November 2012

The fresh, newly remodeled center is taking the place of our Campus center at 780 Welch Road in Palo Alto, which will be shutting down on December 7th as part of the Stanford Renewal Project.

In preparing for the move, we wanted to get to know our future community a bit better. So here we share with you a few interesting facts about Menlo Park, according to Wikipedia:

• Google Inc. was founded here on September 7, 1998
• Home to the original store of the Round Table Pizza chain
• Home to the oldest continually operating train station in California
• One of the most educated cities in the U.S., with nearly 70% of its residents having earned an advanced degree

We're looking forward to the move and to seeing many new faces there!

The book also has a social good purpose. I am donating my royalties to support the Sharing Foundation‘s college education program for young people in Cambodia. My family is sponsoring Keo Savon, who we met this summer in Cambodia. She is a second year engineering student and by supporting her education she will have better economic opportunities. By purchasing a book, you will not only help your nonprofit improve its program impact, but you will changing the lives for young people in Cambodia.

I’m blessed that I am able to combine my passion for teaching nonprofits how to embrace networking for social change results with my desire to make the work a better place. As many of you already know, I have been raising money for a decade for the Sharing Foundation that supports young people in Cambodia. I’ve done this through social media, winning some of the early online fundraising contests. I also donated my share of the royalties from my first book, The Networked Nonprofit, to support the Sharing Foundation’s college education fund. The money went to support students like Maneth, an IT major who now teaches computer lessons in the orphanage where my children lived.

We are honored to have Laura Arrillaga-Andreesen, author of Giving 2.0, write the foreword and it articulates from the donor perspective why nonprofits need to embrace measurement and learning.

I could not have written this book alone, especially as a reformed measurement phobic. KD Paine taught me the joy that is measurement. We were also lucky to have a talented editor, William T. Paarlberg, who guided us in the polishing and revising stage and who made us go through a 10-draft revision process for each chapter. We had an all-star team of nonprofit, philanthropy, and measurement experts as peer reviewers who helped make the book more useful.

To help those who need to learn to laugh at measurement, not fear it, I commissioned Rob Cottingham to create cartoons that capture the essence of each chapter’s advice. (There were numerous times when I snorted my latte from laughing so hard!). The early reviews are starting to come in and, like these two from Simon Mainwaring and Geri Stengel, capture the essence of the book.

Stay tuned to our blogs as we share more stories about how nonprofits apply the advice in the book and I’ll keep you posted on Keo Savon’s studies.

In the following Q&A, she answers a selection of the questions submitted via the @SUMedicine Twitter feed and Scope, which range from the effectiveness of the flu shot to concerns related to vaccinating children.

Austin Peer asks: Approximately what percentage of patients receiving the injection still contract the virus? Additionally, what is the selection process for choosing which strains of the virus will be contained in the vaccine from year to year?
The definition of influenza vaccine effectiveness is complicated by many considerations, but the general answer is that it provides 70-90 percent protection overall. Among the factors that need to be kept in mind is that influenza vaccine composition is redefined every year. Some years this results in a vaccine with a good match to the viruses that circulate during flu season. However, during other years the vaccine is not so well matched against one or more of the three influenza strains chosen. Differences in match from year to year, the design of clinical studies and endpoints used to define effectiveness and in the populations tested also contribute to variation in the published rates of vaccine effectiveness.

Every year, viruses are chosen to represent influenza A/H3N2, A/H1N1 and influenza B for the upcoming year’s flu vaccine. Selection of the virus strains is made in late February by the World Health Organization (WHO) after detailed analysis of influenza viruses collected by more than 100 national centers during the prior year’s flu seasons. A prediction is made for the next season based on this analysis and availability of new candidate virus strains is confirmed. After the WHO makes their general recommendation, each country determines which exact virus strains will be used in their licensed vaccines. For the United States, the group deciding this is the federal Food and Drug Administration in consultation with their advisory committee of vaccine experts.

Dave P. asks: A recent article in the Scientific American reports there is a lack of scientific evidence that flu vaccines are effective for the elderly or very young. What is your perspective on this research?
I think the research confirms that while there is certainly room for improved influenza vaccines for individuals at the extremes of age and for those with some medical conditions associated with poor vaccine response, there is still value to getting immunized. Importantly, we can’t predict at the individual level who will be protected and who will still become sick from influenza infection. This was borne out in a study reported this week from Centers for Disease Control and Prevention that indicated that 43 percent of 817 children who died of influenza over the eight influenza seasons in the United States had no pre-disposing illness and the time from symptom onset to death was in fact shorter among children with no underlying high-risk conditions compared with children with at least one high-risk condition. This reinforces our current recommendation to vaccinate all children annually against influenza if older than 6 months of age, with very rare exceptions.

For the elderly, the only trial that compared vaccinated vs. unvaccinated individuals using a randomized, controlled design was done in the Netherlands during the 1991-1992 influenza season. Vaccine efficacy was 58 percent for preventing clinically-defined influenza with serologic confirmation of infection in this study. Because we now recommend that everyone get a flu shot, it is no longer possible to do such studies with unvaccinated controls. In the future, studies that use more specific endpoints of culture and/or PCR confirmation of infection will help refine effectiveness estimates across multiple influenza seasons. Although, the adequacy of vaccine strain match to circulating influenza strains will always complicate things.

MDB asks: I’ve read that getting a flu shot during pregnancy can lower the risk of babies being born prematurely or underweight, as well as boost their immunity. Can you further explain how getting a flu shot while pregnant can result in such added health benefits for newborns?
These results come from a randomized, controlled trial conducted in Bangladesh of influenza vaccine vs. pneumococcal vaccine given to pregnant women and a retrospective cohort analysis of a large surveillance dataset (the Georgia Pregnancy Risk Assessment Monitoring System) done by the same authors. In both studies, maternal influenza immunization was associated with higher birth weight and lower risk of premature birth – but only during periods when influenza virus was circulating in the community. This implies that the effect is from prevention of influenza infection in the mother, infection that itself is associated with premature labor and lower birth weight infants. The authors speculate that the vaccine effect may be mediated by preventing release of inflammatory cytokines associated with preterm labor and from stimulation of prostaglandins that provoke uterine contraction. The effect on birth weight was more prominent in the Bangladesh cohort and may also be explained by inflammatory mediators having an effect on maternal and infant metabolism. More work needs to be done to follow-up on these intriguing findings.

Kelli asks: I am an RN and required to get a flu shot every year for my job, but my husband has never had a flu shot. We have an infant son who was born with aortic stenosis and a unicuspid valve. Is it important for my husband to get a flu shot annually because of the baby, or can he skip it?
It is important for your husband to get the flu vaccine to maximize protection for your son and, of course, also himself. Remember that the first time a child gets the flu vaccine it takes 2 doses a month apart to fully immunize. Children and adults with heart disease are in one of the high-risk groups for influenza complications; more information about children and influenza can be found on the Centers for Disease Control and Prevention website.

Ballot comes from the Italian word, ballotta or little colored ball. Several hundred years ago, ballottas were used to cast votes (if their candidates did not win, did they throw the balls at each other?). Each voter would drop either a white ball (in favor of the candidate) or a black ball (opposing the candidate) into the ballot box. Paper ballots were first used in North America in 1629 and later became widespread.

Over the centuries, certain individuals have been excluded from dropping that slip of paper in the box. Women did not win the right to vote in this country until 1920; poll taxes were not eliminated until 1964; and literacy tests, used to deny African Americans the right to vote, were not totally outlawed until 1965.