Day 2

TUESDAY, MAY 24 – Perceptions of Environmental Issues, Media Views of Sustainable Agricultural Issues, Environmental Realities of Disease

8:45 a.m. – Continental breakfast (Laminan Lounge, Olin Center)

Unless otherwise noted, the following events will be held in Olin 002, on the ground floor of the Olin Center

9:00 a.m. – Discussion of sustainable agriculture articles

9:30 a.m. – Media Perceptions and Environmental Issues (Julie Dobrow)

10:15 a.m. – Field trip to Waltham Fields Community Farm, picnic lunch

2:00 p.m. – Case study #2: Realities of disease- the vaccination debates (Wendy Wornham, Children’s Hospital/Harvard Medical School/Lexington Pediatrics)

  • Vaccination – Historical and contemporary issues
  • Environmental issues, hype, issues for the practicing pediatrician and the parent

Discussion

3:00 p.m. – wrap up & thinking points

TUESDAY, MAY 24 – HOMEWORK

Find two examples of how a disease is explained and discussed.  For example, you could find a piece on the spread of a disease that’s appeared in a medical journal and in the Boston Globe.  Think about how the two examples can be contrasted, what this says about the dissemination of information about disease, how it does or does not reflect environmental and media issues, how they do or do not come together.  Post your responses below.

17 Responses to Day 2

  1. Matt Panzer says:

    I read about autism spectrum disorders (ASD) in two venues: (1) on a wikipedia page, and (2) in a scientific journal article in Clinical Psychology Review. It was interesting (but not surprising) how much more accessible/readable the content in the Wikipedia page was… for a non-expert, this venue seems to be highly preferable for gaining a basic understanding of a disease compared to the highly specialized scientific journal. The problem, of course, is that I am skeptical of Wikipedia’s accuracy in its content…. but I find it interesting that I often still turn there to get a “quick” introduction to a previously foreign topic. Do I see the two venues coming together (for the average reader)? Not so much – more like night and day in accessibility of the language used and how ideas were explained.

  2. Diego Millan says:

    looked at “Antiplasmodial and cytotoxic activities of medicinal plants traditionally used in the village of Kiohima, Uganda” from the Journal of Ethnopharmacology, Volume 133, Issue 2, 27 January 2011, Pages 850-855″ and found a detailed examination and discussion of the use of local plants to combat malaria. While the details over why/how some of the plants were effective, it does do a decent job of keeping jargon relegated to methods and discussion. By doing so, the authors of the article were able to introduce Malaria in a cogent manner with cited references to back up their claims. Visually, the tables were clear (even if some of the language was specific to those who study plants) and there was a color map showing the area in Uganda as well its relative location in Africa. All the context was helpful in creating an inviting atmosphere for the non-discipline reader, I felt. The conclusion also struck a wonderful balance between science and the need for existing biodiversity and the pharmacological knowledge held by the people in this particular region of Uganda.
    In contrast, I read a piece about Malaria and DDT from the May 18, 2011 NY Times. The piece, predictably it seems at this point, introduced the issue through the perspective of one farmer whose economic productivity was dealt a hard blow when DDT was used to combat malaria and he lost his organic certification (with the prospects of losing it for 15 years). The Times article went on to discuss the political issues surrounding the decisions and some of the fallout. The overlap between the articles would be their acknowledgment of the pervasive and difficult challenges in Uganda with respect to malaria and some of the ways in which people are using science to provide answers (albeit in vastly different ways!). More general, the Times piece was accessible and ran through multiple facets of the issue. This cursory approach gives the semblance of knowledge, but I think, following Al’s suggestion this morning, it is fair to say that much more prodding would need to be done.
    Comparing the two on how information is disseminated, then, we see the highly specialized report from the scientific journal focusing on a very narrow aspect of a larger issue, while the more general news article having to present a broader brush stroke (no surprises there). However, the Times piece pits itself as invested in the individual experiences, by discussing issues we are familiar with (DDT, spraying insecticides, the negative results of such actions), the only inlet into the issue are through avenues with which we are already familiar. In contrast, the journal article takes up the Ugandan perspective and really makes a strong case for understanding their medicinal practices (being the Journal of Ethnopharmacology that’s to be expected). So while the former seems to unconsciously (or maybe subliminally) place the U.S. as a super power making hard decisions that must be made, the latter seems to open up into discussions of biodiversity and ecological solutions that might be better for the environment.

  3. Michael Reed says:

    I read an article in the Guardian about a disease outbreak in greenfinches (a garden bird in Europe), and the scientific publication on which the story was based. Fortunately, the article was published in an open-source journal, so there was a link to it that the public could read.
    The news article reported England greenfinch numbers dropped by 1/3 in a year due to an outbreak of trochomonosis. A scientist was quoted as saying that this rapid decline in bird numbers in a short period of time from a disease shows that a rapid decline in bird numbers can occur in a short period of time due to disease. The article drew attention to the use of citizen scientists to gather the data. They claimed the disease spread by birds feeding each other (not too likely, from my perspective) and twice they told me that the disease was most common in Aug-Oct.
    The scientific publication on which the article was based said that a rapid decline in bird numbers occurred in a short period of time due to disease – and then gave lots of details on it. They tried to make the result sound novel, and it was within a narrow range of disease types and bird types, but it is not that unusual when considered across all bird species and other disease types.
    The news article did a fairly good job of reporting the scientific article.

  4. Michelle Boyd says:

    “Vitamin D deficiency soars in the U.S., study says”
    Scientific American
    Author: Jordan Lite
    March 23, 2009

    “Demographic Differences and Trends of Vitamin D Insufficiency in the US Population, 1988-2004”
    Archives of Internal Medicine
    Author: Adit A. Ginde, Mark C. Liu, and Carlos A. Camargo Jr,
    March 23, 2009

    The Scientific American (SA) article is reporting on findings that were to be published in the Archives of Internal Medicine (AIM)
    • The article provides a brief rationale for why higher rates of deficiencies may have been found (which is offered by the AIM study first author, Ginde) namely, skin cancer-prevention measures (e.g., use of sunscreen)
    • The article notes the disproportionate rate of deficiency in African-Americans found in the AIM study
    • The article mentions suggestions for vitamin D recommendations offered by Ginde, including a specific recommendation for African-Americans

    The SA article also referenced another study’s findings – specifically, one published in the American Journal of Clinical Nutrition (AJCN; November 2008)
    • The article referenced a co-author (Picciano) from this previous study
    • The article includes a quote from Picciano where she offers possible reasons for why such a high rate of deficiencies may have been found and reported in the AIM publication – for example, changes in the test used to measure blood levels accounted for some of the deficiency cases found in the AJCN published study – thus, she concludes that the AIM study’s findings are “far overstated” and inaccurate

    Lastly, the article also offers insight from a professor unaffiliated with the studies and he agrees with points made by both Ginde (i.e., deficiencies exist especially among African-Americans) and Picciano (i.e., it is imperative to consider differences in testing methods), respectively.

    Like the SA article, the AIM publication provided contextual information by stating what ailments are associated with this deficiency (including cancer, heart disease, diabetes, and rickets) and explanations for why higher rates of deficiencies may have been found. The space allowances in the AIM publication allowed the authors to provide more detailed information and cite references. Unlike the article, the AIM publication uses images (i.e., tables and figures to detail the results).

    In general, the AIM publication does not cite any information that would undermine the study’s purpose or findings (and implications of the findings) unlike the article. For instance, the authors suggest that Vitamin D deficiency among African-Americans may be linked to higher incidences of and worst outcomes for certain illnesses and diseases (e.g., cardiovascular disease and certain cancers) but it may have been worth discussing lower incidences of osteoporosis and bone disease among African-Americans (compared to other ethnic or racial groups), which are also associated with Vitamin D insufficiency.

    Taken together, the SA article provides a starting place for becoming more informed about the issue overall. Not surprisingly, the AIM publication presents a more narrowed viewpoint that validates the purpose and findings of the study (with statements about limitations coupled with statements of why the limitations do not necessarily negate the integrity or rigor of the study). Unfortunately, neither the article nor publication discusses the multi-factor nature of the issue. As suggested by Ginde, should recommendations for Vitamin D intake simply be higher for African-Americans? Or should there be different standards for what are adequate levels for different ethnic or racial groups (versus recommendations that only vary by age)? What are possible adaptive (evolutionary) bases for explaining these findings, especially as it relates to African-Americans? Despite these concerns, I believe both examples validate what is expected from such articles and publications based on the outlet and intended audience – they give their respective audiences what they expect.

  5. Regina Raboin says:

    I read about bacterial meningitis from three sources: an academic journal, newspaper article and a podcast.

    Academic Journal
    Signs, symptoms and management of bacterial meningitis.(Continuing professional development). Paediatric Nursing 22.9 (Nov 2010): p30(6).
    This report provides solid medical (clinical), nursing and public health information about the disease bacterial meningitis. It provides an overview of the disease and includes and supports the information with current published guidelines for treating the disease. The article is definitely geared towards nurses, and although a clinical report the writing is clear and concise, focusing on education and comprehension. At several points in the article there are “Time Outs”, which are discussion q

  6. Colleen Butler says:

    I looked for articles on fibromyalgia, because I’ve seen lots of commercials for drugs to treat fibromyalgia. The first article was from Web MD. It was very short and discussed a recent article in the journal Pain. It was mostly written as an ‘isn’t the human body so kooky?” kind of a story. It didn’t use any emotional hooks or provide any practical information.
    http://www.webmd.com/pain-management/news/20110520/pain-relief-strategy-cross-your-arms

    The second article was from the LA Times. It was an interview with an expert on fibromyalgia who suggested light strength training to ease pain.
    http://www.latimes.com/health/boostershots/la-heb-fibromyalgia-questions-20110524,0,63340.story
    Neither of the articles had any tie to the environment. Both were very short and did not provide much information about fibromyalgia.

  7. Regina Raboin says:

    I read about bacterial meningitis from three sources: an academic journal, newspaper article and a podcast. To locate these resources I searched in Academic OneFile and Boston Globe, 1980 – (full text)

    Academic Journal
    Signs, symptoms and management of bacterial meningitis.(Continuing professional development). Paediatric Nursing 22.9 (Nov 2010): p30(6).
    This report provides solid medical (clinical), nursing and public health information about the disease bacterial meningitis. It provides an overview of the disease and includes and supports the information with current published guidelines for treating the disease. The article is definitely geared towards nurses, and although a clinical report the writing is clear and concise, focusing on education and comprehension. At several points in the article there are “Time Outs”, which are discussion questions on topics such as “public perception of the disease”, “information and advice to anxious parents” and “public health guidelines”. There is definitely solid, documented information about the disease in this article.

    Newspaper Article
    Boston Globe

    Boston Globe
    Three, maybe 4, children have bacterial meningitis
    12 January 2007
    http://search.proquest.com.ezproxy.library.tufts.edu/bostonglobe/docview/405053558/12F8A407D1F22C2DE73/3?accountid=14434

    A matter-of-fact news article about 3 or perhaps 4 children who contracted bacterial meningitis; the 4 child was included although it’s made clear that this case is related to the other three. The article does discuss how the disease is thought to have spread and it cites three experts, two in public health, the other, disease control. The spread of the disease is briefly discussed, as is the number of cases for the previous two years and a brief disease definition and symptoms. While data is reported in the article, sources of this data are not included, although one could assume this was given by one of the experts or the MA Dept. of Public Health.

    Podcast
    CDC Podcasts
    Meningitis Immunizations for Adolescents
    http://www2c.cdc.gov.ezproxy.library.tufts.edu/podcasts/downloader/download.mp3?af=a&f=9956

    A short, overview of bacterial meningitis, how it spreads, who is susceptible to the disease, symptoms, treatment and a small public service announcement supporting vaccinations in children. I liked it because it was a Q&A with a CDC epidemiologist, factual and informative. A very effective way to communicate important information in a non-threatening, calm format.

    All three resources were written to provide information about bacterial meningitis, however the news article was a little more sensational, while the journal article was definitely geared towards professionals, although a lay person could easily understand it and be helped by the “time-out” questions. For mass effectiveness I could see the local public health dept, schools, hospitals and physicians distributing the podcast to patients and the public via email, web sites, social networking media such as Twitter, blogs, Facebook, etc.

  8. Regina Raboin says:

    Suggested reading
    Peterson, Dale (2011). The Moral Lives of Animals. New York: Bloomsbury Press.
    http://library.tufts.edu/record=b2143081~S1

  9. Lai Ying Yu says:

    Wall Street Journal, Apr 6, 2011
    “Pfizer, Biotech Partner to Develop Drugs for Rare Diseases” was about Pfizer’s unusual early-stage drug-development partnership with a biotech firm that had yet to develop a drug to treat lysosomal disease, a genetic disorder that causes mental retardation and leads to early death. The only “scientific” information offered was that promising “molecules” have been developed toward a drug treatment. Most of the article focused on Pfizer’s new focus on rare disease drug development and its willingess to support early research.

    NYTimes, “For Edge on Alzheimer’s, Testing Early Treatments” is about when and how best to identify the first changes to the brain that indicate alzheimer’s disease, with the hopes that by identifying the changes early more effective drugs can be developed to prevent its onset. The article focused less on the explanation of the disease (but did explain that it can be caused by both genes and unknown factors) and more on the methods for testing patients for alzheimer’s.

    Unlike the WSJ, the NYTimes did give space and attention to the scientific methodology that went into testing (the number of ppl tested, who were being tested, what age groups, and the kinds of tests being conducted – brain scans, spinal taps, memory tests). For a layperson who might be interested in either of these diseases – lysosomal or alzheimer’s, the latter article was far more satisfying. In fact, I think it included enough “scientific” explanation (methodology, overview of Alzheimer’s) that I would have been satisfied reading it and passing it on to anyone who I thought might also be interested about new developments in treating the disease. In terms of how media and the environment might be reflected in these articles, I believe the WSJ was appealing to an audience who was reading for business and investment news, not for the disease research — or, if that, secondarily. The NYTimes also seemed to appeal to its specific audience base, ppl who might be affected by this disease in their lifetime and might be very interested in learning about what developments are taking place. And I think it succeeds on that level of accessibility, but also on the level of information — the argument being made sounded responsibly researched and made me feel that I could use that as a reliable springboard to finding more in-depth information reflective of the summary it was giving me about these research developments. . .
    But, as I think more about what it means to have an article reflect environmental issues, I have to admit I’m not sure I know what that might look like in relation to the articles I’ve just read(!). . .

  10. Leafing Las Vegas: Health dangers of city plants revealed, 18 June 2009 by Kate Ravilious, New Scientist

    This article talks about how terpenes emitted by vegetation can increase ozone levels in cities, which can cause breathing difficulties and may cause cancer. The piece is written for a science-literate audience. It references an article in a scientific journal and quotes the author. It does suggest drama (“A new study shows that some plants can increase the rate of ozone production by up to 50 times”, “ozone levels exceeded the US Environmental Protection Agency safe standard”).

    TREES REALLY CAN (COUGH, COUGH) POLLUTE THE AIR
    San Jose Mercury News (California), March 29, 1995 Wednesday MORNING FINAL EDITION, FRONT; Pg. 16A, 232 words, Reuters
    This very short piece succinctly summarizes the findings and quotes the news release of the researcher. It is a very short piece on page 16A. It does introduce the topic by pointing out that Ronald Reagan was already saying trees pollute and ends by pointing out that Reagan was ridiculed for saying this.

    This topic is interesting because it shows two things – how dangerous advertising is (many products especially fragrances that are labeled “ECO” emit VOCs) and how eager people are to point out that it is not only people who pollute.

  11. Anne Cantu says:

    “In Diabetes, a Complex of Causes”
    By Amanda Schaffer
    Published: October 16, 2007 NYTimes.com/Health
    http://www.nytimes.com/2007/10/16/health/16diab.html

    The article starts out with a hyperlink to a NY Times diabetes guide that gives facts and definitions. The text itself discusses a breakthrough in diabetes research and quotes a number of researchers and professors of medicine at a variety of institutions. It explains how the research was conducted and what the findings were. In all, the article explains how diabetes works and what these new findings could mean. There is an attempt at presenting scientific information, but the language is not that of a professional journal. This means that I can actually read and understand the basic explanation of the function of different parts of the body, including the brain, in the process of glucose production. I found that very helpful and enlightening. The title is actually fairly accurate, and there are two images, one scientific and the other intriguing (it caught my attention). When I tried to find an article on diabetes in a peer-reviewed journal, I realized that my lack of medical/scientific background did not allow me to get enough out of the readings and did not insist. So I feel that for most people, the article on the Times website was a good source of information. I have to take their word for all this since I cannot judge the value of the data given.

  12. Blake Ratcliff says:

    Articles:
    1. “Developing-World Lung Cancer: Made in the USA,” by Thomas Bollyky, published online by The Atlantic today
    2. “UN Role is Found in Haiti Cholera,” by Joe Lauria in the Wall Street Journal on 5 May 2011

    The two articles discuss the spread of two different health crises, international tobacco usage and cholera, which were caused and allowed to explode by developed states that were distracted by other situations.

    The first article details the surprising discovery that US efforts to curb tobacco usage and reduce the preventable deaths associated by resulting conditions (heart disease, cancers, etc.) end at our borders, as our domestic crackdown with taxes and regulations came while the US government pushed Big Tobacco’s interests abroad through reduced tobacco tariffs and bans on warning labels on packs. Worldwide tobacco usage has surged in recent years due these US efforts, particularly in states with poor health care systems and insufficient regulatory and taxation institutions that do not have the power to collect tax on tobacco sales and spend those revenues on care or prevention. It’s difficult to be proud of the enthusiastic and admirable strides made in the US–against teenage smoking and child secondhand smoke exposure, adding warning labels, etc.–when those very same preventable concerns were permitted to skyrocket in other countries so that American tobacco companies and stockholders could continue to grow and profit abroad.

    The second article documented another uncomfortable, head-scratching truth: that recent widespread cholera epidemic in Haiti, following the devastating earthquake, was in part the fault of the international aid workers who flew down to Haiti to assist with the earthquake aftermath. Over 4,500 Haitians died from cholera, 300,000 became ill, and more died from violent riots that erupted as the epidemic swept across the panicked country. The article discussed in some regard the science and perfect storm of conditions that allowed cholera to spread. Aid workers brought the cholera bacteria from SE Asia, most likely contracting it in providing post-tsunami aid. Apparently, the aid worker compound had poor sanitation conditions and did not realize that their toilet facilities drained into a major tributary of Haiti’s largest river that’s routinely and widely used by the population in various ways. The disease overwhelmed the already over-taxed health care system and shortages of drinking water.

    I found that coverage of both issues was colored by the respective political leanings of the publications. The Atlantic is a well-known liberal magazine, and many left-leaning pundits tend to doubt the effectiveness and ethics of free trade. The Atlantic article contained a section that seemed to cast doubt on all US trade negotiation motives, in a sense asking whether most US negotiations for policies to liberalize trade were actually disguised efforts to push US interests. The WSJ is a right-leaning paper that generally opposes most collective actions of international organizations, and its coverage of the Haiti cholera epidemic fed into their usual portrayal of the UN and UN workers as bumbling, unprepared Westerners whose interventions cause bigger problems than their original underlying challenge they aimed to solve. These two stories were obviously not exclusively covered by these sources, as a casual internet search would show, and so I found it very interesting that both The Atlantic and the WSJ colored their coverage of these health conditions in a way that would resonate with their respective audience.

  13. Sara Hasselbach says:

    Appearing on the Doctors Without Borders website in July 2009, “100 Years of Neglect: Chagas Disease in Bolivia” marks the 100th anniversary of the discovery of Chagas disease (also known as American trypanosomiasis). In the title and brief introduction, the article acknowledges that a century of awareness of the disease has not met with progress toward its elimination; in fact, this piece claims that it remains “one of the world’s most neglected diseases.” The article provides a cursory explanation of the cause and scope of the Chagas disease, which primarily affects “poor people throughout Central and South America,” of whom roughly 15,000 die annually. The article proposes that 14 million people have the disease, which is caused by a parasite transmitted through: the bite of the vinchuca insect, blood transfusions, pregnant mother-to-baby, organ transplants, and contaminated food or drink. The introduction ends with a mention of the work of MSF (Doctors Without Borders/Médecins Sans Frontières), which has established clinics and treatment programs for both children and adults alike (a practice uncommon in Chagas intervention).

    Moving from general information to specific anecdote, the article then details the case of Araceli Espinoza, a 10-year-old Bolivian girl who contracted Chagas disease. A picture of Araceli with her siblings and grandmother, crowded into their shared bedroom, appears opposite the story. The article subtly stresses the role of poverty in Araceli’s contraction of Chagas, as it includes details about the “tiny room” that Araceli shares with “three siblings and her grandmother” in their “mud-brick home” in a “poor neighborhood.” More information specific to Araceli’s case is followed by wider-ranging information about how Chagas remains relatively misunderstood by victims and medical personnel in Bolivia (where a staggering 10% of the population is infected) and elsewhere. Since the disease can manifest for years without outwardly visible symptoms, the article contends, “it is perceived as a complicated disease to diagnose and treat.”

    Integrated into the article, a text box features a bulleted list of “What needs to be done to fight Chagas,” providing a clear and accessible plan for future successful action. The article then moves on to discuss another specific case, 35-year-old Adriana Villa’s battle with Chagas disease, including the barriers she faced in seeking government-provided treatment and in taking medication (developed in the 1960s and 1970s) with negative effects. To date, Villa uses her story to raise awareness of Chagas disease.

    With a balance of fact and sympathetic appeal, this article also performs the function of raising awareness of Chagas disease. After reading this article, I was left wondering more about Chagas disease’s specific symptoms, preventative techniques, and outreach efforts. However, the article presents a clear and compelling case for the lack of awareness about the disease, both within and beyond its contaminated areas.

    The other consideration of the Chagas disease, “Darwin’s travels may have led to illness, death,” appears in a May 2001 issue of The Boston Globe. This article begins by invoking an ironic, rather than a sympathetic, approach to disease: “The very travels that inspired Charles Darwin’s theory of evolution and shaped modern biology may have led to one of the illnesses that plagued the British naturalist for decades and ultimately led to his death.” The author proceeds to cite the origin of interest for this topic, the annual medical conference in Baltimore that compiles and discusses medical diagnoses for historical figures who have had mysterious illnesses. By introducing the Chagas disease—one of the three ailments that scientists believe Darwin suffered from—in these terms of interest and irony, the presentation veers away from the serious treatment that this disease deserves (given the statistics in the article from the Doctors Without Borders website) and comes dangerously close to highbrow celebrity gossip.

    A brief sketch of Darwin’s travels, followed by a discussion of his medical symptoms and proposed ailments, segues into the Chagas diagnosis. The article only includes one relevant detail of the Chagas disease besides a cursory mention of its symptoms: that Darwin wrote about a triatomid bite, which could have caused the illness. In the end, the article concludes vaguely, by stating that “treatment for Chagas might still be difficult after the illness damages the body.” The article quotes an excerpt from a poetry book by Ruth Padel, the great-great-gradndaughter of Darwin. In it, she describes the insect’s bite and the ensuing swelling of infection within Darwin’s system. By abstracting the disease into the artistic vehicle of poetry, the article further removes Chagas disease from real people who are really suffering, like Araceli Espinoza, Adriana Villa, and the other 14 million people currently battling this under-diagnosed disease.

  14. Colin Orians says:

    Landscape heterogeneity and disease spread: experimental approaches with a plant pathogen. Ecological Applications 2011

    This study experimentally examined what factors favor the spread of a fungal disease on wheat. The tested the effects of three factors, host frequency, size of patch and, the size of the initial inoculation. They found the host frequency and inoculation size are critical. That the size of the patch did not matter was surprising. While this certainly helps ecologists and epidemiologists (people who study disease spread), how this is likely to actually change agricultural practices is unclear.

    I then found info on AgInfo.net about the same disease. It was amazingly devoid of info. Only that it is not too late to spray in the Pacific Northwest this year (written on May 24, 2011). Should we take a field trip? I would have liked the author to begin by giving us some info on the disease – what is the cost of not spraying a fungicide?

  15. The site Michael talked about – pollution search
    http://scorecard.goodguide.com/

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