2013 was a big year for public health. We were thrust to the forefront again with disease outbreaks, and have had to deal with increased skepticism of the nature of what we do from the public. Meanwhile, within the establishment, rifts have been growing between groups, as different professional organizations vie for power and control. Here are my top five public health stories for 2013, presented in no particular order, but I’d love to hear yours in the comments.
1. Polio in Syria
Polio is a crippling disease that has been covered on the blog before. It’s been almost completely eradicated, but is still endemic to certain parts of the word. However, following civil unrest in Syria, polio has started to spread again and has, to date, crippled 17 children. Before the March 2011 uprising, vaccination rates were estimated to be above 90%. However, since then, estimates for vaccination rates hover around 68% – enough to prevent the benefits of herd immunity from kicking in. In order to increase immunization rates, the UN is trying to mobilize a vaccine drive. However, due to political and safety concerns, they are having a hard time ensuring that all children are vaccinated. To quote NPR:
Polio does not stop at borders or military checkpoints. Without a comprehensive response to stop the virus, aid workers fear that the outbreak could become a public health catastrophe.
In Canada, the top three causes of death for men are cancer (31.1%), heart disease (21.6%) and unintentional injuries (5.0%). The top two are the same for women, although with slightly different percentages: cancer and heart disease account for 28.5% and 19.7% of all deaths among women, with stroke (7.0%) coming in third. In the US, men die at an overall rate 1.4-times higher than women, of heart disease 1.6-times more, and are twice as likely to die from an unintentional injury.
In fact, women outlive men by 4.5 years on average worldwide – 66.5 years vs 71.0 years. This difference increase to 7 years in the developed world. Not only are men more likely to die from the causes above, men are also more likely to commit suicide than women. This gender difference increased following the recession. A time trend analysis from the UK found that approximately 850 more men, and 155 more women committed suicide than would have been expected based on historical trends following the 2008 economic downturn, with the highest increases in those regions that were most affected by rising unemployment.
But what leads to these outcomes? Given we live in a world where people can get help when they need it, why should men be dying at a rate that is that much higher than women for (almost) the same diseases? And why are they dying younger than women?
The CDC has a program known as the Epidemiologic Intelligence Services, where individuals trained in fields such as epidemiology, medicine, statistics and veterinary sciences come together to identify causes of diseases. For an overview of the EIS, check out this review of “Inside the Outbreaks” by Travis Saunders over at Obesity Panacea. The EIS was set up Alexander Langmuir, who has been profiled on the blog, and their work has been instrumental in learning about, and thus containing, disease outbreaks all over the world. Dr Levitt is well positioned to speak on these issues, having worked at the CDC since 1995, although it should be noted that this was written in her free time, not as part of her position at the CDC.
Today, the APHA is encouraging you to be prepared with their annual Get Ready Day! Across the country, people will be preparing for disasters, and encouraging people to consider how they are ready for any disasters that might happen.
The typical image that comes to mind when people think of getting ready for natural disasters is the “Y2K bunker,” where people have months of canned goods, water jugs, and matches, preparing for an apocalypse where we live in a Walking Dead or Mad Max style wasteland, struggling for survival. These individuals may or may not be sporting a beard and wearing camouflage gear in the middle of suburbia.
But that’s not what we’re talking about (although similar principles apply). A disaster could be anything ranging from a fire, a flood, a terrorist attack, or something more localized such as a storm taking out power in your neighbourhood, or a tree falling down on your house. These sorts of events will happen, and being prepared can help you and your family stay safe throughout.
Public speaking is something that terrifies many people, and is one of the most common fears people have. The combination of nervousness, wondering if people will understand you and finally just having everyone focused on you is not a relaxing experience.
As adults who have passed their early twenties, there are two places you’ll be invited to speak: At a wedding, or at conferences. Both are high stress situations. In both cases, you’ve been selected to talk to a group of people you’re unfamiliar with. But, despite their superficial differences, they have a lot in common. To aid you with your next wedding toast/academic presentation, I’ve come up with the following five tips.
Wedding/Presentation Tip #1: Be brief
How much time do you have? 10 minutes? Cut off two minutes. Always aim to be shorter rather than longer. Three key reasons why: 1) This gives you a few minutes as a cushion in case you lose your train of thought/start crying, 2 ) if the moderator holds up signs when you have 2 minutes to go, you know that you’ll be done before then (wedding analogue: when the MC starts edging towards you slowly) and 3) you’re less likely to lose people’s attention if you’re short. Keep things short, keep things precise. Get up, make your point, sit down.
Wedding/Presentation Tip #2: Be prepared
I once heard that the best public speakers aren’t naturally gifted; they’re the best prepared. Run through your talk multiple times before to ensure that you have your timing down. Be comfortable with your talk. Present to your friends and get them to critique you – does your talk make sense? Is the pacing okay? Read it out loud to yourself to see how it flows. These are all structural problems that can be fixed before your talk and will help you wow your audience.
Now, there are exceptions to this. Bill Clinton adlibbed a large chunk of his speech at the 2012 Democratic National Convention, and it was well recieved. However, not only is he a talented speaker, he has also spent years perfecting this skill. Your best friend’s wedding is not the place to practice. Practice takes time and effort. You may have to start working on your presentation further in advance to ensure you have it done and have enough time to rehearse. No more last minute presentations. But that’s the difference between the presenter who gets up there and looks professional, in control, and organized and the presenter who gets up there and says “Oh. I didn’t know this slide was coming up next.”
Wedding/Presentation Tip #3: Know your audience
If your talking at a wedding and you know the in-laws are very conservative/religious, you have to tone down your jokes to be appropriate. Similarly, if you’re giving a talk to a room full of students, or researchers in your field, or the general public, you have to change your talk accordingly. Know your audience and what their background is when preparing your talk. For weddings this means introduce yourself and your relationship with the couple as not everyone knows you and ensuring you add enough backstory to your speech so that you don’t lose your audience. For academic presentations, take a step back and start by explaining your research in broad terms, rather than jumping directly into the nuts and bolts of what you’re doing.
Wedding/Presentation Tip #4: Inside jokes/Jargon
One of the worst things to hear at a wedding is 10 minutes of insides jokes that no one else in understands. No one wants to hear you drone on about that one time you guys had a burrito at 3am. Analogously, no one wants to hear a sentence full of acronyms at a presentation. However, this does play into point #3 – if the audience is one that knows the jargon in your field (at which it’s no longer jargon), then you’re fine. But if the audience is not, then avoid any unnecessary technical language, or if you do use it, make sure you define it clearly up front. KISS. Keep It Simple Stupid.
Wedding/Presentation Tip #5: Enjoy yourself
Have fun with it! If you know what you’re going to say, and if you have practiced that will go a long way to alleviating any stress you might be feeling leading up to the big day. Being prepared will allow you to have a presentation that feels comfortable and one that is true to you, and that confidence will come through in your demeanor, approach and body language. This isn’t something that will improve overnight, but with every talk you give, you’ll get better.
Good luck to you, and here’s hoping the lucky couple/your supervisors love your talk!
An issue that keeps coming up at conferences I’ve been at lately has been the role of industry in public health. It’s an interesting question, as funding for prevention requires a level of political will and foresight that will not lend immediate dividends, and may not for 10, 20 or even 30 years. Given how many politicians now exist in a perpetual election cycle where any misstep is captured and covered ad nauseum, not having immediate payoffs are a risky proposition. Add to this an aging population that requires immediate and tangible medical care, and (in those countries that have public healthcare) there is a tough decision that has to be made: immediate and tangible dividends, or long term goals that you may not be around to enjoy.
As a result, groups have turned to other partners to acquire funding for public health interventions. These range from other public health groups, NGOs/NPOs as well as industry. While there isn’t much controversy surrounding the first two groups, the third raises no shortage of concerns among both public health people and the public. The basic question is this: Can we partner with industry, and if so, how can we partner with them in a way that keeps both sides happy?
I’ve been mulling this post over for a while now, as there isn’t an easy answer to the above question. As mentioned above, this is an issue that keeps coming up – especially in the obesity area (which comprises one of the focuses of my PhD dissertation). It culminated in an event organized by the Canadian Obesity Network – Student and New Professionals National Executive where they invited 4 speakers to speak on the issue – ranging from those who were profoundly against partnership, to those who were all for partnership, and even those in between. I’m not going to go into whether or not you *should* partner with industry, as both sides of this debate have been covered very well by Dr Arya Sharma and Dr Yoni Freedhoff in their respective blog posts on the topic.
Just a short note today – I (Atif) will be heading to the Canadian Public Health Association Conference next week, which is being held in my home town of Ottawa, Ontario. I’ve never been to the CPHA Conference, so I’m looking forward to it.
I’ll be tweeting findings from the conference using the #CPHA13 hashtag, and I’m hoping others will be too. There are a wide range of presentations this year, and I’m excited to hear about all the research that people are doing, as well as the vision that CPHA has for themselves and for their role in promoting public health in Canada.
I’m going to presenting a poster on one of the studies from my PhD titled “A Cross-sectional Analysis of Immigrant Status and Its Relation to Physical Activity Among Canadian Youth.” I’ll be by my poster for the breaks, so drop by Canada Hall 2 to learn all about it.
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!
Those of you who know PLOS know that PLOS is a big advocate of Open Access – making research and findings available to everyone. To support Open Access work, and to highlight innovative and creative uses of OA, PLOS recently announced the new Accelerating Science Award Program (ASAP), three $30,000 award aimed at highlighting three exceptional ways that individuals have used OA research in fields as diverse as science and medicine, technology or even at the societal level.
Nominees can be individuals, teams or cross-disciplinary groups – as long as the Program Rules are met, it’s all fair game! I wanted to highlight this award for our readers, as I’m sure there are some of you using OA research in innovative ways, and I strongly encourage all of you to consider nominating yourself (or others) for this award.
I also ask that you spread the word through your institutions, organizations and other connections – this is a great initiative and can help promote excellent Open Access work that is occurring worldwide.
The deadline for ASAP nominations is June 15, 2013, using an online form located on the ASAP website.
Some specific details about the award: The project/idea must be based on research articles or content published through Open Access before May 1st, 2013 in a peer-reviewed journal or in a repository recognized in the Open Access community. If the use results in a publication, the publication must be Open Access. For those interested, there are details available on the Program Rules.
From the ASAP FAQ, here are some examples. These are for illustrative purposes only and don’t refer to anyone in particular, and there are other projects that would fit the ASAP requirements. If you are unsure, you can contact ASAP[at]plos.org to check.
The health minister of a low income country was able to confidently and quickly change cancer treatment protocols based on an oncology research article detailing successful uses of a repurposed cancer drug published by a peer reviewed, Open Access journal, which had been translated into multiple languages by a group of retired language teachers.
A climate policy expert took original figures and examples from a recent Open Access climate change research paper — correlating temperature increases with rises in ocean depth — and repurposed these findings in a policy-focused presentation at a conference of experts from 25 Asian and Oceanic countries – leading to the adoption of stricter emissions standards by several participating countries.
A technologist used the APIs provided by Open Access publishers and aggregators to chart trending topics in environmental science research. He then mapped these research priorities against NSF and RCUK grants to show how grant monies impact what areas researchers pursue.
A team of bioinformatics researchers utilized tissue samples from an Open Access repository to obtain tumor DNA sequence abnormality data, which they repurposed to create a new web-based app for oncologists to analyze a new patient’s tumor cells – thus facilitating personalized cancer treatment.
I’m excited to see the nominees for this award, and I can’t wait to see how people have used OA research in new and creative ways. Good luck to all the nominees!
I’m a huge fan of science fiction and fantasy. There are few feelings quite as impressive as when an author crafts a world that draws you in (See: Arrakis, Middle Earth, Westeros, LV-246, Hogwarts etc). Perhaps what I find most fascinating though, is how quickly science fiction can turn into real life. For example, the tricorder from Star Trek was a fictional device that could scan different aspects of the environment depending on the requirement, ranging from geological, such as mineral content of rocks, to metereological, such as air pressure and temperature, to biological, such as heart rate and blood pressure. While this sounded like a great dream in the 1960s (when The Original Series aired), we’re now, within a single generation (pun *totally* intended), able to turn this into reality. The new Samsung Galaxy S4, for example, is slated to be released with a suite of health apps (dubbed S Health), including apps to measure heart rate, blood pressure as well as track caloric expenditure. Even things as simple as being able to communicate without needing a bulky cellphone have now become a reality.
As teachers and educators, we suffer from a very real limitation when it comes to teaching. Either due to time, lack of equipment or other constraints we cannot teach some issues the way we would like. But even in the most well-equipped lab, sometimes we can’t teach a concept because the technology doesn’t exist. In those situations, we can use outlandish examples to discuss a concept, and then work backwards from there to discuss the limitations we currently face, a concept called a Thought Experiment. By imagining a scenario, we can push the boundaries of our understanding, discussing the issue from a “what about if X happened,” or “Would Y still occur if A and B happened.” There are many types of thought experiments, and it means different things to different disciplines. I’m going to be using it to refer the use of a metaphor to explain a concept, which corresponds to the “prefactual” type of thought experiment, ie. what outcome would we expect if we had conditions A, B and C.