National Barrier Awareness Day - Barriers to Health Care

Barriers to Health Care

• “After you turn into an adult with cerebral palsy, there is little medical support. Most of the studies, surgeries, and what have you are done with children with cerebral palsy. I walk into a doctor’s office and say I have cerebral palsy and get “that look” from the doctor. The look most adults with CP have seen numerous times in their life, the look of “Oh crap, I am going to have to Google this when I get home.” - Mary Catherine

People with disabilities encounter a range of barriers when they attempt to access health care including the following.

Prohibitive costs

Affordability of health services and transportation are two main reasons why people with disabilities do not receive needed health care in low-income countries - 32-33% of non-disabled people are unable to afford health care compared to 51-53% of people with disabilities.

Limited availability of services
The lack of appropriate services for people with disabilities is a significant barrier to health care. For example, research in Uttar Pradesh and Tamil Nadu states of India found that after the cost, the lack of services in the area was the second most significant barrier to using health facilities.

Physical barriers
Uneven access to buildings (hospitals, health centers), inaccessible medical equipment, poor signage, narrow doorways, internal steps, inadequate bathroom facilities, and inaccessible parking areas create barriers to health care facilities. For example, women with mobility difficulties are often unable to access breast and cervical cancer screening because examination tables are not height-adjustable and mammography equipment only accommodates women who are able to stand.

Inadequate skills and knowledge of health workers
People with disabilities were more than twice as likely to report finding health care provider skills inadequate to meet their needs, four times more likely to report being treated badly and nearly three times more likely to report being denied care.

Addressing barriers to health care

Governments can improve health outcomes for people with disabilities by improving access to quality, affordable health care services, which make the best use of available resources. As several factors interact to inhibit access to health care, reforms in all the interacting components of the health care system are required.

Policy and legislation
Assess existing policies and services, identify priorities to reduce health inequalities, and plan improvements for access and inclusion. Establish health care standards related to the care of persons with disabilities with enforcement mechanisms.

Service delivery

Provide a broad range of modifications and adjustments (reasonable accommodation) to facilitate access to health care services. For example, changing the physical layout of clinics to provide access for people with mobility difficulties or communicating health information in accessible formats such as Braille. Empower people with disabilities to maximize their health by providing information, training, and peer support. Promote community-based rehabilitation (CBR) to facilitate access for disabled people to existing services. Identify groups that require alternative service delivery models, for example, targeted services or care coordination to improve access to health care.

Human resources
Integrate disability education into undergraduate and continuing education for all healthcare professionals. Train community workers so that they can play a role in preventive health care services. Provide evidence-based guidelines for assessment and treatment.

WHO response

In order to improve access to health services for people with disabilities, promote strategies to ensure that people with disabilities are knowledgeable about their own health conditions and that healthcare personnel support and protect the rights and dignity of persons with disabilities.

Resources
1. Access To Medical Care for Individuals With Mobility Disabilities, U.S. Department of Health and Human Services Office for Civil Rights
2. Disability and Health, World Health Organization

May 6, International No Diet Day - A Celebration of Body Acceptance and Body Shape Diversity

International No Diet Day (INDD) is annually observed on May 6th. It is a celebration of body acceptance and body shape diversity. The day is dedicated to raising awareness of the dangers of diets. A blue ribbon is used to symbolized INDD cause.

The INDD was created in 1992 by Mary Evans Young, a British woman who decided to fight the diet industry in order to raise awareness of the dangers of dieting, anorexia nervosa, and other eating disorders.

The Goals of the INDD:
1. Doubt the idea of one "right" body shape.
2. Raise awareness of weight discrimination, size bias, and fatphobia.
3. Declare a free day from diets and obsessions to body weight.
4. Present the facts about the diet industry, emphasizing the inefficacy of commercial diets.
5. Show how diets perpetuate violence against women.
6. Honor the Victims of eating disorders and weight-loss surgeries.

Resources:
International No Diet Day. Wikipedia 

National Shrimp Day - Nutrition and Recipe Ideas

ShrimpTacos with Green Apple Salsa, Cooking Light  

Resources

1. LouisianaShrimp Association

2. Food Network, Healthy Shrimp Recipes

Tuna Creations, Sustainable Seas World Tuna Day

Tuna Creations, Sustainable Seas. From classic to stylish, each dish offers a taste of the ocean's bounty, sustainably sourced and beautifully served. #WorldTunaDay #tuna

Tuna is a saltwater fish belonging to the mackerel family (Scombridae). It is one of the only species of fish that can maintain a body temperature higher than that of the surrounding water.

Mercury Concerns

Questions & Answers from the FDA/EPA Advice on What Pregnant Women and Parents Should Know about Eating Fish, FDA

Fish are a high-quality protein source, and lower mercury fish are a good choice for everyone. This advice is specifically for women who are pregnant, might become pregnant, or are breastfeeding, and for young children, but everyone can follow this advice.

Albacore has more omega-3 fat per ounce, but since it comes from a larger tuna species, it also has more mercury. On the other hand, chunk light comes from a smaller fish species and has less mercury and omega-3 fat.

The Food and Drug Administration and EPA recommend that women who may become pregnant, pregnant women, nursing moms and young children eat up to 12 ounces (2 average meals) of lower-mercury fish and shellfish each week. Since albacore ("white") tuna has more mercury than light tuna, when choosing your 2 fish, you can safely eat up to 6 ounces of albacore tuna each week (which is a healthy serving of tuna for one average meal).

Use the chart to help you choose which fish to eat each week. Eating a variety of fish is better for you and your child than eating the same type every time.

Canned Tuna
Tuna is one of the easiest protein sources to keep on stock for a quick meal.


Choosing the Right Can
Water and Oil-packed tuna can be used to create a healthy recipe. The most common water-packed varieties in the market are albacore and chunk light. Albacore has a milder flavor, while chunk light tends to have a stronger flavor. Three ounces of tuna canned in water has the following nutrition information:

Recipe

Tomato, Tuna & Tarragon Salad

Serves 6

Ingredients.
1/2 cup diced Red Onion
1/3 cup low-fat mayonnaise
Freshly Ground Pepper To Taste
6-ounce, 2 cans chunk light tuna in olive oil, water-packed
2 Celery, stalks, thinly sliced
1/4 cup Packed coarsely chopped fresh tarragon leaves
8 cups Torn lettuce, or mixed greens

Directions.

1. Place onion in a small bowl and cover with cold water. Refrigerate for 20 minutes. Drain.

2. Whisk mayonnaise and pepper in a medium bowl. Add tuna, celery, tarragon, and onion; stir to combine. Serve on top of the lettuce (or mixed greens) with tomato and lemon wedges.

Resources

1. World Tuna Day United Nations
2. 10 Healthy Canned-Tuna Recipes, #TobyAmidor, #RDN, #FoodNetwork 

tuna fish

From Tree to Table: Celebrating Arbor Day with Garden Fresh Delights

A Tour through Our Garden

From Tree to Table:
Celebrating Arbor Day with Garden Fresh Delights

"Arbor Day is a time to celebrate the wonders of nature
and to plan for an even greener future by
planting and caring for trees."

Our Mango Trees

Last year, our mango tree produced over 80 fruits.
This year looks like another high yield.

Our Banana Plant(s)

I asked for a Banana Plant for my birthday (July 5, 2020).
It stood about 2 feet high. In less than 10 months, the
banana plant grew to a height exceeding 10 feet.
In November 2021, the Banana Plant produced an
amazing first harvest. In addition, that
one Banana Plant is now 4 Banana Plants.
Banana plants appear to multiply as fast as rabbits.

John Denver - Plant a Tree

While growing up in East Meadow, New York, we had a huge apple tree in our yard. I would climb up the tree and sit on the branches for hours, eating the apples while watching the world below.

When Jake and I moved into our home in 1998, we planted a mango tree. We watched it grow and flourish. Then, in 2005, Hurricane Wilma hit and damaged the tree. We tried to nurse the tree back to health for years, but the infection had spread into the roots.

Finally, on April 25, 2012, we removed the old tree and replanted a new Valencia pride mango tree. Today, the tree stands tall, even after surviving Hurricane Irma.

In April 2018, we decided to plant another Mango Tree. This time, we planted it near the road so that if people walked or drove by, they could grab a mango.

Planting a fruit tree is good for the environment and economics and marks special moments.

Visit the Arbor Day Foundation. Resources, membership, free trees, and a lot more.

Our Nation's Forests are National Treasures

Zucchini Walnut Bread

Zucchini Walnut Bread

Yield: 2 loaves (12 slices per loaf)
Servings: 24
Equipment: Two 9-by-5-inch loaf pans
Total Time: 2 hrs 30 mins

Ingredients
3 large eggs
1 ½ cups granulated sugar
1 cup canola oil
1 teaspoon vanilla extract
1 ½ cups all-purpose flour
1 ½ cups whole-wheat flour
1 teaspoon ground cinnamon
1 teaspoon baking powder
1 teaspoon baking soda
1/2 teaspoon salt
3 cups shredded zucchini (about 1 pound)
½ cup walnuts chopped finely

Directions

• Preheat oven to 350 degrees F. Coat two 9-by-5-inch loaf pans with cooking spray.
• Whisk eggs, sugar, oil, and vanilla in a large bowl. Whisk all-purpose flour, whole-wheat flour, cinnamon, baking powder, baking soda, and salt in a medium bowl.
• Add the dry ingredients to the wet ingredients and mix until smooth. Fold in zucchini and walnuts. Divide the batter into the loaf pans and smooth the tops.
• Bake for about 1 hour or until a toothpick inserted into the center comes out clean.
• Let the loaves cool in the pans for 10 minutes. Turn out onto a wire rack for about 1 hour.

Nutrition Information.
Calories (kcal) 214
Protein (g) 3
Carbohydrates (g) 25
Total Dietary Fiber (g) 1
Total Sugars (g) 13
Added Sugar (g) 13
Fat (g) 12
Saturated Fat (g) 1
Cholesterol (mg) 23
Calcium (mg) 26
Potassium (mg) 84
Sodium (mg) 125

April 22, Earth Day Small Changes Make a Big Difference

Earth Day

What Is Your Ecological Footprint?  

Small Changes Make a Big Difference

April 22, 1970, was the first Earth Day and it awakened almost 20 million Americans from all walks of life to launch the modern environmental movement. From that first earth day came the passage of the landmark Clean Air Act, Clean Water Act, Endangered Species Act, and many other environmental laws. Today the Earth Day Network (EDN) works with over 75,000 partners in 192 countries to broaden diversify and mobilize the environmental movement. More than 1 billion people now participate in Earth Day activities each year, making it the largest civic observance in the world.

Earth is Our Home—Let's Protect It
National Geographic 

A Billion Acts of Green®
A Billion Acts of Green® – the largest environmental service campaign in the world – inspires and rewards simple individual acts and larger organizational initiatives that further the goal of measurably reducing carbon emissions and supporting sustainability. 

Earth - Small Changes Make a Big Difference

YouTube has a wide range of resources, from the young, older, news, family, scientist, schools, communities, governments, and industry describing how they are making a difference and how we can make a difference in saving our Earth.

Mobilize The Earth

Green Mom

Cost of Food

Americans have been spending less and less on what we eat. But those savings come with a high cost: obesity, diabetes, and big health care bills. Here's a look at how our diet has changed over the last 50 years, and what we can do to make it better.

Recycle Guys

Pineapple Upside-Down Cake , Lower in Calories

A low-calorie Pineapple Upside-Down Cake that's both delicious and lighter in calories than traditional recipes:

Ingredients:
1 can (20 oz) pineapple slices in juice, drained (reserve 1/2 cup of the juice)
5 maraschino cherries
1/4 cup unsweetened applesauce
1/4 cup light brown sugar
2 tbsp honey
2 tbsp unsalted butter, melted
1/2 cup all-purpose flour
1/2 cup whole wheat flour
1 tsp baking powder
1/4 tsp baking soda
1/4 tsp salt
2 large eggs
1/2 cup nonfat plain Greek yogurt
1 tsp vanilla extract

Instructions:

1. Preheat the oven to 350°F (175°C).

2. Coat an 8-inch square baking dish with cooking spray.

3. Arrange the pineapple slices in a single layer in the bottom of the baking dish. Cut the maraschino cherries in half, and place one half, cut-side up, in the center of each pineapple ring.

4. In a small bowl, whisk together the reserved pineapple juice, applesauce, brown sugar, honey, and melted butter until smooth. Pour the mixture over the pineapple slices.

5. In a medium bowl, whisk together the all-purpose flour, whole wheat flour, baking powder, baking soda, and salt.

6. In a separate bowl, whisk together the eggs, Greek yogurt, and vanilla extract until smooth. Gradually add the flour mixture to the egg mixture, stirring until just combined.

7. Pour the batter over the pineapple mixture into the baking dish.

8. Bake for 25 to 30 minutes or until a toothpick inserted in the center comes out clean.

9. Allow the cake to cool in the baking dish for 5 minutes, then carefully invert it onto a serving plate.

10. Serve warm or at room temperature.

 

Lima Bean Respect Day

Lima beans are fresh in summer, though they are most commonly found dried, canned or frozen, all year long. Lima beans are also known as "Butter Beans"  in many parts of the United States.

There are warnings to avoid raw lima beans because they contain linamarin (also called cyanogens), which releases a cyanide compound when the seed coat is opened," according to Fruits and Veggies Matter. Linamarin is deactivated during cooking.

Modified Recipes

Lima Bean Burgers

Serves 4

Ingredients

1 (16 ounces) can lima beans, drained and rinsed

1/2 green bell pepper, cut into 2-inch pieces

1/2 onion, cut into wedges

1 clove garlic, peeled

1 egg or 2 egg whites

1 tablespoon chili powder

1 tablespoon cumin

1/2 cup bread crumbs

Directions

1. Preheat oven to 375 degrees F and spray baking sheet with a non-stick cooking spray. 

2. In a medium bowl, mash lima beans with a fork until thick and pasty. Finely chop bell pepper, onion, and garlic and stir into mashed beans.

3. In a small bowl, stir together egg whites, chili powder, and cumin. Stir the egg mixture into the mashed beans. Mix in bread crumbs until the mixture is sticky and holds together. 

4. Divide mixture into four patties. 

5. Place patties on a baking sheet, and bake for about 10 minutes on each side.

6. Serve on a whole-wheat hamburger bun with kale, onion, tomato slices, and avocado.

Nutrition Facts: 255 Calories; 12g Protein; 44g Carbohydrates; 9g Dietary Fiber; 6g Total Sugars; 5g Fat; 0mg Cholesterol; 28mcg Folate; 4mg  Iron; 358mg Sodium

The Delaware Department of Agriculture
presents a Food for Thought 
video on Lima Beans.

National Garlic Day Garlic: A Flavorful Fusion of Taste and Health

Garlic comes from the lily family and is the edible bulb from a plant. It is used as a spice to enhance the flavor of foods and in medicine, Garlic claims have been made to cure heart disease, cancer, colds, hair loss, bug repellant, and many other medical conditions.

The medical research on the safety and effectiveness of garlic has been limited, flawed, inconclusive, or failed to prove its curative powers in most of the claims made.

The following conditions have been rated based on the scientific evidence available as to the effectiveness of Garlic as a treatment. From Medline, service to the U.S. National Library of Medicine, National Institutes of Health Department of Health and Human Services. 

Ratings
A: Strong scientific evidence for this use;

B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.

High Cholesterol (Rate B). Multiple studies in humans have reported small reductions in total blood cholesterol and low-density lipoproteins ("bad cholesterol") over short periods of time (4 to 12 weeks). It is not clear if there are benefits after this amount of time. Effects on high-density lipoproteins ("good cholesterol") are not clear. This remains an area of controversy. Well-designed and longer studies are needed in this area.

Anti-fungal, applied to the skin (Rate C). Several studies describe the application of garlic to the skin to treat fungal infections, including yeast infections. Garlic can cause severe burns and rash when applied to the skin of sensitive individuals.

Anti-platelet effects, blood thinning (Rate C).   Garlic has been associated with several cases of bleeding, therapy should be applied with caution (particularly in patients using other agents that may precipitate bleeding).

Atherosclerosis, hardening" of the arteries (Rate C).   Preliminary research in humans suggests that deposits of cholesterol in blood vessels may not grow as quickly in people who take garlic. It is not clear if this is due to the ability of garlic to lower cholesterol levels, or to other effects of garlic.

Cancer (Rate C).  Preliminary human studies suggest that regular consumption of garlic (particularly unprocessed garlic) may reduce the risk of developing several types of cancer including gastric and colorectal malignancies. Some studies use multi-ingredient products so it is difficult to determine if garlic alone may play a beneficial role. Further, well designed human clinical trials are needed to conclude whether eating garlic or taking garlic supplements may prevent or treat cancer.

High blood pressure (Rate C).  Numerous human studies report that garlic can lower blood pressure by a small amount, but larger, well-designed studies are needed to confirm this possible effect.

Tick repellant (Rate C).  In early study, self-reports of tick bites were significantly less in people receiving garlic over a placebo "sugar" pill. Further, a well-designed study is needed to confirm these results.

Upper respiratory tract infection (Rate C).  Preliminary reports suggest that garlic may reduce the severity of upper respiratory tract infections. However, this has not been demonstrated in well-designed human studies.

Diabetes (Rate D).  Animal studies suggest that garlic may lower blood sugar and increase insulin release, but human studies do not confirm this effect.

Heart Smart® Tip of the Day: Garlic with

Darlene Zimmerman, RDN

Why go to the market,
when you can grow garlic in your garden.

National Animal Crackers Day

Animal crackers are usually in the shape of circus animals such as lions, tigers, bears, and elephants. During the late 1800's, animal crackers were imported from England to the United States. The first batch of animal crackers was made by Stauffer's Biscuit Company in 1871 in York, Pennsylvania. Other local bakeries soon came together under the National Biscuit Company, or "Nabisco Brands." In 1902, the animal cracker's box officially became "Barnum's Animals" with the circus-themed box.

Animal Cracker Nutrition

Create Fun and Healthier Snacks

Shirley Temple - Animal Crackers in My Soup

Go Bananas: A Journey from Tree to Table

National Banana Day

Nutrition Profile

Selection

Choose bananas that are firm and free of bruises. Bananas are best to eat when the skin color is solid yellow and speckled with brown. Bananas with green tips or with practically no yellow color have not developed their full flavor. Bananas are overripe when they have a strong odor.

Storage

To ripen bananas leave at room temperature for a couple of days. Once ripe store in the refrigerator for 3 to 5 days. The peel may turn brown in the refrigerator, but the fruit will not change.

Recipes

If you love bananas, Eating Well has a collection of Banana Recipes you are sure to enjoy.

Chiquita Banana The Original Commercial 

Produced by Disney Studios in the '40s, this commercial appeared only in movie theaters, and for over 50 years kept us humming its catchy tune.

DOLE Banana Growing and Planting
Dole explains the growing and planting of bananas.

Banana Farm

The banana farm at EARTH University uses socially and environmentally responsible practices at every stage of the process. The farm plants trees along river banks to promote biodiversity and reduce harmful erosion. In addition, they do not use herbicides. The farm's eco-friendly practices produce some of the most flavorful bananas in the world.

April, National Garden Month a Tribute to the Cooperative Extension

The ground has thawed from the winter, at least in most areas. Many people decide if they want to start a garden or what crops they will plant this year.

Plant a Seed, Grow a Dream

Gardening is a passion of mine. I initially started my studies in agronomy and later changed to nutrition. The cooperative extension became an important part of my education and a wonderful resource. It was also my first job as a dietitian, teaching nutrition in a summer program through Cornell University Extension.

What is the Cooperative Extension?

The Cooperative Extension, also known as the Extension Service of the United States Department of Agriculture, is a research-based educational program designed to help people in the areas of agriculture and food, home and family, the environment, community economic development, and youth and 4-H. The service is provided in every state's designated land-grant universities. 

NIFA is the federal partner in the Cooperative Extension System. It provides federal funding to the system and, through program leadership, helps the system identify and address current issues and problems.

History 

The Morrill Act of 1862 established land-grant universities to educate citizens in agriculture, home economics, mechanical arts, and other practical professions. Extension was formalized in 1914 with the Smith-Lever Act. It partnered with agricultural colleges and the USDA to provide cooperative agricultural extension work. 

Over the last century, the extension has adapted to changing times and continues to address a wide range of human, plant, and animal needs in urban and rural areas. The cooperative extension focuses on education in six major areas: 

1. 4-H Youth Development 
2. Agriculture
3. Leadership Development
4. Natural Resources
5. Family and Consumer Sciences
6. Community and Economic Development

Below are educational videos prepared by various Cooperative Extensions across the United States.

How to Grow Blueberries

North Carolina Cooperative Extension

Caring for Asparagus

University of Maine Cooperative Extension

Eat Smart New York! - 

Cornell Cooperative Extension Westchester County

Color Yourself Healthy

University of Nebraska

Florida Statewide Extension Sustainability Programs

Resources
1. To find your nearest Cooperative Extension office.
2.  National Gardening Association
3.  Food Gardening Guide