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Tuning out the noise

My mind is a very noisy place.

To say that my brain runs on overdrive is an understatement. I have a very inquisitive mind. I love to ask questions, learn new information, and come up with novel ideas. But that also means I like to overthink, overplan, and overanalyze. This has only amplified this past year, with multiple facets of life competing for my attention. Needless to say, it feels quite crammed and loud up there.

This recent increase in neuronal commotion has had me wondering why I need to constantly feed my brain with information, and perhaps find a way to turn down the volume. Through some introspection, I think I have managed to pinpoint the culprit: everything has to make sense to me. When I see problem or a situation that is left hanging, my innate response is to find a solution. I mean, if you solve the problem, the problem is gone, right? And it doesn’t matter if it’s my own conundrum, or if it’s someone else who can’t quite figure out what is happening in their life. My mind creates a conceptual framework and goes full-blown autopilot: find the root cause and fix it.

But, you can’t ways do that in life. Life is incredibly messy. Things never roll-out according to plan, situations arise all at once, and certain chapters end in no clear ending at all. Yet, when you constantly want to fix things, life and its mishaps have the ability to create an environment of havoc and cognitive dissonance… which feeds into your anxiety and makes it harder to let go and let it be. 

Meditating and mindfulness have given me a way to manage these urges. I’m starting to become comfortable in the discomfort of things left unsaid, undone, and unfinished. I am able to remove myself, albeit slowly or hesitantly, from situations that seem to end in an ellipsis. But, most importantly, I’m learning to step away from what I cannot solve without a sense of unfulfillment. 

img_6273Getting into the mindfulness habit has been a slow process. At first, I couldn’t focus or fully relax. As soon as I would close my eyes, a million thoughts would flood into my head. I could see my to-do lists growing, and hear my “what-ifs” getting louder. Instead of a calm ocean, it felt like being in the middle of a storm. But, after a few days of consistency, it all began to die down. I’m finally able to find a focal point (mainly my breath) and just… be.

Yes, my mind still wanders, but I am learning how to quickly identify my fleeting thoughts and come back to a place of peace. I also realized I need to meditate more than once a day, so I’ve started incorporating a morning and evening routine. This has been a great way to start the day with gratitude and culminate in calmness.

Obviously, I haven’t achieved this on my own. As I mentioned in my last post, I’ve been exploring several apps and have landed on three I love: Headspace, Buddhify and Meditation Studio. All three offer a plethora of guided meditations. I’ve been starting my day with Meditation Studio, wrapping it up with Headspace, and using Buddhify in between (they have a great tailored meditation color wheel). I’ve also been tuning in to a great podcast by Meditation Studio: Untangle. Absolutely worth checking out.

I’m still struggling to fully let things go and beat the urge to fix what is out of my control, but my mind is definitely less crammed and slowly quieting down. My modus operandi is shifting from “go big or go home” to “just breathe.” I’m looking forward to incorporating new ways to increase that clarity. In the meantime, “just breathe” is good enough for me.

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What I’ve learned from my 10-day social media hiatus…

I tried. I really did!

I told myself I needed a social media hiatus (specifically, a Facebook and Instagram detox) for a myriad of reasons. It’s too distracting. It eats up too much of my time – time better spent writing, reading, creating, class prepping, meditating, any-other-ing but social media-ing. It sometimes makes me anxious, upset, and fidgety. It makes me prone to oversharing and unnecessary people watching. It interrupts my attention span and my time in the “real-world.” It messes with my OCD-tendencies: how many times do you really need to hit “refresh” to see new notifications? And, every time I read an article about 45, it makes my blood boil.

So, I figured I’d cut cold turkey. Rip the bandaid right off. I did it once before, years ago, and it was fine. Off Facebook for over a year. This would be a piece of cake. Think “sugar detox,” but “no notifications” instead.

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Well… this time has been different. Yes, it’s been good to be offline: I have had a chance to really hone in on developing class content for the class I am teaching: “Social Media and Public Health” (oh, the irony!). I’ve also stopped mindlessly scrolling and engaging with content that I don’t particularly need in my life (because, let’s be honest: scrolling through Twitter and LinkedIn will NEVER be as satisfying). My real-time Face Time game has also improved: less interruptions from an inanimate object in my hand = more in-depth conversations with the people in front of me. And, instead of looking for my social media apps, I’ve been spending some time on Headspace and Buddhify.

Yet, I also realized the added value these social media platforms bring to my life. As a social media researcher, I’m constantly looking at my social media content with a critical lens. I can’t help but see different ways social media affects our daily lives, which makes me strive to fully understand these platforms and their effect on our interactions and communication.

I’ve also been having such an amazing time teaching this course… every time a student asks a thoughtful question, or when I can see it all *click* in their eyes, I just want to share that excitement with my friends and colleagues. Not because I need validation for teaching, but because one of the personal uses and gratifications I get from being on these platforms is being able to share my experiences with those I care about. I love being able to express the joy, ridiculousness and happiness that are living, just as much as I want to share the frustrations, pains, sorrows and unexpected things that happen in life. It’s an outlet to express the things that matter, and it gives me a window into how others in my life are experiencing their lives, as well. And, for those who know me and my complete inability to keep my emotions inside, there is nothing more rewarding than being able to share experiences and genuine happiness with important people who play a part in my life story.

And, of course, there’s the fact that in four days it will be one year from the day Puerto Rico was changed forever… and that 45 is an insensitive narcissist who expels filth every time he presses “tweet.” At first, I thought it was good that I decided to take a break that coincided with his word vomit. It is only distracting and anger-provoking, and that time would be better spent working on things that matter (which, is 100% accurate). But then, I watched two documentaries that have stayed with me: CNN’s film on Ruth Bader Ginsberg and Mr. Rodger’s “Won’t You Be My Neighbor.” In different ways, both films reminded me that, when shit hits the fan, you cannot sit idly. Words have power, and action creates change. While, yes, it’s true that posting a livid message on Facebook will do absolutely nothing in the grand scheme of 2018’s debacle, expressing yourself does a few other things.

Expressing my pain last year led me to share information on ways to help and mobilize my immediate network via FB and IG. Expressing my anger in light of the response to Hurricane María helped others stay aware that the situation was far from over and find ways to contribute. Sharing our work through Puerto Rico Stands provided people with proof that grassroots mobilization is effective at getting people what they need. Using my blog to write about Harvard’s study (the first of three reporting excess death rates after the hurricane) let people unfamiliar with public health research understand the validity and transparency of their findings. And, more importantly, it gave me a vehicle to express my emotions: my grief, sadness, resilience, and desire to make home a better place. A place where people are provided the dignity they deserve.

So, I’ve decided to stop my hiatus. Instead, I’ll be setting some boundaries to see how it fares. Time limits. Maximum visit limits. Posting limits? Maybe I’ll go full-on grayscale. Or keep social media to every other day. We’ll see how it goes (any suggestions, please add below!). The goal is for it not to interfere with the other things I have going on, like meditating (which is soooo hard) and finishing up my post on Summer 2018 (on it!). Intentional use only.

And, I’ll also be playing around with randomly calling my friends and loved ones… for as much as their presence on Facebook and Instagram make me smile, I need to play catch-up on quality phone time. So, don’t get scared if you see my name and number show up on your phone… just calling to say hi! 😘

OII SDP 2018

For those of you who have been following my #phdjourney, you know I’ve been pretty vocal about the challenges it brings. It can be a pretty lonely and daunting process at times, particularly if you embark on a more independent path. That is why this summer at Oxford was so special.

During the first two weeks of July, I had the pleasure of experiencing a once-in-a-lifetime opportunity with 29 other magnificent individuals at the Oxford Internet Institute‘s Summer Doctoral Programme (OII SDP). The OII SDP is a two-week intensive summer program tailored to doctoral students who are focusing their dissertations on topics related to the Internet and how it continues to shape society. During the program, faculty from the OII provide multiple seminars and workshops related to their research and the current Internet landscape. As a public health practitioner, I can now confidently say I know what TOR, the dark web, STS, and affordances are… and can proudly differentiate between supervised, unsupervised and reinforced machine learning. It was also mad entertaining: I mean, where else do you get to have academic discussions about the importance of memes and their role in society? 🤓

While these two weeks are designed to give students the space to learn about a myriad of novel topics related to Internet studies, they also provide the invaluable opportunity to learn and receive feedback about your dissertation from faculty and – most importantly – your peers. This, I would say, is one of the most rewarding aspects of the program. These are people going through similar hurdles and understand the challenges that come with researching an ever-changing media landscape. Being able to listen to and constructively critique each others work in a collaborative environment is something every PhD student should have the opportunity to experience.

Another strength of the program is the diversity among the student body. Not only is it culturally and geographically diverse (literally every continent but the penguins was represented), but it is incredibly interdisciplinary: Communications. Law. Journalism. Science, Tech and Society. Media Studies. Health. Anthropology. Sociology. Critical Theory. And the list goes on. As a PhD candidate in Public Health, this was exactly where I needed to be to gain exposure to new literature and novel research in the realm of social media. It provided me with additional methodological rigor and validation that my innovative methods are in line with how others are approaching social media research in their respective fields.

What made this experience even more rewarding is that I didn’t just meet 29 PhD students who happened to be at Oxford at the same time. I met 29 brilliant, vibrant, soulful humans from around the world, all critically thinking about how the Internet continues to shape our lives and society. I learned so much from each and every person there. We are all doing such creative and important research, full of passion and thoughtfulness. The input provided has been invaluable, and couldn’t have come at a more perfect time. It re-energized me and let me know I am not crazy for doing the kind of work we do – so thank you! I now have a group of friends and colleagues whom I will not only cherish forever, but also bug whenever I have a question or unconventional idea to research.

Yet, it wasn’t just about the seminars, presentations, and workshops. It was about the laughs whilst exploring Oxford, the 3am courtyard “shut ups”, the punting and unexpected diving into the river, the Five Guys evening runs, the morning coffees at The Missing Bean, the “chisme”, the Ashmolean memes, the World Cup escapades, the 7:30am “wake-up calls”, the late night conversations about life, the lovely hugs, the epistemological bonding… and all the other things I’m missing here, yet we all cherish.

So, to anyone considering applying to the OII SDP, I would encourage it wholeheartedly. Not only will you gain incredible colleagues and networking opportunities, but you will have the unique pleasure of bonding with talented, young professionals with passion for the work they do. And that is invaluable.

And a special thanks to Vicki, Jordan and Solenn for making this experience so special. Your thoughtfulness, attention to detail and planning of fun events made our time there that more incredible.

Lastly, to my OII friends: I am truly honored to have been part of the OII SDP 2018 cohort. You are all brilliant – but, most importantly, BEAUTIFUL – humans. So much joy! I already miss you all dearly. Thanks for making this experience 1,000 times better than I ever imagined! Can’t wait until the next conference to see you all again! img_8313

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Summer 2018

As you already know, this summer was a whirlwind. Last I wrote, I was wrapping up my first wave of dissertation research in Tampa, and right about to head out to England for a two-week summer program at Oxford University.

Needless to say, it was amazing. But the summer didn’t end there – it was followed by a three-week trip around the UK and Ireland… one that I cannot adequately or succinctly put into words.

Several people have asked about the trip, so I’ve decide to share some short posts for each of the places we visited during our travels. I’ll be writing about places to visit, where to eat and just all-around fun experiences about the trip. You can check them out below (I’ll be linking as I write):

  • Oxford and the OII SDP
  • Cambridge
  • Stratford-upon-Avon
  • The Cotswolds
  • Wales
  • Ireland
  • Northern Ireland
  • Edinburgh
  • London

While summer is almost over, I was able to squeeze in a second trip to Tampa for some more dissertation interviews, and am just coming back from a quick trip to Puerto Rico for my cousin’s wedding. Then, on Tuesday, I embark on a new journey: I start teaching my first course at Johns Hopkins called Social Media and Public Health. I’ve always dreamt of teaching my our curriculum at the college level, so you can imagine how excited (and good-nervous) I am about this experience. All I can say is that I hope to inspire a new group of young, inquisitive minds to think outside of the box and critically assess our realities.

All in all, it’s been a great summer. These trips have both challenged me and forced me to be more introspective. I’ve grown substantially more comfortable in my own skin and abilities, and can’t wait to use the next three months to hit 35 as the best version of myself.

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Best. Meringue. Ever.

Guys… Look at this meringue! 

I found this incredibly massive piece of deliciousness on Wednesday while walking the streets of Oxford with some friends from a doctoral summer program I’m attending.

We ended up going to Baker and Spice (thanks to Emily – check out her IG hair diary!), and saw these meringues through the storefront window. For those who don’t know me, I’m a sucker for desserts… and I absolutely love a good meringue. When done well, they are crunchy, sugary pieces of heaven that melt in your mouth… and that, it did!

Yum

They had two flavors: chocolate and strawberry. I went for the chocolate one, which is more of a traditional meringue, with powdered chocolate on top. It’s massive, definitely enough to share with several people… if you choose to go that route. We, however, decided to each get one for ourselves. 🙃

The easiest way to tackle and not make a huge mess is with a knife. I took a few direct bites, but it was a little difficult to maneuver. The outside is super crunchy. Because it’s so large, there are some hollow parts inside, and some parts that are a little softer (for those who like the “mushy” part of meringues). Think of it as the best of both worlds. I ate half there… and once I got to the dorm and changed into my pjs, I proceeded to unapologetically finish the other half. Divine!

Definitely check it out if you have a sweet tooth and want to try something delish while in Oxford!

 

Navigating that #phdlife: Dissertation Diaries


Let the dissertation games begin!

When I first envisioned this series of essays about the PhD experience, I thought I would write about them chronologically… how to apply, what to expect, how to pick your mentors/advisors, how to manage the first few years versus the latter portion of the doctorate trajectory. However, I’m currently smack in the middle of collecting data for my dissertation… as a matter of fact, I just got back home after a month doing fieldwork in Tampa. So, instead of waiting to write about this later, it feels right to share my experience – and all its challenges – as it happens.

(If you want to know a little bit about my dissertation, here you go!

Prepping for data collection

When the time comes to decide what your dissertation project is going to be, you have several choices. Of course, there’s deciding what methods you will use: Quantitative? Qualitative? Both? Then, there’s deciding how you will get that data. Some decide to work on an existing project, teaming up with an advisor or another faculty member to add-on to a study that is already ongoing. This may entail in some primary data collection, but not necessarily. Others may decide to embark on a project that uses already existing data to conduct a secondary data analysis. And yet some others (like myself) may decide to develop something from scratch. Primary data collection and starting a project from scratchwas the right decision for me, as I really wanted to delve into a topic that hasn’t been explored in public health and cancer health disparities research. It was fun to develop my proposal and go through the oral examination process (I’ll write about that at some other time) – especially because my proposed (highly qualitative) mixed methods are a novel approach to social media research.  

That being said, doing something from scratch means extra work: you have to secure funding to conduct your study; you don’t necessarily have a study team supporting the little things that need to get done (like printing flyers, recruiting participants, organizing materials, budgeting expenses, scheduling travel, etc.); and you are responsible for all facets of planning and implementation.

While I defended my proposal a year ago, it took until this summer to start data collection (in part, due to my focus on relief efforts in Puerto Rico after the hurricane). Getting ready for data collection required a lot of prep time: submitting to IRB, preparing study tools and resources, preparing a data management plan, securing sites to conduct my private one-on-one interviews, and recruiting up the wazoo. Not only this, but I decided to conduct my study pretty far from where my PhD program is located, meaning I had to schedule travel, lodging and transportation.

Given some other projects I have on my plate, my first data collection trip was limited to June… which meant I had less than 30 days to recruit and conduct as many interviews as possible. This meant a lot of hands-on work, planned and managed by myself. My goal: to get 15 of the total 30 interviews finalized by end of the month… and not lose my mind while at it. 🙃

A visit from Mr. Imposter Syndrome 

When I finally arrived to start recruitment and data collection, I was a little overwhelmed. Even though I had previously lived and worked in Tampa (where study interviews are being conducted), I still had a lot of hands-on work to prep and start recruiting participants. Since it’s just me, I had to make sure I was really organized and had every day planned out.

As I tried to secure my interview sites, recruit participants, and have a few practice runs of the two-hour interviews, I started to have a lot of self-doubt and anxiety. In essence, I was dealing with a major case of imposter syndrome. What did it look like? For starters, lots of sporadic ugly crying. Even though I knew I had extensive experience conducting quality qualitative research, and that my proposed methods were very well thought out, I was still having a hard time believing in myself. The days leading up to that first interview had me questioning my approach, my ability to do a good job… even second guessing my research proposal. Anxiety kept creeping up, while I constantly envisioned worst-case scenarios: What if I panicked and forgot an important question? Would they know? What if my findings weren’t rigorous enough? What if I made a mistake in my proposed design? What if? Those “what ifs” got to me – especially the day before my first interview, while I was practicing with my husband and had a hard time getting through my interview guide. Cue the waterworks. (In hindsight, I was really rough on myself and was extremely exhausted. I started my practice round at 9pm, after a long day of flyering. NEVER DO THAT. Give yourself time to rest.) This self doubt continued the morning of my first participant interview, when I woke up with some crazy heartburn  that was thankfully tended to by a Zantac and Kaopectate cocktail.

Hold on!

A pretty accurate depiction of me, holding on to dear life… Thanks, Charlie 💕

Thankfully, this experience didn’t last too long: the first interview was amazing! It was the exact boost of confidence I needed to keep going. But, it wasn’t just a good interview that helped me get out of the I.S. funk. I am lucky to have a strong, supportive network of colleagues, friends and family who were just a phone call away when I needed it most. My husband always picked up the phone to hear me out when I was having hard time, and reminded me of all the hard work I had put into designing this research. Multiple friends and colleagues told me how excited they were about my study, because I always spoke about it with so much passion and enthusiasm. One friend in particular told me how much she admired my dedication and desire to pursue my goals – and that she, too, had gone through moments of feeling like an imposter, but that we should never doubt our capabilities. My advisor and mentor sent words of encouragement to remind me they believe in my work. I’m also part of a lovely doctoral support group, with three amazing women who share words of encouragement and positivity that keep us going during this intense process. It’s these types of relationships that are essential during the dissertation process to keep you grounded and remind you that you are READY and ABLE to conduct quality research.

Ask and they will come… all at the same time

Like I said above, the first interview was fantastic. Once it started, I knew I was onto something new, exciting and *hopefully* important as hell. We addressed all the questions I wanted to tackle, and had some interesting conversations emerge from these discussions. Once that interview was done, I had another two interviews scheduled (each on a separate day) and was hoping to start hearing back from others. But in the back of my head, there was that constant, “Oh no… they aren’t calling! I’ll be lucky if I hit 5 interviews…”

That’s when recruitment efforts started to bear fruit. Before I knew it, I was scheduling two interviews a day – up until my last day in Tampa. Not only did I hit my target 15, but I also had to start scheduling interviews for when I return in August.

While that has definitely been exciting, it’s also quite exhausting. Each interview takes approximately two hours, and it’s hard to debrief when you have to drive to another location, or if interviews are scheduled back-to-back because that’s what works for participants. That’s one thing you need to take into account when scheduling your data collection plan, particularly if you will be traveling to do so. Ideally, I would have spaced out my interviews to have time to debrief and write detailed memos that capture my thoughts on each interview. Even better, only have one interview a day. In the real world, though, you won’t always have time and resources to space out your interviews. There were several occasions when I was rushing to buy a bag of almonds, an RX bar and bottle of water to wash it all down while I was driving to my next location. Or a banana and a bag of salt and vinegar chips… because, BALANCE, right?

About balance… or lack thereof?

Before arriving in Tampa to start data collection, I thought I would be able to keep my Baltimore daily routine going. In my mind, this entailed exercising at least four times a week, eating (relatively) healthy meals on a set schedule, and even reading a book or writing in my “spare time.”

Truth be told, there was no spare time. Although I managed to keep a relatively normal schedule the first week and a half, things quickly picked up. That meant being flexible and reminding myself that I had to re-shift some priorities for a short period of time.

Yes, I was still able to squeeze in some exercise while I was in Tampa. During the first few weeks, I managed to do some yoga, spin and HIIT to release stress. However, this became increasingly difficult as time went by and I had to schedule two interviews a day. Although not ideal, I reminded myself that the whole point of being in Tampa was to focus on the dissertation. I could have been hard on myself for not being able to work out, but I instead chose to be kind to myself and acknowledge this was a difficult time to keep my regular routine going. Yes, exercise was a fantastic way to decompress, but not at the expense of stressing out because the only classes available coincided with participant interviews. Given my abbreviated timeline, I prioritized data collection and worked around this schedule to fit in exercise whenever I could. (I also prioritized sleep over exercise; de-stressing is great and all, but holding interviews without a full night’s sleep is impossible).

Oh, and cooking happened once. That’s all I’ll say about that. Instead, I tried to pick healthy options when possible. Expect when I desperately wanted Urban Cantina or Sprinkles (seriously – they have a CUPCAKE ATM). I also tried to schedule dinners with friends who live in the area, which was a great way to decompress after a long day and enjoy some good company.

In essence, I focused on being kind to myself, given the current circumstances. I reminded myself that I would get back to my routine once summer is over and I’m settled back in Baltimore. In the meantime, my priorities were to focus on the dissertation and be kind to myself.

Keeping your eye on the prize 

Although this past month was extremely challenging, I am really proud to have met my goal of 15 interviews – which means I’m at the data collection halfway mark. Being malleable allowed me to roll with the punches, and having a supportive network was essential in being able to do so. While “dissertating” feels lonely at times, having people to rely on when you need to talk it out (or just vent) makes it more manageable. So THANKS to all those who were (and continue!) to be there during this process. You know who you are.

I haven’t had a chance to process all the information shared in these interviews, but I’m hoping to be able to do so in the upcoming days, as I had out to Oxford Internet Institute for the Summer Doctoral Programme. ✈️🇬🇧 I leave tomorrow (still haven’t packed, thank-you-very-much), but I’m so excited to share where I’m at with the dissertation with another 29 international PhD students doing internet research on a myriad of topics! I’ll also get a chance to nerd it out with professors from the Internet Institute and learn new ways to approach social media research. 🤓 Then, it’s off to some well-deserved off time in the U.K., before finishing up data collection in August.

So… still have lots to do, but looking forward to it! On my way to turning these Facebook interviews into something special…

We got this.

As I continue to share my journey through the dissertation phase of the PhD, I hope they shed some light to the different experiences and emotions you may encounter during the process. As I’ve said in the past, it isn’t all easy, but it’s definitely worth it if you are doing it for the right reasons. So, keep your eye on the prize and remember: you’ve made it this far because you have what it takes. We got this! 💪🏼


I hope you enjoyed this post on navigating the #PhDLife! To receive updates on future posts, follow my Facebook Page or sign-up for blog updates below.

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Cuatro mil seiscientos cuarenta y cinco…

El pasado martes, 29 de mayo, el New England Journal of Medicine publicó un estudio conducido por investigadores de Harvard University, donde se estiman 4,645 muertes relacionadas al paso del huracán María en Puerto Rico.

He leído varios comentarios del público relacionado al estudio, algunos de los cuales cuestionan la veracidad de estos números, mientras que otros solo se enfocan en esta parte de los hallazgos. Aquí comparto mi opinión sobre los resultados del estudio y sus interpretaciones. Lo intentaré hacer de una manera simple, sin mucho tecnicismo, para que sea más fácil entender de dónde salieron los números estimados y cómo podemos utilizar esta información para mejorar nuestros sistemas de salud pública en preparación para próximos huracanes.

Sobre los métodos

Quiero empezar por darle un poco de contexto a la metodología que se utilizó para calcular estos estimados. Primero, el gobierno de Puerto Rico aparenta no haber querido compartir sus estadísticas con los miembros del estudio. Lamentablemente, esto es  algo bastante común en la isla… las agencias gubernamentales tienden a retener este tipo de información (por ejemplo, han sido extremadamente celosos con compartir estadísticas sobre las infecciones de Zika en la isla). Al no tener acceso a esta información, los científicos utilizaron métodos estándares para estimar muertes en áreas afectadas por desastres naturales. Este tipo de estudio se hace cuando no se puede llegar a todos en la población (primordialmente, porque es demasiado caro y no es costo-efectivo) y/o cuando no hay maneras concretas para calcular muertes exactas (ya sabemos lo difícil que esto se hizo en los meses después del huracán). Los autores dan ejemplos de estudios previos donde se han calculado muertes después de terremotos y otros desastres naturales; en estos casos, típicamente se trabaja por medio de encuestas para estimar muertes. Esta práctica es común en el mundo de la bioestadística y salud pública, donde se diseñan estudios para que los hallazgos puedan representar a toda la población. En este caso, la metodología que utilizaron los investigadores para seleccionar barrios y sectores en múltiples partes de la isla está basada en prácticas aceptables y comunes en el mundo de las ciencias. (Sin entrar en mucho detalle, identificaron y categorizaron barrios desde más cercanos hasta más remotos a ciudades con sobre 50,000 habitantes, y de estas categorías escogieron barrios al azar). De ahí, los investigadores pueden estimar muertes y otros factores al resto de la población.

Otra cosa sumamente importante es que los investigadores han permitido que sus datos estén disponibles públicamente, para quienes quieran hacer sus propios análisis. Para la comunidad científica, este nivel de transparencia es óptima en estudios donde se tienen que hacer ciertas suposiciones en los cálculos. De igual manera, los investigadores del estudio han compartido las preguntas que se hicieron en la encuesta (las puedes leer aquí). Estas son fáciles de entender y no requieren que los participantes hayan tenido que acordarse de cosas que pasaron hace mucho tiempo, lo cual minimiza tener respuestas erróneas en este tipo de estudio. También son muy transparentes en explicar las suposiciones que hicieron en sus cálculos, explicando cómo estas afectan los resultados. Los investigadores reconocen que hay varios factores que tuvieron que omitir, y es por esto que están abiertos a compartir sus datos para que otros investigadores puedan hacer estudios adicionales.

Sobre las muertes estimadas 

En el campo de la salud pública, pensamos tanto en lo micro, como lo macro. O sea, aunque nos interesa capturar las muertes inmediatas, también queremos saber cuántas muertes ocurrieron a causa de condiciones y/o falta de servicios ligadas al paso del huracán María. Los investigadores del estudio consideraron electrocuciones, interrupción de servicios médicos, complicaciones clínicas, suicidios y otros entre las causas de muertes atribuibles al huracán.

Según sus hallazgos, los investigadores estiman que las muertes por causas relacionadas al huracán entre septiembre y diciembre del 2017 pueden ser tan bajas como 793 y tan altas como 8,498. Aunque este es un rango bastante amplio, los investigadores fueron conservadores en sus cálculos, ya que no incluyeron posibles muertes en casos donde las personas entrevistadas vivían solas. En otras palabras, supusieron que ninguna de las personas en Puerto Rico que vivían solas entre septiembre y diciembre del 2017 murieron a causa del huracán. Hicieron esto porque es imposible entrevistar a personas que hayan vivido solas y fallecido a causa del huracán (ya que estarían muertas). Sin embargo, cuando hacen ajustes basados en las muertes que hubo en el 2016 en Puerto Rico para personas que vivían solas, sus estimados suben a 5,045… y al hacer ajustes basados en los tamaños de las familias en la isla, el total sube a 5,740. Nuevamente, los intervalos son amplios, pero siguen siendo números mayores a los reportados por agencias gubernamentales.

(Es importante recalcar que las cifras reportadas no son exactas, sino que son estimados. Las cifras están basadas en las respuestas que dieron los participantes, quienes representan al resto de la población en Puerto Rico.)

A las personas que hemos estado trabajando con comunidades remotas afectadas por el huracán, no nos sorprenden estas cifras estimadas. Muchos hemos escuchado historias sobre cómo el paso del huracán afectó el acceso a atención médica. Como un ejemplo personal, la tía de mi padre tuvo un accidente durante el huracán mientras ella estaba sola: una ventana se colapsó y le dio en la mandíbula, mientras ella intentaba mantenerla cerrada. Por meses después del accidente, ella tuvo muchos problemas para poder ingerir comidas sólidas, particularmente por el dolor que le causaba. Esto le causó una deshidratación y malnutrición severa. Falleció en marzo por fallo renal, después de haber bajado de peso a menos de 90 libras. Esta es solo una historia de muchas, por lo cual es importante no tan solo cuantificar casos como este, sino entender por qué sucedieron.

Sobre los demás hallazgos 

También quiero mencionar otros hallazgos del estudio que considero sumamente importantes, pero que a mi entender, no han recibido tanta atención en los medios. Aunque el propósito principal del estudio era estimar la cifra de muertes, también estima la cantidad de personas que emigraron a distintas partes a causa del huracán. Las cifras reportadas son muy similares a otros estimados y vislumbran posibles cambios en la tasa poblacional de la isla para el próximo censo. Y, claro, están las posibles ramificaciones políticas en los estados hacia donde emigraron estas personas.

Este estudio también estima la cantidad de personas y familias que estuvieron sin servicios de luz, agua y teléfono después del huracán. Me interesaría comparar estas cifras con las que reportó el gobierno local por medio de sus páginas de internet y la prensa local durante esos meses…

Finalmente, creo que es bien importante compartir que los investigadores incluyeron preguntas en su encuesta para describir qué tipo de problemas tuvieron las personas en obtener cuidado médico debido al paso del huracán. Según sus hallazgos, 31% de hogares tuvieron algún tipo de interrupción de servicios médicos. Entre estos hogares, aproximadamente:

  • 14% no tenían acceso a medicamentos
  • 10% no tenían acceso a carreteras
  • 10% no podían utilizar equipo respiratorio que requiere electricidad
  • 9% reportaron que habían facilidades médicas cerradas
  • 6% reportaron falta de doctores
  • 4% no podían costear gastos médicos
  • 3% reportaron problemas con transportación
  • 2% no pudieron comunicarse al 911
  • 1% tenían personas quienes no pudieron dializarse

Esta información le da contexto a las cifras de muertes reportadas en el estudio. Aunque los investigadores indican que no todas estas interrupciones necesariamente causaron muertes, sí ayudan a explicar cómo ciertos factores relacionados a falta de servicios clínicos pueden impactar a personas con enfermedades crónicas. Los investigadores no se limitaron a solo preguntar “sí” o “no” en cuanto a la interrupción de servicios médicos. Esto permite que futuros estudios puedan analizar los efectos que tuvieron los distintos tipos de retrasos en servicios en el total de muertes, al igual que otros factores capturados en la encuesta (como emigración).

Estos hallazgos también nos permiten tener conversaciones sobre cómo el huracán destapó problemas que llevan tiempo “cuajándose” en Puerto Rico, como diría mi abuela. Llevamos años discutiendo los efectos que el éxodo masivo de doctores y profesionales de la salud tendrá en la población de Puerto Rico, particularmente porque esta sigue envejeciendo y padeciendo de múltiples enfermedades crónicas. Mientras no se hagan esfuerzos para reponer y retener a doctores (y otros profesionales) en la isla, seguiremos sufriendo de estas situaciones.

En fin…

Los hallazgos de este estudio, por más limitaciones que tenga, tienen ramificaciones bien grandes. Aunque las encuestas siempre tienen ciertas limitaciones en comparación con métodos que utilizan actas de defunción para estimar muertes, los investigadores demuestran que sus extrapolaciones rindieron resultados comparables con estimados de la población durante otros años. En cierta forma, le dan veracidad a los hechos y confirman sucesos que antes pasaban como simples “anécdotas”… ¡y esto es importante! El trauma que el huracán ha causado no debe, ni puede ser ignorado. Confirmar estos incidentes por medio de estudios científicos nos permite, como pueblo, exigirle cuentas al gobierno y entender cómo podemos hacer mejoras públicas que impactan nuestra salud y bienestar. Además, creo que estos hallazgos demuestran que el gobierno no ha divulgado información suficiente (ni transparente) sobre las muertes y los efectos del huracán en nuestra sociedad. Estudios independientes, como este, son de suma importancia para entender los verdaderos efectos del paso de un huracán de esta magnitud en la isla.

Por mí, que venga el próximo estudio. Pendiente estaré a lo que reporten los investigadores de George Washington University…


Foto cortesía de Tostfilms 

Writer’s Block…

Inspiration, where art thou hiding?

Guys… I’m suffering from a severe case of writers block right about now. It could be that I am anxious about what the next few months hold, since I’ll be away from home working on my dissertation. It might also be that my current schedule has been making it hard to find the time to write. Or, let’s be honest: it may just be plain ol’ laziness.

It’s not that I don’t have things to write about… I guess I’ve just been lacking a little inspiration to get it all expressed in written form. I normally listen to podcasts that get me excited about certain topics (here and here are two of my favorites). I also like to read articles and essays that discuss growth and self-discovery – especially when they are written by people who have found it within themselves to share their views on life and all its intricacies. And, there’s my favorite movie of all time, Before Sunset, which always reminds me of the complexities of love, of living, and of sharing your deepest thoughts with people who bring out meaningful conversations. *Maybe I should write about that someday… 

But, like I said, I’ve hit a wall. I’m looking for some inspiration… and I’d love to hear what others have done to find it! Are there any books or pieces you’ve read recently that have inspired you? Any movies that have made you think about our fragility – or our resilience – as humans? Any podcasts or music worth listening to that give you a distinct perspective? Even better, is there anything you would like to read about here?

In the meantime, I’ll be watching Celine and Jesse wander the streets of Paris, talking about everything and nothing all at once… 💕

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Back at it

A lot can happen in a month.

When I started this very young blog back in the cold, snowy month of March (which feels like eons ago), I thought I would be able to write at least once a week. I figured it would be a way to channel my thoughts and process my emotions as life happens. However, the past five weeks have been pretty intense… not so much in the negative sense of the word, but in the pace at which things have been occurring. Ergo, writing here fell to the wayside.

I’m currently juggling several facets of my life that are all in alignment and important, yet managed to speed-up simultaneously. Since my last post, I was involved in back-to-back activities related to relief efforts in Puerto Rico post-María. I first moderated a panel discussion regarding the social, economic and public health impacts of the hurricane six months after its passing (it was really informative – you can watch it here). The following week, I took over my university’s Instagram account to share a fundraising event for community members in Sector Maná. Thankfully, both events were incredibly successful at raising funds and getting the word out about the needs Puerto Ricans are still facing. This also led to more exposure about PR Stands, which has brought about opportunities for new projects, partnerships, funding mechanisms, membership growth and other very exciting things that require lots of time and planning.

Yet, my month didn’t stop there. Simultaneous to the growth of our organization, the PhD side of things also picked up. I received IRB approval for my dissertation research, which is scheduled to happen over the summer in Tampa. With IRB approved, I finally had the green light to start planning my trip and data collection timeline. A few days later, I received the amazing news that I was selected to attend a summer program for doctoral students at the Oxford Internet Institute for two weeks this July… so I had to start scheduling that in as well. Then, another email came in: I had a manuscript I’ve been working on for quite some time accepted with minor revisions (finally!), which were due by the end of April. Oh, yeah – I also had pending data analyses for a study exploring Snapchat advertising among adolescents… plus two personal trips scheduled smack in the middle of April: one to Puerto Rico to visit my sister, and another week-long trip with my husband to New Orleans.

Needless to say, I’ve had a lot going on; so much so, that the end of March and beginning of April felt like a blur. I was going through the motions, but didn’t have the time to process and contextualize my emotions given the pace at which things were happening. The events related to PR relief efforts left me with conflicted feelings: I was elated that our efforts were successful and impactful, yet I was frustrated with the current situation in the island. I mean, just recently there were two major blackouts within a week of each other, and there are a myriad of social and political issues being trampled upon by the island’s current administration – which is why thousands are marching today. I was also really excited about the professional and academic opportunities coming my way, but felt anxious about getting everything done on time and in a way that meets my standards. It was a lot to try to put my finger on, and it took a bit of mental gymnastics to figure out how to manage it all.

Although things are not slowing down quite yet, I’ve managed to get a handle on the speed at which things are happening. How? This is what has worked for me:

(1) Make a list.

When things start to feel chaotic and messy, I try to realign myself by making lists of what needs to get done. It may sound somewhat mechanical or overly simplistic, but it really forces you to think about what it will take to get things accomplished and how much time is needed to do so. It also compartmentalizes your thoughts into plans that are easier to digest. Making detailed lists for each project has helped me identify what needs to be resolved immediately, and what can be tabled for later. It also lets me visually compare tasks and make a timeline; mine is currently out until the beginning of August. Now that I mapped it all out, it’s easier to tackle each day and build in time for myself. Personally, I use several journals and a weekly/monthly planner to break down my days and write down my thoughts as things come up. Whatever methods works for you, the most important thing is to remember that there are only 24 hours in a day – no matter who you are. So, manage them wisely.

(2) Say no.

One of the harder things in life is saying no, both to things that are out-of-scope and to people who take you off track. Again: our time is limited. Every thing you do takes up a portion of that time. Therefore, when you say yes to things and/or people misaligned with your goals, you are saying no to yourself. Recently, there have been several opportunities that I’ve had to politely decline because I knew that the quality of my work would suffer if I took on another project. And, even if the quality of my work didn’t suffer, my mental health would. Meeting other people’s deadlines and priorities at the expense of unnecessary anxiety and stress is not a worthwhile investment. I’ve also had to say no to people – those who truly matter will understand when you need to disappear for a while and take care of what’s important. Here’s a great essay on the need to say no.

(3) Surround yourself with similar vibes.

Energy flows from person to person. In my experience, this energy has the power to fuel you when life gets difficult. When those around you have ideas and priorities that resonate with your own, it’s much easier to stay motivated and use their energy to fuel your own. Being around friends with similar values has allowed me to stay concentrated on things that matter and refocus my energy on getting tasks accomplished. It also keeps me positive, which is so important when life starts to get stressful. Yet, not everyone has energy or values that align with your own; some people’s energy can be draining. It’s okay to remove yourself from this negativity, if it is starting to influence the way you approach things or the way you feel about yourself. It may be temporary, but it could well be permanent – that’s for you to decide. In the words of Joshua Fields Millburn, “You can’t change the people around you, but you can change the people around you.”

(4) Share your emotions.

With time, I’ve learned the importance of expressing my emotions when I start to feel overwhelmed. Doing so allows me to process things that don’t quite make sense. Sometimes this takes place in written form, when I start making lists and jotting down random thoughts. Other times, it’s more helpful to talk to someone who might be able to share valuable insight – or just lend a friendly ear. There are times when all it takes is listening to yourself say something out loud to find the answers you are looking for! That’s the great part of surrounding yourself with people who care and bring out the best in you: it is easier to share your thoughts and figure out how to best navigate present challenges. Regardless, my experience has been that the more you articulate situations and the accompanying emotions, the easier it becomes to identify how you feel about them. Getting clarity in this regard can help you figure out how to tackle what’s right in front of you.

(5) Take a break.

Seriously, find a way to stop the madness and center yourself. At first, I was somewhat anxious about my two pre-scheduled trips, because that was time I wouldn’t be able to get work done. Then, I decided to do the exact opposite: I did zero work those 10 days. Instead, I used that time to enjoy myself and let my mind relax. Rather than chastise myself for taking this time off, I gave myself permission to do something fun and soaked in every second of it. Whenever I started to feel anxious, I reminded myself I deserved to take a break. Once I returned home, I had the energy to hit the ground running with a new sense of clarity. Although I know it isn’t always possible (or realistic) to take a vacation when you need a break, it is feasible to take some time for yourself – exercise, mediate, sing, dance… whatever feels right. Do it – your mind will thank you!

It’s normal to feel overwhelmed when multiple things – good or bad – happen all at once. Instead of letting it overpower me, I’m embracing the ebbs and flows of life and findings ways to manage the things that matter. Taking this approach has allowed me to find balance and tackle things with a new sense of purpose.

And, before I knew it, time did its thing: it’s no longer snowing or 30 degrees outside. Instead, April showers brought beautiful May flowers… and lots of sunshine. Like I said, a lot can happen in a month!

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Six Months Later…

As I have mentioned in previous posts, Puerto Rico’s recovery in the aftermath of Hurricane María is far from over. Today we hit the six month mark of the storm’s impact, and there is still much to do.

As a founding member of Puerto Rico Stands, I have been working with members of the Johns Hopkins community to host several events to raise awareness about the public health needs still affecting Puerto Ricans. Check them out and see how you can help!


Tuesday, March 27, 2018 – Panel Discussion

Race in America

Johns Hopkins University (JHU) forums on Race in America is hosting the panel, Six Months After Maria: Public Health Issues in Puerto Rico. The following article by JHU’s The HUB outlines the current state-of-affairs and the topics to be discussed. Here is an excerpt of my interview:

“It’s important to continue to bring light to the issues that are happening on the island,” Rivera says. “We thought it would be good to do a follow-up six months later to remind people that the people of Puerto Rico are still facing days and nights without power, without running water, and without some of their basic needs met.”

[…]

She adds, “These are U.S. citizens, and they’re going through loss and mourning. It’s our job as public health professionals—and as citizens—to try to assist them in whatever way we can.”

I will be moderating the panel, so if you have any questions you would like addressed, let me know in the comments below!

Livestream broadcast can be watched here.

For free tickets via EventBrite, click here.


Monday, April 2nd, 2018 – Fundraising Event

Barranquitas

The majority of community members in Sector Maná and Sector Palmarito in Barranquitas, PR still lack power and running water. Others lost their homes and need assistance rebuilding. That is why Puerto Rico Stands and the Latino Public Health Network will be hosting a Food Expo to raise funds for this community. Although the event will only be open to members of the Johns Hopkins community, anyone can donate through our Go Fund Me page. Every dollar counts, so chip in if you want to directly help those impacted by the storm!

Funds will be used to purchase construction materials to rebuild houses, help bring power and running water back to the community, and assist in any other basic needs identified by community leaders from El Familión.


LPHN Food Expo


Puerto Rico will take a long time to rebuild, but if we start small and scale up, anything is possible. Thanks for being part of the solution.img_8313

“People are not built in silence, but in word, in work, in action-reflection.”

~Paulo Freire