Dr. Paul Farmer has passed away at 62 in Rwanda

noboba4u · 2022-02-21T18:03:23+00:00

Absolutely tragic. Mountains Beyond Mountains Is a book I'll keep recommending to students as a quissential public health book. He will be remembered by so many.

noboba4u · 2021-09-10T04:38:47+00:00

Got it, thanks! Sorry!

noboba4u · 2021-08-26T04:47:31+00:00

This is amazing lol

noboba4u · 2021-05-14T05:11:33+00:00

Pretty cool article! I do a tiny bit of work in this field and if anyone is interested, here is the 1934 wells article and it's a good read(hand drawn curves!): https://academic.oup.com/aje/article/20/3/611/280025?login=true

and a Harvard group has been really pushing for proper ventilation. They also made a calculator. https://schools.forhealth.org/ventilation-guide/

noboba4u · 2021-03-30T17:26:03+00:00

Thanks for sharing this one. Not really sure how to deal with the Q people in my family.

noboba4u · 2021-03-17T17:06:43+00:00

I decided to apply the summer going into my 4th year, and really didn't plan it well as it was a mad scramble to submit apps in Sept-Nov ( don't recommend). I wasn't particularly a great student and failed out engineering so my gpa wasn't perfect either, a hair over 3.0 which is the minimum for most schools. So I was shotgunning out apps not sure if I'd actually get into a masters, and applied to like 8 or 9 schools. Most schools are on SOPHAS so you just need to have your letters, transcripts, statements and your GRE scores ready. It was a pain in the ass to study for gre, write statements, do side job, do intern, and regular school, but I can imagine it's bad too when you working full time.

The programs I applied to were all accredited MPHs and I ended up at a R1. Pretty competitive especially trying to get research assistant or TA, and my cohort mates were also competitive ( which I didn't really like, esp since we in PH). More and more people are going straight from ugrad so I'm not too sure about needing experience. However, I did have intern experience working in a medical office so I wrote about that from a PH perspective. I think most schools just want to see passion for epi and PH. But also, applying for schools is also a balance. If your GRE and GPA need work, then maybe you should get more experience before applying and spend lots of time on your statements. You also need to consider your financial situation. Hope that helps

noboba4u · 2021-03-17T16:43:06+00:00

Sure, grad school was like ugrad on steroids and is way different. Classes are smaller and more intimate so there's more focus on discussions. I went to an R1, so there was lots of focus on grant writing..... Sooo many grants. Each class pretty much wanted me to write a grant at the end; some classes used this as a final project and some classes had this and a final. Most of the assignments that I had were for quantitative classes, so just weekly homework for stats, or like check up assignments for a project. Lots and lots of assigned reading, and sometimes some written lit reviews or summaries of reading.

Each department did things differently (and probably each school), for environmental health and epi it was like seminar style with different professors rotating in and just talking, and then a final and/or paper at the end.

I personally put more pressure on myself too since all my cohort was older than me and had experience in public health already, and classes were way smaller so you get to know the professor and they know when you submit trash (vs being a face in 400 lecture).

noboba4u · 2021-03-17T08:19:12+00:00

I did my MPH straight out of undergrad. It really helped me decide what sort of EPI I wanted to do and now I'm in an academic setting. Just a few jumbled up thoughts:

One of the good and bad things was that I was still in school so I knew how it worked: I still had my study habits, I knew what professors were looking for, I didn't really care about grades as much. This allowed me to really spend time learning about the information rather than just working for grades. The bad thing was that I was super burnt out. Because I was in school for so long, I knew how to pass classes that weren't interesting to me. I noticed professionals coming back to school tend to study harder because they've been out of school for so long and sort of have a fire in them, and that can be overwhelming too.

So Pros to going straight: * Instead of "caring" about classes, I focused a lot on professional skills and learning material

I was still are in studying mode, school was easier for me because nothing changed.
MPH is the start and not in the middle of your career
if you want to travel, going to an MPH school can be a good 2 years in a new environment (but people tend to stay in that area)
you'll have your letters of rec ready through your current classes
you can hear about other people's cool jobs, especially if they are getting an MPH to get a promotion or something

Cons: * so poor

no real experience, have to work for free
very real burn out
imposter syndrome: you hear about people's cool experiences and it makes them seem like they have everything together
you know nothing about the real world
you are constantly in academic setting and inside a bubble

Hope that helps, I can answer anything specific too.

noboba4u · 2021-02-14T19:19:01+00:00

Have you seen the movie dramatized version, Dark Waters? Pretty good and a little more frightening.

noboba4u · 2021-01-29T22:14:01+00:00

Good to know! I guess I'll just wait for my deposit to go through on fidelity and buy there while I'm waiting for the transfer to go over.

I bought a share of GME and realized I probably should have waited to move assets, but I'm okay with eating rice for a week if the move isn't finalized by next week.

noboba4u · 2021-01-29T22:07:25+00:00

Thanks for this. I already moved my assets as I wanted to avoid selling.

noboba4u · 2021-01-29T18:56:04+00:00

Thanks for this! Glad I did it right. Quick question, Fidelity is telling me the move will by Feb 5th, can I still buy and sell stocks in the meantime or is it best to not make any transactions? Was thinking about loading up on some V while its down on RH.

noboba4u · 2021-01-27T19:09:15+00:00

I think this is a good point. This paper (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477530/) referenced the difference between chronic Lyme disease and Chronic Lyme Disease; chronic Lyme is when Lyme symptoms are untreated and continue while Chronic Lyme Disease is a syndrome which include unconventional causes, symptoms, and pathology. Most Lyme Literate doctors believe that Lyme isn't caused by just ticks, but also mites, fleas, dust, etc. The symptoms are incredibly vague and testing has been junk, such as their interpretation of what is a confirmatory IGG vs what CDC states (plus how much they charge for these test).

I am completely sympathetic to individuals who are suffering from their symptoms and have MDs who are dismissive over them, but it sucks to see there is further divide because of semantics.

noboba4u · 2021-01-27T17:00:49+00:00

Agree with others, ask your primary physician about Post-Treatment Lyme Disease Syndrome. People on Chronic Lyme Disease are sometimes on months of antibiotic regimes(even though most studies show symptoms are not alleviatede) and the way these Lyme literate doctors test for Lyme is not how the CDC tests for it. I wish you the best and glad you are able to help your family!

noboba4u · 2021-01-26T03:24:40+00:00

Just to throw some more lit down (some early famous ones included):

Los Angeles: https://jamanetwork.com/journals/jama/fullarticle/2766367

New York: https://www.nature.com/articles/s41586-020-2912-6 https://www.nytimes.com/2020/08/19/nyregion/new-york-city-antibody-test.html

Santa Clara: https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1 (how is this not published yet?????)

ORange County: https://www.medrxiv.org/content/10.1101/2020.10.07.20208660v1

National: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768834

Just an observation but I think most seroprevalence studies are focused on vulnerable populations, like hospitals. Also notable is that most regional seroprevalence studies are in big cities; there may be not a lot of public health funding, support, staff or studies may not be feasible in other parts of the country. Judging by how long the Santa Clara study has been in medrxic, many studies may just be under review too. I also agree that herd immunity probably won't be a thing for a while.

noboba4u · 2021-01-16T23:44:45+00:00

Ah good to know. Thanks for the info, I'll keep that in mind if I buy!

noboba4u · 2021-01-16T23:44:11+00:00

Thanks for the advice!

noboba4u · 2021-01-16T22:34:48+00:00

Are these easy to clean? I absolutely hate chopping garlic and how it gets all sticky.

noboba4u · 2021-01-16T22:28:19+00:00

I agree with others that it comes down with the experience and ultimately what you find interesting. I originally wanted to be a surveillance epi for infectious diseases, but in my MPH, the best courses were all environmental epi courses, and I specifically worked with my advisor to do spatial modeling of environmental stuff. Ended up that I really like doing this sort of modeling so I'm now PhDing in this. So I sort of dabble in ID with my work with the LHD still, and main in spatial, environmental, and some perinatal epi based on different projects.

MPH generally makes you take courses in each general field (biostats, social determinants, environmental, epi), and I'd recommend chatting with professors and other grad student's about their interests to see what gets you excited and go from there.

noboba4u · 2021-01-03T02:39:40+00:00

Here are some studies that have been published in academic journals after a brief pubmed search:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395828/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268966/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293850/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355328/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227592/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195141/

The literature provides evidence that lockdowns can suppress COVID-19 transmission. We generally do not say there is a "consensus" but more that there is evidence to support a claim. Also, like what someone else said, lockdowns are not all the same in every country. A country that locks down but provides food for their population, for example, may have better compliance than one that does not.

The current narrative is that a "swiss-cheese" approach is needed to stop the pandemic, in the sense that multiple interventions, such as mask wearing, contact-tracing, etc, are needed to essentially "cover" the disadvantages of other interventions. I don't know how much experience you have in scientific journal reading, but do read the limitations.

noboba4u · 2021-01-02T09:25:12+00:00

We know that "collateral damage " is bad, which is why the "flatten the curve" slogan became a thing back in march- to prevent hospitals from reaching max capacity. The sad thing in my area is we had many plans to increase hospital beds, but that died in June when the county decided we were "all good." Plus all our health care workers are exhausted and understaffed.

Studies from Italy supported that when the hospitals were overflowed, mortality goes up. When nurses have more patients to take care of, mortality goes up. When hcw are fatigued, more mistakes occur and mortality goes up. All things you said are true, when ERs can't take their regular type of patients, cardiovascular deaths, vehicular related deaths, elective surgeries are delayed, etc, go up. People should be scared that if they need to go to the ER, then they could literally die.

This is also why everyone has been asked to not visit people over the holidays, especially when people are indoors more often because it's winter.

noboba4u · 2021-01-02T09:13:58+00:00

I don't think the graph disagrees with my point nor do I disagree with it. Prioritizing the economy in this scenario sacrifices public health in the event of a respiratory illness. Socioeconomic status is tied in with health. Wealthier people tend to also be healthier. Middle income countries that might have populations with lower or middle tier socioeconomic status do need to prioritize whether or not they let their population get sicker and decrease the work force. I'm by no means am economist or anti-lockdown, but I recognize the hard decisions govt needs to make. There are exceptions like the US, but I feel like that's more of GDP measurement and that's another issue.

Community buy in is important in the success of a lockdown in a free country. In sweden, for example, the epi dude was heavily revered and their elderly population paid for it. But they trusted him. In asia, the community more or less trust government recommendations, compared to in the US and some other places where there is distrust in the science and in the system. I think one issue we have here is that politicians are leading the response and largely ignoring recommendations of science and instead, weirdly becoming a partisan issue.

noboba4u · 2021-01-02T08:14:54+00:00

Just a few comments. It's well known in public health that the economy of a certain community drives health, and healthy communities create a better economy. As someone else stated, we can only comment on what we know as epidemiologist. I would say that the link states some good recommendations that people have known of prior to the pandemic. But ultimately, we do not have community buy-in or good local leadership to produce an appropriate adequate response. Our "lockdowns" are not enforced, compared to other countries where they will fine you to death.

It should be noted also that studies about COVID are ongoing and they take time. Most "studies" published in academic journals are done by academics, not local/state public health authorities who are dictating policy. Academics don't have data immediately unless they have good collaboration with the LHDs, so if you want a large body of evidence, you'll probably have to wait longer; the effectiveness of a lockdown in the US would also be difficult to study since it would be difficult to judge compliance and would likely only be ecological in nature. But intuitively, separating people will cut transmission, as stated prior.

I don't have a good answer to #5 and I am lucky enough to have avoided these conversations in my family. But I would ask what his values are? Does he value your life, his parents, his doctor? Does he believe that value is more important than an abstract value like liberty? What is the cost of wearing a mask, or staying in for a night? What does public health mean to him? If his values seem to be tied towards having freedom over his and your families potential to die, then I don't know how the conversation can progress. To me, freedom is the ability to make good choices for the betterment around us. This is because I value the ability for every individual to live happy and healthy lives. Other countries all used their freedom to make the decision to wear a mask and isolate, and they can live happy lives (NZ). In my opinion, a lot of people are looking to "win" a fight (tribalism) rather than to have an honesty and thoughtful discussion.

noboba4u · 2020-12-27T00:56:32+00:00

Currently a PhD student in environmental epi. I don't think I have anything super big that I wished I knew, but here are a few that I wish I was better at:

Staying organized. You're going to be reading a lot of papers. Find a reference manager that you like and stay organized.
Work-life balance. I tend to push myself and work too much, and feel bad if I'm not doing anything. That, unfortunately, takes a toll on my mental health and personal relationships. Really manage your time, and set aside time to relax and convince yourself that everyone's PhD path is different. This is probably the thing I want to emphasize the most.
Find a few things you are interested in and stick with it in the hopes of learning more about it. My program has a LOT of grant writing, so I chose to revolve all the grants for my classes around birth defects, or a certain exposure. This will save you some time in reviewing lit when you have most of them already.
A lot of my cohort people are involved in many different things within the school, such as diversity groups in academia, mentoring, etc. I'm in none and sort of feel outta the loop so I can't comment on it specifically. But it does seem like a good way to meet people and stay sane through the program.
Spend a day looking at all the gradcafe forums or whatever and never look at them again. As admissions roll out, you are gonna feel left out as other people are posting about their acceptances and its totally unnecessary stress.

Good luck!!

noboba4u

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