Saturday Stories: Peer Review, #Masks4All, Talking To Kids, And The Public Health Of Protests

Simine Vazire, in Wired, on the failings of scientific peer review

Kimberly A. Prather, Chia C. Wang, and Robert T. Schooley, in Science, on how to reduce transmission of SARS-CoV2 (tl;dr – wear a mask)

Kate Julian, in The Atlantic, on how to talk to kids about the sad, scary, and unjust issues permeating society today.

Tara Haelle, in Forbes, on why public health experts support Black lives matter protests.

Photo By Mike Shaheen – https://www.flickr.com/photos/63015897@N02/49979513917/, CC BY 2.0, Link

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Free Mentorship Offer!

One of the consequences of the COVID epidemic is that I am now doing most of my work from home. This has led to significant efficiencies, leaving me with some extra time on my hands, which I would like to put to good use. So here is my offer to my professional readers: I am offering a free 60 minute mentorship video-call to three individuals struggling with any one of the following questions: Are you a medical practitioner interested in improving your approach to helping your patients manage their obesity? Are you a new faculty member hoping to build an academic career in obesity research? Are you interested in obesity but can’t decide whether a career in academia, medical practice, government, or industry is right for you? If you are interested in talking to me about any of these issues, please send me an e-mail describing (in 500 words or less) your current situation and what you hope to get out of this call. Please also explain (in 300 words or less) why you think my advice would be of value to you. Please provide your complete contact details including a phone number where you can be reached. You can e-mail me at amsharm@ualberta.ca I will pick three individuals based on whether or not I feel I can be of help to them. My only request to the “winners” is that they are willing to make a donation (you decide the value) to Obesity Canada. Act now, as I will only be accepting entries over the next three days (end of day Friday, June 26). Please note – these mentorship calls are for professionals only – I cannot give any personal medical advice to individuals living with obesity. Looking forward to hearing from you. @DrSharmaEdmonton, AB

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Saturday Stories: COVID And Kids With Disabilities, Racist Statues, COVID Death Mysteries, And Virus Hunters

Hallie Levine, in The New York Times, on how children with disabilities are being left behind while the rest of country slowly reopens.

James Stout, in Popular Mechanics, explains how to use science to topple a racist statue.

Joel Achenbach,  Karin Brulliard and Ariana Eunjung Cha, in The Washington Post, on what we do and don’t understand about who lives and dies with COVID. 

Maryn McKenna, in Smithsonian Magazine, on some of the world’s foremost virus hunters.

Photo By Quidster4040 at English Wikipedia, CC BY 4.0, Link

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How COVID-19 has Changed Continuing Medical Education

Yesterday morning, I first gave a 60-min presentation on, “The Science of Obesity”, to colleagues from across Central America. An hour later, I gave a 45-minute key-note talk on, “Managing Obesity as a Chronic Disease in Primary Care”, to over 200 primary care physicians from the UAE and other Gulf countries. Both presentations were given sitting comfortably at home at my computer. Before COVID, for a presentation like this, I would have had to hop on a plane to Dubai or Panama City, to deliver the talks in person – giving both talks on the same day would have been physically impossible. As much as I enjoy the opportunity to fly across the globe, even for a day or two, I would dare say that all things considered, my presentations were probably not that much different from being there in person. In fact, the only real advantage of physically being in Dubai or Panama City, would have been to personally meet my colleagues from the region, as many important conversations take place in the breaks and after the meeting. In the past, this would have been the key to building a network of personal professional relationships with colleagues from around the world. However, looking back, I wonder if there would be any justification at all to going back to the way things were. Never mind the ridiculous carbon-footprint of such endeavours, or the time factor, or the health and other risks of travelling across countless time zones – the real question is whether virtual conferences will from now on replace the conventional in-person meeting for medical education (or for that matter conferences in general). The advantages for organisers, attendees, and speakers are obvious. No travel, no taking days off from work, lower registration costs (if any), attend at your own convenience – most virtual talks are recorded and can be viewed after the event. So really, the only disadvantage of virtual events, is missing out on the informal networking that happens  around such meetings. Thus, sharing a coffee break with a group of colleagues from another country does much to foster a better of understanding not just of medical issues relevant to obesity management. There is also no doubt that in that past, having the good fortune of creating a personal global network of colleagues, many of who I would consider friends, has been invaluable in my own career as… Read More »

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Edmonton Obesity Staging System (EOSS) Predicts Use of Health Services and Pharmacotherapies in Australian Adults

The Edmonton Obesity Staging System (EOSS), which classifies obesity based on the presence of medical, mental, and functional impairments using a 5-point ordinal scale, is now increasingly used in the clinical assessment of individuals presenting with obesity. We have previously shown that EOSS, which is largely independent of BMI, is a far better predictor of mortality than BMI, waist circumference, or the presence of metabolic syndrome (Padwal et al, CMAJ 2011). Now, a cross-sectional analysis of data from the Australian Health Survey by Evan Atlantis and colleagues, published in Clinical Obesity, shows that EOSS is also significantly better than BMI for predicting polypharmacy and health service use. The researchers examined data in a subgroup of individuals from the nationally representative sample of participants in the 2011-2013 Australian Health Survey for whom physical measurements of BMI and waist circumference were available (n = 9730). Overall, the number of primary care physician and specialist consultations, encounters with allied health care, number of pharmacotherapies and hospitalisations increased by EOSS stages. In contrast, BMI was a significantly better predictor of having discussed reaching a healthy weight, increasing physical activity, and eating healthy food with their primary care physician in the last 12 months than the EOSS. Overall, the results are not surprising. EOSS is a measure of health rather than size, which readily explains why individuals in higher EOSS categories, who are sicker, also experience greater healthcare needs. Although EOSS (by definition) identifies sicker individuals living with obesity, importantly, the data also shows that doctors’ advice to improve health behaviours is largely driven by patient size (BMI). It thus appears, that larger patients are more likely to receive advice on weight management, healthy eating or physical activity, irrespective of their actual health status. With regard to hospital use, the authors note: “Since hospitals account for the majority of health spending,31 preventing patients from progression through the higher EOSS stages should be a high priority in health policy and a key clinical objective rather than weight loss. For instance, there is likely to be a greater reduction in health costs if an individual at a lower BMI with higher complications status (EOSS stages 3 and 4) has early access to effective medical and surgical management of obesity than another at a higher BMI with no or few health impairments (EOSS stages 0‐2). Thus, health policy and clinical guidelines about access to clinical obesity services or intensity of… Read More »

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How Virtual Medicine Is Changing My Practice

If there is anything positive that can potentially come as a direct result of the COVID-19 pandemic, it is likely to be a turbo-charged advance in virtual medicine. Although “tele-medicine”, in  one form or another, has been around for well over a decade (if not longer), it was essentially a side show. Even where widely used, tele-medicine was generally used to reach patients in settings where geographic distance made in-person consultations impractical. In the past, this generally involved booking time in the tele-medicine suite where you could consult with the patient, who in turn had to travel to a local tele-medicine outlet at their end, for a video consult. Thanks to the COVID lockdown and the advances in technology, this rather cumbersome process has dramatically changed (in a matter of weeks if not days!), thanks to smart phones. By now most of us are routinely using Zoom or some other virtual platform (if not just the telephone) to consult and counsel our patients. Not only have both providers and patients rapidly adopted this technology, but health authorities have, almost overnight, come up with new billing codes for virtual patient care that make this an economically feasible venture for healthcare providers, who in the past only got paid for office visits. All of this has of course also affected by own practice (currently entirely virtual) and it is fair to say that both my patients and I are pretty happy on how things are going. In fact, looking back, one wonders why in the past we routinely expected our patients to endure lengthy commutes for a 20-min in-person appointment, which, as we now see, could easily have been dealt with using a smart phone during their coffee break. Now, that everyone appears to be comfortable with this, it is hard to see us going back to the old ways. In fact, in Alberta, Alberta Health has just announced that they are making the newly instated billing codes for virtual consults permanent. However, the fact that with virtual medicine, the geographic location of the patient becomes virtually irrelevant, one wonders what impact this will have on medical practice that crosses jurisdictions. Traditionally, the practice of medicine is tightly regulated from province to province – thus, for example, I am licensed to practice medicine in Alberta but not in neighbouring British Columbia or Saskatchewan, never mind outside of Canada. Thus, although I probably receive… Read More »

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Saturday Stories: COVID files


Dr. Stephan Kamholz – Chair of Medicine at Maimonides Medical Center, died of COVID19 on June 11th, 2020. May his memory be a blessing 

Sharon Begley and Helen Branswell, in STAT, spoke with 11 epidemiologists to explore what we need to ensure such that we don’t screw up dealing with COVID’s inevitable second wave.

Tomas Pueyo, in Medium, on whether we should all be striving to respond more like Sweden?

Jonathan Corum and Carl Zimmer, in The New York Times, with a coronavirus vaccine tracker.

Siddhartha Mukherjee, in The New York Times, moderates a discussion about whether or not a coronavirus vaccine can be produced in record time

Rachel R. Hardeman, Eduardo M. Medina, and Rhea W. Boyd, in The New England Journal of Medicine, discuss stolen breaths and racial inequities in medicine.

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Saturday Stories: Some Anti-Racism Resources #BlackLivesMatter


May his memory be a blessing

Corrine Shutak, in Medium, with 75 Things White People Can Do for Racial Justice.

A non-bylined Google Doc of anti-racism resources for white people.

Quakelabs’ collection of Canadian specific anti-racist resource.

Farrah Penn, in Buzzfeed, with 23 Phenomenal Young Adult Books By Black Authors From The First Half Of 2020

The University of Toronto’s Office of Inclusion and Diversity with their collection of recent stories and resources on anti-racism.

@antisocialbritt, on Twitter, with her thread of children’s books that discuss racism.

@bronze_bae, on Twitter, with her thread of young adult books that discuss racism.

Photo By Lorie Shaull – https://www.flickr.com/photos/number7cloud/49959004213/, CC BY-SA 2.0, Link

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Saturday Stories: This Week’s COVID Selections


Dr. Earline Austin, 63 yo NYC Physician, died on 4/3. Originally from Guyana, she lived in Fresh Meadows and was affiliated with Staten Island University Hospital. Attended Ross University for Medical School. May her memory be a blessing

Emily Chung, in the CBC, with everything you need to know to understand R-naught values.

Andy Larsen, in the Salt Lake City Tribune, with a breakdown of different locations and events and what we know of their risks in terms of spreading COVID.

Kimberly A. Prather, Chia C. Wang, and Robert T. Schooley, in Science, on how if you want life to return to some remote semblance of before’s normal, if you’re not already doing so, you need to start wearing a damn mask

Clayton Dalton, in The New Yorker, on what we lose when we become numb to mass death.

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Saturday Stories: The COVID files


Dr.Sudheer Singh Chauhan, Internal Medicine Physician and Associate Program Director IM Residency Program at Jamaica Hospital, New York, died of COVID19 on May 19th. May his memory be a blessing
Kai Kupferschmidt, in Science, on why only some people are COVID super spreaders 
Natalie Kofler and Françoise Baylis, in Nature, on the perils, pitfalls, and disparities of “immunity passports”. 
And if you don’t follow me on Twitter or Facebook, here’s a segment I did with CTV’s The Social on the very real impact these scary times has on our physical and mental well being
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