Mr Epidemiology

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“Oh no! What happened?” “W220.2XD: Walked into lamppost, subsequent encounter.”

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.

Do you know what code it is if you get hit by a Macaw? Because one exists. | Photo via National Geographic
Do you know what code it is if you get hit by a Macaw? Because one exists. | Photo via National Geographic

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…)

Click here for the rest of the post!

Going to #CPHA2014

The 2014 CPHA conference will be held in Toronto, ON | Picture courtesy Wikimedia

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).

Click to go to the conference website

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

Heading to #SciWri13!

ScienceWriters 2013!

A quick update for all our readers – Cristina and I (Atif) will be in beautiful Gainesville, Florida this week for the National Association of Science Writers/Council for the Advancement of Science Writers annual conference!

I will be speaking on a panel on Saturday November 2nd titled “Take a lesson from the universe: Expand” in the Dogwood room at 11am. I’m excited to be speaking on this panel, along with some of my favourite science communicators in Alan Boyle, Joe Hanson, Matt Shipman and Kirsten “Dr Kiki” Sanford. Thanks also to Clinton Colmenares for organizing this wonderful opportunity and what promises to be an excellent discussion.

A description of the session from the program:

Scientists know science. And they’re good at getting science news. Know who’s not? Non-scientists. Yet non-scientists outnumber scientists, and their attitudes, believes, intellects (or not) and their votes help determine science policies, from funding for stem cells to what’s taught in school. The near-extinction of science reporters at local news outlets has created a gap in a steady stream of legitimate, dependable science news. Yet today there are more ways than ever to reach the general public. This session is about expanding your audience beyond the science in crowd. We’ll talk with two young scientists who are passionate about finding new ways to reach new audiences and we’ll explore ideas for how PIOs, freelancers, staff reporters and even scientists themselves can take a lesson from the universe and expand.

If you see either of us around, be sure to say hi! We’ll be at most of the events, and would love to meet you!

This was published simultaneously on PLOS Sci Ed

Dealing with negative feedback

You know the feeling.

You’ve spent the last month working on a manuscript/paper, have fleshed out your ideas, spent countless late nights editing and making things sound *just* right, and you’ve finally sent it in to your supervisor. This will be the draft. This will be the one that they read and go “Wow! Good job! Submit this to Nature immediately!” And it’ll be accepted within a week, and you’ll be flown to Washington to present the paper to President Barack Obama himself, and, while you’re there, BB King will show up and you’ll jam together in the oval office, and, just when you think you’re about to finish your Epic Blues Jam Session, Bill Clinton will come by and play the saxophone.

But then, your supervisor sends you your paper back, and it’s either covered in red ink or there are 714 comments in Microsoft’s Track Changes.

This is *literally* the most appropriate GIF I could find.

One of the major reasons you’re in grad school is to learn from these experiences. There is a reason your supervisor is the Canada Research Chair of Awesomeness, or is internationally known for their work. It’s because they’re very good at what they do, and part of what they do is write, and write well. Your goal is to learn everything you can from them, and in that process, improve your skills. And writing is just one part of this process – your ideas will need refinement, your writing will need work, your teaching will need improvement, all of these are skills you can work on during your graduate education. However, in order to improve, you need to deal with feedback, which can come from a wide range of sources including your supervisor, your students (via TA/TF evaluations) and people at conferences.

1: Take a break.
The first thing I tell all the students I work with when they get back corrections is to read it, then leave it. Skim over the comments, get that initial “THIS IS THE WORST NEWS EVAR!” feeling out, and then go for a walk. Once that initial visceral response has passed, you can start dealing with the comments themselves. As this 99u article says:

Don’t react defensively – or aggressively – no matter how hurt, disappointed, or annoyed you feel. Start by taking a deep breath and reminding yourself of your goal.

2: Remove emotion from the equation.
As silly as it sounds, you do get emotionally attached to your writing over time. You’ve spent countless hours tweaking everything, making it sound *just right* before sending it in. You’ve read and reread sentences again and again to make sure they’re clear. Your supervisor then rewrites many of those sentences, and may suggest that some are unclear and need work. At a conference, someone might be less diplomatic, and call your work all kinds of names. You need to take emotion out of the equation as you hear those comments, and decide what comments have merit and require further thought. One thing you should not do is take criticism of you to be a personal attack. Negative feedback isn’t personal. By removing any emotional responses from the comments, you can evaluate comments on their own merit, and decide how to deal with them.

This may be extreme, but you get the idea.

3: Triage comments
In an emergency room, patients are triaged. Those with life-threatening conditions are identified as high priorities, while those who do not need immediate attention will be waiting for beds to open up. Similarly, you need to identify which comments are important, and need to be addressed immediately, and which are stylistic and you can let slide. Pick your battles.

4: Identify constructive criticism
We’re now thinking of comments outside of those that your supervisor would give you – we’re into the realm of feedback from students, audience members at presentations, and others. Listen to the comments, and understand why the feedback is being given and what you can do to improve. What you really need to do here is identify what is constructive and helpful, and where the comment is coming from so you know how to fix it. Use the comments to help you, and be objective about whether or not it is useful – even if you don’t like the comment.

5: Ignore personal attacks
One of the best pieces of advice I got as a Masters student was to listen to all comments and evaluate them all, even the ones you don’t agree with, but to always ignore personal attacks. And you will get personal attacks – students will write mean comments in TA evaluations, people will attack you at conferences, and, especially if you put your ideas out on the internet, you will get called all kinds of names. It’s very easy to dwell on those comments: don’t. You know you’re good at what you do, and don’t let anyone tell you otherwise.

This GIF always makes me laugh. I don’t know why.

6: Don’t listen to everyone
And thus we get to the final point: don’t listen to everyone. Everyone will have advice, everyone will have an opinion. Take the points that you like, synthesize them, and use your own judgement to decide what works for you and fits your project/worldview (that includes this article). Don’t accept everything blindly. Decide what you stand for, and if someone is arguing with you about it, plant your feet firmly and don’t budge.

This was originally published on Gradifying.

Selling Science: Marketing Public Health Messages

Think about the most recent message you heard on TV. If you’re like me and watch a lot of sports it probably had something to do with going “All in for Week 1.” Alternatively, maybe you’re thinking about Importing from Detroit. Or maybe you want to see a day in the life of LeBron’s Samsung Note II. But how often do we see effective marketing of public health messages?

When it comes to public health, how much time do we spend promoting our message? Perhaps the only “public health” messages people see relate to two things: 1) phamarceuticals (although this varies by region) and 2) seasonal vaccination programs. The way advertisers think about messaging is markedly different to the way public health professionals think and thus how we convey information. Rather than talk about how to “communicate a health risk” maybe we should think about how to “market a message.” It’s a simple, but seismic shift.

Continue reading on PLOS Blogs Public Health Perspectives!

Science Heroes: Why Science Needs A Celebrity Spokesperson

We exist in a strange society these days. Jenny McCarthy is viewed as an authority on vaccines and people listen to the opinions of Ben Affleck and Sean Penn when it comes to politics. Yet people who study and have dedicated their lives to these causes remain out of the limelight and hidden from the public. While everyone knows about celebrities who campaign on issues, how many people can name a researcher who study them? One  problem facing scientists is the lack of communication between science and the public: we’re perceived as living in the ivory tower of academia and are totally out of touch, or worse, we’re in the pocket of Big Pharma/Food/The Umbrella Corporation/Evil Faceless Corporate Interest.

But in reality, scientists are just regular people with an interest in one specific part of our world, and we want nothing more than for everyone else to find out work as fascinating as we do. It’s something that Jorge Cham of PhD Comics discusses in his TEDxUCLA talk, where he highlights how he was hired to create a video (that you may have seen) about the Higgs Boson.

There’s a definite gap between scientists and the public, and three questions immediately come to mind: 1) Why do scientists not engage, 2) How can scientists engage and 3) How do we find a celebrity to endorse “science”?

Click here to continue reading!

#overlyhonestmethods – Reaching out with humour

For a week and a half, I was a minor internet celebrity!

Science has an awkward relationship with the public. There’s a perception that we exist in an ivory tower, and the common media perception (as is evident by shows like The Big Bang Theory) is that we’re somewhat socially inept, with a lack of people skills and an inability to talk about our work in a way that others can understand.

So I was thrilled when #overlyhonestmethods became a thing. There have been many little science in-jokes floating around the twittersphere; one of my favourite was the hashtag #middleearthpublichealth which came out right before The Hobbit released in theatres. Tweets like “Craving the ‘Precious’: Gollum, a case study of the public health impact of severe ring addiction, Lancet 2010” abounded, and they illustrated public health rather nicely (for more, check out Brett Keller’s blogpost). However, they only catered to a niche audience: public health professionals, and public health professionals who got the Lord of the Rings references.

Click here to continue reading!

Science and Storytelling

A short post today, as I know everyone is busy, and the time you spend reading could be better spent listening to me in the YouTube video above :)

I was fortunate enough to speak at TEDxQueensu last semester. For those of you familiar with the TED format, it’s a short (< 18 minute) talk about an idea or concept. Some famous ones are by Sir Ken Robinson (Schools Kill Creativity), Candy Chang (Before I die, I want to) and this talk by Simon Sinek (How great leaders inspire action). The latter is the one that inspired me to do this talk.

In a nutshell, I think science is awesome. But I also think that science is suffering a public relations crisis at the moment, with people having a hard time understanding what it is we do, and more important why scientific research matters. That idea is what fuelled my TEDx talk above.

For those wondering, TEDxQueens was a great experience. There were a range of people there, including fellow PhD candidate Heidi Penning, who spoke about her experiences raising a child with autism in her talk entitled “Discovering what lies beyond the bend.” I’d definitely recommend attending next year if this is the kind of thing you enjoy – and definitely audition if you have an idea worth spreading!

Thanks again to the TEDxQueensu team for such a great opportunity and for putting on such an awesome event.

This piece was simulblogged on Gradifying

New Post on PLOS Sci Ed: Unintentional Benefits of Open Access: The broader impact of making publications free

The Carleton University Library. I spent many hours here, studying, photocopying, sleeping. Photo via Emilybean

When I was in undergrad, we would photocopy articles down in the basement of MacOdrum library at my alma mater, Carleton University. You’d have to find the call number of the journal, head down into the basement, find the right row, then bookshelf, and finally discover someone had already taken the journal to photocopy it. I learned quickly to check the photocopy room first to see if someone already had the article rather than looking for it first.

But now we’ve moved into a world where everything is done electronically. Through the power of PubMed, Google Scholar and numerous others, you can obtain PDFs of many articles via your institution. And now, many of those articles are available under Open Access rules – so anyone can access them, regardless of academic affiliation.

Click here to continue reading!

New Post on PLOS Public Health: Public Health 2.0: Electric Boogaloo

Session: Public E-Health

I love conferences and seminars. Having someone who is passionate about an issue get up and present is one of the best ways to learn about something new, and can really bring something to life. But what’s perhaps most interesting is not how effectively someone can communicate an issue, but it’s in the break immediately afterwards. Do people leave to discuss the topic that was just presented? Do they leave thinking about what you said? In my mind, that’s one mark of a good presenter: they make you think about the issue so deeply that it dominates the conference lunch immediately afterwards.

I had this experience last week. As part of an introductory epidemiology course, the students were allocated to a side and had to “debate” an issue. One of the topics was “Vaccination campaigns can be helped by social media,” with the two teams arguing accordingly. That got me to thinking: How is social media used by public health professionals? And can it be used effectively?

Click here to continue reading!

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