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William M. Silberg, is a strategic publishing and communications consultant with 30 years experience in health, medicine, health policy and science, in both the professional and consumer sectors.

A recent paper in the American Journal of Preventive Medicine (disclosure: I’m AJPM’s Editor-at-Large) offers some sobering data relevant to any health professional trying to make sense of clinical guidelines and, more importantly, help patients and the public with that plaintive question – “so what should I do?” Further, it’s a powerful example of what happens when health, media and policy, um, “collide.”

The paper, by Linda B. Squiers, PhD, and colleagues at RTI International, looked at media coverage and sampled public understanding of the November 2009 release of new mammography guidelines by the US Preventive Services Task Force (USPSTF), an independent panel of experts in primary care and prevention. The new guidelines, which update those the Task Force issued in 2002, recommended against routine mammography for women prior to age 50 and suggested that screening end at age 74. They also recommend changing the screening interval from one to two years and suggested that women aged 40 to 49 who are at high risk for breast cancer consult with their clinician about the optimal time to begin regular, biennial screening mammography.

The bottom line: many women told the RTI researchers in a web-based survey that they were confused by the new guidelines. Those confused most? Women aged 40-49 and those who’d never had a mammogram or had one more than two years ago.

Renata Schiavo, PhD, MA, Associate Professor, Director, Comunity Health/COMHE Program at CUNY School of Public Health at Hunter College. 

tclogoThe 2011 Seventh International Conference on Technology, Knowledge and Society was held at Universidad del País Vasco – Euskal Herriko Unibertsitatea Bilbao, Spain from 25-27 March 2011. The conference and its associated journal were created to provide a transdisciplinary forum that examines the relationship between technology, knowledge and its societal context. This is a forum that brings together a diverse range of researchers, teachers and practitioners. It serves as a meeting point for technologists and those who may work in non-technological areas, but are nevertheless concerned with the social impact and import of technology.  In addition to its plenary sessions, the conference also includes virtual presentations to expand its reach and to include presenters who may not be able to attend in person.

Have you ever sat through a meeting and endured the pain of a text-heavy slide that the presenter then reads verbatim the text on the slides?

(Image from Flickr/CreativeCommons)

(Image from Flickr/CreativeCommons)

This sort of drivingly dull exercise is how the vast majority of academic presentations go.  The use of presentation software, most often the Microsoft-branded Powerpoint, ends up being a slow, painful experience widely known as “death by powerpoint.”

My own personal (anti-)favorite version of this is the text-filled slide, built using one of the standard, awful templates that come packaged with Powerpoint (PPT), that the presenter then *reads* to the audience with their back turned to everyone in the room while they look at the slides (as in the image here).   This is not only insulting (I’m not an idiot – but I feel like one when you read to me) it’s also a very ineffective way to communicate a message.  People can’t actually read and listen at the same time, or – they can, but they end up getting less of what you’re trying to get across to them.

To avoid this, academics doing presentations need to think differently about their use of slides.  A much more effective use of slides is to consider them visual illustrations of the key points you want to make.   Begin to think of your presentation as a “slide deck” filled with images and a little text, rather than a way to dump a huge bunch of text.

Guest Post by Michael Lerner, PhD, President, Commonweal, Co-Coordinator of Collaborative on Health and the Environment’s (CHE’s) Breast Cancer Working Group, Co-Coordinator of CHE’s Cancer Working Group, Co-Coordinator of CHE’s Integrative Health Working Group

The crash and burn of an autism guru. Andrew Wakefield has become one of the most reviled doctors of his generation, blamed directly and indirectly, depending on the accuser, for irresponsibly starting a panic with tragic repercussions: vaccination rates so low that childhood diseases once all but eradicated here have re-emerged, endangering young lives. New York Times [Registration Required]

This article in The Times and the Robert MacNeil autism series on PBS are both testimony to how the public and scientific dialogue on autism is changing.  Martha Herbert of Harvard was a leading voice in MacNeil’s documentary.  Herbert is a senior advisor to CHE-Autism, and one of the most distinguished proponents of the new paradigm of autism research and treatment.

When MacNeil on PBS gives such strong authoritative visibility to Herbert’s perspective, it is clear that the field has shifted in a significant way — and shifted in the specific direction that many CHE Partners have believed was warranted for many years.  So it is a good moment to reflect on what we are witnessing and lessons learned.

We are witnessing a decisive shift toward mainstream researchers recognizing a contributing role
of environmental factors interacting with genetic factors in ASD.  There is also, specifically, more mainstream recognition of the contribution of GI disorders to symptomatic distress in some ASD spectrum children — and the benefit of dietary change for some of these children. The debate continues over an essentially linguistic question of whether the dietary shifts that reduce symptomatic distress represent a treatment for the ASD disorder or simply a relief of GI distress unassociated with ASD. Those who argue the latter are on shaky ground because of the scientific evidence of strong gut-brain connections. Nonetheless, the linguistic conceit that this is “just” GI relief unconnected to the ASD disorder is a step forward since it allows mainstream clinicians to treat the gut disorder without needing to accept that for some children this may indeed affect the theoretically separate ASD disorder as well.  This reduces human suffering — the key purpose of the whole enterprise.

With this middle ground increasingly established, despite the linguistic variants of interpretation,  the remaining controversy shifts increasingly back to the vaccine debate, which has always been more hotly contested.  Part of that debate is whether vaccines contribute to the gut disorder.  Increasingly, we see some mainstream researchers agree that the role of vaccines in a subset of ASD children “deserves further study.”  This debate is, of course, so hot because of the concern of pediatricians and public health officials with declining vaccination rates and associated health dangers.  Again we see movement toward middle ground:  reformulation of vaccines, teasing apart which vaccines have a higher priority, teasing apart timing of vaccines, dis-aggregation of vaccines, and exploration of integrative approaches to enhancing resilience both to disease and to vaccines.

The lawsuit against U.S. oil giant Chevron brought by indigenous people in Ecuador’s Amazon can tell us a great deal about corporate propaganda, new forms of media activism – both good and bad – and the consequences these have for environmental health.

First, a little background if you’re not familiar with the case. Ecuadorean indigenous people said Texaco dumped more than 18 billion gallons (68 billion litres) of toxic materials into the unlined pits and rivers between 1972 and 1992, and that these activities had destroyed large areas of rainforest and also led to an increased risk of cancer among the local population. In 2001, Chevron acquired Texaco. The current trial began in 2003 when a U.S. appeals court ruled that the case should be heard in Ecuador.

A number of studies have attempted to quantify the health impact of the oil giant’s operations in Ecuador. Epidemiological surveys have confirmed what people in the area know from their own experience: rates of cancer, including mouth, stomach and uterine cancer, are elevated in areas where there is oil contamination. A court-appointed independent expert in the trial estimated that Chevron is responsible for 1401 excess cancer deaths.

The latest news in the case is that in February, 2011 a court in Ecuador ordered Chevron to pay more than $8.6 billion in damages ruling in favor of the 30,000 indigenous people represented by the suit.    However, Chevron has vowed to appeal the ruling, meaning that the long-running case dating from drilling in the South American nation during the 1970s and 1980s could last for years.

True to its word to fight the judgment at each step, just before the historic judgment lawyers for Chevron went to the U.S. District Court in New York and got a judge to issue an order to stop enforcement of the anticipated order.   The judge granted the order preventing enforcement, and the case remains in legal limbo.