDP would be used to fund R&D rather than the patented sales of a new drug.
Significant advances in health have been made in the past century through the development of new drugs and vaccines that have enabled us to effectively prevent and treat several of the top-killing diseases. However continued progress is inhibited by profit-motivated investments in R&D, and structural changes will likely be needed.
The Obesity Disease: The Medicalization of Obesity
By: Janavi Mehta
In 2014, Michelle Obama introduced her Healthy, Hunger-free Kids act to provide better nutritional quality lunches for students, especially for lower-income students (Chandler). It was part of a movement to combat the rising obesity rates among children. Obesity has become a larger concern for society because humans are in the Age of Obesity and Inactivity (Barken). These changes have led to an increase in chronic diseases related to obesity and more obesity-related physician visits (Ciciurkaite, Gabriele, et al.). Moreover, in recent years, the way obesity has been looked at or treated in the medical world has changed. Obesity has been treated more and more like a treatable disorder and that process is called medicalization.
Medicalization “refers to the process by which nonmedical problems become defined and treated as medical problems, often without good evidence of their medical nature” (Barkan). Obesity is known to lead to a higher risk for certain diseases like heart disease and trying to treat obesity itself as a disease can have positive and negative outcomes. On the one hand, the medicalization of obesity means that doctors can push aggressively for preventative actions before further harm is done, but also measures that doctors think will help will be covered by insurance if obesity is further defined as a disease. This will help reduce the costs of treatment if people wish to pursue that path. This medicalization of obesity also drives the narrative of “fat bodies” away from the fault of the individual for being fat and focuses on the body's biological processes that led to that condition.
On the other hand, medicalization will increase the number of drugs in the market that can be used or abused for weight loss. It will push for bariatric surgery as the cure, which will further profits for the hospital and pharmaceutical companies and it will downplay the role of poverty, poor nutrition, and other environmental and societal causes of obesity, which is dangerous (Barkan). It is a complex issue with many consequences, good and bad. Only the future will tell if this is the right direction to be heading in.
Medicalization has been observed in many other diseases over the course of the decades such as ADHD, certain disorders relating to the female body, and now obesity. The trend is nothing new, but the outcomes have not been stellar in all departments. Specifically for obesity, this will not help all obese individuals, and nor do all obese individuals want to be “diagnosed” or told that they are obese and want to change that. It takes away the social cause of these problems often which will do nothing to address the root problem. Obesity is both an environmental consequence, but also a biological one. To find a proper solution to obesity and its health-related problems, a tailored approach fit to each individual would be ideal.
The Sex Talk You Never Had:
Menopause Awareness
By: Zoe Du and Tanya Baiju
“Women are too hormonal.” It’s a phrase we have probably all heard and bristled at. It feels demeaning, implying that women are irrational, and it represents a sexist sentiment that for millennia has been used to justify denying women the same rights and opportunities as men. Men also have hormones, including estrogen, the notorious “female” hormone that somehow renders women incompetent. The reality is that hormones are essential to keeping all of us alive, regardless of sex or gender, and we should be having honest conversations about how hormones and hormonal changes affect the way our bodies behave and feel, rather than using “hormones” to belittle or discredit people, nor should they be taboo to discuss.
People who menstruate are intimately familiar with how the cyclic rise and fall of hormone levels can affect their bodies. Still, the topic is often viewed as taboo, despite periods being a reality for 26% of the world’s population. Closely related is the lack of education and discourse about menopause and perimenopause, the transitions from regular menstruation to after an individual has their last period. Lasting an average of seven years, but lasting up to 14 years, perimenopause can have a wide range of effects, ranging from hot flashes to depression, to brain fog, to joint pain. The extent to which perimenopause and menopause affect someone varies widely, but in more severe cases, the symptoms can be debilitating.
One of them being heart disease. According to the American Heart Association, awareness that heart disease is the leading cause of death among women fell between 2009 and 2019. Not being aware of the possible symptoms and long-term effects of menopause can be detrimental to overall health. The topic of menopause in itself is overlooked and not talked about enough. Symptoms are often written up to be nonserious, which leads many to be unaware and uninformed about menopause. Another aspect of menopause is the effect it takes on mental health. It leaves many with a sort of loss, which leads to depression.
Menopause awareness strives to rid the stigma and taboo that follows it. It is an effort to normalize and bring knowledge to the symptoms, causes, and treatments that those who go through menopause can easily access. Menopause should not be a taboo topic as it is a normal process and instead be talked about more freely to bring awareness.
Misdiagnosis of ADHD
By: Hafsa Mohammed
Attention deficit/hyperactivity disorder or otherwise known as ADHD has been long debated on the global stage as a legitimate disorder. In the past, the inability to stay focused and hyperactivity was commonly attributed to laziness and bad behavior. It took an immeasurable time for ADHD to be accepted as a valid mental disorder rather than an “excuse” for bad grades and rowdy behavior. Now, ADHD is perhaps the most common neurodevelopmental disorder there is to be diagnosed in children. Around 6 million, 9.8% of children ages 3-17, have been diagnosed with ADHD. In recent years, there has been a jump in the number of diagnoses (42% increase), especially within the US.
It is imperative to point out that the issue is not the overdiagnosis of ADHD, but rather the misdiagnosis. There has been quite a bit of debate on whether ADHD is overdiagnosed. Many argue yes, but that it is a necessary by-product to be accepted for the better good. They contend that the cons of limiting the scope of an ADHD diagnosis would be greater harm to the neurodivergent community than maintaining the bar as is. That is not to say that children diagnosed with ADHD are exaggerating their symptoms, but rather there may be other developmental or environmental factors at play instead. The three prominent detracting influences on misdiagnosing of ADHD cases are:
Lack of consideration for developmental milestones, ADHD has been increasingly diagnosed in young children. A Taiwanese study concluded that ADHD is misdiagnosed for younger children at school due to maturity and neurodevelopmental factors. (Chen et al., 2016).
Sex-specific behavior traits, A 2015 study on the Misdiagnosis of ADHD found that boys are diagnosed with ADHD three times as much as girls. While this does not apply to all boys, traits such as hyperactivity and disruptive behavior are behavioral symptoms associated more with males than females.
Mood disorders, Other common psychiatric disorders such as depression, autism, anxiety, bipolar disorder, and dysthymia may present similarly to ADHD resulting in a false diagnosis.
The point in question now brought up is why the misdiagnosis of ADHD poses an issue. Around USD 410 million is spent on ADHD medication for misdiagnosed childhood ADHD cases. Perhaps more troubling is the unnecessary, overprescription of ADHD medication. In 2022, the FDA announced a shortage of Adderall, a formulation of amphetamine commonly used to treat ADHD symptoms. Quite simply, demand has overshot supply by miles. Pharmacies are flooded with calls from patients who are unable to get their hands on Adderall. There has never before been such a high demand for Adderall prescriptions to date. The demand has been attributed to growing awareness about ADHD, but more distressingly due to unnecessary prescriptions of Adderall by physicians. This is a serious problem for patients who are dependent on Adderall for functioning through day-to-day activities. The fallout of the Adderall shortage brings attention to the underlying predicament in the US of how childhood ADHD is often misdiagnosed. While the problem may not be prominent in mainstream media as of yet, it is most likely to escalate into a larger issue if not addressed.
Letter to the Editor: Upgrading Your Workplace
By: Aaliyah Sherfuddin
When COVID-19 first impacted our daily lives, we all immediately shifted into virtual environments. Whether you were a student or employee, all schools and workplaces were not in session and we had no choice but to work at home. Creating a workplace at home is extremely crucial as it is a functional place for your everyday work, whether you are studying, getting projects completed, or more. Making an effective workspace will not only increase your productivity but also ensure you are being the healthiest version of yourself and improve your lifestyle overall.
Here are some ways you can effectively upgrade your workspace!
What physically makes up your space?
Ergonomic furniture by definition is designed to complement the human body and create
safe working environments by considering multiple factors such as posture, back support,
distribution of weight, comfort, and movement.¹
Chair: By sitting in a normal non-ergonomic chair, you put yourself at risk for musculoskeletal disorders due to a lack of upper back support.¹ Additional risks include improper posture from pressure on your spine and backbone leading to back pain and restrained blood flow.¹ It is important to look for a chair with multiple adjustable parts in order to keep your joints and tissues in a neutral position with feet flat on the floor and knees at hip level. Sitting in a comfortable chair reduces the risk of injury and strain, giving you more energy to focus on your work without distractions.¹
Monitor: Position your monitor directly in front of you at an arm's length away from or slightly below eye level.
Keyboard: Keep your keyboard below your workspace, since usually the standard workplace keyboard is on the same surface as the screen and is positioned too high for proper ergonomic positioning.² Keyboard height should be maintained even with your elbows.²
External factors to your workspace
Light: Ensure that your workspace is well-lit with lamps or bright white room lights to prevent eye strain. Angle your screens to prevent glare with lighting or nearby sunlight from windows.
Noise: Set up your workspace in a quiet environment free from distractions. Loud environments can be very distracting and hinder your work when you are fully focused.
Snacks: It’s generally easier to eat finger food in the midst of working to not completely lose focus. Some healthy snack options that will keep your energy up are fresh popcorn without preservatives, nuts such as almonds, baked veggie chips, string cheese, seaweed, and granola.³
Good work habits
Breaks: It is important to maintain blood circulation by getting out of your seat to stretch. Not only will you reduce fatigue by remaining energized, but you can also prevent aches and pains from developing. During breaks, avoid electronic screens if most of your work has been centered around staring at a monitor for hours on end.
Hydration: Remember to always have water near your workspace. Even when you are in the zone of working, you need water to maintain energy levels and avoid stomach cramps.
Standing workspaces
If your work involves sitting for long periods of time, it would be valuable to consider a
standing desk. Standing desks keep your body more active with a higher heart rate, contributing to increased productivity on a task.⁴ If you don’t want to be standing all the time, there are sit-to-stand desks that let you change your set-up. Many people with this option stand while working and sit down after a task is complete to relax before standing to start another task.⁴ Alternatively, if you want to be more active while working, treadmill desks have been incorporated into workspaces and promote more exercise. It is great to multitask if you don’t find enough time in your day to exercise, but should not completely replace an exercise regime.
Standing desks, sit-to-stand desks, and treadmill desks are all very good alternatives to a
traditional workspace if you like to stay moving and on the go!
Customizing a workspace for yourself is the best way to take care of your daily, professional, personal, and health needs for the long-term run. By prioritizing how you work early on, you have the best chance of putting your best efforts forward. Maintain healthy habits for the best results!
Sources
https://www.cnn.com/2023/02/19/politics/us-relief-turkey-syria-earthquake/index.html
https://www.insiderintelligence.com/content/spotlight-us-healthcare-pharma-digital-ad-spending-2022
https://www.nytimes.com/2018/11/19/health/vaccines-poverty.html?
https://www.cbo.gov/publication/57126
Essentials of Global Health, edited by Babulal Sethia and Parveen Kumar
https://www.unicef.org/press-releases/fast-facts-nine-things-you-didnt-know-about-menstruation
Barkan, Steven E., and Steven E Barkan. Health, Illness, and Society: An Introduction to Medical Sociology, first ed., ROWMAN & LITTLEFIELD, 2017, pp. 64–67.
Chandler, Ashlie. “News & Events.” Obama-Era School Nutrition Policy Led to Better Diets for Students but Faces Changes | UW School of Public Health, 28 July 2020, https://sph.washington.edu/news-events/news/obama-era-school-nutrition-policy-led-better-diets-students-faces-changes.
Ciciurkaite, Gabriele, et al. “The Incomplete Medicalization of Obesity: Physician Office Visits, Diagnoses, and Treatments, 1996-2014.” Public Health Reports (Washington, D.C. : 1974), U.S. National Library of Medicine, 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410477/#:~:text=Obesity%20is%20another%20example%20of,with%20many%20negative%20health%20effects.&text=In%202013%2C%20the%20American%20Medical%20Association%20officially%20declared%20obesity%20a%20disease.
Idea was inspired by a very lovely Instagram story from my friend Mariyam https://www.cdc.gov/ncbddd/adhd/data.html
https://www.jpeds.com/article/S0022-3476(16)00160-8/fulltext.
https://www.pghr.org/post/the-global-misdiagnosis-of-adhd-and-the-devastating-long-term-effects
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443828/
https://www.medicalnewstoday.com/articles/325595#auditory-processing-disorder
https://msutoday.msu.edu/news/2010/nearly-1-million-children-potentially-misdiagnosed-with-adhd
¹https://ergonofis.com/en-us/blogs/news/ergonomic-office-chair-choose-best ²https://www.ergotron.com/en-us/ergonomics/ergonomic-equation#:~:text=Adjust%20the%20mo nitor%20height%20so,larger%2C%20add%20more%20viewing%20distance. ³https://www.healthline.com/nutrition/healthy-snacks-for-work#TOC_TITLE_HDR_16 ⁴https://standdesk.co/blogs/news/standing-desk-vs-treadmill-desk-which-one-is-better
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