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Reflections of a Life Scientist: The Impacts of Cities on Epidemiology

The exponential establishment of cities throughout the globe in the last century is without a doubt a marker of our technological and societal advancements as a human race. Better infrastructure and improved healthcare, are just a few of the many associated benefits of living in a city. At the same time, we cannot ignore the negative impacts of the establishment of cities. In particular, with regards to the realm of life sciences, cities have been a huge curveball for all living beings, the environment, and not forgetting the scientists who study them. Cities have introduced a multitude of new factors for scientists to consider. In epidemiology especially, there are new challenges presented every day to the scientists who already have the difficult task of understanding the complex field of diseases and their transmission. This essay will focus on the challenges and changes that epidemiologists and other scientists in the field, like myself, face as a result of the establishment of cities in the past decade.

  In the field of epidemiology, studying the of risk factors of a disease or infection is crucial in understanding its spread. As scientists, we need to be sensitive about the factors that help exacerbate or proliferate diseases and illnesses within a population in order to accurately study its transmission and growth mechanisms. With the rapid establishment of cities in the last century, we have introduced into the equation a completely new set of risk factors– the urban environment and everything else that comes along with it. For instance, the establishment of cities has brought about a change in lifestyle for people, and epidemiologists are seeing an increase in noncommunicable diseases or lifestyle-related diseases as well as mental health issues (Hubacek & et al., 2009). While it is true that cities bring better access to healthcare and technology, this has greatly changed the trends of morbidity and mortality (McKeown, 2009). In many countries with booming cities, there is a sharp rise in the ageing population (World Health Organisation, 2011).

  There is extended morbidity despite the lower rate of mortality because people in cities are living longer, but it does not always translate to a better quality of life. In developing countries where more are moving to cities, more elderly are left without informal care from their families or relatives (World Health Organisation, 2011). On the same note, noncommunicable diseases exponentially increase with age, therefore the increasing elderly population in the world is not only a societal and economic burden but a challenge for scientists to keep up with too (Yoshikawa, 2000; World Health Organisation, 2018). Hence, epidemiologists are faced with a new understanding of how cities influence this new age of diseases.

  Where there are people, there is a chance to transmit disease; Cities multiply this effect by the hundredfold, by bringing people physically closer together. Generally, cities are characterised to have a higher population density than their rural counterparts. Hence, contact with another person is much more imminent. The high population density in cities increases the propagation of infectious diseases, including those that transmit by air, bodily fluids, water and other vectors (Lee, 1994; Monteiro & et al., 2006). Cities are at greater risk of spreading infectious diseases, not just because of their high population density but their greater connectivity with the rest of the world and other cities (Alirol & et al., 2011). With over 35,000 international flights in a day, Singapore Changi Airport was dubbed the most connected airport in the Asia Pacific region (OAG, 2018). Imagine the scale at which an infectious disease could be spread to the rest of the world from there. It could easily result in a global pandemic, similar to that of the various strains of influenza in the past (Pattemore & Jennings, 2008) and more recently, Ebola virus (Park & et al., 2015). Of course, that is why health organizations and governments worldwide are so wary of such an event happening (Barnes, 2018). The greater the speed of transmission of diseases within cities is important to understand and morphs today’s modern approach to epidemiology. As diseases evolve at a terrifying rate (Leventhal & et al., 2015), scientists need to look closely at cities and how they can more accurately model the transmission of disease based on human networks.

  In the face of urbanisation, epidemiologists cannot take for granted the state of affairs when it comes to diseases. Upon reflection, my approach to learning about the transmission of diseases has changed because of the establishment of cities, more so because I live in one. As mentioned previously, there has been a shift in prevailing diseases amongst cities, a rise in noncommunicable diseases and age-related diseases. In Singapore, the ageing population is a real concern. Projections estimate that Singapore may be the fifth most elderly populated country in a matter of almost 30 years (United Nations, 2015). This makes studying the epidemiology of ageing and its associated diseases, even more, relevant for me. I have become more sensitive to the risk factors in urban environments. I have also had to change the way I perceive research and my scientific method when it comes to dealing with the confounding effects of cities on my research in this area. Being in a city, such as Singapore, I get to enjoy the comforts of better infrastructure and in turn, better technology. However, I often do not notice the over-reliance on technology as a scientist in a city. Internet connection is a ‘basic necessity’ nowadays. And as a student, it is hard to imagine a life without it, let alone having to do literature reviews and research without the vast pools of e-libraries and repositories at my fingertips. Moreover, most modern laboratories in cities are well-equipped with air-conditioning and huge freezers to store cell samples, consuming “three to four times more energy than the average building” according to a study by Eades (2018). Therefore, in the laboratory, I try my best to be more energy-saving and environmentally conscious when carrying out my research. Trying as much as possible to use glass-stirrers instead of disposables ones, and doing simples things like turning off the fume hood when not in use, I choose to reduce the carbon footprint of my laboratory.

  As much as my research is important, it is just as important to try to reduce the negative impacts brought about by the establishment of cities. If not, scientists would just be adding on to the impacts caused by cities, and we already have enough problems to face as it is. With no sign that the growth of cities is going to slow down any time soon, we should be very aware of the novel challenges that studying diseases in cities pose. I strongly believe that understanding cities is vital to understanding diseases in the 21st century, and eventually how to control them.

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Why I decided to start a business

“Pursue your passion they say, follow your dreams they say!” But what if you didn’t know what that dream or passion might look like? Often times, as young people we mould our ideas and perspectives based on whatever is around us. So like most Singaporeans going through the public system of education, I was surrounded by the idea that STEM was the way to go. I was good at it, liked it, and was convinced that I loved it.

In Singapore, there is an abundance of research/STEM exposure for pre-tertiary students. Personally, I’ve participated in Math Olympiads, and research symposiums during my secondary school days (high school equivalent). And I really did enjoy it. I could see myself doing that as a career- or so I thought at the time. Currently, I’m coming to the end of my second year in university, doing a major in Life Sciences. While I still enjoy what I learn, these past four semesters have allowed me to open my eyes to what I am good at and what I am genuinely interested in. I had come to university with the end in mind: study life sciences with a minor in psychology. That’s it. My STEM background in secondary school and junior college (pre-university) had really shaped my motivations in what I wanted to pursue. I could not imagine myself doing anything else, because how could I when I did not know what else was out there?

Now comes the meat of this post, why I decided to start a business or more precisely what changed my career perspectives. So in my first semester, I took what has now become quite a dreaded module for all ‘non-computing’ undergrads: CS1010S. CS1010S is basically an introductory course to programming methodology, in my case it was taught in python. The ONLY reason why I took it at the time was that it was a compulsory module for all faculty of science undergrads. Let me tell you, as someone who was never exposed to the idea of computing, it was a pure nightmare. And it was not just because it was difficult for me to learn, but there seemed to be a stigma towards the subject in the first place. The other students from the faulty of science that were taking the course with me had a very discouraging attitude towards the module. It seemed that everyone was taking it for the sake of completion. I guess I picked up the same sentiments along the way. After the module, I knew I enjoyed learning about it but I told myself I wouldn’t touch computing again.

Fast-forward to my second semester, I was seriously considering a change in my major. I questioned why I was still studying what I was studying. A friend of mine was going through a similar crisis and we talked about what we would seriously consider doing after graduation. Would I be satisfied with doing research? Why am I afraid to venture elsewhere? Those were the questions in my head and that was the beginning of some serious thought into becoming self-employed. And so it began: the two of us started throwing business ideas back and forth, but nothing concrete was ever done. Dreamers on a cloud. Another semester passed, and I was still lacking direction.

Finally, enough was enough. I was either going to stop dreaming and do something about it, or stop dreaming and move on. I chose the former. I actively sought out ways to improve myself in terms of the technical skills I would need to start a business, interestingly enough that included taking another programming module in my third semester. Despite struggling to learn Java (a whole new world beyond what I did in my first semester), I was so glad I did because it really got me interested in the power of technology in businesses and problem-solving.

January this year, my friend (now business partner) and I have started on our milestones for this year. We began our marketing research, which is a topic for another day. I switched my plans to a business analytics minor.

Now, why I’m sharing this is also partly to document my journey but at the same time, I hope to encourage young people (in Singapore especially) of two things.

  1. Don’t be boxed in by what you choose. (There’s still time to explore other options.)

  2. If you want to do something, make small steps towards achieving those goals. (As cliche as it sounds.)

 

We make this prayer in Jesus name, Amen.

Yesterday morning, as I was eating in the dining hall, someone came up to me and said hi. Here’s how that conversation went:

F: “Hey Jan, how are you? I saw from over there and saw you with your eyes closed for so long.”

J: “Oh, I was praying.” I smiled.

F: “What, oh sorry. Usually people pray really fast. Is there so much to be thankful for anyways?”

J:”…there’s always many things to be thankful for, especially for surviving this hectic week.”

H: “Yea, she always prays very long (before meals), and that’s a good thing.”

I’m really fortunate to be living in a time and place where I’m able to openly practice my faith. People in my RC, for the most part, are very understanding towards their Christian friends who say grace before meals. I guess the more you are around people of different race and religions you tend to become more empathetic when you understand their practices.

At the same time, I’m very fortunate to have meals with friends who say grace too, because I feel that our prayers together are so much more beautiful.

So whether or not you practice praying regularly, I just wanted to remind y’all that if you take time to reflect, there’s definitely a lot of things to be thankful for.

And there’s no need to rush through saying grace, you realise you’ll enjoy your meal a lot better.

monitor the condition

The patient’s condition has finally stabilized…*phew*

All vitals look normal. 7:45PM.

Good work everyone.

. . . . . .

What’s happening?

I’m not sure, but it was alright a minute ago! The readings are everywhere, she might go into a relapse. Her heart rate is erratic!!

I need a dose of 200mg of peace and 500mg of faith. STAT.

On it! …Patient’s condition is worsening.

Maintain the airway and breathing, we’re not going to lose that easily. Hold on, I see the source of the haemorrhaging. It’s much deeper than we thought.

Must have ruptured from the previous procedure yesterday.

Everything is going to be fine. Everything is going to be fine. Everything is going to be…

Heart rate is declining back to normal. I wonder what’s wrong today?

Didn’t she just go for healing treatment at the Ministry of Acute Specialised Surgery unit? The damage must have been pretty bad.