This a short post mainly to share a Prezi link of my project`s presentation: Prognostic implications of oral health status in HIV positive women in St.Petersburg, Russia.
I included only main slides, more will be in the publication that I submit to Community Dentistry and Oral epidemiology journal.
Here is a video explaining the issues related to HIV & Oral Health, that is not always covered in media.
and in Spanish:
Annual Business of Health Care Conference, a one-day conference organized by fellows of a dual degree program (MBA/MPH) of Haas Business School deserves attention as it has attracted entrepreneurs, health care practitioners, industry professionals and investors.
Today health care faces great challenges costs, demographics, adoption of new tratement types, etc. , but mainly reducing the burden chronic illnesses, and foster advances in health care delivery. Mike Buck, president of Abbott Ventures Inc., has guided us through the transformations of a large Abbott company that had created venture division to invest in research and development companies.
Among the most impressive panels were “Health and Wellness-Mobile and Web-Based Technology” with
I instantly recalled of GBC’s HEALTH@WORK Employee Education Program to raise awareness among employees, on HIV/AIDS,TB and other preventable diseases.
The solutions that arise everyday are impressive and transformations and their accessibly is truly amazing. New companies create new jobs and now directions in science.However, some presenters did not focus on the incorporation in existing systems, metrics of tracking and success, that I assume is essential in any health care related innovation and activities. In addition, not every start-up has a staff with clinical/public health experience.
Similar opinion and more on Health IT start-ups: go to Anne DeGheest`s blog.
The closing speech from Daniel Kraft, MD summarized the most recent innovations in health care: “As a cancer doctor, I’m looking forward to being out of a job.”
This summer time was challenging due to data collection for my research project Prognostic implications of oral health status in HIV positive women.
Why focus on women? Women are often excluded from studies or not enrolled in the studies for various reasons and now global epidemiological data shows that almost half of HIV positive individuals are female.
The situation in Russian Federation is similar. Russia has one of the largest HIV epidemics in Europe, with 589 581 registered cases and 58 633 new HIV cases in 2010(HIV Federal Center report), an incidence 20% higher than during the previous years. The prevalence of HIV-infection in the country is still dominated by men (64.9%), however, this gap is closing due to increased incidence among women in recent years. In fact, during the period 2004-2010, 41-43% of new HIV infections were among women, double the 20.6% among women in 2000. New cases among women are predominantly caused by heterosexual contact (64.7% of new cases), and among men the primary mode of transmission is injecting drug use (74.5% of new cases). There has also been a notable rise in HIV transmission during sexual contact among reproductive-age women, from 7.6% in 2006 to 38.0 % in 2010.
In St. Petersburg, the second largest city in Russia, 39 809 cases of HIV have been reported since 1987, including 13 144 women (33% of all cases). Consequently, St. Petersburg also has the unfortunate distinction having the most HIV-positive pregnancies in Russia.
The age group most affected by HIV infection is those 18 to 30 years of age. The majority of these patients are, or soon will be, in the secondary stage of disease progression with diverse clinical manifestations, and are seeking surgical, dermatovenerological, and dental care.
The total number of female patients visiting a dentist at the St. Petersburg City AIDS Center (CAC) has increased 71% from 255 (Jun-Dec2009) to 436 (Jun-Dec2010). The number of HIV-positive pregnant women has skyrocketed from 4 to121 during the same period.
Limited access to a full range of dental care services for HIV-infected women results in poor dental hygiene, a risk factor for transmission of oral bacteria, including cariogenic, as well as the risk to the fetus of premature delivery and low birth weight.
High caries prevalence was observed with a few oral lesions . This may have a substantial impact on health and quality of life in this vulnerable population.
Next study focused on unmet dental needs among HIV positive women. The self-administered survey was developed to assess information about demographic and perceived oral health status, along with dental needs of HIV-positive women.
I will post links of the articles once they are accepted.
Public Health in Film & Fiction Course organized by Carol Whittaker,who has combined the works of writers, and filmmakers with public health themes in different life scenarios. In my opinion, it was a great idea for the graduate students to see the public health challenges from other professional point of view, even though without the scientific preciseness. The course has allowed to observe and provide feedback from a public health professional’s view through discussions.
One of the most important take-out from the course is learning and understanding ” the usefulness of art in creating public health awareness” and thinking how others might view the health problem and what significance they put into difference diseases or public emergency situations. Here are some of the movies I watched, dropping by: Upton Sinclair’s The Jungle.; A Paralyzing Fear: The Story of Polio in America; Philip Roth’s novel Nemesis. The most touching and impressive story of polio in the US from outbreaks and constant fear among population to finding vaccine, trials, and eradication.
Topics in Infectious diseases (Vaccines concentration) class taught by Louise-Anne McNutt was memorable as it was a mix of immunology, behavioral social change theories, staging the National Vaccine Committee workshop, social media application in public health and several group tasks.
I had a pleasure of working with Madhu Anand and Megan Mitchell for a final project where we have designed web-based educational campaign for new or newly expectant mothers basically a health blog called My MMR. I took the lead to encourage my colleagues to use new type of presentation and analyse and transform the existing knowledge in the way to address patients fears, beliefs and attitudes. The website and auxiliary sources offer young women take their time to think over important decision.
Among all vaccines we have chosen Measles, Mumps, and Rubella (MMR) vaccination due to recent anti-vaccination moods and several outbreaks in the US. The summary of the project was made in Prezi, that has allowed us to present the project more vividly. Other group of students (Lia Gvinjilia ,Patel Nimish, Mingzeng Sun) came up with a video for yellow fever vaccine.
These are academic public health projects, but a demonstration of how various means of mass communication can create awareness as well as provide accurate knowledge for population to make decisions. This is the right time for research, especially when “half of America is using social networks” and already this week I was reading research by E. Miller and A. Pole and their article where they take a close look at Health blogs, its influence, usage and current perspectives.
Dr. Shah, the current NYS Commissioner of Health is a social media supporter, who gave a guidance speech encouraging to focus on patient-centered approach and use of modern technology.
I hope social media will help bridge the access gaps to health care providers, and to high quality health care services. I sincerely believe it is possible through the combined efforts from committed healthcare and IT professionals.
Finally, I would like to post a video from the Gates Foundation that explicitly explains the history and values of vaccines:
This Fall I took a Genetic Epidemiology class taught by Prof. Roxana Moslehi. We covered a lot of various topics ( linkage analysis, genetic counseling, genome-wide studies, microarrays,etc) in a quite a short period if time. One of the most fascinating was watching a film about DNA discovery, how genetic research was banned at MIT, the dialog about ethics, legal and biotechnology perspectives between scientists and society which still continues nowadays. The giant leaps that have been done in the past 30 years with Human Genome project and numerous genetic test, public awareness, specialized web resources, one of them that I found useful is Huge Navigator to search cancer, stroke, Crohn`s disease and other disease with genetic association, track the evolution in human genome epidemiology as well as find investigators in a particular field of human genome epidemiology.
It seems to me that some of us still do not realize that genomics and personalized medicine already has an enormous impact on public health by providing a better understanding of diseases pathogenesis, accurate assessment of disease susceptibility and prediction of drug response. For example, screening of newborns for elevated phenylalanine to identify the affected babies to prescribe diet in order to prevent mental retardation; prevention of adverse and costly drug reactions by pharmacogenomics approach.
This January I attended Harvard Wellness project conference which was a of a great need for students “due to the prevalence of unhealthy behaviors (i.e. sleep deprivation, lack of time to exercise, depression, anxiety, stress)”. I must say it was wonderful and the Wellness Project has achieved a lot in raising awareness and helping us move towards happier and healthier lives.
It has inspired me in many ways from meeting people to introducing changes in myself. The lectures about nutrition( from Dr.Clifford Lo) and time management( from Dr.Frank McNamara and Claire Shindler)were not only thought-provoking, but bringing changes and action in my life.
I can`t help mentioning that I won`t forget the energy boost from Tess Hellgren and her dance class that was moving in all senses and it makes me laugh when I recall it.
Most of all it was a pleasure to meet Poonam Tandon, who guided us through the world of yoga
and learn about her teacher Sri Sri Ravi Shankar whom I found in youtube @ MTV’s Fantasy Factory.
I have been to several classes of fitness yoga before, but it did not feel exactly right and after borrowing a book of yoga at the public library I did some at home but not for long. Once I tried yoga with my partner which was a good experience. It seems to me that the atmosphere and time matters. I feel changes inside: it easier to communicate with people and even strangers, now I look at things differently, and what once seemed a problem – now is not important, finally, less nervous and I have more peace and strength when thinking about the coming work in the semester.
Thank you Priyanka Mitra, Zena Mengesha, Belinda O`Donnell, Beverly Pozuelos, Preetha Hebbar, Rachel Bervell, Ashley Anglade!!!!!!
“The War” that is how the discussions on this topic can be described as well as the consequences.
This semester I signed up for a new experimental class called Vaccines: biology,epidemiology, and psychology in the series of Topics in infectious Disease Epidemiology.
One of the videos watched in class was to initiate the discussion how persuasive were the fighting parties. I consider this to be a good combination of information as majority of videos in the internet present only one version or opinion on the subject. We can see scientists, doctors, mothers, who explain their theories of vaccine toxicity, evidence-based medicine, people who want to act and make decisions, public health professionals who want only the best for the population.
The CDC or researches are not persuasive enough and currently can not give good reasons for the mothers who decide to be ” natural” and live in their own bubble without caring about those around them. I say we need guidelines, standards as people are traveling, contacts are more frequent within the communities. I do not have children, but the women talking in the program lack knowledge and being very irrational fighting back with something like I don`t care if anyone is sick I only care for my baby.
I had a number of vaccinations as I was born in Soviet Union where at that time the public health system was relatively strong: Red Medicine: Socialized Health in Soviet Russia, Sir Arthur Newsholme , K.C.B.,M.D. and John Adams Kingsbury, LL.D.), “Each doctor is expected to consider the health of his patient, not merely as a patient, but as a member of the community, whose efficiency, if possible, must be increased.” I recall regular check-ups, vaccinations and a personalized booklet where the nurse signed.The education on vaccines was provided for everyone to make sure we understand what is the shot and why it is needed. I still keep it as a vitally important document of my health history which soon will be gradually transferred to Google health.
During my winter break at SUNY I was looking for a book about American history, but I found something even more interesting. “The Founding Fathers on Leadership” by D. Phillips not only gives an insight of American revolution events, but also provides the leadership principles. Which is, in my opinion, the essence of communication and interaction among people in any settings.
I have been to Philadelphia in a hall where the Declaration of Independence was signed, but the details from the book made my imagination vivid by reading some small details. That Thomas Jefferson had experienced loss of his children and wife just a few months before he started writing the Declaration. How Washington stayed close to the troops and communicated to them his vision.
At the Independence Hall, Philadelphia
“Leadership is leaders acting- as well as caring, inspiring and persuading others to act- for certain shared goals that represent the values- the wants and needs, the aspirations and expectations- of themselves and the people they represent. And the genius of leadership lies in the manner in which leaders care about, visualize, and act on their own and their followers` values and motivations”
The book is structured in chapters where the main American revolution historical events of are described and followed by a summary of principles.
I will quote several principles that I liked most. All of them are thought-provoking and I spend and enjoyable time learning and creating in my mind the situations when they can be applied.
1.Have a pretty good idea of where you want to go before you act or attempt to inspire others
2. Sense your opportunity and seize the moment
3.Make your vision simple and clear so that everyone may understand it
4.Begin communicating your vision slowly and softly so that others may first think it over
5.Collect your thoughts and set your goals down on a paper
6.Hope for the best, prepare for the worst
7.Create an effective team to help achieve your vision and goals
8.When making a decision, gather information and understand the facts, consider various solutions and their consequences, make sure that the decision is consistent with your objectives, and effectively communicate your decision
9.Analyze your situation with a child like point of view, with no past biases
10.Be a frequent reader of a controversial literature of the day
11.Listen then speak; follow then lead
12.Work by day, think by night
13.One inspiring communication can turn the tide
14.Hold regular, informal gatherings that provide enjoyable opportunities for immediate and continuous personal communication
15.Two-way communication has a tendency to create and strengthen emotional bonds
16.Keep people out of trouble by keeping them busy
17. To for a just idea, you must be on the spot
18.Lead by example
19.rest when necessary, but stay close to the competition so as to keep a watchful eye on their actions
20.Never give up hope
21.Share the hardships of the people you lead
22.Keep you sense of humor , even during the worst moments of crisis
23.Don`t simply allow creativity and innovation; encourage it
24. Be smart enough to realize that you cant do it all yourself
25.Frequently, the most effective way to defend is to attack
26.Employ tactics that make your organization seem larger that it is
27.It is natural to think of forming alliances, especially if you are pressed
28.Send out letters to various organizations testing the waters as to whether they might be inclined to enter a joint venture
29.Remember that everyone thinks they know how to manage financial affairs, but few really can do it
30.When you fail to receive help from parent organization, don`t just sit there. Create your own system to solve your needs
31.The larger your organization, the more you must delegate
32.Do not lose sight of your overall mission or be distracted from taking necessary action to achieve that end
33.Trust the experience of error will enable you to act better in the future
34.Upon starting a new assignment, tell everyone that you are there to learn , not to teach
35.Ability to learn+ Action=Effective Leadership
36.When arriving to assume a new leadership position, first respect the culture of the organization as it currently exists
37.When you fight and get beaten, rise and fight again
38.When outnumbered, stay a step ahead of the competition until they wear down and you outnumber them
39.Even with a series of defeats, you may be victorious in the long run
40.Before major action, meet all the members of your team personally. Shake their hands and salute their efforts
41.As a leader you are an agent of change
42.The greater the risk, the greater the glory
43.New problems are often created after a revolution is won
44.It is much easier to inspire movement of masses during a crisis situation that in a time of relative peace.
45.Take the best of the people as they are , since you cannot have them as you wish
46.Changing times require new approaches and new ideas
47.Understanding human nature not only allows you to comprehend the motives and reactions of the people you lead, it also helps you improve yourself
48.Form a culture that will give consistency, stability, and dignity to your organization
49.Combine the past and the present to built a bridge to the future
50.The better any man is, the lower thoughts he has of himself
51.Create small committees to resolve big issues
52.Search for common ground and create Win/Win situation. Remember that compromise is the tool of a true leader
53.Winner attract winners
54.Alway remain optimistic. See a rising sun rather that a setting sun.
55. When introducing radical change, be prepared to be attacked personally- both verbally and physically
56.It is in the nature of people to pursue their own interests
57. Think of every possible question that might arise in opposition to your plan- and then come up with answers to these questions
58.Seize the initiative to educate people through the mass communication methods of the day
59. In order to get to know them better, take your top executives on a fishing expedition- or some enjoyable trip
60.Successful leaders do not sit back on their laurels.
61.The fire of a truly leader is always burning
62.Develop the future leaders. Pass the torch to the next generation
Final analysis from the author :” The principles of leadership are nothing less than the principles of humanity: treating people with respect and dignity; raising awareness; creating a vision and involving others; bonding together through alliances and teamwork; risking all; learning form mistakes; refusing to lose; inspiring rather than coercing; listening; compromising; caring; ever changing and ever achieving”
The New York State Department of Health (NYSDOH) AIDS Institute, in partnership with AIDS.gov, was holding a one day forum on social media and HIV/STIs at New York University’s Kimmel Center in New York City.
The first HIV/STI-relatedsocial media conference started with a welcome word from Richard F. Daines, M.D., the 14th Commissioner of Health for New York State, telling about the public health approach to get access to communities, not through old fashioned NY street journal, newspapers.
Where do we place the messages? Youtube video channel, twitter, blog? What is a successful health care media campaign?
Miguel Gomez, the Director of AIDS.gov, Office of HIV/AIDS Policy, U.S. Department of Health and Human Services, describing a Media transforming health communication and its current challenges. For instance, integrating SM in public health planning, launching AIDS.gov to understand new media, how to extend the reach, and placing basic HIV data as according to survey for 80% of users the main concern was this type of information; National HIV/AIDS strategy, the practice of recreating blog post into a twit, video and a podcast-3 products out of 1 for the clients of the website.
Lily Williamson , Manager of Strategic Partnerships and Public Affairs at MTV Networks talked about negative effect of new media and the digital abuse (blackmail, abuse, lying, sexting) and the research conducted by carrying out 75 min interviews with 18-24 years old. This age group have it as part of life , do not recognize overuse, and using the new media without a “code of ethics”. MTV’s A Thin Line campaign that was especially developed to identify, respond to, and stop the spread of digital abuse in the youth life: ” The campaign is built on the understanding that there’s a “thin line” between what may begin as a harmless joke and something that could end up having a serious impact on you or someone else. We know no generation has ever had to deal with this, so we want to partner with you to help figure it out.” The project is meant to promote responsibility among youth clients, encourage them how to use technology and empower to identify digital abuse.
and a round of social media initiatives presentations that have been recently launched :
Love heals -online peer education for young women with series of 90-180 seconds videos of topics- HIV prevention and it is not only about a disease, but a whole range of other issues. Social support among youth peer to peer recruitment, that recommended to stay away from Facebook as they are concerned about privacy of their status. As a result youth recommended peers for HIV testing.
Harm Reduction coalition has been working with SM tools and trying to introduce it among hard to reach high risk group: drug users. Podcasts with voices of the drug users, blog, personal twitter posts turned out to be most effective.
Text in the city pilot project for too embarrassed youth to connect to health care, it focuses on 3 separate functions:
- chat- ask question reply with in 24 hours
-birth control reminders-daily weekly
-health byte- text about sexual health and healthy living,weekly.
HIV testing initiative in Brooklyn with a goal of increasing HIV voluntary testing to overcome stigma and make this test a routine.
The conference provided me with a comprehensive update of social media in health care and its application to form a strategic plan for a St.Petersburg AIDS Center where I am working to create a social networking space for patients and doctors.
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SUNY
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