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Tracey Koehlmoos

Tracey Koehlmoos: To screen or not to screen—mixed messages on mammography

6 Dec, 12 | by BMJ

Tracey KoehlmoosYou might not know this, but I am over 40 and I am a woman.

In the US having breasts and being over 40 means something to doctors and patients. It is a healthcare trigger to start having annual mammograms. If you are reading this in the UK, Canada, or Europe, you might be surprised because your own guidelines are so different—starting at 50 and with greater spacing (2-3 years), which is where the evidence show us we get the most benefit from routine screening. more…

Tracey Koehlmoos: Training the next generation of NCD researchers in developing countries

30 Oct, 12 | by BMJ

Tracey KoehlmoosWho will be the leaders working on the front lines in the battle against the rising tide of non communicable diseases in developing countries? Who will prepare them to take on this task? More practically, how will we pay for this and how will there be enough strength in numbers to make a difference?

If you are reading in the UK, the US or in any high income country, imagine the situation that despite numerous calls for action and for funding (1-6), the health systems and research and service delivery funding in most developing countries, especially in low income countries, remain focused on maternal and child health, and infectious diseases. This means that in many places on the planet people do not know they are sick and at risk of serious clinical and life changing events. They have no public health services available to meet their adult health needs. It is helpful to remember that approximately 80% of deaths caused by NCDs occur in developing countries, generally in a younger population than those in high income countries (8,9). more…

Tracey Koehlmoos: Transforming communities to be healthy and active

5 Oct, 12 | by BMJ

Tracey KoehlmoosAudacious actions are being taken in Aruba, an island paradise in the Caribbean, to improve the health of its residents, said Richard Visser, the Minister of Health, Welfare, and Sport of Aruba at a recent meeting I attended. Of late the residents of this paradise have taken a turn for the worse healthwise as more than 81% of the population is overweight and 51% are obese. The challenge is tremendous especially for childhood obesity. However, in the five years since programmes to combat this have been implemented, the number of people doing moderate to intense physical activity increased from 9% to 39%. With a special focus on children, Visser created an island appropriate nutritional guide, and fruit and other healthy choices are now within reach. more…

Tracey Koehlmoos: Self plagiarism

4 Sep, 12 | by BMJ

Tracey KoehlmoosIn the US there has been a spate of high profile plagiarism incidents. In some cases, the writers have been penalized and in others the adage that the stars are different from us has rung true. However, the most interesting case to me—as a researcher and writer—involved a reporter for the New Yorker who was accused of and then excused of self-plagiarism. [1] more…

Tracey Koehlmoos: The ups and downs of the publishing process

23 Jul, 12 | by BMJ

Tracey KoehlmoosPublishing is at times a joy and also a curse. The process can be taxing both emotionally and in terms of time commitment, but I know that it is the system to which we as researchers subscribe, and in which we participate as volunteers. I will admit that the some of the best moments on the job are the few and far between days when a message arrives informing me that a manuscript has been accepted for publication. Normally my response is a cross between, “Pop the champagne, we are in press!” and, because I do not actually drink champagne and work in Bangladesh, “Send out for mishti, we are in press!” more…

Tracey Koehlmoos: Implementation research evidence uptake and use for policy making

25 Jun, 12 | by BMJ

Tracey KoehlmoosFor the last two years I have worked on a project about implementation research with more than 120 colleagues from across the globe: India, Chile, Mexico, Switzerland, Brazil, Canada, Uganda and more.  The book, which was published by the World Health Organization (WHO) and the lesser known TDR  is called Implementation research for the control of diseases of poverty.

I know that many people are not familiar with TDR, which is the Special Programme for Research and Training in Tropical Diseases. It is a global programme of scientific collaboration that helps coordinate, support, and influence global efforts to combat a portfolio of major diseases of the poor and disadvantaged. TDR was established in 1975  and is based at and executed by the WHO, and is sponsored by the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the World Bank, and WHO. more…

Tracey Koehlmoos: Put that french fry down!

22 May, 12 | by BMJ

Tracey KoehlmoosLast week, a concerned community member was investigating the type of oil used for frying at the American Club in Jakarta. It turns out that the club had been using a solidified palm oil for frying. I happened to be standing there at the moment of discovery. My public health adviser instincts kicked into gear: “Put down that french fry boys.”

I do love a good french fry, especially the thin and crispy ones. A fry is the perfect conduit for eating ketchup.  Similar to a social smoker, I only take fries from the plates of other people so this generally limits me to stealing a fry or two from one of my boys who are more likely than me to order a hamburger accompanied by fries. Thus, the argument, all french fries are bad may ring true, but some fries are worse than others depending on the type of oil in which they are prepared. I realise that many people may not be well-versed in the risks or benefits of different types of cooking oils. In terms of thinking about being a policy maker in your own life, this tends to be the greatest area of confusion. There is an easy to understand table at this link from the Cleveland Clinic. more…

Tracey Koehlmoos: Bringing systematic reviews with a development focus to South Asia

24 Apr, 12 | by BMJ

Tracey KoehlmoosA substantial body of evidence exists to answer many of the questions asked by policymakers and development partners in low and middle income countries (LMIC). However, evidence is often scattered, inaccessible, and rarely presented in a form that provides an indication of the quality of evidence. Systematic reviews in all sectors have the potential to contribute to improving the evidence base from which policies and interventions can be developed and implemented. The principles that underpin the international effort to prepare and use systematic reviews of controlled trials for evaluating clinical practice, particularly in high-income countries can be similarly applied to the challenges of poverty reduction and development in LMIC. more…

Tracey Koehlmoos: Whatever happened to the diaphragm?

21 Mar, 12 | by BMJ

Tracey Koehlmoos

The recent debate in Washington about birth control being mandated for coverage by employers or by health insurance as well as the 101st celebration of International Women’s Day makes me feel empowered to write about a women’s health related issue that I am experiencing now as part of life in the widow-hood.

When the Colonel died in August, I was surprised by how many friends were quick to mention that I would have sex again but with other people. Protocol-wise, there is little written about what to say to the recently widowed but this seems to fall outside of Oretha B. Schwartz’s “Service Etiquette” 4th edition, which suggests the rather limited conversation: “I am so sorry for your loss,” to which the response is, “Thank you.” more…

Tracey Koehlmoos: The view from Bangladesh on global poverty reduction

15 Mar, 12 | by BMJ Group

Tracey KoehlmoosA report released by the World Bank on 29 February highlighted that, despite the global recession, the number of people living on $1.25 per day has reduced across all regions of the world. For South Asia in general the bank reported that the poverty rate fell from 61 percent to 39 percent between 1981 and 2005 and fell a further 3 percentage points between 2005 and 2008. The proportion of the population living in extreme poverty is now the lowest since 1981. The world has achieved the Millennium Development Goal 1 (MDG 1) to reduce extreme poverty by half, years ahead of the 2015 deadline, despite the economic downturn and slow recovery in the United States and Europe. more…

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