Last week, I ran across this very entertaining piece over in Healthcare Dive about the new ICD-10 codes. The International Classification of Diseases (ICD) is an incredibly useful tool in public health that basically can reduce an injury to a series of numbers. As you can imagine, this is very powerful when it comes to determining if something is on the rise. Researchers can easily count the number of times something occurs, and if it’s up from previous years, there might be something there.
Part of the beauty of the ICD-10 codes is how specific they are. The previous system, ICD-9 (creative, I know) wasn’t nearly as specific as they only had 13,000 codes compared to the 68,000 in ICD10. With the advent of ICD-10, The Powers That Be have gone into painstaking detail breaking down injuries, diseases and other maladies into incredible precise codes that can be used by researchers and public health professionals.
Today, we’re going to go through my favourite ones.
W55.89XA: Other contact with other mammals
There are many codes for contact with mammals. Raccoons, cows, pigs and cats are all represented. However, the mighty seal is not covered, which made Buster Bluth very sad. He would have suffered from W55.89XA.
W61.12XA: Struck by macaw, initial encounter.
Look like our patient
*puts on sunglasses*
Is a little Macaw-struck
(The other option here was for an AC/DC reference…)
Commander Chris Hadfield captured the world’s imagination last year, when, from 13 March to 13 May 2013, he was the first Canadian Commander of the International Space Station. While aboard the ISS, Commander Hadfield did a series of “experiments,” both for scientists, but, perhaps most importantly, for youth. This included genuinely interesting questions like “How do you cry in space? (video above)” and “How do you cut your nails?” and the always important “How do you go to the bathroom?” His amicable nature and genuinely infectious enthusiasm brought science to the masses, and helped inspire thousands of youth.
Recently, Chris Hadfield released his book – “An Astronaut’s Guide to Life on Earth.” My sister waited in line for 3 hours at our local Costco to get me a signed copy for my birthday, and I finally got around to reading it for this review. The book follows the life of Chris Hadfield as he becomes the commander of Expedition 35, detailing his attitude and the path he took to become the first Canadian Commander of the ISS. The book is split into three broad sections leading up to Expedition 35 titled “Pre-Launch,” “Liftoff” and “Coming Down to Earth,” with several chapters within each section.
In December of 2012, I was asked my thoughts on the Sandy Hook shooting on Twitter, and if I was going to write about it through a public health lens. I said no – I didn’t want to weigh in so soon, and I didn’t really know where to start. Sandy Hook capped off a year where 130,437 people were shot by firearms. Of these, 31,672 people died, with almost 60% listed as suicides. Since that exchange, there have been several more mass shootings (defined as 4 or more fatalities in one instance – not including the shooter), and I kept surfing the internet to explore the arguments on both sides of the gun control debate. As pointed out by Kathleen Bachynski over on The 2×2 Project’s series on gun violence, aptly titled “Fully Loaded“, if “measles or mumps killed 31,672 people a year, we would undoubtedly consider the situation to be a public health emergency.”
The issue is, I’m not inherently against owning firearms. Sure, I don’t understand it, and it makes little to no sense to me how owning a gun makes you feel safer given how every other country in the Western world doesn’t and they seem to be getting along just fine, but that’s not the point. Many gun owners own firearms for self-defence, but use them mainly for fun and recreation – shooting targets and hunting are two of the major uses. More importantly though, Americans don’t want to give up their firearms, and that attitude isn’t going away any time soon: Anyone who thinks advocating for a universal ban on firearms in the US is wasting their time.
I’m now in the midst of my sixth Kingston summer. Between the Masters and PhD, I’ve been here for a few years, and every year I find myself looking forward to the same things every time the campus clears out and the summer starts up (I’m a creature of habit, what can I say). But Kingston still surprises every year, and new things show up every year that keep things interesting. Amanda, Sharday and Rachel have all weighed in, and now it’s my turn! :)
1) Best summer eats
This is a toughie. Rule 1: Everything is better on a patio. Woodenheads, Atomica, The Toucan, their food is just better when you’re sitting outside enjoying it. I’m a big fan of the Pomegranate Italian Soda at Atomica, but this year I “discovered” the raspberry chocolate smoothie at Sipps. It was delicious, and I highly recommend it.
I’ll also add in the Kingston Olive Oil Company. It’s got lots of gourmet olive oils and vinaigrettes available, and is a great way to spice up a meal with some fancy olive oils accompanied by fresh bread from Pan Chancho. I recommend the fig vinaigrette and garlic olive oil, but you can try them all out in the store and see if one strikes your fancy!
2) Best ice cream place
Ice cream!! Is there a more summery meal? I think not. My favourite place by a mile is White Mountain – mainly because you can get ice cream, then wander down to Confederation Basin and watch the boats come in. It’s a great way to spend an evening. As Rachel pointed out though, they only accept cash, so come prepared!
3) Best spot for drinks
I’m a big fan of the patio at the Brew Pub – it’s got a nice, secret garden-esque vibe going on. Plus the food there is delicious! Try the salted pretzels with a beverage of your choice. It’s a great post-work-pre-dinner snack (thanks to Kim for showing me the light on that!)
4) Best summer locations
I love Confederation Basin. Sitting out, watching the water and the boats, and chatting with friends is one of my favourite ways to spend lazy summer days. People are milling around, some have blankets out, there are families walking their dogs and children playing. It’s just a really nice atmosphere. And it’s super close to the aforementioned ice cream.
5) Best summer festivals
Two of my favourite events are Movies In the Square and the Kingston Buskers Festival (July 10 – 13). The former is a great outdoor experience (bring your own chair though!) and they show the classics. This year, they’re showing Jurassic Park, Princess Bride and Space Jam (among others)!
The Buskers Festival is another fun one to watch – especially the fire show. The Buskers are incredibly skilled and really entertaining for the whole family, and they really bring the city to life. It culminates with a final show at Confederation Basin with the best Buskers pulling out all the stops to really blow you away. I highly recommend it!
This marks my final post on Gradifying, and so I’d like to thank all my co-authors – Sharday, Megan, Rachel, Amanda – for their input and support, as well as Colette Steer for her guidance with this position. I’m looking forward to seeing what you guys do next!
THEY ALL WENT TO AN ADVANCE POLLING STATION NEAR THEIR WORKPLACE AND VOTED.
We’re going to take a break from our regularly scheduled programming to talk about the 2014 Ontario Provincial Election. The election is currently scheduled for June 12, and stations will be open around the country at many different locations.
But why wait?
Right now, you can go to the JDUC and vote. Easy as that. Show up with a photo ID with your current address in Kingston. Or, if you’re like me and don’t have your current address on your drivers licence, show up with your existing ID (such as a drivers licence), and something else that proves that you live in Kingston. I used my Telus phone bill, but I’m sure you can use other things. You’ll have to fill out some paperwork, but that’s straightforward and the clerks are more than happy to help you. It’ll take you the same time you’d spend waiting in line at Tim’s during exam season.
QUEEN’S UNIVERSITY – ALMA MATER SOCIETY
Location: LOWER CEILIDH LOUNGE
Address: 99 UNIVERSITY AVE, KINGSTON, ON K7L 3N6.
Access for people with disabilities: Please contact the Returning Office below for information on the accessibility of this location.
Days and Hours of Operation: 1/6, 2/6, 3/6, 4/6, 5/6, 6/6/2014. 10 AM to 8 PM.
Here’s my beef. None of the political parties care about our demographic. And why should they – we don’t show up, we don’t vote, and thus, we don’t matter. The programs and policies they develop are aimed at the boomers because THE BOOMERS VOTE. We don’t. But if we start showing up, even if we’re not 100% sold on a party, we’ll start being noticed as an important voice. And once that happens, they will have to start tailoring messaging and programming to us. I don’t care who you vote for, as long as you are informed and pick the person who best represents you and your interests and hopes for Ontario.
So show up. Bring your lab. Bring your friends. Encourage everyone you know to vote and exercise their civic responsibility and make their voice heard. Make a field trip out of it. Because if we don’t vote, nothing is going to change.
“Voting is not a horse race, you’re not going there thinking “Gee, I gotta pick the winner so I can brag to my friends ‘Oh, I picked so-and-so and he or she won'”. Voting is voting your heart and voting your conscience and when you’ve done that, don’t ever, EVER let a Democrat or Republican tell you that you’ve wasted your vote because the fact is, if you DON’T vote your heart and conscience then you HAVE wasted your vote.”
― Jesse Ventura
Next week, I (Atif) will be heading to the Canadian Public Health Association Conference, where I’ll be presenting at two different points.
I’ll be chairing a session titled “Youth Injury Prevention in Canada – Where should we direct our intervention resources.” It promises to be an interesting presentation, where we’ll be discussing injury in Canada, and where to start tackling the problem of injury. This session is scheduled for Wednesday, May 28th from 1:30pm – 3:00pm.
Injury represents one of the most important negative health outcomes experienced by young people in Canada today. Injuries inflict a large burden on children and adolescents and their
families and communities. Injury events are costly in so many ways, whether measured in premature mortality, or the pain, disability, lost productivity and emotional consequence of non-fatal events.
This panel will be made up of child injury researchers and advocates who will make their case for different forms of injury prevention intervention. At the end of this panel, delegates will: understand more about the burden of youth injury in Canada; be aware of at least four different avenues for injury prevention intervention (primordial intervention, context-level interventions, safe sport and peer-influence interventions); have identified the rationale, strengths and limitations of each intervention approach; and have learned more about ways to undertake and gain support for youth injury prevention (from the CPHA conference program).
My second presentation is one of the studies from my PhD, titled “The influence of location of birth and ethnicity on BMI among Canadian youth.” This is a study that’s in press (woo!), and represents my own research focus. This one will be in the Kenora Room, on Thursday May 29th 2014, from 11:00am to 12:30pm.
Body mass indices (BMI) of youth change when they immigrate to a new country. This occurs by the adoption of new behaviors and skills, a process called acculturation.
We investigated whether differences existed in BMI by location of birth (Canadian vs foreign born) across 7 ethnic groups, both individually and together. We also examined whether time since immigration and health behaviors explained any observed BMI differences.
Data sources were the Canadian Health Behaviour in School-Aged Children Study and the Canada Census of Population. Participants were youth in grades 6-10 (weighted n = 19,272). Sociodemographic characteristics, height, weight, and health behaviors were assessed by questionnaire. WHO growth references were used to determine BMI percentiles.
Foreign-born youth had lower BMI than peers born in Canada, a relationship that did not decrease with increased time since immigration. Similarly, East and South East Asian youth had lower BMI than Canadian host culture peers. Finally, Arab/West Asian and East Indian/South Asian youth born abroad had lower BMI than peers of the same ethnicity born in Canada. These differences remained after controlling for eating and physical activity behaviors.
Location of birth and ethnicity were associated with BMI among Canadian youth both independently and together.
Our findings stress the importance of considering both ethnicity and location of birth when designing and implementing interventions. While currently either one or the other is addressed, our study shows there is heterogeneity in BMI by specific ethnic groups depending on whether they were born in Canada or not.
As always I’ll be trying to livetweet the conference. I’ll be using the #CPHA2014 hashtag, so feel free to follow along online! As always, there are a wide range of presentations and workshops, so I’m excited to attend.
If you’re attending the conference, leave a comment with details of your own presentation so that other readers can attend your talks. And if you see me at the conference, be sure to say hi!
This was posted simultaneously on my blog PLOS Blogs Public Health Perspectives
Last week, my Gradifying co-author Amanda highlighted how her degree is structured. Today, I’ll be talking about the degrees offered by the Department of Public Health Sciences.
There are six factors that differentiate programs: the degree structure, courses, comps, research project requirements, teaching and timelines.
The degree itself
In my program, research projects are wildly different in terms of substantive research area, and students come in with very different backgrounds. My lab buddy in my Masters had a degree in engineering, I had a background in Psychology, another colleague had a degree in political science. With these different interests comes different theses. I’ve seen students do molecular projects that are most similar to biochem/bio projects, students who have either obtained or are in the process of obtaining their MD that are clinical in scope (note: clinical research projects are also performed by non-clinicians), and then there are projects like mine that draw heavily from psychology and sociology. The intricacies are driven by the interests of the student and the supervisor. There is also the Master’s of Public Health program that is a course-based, professional degree offered within the Department of Public Health Sciences.
For the MSc in Epidemiology program, students have to take 4 core courses, and 3 elective courses. Usually, students will complete all but one elective in their first year, and will take one elective in their second year. Core courses include biostatistics and research methods, both of which become vital to your career as an epidemiologist. In addition to this, they are expected to complete a Masters Research Thesis.
The Masters of Public Health program is structured as a professional program where students get a broad background in public health. Students in this program take seven core courses and three electives, as well as a skills class (that I have guest lectured). Finally, they complete a 16 week practicum over the summer after their first year.
The PhD is completely different. We have one full-year seminar course, and one advanced biostatistics course. The course requirement is relatively light in that regard – if you want further, specific, training, you can seek that out yourself.
As I walk through the valley of the shadow of comps, I will fear no evil …
In the PhD Epi program, comps are scheduled to occur in the summer of your first year. They consist of a 4 hour open-book written exam that covers basic epidemiology principles. Following this, you are given a paper in your substantive area, and given two weeks to prepare two presentations. This forms the oral exam portion of the comps process, and is given to three professors in the department. For the first, the candidate is expected to present a 20 minute presentation where they summarize and critically evaluate the paper. Following this, they are asked questions about the paper and how the authors evaluated core epidemiology concepts. The second part of the exam requires the student to design and present an appropriate follow up study, addressing the shortcomings of the previous paper. The process takes between 90 minutes and 2.5 hours.
Typically, comps occur in late-June to early-July. The cohort of PhD students will typically study together from around April onwards, and there’s a certain solidarity that develops from going through this process together.
Research Project Requirements
For the MSc Epidemiology program, students are required to submit a 2 page outline of their project. Upon approval of the outline, they then prepare and submit a 20 page proposal. The proposal forms the basis of an open oral defence, where peers can ask questions. There is also a designated faculty member who acts as a reviewer for the project. Once the student passes their oral proposal defence, they can then continue with their project. Finally, they have a Masters thesis defence, where they present their work to an examining committee, consisting of 1) a professor external to the department, 2) one internal to the department, and 3) the department head (or someone in their stead).
The PhD in Epidemiology follows a very similar process, except everything is bigger. Students submit a 5-6 page outline, followed by a 20 page proposal of the project. Again, the proposal is followed by an oral exam, with two faculty members acting as reviewers as opposed to one in the Masters program. Once approval has been granted, the candidate now proceeds with their project, culminating in a PhD dissertation. This is defended to a committee consisting of a professor external to Queen’s in addition to the members of the Masters defence committee.
At both the outline and proposal stage, students are given feedback that they can consider with their supervisors as they move forward. Due to the variability in projects, there are no expectations around the number of manuscripts that you should produce, although I’ve seen Masters students produce 1-2 from their thesis work, and more if they did RA work. Doctoral candidates aim for 3-4 core manuscripts, and again, produce more if they work as an RA. These can be written while in the program, which results in a “manuscript-style” thesis (see mine here), or a “traditional” thesis, where, after defending, the student will prepare manuscripts for publication. My Masters was a manuscript based thesis, and my PhD will be as well, but this really varies on the project and whether this is feasible for you. My PhD fits nicely into four self-contained projects, and so publishing as I go was the best way to approach my PhD (you can read more about the first study from my PhD here, and the Queen’s press release here).
Teaching and Supervising
There’s no undergraduate program in epidemiology, and so teaching opportunities are limited. That being said, there are lots of opportunities to be a TA for graduate courses, and there are undergraduate courses that are offered. Many of the TA positions include opportunities to lecture and lead small group tutorials, which makes them a lot of fun and rewarding. Perhaps the most fun is the ability to really tailor your tutorials and classes to your own style and interests – I’ve taught several classes using data from the NHL to illustrate basic statistical concepts (what are the average number of goals scored, what’s the modal number of goals scored, why are they different).
This is really left up to the student and supervisor – the department asks for progress reports by semester, but the onus is on the student and the supervisor to stick to the timelines set out in the proposal. I meet with my supervisors as required, and so we have gone 2-3 months without meeting in person if I’ve been working on a specific aspect of the project, and more often if I need feedback from them as I’m working through something. However, we touch base by email often, and this works well for us. Your mileage may vary – other students and supervisors work best with regularly scheduled meetings.
So while this is my experience in graduate school, I would suggest meeting with the department and potential supervisors if you are interested in joining the Department of Public Health Sciences. These are some of the core requirements and expectations, but these do change over time, and so if you’re finding this a year or more from now, be sure to check what the current requirements are.