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Young Epidemiology Scholars (YES) competition closes

Having been a judge in this competition for the past few years, and a believer in the value of epidemiology as an important and underused discipline in education, I’m disappointed to see this program, funded by RWJF and run by the College Board, come to an end. For a great perspective on it’s potential – be sure to read David Fraser’s essay “Epidemiology as a Liberal Art“.

The press release announcing the closure of the program has some statistics on the reach and influence it achieved.

The April 2011 Young Epidemiology Scholars (YES) Competition in Washington, D.C., was the eighth and final YES Competition. YES was launched in 2003 by the Robert Wood Johnson Foundation and the College Board to encourage high school students nationwide to apply epidemiological methods to the investigation of public health issues and inspire the brightest young minds to enter the field of public health. Nearly 5,000 students from all 50 states have participated in the YES Competition, which has awarded $3.7 million in college scholarships to 976 students, including this year’s participants. YES has been successful in inspiring student interest in and understanding of public health and epidemiology: 75 percent of YES Regional Finalists who have declared an undergraduate major are pursuing a health and/or science related major.

For me, YES was also about an annual trip to DC, to meet with a fantastic group of scientists from universities and public health. We all brought high expectations but more often we sat together in respect and satisfaction at great work.

AAAS session on anthropology and global health

Earlier this year I had the opportunity to speak at the American Association for the Advancement of Science (AAAS) annual meeting in Washington DC. I was part of a panel on anthropology and public health organized by anthropologist Cynthia Beall from Case Western Reserve University.

Kathleen Barnes (Johns Hopkins) presented research examining how allergic asthma may be a by-product of an evolved immunological defense against extracellular parasites. She showed some very interesting genetic epidemiological evidence that mutations associated with IgE (and the development of allergic disease, therefore) may be protective against schistosomiasis infestation. Her works is classic evidence for the hygiene hypothesis, to the extent that we focus only on allergic asthma. More importantly, though, it provides an all too rare view into what research into the primary determinants of asthma at the population level actually looks like. In other words, what changes (with some evolutionary probability) are occurring to shape the overall prevalence of asthma in a population. [Some great coverage of Kathleen’s talk]

My talk weaved together research on asthma over the past 15 years in India, Wisconsin and among Native Americans in the US Southwest and Alaska, to highlight variability in the diagnosis of asthma among physicians and in the management of the disease day-to-day by local populations. The Univ of Wisconsin issued a press release on my talk here, and Rachael Rettner, of MyHealthNewsDaily, wrote one of the better articles on my presentation.

Anna Di Rienzo, from the University of Chicago, summarized her work scanning the human genome for genetic adaptations to environments and climates. Many alleles she discovered overlap with those identified by recent genome-wide association studies, including polymorphisms associated with pigmentation, autoimmune diseases, lipid levels and type 2 diabetes.

Pete Zimmerman, from Case Western Reserve University School of Medicine, reported some very interesting findings from Madagascar, where something important is happening with the malaria parasite, P. vivax, to permit it to infect Duffy blood group-negative people, who have formerly been resistant to P. vivax infection.

Margaret (Peggy) Bentley drew from her incredible trove of filmed infant feeding observations from around the world to talk about how to improve growth and nutrition in different cultural and economic settings.

Unfortunately, Marcia Inhorn, who was supposed to be on the panel was unable to make it. She was scheduled to give a talk on assisted reproduction in the Middle East.

I really enjoyed the meeting and the time we got to spend together as a group. I love seeing anthropologists like my colleagues on this panel working deep in complex, meaningful fields, and yielding great progress through cross-pollination, unending curiosity and observation.

The limits of adherence to daily asthma treatment

In an interview with the BBC about an article published by his group in the Lancet, Fernando Martinez, from the University of Arizona, said: “If you have a daily drug and a very significant number are not taking it, then that tells you it’s a losing strategy.”

The BBC summarizes: “Researchers at the University of Arizona believe there is a problem with the way the disease is managed.”

I think Dr. Martinez has framed lack of adherence in a different and potentially productive way.

Only half of specialist referrals ever happen

Indiana Univ study shows that only 71 percent of patients age 65 or older who are referred to a specialist are actually scheduled to be seen by that physician. Furthermore, only 70 percent of those with an appointment actually went to the specialist’s office. Thus, only 50 percent (70 percent of 71 percent) of those referred to specialist had opportunity to receive the intended care.

My ER Wait Times Experiment

Last year, I became interested in emergency room wait times when a family member needed medical attention but did not want to spend his day waiting for treatment.

I had recently seen an article about the growing number of hospitals publishing their wait times online, but since that information is scattered across multiple sites, I found it a challenge to quickly compare and evaluate wait times in a given geographic area.

In addition, I found that there was no mechanism for people to independently report how long they waited to be seen by a physician.

As an experiment, I built ERwaittimes.us to aggregate current wait times published by hospitals nationwide and to provide a way for people to add their own wait times for every emergency room and urgent care. So far, it’s just a simple site that needs a lot more development. Please let me know what you think of the idea and how it could be improved.