Tag Archives: public health

Prescription drugs overused and abused in the Mideast

Posted on by

It turns out that, in the Middle East, getting access to prescription medications for serious ailments, in the absence of supervision, can sometimes be as easy as picking up an over-the-counter medicine for a headache or the common cold, or so claims a new review published in Pharmacology Research & Perspectives.

In theory, the regulations separating access to either brand of medication is there. In practice, the review cites a “massive problem” of self-medication misuse in the region, particularly with prescription medication, one that eventually leads to greater health risks among patients, including drug dependency and addiction.

Drugs that are used recklessly or sometimes abused by Middle Eastern patients include codeine containing products, topical anesthetics, topical corticosteroids, antimalarial, and antibiotics. According to the review, which looked at 72 papers published on the subject between 1990 and 2015, self-medication medicine misuse cannot always be exactly quantified in the region but it seems widespread.

Some of the statistics that the review highlights are quite jarring.

For instance, 73.9% of the Sudanese population have reportedly used antibiotics or antimalarials without a prescription. Equally alarming trends have been observed in Syria, Yemen, Jordan, Tunisia, Egypt and the UAE, with drugs such as amoxicillin or ampicillin being dispensed freely. According to the review, most patients self-medicating on antibioitcs did not even follow through the full course of the medications and took them for less than three days.

Many of the patients follow the advice of relatives, or have a drug prescribed to them by a doctor over the phone. As well, some pharmacists play a role. “People tended to select medication based mainly on advice received from community pharmacists,” says one of the studies cited.

One study said that the majority of the 200 pharmacies under scrutiny in Syria had sold antibiotics without prescription, and in Saudi Arabia, only a single pharmacy had refused to release the medication without a doctor’s prescription.

As well as stacking prescription medications for future use, Middle Eastern patients often used them inappropriately; it’s not uncommon for many to pop antibiotics to treat illnesses unrelated to bacterial infections, for instance, or with incorrect dosages for inappropriate period of time, according to the review.

Taking the long way to international development

Posted on by

How Panagiotis Vagenas ended up withdrawing from NIH funding for a research position with a non-governmental organization.

I work for Project Concern International (PCI), an international development nonprofit, in San Diego, California. In my role as the Senior Technical Advisor for Research, Monitoring, Learning and Evaluation, I lead the organization’s research agenda and advise PCI staff in the US and our field offices in low and middle-income countries around the world on rigorous research methodologies. Most of my colleagues found a more straightforward route into the field of international development. My path was longer.

IMG_3429-smaller

Some of the beneficiaries of PCI’s Women Empowered initiative.

Training in biochemistry and immunology

After leaving school in Greece I studied biochemistry at Imperial College London. I stayed in basic science for the next 14 years, pursuing a master’s in biochemistry and a PhD in immunology, still at Imperial, followed by a postdoctoral fellowship in the Population Council’s labs at the Rockefeller University in New York City.

I enjoyed my lab work on HIV vaccines but wanted my work to be closer to the impact on human lives. Mentorship is crucial and looking for additional mentors outside one’s primary role is beneficial. Even the most senior colleagues are happy to offer advice and spend time mentoring. After ten years in the lab, I pursued a Master’s in public health (MPH), at Yale University.

Moving to public health

After my MPH, I started a second postdoctoral fellowship at the Yale School of Medicine. I joined a dynamic multi-disciplinary group of public health, anthropology and communications PhDs, complemented by physicians with interests beyond the clinic, all of whom investigated the intersection of substance abuse and HIV among vulnerable populations, including prisoners, sex workers, transgender women and men who have sex with men (MSM).

This work exposed me directly to the overwhelming disparities faced by these populations, especially in the developing world. My main project focused on alcohol use disorders among MSM in Peru and how these fuel the HIV epidemic. I was also involved in clinical trials of an opiate antagonist, naltrexone, for the treatment of alcohol use disorders among people living with HIV in Peru, as well as in New Haven, CT and Springfield, MA.

Looking for funding

After my postdoc, I joined the faculty of the Yale School of Medicine. When I reached the essential stage of securing my own research funding, however, I hit a roadblock. The 2013 US budget sequestration hit the NIH hard and money for research was hard to find. My first attempts at a NIH grant were rejected. Continuing to live with inadequate salary support for more than four years was suffocating – a problem I hear constantly from fellow academics. It is very disappointing that following many years of specialization, both adequate pay and research support are extremely hard to find, even at a prestigious research institution like Yale.

Jumping ship

My desire to be closer to the human impact of my work never diminished, so I believed that this was finally the time to jump ship from academia and join an organization that implements projects on the ground and directly helps the lives of those who need it the most. Research positions in global health and international development organizations are not plentiful, but these organizations are realizing the impact that rigorous research can have in their work, as well as providing a direct feedback loop of knowledge from the implementation of programs back into the design of new programs. PCI has made such a commitment to rigorous research. It implements a very broad spectrum of projects not just in public health, ranging from women’s empowerment and human rights, to nutrition, literacy, water and sanitation, HIV, TB and Ebola, urban development and resilience and emergency humanitarian assistance.

Research in the development field

This transition was not without its challenges. While I am leading a number of studies, my main role is to advise on research methodologies, instead of being the researcher myself. In addition to that, the breadth of the subject areas I now work in is large and the learning curve was steep. Nevertheless, the work has been fascinating and rewarding.

PCI’s Women Empowered (WE) Initiative has occupied a big part of my time in my first year here. WE is a multi-country savings-led microfinancing program, which aims to empower women both socially and financially. It does that by bringing women together in a group setting where they learn how to save money, in addition to discussing social themes of interest to them and their communities. The results are inspiring: during a visit to PCI’s Guatemala offices last summer, I met with many WE group members in the remote highlands of Huehuetenango province whose enthusiasm for PCI’s initiative was hard to mask, even in the middle of unmistakable poverty. I met a happy, outgoing woman who shared with me that before WE, she had no social network and no say in her home.

Another, a young single mother, used a loan from her WE group’s savings to build her own home, which she showed our team with great pride. Seeing these women, talking to them in person and hearing how PCI truly transformed their lives was deeply moving and finally gave me the personal satisfaction and fulfilment I was always seeking from my work.

A research study on WE that I am leading investigated the post-project sustainability of our WE initiative in Ethiopia, between three and six years from the end of the PCI program. PCI is committed to designing programs that are sustainable after our support ends and has committed funding to researching this sustainability. WE groups were still meeting even six years after PCI support ended. Analysis of our overall impact is under way currently, but the preliminary results are encouraging and full of lessons for future sustainable programming.

An email in March

A few months into my new job, I received an email from the NIH saying that my reapplication for my research grant at Yale was slated to be funded. I went on to withdraw that application because I was now in a position that meant more to me in many levels.

The reason I want to share this story is to encourage fellow scientists who may be not fully satisfied in their work to think outside the box and be open to options that may not be immediately obvious – and who knows, you may end up in a paradise like San Diego! I feel that my science background and career path have made me a strong researcher, ready to develop professionally in my new field, a field that may be more open to science PhDs than one may initially think!

 

Panagiotis Vagenas grew up in Athens, Greece; studied biochemistry and immunology at Imperial College London and public health at Yale University. He conducted research on HIV vaccines at Rockefeller University and HIV and substance abuse at Yale University. He is now the senior researcher at Project Concern International (PCI), an international development nonprofit in San Diego. You can find him on LinkedIn and Twitter.

 

Suggested postspic-smaller-cropped

Impact: the search for science that matters

Finding job satisfaction as a science liaison

Finding job satisfaction as a humanitarian researcher

Charities: Profiting from non-profits

Finding job satisfaction as a humanitarian researcher

Posted on by

Panagiotis Vagenas left Yale University to advise a non-profit on research design and quality.

What did you do before Yale?

I’m from Greece originally. In 1996 — when I was 17 — I moved to London, UK. I studied biochemistry for my degree and did a PhD in immunology. When I graduated I moved to the Population Council labs at the Rockefeller University in New York to start my postdoc.

pic-smaller-cropped

Panagiotis Vagenas

What did you study?

I worked on basic research in HIV. What’s always motivated me is trying to help people — to have a meaningful career in that sense. So in summer 2010 I moved to Yale School of Public Health and did a master’s in public health (MPH), and went on to join the faculty at the Yale School of Medicine in 2013. Continue reading →

Scientists and journalists need different things from science – Response 3: Science blogging in the New Zealand media

Posted on by
Reply

Grant Jacobs, Ph.D., is an established computational biologist contracting to research groups, organisations and companies offering his background in molecular biology / genetics and computer science locally and internationally through his consultancy, BioinfoTools. He has wide personal research interests, including epigenetic and chromatin-level control of gene expression, the three-dimensional organisation of genomes, structural biology and development of new algorithms. Outside of work he is a fan of travel, tramping (hiking), good books and, more recently, writing. He is the author of Code for life and tweets under @BioinfoTools.

During a recent Royal Institution debate (written up here by the nature.com Communities team), Fiona Fox, head of the UK Science Media Centre (SMC), was quoted as stating that “blogs [are] fantastic but no journalists go to them to look for full stories.”

This has not been the experience of those writing at the Sciblogs, New Zealand ’s largest on-line science writing collective. One element to this may be that the New Zealand SMC not only links journalists with scientists, and vice versa, but also promotes to the media the scientists’ causes as presented through articles on blogs. It likely helps that the NZ SMC runs Sciblogs and are in touch with the writers there daily. The SMC imprimatur may give journalists more confidence to use this source for material. An additional factor may be thatNew Zealand lacks science columnists for print and television (a notable exception is Radio NewZealand who have a long-running regular science feature). As a consequence of these factors, it may be that the media are turning to those scientists who make a direct effort to address a general audience.

Peter Griffin, who heads the NZ SMC, reports that he regularly receives requests based on material initially seen on Sciblogs. Where some articles result from interaction facilitated through the NZ SMC, others arise from direct contact between the media and the scientist. In some cases blog articles are re-worked to be run as columns in local newspapers.

Scientists writing blogs at Sciblogs have been called up to radio and television appearances, quoted in newspaper articles, or had their work presented as articles in newspapers. In addition, the NZ Herald opts-in to present blogs on their website, usually opinion pieces or backgrounders to current issues (see Appendix at the end of the article for specific examples).

Below the work of a few writers are presented as representative of the relationship between science blogging and the media inNew Zealand. These examples span three broad areas:

i) Public health issues, such as disease outbreaks and prevention

ii) Science education issues and evaluating risk

iii) Science of topical public concern e.g. the recent earthquakes

It is worth bearing in mind that a wider range of articles (and authors) have been associated with the media than the examples presented here, for example covering technology, climate change science and policy, and so forth – a limitation of the brief coverage here.

Public health issues

Microbiologist Siouxsie Wiles has found herself on radio, in newspapers and television:

– An article on using bees to diagnose tuberculosis (TB) led to an interview on Breakfast with Spanky (RDU 98.5 fm, 31st October 2011) as did an article on ’ferret’ flu (9th February 2012), which also featured on ABC Radio Australia (Connect Asia, 22nd December 2011) and was quoted in various Australian print media (The Australian, Sydney Morning Herald and the HeraldSun).

– Tilting against ’quantum-homeopathic-biophotonic flea-control pendants’ was quoted in Sunday Star Times (Charles Anderson, 22nd Jan 2012) in Scientist gets hot under the collar over flea remedy.

– An article on HPV vaccination was reworked as an op-ed piece for The Dominion Post (Offering HPV vaccination to boys the logical, ethical thing to do, 15 Dec 2011) via an university communication team member inviting her to rewrite the piece.

– The German E. coli outbreak of June last year found Siouxsie on current affairs television (TVNZ Close Up, 3rd June 2011) and radio (Radio Live Drive Time, 3rd June 2011) explaining the story to the public.

Science education issues

– Alison Campbell, whose interests lie with how science is taught, has been on radio, with several of articles from her blog re-worked for newspapers and periodicals. (Changing the culture of science education. New Zealand Herald. 27 January 2011; Predicting earthquakes: hedging your bets – National Business Review, 04 March 2011; Resistance to science. Skeptical Intelligencer. 14: 26-27 (2011); Oxygenated food for the brain Skeptical Intelligencer 13: 23-24 (2010).)

– Michael Edmond, a chemist, has taken part in a panel on radio covering the chemistry of food, sex and ageing. He feels that the presence of the blog made it clear that he was interested in science communication, which led to the opportunity.

Science of topical concern

– Our coverage of the disasters in New Zealandhas been cited in a number of articles, for example in the NZ Herald.

– One of the better-known cases is David Winter’s post examining the statistical meaningfulness of astrologer Ken Ring’s ’forecasts’ of further earthquakes in the Canterbury region following the damaging earthquakes there. Mr Ring’s ’forecasts’ raised considerable pubic debate and concern. David’s article led to an appearance in a prime-time current affairs presentation to relay the gist of his article to a wider audience; his articles was quoted and referred to in prominent print media inNew Zealand.

Colleagues have noted that they are typically introduced as scientists in these presentations, particularly when on radio or television, and the blog is not mentioned. However, it is clear that it was the blog article that led to their media invitations.

With this (and much more) evidence of the interaction of mainstream media with science blogs, perhaps there is a case for science media centres elsewhere to be more active in promoting the role of science bloggers and it should be more widely recognised that, given the opportunity, scientists who regularly address the general public have a lot to offer to improve public engagement with, and understanding of, scientific news.

Less evidenced is a perceived shift by some media venues and publications towards more science coverage. There may be no ready way to quantitate this, but one would hope that in part this is a consequence of exposure of science writing withinNew Zealand. The author’s impression has been that blog articles can act as leads to science-related stories in an indirect fashion. Finally, it’s worth noting that the traditional focus on journalists as the sole source of public information has changed. People can now access information ’straight from the source’ or via (perceived) informed comments on social media sites and blogs.

Footnote: I would like to thank my science blogging colleagues for their contribution to this article and extend my sincere apologies to any of you that have not been mentioned. With so many of you and so many articles that have made it to the media, it has been difficult to represent them all. My thanks, too, to Lou Woodley for constructive suggestions that have improved this article.

Appendix: Examples of coverage in the NZ Herald website

As mentioned, the New Zealand Herald ops-in some articles on sciblogs to their Science/Technology pages. In the previous Appendix, the topics of the examples reflect the writers’ interests.

(Search ’sciblogs’ at the NZ Herald website for other examples).