1 09 2009

Games at - Sneeze Another part of the multiliteracies project was identifying relevant texts to use with students to teach grammar and other concepts. In this day and age it’s important to recognise non-written grammars (colours, lines, vectors etc.) and digital texts. So I am able to use flash games as learning aides.

Sneeze! is a gem of a game. Very simple and illustrative. Use your single loaded sneeze to infect as much of the level as possible.

In addition to all the pretty colours – which set the mood, and add meanings – there’s also some audio to get children to analyse too.

Hattip to Nature’s The Great Beyond.

Unit: Swine flu and you

1 09 2009

What would you do?

For my multiliteracies assessment I have planned out (somewhat) a Swine Flu/Public Health unit for a hypothetical group of year 7s. The unit combines essential learnings mostly from the Key Learning Areas of English (we had to include English) and the Health in HPE (which suits disease units better than Science standards).

A main part of the unit planning task was to come up with multiple outcome tasks for our students, that would cater to a range of diverse learners. Gone are the days when everyone is expected to hand in a written information report. We had to design our tasks to combine not only multi-modes, but also cross-genre tasks.

The tasks I set this imaginary groups of four students were:

  • An animated morality play: Students would script and create an animated (stop-motion, flash-based, cut-outs) narrative short film that will educate a peer-level audience on appropriate disease prevention and control strategies during an influenza pandemic. This group would have some help in accessing technical expertise from a high school AV club (one good thing about a hypothetical classroom of hypothetical students with hypothetical tasks meant we could hammerspace mentors and equipment). Outcome: Script. Character outlines. Final edited video.
  • Expert interview podcast: Students would identify and approach a small number of relevant community opinion leaders (doctors, scientists, nurses, school officials, mayors etc.) to interview. They would then use excerpts of the interviews to assemble an audio podcast on disease prevention and control in the event of a local influenza outbreak. This group would also receive guidance from our friendly teens in the AV club. Outcomes: Question plans. Opinion leader profiles. Final edited podcast.
  • Public health campaign: Students will design an entire school-based public health campaign that would encourage peers to engage in activities that prevent and control spread of influenza. The school’s art teacher has thankfully volunteered to help students produce printed materials (posters, pamphlets etc.). Outcomes: Multiple campaign materials. PowerPoint and group oral presentation of campaign to class.
  • Digital art gallery: Students will create a digital art gallery centred on a specific theme related to pandemic prevention and control. Students select a variety of images and illustrations, decide how to arrange them appropriately to create a user-friendly interactive display. Each picture needs to be accompanied by a short amount of text. Outcomes: Digital gallery – pictures, captions, layout and interface.
  • Recommendation report: Students will research pandemic responses around the world and produce an information report that compares these with actions taken in Australia and then provides recommendation on actions Australia should enact in the future. The report is for the Federal Minister for Health and will have a cover letter that provides a synopsis of the reports findings. Students will also provide a small resource folder that reports on ‘further reading’ resources the minister could use. Outcomes: Cover letter/synopsis, information report, recommendations, resource folder.

What sort of learners do you think each task was designed to cater for? Do you think I missed out on a particular group of learners with these tasks? Do you have a preference for which task you would like to be allocated if you were in my hypothetical class of year 7s?

What do you think of the idea of students being set different assessment tasks? Is it fair? Is it realistic?

You may notice that some of these tasks overlap in both content, genre and modalities. This is deliberate. After all, I cannot be expected to teach five totally distinct learning outcomes to a single class at the same time (or am I?) All students are working towards the HPE Essential Learning to “understand how to/apply skills to promote health and wellbeing” among other things.

Note: This assignment has been handed in and is currently being marked. The above outcome tasks have been somewhat refined from their original state.

For just one dollar a day

29 06 2009

No, I am not about  to con you into some religious sponsorship program.* Absolutely no African children for sale here.

It’s about SunSmart awareness and skin cancer prevention. The idea is that for $1 per day per person the Australian government could encourage people to regularly use sunscreen and prevent over 100,000 cancers and 20 deaths each year. This is based on some trials done in Queensland.

Now some of you might be trying to do the math. It is a little over 8 billion dollars annually for Australia’s 22 million inhabitants. But the authors make a compelling case by comparing it to the cost of public cosmetics expenditure, as well as government spending on vaccines (which cost $100s per dose).

Sunscreen is important for all Australians.

An exemplary example of framing science?

*Food for thought on religious-based missions here, here, and here

Scabies treatment uptake in regional indigenous communities

21 06 2009

ResearchBlogging.orgIn doing some background research for this blog entry, I discovered scabies causes 1 death in Australia per year. Yikes!

That aside, the point of this blog was to help illustrate that health is not just about big killer diseases. And that non-lethal diseases are not issues that do not need to be taken seriously. A non-lethal disease like scabies still represents a burden on the community. It drains on health resources, it also drains on family resources, and can also be a source of conflict and agitation.

This paper is an Australian study published through PLoS Neglected Tropical Diseases, it examines scabies and treatment uptake in two rural Aboriginal communities in northern Australia. A number of factors lead to these communities experiencing a high burden of scabies infestation – including distance from resources, household overcrowding and high mobility between households. Those most at risk are young children.

In general, the best known way to control endemic scabies is through community-based mass treatment initiatives. However these initiatives require community awareness and cooperation in order to be successful. This study looked to not only measure levels of cooperation and success, but also what barriers exist in the community that might hinder such initiatives.

Scabies is primarily an inflammatory condition caused by the bodies reaction to burrowing behaviour and eggs laid by the scabies mite (pictured to the left). In Australia, the approved treatment for scabies is a topical cream, permethin that is applied to the entire body. In the study, a “Healthy Skin Day” was held in the community, and all community members were advised to utilise the cream over an 8-day period. The study then followed those households in which at one or more cases of childhood scabies were subsequently identified.

If a child was diagnosed with scabies, the parent was given cream to use not only on the child, but every other member of the household. Not only is this because there is likely to be others not diagnosed but affected in the same household, but the mites are likely to just leave the treated person and go over to new host.

As expected scabies susceptibility was lower in households that experienced universal treatment. However, while 80% of children directly diagnosed with scabies used the supplied creams, compliance rates amongst other people advised to follow the treatment because of someone else in the household being diagnosed was less satisfactory (44% of these persons used the cream). Just over three quarters of households had at least one household member not take the treatment, and in almost a fifth no one followed the treatment. The study also noted that treatment cooperative households were more likley to remain in the study, meaning that if anything these statistics are possibly over-estimating compliance rates.

There were multiple factors that contributed to treatment not being followed through: treatment not being a priority, treatment was not considered necessary, and treatment caused discomfort. The first two of these responses point to issues in education and trust. The community needs to be aware of the burden of disease on the community, and the benefits of treatment. Trust is a more trickier issue, as the relationship between indigenous communities and the government is one giant elephant that I’m not quite ready to take on that I’m not quite wanting to take on at the moment. The last points to a question of whether the proscribed treatment is appropriate for these communities.

The authors point out that in a hot, crowded environment, a sticky cream-like substance is possibly not the most enjoyable of treatments to experience. The cream also needs to be washed off in the morning, and with drought and water access also being an issue in regional communities, provides further complications with treatment compliance. Sadly while creams like permethin are the only treatments available in Australia at present, oral treatments for scabies do exist and would seem on the front a more acceptable treatment for the tropical environment. Pills might also be considered more like “real working medicine” and therefore encourage higher rates of compliance.

This study, while obviously not carried out with unlimited resources, does a very good job at highlighting the multiple factors that complicate rural health.

La Vincente, S., Kearns, T., Connors, C., Cameron, S., Carapetis, J., & Andrews, R. (2009). Community Management of Endemic Scabies in Remote Aboriginal Communities of Northern Australia: Low Treatment Uptake and High Ongoing Acquisition PLoS Neglected Tropical Diseases, 3 (5) DOI: 10.1371/journal.pntd.0000444

Image credit: Scabies by MacAllenBrothers

Trends in internet influenza

20 06 2009

At the start of the month, Google announced it was expanding its search-engine-based epidemiology surveillance tool, Flu Trends, to process information originating from Australia and New Zealand (previously it was processing U.S. statistics and a beta Mexico version).

The tool is based on there being a correlation between the number of people typing in influenza-related keywords into Google and the actual number of cases of influenza in the country. Google claims it is supported by historical data. The concept does make sense: when you are your family are sick with flu-like symptoms, that would be the time you are more likely to search for information on possible causes – Thus people searching for “flu” could reflect the cases across the country.

But I was skeptical at how well it would work in a pandemic. Google’s data might hold up for its recorded history, but that does not extend back to 1968-9 – the last influenza pandemic. A pandemic not only involves the potential for an increased number of influenza cases and increased severity of those cases, it also means an increased amount of media coverage and public awareness. When I last looked at Google Trends and health searches, I saw a possible link between media coverage of Kylie Minogue and Australian searches for breast cancer. There is a good reason to suspect that the statistical relationship between search terms and disease cases will not hold up during pandemic conditions. This concern is not addressed appropriately in the Flu Trends FAQ.


Google Flu Trends Data, as of 20 June, 2009. Click for larger image. A - US 2008/09 search data c.f. historical B - Australia 2008/2009 data c.f. historical (2008/09 dark blue, historical light blue). C - Australia historical data (blue) compared with official epidemiological seasonal ILI (infleunza-like-illness) data (orange)

Google Flu Trends Data, as of 20 June, 2009. Click for larger image. A - US 2008/09 search data c.f. historical B - Australia 2008/2009 data c.f. historical (2008/09 dark blue, historical light blue). C - Australia historical search data (blue) compared with official historical epidemiological seasonal ILI (infleunza-like-illness) data (orange)

Looking at the U.S data, for this past season, it looks like it could be an accurate reflection. And if anything, rather than seeing a spike of search term activity this year, there was not much difference than previous years. In fact, the historic data contains several search spikes that do not exist in this years trends. All this information could either accurately reflect that the influenza pandemic thus far has been little more than out-of-season seasonal flu, or, just maybe, that the increased media activity and awareness have actually actively decreased usage of Google for health information.

Were people being directly channeled towards non-search websites, like Were they getting enough influenza information from other websites they frequent, like news websites? Was there enough offline influenza resources that people did not feel the need to Google to find out more? Or were people just overloaded and desensitized by the mass media hysteria?

I still prefer the Rhiza Labs case-mapping tool. It is much more informative and accurate.

First swine flu death in Australia

20 06 2009

My boss and some co-workers are flying to Melbourne on Monday to meet with clients. We were joking about how they should be extra careful while visiting the “swine flu capital of Australia“. Maybe she should put herself in a week-long quarantine when she gets back.

One of our Medical Writers pointed out how its all overblown. And I pointed out that no one had died in Australia yet.

Well, I guess I should stop opening my mouth to talk about swine flu from now on. A 26-year old Indignous man from central Australia died in Royal Adelaide Hospital ICU died from a number of complications, including pneumonia. He was infected with the Mexican Influenza A/H1N1 virus.

It is not known where or when the man contracted the virus, nor how much it may have contributed to his fate.

I’ve pointed elsewhere on the internets that WHO has expressed concern over the possibility that Indigenous Canadian groups may be more susceptible to the A/H1N1 virus. Let’s hope that situation is not true here (or there, even).

Do we take this as a sign to panic? That we aren’t doing enough? Or are the governmental precautions still too heavy handed? They won’t do anything to help, they did not help this man? Does this change anything? Is it just a continuation of SNAFU ‘flu?

Image Credit: ‘Chasing pig at Gatton College‘, Unknown circa 1940sState Library of Queensland on flickr

Free drugs: Just say no?

28 05 2009 “Everybody likes something free.” I don’t think anyone is going to disagree with Chimonas and Kassirer there.

Drugs are expensive. And even if in a country like Australia, universal insurance may mean that vital medicines are cheap for the end-consumer, somewhere someone has pay the full price (i.e. the government).

Because drugs are so expensive, many drug companies – particularly when releasing a new product, will offer “free samples”. Now these aren’t quite like a give-away taste-test counter like at the local deli – the drugs still need to be prescribed by the doctor to a sick patient – but the principle is the same. You try it, and if it works, hopefully you’ll buy the real deal.

Sounds great! Hospitals get free medicines. Doctors learn about new treatments. Patient receives expensive treatment cheaply. And Pharma makes a friend. Everyone is a winner! What’s not to love?

Well… turns out it’s not quite the rosy picture we’d pictured. PLoS Medicine carries an investigative essay on the ramifications of free drug samples on the health care system.

Summarised points below: Read the rest of this entry »