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A Door Opens for Public Health Studies SPH partnership gives researchers unprecedented data accessDan Berlowitz
Researchers at the Boston University School of Public Health (SPH) have unprecedented access to medical claims and clinical data, under a partnership forged with Optum Labs, a Cambridge, Massachusetts–based research center.
Optum Labs reached agreements to collaborate with seven health care organizations including SPH—the only school of public health on a list that includes Pfizer, Tufts Medical Center, and the American Medical Group Association.
Partners have access to millions of medical claims and clinical records of insured patients, for research that could range from medication studies to health policy and outcomes analyses.
The de-identified records include information about tests, treatments and costs of care, as well as patients’ race, income level and geographical location.
“As a school of public health, we hope to bring to this partnership a whole new set of questions that large data sets are able to address—not just about the effectiveness of medication, as many studies may look at, but everything from understanding environmental health exposures, to basic epidemiology, to health policy questions,” says Dr. Dan Berlowitz, a professor of health policy and management at SPH who is leading the collaboration.
“These data represent a broad swath of the population—not just the elderly, as Medicare does, or veterans who are seen in the VA, but children and people of diverse ages and backgrounds,” he says. “This broadens the opportunities for our faculty and students throughout the institution to explore issues using detailed data representing millions of people.”
Traditionally, access to claims data has been relatively limited, with many studies relying on smaller databases, or on records of patients covered by Medicare and Medicaid, federally funded insurance programs. The partnership with Optum Labs will allow researchers to access a much larger pool of de-identified clinical and claims data, in collaboration with researchers and experts from other health care institutions.
“Data is sort of the life blood of what we do in research,” says Dr. Mark Prashker, SPH associate dean of institutional development and strategic planning and an associate professor of health policy and management. “This gives us big data in health care—it allows us to ask questions we couldn’t ordinarily ask…I think it has the potential to revolutionize how we think about solving health care–delivery questions.”
Researchers who want access to the data are asked to submit proposals to a SPH review committee, which will work with Optum Labs and other research partners to ensure collaboration.
Among the possible areas of research are cost-effectiveness studies related to health care delivery, and comparing the success of various clinical interventions, Berlowitz and Prashker say.
Dr. Paul Bleicher, chief executive officer of Optum Labs, said the partnerships will help Optum Labs “accelerate the pace of our innovation, paving the way for exciting new research initiatives that can be directly translated to improvements in patient care.”
Optum Labs—founded by health care company Optum and the Mayo Clinic in 2013—already has more than 20 major research initiatives underway, ranging from studies that compare the effectiveness of various medical devices, to research into how treatment patterns vary across geographic areas. Optum Labs encourages dissemination of research findings through publication in scientific journals and presentations at professional meetings. Several projects are slated for publication in mid-2014.
Optum is an arm of UnitedHealth Group, one of the country’s largest health care companies.
Dr. John Noseworthy, president and CEO of Mayo Clinic, said the research collaborative is “excited to welcome the fresh insights and perspectives that new partners will bring.” In addition to having access to large sources of clinical and claims information, he said, “all partners will now benefit from the unique viewpoints that others bring, as we work to transform health care in the US.” and improve access and treatment.
Other new partners include: Lehigh Valley Health Network, of Allentown, Pennsylvania; Rensselaer Polytechnic Institute, of Troy, New York; and the University of Minnesota School of Nursing.
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Cdc’s Rochelle Walensky Visits Bu’s School Of Public Health
CDC’s Rochelle Walensky Visits BU’s School of Public Health
Rochelle Walensky, director of the Centers for Disease Control and Prevention (right) reflected on her tenure at the federal agency during a Public Health Conversation at Boston University’s School of Public Health on Thursday, March 30. She was joined by Sandro Galea, SPH dean and Robert A. Knox Professor. “Our job is successful when nobody hears about public health,” Walensky said during the event. Photo by Michael Saunders
Coronavirus
CDC’s Rochelle Walensky Visits BU’s School of Public Health Director of Centers for Disease Control and Prevention reflects on agency’s pandemic mistakes and successesWhen President Biden selected Rochelle Walensky to take the reins of the US Centers for Disease Control and Prevention (CDC), the former infectious diseases division chief at Massachusetts General Hospital and professor of medicine at Harvard Medical School asserted in her nomination speech that “leading with science is the only way to deliver breakthroughs, to deliver hope, and to bring our nation back to full strength.”
During a recent visit to Boston University’s School of Public Health, Walensky said she stands by that statement—with one caveat.
“I assumed, which was not appropriate, that the people who were listening understood that science would change,” she said during a wide-ranging Public Health Conversation moderated by Sandro Galea, SPH dean and Robert A. Knox Professor, on Thursday, March 30. “Scientists and academics understand that, but not everybody understands that. [I] should have said, ‘science—and it will change,’ or ‘science, for now, and we will update you and give you more information as we have it.’”
Walensky reflected on the agency’s oft-criticized COVID-19 communication missteps, as well as a number of other topics, in front of the more than 1,100 people who attended the hybrid event in person and via Zoom.
The discussion spanned the public health gamut, exploring the CDC’s mistakes, successes, and lessons learned during the first pandemic in the age of digital media, and identifying pathways for the 76-year-old agency—and broader health and science fields—to regain the trust of the American people, develop clear and effective messaging, and confront other urgent national crises, such as climate change, gun violence, and maternal mortality.
Confronting the rampant misinformation on social media is difficult, but necessary, Walensky said. “We like that kind of active discussion and disagreement, but at the same time it’s not always used for productive purposes,” she noted, adding, “It’s a really interesting, but really difficult space right now for social media.”
Over the course of the pandemic, the CDC has adjusted the way it develops certain recommendations, currently applying a more layered strategy that “can apply to Manhattan, and tribal country, and Guam, and rural Idaho,” she said. “We need to provide options for what you can do in your place when you have these resources, and this capacity, and this sort of political will.”
“Do you place value on your economy being open over your risk of health?” Galea asked.
“Those are values judgments, and we don’t get to decide how everybody else places those values—and at that intersection is politics,” Walensky replied.
“Do we have a role to play in shaping values?” Galea followed.
“I think we have a role to play in helping to understand risk [and provide] accurate science to help shape those values,” she answered.
Noting that she inherited a “frail public health infrastructure,” Walensky stressed that evaluating and improving the systems and processes within which the agency collects, analyzes, and disseminates public health data will be critical to the CDC’s future—a future that will continue to encounter numerous infectious diseases, she predicted.
These challenges necessitate faster production of data without compromising the accuracy and clarity of information, she said. Strengthening the agency’s laboratory infrastructure, modernizing data systems, and supporting data analytics training will improve monitoring capabilities, such as wastewater and genomic surveillance. And all of this work must be done through an equity lens, aiming to close racial and socioeconomic gaps in access to adequate healthcare and community resources.
Walensky also touted several public health accomplishments during her tenure, such as the agency’s successful efforts to publish the first technical briefs worldwide on the performance of the mpox (formerly known as monkeypox) vaccine, following the rapid and unexpected spread of the mpox virus across the US last year.
In other public health successes since she took the helm at the CDC, the agency formally named racism and firearm violence public health issues, established the agency’s Center for Forecasting and Outbreak Analytics, and administered more than 673 million vaccines in the last two and a half years.
Walensky noted that some of the successes were small and mostly unheralded, such as when US government officials dropped test kits from a helicopter to stranded passengers aboard the luxury Diamond Princess cruise ship during the first COVID wave.
And during last year’s Operation Allies Welcome, the federal government coordinated support to resettle vulnerable Afghans and welcomed 80,000 people into the US in August 2023, she said. Unknown to many outside of the agency, there were 44 active measles cases and 14 active mumps cases among the refugees, and neither disease spread to the broader community, thanks to the swift containment efforts by the CDC.
“Our job is successful when nobody hears about public health,” Walensky said.
During the event, Galea selected several questions that members of the audience submitted electronically. In responding to a question about the CDC’s role in developing policies to curb gun violence—as the nation reels from the latest mass school shooting, which took the lives of three children and three adults in Nashville, Tenn.—Walensky made an appeal for unity on an issue that continues to destroy families in every corner of the nation.
First acknowledging the Nashville tragedy as a parent, she said the administration has expanded research on firearm violence prevention, but noted the additional need to collect data and address firearm injuries and other lasting effects of gun violence on shooting survivors.
“We do have to come to terms on what we agree on across the aisle because we have to get to ‘yes,’” Walensky said. “Can we agree for firearm owners and [non-firearm owners] that we do not want to have loved ones die unnecessarily of a firearm death? Let’s just agree on that. I’ve been to a firearm training facility where they were teaching eight-year-olds to shoot. What is it that you should also be teaching your eight-year-olds about safe storage—about how we engage in prevention of community-based violence? Let’s get everybody to the table so that we can agree.”
Watch the full conversation with Rochelle Walensky here.
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Sph Podcast On Health Studies Helps You Lose Weight (Not Really)
SPH Podcast on Health Studies Helps You Lose Weight (Not Really) Free Associations scrutinizes health claims, and has fun doing it
The SPH professors hosting the Free Associations podcast: Donald Thea (from left), Matthew Fox, and Chris Gill. Photo by Nick Gooler, School of Public Health
It drives people nuts.
One study says coffee will extend your life. The next one says it will kill you.
Or it’s red wine. Or bacon. Or whatever.
“Last week they said this, this week they’re saying that, and as a consumer that’s really hard to wade through and figure out what is real and what is not,” says Donald Thea, a School of Public Health professor of global health, one of three voices on the new Free Associations podcast, which looks at the validity of the research behind the most recent health claims.
The podcast, a fast, funny and well-informed conversation among health experts, launches tomorrow. It’s produced by the Population Health Exchange (PHX), SPH’s new resource hub and continuing education initiative focused on public health. The podcast hopes to help listeners sort through competing claims and look beyond those DRAMATIC HEADLINES! to the actual medical research behind them. The first two episodes will be available for download Tuesday, and new episodes will be released every other week thereafter.
Listen to a sample of their conversation about an infamous claim that the measles/mumps/rubella vaccine causes autism:
“The three of us are deeply cynical iconoclasts,” says Thea, who cohosts with Matthew Fox (SPH’02,’07), an SPH professor of epidemiology and global health, and Christopher Gill, an SPH associate professor of global health. “We very much like to question authority.”
But they do it with science. They take apart and examine the scientific method behind publication studies, looking for biases and errors. They also compare what the results actually say to what can be reported via sound bites on the evening news.
“What we are doing is pulling back the curtain on how you make the sausage and showing that maybe the conclusions that are being sold as true aren’t, because they got it wrong,” says Thea, who is also director of BU’s Center for Global Health and Development.
What the media find interesting tends to quick fixes and studies that in the long run may not be borne out, they say. Among the subjects in the first six episodes are a report that moderate wine drinking is good for your health, and one on the relationship between chocolate consumption and atrial fibrillation. Each 45-minute episode includes shorter segments explaining study methods and terminology (e.g., selection bias or how peer review works) and offbeat health-related news. Regardless of the topic, fans of National Public Radio shows like Car Talk or Wait, Wait…Don’t Tell Me will feel right at home with their sardonic banter.
All three hosts attend what are called journal club gatherings at SPH, where staff and students get together informally to hash over notable articles in recent medical journals. Who suggested turning those conversations into a podcast? “It was Matt’s idea,” the others say in unison, as Fox nods in mock contrition. A fan of the NPR podcast Pop Culture Happy Hour, Fox pitched the idea to Leslie Tellalian, SPH director of lifelong learning and prime mover behind PHX.
She said yes. The three speak to a very broad audience, from public health students and professionals to the general public, Tellalian says, and she hopes they’ll attract listeners to PHX’s other offerings. “I think they’re really good people to open doors for us,” she says. “Understanding what they do and how they do it helps people understand what public health is and the role it plays and the importance of it.”
In addition to being friends, the podcast hosts have each taken a turn teaching the course Skills in Critical Analysis and Evidence-Based Writing for Public Health Professionals. They’ve taught students how to analyze a journal article, find its strengths and weaknesses, and come up with conclusions about its value.
“The students love it when we tear down these icons of authority, like the New England Journal of Medicine or The Lancet, and say, ‘That article’s a piece of crap,’” Thea says.
“We all do this research too, so we’re pretty familiar with the ways that we’ve gotten it wrong,” says Fox. “We just thought it would be fun to get together and do something that was topical and use those critical thinking skills.”
Such critiques are not just intellectual exercises. There were localized outbreaks of measles after the MMR-causes-autism study, and more recently, the Zika virus outbreak led to several irresponsible theories likely to cause more harm than good, according to Thea.
“There is this belief that anything that is published is true,” says Gill. “That is not the case.”
Free Associations seems especially timely in the age of fake news, phony internet experts, and a president who claims that global warming is a Chinese hoax. The hosts say it’s frightening the way basic science is being called into question, often for political reasons.
“What’s going on at the EPA has been another thing that’s motivated some of this,” Fox says. “Seeing the way they are going off a complete lack of science in making these policy decisions just made me more interested in what the science actually says.” The three profs are not trying to sow doubt in the scientific process by debunking some reports, he says, but are saying that challenging the results is part of the process.
“The real issue is that the scientific process is a lot messier and less definitive than is popularly believed,” says Gill. “It’s much more incremental, it lurches back and forth before taking paradigm shifts and exposing new truths.”
PHX Free Associations Podcast Launch and Listen Party, featuring the live recording of an episode, is Tuesday, September 12, from 5:30 to 7:30 p.m., in the Hiebert Lounge, 72 E. Concord St., on the Medical Campus. It is open to all, and there will be refreshments and prizes. RSVP here.
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Tips For Improving Employee Mental Health
Even before the COVID-19 pandemic, a work-based mental health crisis was emerging. Now, things are much worse.
In response to the crisis, the World Health Organization has released guidelines on workplace mental health.
Taking practical steps to support employees’ mental health is good for employees and the company’s bottom line.
This article is for business owners who want to create a healthy workplace where employees feel supported.
Studies have shown that mental health challenges, especially anxiety and depression, were steadily growing in the years leading up to the COVID-19 pandemic, particularly among young adults just as they were entering the workplace. The pandemic only compounded these issues and exacerbated the growing workplace mental health crisis.
These trends have dramatic implications for entrepreneurs and business owners. Employees who struggle with their mental health are less productive, more likely to miss time and more likely to job hop, taking institutional knowledge with them. As an employer, you can play a critical role in supporting employees’ mental health and preventing worker burnout through policies, benefits and the organizational culture you create.
A growing workplace mental health crisisMental health challenges are widespread and growing. More than 20% of U.S. adults experience mental illness annually, with 5% experiencing serious mental illness. Even before the COVID-19 pandemic arrived in 2023, mental illness was on the rise among the U.S. workforce.
When the pandemic hit, this trend rapidly accelerated, with the prevalence of anxiety and depression increasing by a staggering 25% worldwide, according to the World Health Organization (WHO). In a 2023 survey, the American Psychological Association found that nearly 4 in 5 employees experienced work-related stress in the month prior and that 60% reported negative impacts of that stress, including a lack of motivation and a lack of energy.
In response to these issues, the WHO issued new workplace mental health guidelines, which recommend that employers improve workplace conditions, provide better mental health training for managers, train employees on mental health self-management, and educate human resources staff on how to work with employees or job applicants who are facing mental health challenges. The guidelines also include information regarding how soon employees should return to work after facing a mental health crisis.
Mental health is more than just a personal issueAmy Edelstein, a bestselling author and the founder and executive director of Inner Strength Education, stressed that mental health issues cannot be viewed in isolation.
“Our social, emotional and mental health impacts everything from our immune systems (think cost of employee absences or project delays) to quality of communication to ability to manage pressure,” Edelstein said.
Research by the WHO bears this out: The organization estimates that 12 billion working days are lost annually to depression and anxiety, costing businesses $1 trillion in lost productivity.
In particular, burnout – a more nebulous mental health issue but one that is spiking sharply – is a threat. In a pre-pandemic study by Kronos Inc. and Future Workplace, nearly half of human resources leaders said employee burnout was responsible for between 20% of 50% of their workforce turnover, and almost 10% of those leaders believed burnout was causing more than half of annual turnover.
Did You Know?
The average cost of employee turnover is thought to be roughly six to nine months of an employee’s salary or wages. Consistent churn among your workforce can become incredibly expensive.
Mental health: good for employees and the bottom lineHealthy, happy employees are productive and tend to stay with one employer, take on new responsibilities, and grow in both their roles and within the organization. At a time when it’s harder than ever to find and retain talented workers, investing in employees’ mental health is not just the right thing to do; it’s an essential human capital strategy.
How To Generate A Public/Private Ssh Key In Linux
If you are using SSH frequently to connect to a remote host, one way to secure your SSH server is to use a public/private SSH key so that no password is transmitted over the network. It can prevent against brute force attack too.
In Linux, creating a public/private SSH key is easy.
Open a terminal. Type:
ssh-keygen
-t
rsaAlternatively, you can also use the DSA (Digital Signing Algorithm) technology to create the public/private key.
ssh-keygen
-t
dsaNote: there has been much debate about the security of DSA and RSA. In my opinion, unless you are very particular and love to delve into the technical detail between the two technologies, it doesn’t matter which of the two you choose. Both will work fine.
In the next screen, you should see a prompt that asks for the location to save the key. The default location is the .ssh folder in your Home directory. Press Enter to accept the default setting.
You will be prompted to enter a passphrase – NOT the passphrase to connect to your remote host, but the passphrase to unlock the private key so that no one can access your remote server even if they got ahold of your private key. The passphrase is optional. To leave it blank, just press Enter.
Your public and private SSH key should now be generated. Open the file manager and navigate to the .ssh directory. You should see two files: id_rsa and id_rsa.pub.
Upload your new SSH public key to your remote host by running the following command:
ssh-copy-id username@
remote-host-ip-addressLog in to your remote host and edit your SSH config file:
ssh
username@
remote-host-ip-addresssudo
nano
/
etc/
ssh/
sshd_configScroll down the config file and make sure the following attributes are set correctly:
RSAAuthenticationyes
PubkeyAuthenticationyes
PasswordAuthentication noPress Ctrl + O to write and save the file, then Ctrl + X to close the file.
Restart the SSH server in the remote host:
sudo
systemctl restartssh
That’s it. You can now connect to your remote host with the following command:
ssh
username@
remote-host-ip-address Frequently Asked Questions I copied my SSH key to my remote server and am getting a “Permission Denied” error.This problem is most likely due to an issue with your remote host’s “.ssh” folder. By default, the SSH daemon rejects any incoming connections if its configuration folder and “authorized_keys” file does not have the right permission bits.
To change the file and folder permissions, access a local console for your remote machine, thrn go to your “/home” directory and run: chmod 700 /home/$USER/.ssh && chmod 600 /home/$USER/.ssh/authorized_keys. Lastly, restart the daemon to apply your new settings: sudo systemctl restart ssh.
Is it possible to create multiple SSH keys for the same remote server?Yes! However, you need to make sure that each SSH key in your machine has a unique file name by running: ssh-keygen -f /home/$USER/.ssh/filename.
Aside from that, make sure that you specify the key you want to use to log in to your remote host by running: ssh -i /home/$USER/.ssh/filename [email protected].
Is it possible to import a new SSH key to a remote host with an old working key?Yes! First, import your new key to the SSH authentication agent: ssh-add. Next, log in to your old machine and import its key to the same authentication agent: ssh -A old.machine.ip.address && ssh-add -c.
Lastly, leave the old machine by pressing Ctrl + D and connect to your remote host with both your new and old keys.
Image credit: Unsplash. All alterations and screenshots by Ramces Red.
Ramces Red
Ramces is a technology writer that lived with computers all his life. A prolific reader and a student of Anthropology, he is an eccentric character that writes articles about Linux and anything *nix.
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5 Content Marketing Ideas For Health Tech Startups
If you are in charge of the content marketing efforts for a healthcare technology startup, you have lots of challenges and opportunities facing you. Before you start your content marketing efforts, check out these strategies.
Add a Human TouchOne issue that vexes businesses in the healthcare industry is the perception that dollars and data matter more than people. The perfect medium for challenging this perception is content marketing. Create content such as employee bios and your company story. Let people know about your and your staff’s passion for your product and commitment to wellbeing. As you create your overall strategy, be sure your focus remains on showing that you care and providing wellness information rather than pushing sales.
Provide Answers Your Audience Can UnderstandInformation is important to your audience. Your ability to provide that information in a way that a lay person can understand it, is extremely important. Avoid medical jargon in your content marketing. You may think that using complex terms will increase the perception that you are an expert in your field, but the reality is you will just confuse people and drive them away.
Give a GiftThis strategy is not unique to healthtech. However, the gifts you choose to give should be. For example, if a consumer provides you with their email information to subscribe to your monthly newsletter, you could include access to a free trial of your product. If another customer submits information to receive a free quote, you could provide them access to a free eBook with wellness tips and healthy recipes. Giveaways are a great way to thank your customers when they complete micro conversions. Keeping the giveaways focused on healthcare related products helps to cement your branding.
Lebron Meng, founder at Check Pregnancy says this about using gifts in healthcare, content marketing:
“People associate so many negative things with the healthcare industry. In fact, if you bring up words such as doctor’s appointments or medical treatment, and people associate that with bills and financial hardship. Even a lot of wellness outreach efforts are seen as guilt inducing. In the midst of all of this, a simple gift is really meaningful.”
Share Customer Stories Not TestimonialFor some industries, testimonials are a great thing. The basic formula of a testimonial is this. Description of problem + description of negative impact of problem + description of how product X solved problem + description of positive results due to solving problem = testimonial. That’s not enough for the healthtech industry. Instead, encourage customers to share their stories, just like you encourage your staff to share theirs. For example, a testimonial might look like this:
I’ve been struggling to make it to doctor’s appointments due to my work schedule. I’ve even had to skip over important well visits with my doctor. Thankfully, the 24-hour clinic that is now available at my local pharmacist can see me at any time. I can even download their app to access my health records 24/7. My health needs will never get put on the backburner again.
In contrast, here’s how a story will look:Two months ago, I had an important appointment with my doctor. Then, my boss told me I had to work mandatory overtime. I couldn’t say no. So, I called to reschedule my appointment, and I was told it would be six months before I could be seen again. I was devastated. I’d been dealing with painful symptoms for months and had no answers. Now, I was put off for another six months. Why wasn’t there a healthcare option available for people like me, where access was a priority? Thankfully, a friend told me about a new health center that was open 24 hours per day. I can even use their app to access my records and submit questions to the nursing staff.
Put Your Spin on Healthcare NewsThink of all of the healthcare stories that have hit the news over the past year. The Zika virus, Martin Shkreli, The Affordable Care Act, and the recent Aetna crisis are just three examples of major news breaking stories. When these stories break, people often don’t know what to think. This is why your input is so important. Keep track of trending healthcare news. Then, take the role of a thought leader and give your expert opinion and perspective.
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