Monthly Archives: July 2018

Post-Transplant Group Nutrition Class at Tufts Medical Center (Practicum Update)

The summer is flying by! Hope everyone has been enjoying their practicum experience so far.

I have been working on developing a group nutrition class for post-transplant recipients at Tufts Medical Center (TMC) this summer.  This will be a pilot program because we have never offered anything like this before.  I started my experience by doing lots of research and gathered some data on nutrition-related issues amongst this population, including those who are followed at TMC.  I also spoke with the team and inquired about what issues they thought should be addressed.

For some background, immunosuppression medication is needed for most transplant recipients to avoid rejection after getting a new organ, however the medications come with a host of side effects.  These side effects can range from hyperlipidemia, HTN, weight gain, osteoporosis and diabetes as well as other electrolyte abnormalities. Therefore, nutrition and a healthy lifestyle are very important to help combat these potential side effects.

I will be running group classes on 3 different dates to accommodate a variety of clinics/schedules.  The first class will kick off tomorrow and the other 2 will be next week.  I sent flyers in the mail about a month ago to those who received a kidney or heart transplant recipient at TMC over the last 2-2.5 years; there was a total of 160 letters sent out.  Additional flyers were posted in several clinics and doctors were given extra copies of the flyers, as well as a brief explanation of what the class objectives were.  I asked patients to RSVP but also mentioned showing up would be acceptable so it’s hard to anticipate how many people will be coming!  As of now, I have 8 people confirmed for 8/7.

The class will focus on short and long term diet goals, food safety tips, immunosuppression medication and their side effects as well as tips on how to manage/prevent these side effects.  There will be a pre and post test so I can evaluate how successful the class was as well as get feedback from participants.  Hoping the first class goes well tomorrow… wish me luck!

The summer is flying by! Hope everyone has been enjoying their practicum experience so far.

I have been working on developing a group nutrition class for post-transplant recipients at Tufts Medical Center (TMC) this summer.  This will be a pilot program because we have never offered anything like this before.  I started my experience by doing lots of research and gathered some data on nutrition-related issues amongst this population, including those who are followed at TMC.  I also spoke with the team and inquired about what issues they thought should be addressed.

For some background, immunosuppression medication is needed for most transplant recipients to avoid rejection after getting a new organ, however the medications come with a host of side effects.  These side effects can range from hyperlipidemia, HTN, weight gain, osteoporosis and diabetes as well as other electrolyte abnormalities. Therefore, nutrition and a healthy lifestyle are very important to help combat these potential side effects.

I will be running group classes on 3 different dates to accommodate a variety of clinics/schedules.  The first class will kick off tomorrow and the other 2 will be next week.  I sent flyers in the mail about a month ago to those who received a kidney or heart transplant recipient at TMC over the last 2-2.5 years; there was a total of 160 letters sent out.  Additional flyers were posted in several clinics and doctors were given extra copies of the flyers, as well as a brief explanation of what the class objectives were.  I asked patients to RSVP but also mentioned showing up would be acceptable so it’s hard to anticipate how many people will be coming!  As of now, I have 8 people confirmed for 8/7.

The class will focus on short and long term diet goals, food safety tips, immunosuppression medication and their side effects as well as tips on how to manage/prevent these side effects.  There will be a pre and post test so I can evaluate how successful the class was as well as get feedback from participants.  Hoping the first class goes well tomorrow… wish me luck!

YMCA practicum updates

I have been busy implementing nutrition education at the Y! It has been interesting to see what has been working and some things that needed tweaking. I have been doing individual counseling sessions on Mondays and Saturdays with members which has been going great, I have a few “regulars” and then some members who just stop by to as a quick question.   Most stop while they are waiting for their child to finish swim class. Tuesdays adult class has not been going as well and kind of turned into another individual counseling sessions. I think its because the class is a bit later after all the other ones and Tuesdays tend to be slower. However, I am happy to implement any type of education as that is the whole idea.

I also did some nutrition classes with the children in the summer camp, there is 5 age groups ranging from 4-14 years old which was a blast! I need to come up with different lessons since there is such a wide age range to teach. Below is a picture from the 8-9 year old boys class where we played a version of “Headbanz.” We discussed the food groups then broke into groups of three and one person put a picture of a food on their forehead without seeing it and the other two children had to describe the food while the person with the card on their forehead guessed what it was! They loved it. It was also neat that the YMCA featured the class on their Facebook page with the picture below. I also did jeopardy with the 12-4 year olds and portion sizes with the 10-12 year olds.

The other picture is a “Less Sugar for Summer” demonstration I did in the lobby showing sugars in drinks like Vitamin Water, Gatorade, & Coke.  Next Tuesday is a National Night Out Health Fair so I am looking forward to setting up a booth for that!

 

Franklin Agricultural Commission Practicum Update

I continue to be very busy completing my practicum with the Franklin Agricultural Commission.  I have attended meetings, visited farms and the local farm store .  I am really enjoying this experience so much.  Not only am I learning a lot, but I am able to share it with the community through my newsletters.  I have now published 6 newsletters and I am currently working on my 7th.  I hope to do at least one more with the short time we have left, but would be much happier if I can squeeze more than that in.

Here is a list of topics that I have covered in my newsletters and the links to view the newsletters.

Franklin Farming:   https://www.smore.com/y8ka3

Franklin Agricultural Commission:  https://www.smore.com/8d2p5

Grateful Farm:  https://www.smore.com/cragb

Franklin Farmers’ Market:  https://www.smore.com/br8zg

Gianetti’s U-Pick Blueberries:  https://www.smore.com/v7sdp

Franklin Agway:  https://www.smore.com/spbc4

Franklin Honey Company (upcoming)

 

Thanks!

Jennifer Nicholls

 

My Second Cooking Demonstration at the Tewksbury Senior Center

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As I am becoming more familiar with the seniors who regularly attend the center and they are becoming more familiar with me and my presence at the senior center, it became more fun educating them and having a talk with them about their diet and what they can do to improve it. Today’s cooking demonstration was about the preparation of a heathy breakfast “Overnight Oatmeal” between 10 AM and 12 PM on the 25th of July 2018.

I brought a ready made oatmeal which I refrigerated overnight made of rolled oats, organic blueberries, unsweetened shredded coconut, chia seeds, pure maple syrup and low fat organic milk. Toppings include bananas, chopped dates, raisins and unsweetened shredded coconut. I also brought small glass jars for anyone interested to make one and take home.

I explained to the seniors the benefits of oats in lowering  LDL cholesterol and the supply of fibers. Most seniors enjoyed their oatmeal despite the fact that most of them are used to eating it warm not cold. They liked the idea that this meal does not require any cooking. They asked about the difference between rolled oats and cut steel oats as well as the presence or absence of gluten in oats.

It was a great experience educating the senior about ways to have a healthier breakfast. Later we gave out small glass jars filled with oats, raisins and coconuts to take home. We explained that they on need to add milk and a sweetener like honey or pure maple syrup. They accepted it with joy.

Iman Djarraya, MBChB, BMedSci, CHC

MPH Nutrition student at UMass Amherst

Health Fair at The Tewksbury Pubic Library

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It was a great day today 23rd of July 2018 at the Tewksbury Public Library, Tewksbury, MA. I planned, organized and implemented a Heath Fair for children between 10:30 AM and 12:30 PM in the meeting room at the library. We had five main stations:

  1. Station 1: MY Plate Arts and Crafts : Children are educated about the components of a healthy plate and that half of our plate need to be fruits and vegetables. They were given a paper plate each with a marker line which marks the middle of the pate. They were encouraged to draw and glue in pictures of a variety of fruits and vegetables as a reminder to consume more of it. Children enjoyed this station and were very creative.
  2. Station 2: The Identification of a Variety of Fresh Fruits and Vegetables. In order to increase the familiarity of children with fresh produce. They were asked to match the right name label with the right produce. There was avocado, artichoke, cucumber, lemon, mango, garlic, onion, zucchini, Anise, eggplant, broccoli, cauliflower, summer squash, kiwi and lime. The second component of the station, the child tried to identify different produce by putting his/her hand in a grocery bag without looking. There was lemon, cucumber and avocado.
  3. Station 3: The Identification of Fresh and Dried Herbs, Spices, Beans and Grains. Children enjoyed looking at the components of different containers. They looked, smelled and touched these different heath foods. The following were available: cinnamon sticks, cinnamon powder, fresh basil, fresh thyme, fresh cilantro, fresh parsley, fresh rosemary, turmeric, sweet red pepper, ground cloves, cardamom, lentils, chickpeas, brown rice, pinto beans, black beans, oregano, cumin and fennel seeds.
  4. Station 4: Visual Demonstration of the Sugar Contents in Different Sugar Drinks. Children can measure sugar in teaspoons of different drinks such as coke, Gatorade, Sunny D, Vitamin Water and Tru Moo. I also made fresh smoothies made of strawberries, bananas, mango, peaches and plain Greek yogurt to children and parents. Most of the children and parents oved the smoothie and many asked for more.
  5. Station 5: The Movement Area. There were different toys available to entertain the children and encourage them to move such as a movement mat, hula hoops and jumping ropes.

The Town nurse Sarah Kinghorn booked the meeting room, provided the smoothie ingredients and some of the fresh produce. She educated the children about different herbs, spices, beans and grains (station 3).  Sheila Castillo volunteered to coach the children and guide them to make MY Plate arts and crafts. My friend Sarah Manchester coached children in station 2, participated with different fresh produce and educated the children to increase their consumption of fruits and vegetables. Station 5 (the movement station) was loved by children and used continuously throughout the two hours educational fair. Children were given reward stickers with messages about healthy eating. Few children won fresh herbs plants after doing exercise challenges.

Overall, it was a very successful experience and a fun-filled educational program. About 25 children and parents attended the heath fair and many of them stayed an hour or longer. Children left happy, joyful and full of energy. The community has needs for similar health promoting events.

 

Iman Djarraya, MBChB, BMed Sci, CHC

MPH Nutrition Graduate student at UMass Amherst

Tewksbury Community has been Supportive

I lived in Tewksbury for eight years and it has been a great experience. I planned, organized and implemented a nutrition education program in Tewksbury to give back to my community and its residents. Nutrition education, posters and workshops took place at the Tewksbury Public Library, Tewksbury Senior Center and the Food Pantry. It has been an enlightening experience that helped me understand my community and their health needs more. I had the opportunity to talk with hundreds of people of different ages and backgrounds.

The director and the town nurse of the Tewksbury Health Department welcomed the idea of implementing community nutrition programs and they supported me through the entire process. The Tewksbury Pubic Library was also welcoming of the idea, they provided me with a table and shelves for my displays and a large meeting room for my upcoming health fair. The head of children’s services at the library shared her ideas and suggestions and provided workshop flyers to the visitors at the library desk. The senior center also gave me the space and table to do my cooking demonstrations and tasting workshops as well as a table to display my posters and flyers. I was welcomed to use their kitchen for food preparation. Despite the limited space at the food pantry, I was also welcomed and provided the space to do smoothie demonstrations and tasting. Most parents welcomed the idea that their children join the health and wellness weekly activities. They all agreed to fill in confidential surveys  about their children’s eating habits. 

Many local newspaper reporters were eager to learn more about the program, interview and take photos. Please find attached articles and photos of my community nutrition project that was posted on the front page of a local newspaper Tewksbury Crier on  July 18th 2018. An article in the MAPHN Newsletter also described the poster that I presented at the Tewksbury’s Annual Bike Rodeo and Health Fair 2018 (follow the link provided page 4 ) Overall, it has been a great experience. I learned that there is so much demand for community nutrition programs and there is a lot community support available for public health professionals who are interested to implement these projects.

Iman Djarraya, MBChB, BMedSci, CHC

MPH Nutrition Graduate student at UMass Amherst

 

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Nutrition Education, Cooking Demonstration and Sampling at the Tewksbury Senior Center

I planned four weekly cooking demonstration sessions and sampling at the Tewksbury Senior Center, Tewksbury, MA. This center works to enhance the quality of life of seniors by developing programs, activities and resources to enrich the quality of life. In order to do these demos, I took two certifications: ServSafe Food Handler and Allergy Awareness Training Certificates (attached below). ServSafe program delivers food safety training to employees. Allergy Awareness Training is provided to educate food services professionals about food allergies and how to prevent cross contamination.

I did my first cooking demonstration this morning 18th of July 2018 between 10 AM and 12 PM. I started setting the table and organizing it at 9 :15 AM.  Today’s Demonstration was about making healthy smoothies and its benefits to health and well-being. A list of the smoothie ingredients and toppings was provided and explained. The smoothie consists of fresh bananas, frozen strawberries, mangoes, peaches, pineapple, organic plain yogurt and organic spinach. Toppings are chia seeds, pumpkin seeds, unsweetened shredded coconut and fresh sliced berries.

Most seniors happily welcomed the smoothie and enjoyed it, few refused it due to diabetes and dietary restrictions. Four seniors were very enthusiastic to learn more and ask questions. They were very motivated to learn new things and intend to use the new tips at home. They were also happy to learn that I’m implementing three more nutrition workshops in the next 3 weeks.

It was enjoyable and rewarding educating the senior group who were curious and loved to ask questions and learn new things. It was a learning experience understanding the group who were hesitant to try the smoothie because it had spinach or because it was slightly green. I look forward to my future workshops and more understanding of the seniors in my community.

Allergy Awareness Training Certifcate

ServSafe Certificate

Iman Djarraya, MBChB, BMedSci, CHC

MPH Nutrition Graduate Student at UMass Amherst

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Tewksbury Food Pantry

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I spent the morning of July 14th 2018 at the Tewksbury Food Pantry. I worked with the Town nurse who is a wonderful lady who is passionate about her job and genuinely cares for people and their wellbeing. We did a workshop and a blood pressure checkup for the customers of the food pantry between 10 and 12pm.

Our focus was on raising awareness about healthy eating, health and wellness. I made a smoothie which consists of strawberries, bananas, spinach and plain yogurt. Most people welcomed the smoothie offer after describing its contents but few people refused due to reasons including intolerance to dairy and diabetes. During the time I spent at the pantry my thoughts were on how we can improve the quality of the food provided and how can we include fresh produce? Most products available were sugar filled such as cereals and snacks.

I presented a demonstration of the commonly consumed sugar drinks with the exact amount of sugar inside each of these bottles as well as the label clearly written on a card and attached to each bottle. Each card describes the exact amount of sugars in teaspoons and the ingredients. My focus is on how can we reduce the amount of added (artificial) sugars which we consume daily. Also, to explain that our source of sugar is better when it comes from natural foods such as fruits. Fruits are rich in vitamins and antioxidants and the sugar is absorbed slowly into our system avoiding the spikes in blood sugars.

Future preventive and public health work needs to focus on improving the food quality and the provision of fresh produce to the consumers in order to reduce the obesity epidemic and improve the health and wellness of the communities.

Iman Djarraya, MBChB, BMedSci, CHC

MPH Nutrition Graduate Student at UMass Amherst

FARM STEW International Practicum Experience

It is such an honor to be working with FARM STEW International this summer for my practicum experience. I wanted to focus this learning opportunity on global nutrition and have the ability to travel abroad. FARM STEW International’s mission is to improve the health and well-being of rural, small farm families throughout the world. The organization launched its work in rural Uganda in 2015 and has since expanded into Sudan and Zimbabwe.

When the practicum began, I was located in the states and spent most of my time working alongside my supervisor, Joy. These four weeks were spent establishing public health teaching curriculum for FARM STEW trainers in Sudan and Zimbabwe, creating baseline and outcome surveys to implement in the field, learning about the organization, and researching nutrition and public health statistics in the involved countries to better understand the community’s needs. Next, I traveled to Zimbabwe where I joined the local FARM STEW team to gain hands on experience. Currently, I am in my third and final week in Zimbabwe. It has been fun working alongside the FARM STEW trainers to conduct lessons in the rural villages. A few of the lessons we conduct include gardening/compost, meals/nutrition, and sanitation. A goal of the organization is not just to educate but demonstrate and apply the lessons. During our lessons we work with the villagers to create wash stations, latrines, rubbish pits, compost piles, and organic gardens to improve their living circumstance for months and years to come.  In addition to being in the rural villages, I also delivered competency trainings with the FARM STEW trainers using the curriculum established during the first few weeks of the practicum.

Overall, this trip has been a very valuable learning experience and has exceeded all my expectations. I am excited to return home to family and finish up the remaining work. As the FARM STEW team in Zimbabwe continues their mission, they will begin utilizing the developed baseline and outcome surveys. I look forwards to analyzing these statistics to see the effect of FARM STEW’s efforts on rural families.

 

Carly K

 

Pictures:

Compost lesson in Dorset- 

Gardening class in Sikombingo- 

Sanitation lesson and new WASH stations at Mandindindi Primary School- 

Cooking class and nutrition lesson in Mandindindi- 

Tewksbury Annual Bike Rodeo and Heath Fair

My practicum is at the Tewksbury Health Department in the town of Tewksbury in Massachusetts. I am creating and implementing community nutrition projects for children ages 5 to 12 at the Public Library, seniors at the Tewksbury senior center and at the food pantry. With the board of heath team, we set a table at the Tewksbury’s Annual Bike Rodeo and Health Fair, Sunday June 3rd 2018 from 10 am to 1 pm at the Tewksbury Memorial High School. This event was sponsored by the Tewksbury Police Department and the Tewksbury Health Department.

I created and presented a poster which demonstrates the sugar contents of the commonly consumed drinks as well as the harmful effects of sugar on health. Parents and children were very interested and surprised by how much sugar there is in the commonly consumed drinks. They were interested in the visual demonstration of sugar content, asked questions and talked about the drinks that they usually consume. Frappuccino from Starbucks contains 66 grams of sugar, that’s 13 teaspoons of sugar, Monster Energy 50 grams (10 teaspoons), Red Bull 27 grams (5.4 teaspoons), Coca-Cola 39 grams (7.8 teaspoons), Gatorade 34 grams (6.8 teaspoons), Snapple 23 grams (4.6 teaspoons), Capri-Sun 18 grams (3.6 teaspoons), TruMoo flavored milk which is distributed daily in schools contains 22 grams (4.4 teaspoons) and Vitamin Water 31 grams (6.2 teaspoons). The poster also describes that sugar trigger weight gain, raise inflammation, raise blood sugar, increase risk of heart disease, diabetes and gout.

A teacher who was attending the fair was very interested and took a photo so that she can show it to her students in class. I also provided a bag of white sugar, teaspoons and cups for anyone who wanted to measure the amounts of sugar. We also provided handouts ” 40 Things to Know about Sugary Drinks” and  “Sodas and Energy Drinks What Everyone Should Know”. It was a great learning experience.

Iman Djarraya, MBChB, BMedSci, CHC

MPH Nutrition Graduate Student at UMass Amherst