Andy

I thought I would sneak a short message in before all the “commencement blogs” are uploaded. Who cares about graduation anyway? Some of us have a whole other year left. This blog focuses on what’s important, the accomplishments of the Class of 2014 (Joking, congratulations to all the graduates!)

A few days ago, I hosted an end-of-the-year soiree before all departing to our respective summer internships. Good weather. Good drinks. Better friends. It is always a pleasure to get together and share in the festivities of fun-employment, at least for a day. As always, I was struck by the professional and intellectual diversity of our HMP cohort. The University’s resources are great, the faculty is outstanding, and football is a religion. However, when prospective students asked me, “What is the single greatest thing about Michigan?” I told them about my friends. Yesterday was only a reminder.

As I reflect on the past year, it seems surreal that year one has come to a close (grades pending). I look forward to hearing about all the incredible practicum experiences upon return. From Geneva to Los Angeles to right here in Ann Arbor, I am 110% confident that everyone will be a massive success and realize how valuable they truly are to the field of healthcare management and policy. I’ve always said, the sooner my friends become CEOs, the sooner they can hire me. I wish them all the best in their future summer endeavors.

For the few HMP Class of 2015 students who read this blog, here is some advice for next year: Hang out with us! Ask us for help. Internship opportunities, check. Best places to eat, check. Cheap places to “hydrate”, double check. We went through the process and are more than willing to assist. Just remember we are upperclassmen, hence cooler, smarter, and more accomplished than any of you…

Andy Mychkovsky is a first year HMP student at the School of Public Health.

Students in La Briut enjoying a homemade Shabbat dinner.

Earlier this semester, the Jewish Student Association held a panelist event at U-M SPH.  Professor Ed Goldman, Professor Peter Jacobson, Rabbi Seth Winberg, and Rabbi Kim Blumenthal were panelists.  The evening took a lot of coordination, but it was well worth it. Below is an article I wrote about the event for the Detroit Jewish News. Thank you to the Detroit Jewish News for allowing me to share this on the SPH Student Life Blog.

When I started my master’s of public health degree at the University of Michigan, I noticed that the Jewish students were well represented in the School of Public Health, but did not find a venue within the school to bring us together.

So I decided to form a student organization called La Briut (Hebrew for “to your health”), which has about 30 members. La Briut fosters community among Jewish students of all backgrounds in the school and creates a space to explore health-related issues that affect the Jewish population at large. Since its inception last year, we have organized a number of social, religious, and educational activities together. We recently sponsored a panel about refusing medical treatment.

Ed Goldman, professor of health management and policy at the School of Public Health, opened the discussion with anecdotes about cases involving the refusal of treatment on religious grounds. For instance, what steps should be taken when a Jehovah’s Witness’ child needs a blood transfusion and his parents will not consent to the procedure? He described receiving calls from doctors at 2 or 3 in the morning asking for his advice on these matters.

Professor Peter Jacobson, also from the department of health management and policy, addressed the conscience legislation recently proposed in Michigan. The legislation, which didn’t pass, would have given healthcare providers freedom to refuse to treat a patient if it violated the provider’s moral and religious principles.  Conscience clauses usually relate to issues such as abortion, contraception, and stem cell-based treatments.  In Jacobson’s view, health providers have a duty to fulfill a patient’s legal medical needs, irrespective of their personal position on the issue.

Two rabbis added the Jewish perspective on refusal of treatment. Rabbi Seth Winberg of U-M Hillel explained that today the standard view is that the Jewish tradition of saving life above all limits patient autonomy, and “consequently, a patient would be required to accept medical treatment.”

But he then cited several precedents that challenge such a view, suggesting that there may be reasons for a patient to refuse medical treatment—if, for example, the treatment is experimental or too risky.

Rabbi Kim Blumenthal from Beth Israel Congregation of Ann Arbor shared some of her experiences of counseling congregants.  Her take on the matter was simple: If someone comes to her seeking advice about a difficult decision, she sees her main role as comforting the individual and then guiding him or her through the process of making a decision.

Each viewpoint was unique, nuanced, and interesting.  I do a lot of thinking in my public health courses, but this panel pushed me to think in a different way.  It was provocative and stimulating, and I got the sense that the speakers were enjoying the experience as much as the students. I left the event understanding that we had only begun to delve into this topic and to wrestle with its many intricacies and uncertainties.

The process of developing a readable, interesting, and informative blog began with selecting a captivating topic that would (hopefully) appeal to readers—and to myself, the writer.  If I wasn’t interested, chances are it would show through.

I used the course as an opportunity to delve into topics such as alcohol and pregnancy, shingles, and Adderall use among

Image courtesy of photopin.com

college students.  One of my classmates cleverly said that for her, the class offered a kind of “choose your own adventure” experience.  She was spot on; each of us was responsible for choosing the direction our blogs took.  Some MTSG bloggers even used an investigative style, uncovering relevant research along with readers as the post progressed.

No matter the approach, each MTSGer this semester was able to establish a certain narrative style and audience. For anyone who enjoys writing (or wants to learn how to enjoy writing) and pouring through scientific research, I highly recommend this class. I’ve really learned a lot about my interests in the field.  I’ve also learned how to tighten my writing and focus in on only the most significant details.

I want to share my final post of the semester from the class, which looks into the  “flow experience” and some of its health implications.  In these final weeks of my graduate school career, I have been thinking a lot about what makes me happy and what kinds of activities most engage and absorb me. As such, the notion of flow has become particularly interesting and relevant to me. I hope you enjoy reading.

Here is my post as seen in Mind The Science Gap Winter 2013…

GO WITH THE FLOW: A BALANCE BETWEEN SKILL AND CHALLENGE 

Although the outcome of last night’s NCAA championship game left me disillusioned and withdrawn (along with thousands of other disappointed fans), the game itself was pregnant with energy and Michigan spirit.  During the game—when my spirits were still high—I watched in awe at the way in which each of the basketball players was able to get into “the zone”.  They seemed to forget about the giant roaring crowd, forget about the depleting timer, and (at least momentarily) forget about the immense pressure they were under.  But does “the zone” exist? Or is it just a term we throw around all the time along with other, similar buzz words like “in the moment”, “wired in”, and “in the groove”?

One of the world’s leading researchers in the rather new area of psychology called positive psychology has actually studied this phenomenon for many years.  Mihaly Csikszentmihalyi (pronounced cheek-sent-me-high),  calls the complete absorption in what one is doing the mental state of flow or the flow experience.  As he notes in his TEDx talk, when he first began researching flow, he spoke with a number of experts—painters, singers, surgeons, athletes—to get a sense of what it feels like to engage in their craft. Many of them described the feeling they get when as a “spontaneous flow” and transcendence.

But flow is not just for the athletes and scholars among us. In fact, research suggests that it may be a common part of human existence.  In a survey of Americans and Germans, only about one third of participants reported that they never, or rarely experienced flow.  However, the frequency and intensity of flow experiences is different from one individual to the next. It is a state that anyone can achieve if the proper conditions are in place.  In one of his books, Csikszentmihalyi designates nine characteristics of flow: a balance between skills and challenges, clear goals, immediate feedback, autotelic experience (e.g. intrinsically rewarding), concentration, merging of action and awareness, loss of self-consciousness, transformation of time (feels like more or less time has passed than the reality), and feeling in control.

According to Csikszentmihalyi and his colleagues, to achieve flow, one must be faced with a challenge that is a match for his or her skills and offers new knowledge and new inspiration.  Flow can occur when completing a task at work, playing a challenging computer game, or cooking a meal. There is even group flow!

Since flow is characterized by absolute enjoyment in the process of completing the activity, anxiety or boredom restricts the state of flow.  If a challenge is too great, then the individual will be anxious. On the other hand, if one’s skills are too great, then the individual will be bored.  Tasks and activities that result in flow are about an enjoyable absorption in the process.

However, while flow is a well-documented concept in the literature, a major challenge in flow psychology research is quantifying the flow experience. Discrepancies in how researchers define and operationalize flow from one study to the next makes it difficult to appreciate the flow activities and how they affect the individual involved.  In addition, most of the flow studies to date are correlational in nature, meaning we can’t be certain that the flow state actually causes any notable outcomes or vice versa.  Despite these challenges, the diversity of the research on flow has continued to grow.

Is being in a state of flow good for your health?

On the whole, the answer is yes.  Studies demonstrate that flow is linked to positive affect, (enjoyment, joy, excitement, interest) and a reduction in negative affect in later life.  Based on the research, it is clear that positive affect and life satisfaction are correlated with lower morbidity and lower mortality.

For instance, in a university study, college studentswere randomly divided into two groups and asked to record 8-10 major

activities that they do in a typical week. They were then told to report what emotions they normally felt during the activity from

1 (never) to 10 (always) on boredom, challenged, ‘‘in the zone”, and upset. The researchers asked students assigned to the high flow induction group to perform one of their top three ‘‘in the zone’’ activities and the low flow induction group to perform one of the three lowest “in the zone” activities, for an hour in the next week. Participants assigned to the high flow condition experienced a greater increase in positive affect and greater decrease in negative affect based on surveys before they completed the activity to after they completed it than those in the low flow condition.  This particular study also demonstrates that different activities trigger flow for different people based on personal characteristics and experiences.

In another study, with older adults, respondents were asked to self-evaluate their experiences of flow.  They each provided retrospective accounts of daily flow experiences throughout a seven-day period.  They also rated themselves on measures of affect, life satisfaction, presence of flow, and quality of flow experience.  Surprisingly, the analyses showed that experiencing flow was not associated with life satisfaction. But there was a clear positive relationship between the quality of flow experiences (the degree of intense concentration, increased confidence, and loss of self-awareness) and happiness.

Can flow be harmful?

The answer to this is yes as well. First of all, being engaged in “too much” flow can have a reverse effect: a decrease in positive affect.  In the older adults study, researchers Collins et al. found that having a higher number of days with flow had a negative relationship with positive affect.  As one possible explanation for this, the researchers note that flow may offer a greater boost for positive feelings when it is a rare incidence rather than an everyday occurrence. It is also possible that individuals who are unhappy seek out flow experiences in an attempt to feel better.

Moreover, a study looking at the physiology of flow experiences, found that flow may reduce one’s heart rate variability (variation in the time interval between heart beats), which can be linked to worry and a high mental workload.

Flow may also result in stress as indicated by relatively high levels of salivary cortisol during a flow state.  While there are positive forms of stress (such as estress), the researchers for this study did not find any indication that the stress in this case was positive or healthy.  The researchers state that: “in our view, it is questionable whether increased levels of cortisol can be considered as healthy—in particular when they endure for extended periods.” Thus, this line of flow research may warrant further study.

Finally, flow can become dangerously addicting. When someone is addicted to a particular flow-inducing activity such as gambling or gaming, rather than being a choice, a particular activity becomes essential.  In addition, other activities that used to result in flow for an individual no longer do so.

The conclusion?

In Csikszentmihalyi’s words, “Enjoyment appears at the boundary between boredom and anxiety, when the challenges are just balanced with the person’s capacity to act.”

Flow is an inherently enjoyable, positive experience that almost all of us can say we have experienced. The literature suggests that it can result in some possible undesirable side-effects. But additional research in this area may lead to more conclusive findings.

Now, I have a question for you.

Do you ever get involved in something so intensely that nothing else seems to matter and you lose track of time? In other words, what makes you “flow”?

Claudia

Since the launch of the school-wide student climate assessment in April 2012, the Office of Academic Affairs and the Office of the Dean have been collaborating with students, faculty, and staff at the school of public health, as well as with other UM staff and community partners, to contribute to the development of an inclusive academic environment where all students are valued and validated both in and outside of the classroom.

This semester,  the College of Literature, Science, and the Arts (LS&A) has launched the Understanding Race Theme Semester which is coordinated by the Museum of Natural History,Department of Afroamerican and African Studies, Ginsberg Center, Program on Intergroup Relations, and School of Social Work, and a faculty and staff Steering Committee.

As a result of emerging themes from the SPH Student Climate Survey and Student Town Hall meetings, SPH began participating in the Understanding Race Project and has organized two visits to the Race: Are we so Different? exhibit at the UM Museum of Natural History.

SPH faculty and staff will be accompanying SPH students on a trip to see the RACE: Are We So Different? exhibit on two Thursdays this month, March 14th and March 21st. We will be meeting in the SPH lobby at 5:45 pm to head over to the museum. Admission is FREE and there we will be a served dinner catered by Noodles & Co. We will have an hour to explore the exhibit followed by a debrief discussion conducted by the docents at the museum.

You can register below:

March 14
March 21

For more information, contact Chanel DeGuzman, Director of Diversity Initiatives, at cdeguzma@umich.edu

Ine

Now that I’m well into the final semester of my last year here at UM, the reality that the end is near is sinking in. As an executive board member of the Health Policy Student Association (HPSA), I and the rest of the board are taking a step back and allowing the next generation of members to exercise their agency. I became Professional Development chair almost a year ago with the idea to hold the first health policy case competition at SPH in order to give policy-interested students a chance to gain practical experience solving real-world issues, similar to the way management-focused students do in typical management case competitions. Though it was my brainchild, I must say most of the credit for bringing the event to fruition is the amazing Case Competition Committee that is comprised of mainly first-year HPSA members in Health Management & Policy (HMP), Social Welfare, Ross, and Public Policy. Their hard work and dedication have assured me that HPSA will be in good hands after the board graduates in May.

We would be happy to have as many interested graduate students from across campus participate in this competition as possible. For more information, see below.

Calling all graduate and professional students:

Would you like to apply your classroom knowledge and internship experiences to real world challenges? Would you like to help solve health policy issues right here in Michigan? Would you like to work with fellow colleagues to earn some extra spending money?

The Health Policy Student Association invites you to participate in its first annual case competition to be held at the University of Michigan School of Public Health opening on March 13 with final presentations on March 22, 2013. This competition will be judged by academics and professionals from various backgrounds and sectors.

$2,500 for 1st place and $1,250 for 2nd place.

Eligibility:

Students from all graduate and professional programs at U of M are eligible.

Team composition:

• Teams are encouraged to be multidisciplinary
• At least two distinct graduate schools or departments must be represented
• Between 3 and 5 members
• Each student can only participate on a single team

Register your team here. 

Schedule:

• Monday, March 4, 5PM – Registration closes
• Wednesday, March 13, 5PM– Case released electronically
• Wednesday, March 20, 5PM –Solutions due electronically
• Friday, March 22, 9AM – Teams present solutions to judges (Presentations must be made in person at the School of Public Health. Refreshments will be provided.)

Please contact Marisa Fortuna (fortunam@umich.edu) with any questions.

Claudia

There are less than 3 months left before graduation and I am still on the search for the perfect studying spot(s) on campus. During my first year, I was lucky enough to have a work space at the Center for Managing Chronic Disease and this became my go to spot for getting some major work done. I rarely ventured outside the walls of the School of Public Health (SPH) my first year for studying purposes. I tried everything from trying to get homework done at the Glasshouse Café, sneaking in to the Organ room, lying around on the couches of the first and second floor study areas, spending hour after hour in the HBHE student lounge, and walking the halls in search of random empty classrooms or meeting rooms. I even looked around the barren halls of the SPH2 building to find a hidden study spot on the second floor in what used to be the old SPH library.

UM SPH Study Lounges on the 2nd Floor. Photo Courtesy of sph.umich.edu

This year I needed a break from SPH and made it a goal to study in other areas of campus. I found this to be more productive for me (but more boring too) because I wasn’t getting distracted by running into as many classmates. Some of my favorite places to study now are the Rackham Reading Room and Study Halls, the lower levels of Hatcher Graduate Library (the internet signal is pretty bad so there are less distractions) and their tiny individual study rooms on the higher floors. I also have been spending time at the Shapiro Undergraduate Library (this place is usually packed, especially late night, but it is so big that I can usually find an isolated study area somewhere). If I can get myself to go to North Campus, then “The Dude” is the place to be…24hrs of the day!

I still have a few more places to check out before the year is over, but I highly recommend checking out the many buildings on campus and finding your perfect study spot(s). Here’s a link with a few suggestions: http://www.annarbor.com/news/eight-great-places-to-study-on-university-of-michigans-campus/

What’s your favorite place to study?

Eboni

In an effort to honor Dr. Martin Luther King, Jr., last semester I came up with the idea of having an SPH round table discussion regarding Martin Luther King, Jr., his dream, and where we are today. A goal of SPH is to create a sense of community, therefore, I reached out to student leaders regarding the event. In the end, PHSA, La Salud, and AAPHA agreed to help plan this round table event.

On January, 23rd, two days after Martin Luther King, Jr. Day, we hosted our event. Our goal was to bring awareness to the importance of MLK Day, his dream, why his dream has not been fully recognized, and our duty as Public Health students. About 50 students and faculty members engaged in a dialogue discussing race, ideas, thoughts, etc. It was a very rewarding and enriching discussion due to our diverse audience and our call to action regarding service and mentorship at the end of the event.

All in all, it was a successful event. I felt as if the people that attended understood more about Martin Luther King’s dream and their duty as future Public Health leaders. It is very rewarding to see an idea you have come into fruition. Its my hope that this will be the 1st Annual MLK-Beyond the Dream event at SPH. More collaborative events such as this will be happening in the future!

Students thoughts regarding Martin Luther King, Jr. and his legacy

On February 22nd, PHSAD will be hosting our 26th Annual Minority Health Conference: “Innovative Approaches to HIV/AIDS – Prevention Among Youth”. Register today!

http://tinyurl.com/umphsadconference2013

Danielle

On Friday night I was a volunteer usher at Ann Arbor’s 36^th Annual Folk Festival.

I wasn’t familiar with any of the artists in the line-up, but I’m a big fan of folk and indie music and knew it would be an awesome experience.  After being disappointed to find out that the show was completely sold out, I spoke with my friend who said she was ushering.  Well apparently, the Folk Festival is so popular that there was even competition to be an usher! I was put on an “usher waitlist” and had to wait to see if there would be an opening before the event.  It really shows the rich support among the Ann Arbor community for the Arc, which is a non-profit that presents folk, roots, and ethnic music.

A few days before the show the coordinator emailed me saying there was a spot for me.

Friday ended up being a snowy day with piles of slush along the edges of the sidewalks.  I trudged through the snow in the most efficient way possible toward Hill Auditorium, where all the ushers were meeting before the start of the show.  The staff explained the layout of the building, the rules that patrons must follow during the concert, and our role as ushers.  They placed us at different levels and sections of Hill auditorium, which I realized is quite giant and also quite beautiful.  Since I have never ushered before and do not frequently attend concerts, I found myself getting slightly nervous about my impending ushering duties.  But I figured I would be all right and all the concert-goers would probably find their seats just fine even if I happened to misguide them.  When the first people arrived, I realized ushering was even kind of fun—and also a pretty good work out (something akin to being on the stair stepper).

Colin Hay, a well-known Scottish-Australian musician and actor, was the evening’s MC.  To open the show, he joked that he had always wanted to hang out with Bob Dylan—“not sing with him, but grab a bite to eat or get a beer with him”.  Along with his lighthearted humor throughout the evening, Hay brought his brilliant, organic voice to the stage.

One of the show’s highlights was Rodriguez, who is a native Detroiter.  His songs, many of which have influential and politically charged lyrics, became popular in South Africa and several other countries as political anthems.  He did not gain success in the United States until a 2012 documentary about him called “Searching for Sugar Man” won notice at the Sundance Film Festival. The 70-something told the audience that the secret to life was to “breathe in and breathe out”. I have to say that that was very well played.

Among my favorite performances was Delta Rae, a band of six friends (three of whom are siblings) from North Carolina.

I also really enjoyed Trampled By Turtles, a band of six instrumentalists from Minnesota who are simply unbelievable to watch.

After being almost moved to tears by the talent at this year’s Folk Festival, I told my friend, “I only want to go to folk music concerts from now on.” I now have several new artists to listen to and love.

Desiree

Rigor of Program

• Understand that all programs are not created equal. You want to choose a school that will give you the proper training to prepare you to be a leader in your field.  This one can be tricky to assess. While we all love rankings, and top programs are usually synonymous with rigor, I encourage reaching out to students and talking to them to learn more.

Faculty

• You obviously want to go to a place where people are top in the field, however and more importantly, you want to go to a school where the faculty is invested in you as a professional and as a person. If faculty are invested in you, then they will ensure they are supplying you all that you need to develop as a professional. It’s nice to say that you went to a school where ground-breaking Professor X teaches. But more importantly, did you take a course with that professor? Was he or she accessible to you?

Resources

• Are there many opportunities to conduct research? Do events such as guest lecturers, symposiums, and events that help augment one’s educational experience happen on campus? If so, how often? What type of professional and student organizations does the school have? Is there freedom to found my own organization if there is a need? Be sure to check out what types of opportunities are available outside of the classroom. These matter!

School Culture

• What does the school value? Diversity? Health Disparities? Innovation? Is the school student-centered? More importantly, are the values and culture of the schools ones that you agree with or align with? Does the school facilitate personal growth outside of one’s area of academic study?

Andy

“Silence in the face of violence, is evil itself.” Just an example of one famous quote paraphrased by Clarence B. Jones, who spoke at the University of Michigan this past Monday. It was an honor to hear Jones speak on the day of remembrance for his friend and ally of the Civil Rights Movement, Reverend Martin Luther King Jr. During that historic time period, Jones was considered one of the closest political and influential confidantes of Dr. King. Serving as adviser, lawyer, draft speech writer, and friend, few knew him better.

In a brilliant and authentic display of oration, Jones proclaimed, “Except for Abraham Lincoln and the Emancipation Proclamation of 1863, Martin Luther King Jr. in 12 years and 4 months from 1956 to 1968, did more to achieve political, economic, and social justice in America than any other event or person in the previous 400 years.” It seems almost inconceivable, that during a time of racial oppression, lack of social media or internet, and limited popular support, that one man could amass such a following that would change the course of history in this great nation.

Listening to first-person testimonials about the week leading up to the famous “I Have A Dream” speech, opposition to the Vietnam War, and the “Letter from Birmingham Jail”, would have seemed to be enough. However, Jones also weaved a story of anti-violence together, calling to arms action against inaction. He implored the audience to realize the world of violence has many faces, and lies beneath society’s eyes like molten lava. It does not have to be fatal to affect communities. The need for a fierce urgency to make investments toward improving the quality of life, a non-violent future. In the words of Dr. King, “The ultimate weakness of violence is that it is a descending spiral, begetting the very thing it seeks to destroy. Instead of diminishing evil, it multiplies it. Through violence you may murder the hater, but you do not murder hate.”

Lastly, Jones reflected on his feelings when President Barack Obama was first elected as President of the United States in 2008. After succumbing to a rush of emotion, tears filled his eyes. Not for the electoral results, but tears for all those people who made that election possible. Without the collective work of the Civil Rights Movement and sacrifices of millions, we would have never seen such history made. I cannot emphasize enough the goosebumps that appeared on the audience’s skin when listening to the methodical, yet emotional reaction delved so rich in the history of the Civil Rights Movement. To think he stood side by side with arguably the most influential person from American history regarding civil rights was awe inspiring.

When asked, “Who today is most like Martin Luther King Jr?” Jones answered with a rhetorical question, “Who today is most like Shakespeare, like Leonardo Da Vinci, like Michelangelo? No one.”

Andy Mychkovsky is a first year HMP student at the School of Public Health.