Obesity bigger problem than Underweight says Lancet Study - Really???

Maybe the Lancet didn't really say this, but the SMH subeditor certainly did. MPH students - is this is anexample of how a graph can abstract us from the lived experience of those who are graphed? Yes the lines showing % of population with obesity and underweight cross around 2006 - but are these meant to be equal "problems" measured on the same scale?  I suspect the suffering of the hungry underweight is much greater than those weighing in as obese. Isn't it more complex than this graph would suggest?

International Workshop on Participatory Surveillance (IWOPS) in Newcastle

Just had the wonderful opportunity to convene the 3rd IWOPS in Newcastle. Great to catch up with colleagues from around the world working on participatory surveillance. Thanks so much to the Skoll Global Threats Fund for supporting the workshop.   The workshop ended with a seminar at HMRI which is available on Youtube. I interviewed a range of innovators on the enablers and supports for innovation in public health surveillance - both organisationally and personally. And asked them what was around the corner for innovation in public health surveillance from a tech perspective.

Bullshit for You - Transcendence for Me

So for some reason I wrote a response (the reason will be the subject of a later post) to Gord Pennycook's article On the reception and detection of pseudo-profound bullshit entitled  Bullshit for You; Transcendence for Me.  I admit I was way out of my depth but I found the editorial process mediated by the journal editor Jonathan Baron very stimulating. Even though I was attempting to crtitique Gord Pennycook's paper, he and I exchanged several cordial emails and was left with a great admiration for the graciousness of Pennycook and his team. It seems there may even be a new discipline of Bullshit Studies. emerging.

One of those journals that has an internet robot inviting academics to resubmit their papers to their pay for publication predatory journal contacted me as a recognised expert in Bullshit...email transcript follow...

The Public Service has to do More with Less - Unquestionable?

So this is an email I just found that I sent to the NSW Public Service Commission general feedback email address on 30th November 2011  - with no response:

'Hi I have some feedback on the Workwise newsletter - actually its more a question..

In the newsletter it states:

"Productivity

All public sectors around the world are under pressure to deliver more services to the public with the same or fewer resources."

What does this mean?  What does the author intend by this statement?

Is this a statement that is meant to legitimise the provision of more services to the public with same or fewer resourcs as a normative position - because it is a"worldwide" phenomena?

Is the statement lamenting the requirement for provision of more services to the public with same or fewer services?

Should a public service commission provide sophisticated values-based analysis of contexts and question why this is happening world wide -  when it severely impacts upon the very services the commission is attempting to optimise?

How is it in the 21st century that the public service should be expected to receive less funding without questioning the moral and ethical implications of this statement and just accept it as a "given"?

thanks, Craig.'

Contemplative Practice Workshop Primer for Public Health Congress

 So here is a primer for the Contemplative Practice in Public Health Workshop I will be running at the Public Health Congress in Hobart on Tuesday morning next week.

Hopefully this will help prepare everyone so we can get the maximum benefit from the workshop time together. The workshop will be approximately 1/3 theory and 2/3 practice.  Theory - how are the roots of contemplative practice found in Buddhism, Greco-Roman philosophy and Christian medieval practices relevant to the academy today? And what have I learned as a convenor of an undergraduate course on contemplative practice over the last 2 years.  But at least two thirds of the workshop will be experiential contemplative practice (starting with basic meditation which is the "container" that provides a safe space for potentially challenging contemplations).   The traditional contemplative practices have mostly been lost from western philosophical schools but were once the very basis of the academy - they have application in any professional field.  Public health practitioners have found the practices valuable for examining ethical issues, overcoming interpersonal conflicts in teams, and reflecting on the values they bring to public health.  I am happy to take any questions about the workshop via email (craig.dalton  newcastle.edu.au).

So here is what can you do to prepare for the workshop (in order of importance):

1. Watch this video by Mingyur Rinpoche on "What Meditation Really Is".  This video helpfully dispels many of the western misconceptions about meditation. Try practicing any simple meditation practice such as just watching your breath for 5 minutes per day based on the advice in this video.
2. Choose a "problem" or challenge to use during the contemplation sessions - what's a good problem? Something that causes recurring discomfort - a problem with a coworker, a partner, an area of indecision, an ethical challenge in public health practice or conceptual conundrum. Bring it to the workshop.
3. Consider reviewing the evaluation of the pilot program in 2012.

Look forward to meeting you in Hobart!

Brief one page description of the program I ran for our local population health unit:

Contemplative Practice in Public Health

This program was inspired by the incorporation of contemplative practice into programs at the Royal University of Bhutan observed by Dr Craig Dalton during his secondment to Bhutan in 2010.

There is absolutely no inevitability as long as there is a willingness to contemplate what is happening – Marshall Mcluhan

Public health practice is a highly complex and busy undertaking. We “do” many things that have far reaching societal impacts and make choices among an almost infinite number of public health activities. Rarely do we have the opportunity to stop and step back from the sweeping flow of this activity and reflect upon our role in it.  While contemplative practices are rooted in the religious and spiritual traditions, they have an important place in intellectual and ethical inquiry.  

The Contemplative Practice in Public Health at Hunter New England Population Health teaches practitioners:

·         Mindfulness based meditation as a support for contemplative practice

·         Analytical and Resting contemplative practice that alternates between conceptual and non-discursive contemplation

·         A practice to arouse and affirm our altruistic motivations as public health practitioners

·         A method to contemplate and explore the role of our own cognitive biases and ego-centric habits that create further complexity in an already complex world.

Feedback from participants of the program:

“After my first session I felt different, it gave me a different perspective on some things and I really found the concept of mindfulness (without wanting to sound over the top) life changing. I have enjoyed the “mind game” of stepping out of myself and watching how I am acting or speaking and thinking “would I like/ agree” with myself right now. I think this has altered my behavior both at home and at work. It has really helped me understand some colleagues and family members behaviours and altered how I interact with them, with I think, some really positive outcomes.” 

 “I am now looking at journal articles with an eye for underlying values, whether they are explicitly stated or not. The contemplative practice program has helped me to start to draw together the bits that have intrigued and bothered me over the years, it is another (large) step in the journey.”

“An excellent course. I think that it offered a taste test of a lot of complex issues and I would like to   spend more time on these topics/issues in the future.”

Housing Bubble identified by Google Trends ahead of commentators?

Error (title should read Google Trends, not Flu trends)

 First the disclaimer - I am a medical epidemiologist not a real estate data analyst, and no real experience analysing Google Trends data streams - although I did receive some insights into this when invited to Google in 2010 and left very impressed by their methods. (yes even Google Flu Trends). But draw your own conclusions from this graph - would you you invest now?  The search trend was skyrocketing in April - well ahead of todays surprise acknowledgement of the bubble by the Treasury Secretary John Fraser. 

Flutracking breaks record of 23,000 responses per week in 2015

2015 has started as a big year for FluTracking.net, we are receiving over 23,000 responses from across Australia every week (most within 24 hours of sending the Monday morning survey.  We are still seeing low level early season influenza activity at this stage. Please invite your friends and work colleagus to join. You can see the real time engagement on our website on a Monday morning here

How to investigate health and coal mining in the Hunter

Published an article Investigating the health impacts of particulates associated with coalmining in the Hunter Valley in Air Quality and Climate Change.
Particularly want to thank the authorship team and in particular C. Arden Pope III as senior author on the paper. Interestingly, some commentators on reading the paper alleged we were "pro-mining" but there was no dispute on the facts presented.  You only have to see how Republican politicians have attacked C. Arden Pope over the years and note my "Vote Green" election poster out front of the house to suggest we are unlikely to be biased towards mining.  Bias is dangerous - you build a house of cards and then you try to defend it.

Dangers of Western Methods in Indigenous Research

 During my time teaching public health in Bhutan I became very aware that many of the supposedly value-free public health concepts I was teaching were dripping with western world views that were almost invisible to me.  Even our ideas of time and space in the west can undermine Indigenous world views.  I got to feeling that just exposing Indigenous students to these ideas was a kind of violence against their culture.  So when I saw the article by Roy suggesting that epidemiology and public health had many parrallels to Indigenous ways of seeing the world I felt compelled to question this - particularly when the author appeared to question Shawn Wilsons's writings, so I wrote this letter to the editor with Shawn Wilson.  Interested in thoughts???

Bath milk - cosmetic or bacteria-laden drink - Conversation piece

So the satirical tone of my article in The Conversation was a little too subtle and some folks thought it was actually an article about cosmetic safety, not food safety.... here

Tax Inspectors Without Borders may prevent next Ebola outbreak

While much of the focus has been on the public health and medical response to the current Ebola outbreak in West Africa, in terms of prevention we need to think beyond medical interventions such as new vaccines.  If we think about the broader determinants of health in society it may be that the work of Tax Inspectors Without Borders will lead the prevention of  Ebola outbreaks in the future - my article published in The Conversation today explores this idea.

Flutracking Launch Video - Tracking Flu Near You

Flutracking has launched again for 2014 - we made this short animated explainer video.  Invite all your friends to join Flutracking.net - takes just 10 seconds per week!

Rapping for Marriage Equality - Professor Macklemore

Something I recently put in the Newcastle Herald. The concert was great!  He has a huge heart!
This IS public health in Action.
If you haven't seen it already - watch the Same Love music video here and share it with your friends - it could really save lives.

Young Gay Men Bullied to Death - more data just in..

As if we need more data to convey the impact of homophobia, stigmatisation and outright bullying on suicide among young gay males, adding to the prior post on this subject, this article in the latest issue of the American Journal of Public Health: Intersecting Identities and the Association Between Bullying and Suicide Attempt Among New York City Youths: Results From the 2009 New York City Youth Risk Behavior Survey found that the effect of bullying on suicide attempt was strongest among non-Hispanic sexual minority male youths (odds ratio = 21.39 vs 1.65–3.38 for other groups).  A public health tragedy that needs greater intervention.

Duelling Rail Corridor Coal Dust Studies Confuses Community

THE latest of three local (Newcastle, Australia) rail-corridor studies on coal dust was released last week. I published an opinion piece on the confusion these duelling dust studies are causing in the community.
The first study was released by the Australian Rail Track Corporation (ARTC) in October 2012. It had multiple limitations and was dismissed by community activists. Under the auspices of the Coal Terminal Action Group (CTAG), they responded by designing and conducting their own community-funded study of coal dust in Newcastle and the Lower Hunter coal train corridor.
The community study also had multiple limitations including - according to Professor Howard Bridgman, the consultant to the study - an inability to reliably calibrate the particle monitors.
Now the ARTC has released the third study of coal dust in the rail corridor. CTAG has dismissed this and says it will begin fund-raising to conduct a fourth study.
Many members of the community are confused by the duelling claims of health impacts and the uncertainty surrounding each of the studies. Uncertainty about health impacts is itself a source of psychological stress and a cause of poor health. More here

Same Love - Rapper Leads Public Health Campaign for Marriage Equality

When I  think of needless public health tragedies, uppermost in my mind are smoking and the suicide of young gay men who feel there is no place for them in a homophobic world.  Lutwaks short piece and accompanying references in The Impact of Not Legalizing Same-Sex Marriage on the Lesbian, Gay, Bisexual, and Transgender Community in the American Journal of Public Health again identifies more evidence that the stigmatisation of gays, lesbians and transgender people leads to suicidal ideation and suicide.  Equal right to marriage is an important public health initiative that can help redress this stigmatisation.  I am grateful to my teenage sons for introducing me to Mackelmore, the rapper from Seattle and Same Love  - the words and images in the music video are raw and honest and there is a touching story played out in a "short film" format.  Send this Youtube clip to everyone you know, the more young (and old) people that see this the better the world will be. Here is a taste of the lyrics..

International Online Influenza-like Illness Surveillance Systems Unite

On April 15 in Amsterdam, the three largest online ILI surveillance systems in the world signed an agreement to share data and harmonise analysis and data display to help build a global picture of influenza transmission.  The collaborators at the official signing were the lead researchers (from L to R) from Flutracking.net Australia (Craig Dalton),Influenzanet Europe (Ronald Smallenburg and Daniella Paolotti) and Flu Near You USA (John Brownstein - Health Map and Mark Smolinkski - Skoll Global Threats)
More on the share learnings from this meeting soon.

Submission to the Air Pollution and Health Senate Inquiry

I made a submission to the Senate Inquiry into the Impacts on Health of Air Quality in Australia as a private citizen entitled How to investigate the impact of coal mining on community health - a  Hunter Valley Perspective.
It focused on 3 suggested solutions:
1. Integrate toxicological and epidemiological research to identify the major sources of
environmental health risk and quantify the risk.
2. Develop an independent Environmental Health Investigation and Conflict Resolution
Centre in the Hunter to:
a. Respond to the environmental health concerns of the community.
b. Initiate participatory research on the environmental health impacts of mining
and related industries collaboratively between community, academia and
government.
3. Develop better methods for assessment and approval of major projects that are
strategic, based on explicit values, participatory and deliberative with stakeholders.
It received some local coverage in Singleton Argus and ABC 1233 and the EPA have started discussing the conceptual model for balancing psychological and physical risk on page 8 of the submission.

H7N9 - Betting its not a pandemic in the making.

So the world is watching the emergence of H7N9 avian influenza - the H7 strain not usually infecting humans - causing severe illness and death in China. But I think it is this paper: Using Routine Surveillance Data to Estimate the Epidemic Potential of Emerging Zoonoses: Application to the Emergence of US Swine Origin Influenza A H3N2v Virus,  and reflecting on the emergence of the 2009 pandemic that causes me to doubt the pandemic potential of an influenza virus that, when we first hear about it, is apparently directly associated with zoonotic spill over - not in all cases but in significant numbers of cases. 

I think the chance of us “being there” in the early days or weeks of the next pandemic and actually seeing it spill from animals to humans is extremely remote and so when we see significant numbers of cases associated with chicken or pig exposure, as in the current H7N9 issue and the recent pig associated H3N2 clusters in the USA,  then I suspect it will more often then not stay that way.    I suspect most of the initial spill overs will escape our surveillance and arise in humans without any immediately recognised links to animals – as did the 2009 H1N1 pandemic.  But this is just a probabilistic argument which will fail sometimes - hence the need to remain watchful.

CDC Conference 2013, Canberra, Australia - Day 2

 Day 2 of CDC 2013, the main themes were foodborne disease, vaccine preventable diseases and anti-microbial resistance.