When or where do you get your best research ideas?<\/strong><\/p>\n This one is a hard one, not to be tripe but I often get them the same way other people do- when I\u2019m driving, in the shower, usually when I\u2019m doing something completely unrelated! I have to say,\u00a0 I\u2019m someone who likes to connect dots and so I find a lot of times some of my best ideas come when I\u2019m reading something tangential to my field, or going to a seminar or presentation and all of a sudden I start to see analogies or approaches that I was unaware of and begin to connect the dots, thinking \u201cHow can I use those in my work?\u201d. It\u2019s a little bit of the subconscious thinking and trying to go outside of your narrow focus.<\/p>\n What is the best piece of advice- work or life in general- that you\u2019ve ever received?<\/strong><\/p>\n I remember when my mentor, Dr. Keerti Shah<\/a>, told me the following: \u201cYou talk too much and write too little.\u201d I recall laughing with a bit of annoyance at the time, but I think what he was trying to say is that ideas aren\u2019t really that helpful unless you act on them. Once you\u2019ve said them out loud, they\u2019re free domain. There\u2019s a lot of competition in science, and I\u2019m inherently a collaborative person and that\u2019s what drew me into epidemiology to begin with. But it is competitive, and you\u2019re taught by your mentors to keep things close and not give things away.\u00a0 This can be difficult, especially since I develop my ideas by talking them out with people. But he said, write things down, make sure you\u2019ve made a stamp on things, but he also told me if you keep everything to yourself you won\u2019t enjoy what you\u2019re doing.\u00a0 So he helped me to find that balance.<\/p>\n What is your top life hack?<\/strong><\/p>\n I\u2019m a horrible procrastinator. I always say don\u2019t ask me how to do things as I\u2019m not the one to ask. I have found, particularly lately when I have a lot of writing to do, the one thing to get me into a more efficient mode is to get out a pen and paper and just start writing it long hand. I\u2019ve found that if I can just do that until a lot of ideas are down on paper it stops you from begin so self-critical and just lets the ideas flow, and then I start typing them in and I can edit from there. I\u2019ve found that can really get me started when I\u2019m in that anxiety phase. There\u2019s something about writing on paper, you really don\u2019t have time to critique every word you\u2019re writing.<\/p>\n What are you most passionate about or inspired by?<\/strong><\/p>\n I\u2019m on a kick lately. My work has been previously in molecular epidemiology where I was trying to understand the natural history of the biological mechanisms around HPV persistence, latency and reactivation, but I\u2019ve really moved more recently into implementation research- we develop all of these novel interventions and screening strategies & tests, why people aren\u2019t using them? In both areas, the thing that I have become really excited about is systems thinking, which is the idea that we\u2019ve gone about as far as we can go with reductionist scientific approaches.\u00a0 A lot of things, including biological systems & healthcare delivery, are complex adaptive systems and they change in ways which are very unpredictable.\u00a0\u00a0 There are ways we can embrace that unpredictability rather than try and control it and still learn things. I\u2019m really excited about the value of simulation modelling, but for this to be maximally beneficial, we need to \u2018re-embrace\u2019 the value of descriptive data collection.\u00a0\u00a0 There is merit in gaining a complete understanding of a system, describing the variability, see how it\u2019s playing out over time, and then use technologies such as simulation help you see if there are particular patterns which tend to come up over and over again, and how contextual changes play out. I think those things are going to be a lot more affirmative over the long run compared to the strict hypothesis testing paradigms of controlled trials.\u00a0 I think the scientific community is still a bit uncertain about how to use these methods, but I\u2019m excited about the potential.<\/p>\n What is the first thing you do after a grant rejection?<\/strong><\/p>\n I definitely have a process. It usually starts with the immediate contempt\u2026\u201cHow can they not understand how brilliant that is?!\u201d then I move onto \u201cThe whole review process is broken! The scientific process is broken!\u201d and then I usually go onto a complete self-doubt breakdown: \u201cOh my god, maybe I didn\u2019t know at all what I was talking about?!\u201d I go from that to \u201cOkay, I can find constructive comments\u201d and then I get back down to business and try again. I let myself be angry for a few days and then I try to see what I can do about it.<\/p>\n In your opinion, what\u2019s the biggest advantage of HPV testing? Or what is the role of self-collected sampling in cervical cancer eradication?<\/strong><\/p>\n I see the two as being very linked together. First of all, HPV testing is the only method that we have right now that would allow you to use a home sample, and I think that being allowed to have that self-collected sample has so many benefits from an implementation perspective; not only can it be less embarrassing to a woman and she feels she has more autonomy.\u00a0\u00a0 But our experience on a study we\u2019re doing In Peru shows that even if women are willing to be tested in the clinic, the need to\u00a0 find a bed for the women to lie down on, find a sterile speculum, everything you\u2019d need for a Pap smear based program and visual inspection program can become serious barriers to screening at the volume needed. So even if the woman\u2019s in the clinic, a midwife can just do a vaginal self-swab or hand it to the woman to do herself. It just frees up so much time and service delivery constraints that really do add up over time. We\u2019ve found an incredibly strong, positive reaction from women and healthcare providers now they can screen many more women so much faster. That\u2019s particularly true in rural areas, where they don\u2019t have the staff so screening will be a lower priority. We can improve coverage substantially, and I think we should be looking at it in lower resource settings- there\u2019s a huge advantage to it.<\/p>\n What\u2019s the next big thing in cancer screening & prevention?<\/strong><\/p>\n If we could acknowledge that the service delivery component, and understand how to deliver cancer screening and diagnosis, treatment, follow up from treatment and palliative care in a way that\u2019s much more efficient\u2026 this could actually be as big of a game changer as the next big blockbuster drug. I think we don\u2019t focus very much on the implementation parts. Going back to the idea of screening as a complex adaptive system; as screening and management algorithms become more complex, more people and health sectors become involved. We need to understand the behaviors and perspectives of all of these actors in order to design the delivery process in a way that minimizes certain bottlenecks. It\u2019s really a matter of placing a higher value on understanding the worldviews and perspectives of the people who set policy, deliver services, and use services.\u00a0 Technologies are only successful if they are used appropriately, and that, I have learned, is quite a complex challenge. I think implementation research applied through a systems thinking lens will be a huge game changer.<\/p>\n Of the papers you have published over the last 5 years, which one is your favourite?<\/strong><\/p>\n I\u2019ve been very proud of my work in HPV latency & reactivation. One of the papers I\u2019m most proud of is one where I connected the dots. I had a random idea after going to a talk which was focused on intestinal parasitic infection. I saw a global map of the endemicity of helminths and said \u201cThat looks exactly like the cervical cancer rates map\u201d globally, the heat maps looked exactly the same. I actually went back to my office, pulled them both up, side by side and said, \u201cThat\u2019s pretty remarkable\u201d. The talk I was attending was really about the immunology of intestinal parasitic infection and the symbiotic infection with the host, but it was definitely skewing and polarising the immune system in a way I thought would not be conducive for strong antiviral responses. So I had an idea, \u201cWhat if those helminth infections are causing a global immune dysregulation that is allowing HPV to persist a little better in a detectable state? Is that one of the reasons why we have this equatorial distribution of high rates of cervical cancer?\u201d I then found Bob Gilman at John Hopkins who said \u201cLet\u2019s test it!\u201d and lo and behold we found a 60% higher HPV prevalence in the 42% women infected with intestinal helminths in the Peruvian Amazon<\/a>.\u00a0 We backed up this observation by looking at the cervical cytokine profiles which were skewed towards Th2-type immune response as expected.\u00a0 So we believe there is biological plausibility for this endemic infection to alter the natural history of HPV \u2013 and treating helminths is cheap and relatively simple. We\u2019re still moving that forward to see if mass deworming of adult women might help us reduce HPV persistence in addition to screening and vaccination to reduce the burden of cervical cancer.<\/p>\n <\/p>\n The views expressed are those of the author. Posting of the blog does not signify that the Cancer Prevention Group endorse those views or opinions.<\/em><\/p>\n Subscribe to our mailing list<\/strong><\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Our \u201cFive Minutes With\u201d series seeks to discover what are the habits, inspirations and obstacles that have shaped the careers of leading cancer researchers and influencers. Professor Patti E. Gravitt, PhD, MS is a molecular epidemiologist whose research in human papillomavirus and cervical cancer spans the translational spectrum from the natural history of genital… Read More »Five minutes with: Professor Patti Gravitt<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":1304,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","cybocfi_hide_featured_image":"","footnotes":""},"categories":[33],"tags":[252,258,324,362,420,474],"class_list":["post-1302","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-five-minutes-with","tag-hpv","tag-hpv-testing","tag-molecular-epidemiology","tag-patti-gravitt","tag-self-sampling","tag-women-in-science"],"_links":{"self":[{"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/posts\/1302","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/comments?post=1302"}],"version-history":[{"count":0,"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/posts\/1302\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/media\/1304"}],"wp:attachment":[{"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/media?parent=1302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/categories?post=1302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cancerprevention.qmul.ac.uk\/index.php\/wp-json\/wp\/v2\/tags?post=1302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/cancerprevention.qmul.ac.uk\/wp-content\/uploads\/2019\/05\/twitter.png\")
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