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The McConnon Strain - A mysterious outbreak of unknown spread

Posted By Lauren Reeves, Thursday, August 14, 2014
Untitled Document

Despite advances in healthcare, infectious microbes continue to be formidable adversaries to scientists and doctors. Deadly Outbreaks—a book of real-life outbreak mystery stories—recounts the scientific adventures of a special group of intrepid individuals who investigate disease outbreaks and figure out how to stop them.

Several upcoming blog posts will describe stories from Deadly Outbreaks, written by Alexandra Levitt. (You may recognize some of these outbreak or their causes, or you may know some of the epidemiologists. Read on to find out….) For example, this week’s post concerns an outbreak of a dangerous drug-resistant disease with the potential for international spread. Like today’s Ebola outbreak in West Africa, the dangers posed by this outbreak underscore the critical importance of maintaining local public health systems that do the day-to-day work of investigating outbreaks and stopping them at their source. We rarely know in advance which small outbreak or disease cluster will turn out to be something truly dangerous and devastating.

Here is what happens in the outbreak story entitled The McConnon Strain:
Epidemiologists sometimes face difficult choices, with moral, political, and financial repercussions that must be weighed against risks to human health. In 1983, for example, two officials, Patrick McConnon (from the United States) and Roland Sutter (from Switzerland), agonized about whether to delay the long-awaited repatriation of 20,000 Cambodian refugees, fearing that some might carry a rare, multidrug-resistant form of malaria. The U.S. Government planned to fly the refugees from Thailand, where they lived in border camps, to the Philippines (where they would be processed for entry into the United States). Stopping the flight would prolong the misery of hundreds of desperate families eager to resettle and start new lives. On the other hand, introducing an untreatable form of malaria into a mosquito-infested part of the Philippines could bring illness or death to thousands or even millions of people. As recorded in Deadly Outbreaks (page 38):

People stranded in refugee camps, displaced, impoverished, and malnourished, are at special risk for infectious diseases such as malaria, measles, and cholera that flourish in crowded and unsanitary living conditions. When infected refugees are moved to new holding sites, repatriated, or resettled in new countries, they can bring these diseases with them. As a result, public health officials like McConnon have overlapping and sometimes conflicting aims: to safeguard the health and welfare not only of the refugees themselves, but also of the people in countries that host refugee camps or accept refugees as permanent residents.

The spread of smallpox after the 1971 Pakistani civil war illustrates what can happen when a pathogen incubated in a refugee camp infects the wider population. Smallpox was carried to the newly established nation of Bangladesh by Bengali refugees returning home from India. According to public health lore, the presence of smallpox in the camps was detected by an epidemiologist in Atlanta, sitting in his living room watching TV, who noticed a man with a suspicious rash in a newsreel about a camp near Calcutta... The epidemiologist called the director of CDC, who called the director of the WHO Smallpox Vaccination Program, who called the Indian Ministry of Health. But it was already too late. Thousands of Bengalis had already left the camp, leading to widespread outbreaks in Bangladesh and making the last Asian country to eliminate smallpox.

McConnon was well aware of this history, because he had worked in Bangladesh in 1975, the final year of the smallpox eradication effort in Asia. He tried to convince an official at the U.S. State Department that it was dangerous to send refugees to the Philippines before screening them for this unusual strain of drug-resistant malaria. But the State Department official was skeptical and demanded to see some evidence.
With few resources and little time, McConnon and Sutter conducted a small-scale epidemiologic study in the border camp. If they could figure out which activities (e.g., farming, fishing, water collection) exposed people to malaria, they might delay the departure of exposed refugees while allowing unexposed refugees to proceed to the Philippines. As part of the study, they plotted the location of each malaria case on a map of the refugee camp, hoping to see a pattern. However, the data did not support any of their hypotheses. There was no association between the malaria cases and growing crops or working near the forest, swamp, chicken coops, or garbage dump. In fact, the distribution of malaria cases seemed entirely random, except for one thing: nearly all the cases involved males between the ages of 13 and 35.
This did not make sense! The mosquitoes that carry malaria do not distinguish between women and men or between the young and the old. McConnon and Sutter remained frustrated and puzzled—until they stumbled on an explanation during a conversation in a local bar when an aid worker mentioned a border-camp activity they had not tested for…
Stephen Ostroff, MD, former deputy director of CDC’s National Center for Infectious Diseases and former director of Pennsylvania’s Bureau of Epidemiology, said that “anyone with even a passing interest in disease investigation will find Deadly Outbreaks to be a great read. So too will all practitioners of public health, from students contemplating a career in epidemiology to the most seasoned veteran.” You can purchase a copy of Deadly Outbreaks by author Alexandra Levitt at amazon.com.

Tags:  deadly outbreaks  infectious disease  malaria  outbreak 

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Integrating our work with primary care

Posted By Katrina Hedberg, Thursday, August 7, 2014
Untitled Document
The landscape for both public health and the healthcare delivery system is changing for several reasons: the Affordable Care Act (ACA); efforts toward public health department accreditation; and requirements for community health assessments conducted by public health departments, hospitals, and accountable care organizations (ACOs). In Oregon, we use a coordinated care organization (CCO) model that envelopes a patient in medical, mental health, and dental care to provide care for the whole person.
For CCOs to be successful in achieving the triple aim of improved quality of care, improved population health, and lower costs, CCOs will need to focus on upstream prevention as well as improved care. CCOs are responsible for achieving metrics related to this triple aim, which should include receipt of clinical preventive services.
Public health epidemiologists can play an important role in helping to identify important metrics for CCOs and ACOs and to encourage these organizations to think about improving the health of the entire community in which their enrolled population lives. In addition, these organizations must work together with public health departments on community health assessments, as we have a role in determining the health status of our communities.
In Oregon, the Public Health Division is part of a larger agency, the Oregon Health Authority. The Office of Health Analytics, a separate division within the Oregon Health Authority, is responsible for analyzing healthcare service delivery data for Oregon’s CCOs. The Public Health Division is implementing an analytics tool that allows users to analyze public health data (e.g. birth, death, and reportable diseases) by not only the traditional state or county delineations but also by CCO service area. Looking at our data through different lenses and denominators helps us work with the CCOs to integrate healthcare and public health. Oregon also has a State Innovation Model grant from the Centers for Medicare and Medicaid Services, funds from which are being used to conduct a BRFSS-like survey of the Medicaid population to look at upstream health indicators.
Last year, CSTE Executive Director Jeff Engel and I attended a conference about the integration of public health and primary care for public health practitioners and clinicians. It was a good meeting, but epidemiologists were missing from the table. Coming away, we knew that epidemiologists have an important piece to inform the discussion, including data availability, metrics, and evaluation. Public health and healthcare systems have different definitions of ‘population health’—Epidemiologists generally think of their population as ‘everyone in a defined geographic location at a particular time,’ whereas healthcare systems hear this phrase to mean 'everyone enrolled or who received a service.' These realms are similar but slightly different, and these two definitions of the same word illustrate the difference. The epidemiologists' definition of population encompasses that of the healthcare system. We have to make sure we are using the same language and terms in order to work together to make our environment conducive to health as well.
From this meeting and these ideas, the Public Health and Primary Care Integration Subcommittee was born. It is clear CSTE can contribute to this new area for epidemiology and for public health. The subcommittee will have conversations that talk about, for example, the ways public health and healthcare use different terminology, what epidemiologists around the country are doing in this area, and how epidemiology can continue to have a seat at the table as health care transformation is implemented.
Katrina Hedberg - State Epidemiologist Oregon

Tags:  affordable care act  healthcare  member spotlight 

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Telling the Stories Behind the Data

Posted By Robert Harrison and Laura Styles, Thursday, July 31, 2014
Untitled Document
As epidemiologists, we view and interpret a lot of data. It's our responsibility to take action on the surveillance we conduct. Public health professionals understand that each case, each dot on a map, each block on an epi curve represents an ill patient, a person who has died, or a worker who has been injured. To us, charts and tables and summary reports tell an important story, but for others, we have to make it more personal to make an impact.
The Fatality Assessment and Control Evaluation (FACE) program is a case-based investigation program for the prevention of work-related injuries and illnesses. When workplace fatalities for landscape services increased in California and nationally from 2010 to 2012, we wanted to look closer. Data from the Census of Fatal Occupational Injuries (CFOI) confirmed that tree trimmers' fatality rate is twice the national average for worker fatalities. There is also a high incidence of workplace injury in this industry, although not all workers report these injuries or receive medical treatment.
At the California Department of Public Health, Occupational Health Branch, we have created videos about worker safety and health issues in addition to fact sheets, fatality alerts and investigation reports. These videos are a new strategy in the California FACE program’s prevention effort – written findings and prevention recommendations are brought to life with video re-creations, photos from the investigation, interviews with co-workers and family members, and clear explanations of how these tragedies can be prevented.
One such video, "Preventing Palm Tree Trimmer Fatalities," tells the story of Roberto, a 35-year-old tree trimmer, who died of suffocation when the palm fronds he was cutting fell on him. The video also explains proper equipment and climbing techniques that prevent this type of hazard. We see these workers every day around our neighborhoods, and they perform one of the most dangerous jobs in the U.S. They often don't have adequate training, and several deaths due to falls, suffocation, and other causes have occurred in California and elsewhere.
Click here to view the video, Preventing Palm Tree Trimmer Fatalities.
The California FACE video uses digital storytelling techniques to create a different kind of narrative to communicate public health data and messages. The key messages for the video are conveyed through real people and a real story; the video shows the devastating impact of not using proper palm trimming equipment or climbing techniques on the job. We listened to those affected by this issue so we could tell their story respectfully. This approach makes occupational health personal and local for viewers and the public, in order to encourage safety and prevent deaths.
A lot of planning went in to creating the video itself. We created a storyboard as a roadmap for the video with planned narration, video, and photos. Production partners included the Los Angeles County Fire Department, and tree climbing and safety professionals. We sought to balance the emotional and the factual, the problem and the solution, and to create a compelling video that could be used in trainings and would tell Roberto’s story.
We have found this and our other workplace safety videos on YouTube to be an effective medium to reach our target audiences and make our surveillance data come alive for maximum public health impact. We hope you can use our experience to weave together data and narrative to tell an important story for your program.
 
Laura Styles is the California FACE Program Manager, and Robert Harrison is the Chief of the Occupational Health Surveillance and Evaluation Program at the California Department of Public Health, Occupational Health Branch.
 

Tags:  collaboration  data  member spotlight  occupational health 

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Epidemiology methods – Our common link

Posted By Matt Thomas, Thursday, July 24, 2014
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As an epidemiologist for the tobacco program and formerly with the healthcare associated infections program at the Vermont Department of Health, I’ve been exposed to several different types of public health practice within applied epidemiology. Every program area has one thing in common—each relies on the same epidemiology and surveillance concepts and methods. These methods provide a foundation that ties all of our work together.

I’m finding in my career that epidemiologist are often in situations in which they may not have enough time or resources to fully utilize their training in epidemiology methods. This might be due to the pressures to quickly provide the public and partners with data or the need to have epidemiologist play a role in a variety of other functions (e.g., disease control, program evaluation, performance measurement, or informatics). The epidemiologist may have a supporting role in all of these activities, but that role shouldn’t be at the expense of the practice of epidemiology methods. While providing data to the public and partners is an essential function of an applied epidemiologist, that data is produced as a result of epidemiology and statistical methods. Placing a priority on that final product without prioritizing methods can lead to less reliable data. The Epidemiology Methods Subcommittee was formed to address these issues.
The Epidemiology Methods Subcommittee gives us the opportunity to highlight why epidemiological methods are integral to public health. The subcommittee focuses on both providing methodological content and building capacity to better allow epidemiologists to practice their skills.
So far, this new subcommittee has begun a series of webinars, each of which focuses on a different topic pertinent to applied epidemiologists. These webinars allow us to listen to our colleagues talk about epidemiology methods in-depth so we can use them in our day-to-day work. For example, one webinar looked at analyzing public health data using census tract-level poverty. Another discussed data analysis in small jurisdictions. Continuing to learn new methods and improve our skills allows us to enhance public health.
Going forward the subcommittee will take on projects related to improving how health departments function as a system in addition to professional development about epidemiology methods. In many settings, improving the organizational setting may be a necessary step that allows epidemiologists to practice the novel methods they learn from the webinars.
I have often heard from leaders in epidemiology that we need to advocate for our role in the public health landscape, especially in an ever-tightening funding climate. The Epidemiology Methods Subcommittee can be a forum for us to improve our skills, promote the value of these skills to our partners, and advocate for the ability to use these methods to their fullest.
I’d like to see this cross-disciplinary group of epidemiologists continue to come together to learn about new topics and ways to promote and advocate for their value. We’re still in our formative stage as a subcommittee, and we could use your participation to shape it into what you want it to be. What do you want help with? What issues are you dealing with in your health department? What have you found success in that you can share?
Matt Thomas, PhD is an epidemiologist at the Vermont Department of Health and the chair of the Epidemiology Methods Subcommittee.

Tags:  epidemiology  member spotlight  professional development 

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Alaska’s New Vaccine Assessment Law

Posted By Joe McLaughlin, Thursday, July 17, 2014

In June 2014, Alaska Senate Bill 169, which authorized the formation of a statewide vaccine assessment account, was signed into law. The intent of this new law is to preserve universal access to state-distributed vaccines for children and to provide state-distributed vaccine for covered adults.

Effective January 1, 2015, the vaccine assessment account will be forward-funded through vaccine payments from payers (e.g., private and public health care insurers, health benefit plans, and third-party administrators), and will be overseen by an independent vaccine assessment council. Payers will be assessed based on their proportionate share of the overall vaccine costs. The Alaska Immunization Program will then use the account funds to purchase vaccines at a discounted rate from a bulk contract and distribute pediatric and adult vaccines to health care providers statewide.  

Although many other states have already created similar vaccine financing solutions, below are some of the distinctive features of the Alaska law that might benefit policy makers in other states who would like to pursue similar legislation in the future.

  • Adult Vaccines: Alaska’s new law allows assessments for both pediatric and adult vaccines. State-distributed vaccine will be available to providers for all children and adults who are covered by participating payers. Most other states that have similar programs only allow for the purchase of pediatric vaccines. 

  • The Model: The two primary models under consideration for the Alaska assessment are the “covered lives” model (e.g., Idaho) and the “dosage-based assessment” model (e.g., Washington). Alaska’s new law is not prescriptive in terms of which model should be used; rather, it allows Alaska’s Vaccine Assessment Council the flexibility to make this determination.

  • Phase-in Period:  Under procedures approved by the DHSS Commissioner, an assessable entity will be able to opt-out of the program during a 3-year phase-in period. The effective dates will likely be on January 1 each year during 2015–2017.

  • Mandatory Participation: The law mandates participation—after the 3-year phase-in period—from all assessable entities, to the extent participation in the program is authorized by law. This includes Employee Retirement Income Security Law (ERISA) plans and publicly funded coverage like Medicare, Medicaid, and TRICARE. While publicly-funded healthcare benefit plans are included in the law’s definition of a health care insurer, it is currently unclear whether this law can require these entities to participate in the assessment program after the 3-year phase-in period, as federal law might prohibit such a mandate for at least some of the plans. Any federal plans that cannot be required to participate might still be able to opt-in to the assessment; those that are not able or willing to opt-in will need to continue directly purchasing vaccine for those clients not covered in the assessment by another payer.

  • Provider Opt-in: Providers will receive, at no cost, state-supplied vaccine purchased with vaccine assessment funds. Unique to the Alaska model, providers who care for uninsured adults can benefit from the state’s bulk purchasing power by opting-in to the program at any time. This provision offers providers a more cost-effective way to fund vaccines for their uninsured adult patients. 

  • Pharmacists: Pharmacists with a collaborating physician licensed in Alaska will be able to receive state-distributed vaccine for all children and adults who are covered by participating payers. Pharmacists can receive state distributed vaccine for uninsured adults if they opt-in to the program. 

  • Alaska’s Vaccine Assessment Council Responsibilities: The Alaska Vaccine Assessment Council will be established within the Alaska Department of Health and Social Services. Responsibilities of the Council include determining 1) the method for calculating the assessment amount; 2) the method for determining proportional costs to payers; 3) procedures for collecting and depositing assessment fees; 4) procedures for collecting data, which includes at a minimum the number of covered individuals and vaccine usage; and 5) developing a system for crediting overpayments. The council will consist of eight members appointed by the DHSS Commissioner; all members will serve without compensation for up to two 3-year terms.

The Alaska Immunization Program is committed to working with providers to make as much state-supplied vaccine available to Alaskans as possible in an equitable fashion.  More information about this Law is available at www.epi.alaska.gov under the “Spotlights” section, “Vaccine Assessment Account FAQ” link.

Joe McLaughlin is the State Epidemiologist of Alaska and CSTE President-Elect.

Joe McLaughlin

Tags:  Alaska  immunization  Law  member spotlight  Vaccine 

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Increasing informatics capacity

Posted By Lauren Reeves, Thursday, July 10, 2014
Updated: Thursday, July 10, 2014
“People are the most important; the systems are secondary.” Joe Gibson, Director of Epidemiology at the Marion County Public Health Department in Indiana, understands the importance of having capable people for public health and informatics capacity. He views epidemiology as decision support: getting the right information to the right people at the right time, to improve decisions affecting the health of the community. The belief in this process is underscored by Joe’s support of public health informatics training. Joe is a mentor in the Applied Public Health Informatics Fellowship program, which provides on-the-job training to recent graduates in order to increase public health informatics capacity. 

The Fellow working in Marion County under Joe’s mentorship is Crystal Clay, a graduate student in the School of Informatics and Computing at Indiana University Purdue University in Indianapolis. Crystal has enjoyed her time as an APHIF Fellow, because she’s received more experience with informatics and has been able to learn about public health informaticians and public health practitioners. “I’ve learned a lot about the value of effective communication, a vital skill for public health informaticians,” Crystal adds. “Effectively engaging stakeholders is especially important in informatics, which involves interacting with a diverse workforce.” She says the mentorship model of the fellowship was extremely helpful in understanding the health department culture, the agency’s structure and dynamics, and completing projects. 

Crystal has worked on several projects as a Fellow. One has dealt with Meaningful Use compliance, working with health department providers to teach them how to use the electronic prescribing system, and to adapt the system to the provider’s needs. “I created a training document and facilitated several training sessions to help providers improve care and ensure compliance,” she says.. “Marion County will continue to benefit from the progress Crystal has made,” Joe says. “She has made considerable progress on important informatics projects for our health department.”

Joe and Crystal both emphasize the role of informatics in public health and the role that business process analysis plays. Business process analysis helps get public health program staff to understand data and information as well as the technical side. Clearer business processes can streamline how public health works, making it more effective. Joe says that “public health increasingly needs rapid access to information. Both developing good information systems and paying attention to processes are important parts of achieving that.”

Perhaps the biggest indicator of the program’s success is the future. Joe says “I’d definitely continue a relationship with APHIF. The fellowship helps us train informaticians with great technical and public health skills.” Crystal, too, is looking towards the future and is interested in staying in public health. She also would like to serve as a mentor one day. “Mentors have played a monumental role in my success. It’s my desire to contribute to the development of other aspiring public health informaticians.”


Crystal Clay

For more information about the Applied Public Health Informatics Fellowship and other training programs offered by CSTE, including how to apply to be a mentor or a fellow, please visit www.aphif.org

Tags:  informatics  member spotlight  workforce development 

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Looking ahead to 2014-2015

Posted By Alfred DeMaria, Thursday, July 3, 2014
The CSTE Annual Conference was stimulating and thought provoking—there were many excellent examples of “epidemiology in action.” Attendees shared ideas and experiences, and created a real “community of practice.”
Now that we’re back from Nashville, I’m looking ahead to 2014–2015. Issues raised at the annual conference reinforced ideas I had about priorities for this coming year:
  • Informatics capacity continues to be a struggle, but we’re making progress. CSTE’s advocacy efforts educate policy makers to increase awareness and encourage funding. CSTE’s workforce development initiatives improve existing and new epidemiologists’ competencies in informatics skills. These continued efforts are important to sustain progress in this area.
  • Developments in laboratory technology are just beginning to have a huge impact on public health surveillance. We will have to adapt to these changes to preserve our ability to do effective surveillance.
  • Public health must align with the changes occurring in healthcare delivery and the focus on accountable care. Accountable care organizations (ACOs) are going to be responsible for the health of the populations in their care, not just their medical care. Public health epidemiologists should be the ones who are recognized as monitoring population health, identifying needs and holding ACOs truly accountable.
  • Hepatitis C, as a public health challenge, is entering a whole new level of complexity. Literally millions of cases are diagnosed and being diagnosed. We are entering an era of cure with more easily tolerated, shorter course, highly effective, but expensive therapy. We will be called on to define the burden and monitor trends, but we have never had the needed resources.
Together we can improve applied epidemiology, improve public health, and improve the health of our communities.
 
Alfred DeMaria, Jr. is the president of CSTE and the State Epidemiologist at the Massachusetts Department of Public Health.
 

Tags:  healthcare  infectious disease  informatics  laboratory 

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We’ve just begun!

Posted By Jennifer Lemmings, Thursday, June 26, 2014
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We at the CSTE National Office spend a lot of time planning for the Annual Conference – determining the topics and the session presentations, finding plenary speakers, getting the right mix of formal sessions and informal discussion and developing networking opportunities. And then, all of a sudden, the conference is here!
We’re at the last day of the conference already, and we’ve had another excellent meeting. Attendees from all over the country gathered to discuss topics ranging from occupational health to surveillance methods to oral health to vectorborne disease. We discussed and approved occupational health and infectious disease position statements that will be posted on our website soon. In addition, Steering Committees and several subcommittees held meetings to discuss their activities in the past year and plans for the upcoming year.
The work doesn’t end with the conference. In fact, CSTE program activities are year round. This summer, CSTE has several collaborative projects and ways for you to stay or get involved.
NNDSS Modernization Initiative (NMI)
CSTE is partnering with APHL to provide technical support for CDC’s NMI on the completion of six message mapping guides (MMGs): generic guide v.2, STD, hepatitis, congenital syphilis, pertussis, and mumps. Through this collaboration, CSTE and APHL will provide technical assistance to invited state and local jurisdictions and assist them in adopting the MMGs and using them to send test case notification messages to the CDC Platform. Stay tuned for webinars, online technical guides, and other training materials to support this implementation. More information on CDC’s NNDSS Modernization Initiative can be found on the CDC website.
New Vectorborne Diseases Subcommittee
This week marked the first meeting of the new vectorborne diseases (VBD) subcommittee. This subcommittee was formed to increase knowledge and improve practices related to VBD epidemiology in local, state, tribal, and territorial settings. The subcommittee will also serve as an overseeing body for reviewing and developing national position statements on VBD-related topics. Activities will include regular conference calls, training webinars, developing white papers, and convening a pre-conference workshop at the 2015 CSTE Annual Conference. If you are interested in joining this new subcommittee, please contact Dhara Patel at the National Office.
Epidemiology Methods Subcommittee
The Epidemiology Methods Subcommittee is another new subcommittee, which aims to increase knowledge and practice of epidemiological methods in state, local, tribal, and territorial settings. The subcommittee meets monthly via conference call to address relevant and emerging topics in epidemiologic methods. The CSTE webinar library is a great place to view past training webinars from this subcommittee and other CSTE program areas—I highly encourage you to check out recent sessions.
Public Health and Primary Care Integration Subcommittee
The Public Health and Primary Care Integration Subcommittee aims to promote partnerships between health providers and public health. This subcommittee addresses community epidemiologic surveillance to support community health needs assessments, the public health interface and use of electronic health records, and sharing lessons learned from successful public health and primary care professional partnerships. Subcommittee activities include regular calls and webinars (available at the webinar library). Contact Jessica Pittman if you are interested in participating in this subcommittee.
CSTE committee conference calls are a great way to find out what’s happening in a subcommittee and participate in discussions. Don’t miss out! Upcoming calls and information can be found on the CSTE calendar.
Not sure what fits best with your interests, or have an idea to share? Call any member of our program staff. We can discuss how you can contribute and be involved. There are plenty of examples of members trying out a committee and finding something they’re passionate about, like Andrea Alvarez or Renee Calanan.
 
We’re looking forward to working with you!
Jennifer Lemmings
Epidemiology Program Director
 
 

Tags:  cross cutting  staff spotlight  surveillance 

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Strike a Chord at the 2014 CSTE Annual Conference

Posted By Tim Jones, Thursday, June 19, 2014
Untitled Document
I am excited to welcome ‘y'all' to Nashville, Tennessee! In addition to taking advantage of a full and exciting conference agenda, I hope everyone takes time to enjoy the great setting of this year's meeting and the best of Nashville's attractions.

This year, our conference includes speakers, presentations, and discussions on a huge variety of topics, covering the full range of applied epidemiology under our theme, “Strike a Chord: Epi with Impact.” The CSTE Annual Conference is a unique opportunity to see colleagues and meet new ones from around the country, those within your program area and beyond. I encourage you to take advantage of professional development and learning opportunities outside your own “silos” to explore aspects of our field with which you may be less familiar.
New things going on at the conference this year include:
  • Poster rounds: This pilot program gives attendees a way to engage with poster presentations more actively. Moderators will lead poster round sessions, modeled after IDSA, to guide discussion and engage both attendees and presenters.
    (Infectious disease, Occupational health, and Surveillance/Informatics Monday at 12:30 pm; Chronic disease/MCH/Oral health and Environmental health Tuesday at 12:30 pm)
  • Informatics fellowship graduation: In addition to the Applied Epidemiology Fellowship graduation ceremony at the Connections Reception, our Applied Public Health Informatics Fellows will also graduate this year!
    (Connections reception Sunday at 6 pm; tickets required)
  • Rapid fire sessions: New breakout sessions this year allow for more presentations and accepted abstracts. As the name suggests, these presentations move quickly and give attendees the opportunity to hear a greater breadth of topics.
    (Chronic disease/MCH/Oral health Tuesday at 10:30 am; Infectious disease Tuesday and Wednesday at 10:30 am)
  • Deadly Outbreaks book signing and roundtable: Hear from author Alexandra Levitt and book contributors about the outbreak investigations featured in the book and get your copy autographed.
    (Book signing Sunday at 5:30 pm; Roundtable Monday at 1 pm)
Focus on informatics capacity development:
I’m very enthusiastic about the attention informatics has received recently. Thanks to CSTE’s efforts, including many of you, CDC has embraced the call for increased informatics capacity at CDC and in state and local jurisdictions. The Informatics Training In Place Program (ITIPP), the CDC Public Health Informatics Fellowship Program (PHIFP), and the Applied Public Health Informatics Fellowship are all examples of increasing efforts to meet this important need.
The Annual Conference will feature lots of sessions and discussions about informatics, including topics such as increasing data quality, Meaningful Use, ELR, and more.
Thank you to the Planning Committee, the Executive Board, the Bylaws Committee, and National Office staff for your work to drive this year’s conference to be another successful one.
And thank you to all of the attendees, presenters, and moderators for making our conference vibrant!
Don’t forget your name badge, mobile device (so you can download the conference app!), or your dancing shoes for a great conference in Nashville next week. I trust that you will enjoy networking, professional development, and contributing to important initiatives, and all leave feeling enthusiastic about CSTE and the future of applied epidemiology.
Tim Jones, MD
CSTE President

Tags:  Annual Conference  membership 

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CSTE Executive Board election results: And the winners are…

Posted By Jeff Engel, Friday, June 13, 2014
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CSTE held its first ever electronic vote this year for new Executive Board members. Our 2012-2014 Strategic Plan explicitly called for a restructuring of the governance to help strengthen CSTE as the home organization for all applied public health epidemiologists. This restructuring resulted in last year’s by-laws changes, when CSTE voted to open Executive Board elections to not just the one representative from each state or territory but any CSTE active member. With the help of modern technology and our National Office staff, 43% of active members participated in the election.

The new Executive Board members are:
  • Joseph McLaughlin, Alaska: President-Elect
  • Kristy Bradley, Oklahoma: Infectious Disease Steering Committee chair
  • Marci Layton, New York City: Member-at-Large
  • Sarah Park, Hawaii: Secretary/Treasurer
And the winners are… you! If you are a CSTE member, you are represented by these capable and experienced epidemiologists who will advocate for your interests within our professional association and to Congress. The CSTE Executive Board and leadership represents the full voice and power of applied epidemiology in its work to partner with CDC and other agencies, to advocate for better systems and processes, to collaborate with APHL, ASTHO, NACCHO, and other partners, and more. You are the winner in this election, because the Executive Board puts a tremendous amount of time and effort into improving our field that, in turn, improves the public’s health.
Please join me in congratulating the newest members of the CSTE Executive Board.
Jeff Engel is the Executive Director of CSTE and a former State Epidemiologist. For more information on joining CSTE and supporting the Board and CSTE’s efforts to improve applied epidemiology, click here or contact the National Office.

Tags:  membership  staff spotlight 

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