Improving Health Outcomes among Head and Neck Cancer Patients
Tomorrow (2.17.12) – Free lecture/Seminar at Temple University
Improving Health Outcomes among Head and Neck Cancer Patients
Carolyn Y. Fang, PhD
Associate Professor and Co-Leader of the Cancer Prevention & Control Program
Fox Chase Cancer Center
941 Ritter Annex (Public Health Conference Room)
February 17, 12-1 pm
Studies of head and neck cancer patients have noted that the social environment may be associated with various cancer outcomes, including survival. To date, the potential mechanisms that may underlie such associations have not been well-studied in this population. This seminar will present data from our studies that highlight key pathways linking the social environment with biological processes that may impact cancer outcomes in this patient population. In addition, directions for future interventions designed to enhance survivorship will be discussed.
Sponsored by the Social & Behavioral Health Interventions (SBHI) lab and the Department of Public Health, Temple University
Funding Cut for Washington State Tobacco Program that Saved $5 per $1 Spent
In the December 2011 edition of the American Journal of Public Health a 10 year study of Washington state’s comprehensive tobacco control intervention found that for $1 spent by the state, they saved $5 in hospitalization and treatment costs. Wonderful! What an incredible investment! 5:1 return!
Here is a graph illustrating when their program went into effect and the decline in % Adults who smoke in Washington state (compared to the national rate).
The program consisted of indoor smoking bans, tax increases on tobacco products, media campaigns, a tobacco quit line, and community and school programs, among other components. This state-based program was meant to serve as a model for other states. Well, it looks like they did a great job. In terms of public health programs and cost savings of $1:$5 is excellent. So what happened? Washington Governor Christine Gregoire and the state legislature cut nearly all the programs funding for fiscal year 2012. Wait, What?!
Why would you de-fund a state program that is saving the state millions of dollars? Instead of writing in a little spending on tobacco control, they are essentially writing in five times the spending in state health care costs. The only explanation I can think of is that the state is so hard up for cash in the short-term that they are willing to kick those unfettered health costs down the road (and basically allowing for increased human suffering over the coming years). And/Or, given the current attitudes towards decreasing the roles of government, it may be that some folks view government-run tobacco control as outside the appropriate scope of government. Since tobacco does cost governments so much money in terms of care, it seems to me that they do and should have the authority to control the impact that tobacco has on the monetary bottom line. The health protection aspect is another story, one that gets at the heart of the arguments about the role of government.
Clearly, there is a lot of work that needs to be done in terms of high-quality research that demonstrates the cost-savings and health-savings afforded by public health programs like tobacco control programs. There is also work that must be done to frame the issue as one that governments should and very much need to be involved in.
Public Health and Environmental Advocacy Groups: YOU NEED CITATIONS!
This post is for everyone, but is aimed at public health and environmental advocacy organizations. First, I want to say that what you do is crucial to the success of individuals, communities and societies as a whole. I commend your hard work (most of it).
However, you often shoot yourself in the foot by failing to provide adequate citations and references in websites, flyers, radio and TV ads, PSAs, etc. Citations are often missing entirely, are incomplete, or only cite one of your own documents which is also missing the reference. This makes it impossible to find the article and will result in emails like this:
“Hello, I would like to know the facts behind your webpage regarding air pollution monitoring. Who is doing the monitoring? How regularly? What are the results and what standard is used? Does your group provide factual information or just distorted hype? Please have the fortitude to respond to simple factual inquiries. I have inquired multiple times without response.”
Painful, but he has a point. If you cannot provide the reference for a scientific study, you should not be using a specific number. For example, You can’t say that a certain law saved 100,000 lives unless there was some study or formulation done that came to that conclusion. Do not make claims that go beyond the scope of the research. Similarly, saying that a certain law or program would prevent “many” deaths, is a weak argument and is unlikely to garner support from funding agencies or politicians.
Failing to provide references and citations for actual scientific research that supports your arguments completely undermines an individual’s or organization’s ability to advocate for change.
The knee-jerk response to my point is often “Who cares, you can make statistics say anything you want.” That is true, to some extent, but that does not mean you should stop citing or conducting research. Providing a citation and reference enables someone from the outside your organization, outside the research, to examine the methods used to gather the data, look at the results, and see whether or not those methods and the claims that follow are appropriate.
This may remind you of high school science classes when you had to use at least 2 citations for a 3 page paper. However, the entire health and environmental advocacy field has shifting towards this standard, which it should! The way governments and organizations spend their money is being scrutinized at a higher level. That means that advocacy organizations need to step up their game in order to maintain relevance, earn respect from the public and public officials, as well as provide the most good for the most people using the least amount of money. Being more steadfast about basing advocacy work/products/literature on scientific research and using citations will not only improve your work, but will also preclude naysayers from claiming that environmental groups are radical zealots making unfounded claims. Like it or not, advocacy, especially in today’s world, requires some scientific prowess and familiarity with research methodologies.
If you, or your organization is uncomfortable with all of this, please, don’t avoid that discomfort. Instead embrace it as a new way for your organization to achieve it’s mission. Depending on your staff’s education, it may only mean that they need to be reminded to provide citations whenever possible. Or, it could mean that your organization needs to look at hiring individuals with a different skill set.
I know, it may be painful. Science and research are scary things to some people. Yet, they are some of the most powerful tools we have as health and environmental advocates. Good research is good advocacy. Good advocacy is based on good research.
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As a side note, unfortunately, many scientific articles are not available for free. However, many are! You just need to look. Open-access journals are out there. For example: Environmental Health. Also, many government websites provide their articles for free. Most other articles are available through college and university library systems. Institutions of higher learning spend millions of dollars annually to give their faculty and students access to the largest and latest research databases. HINT: Maintain staff or interns that are currently enrolled.
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If you have no idea what I am talking about, here is an example:
In your text:
“Research has shown that air pollution levels are higher in metropolitan areas (Dockery et al., 1993).”
At the bottom of your document/website
References
Krewski, D., Burnett, R., Jerrett, M., Pope, C.A., Rainham, D., Calle, E., Thurston, G., Thun, M. (2005) Mortality and long-term exposure to ambient air pollution: ongoing analyses based on the American Cancer Society cohort. Journal of Toxicology and Environmental Health, 68, 13-14.
For most purposes, don’t worry about the different citation styles, or having everything formatted perfectly. That would be great, but you must provide at least enough information for someone else who wants to find the article.
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A couple recommended links:
Smoke-Free Philly Video Contest
Attention Undergraduate & Graduate Students!
Enter the Smoke-Free Philly Video Contest for a chance to win $1000 while raising awareness about tobacco policy & control in Philly!
$1000, $500 and $250 will be awarded to videos ranked first, second and third. The winning video will also be featured on a local broadcasting outlet.
Entry Deadline – October 26th, 2011
For more info:
http://cleanair.org/program/indoor_air_pollution/tobacco_smoke_pollution/smoke_free_philly_video_contest
Structural Equation Modeling (Temple University Dept. of Public Health)
Structural Equation Modeling
Fall 2011 – Dr. Adam Davey
Temple University – Department of Public Health
SEM BLOG/JOURNAL
Selected quotes and my random thoughts as I take the SEM journey.
Here’s the text:
“Unlike multiple regression, though, SEM allows the analysis of curvilinear or interactive relations of both observed and latent variables.”
Whoa! Bring it.
“SEM readily allows the representation and estimation of possible
spurious associations because of common causes.”
On missing data (which is crucial to a proper SEM analysis)
“Also note that there is no magical statistical “fix” that
will remedy systematic data loss. About the best that can be done is to
attempt to understand the nature of the underlying data loss mechanism
and take preventive measures.”
The Power of (Blog) Writing
Despite the increase in use of audio and video formats written communication remains central to academic and scientific work. While publishing with journals is accelerating with online document transfer, the need for information in written form remains. As a doctoral student I am constantly writing, and need to be doing even more of it. I also need to be doing it faster, and at a higher quality.
Like any skill or muscle, writing benefits from exercise. I am choosing to exercise my writing skills through these (semi)regular blog postings. The blog format offers a sometimes less formal setting for free flowing thought, that can also hold manuscript style reporting; depending on the post, or my mood of the day.
Having the blog and knowing if it’s been idle also encourages me to take a more involved and connected role in the advancement of current science. As a professional in health and science fields, finding ways to stay current is crucial to our understanding of health issues, our ability to treat safely, and our ability to increase efficacy and cost-effectiveness across the board.
As an upcoming instructor/professor-wanna-be/researcher, this blog also reminds that what we really need is the opportunity to write. Sometimes you give yourself that opportunity (e.g. creating a journal or blog) and sometimes you are called upon to write something (e.g. my addictions summer class). Either way, writing happens.
Greenfest Philly – Saturday, September 10th, 2011
6th Annual Greenfest Philly
Saturday, September 10, 2011
Headhouse Square
Philadelphia, PA
Greenfest Philly educates the public about steps they can take to be more sustainable in their daily lives. The festival showcases 100s of exhibitors, providing a wealth of information and useful green products. By providing these educational opportunities and resources, Greenfest Philly wishes to impart that being green is something we can all do.
Greenfest Philly has been held the first weekend after Labor Day for the past 5 years. Urban Green Partnership, which created and grew Greenfest Philly, has passed the torch on to Clean Air Council to organize this exciting festival. This year we will be holding the event at historic Head House Square along 2nd St. between South St. and Pine St.
We hope you will join the Council on Saturday September 10th from 11am-5pm for music, food, fun and more!
—-Greenfest Philly is also looking for sponsors and exhibitors! If you are interested, please contact Martin Hage (mhage AT cleanair.org) at Clean Air Council.
p.s. I am DJing this event.
Mid-Atlantic Goods Movement Conference
The Mid-Atlantic region is long overdue for a conference that brings together various stakeholders to discuss the impact of goods movement on public health. Conference topics include goods movement industry trends in the Northeast, impacts on nearby communities, and collaboration to develop cost-effective solutions to reduce air pollution from goods movement. Bringing together health professionals and policy makers will allow these leaders to work together to develop and implement region-specific policies and solutions.
http://www.cleanair.org/calendar/healthy_people_global_goods_conference
Friday, September 23rd, 2011
University of Pennsylvania
Philadelphia, PA
For more information, please contact Katie Edwards at 215-567-4004, ext. 102 or kedwards (at) cleanair.org.
U.S. FDA Reveals New Cigarette Warning Label Images
FDA CIGARETTE HEALTH WARNINGS – LINK
The FDA has released the first warning images to be placed on tobacco products. This move follows suit with other countries around the world who have adopted imagery to discourage tobacco usage.
Free Quit Smoking Programs in Philadelphia
Temple University and the City of Philadelphia are offering free smoking cessation programs that include free nicotine replacement (the patch, gum, etc). Classes are offered all throughout Philadelphia.
For more information please call:
1-800-Quit-Now
or visit: http://smokefreephilly.org/
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