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  • Incontinentia Pigmenti

    Incontinentia Pigmenti

    Source: Genetic and Rare Diseases Information Center – From the National Institutes of Health
    Related MedlinePlus Pages: Skin Pigmentation Disorders

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  • Alumni News: Winter 2024 | Harvard T.H. Chan School of Public Health

    Alumni News: Winter 2024 | Harvard T.H. Chan School of Public Health

    Marty Markay

    Harvard Chan alum Marty Makary chosen to lead FDA

    Martin “Marty” Makary, MPH ’98, will be nominated by President-elect Donald Trump to be commissioner of the Food and Drug Administration. If confirmed by the Senate, Makary would lead the agency responsible for regulating the nation’s food supply, vaccines, medicines and medical devices, cosmetics, tobacco, and biologics. Makary is a physician who specializes in surgical oncology and currently serves as chief of islet transplant surgery at the Johns Hopkins School of Medicine. He’s also a member of the National Academy of Medicine; a former leader of the World Health Organization Patient Safety Program; a medical and health policy researcher who has published more than 250 peer-reviewed articles; and an author who has written three New York Times best-selling books on health care. Read more

    Alumni win re-election to U.S., Iowa House seats

    Two alumni were re-elected to their seats in November: U.S. Rep. Raul Ruiz, MPH’07, of California’s District 25 and State Rep. Megan Srinivas, MPH ’15, of Iowa’s District 30.

    If you know of other alumni who ran in this election, please let us know.

    Epidemiology Alumni Q&A: Raymond Neutra
    Raymond Neutra, MPH ’69, DrPH ’74, has had a public health career in environmental medicine and epidemiology and has held leadership roles in academia and the public sector. Currently he is the president of the Neutra Institute for Survival Through Design, which promotes creative research and design that benefits people and the planet. He spoke with the Department of Epidemiology about his time as a graduate student and offered advice to current students.

    Disentangling complex medical outcomes

    Biostats alumna Linda Valeri, PhD ’13, was recently profiled  by Harvard Catalyst about the pilot funding that was critical to her research career. Valeri is an assistant professor in biostatistics at the Columbia University Mailman School of Public Health.

    Serving the community

    Deborah Cook Kaliel,SM ’06, recently spoke with The Amherst Student about her work with the U.S. Agency for International Development building sustainable HIV programs across the world.

    Alumni notes

    1980

    Jane Newburger, MPH, associate chair for academic affairs in the department of cardiology at Boston Children’s Hospital and Commonwealth Professor of Pediatrics at Harvard Medical School, received the 2024 Eugene Braunwald Academic Mentorship Award at the American Heart Association’s Scientific Sessions 2024 in November.

    1992

    Friday Okonofua, Takemi Fellow, was elected to the National Academy of Medicine in October. Okonofua is the leader of the Center of Excellence in Reproductive Health Innovation, University of Benin, in Nigeria. He has led research on maternal mortality prevention, with impact on policies and programming in African countries.

    1994

    Christine Sang, MPH, was named to the Clinical Advisory Board of Allay Therapeutics in October. She is associate professor of anesthesia at Harvard Medical School and the founding director of the Translational Pain Research program at Brigham and Women’s Hospital.

    1999

    Jessica Kahn, MPH, became the senior associate dean for clinical and translational research and director of the Block Institute for Clinical and Translational Research at Albert Einstein College of Medicine in October. She previously served as co-director of the Center for Clinical and Translational Science and Training and professor of pediatrics at the University of Cincinnati and as the founding associate chair of academic affairs and career development at Cincinnati Children’s.

    2002

    Lu Tian, SD, presented this year’s Lagakos Distinguished Alumni Award on “Adaptive Prediction Strategy with Individualized Variable Selection” in October. He is professor of biomedical data science at Harvard Medical School.

    2004

    Ashwin Vasan, SM, who led New York City through the COVID-19 pandemic as its 44th  Health Commissioner, was named the James McCune Smith Distinguished Fellow for the School of Global Health at Meharry Medical College in October.

    Kaja LeWinn, SM, SD ’07, professor of psychiatry and behavioral sciences at the University of California, San Francisco, received the Trinity College President’s Award for Science and Innovation in October. LeWinn’s research focuses on children’s neurodevelopment and mental health.

    2012

    Alisa Stephens-Shields,PhDassociate professor of biostatistics at the University of Pennsylvania Perelman School of Medicine, was the recipient of the 2024 Myrto Lefkopoulou Distinguished Lectureship in September. Stephens-Shields was recognized for her great capacity as both a methodologic and collaborative biostatistician and as a leader impacting health, statistical education, and inclusion in the field.

    2017

    Huda Zoghbi, SD, was invested as a member of the American Academy of Sciences and Letters in October. She is distinguished service professor at Baylor College of Medicine, an investigator with the Howard Hughes Medical Institute, and founding director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital. 

    2021

    Irina Degtiar, PhD, received both the 2024 ASA Outstanding Statistical Application Award and the Manning Memorial Award for the Best Research in Health Econometrics for her dissertation paper. She currently is a statistician at Mathematica Research.

    2024

    Esias Bedingar, was selected to join WHO’s Global Action for Measurement of Adolescent Health (GAMA) Advisory Group. As a part of this 20-member group, he will help advise WHO and UN partners on research priorities and strategies to improve adolescent health measurement.

    Wedding

    Anup Kanodia, MPH ’08,married Rupal Ramesh Shah in June 2023 in Columbus, Ohio. Several Harvard Chan School classmates attended the ceremony, which incorporated America, Indian, and African traditions. Kanodia runs a medical practice in the Columbus area. See a photo feature on the wedding that ran in the Columbus Dispatch.

    In memoriam

    Evelyn Benson, MPH ’55, died on October 20 at 100. She was a rural public health nurse in Ohio and a community gerontological nurse in Chester, Penn. She later taught at Widener College and Temple University and was assistant dean of the School of Nursing at LaSalle University when she retired in 1994. She co-authored the textbook Community Health and Nursing Practice and wrote dozens of articles on public health nursing, international nursing, and nursing history. Read her obituary.

    Ralph Hoover, MPH ’62, died June 9 at 92. He was a physician and public health officer in Waterloo, Iowa, and in retirement went back to school to become a lawyer. He founded a law firm specializing in health care law. Read his obituary.

    David Wheeler, MPH ’09, died June 29 at 51. He was an internationally recognized biostatistician with a focus on spatial, cancer, and environmental epidemiology. He joined the Biostatistics Department at the School of Medicine at Virginia Commonwealth University in 2011 and was promoted to a full professorship in 2023. Read his obituary.

    DrPH alumni news

    Read alumni news from the DrPH program.

    Harvard Chan School alumni in action

    Tell us about your life since Harvard Chan School.


    Last Updated

    Get the latest public health news

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  • Want To Quit Smoking? A Smartwatch App Can Make It Easier

    Want To Quit Smoking? A Smartwatch App Can Make It Easier

    Is quitting smoking one of your New Year’s resolutions? Breaking the habit can be tough, but what if there was something to nudge you just before you light up? Researchers have developed a new smartwatch app designed to make quitting smoking a little easier by reminding you when you are about to start a cigarette.

    A research team at the University of Bristol, England, developed an app that could detect the typical hand movements of someone holding a cigarette and alert the smoker with a message discouraging them from smoking. According to the team, this is the first-ever just-in-time intervention for preventing smoking relapse that runs entirely on a smartwatch, without the need for pairing with a smartphone.

    “For those who are trying to give up, an initial lapse is a vulnerable moment, and risks leading to a full relapse to smoking. People like smartwatches. They like the idea of it delivering a message at the point that they smoke. Therefore, if we can identify this point of lapse, and deliver an intervention precisely at that point, we have an opportunity to improve the success of the quit attempt,” Chris Stone, Senior Research Associate in Wearable Technology Application Development in Bristol’s Tobacco and Alcohol Research Group, and Integrative Cancer Epidemiology Program (ICEP), explained the idea behind the innovation in a news release.

    The researchers tested the effectiveness of the relapse prevention app on 18 people who were ready to quit smoking. During the trial, participants wore a regular Android smartwatch loaded with the custom app. At the end of two weeks, many reported that the smartwatch helped them become more aware of their smoking habits, and the constant reminders made them pause and reconsider their actions.

    Impressively, 66% of participants found the smartwatch intervention not only feasible but also acceptable, making it a promising tool for supporting behavior change and preventing smoking relapses.

    According to Alizée Froguel, Cancer Research UK’s Prevention Policy Manager, stopping smoking is the best thing you can do to prevent cancer. “This study shows that smartwatches could be a useful method to help people quit smoking, but more research is needed to understand how effective they are. There are many tools available to help people quit, and getting support from your free local stop smoking service will give you the best chance of stopping successfully,” Froguel said.

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  • Does Fasting Help Autoimmune Diseases? 

    Does Fasting Help Autoimmune Diseases? 

    Various fasting regimens have been attempted for inflammatory autoimmune diseases, such as lupus, ankylosing spondylitis, chronic urticaria, mixed connective-tissue disease, glomerulonephritis, and multiple sclerosis, as well as osteoarthritis and fibromyalgia.

    The strongest evidence of the benefits of fasting surrounds the treatment of rheumatoid arthritis, an autoimmune joint disease, as I detailed in my previous blog post. A German study suggested benefits for osteoarthritis, too, and reported improvements in pain and joint function, but we’d really need randomized controlled studies to know for sure. The researchers despaired they only had 30 patients, but that’s 30 times more than many reports on fasting in the medical literature, which may detail only single cases.

    One woman, for example, with a rare autoimmune disease known as mixed connective-tissue disease, which can cause all sorts of painful and distressing symptoms, was treated with steroids in an attempt to suppress her immune system. After 21 days of fasting, and off her medications, “she had no further complaints.” More importantly, her symptoms seemed to stay away, and “she remained free of medication.” So, does fasting work for mixed connective tissue disease? All we can say is that it worked at least once.

    A similar success story was reported with fibromyalgia. A woman with pain throughout her body, who couldn’t sustain activity and was on a lot of drugs, became “symptom-free” after a 24-day fast and remained that way at her “follow-up visit 1 month later.” However, when a modified fasting regimen was tried on dozens of individuals, the benefits seen at week 2 largely disappeared by week 12, as shown below and at 1:32 in my video Fasting for Autoimmune Diseases

    What about lupus? A 45-year-old woman who had remained in pain despite taking immunosuppressive drugs was pain-free by day four of fasting and remained symptom-free for one year when her symptoms began to recur, but she wiped them out again with a second seven-day fast, “after which she had no symptoms.” Note, though, that she didn’t only fast. She water-only fasted, then followed it with a plant-based diet in an attempt to solidify the gains. On its own, a strictly plant-based diet without any animal protein has been shown to control symptoms in at least some cases.

    The same with sacroiliitis, a common manifestation of ankylosing spondylitis, an autoimmune arthritis that primarily affects the spine, causing back pain that can last for years. In the case of a 33-year-old man, all sorts of conventional therapies and drugs were tried, but the pain wouldn’t go away. So, the complete avoidance of animal foods was recommended, and “the complaints improved distinctly and persistently” within days—until the patient ate meat again. Once again, back on plant-based nutrition, he was off most of his drugs and almost completely free of symptoms. So, at least in this case, inflammatory pain refractory to other treatments was abolished by eating more healthfully. At least it’s worth a try!

    Autoimmune glomerulonephritis, where your body attacks your own kidneys, is a common manifestation of lupus. In a case series, 29 patients were fasted for 60 hours, then had only fruits and vegetables until they got better. They described such remarkable recoveries that fasting, in their opinion, “should be an essential part of treatment.”

    What about multiple sclerosis, an autoimmune nerve disease? Individuals with MS were randomized to a “fasting-mimicking diet”—in this case, a modified fast that started out with an 800-calorie-a-day diet of fruit, rice, or potatoes, followed by a week sipping a few hundred calories of flaxseed oil and vegetable broth, then transitioning to a plant-based Mediterranean diet. Over the next three months, they experienced a significant improvement in overall quality of life. They also tried a ketogenic diet, but that failed to offer clinically or statistically significant overall benefit, as you can see below and at 3:34 in my video

    And, finally, let’s look at chronic urticaria (hives), where you get a rash of itchy weals and welts, as seen here and at 3:40 in my video. Individuals started to improve on day 3 of the fast, and their hives completely disappeared by day 11. This is consistent with studies from Germany and Japan that evidently showed around 75 percent effectiveness for such patients with what looks like some sort of tea with sugar diet. It’s certainly worth giving fasting therapy a try, but, of course, fasting should only be done under trained medical supervision. Otherwise, you’d never know if you have some hidden underlying kidney issue that could land you in a coma, then maybe in the morgue. You have to have your kidney function and electrolytes monitored to make sure your body is up for the challenge. 

    “Despite the possible good outcomes, water-only fasting is not a cure or treatment in the traditional sense; it is simply intended to promote the body’s self-healing mechanisms.” Since fasting is unsustainable, by definition, “to maintain the results obtained by water-only fasting, it is necessary to adhere to a health-promoting lifestyle that includes a diet of minimally processed plant foods, adequate sleep, and robust physical exercise.”

    If you haven’t seen it yet, check out my related video Fasting for Rheumatoid Arthritis.

    I’ve held three webinars on fasting. All of the videos are available for free on NutritionFacts.org, but you can also get them in a digital download—as a bundle or separately. See: 

    To see all of the fasting videos currently on the site, please visit our fasting topic page.

    Interested in more on using diet to prevent and treat autoimmune diseases? Check out the related posts below.



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  • Planning To Eat Clean In The New Year? Your Obsession With a Healthy Diet Shouldn’t Turn Into Eating Disorder

    Planning To Eat Clean In The New Year? Your Obsession With a Healthy Diet Shouldn’t Turn Into Eating Disorder

    With the New Year just around the corner, so are resolutions for a healthier year. If you have already committed to eating clean in the coming year, be cautious—obsessing over healthy eating can take a toll on your mental health and potentially lead to eating disorders.

    Orthorexia nervosa (ON) is an obsession with eating “pure” foods to the point that it can take over your social life and mental well-being. Individuals may start organizing their entire schedule around strict dietary rules, skipping social events like Christmas parties or family dinners, and feel stressed or anxious when their eating routines are disrupted.

    Many people may fall into the trap of extreme dieting that cuts out carbohydrates, proteins, and essential vitamins, all in the name of healthy eating. However, this approach can put the body at risk of nutrient deficiencies, leading to symptoms such as hair loss, brittle nails, missed menstrual cycles, and constant fatigue.

    If this obsession with healthy eating goes unchecked, it can escalate into more serious problems, potentially leading to clinical eating disorders such as anorexia or bulimia.

    In a groundbreaking study, researchers explored how healthy eating addiction and extreme beauty ideals among fashion models can trigger eating and body image disorders. Their findings published in Eating and Weight Disorders – Studies on Anorexia, Bulimia, and Obesity, revealed that while 95% of the participants both models and the control group had positive emotions associated with healthy eating, over 35% of female models exhibited signs of ON and over 20% in the control group. The survey also revealed a troubling trend regarding the body mass index (BMI) of the fashion models, with a significant 88.7% of them falling below the underweight threshold.

    For those looking to adopt a healthy lifestyle in the New Year, Dr. Nikolett Bogár, a PhD student researching eating disorders at the Institute of Behavioral Sciences at Semmelweis University, recommends focusing on a long-term, balanced diet while recognizing that eating is not just about nutrition but also a social and cultural experience. She advises against categorizing foods as strictly good or bad.

    “Aim for a long-term, balanced diet rather than an ultra-clean one in January. Occasionally indulging in chocolates or holiday treats should be part of your diet – without guilt,” Dr. Bogár, advises.

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  • Melkersson-rosenthal syndrome

    Melkersson-rosenthal syndrome

    Source: Genetic and Rare Diseases Information Center – From the National Institutes of Health
    Related MedlinePlus Pages: Facial Injuries and Disorders, Mouth Disorders

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  • Adaptive Body Boost

    Adaptive Body Boost

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  • 10 Mindful Books We Loved in 2024

    10 Mindful Books We Loved in 2024

    Don’t miss these 10 mindful books from 2024 that help us nurture ourselves, one another, and the world we share.

    Throughout 2024 we’ve been treated to mindful books that fueled our minds and our hearts. This past year brought us an abundance of new titles, with topics and perspectives that matter—from motherhood to workplace well-being, from self-compassion to collective flourishing. Reminding us that mindfulness is about more than individual wellness, these authors deliver the information and inspiration we need in challenging times. Enjoy perusing the list below—we hope you’ll love these books as much as we did.

    10 Mindful Books From 2024

    1. Mothershift: Reclaiming Motherhood as a Rite of Passage

    Jessie Harrold
    Shambhala

    In Mothershift, writer and doula Jessie Harrold offers a supportive, affirming road map to help women navigate the identity change and transformation that often come with motherhood. 

    Read an excerpt from Mothershift: Grieving the Old You: What to Do When You Feel Lost in Motherhood

    2. Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness

    Dr. Jonathan Fisher
    Manuscripts Press

    In Just One Heart, cardiologist and mindfulness teacher Jonathan Fisher explores the science of the mind-heart connection through the lens of his own journey from burnout and anxiety to healing and joy.  

    Read an excerpt from Just One Heart: A Steady Heart: A Cardiologist’s Advice for Lowering Stress  

    3. Return to Mindfulness: Disrupting Default Habits for Personal Fulfilment, Effective Leadership, and Global Impact

    Shalini Bahl, PhD
    BrainTrust Ink

    In Return to Mindfulness, mindfulness researcher and former town councilor Shalini Bahl illuminates a pathway to reconnecting with what matters and truly living our practice in each moment of our busy lives.

    Read an excerpt from Return to Mindfulness: Compassion in Action: Showing Up Even When We Want to Shut Down

    4. Flourishing Kin: Indigenous Wisdom for Collective Well-Being

    Yuria Celidwen, PhD
    Sounds True

    In Flourishing Kin, contemplative researcher and teacher Yuria Celidwen identifies seven key principles from Indigenous traditions, revealing how this wisdom invites us to meet the world with a joyous commitment to collective flourishing.

    Listen to a guided practice from Flourishing Kin: Guided Meditations by Powerful Women of the Mindfulness Movement: 2025

    5. The Self-Compassion Daily Journal

    Diana Hill
    New Harbinger

    In The Self-Compassion Daily Journal, psychologist and acceptance and commitment therapy (ACT) trainer Diana Hill offers powerful writing prompts to help you let go of harmful self-criticism and welcome kindness and forgiveness toward yourself.

    Read more about Diana’s approach to self-compassion: It’s Selfish, It’s Hokey, and I’ll Lose My Edge: 3 Half-Truths About Self-Compassion

    6. Breaking Bias: Where Stereotypes and Prejudice Come From—and the Science-Backed Method to Unravel Them

    Anu Gupta
    Hay House

    In Breaking Bias, lawyer and researcher Anu Gupta takes us on a journey to explore human identities and identity-based biases and offers a unique toolkit to help us dismantle learned bias, within ourselves and in the world.

    Read more about Anu Gupta’s mindful approach to bias: Using Mindfulness to Break Racial Bias 

    7. Mindfulness in the Workplace: Cultivating Well-Being at Work

    Andrew Safer
    2nd Tier Publishing

    In Mindfulness in the Workplace, meditation teacher and mindfulness program developer Andrew Safer shows how we can cultivate clarity and well-being at work—even in the midst of chaos, competing demands, and rapid-fire change. 

    Read an excerpt from Mindfulness in the Workplace: Increase Your Agency By Responding, Instead of Reacting

    8. Consider This: Reflections for Finding Peace

    Nedra Glover Tawwab
    TarcherPerigree

    In Consider This, therapist and relationship expert Nedra Glover Tawwab helps us stay true to who we are and grow more fully into ourselves through setting boundaries, expressing ourselves with clarity and integrity, and more.

    9. Mindful Self-Compassion for Burnout: Tools to Help You Heal and Recharge When You’re Wrung Out by Stress

    Dr. Kristin Neff and Dr. Christopher Germer
    Guilford Press

    In Mindful Self-Compassion for Burnout, Mindful Self-Compassion founders Christopher Germer and Kristin Neff share empathetic stories, along with quick and effective ways to recharge your batteries, de-stress, and be kind to yourself—so you can be there for others.

    Read an excerpt from a previous book by Neff and Germer, The Mindful Self-Compassion Workbook: The Transformative Effects of Mindful Self-Compassion

    10. Open: Living With an Expansive Mind in a Distracted World

    Nate Klemp
    Sounds True

    In Open, philosopher and mindfulness entrepreneur Nate Klemp examines why we close down when faced with stressors or threats and how we can train ourselves to open up to the fullness that life offers—even when frightened, outraged, or heartbroken.

    Listen to a guided meditation from Open: A 12-Minute Meditation for Understanding Your Expansive Mind



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  • Stay and Play: Creative Ways to Have a Fun-Filled Family Staycation

    Stay and Play: Creative Ways to Have a Fun-Filled Family Staycation

    Stay and Play: Creative Ways to Have a Fun-Filled Family Staycation

    A staycation is a fantastic way to spend quality time with your loved ones without breaking the bank. It’s an opportunity to unwind, relax, and create lifelong memories with your family. In this article, we’ll explore some creative ways to make your staycation a fun-filled and memorable experience for everyone.

    Get Ready for a Staycation Like No Other!

    Before you start planning your staycation, it’s essential to set the tone. Get the whole family involved in the planning process, and let each member share their thoughts and ideas. This will help create a sense of ownership and excitement.

    Choose a Theme

    Why not plan a themed staycation? Pick a theme that resonates with your family’s interests, such as a movie night, a sports-themed weekend, or even a DIY crafting marathon. A theme can help guide your activities and add an extra layer of fun.

    Create a Budget

    It’s crucial to set a budget for your staycation. Plan out your expenses, from food and accommodations to entertainment and activities. With a clear budget in place, you’ll be better equipped to make smart decisions and avoid overspending.

    Get Creative with Accommodations

    Why stick to traditional hotel options? Consider alternative accommodations, such as:

    • Renting a cabin or a house through websites like VRBO or Airbnb
    • Hosting a slumber party at a friend’s house
    • Glamping – camping, but with more comforts!

    Savor a Home-Cooked Feast

    Break away from the norm and plan a mix of meals. Cook a few meals together as a family, taking turns preparing and sharing dishes. You can also prep meals in advance, or even have a family potluck. Just remember to have fun and be flexible!

    Plan Fun-Filled Activities

    Think outside the box (or screen) and plan activities that don’t involve screens. You can:

    • Have a backyard campout or a picnic
    • Set up an obstacle course in the living room
    • Host a family game night with board games or card games
    • Have a DIY craft session or art party

    Spend Quality Time Together

    A staycation is an excellent opportunity to rekindle family bonds. Schedule time for:

    • Family movie nights
    • Scavenger hunts
    • Karaoke contests
    • Cooking or baking together

    Make the Most of Local Resources

    Take advantage of free or low-cost activities in your local community. Visit:

    • Local parks or nature reserves
    • Museums or art galleries
    • Libraries or bookstores
    • Indie movie theaters or free outdoor concerts

    Some Final Tips and Tricks

    • Be flexible and open-minded
    • Be prepared for unexpected delays or changes in plans
    • Make time for relaxation and self-care
    • Take plenty of photos to cherish the memories

    Conclusion

    A staycation is an ideal way to strengthen family bonds, create lasting memories, and have fun without breaking the bank. With a little creativity and planning, you can turn a regular staycation into a memorable and enjoyable experience. Remember to involve your family in the planning process, choose a theme, set a budget, and have fun!

    FAQs

    Q: Can I plan a staycation during the school year?
    A: Yes! You can plan a staycation during the school year, especially during spring break or winter break.

    Q: Is a staycation only for families with kids?
    A: No! A staycation can be enjoyed by anyone, regardless of age or family status.

    Q: What are some other creative staycation ideas?
    A: Consider having a staycation at a music festival, a sporting event, or even a book festival!

    Q: Can I use a staycation as a way to relax and unwind?
    A: Absolutely! A staycation is an excellent opportunity to slow down, recharge, and rejuvenate.

    Q: Can I customize my staycation to fit my budget?
    A: Yes! You can scale back on activities and focus on what matters most to you, such as food, relaxation, or entertainment.

    Staycations offer a unique opportunity to reconnect with your loved ones, create lasting memories, and have fun. By following these creative ideas and tips, you’ll be well on your way to planning a fun-filled and memorable staycation that your family will cherish for years to come.

  • Student Perspective: My lessons in vulnerability

    Student Perspective: My lessons in vulnerability

    Tina Purnat in 1991
    Tina Purnat in 1991. / Photo: Courtesy of Tina Purnat

    In July 1991, I found myself sitting in the back seat of our family car, heart pounding with a mix of excitement and apprehension.

    The 10-day war for Slovenian independence from Yugoslavia had just ended, and while the armed conflict was officially over, the atmosphere was still thick with uncertainty. The weeks prior had been marked by listening to press conferences of the national war cabinet and evacuating hurriedly to bomb shelters. I remember the fear that gripped me as both my parents left for work each day—my mother to care for patients at the regional hospital, and my father, a first responder, on site to protect a key factory from potential bombings that could lead to deadly chemical spills.

    It was against this backdrop that my parents were now driving me to Villach, Austria, where I was to attend a four-week immersive German language course. This was something I had been looking forward to all year—a chance to brush up on my German before entering my freshman year of secondary school where I’d study it as the second foreign language.

    But as we crossed the border, the thrill of the upcoming adventure was tinged with a new, deeper sense of fear.

    When we arrived in Villach, my parents helped me settle in, and then it was time for them to leave. As we stood outside the small dormitory where I would be staying, my mother turned to me with a seriousness I hadn’t seen in her before. “If the war breaks out again,” she said, her voice steady but her eyes betraying a deep worry, “don’t try to come back to Slovenia. Stay here in Austria and find a way to your uncle in Sweden.” I nodded, the gravity of her words sinking in. Suddenly, the world seemed much larger, and far less certain, than it had just moments before. Despite the bombing scares and evacuations I had endured during the brief war, it was in that moment, hearing my mother’s words, that I felt the most afraid. I realized that if conflict erupted again, I would be on my own as a 14-year-old girl in a foreign country.

    For the next four weeks, I was surrounded by other teenagers from Slovenia and various other parts of Europe. We spent our days conjugating verbs, practicing vocabulary, swimming, hiking and navigating the cultural quirks of our peers. But in the back of my mind, my mother’s words lingered. What would happen if the conflict reignited? How would I make my way to Sweden on my own? How would I even find my uncle there? The thought of being stranded in a foreign country, unable to return home, was terrifying. It was my first real encounter with the vulnerability that so many people around the world experience daily—the fear of being uprooted, of losing the safety of home.

    Thankfully, the weeks passed without incident. No more armed conflict erupted in Slovenia, and my parents returned to pick me up as planned. But I was not the same person who had arrived in Villach just four weeks earlier. The experience had left an indelible mark on me, a heightened awareness of the fragility of safety and the ever-present possibility of displacement.

    Tina Purnat
    Tina Purnat today / Photo: Courtesy of Tina Purnat

    Back in Slovenia, I couldn’t shake the thoughts of what might have been. I imagined what it would be like to be forced to flee my home, to live in a place where I didn’t speak the language, surrounded by people who didn’t understand my culture. These thoughts only grew stronger in the following weeks and months as the war in Croatia and Bosnia and Herzegovina intensified. Refugees were fleeing their homes, seeking safety wherever they could find it, and often first in Slovenia before moving on to other countries. Many of them were children, just like me, whose lives had been upended overnight.

    Later on, I decided to volunteer as a companion and homework tutor for kids my own age at the refugee center. It wasn’t just about helping them with English homework and math; it was about being there for them, offering some semblance of normalcy in their otherwise chaotic lives.

    I remember a brother and sister, both in their early teens, who never left each other’s side. I remember thinking: we grew up in the same federation of Yugoslavia, just in different parts of it, and just because of where we were born, I had a home but they lost it. Despite their reserved demeanor, I made it my goal to connect with them. I would bring bubble gum and comic books to our meetups, hoping to break the ice. At first, our interactions were limited to simple exchanges—sharing a piece of gum, pointing out a favorite comic strip. But over time, these small gestures began to build a bond between us.

    We never talked about the war or their experiences—those topics remained unspoken, heavy in the background. But through our shared love of comic books and the simple pleasure of chewing gum, we found a way to connect. They would smile, sometimes even laugh, and in those moments, I knew I was making a difference, however small. We communicated in the language of teen friendship, where words were less important than the shared experiences that brought us a bit of lightheartedness in a difficult time.

    Then, one day, they were gone—moved on to Germany for asylum. I never got to say goodbye, but I like to think that our time together left a positive mark on their lives, just as it did on mine. I often wonder where they ended up—Canada? The U.S.? New Zealand? Sweden? Maybe they ended up settling in Germany? Wherever they are, I hope they remember those afternoons spent laughing over comic books and enjoying the small pleasures of pink bubble gum.

    These experiences shaped my understanding of vulnerability in profound ways. They led me to the profession of public health because public health, at its core, prioritizes the needs of the most vulnerable and at-risk populations. It emphasizes the values I learned from my parents and wider family—the importance of empathy, service, and resilience. My time with those refugee kids taught me that vulnerability is not just about addressing immediate needs but also about the layers of crises people experience and endure, often silently. Public health approaches cannot solve all their problems, but working in this field gives me a tangible way to address some of the critical needs of people who, like those refugee kids, experience and navigate multiple crises. It’s about creating systems, structures and solutions that support their resilience, help them find stability, and, ultimately, help them to rebuild their lives and thrive.

    Thirty-five years later, I’ve built a career in public health. The responsibility to serve and protect the most vulnerable remains at the forefront of everything I do. Whether I’m working with health information and evidence, implementing digital health solutions, combating health misinformation, pointing out deceptive marketing of vapes to youth, or responding to outbreaks, it’s never just about the policy, tools, data or the technology. It’s always about the people—the children, the families, the communities—who need health systems and public health efforts to better serve them and meet their needs.

    Returning to that summer in Villach, I realize now that it was a turning point in my life. The uncertainty I faced then is minute compared to the struggles of those who live in conflict zones or walk thousands of miles in search of a safer home, but it gave me a window into their experience. It taught me that the safety and stability I had always taken for granted could be lost in an instant, and that those who are forced to flee their homes or are displaced within their own country or even within their own city need more than just shelter and services—they need understanding, compassion, and a sense of belonging.

    As I continue my work in public health, I carry these lessons with me. My mother’s words, spoken with such quiet urgency, have stayed with me, reminding me of the responsibility we all share to protect the vulnerable.

    And every time I meet someone who has been displaced, I think back to that 14-year-old girl in Villach, standing alone in a foreign country, and I know that I am doing what I am meant to be doing—helping to build a world where no one has to face that kind of uncertainty alone.

    Tina Purnat is a DrPH student and Prajna Leadership Fellow.


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