Tag Archives: social sciences

Breathe, Baby, Breathe!: The Delivery

Every year in the United States, 12% of all births are preterm births, 5% of all babies need help to breathe at birth, and 3% of neonates are born with at least one severe malformation. Many of these babies are hospitalized in a neonatal intensive care unit. Annie Janvier and her husband, Keith Barrington, are both pediatricians who specialize in the care of these sick babies and are internationally known for their research in this area. In 2005, when their daughter Violette was born extremely prematurely, 4 months before her due date, they faced the situation “from the other side,” as parents. Despite knowing the scientific facts, they knew nothing about the experience itself.

Breathe, Baby, Breathe! is the emotional and personal story written by Annie Janvier, that tells the story of their daughter Violette, alongside the stories of other fragile babies and their families with different journeys and different outcomes. In this post, we share an excerpt from the book.


Excerpt from Breathe, Baby, Breathe!

Part 2: The Delivery and the First Days

The Delivery

Violette was born at 5:21 a.m. in Operating Room 1 at the Royal Victoria Hospital in Montreal. A room that looks like so many operating rooms: too cold, highly impersonal, brightly lit. In some places, they call this an operating theatre, with the OR fluorescent blue light pointing to the main actor and to the precise spot where all the action was focused: my tsouin-tsouin. Whether there was to be a caesarean section or not, all the sick babies were delivered in that room, as the resuscitation room was adjacent to it. The “resusc” room was overheated so that babies didn’t drop their temperature. Dropping temperature is a big concern when tiny babies come out. Their little bodies are wrapped in a plastic bag or under plastic wrap in order to keep their temperature stable.

I remembered three months back, when I was 12 weeks pregnant, nauseated and on call, that I had been urgently woken up at 3 a.m. because a 25-week baby was about to be born. After driving madly through red lights and arriving on time, I felt sick. The mother who was delivering had fulminant chorioamnionitis (a uterine infection) and the smell in the OR was not pretty. I took the baby to the resusc room. The baby stank, a tiny stink bomb, the whole resusc sauna room stank of old diapers and septic tanks. Her heart rate was not coming up with only the bag and mask. I needed to intubate her (place a tube down her throat into her windpipe). I was gagging while I was intubating this poor little girl, but managed to intubate her quickly. Thankfully I had a mask on. The junior resident asked what he could do, with both his eyebrows raised. I hadn’t worked with him before. He was still showing me what the heart rate of the baby was, and his finger was going up and down, but I guess he did not know the protocol for dealing with barfing staff, which list to check, how to assist. When the baby was stable, I asked the resident for some ice. As the main assistant for the resuscitation, he ran out to get some. I am sure he did not know why we needed ice, since we were supposed to keep the baby warm. When he returned, I asked him to place some of the ice in a plastic bag on my head. I felt like I would pass out. This baby did well, though. She was still on the unit weeks later, learning to feed, while I was pushing.

Why was I remembering this baby while I myself was giving birth? I have often tried to understand why over the years. Maybe because I thought my situation was slightly better: I did not stink, plus my physician was not about to puke on my baby. Or maybe because I wanted to vomit with despair. Or maybe because I wanted to remind myself I was not only a failing vessel, a broken belly, the owner of an “incompetent cervix”; I was a strong physician who could intubate a tiny baby in under thirty seconds while puking in her mask. Or maybe because I wanted to think about this pretty little girl who was doing well, in our hospital, with the same care Violette would have, her little preemie-roommate.

Credit: Sasiistock

Axel had been born by Caesarean section, but Violette used the good old “natural route” at a highly unnatural time. So many people were around, but at that moment there could have been a TV crew, a clown, a deep-sea diver, cows, whatever, and I don’t think I would have reacted. I wasn’t supposed to be there. Why not another day, week, hour?? Why had I turned around in bed a week before, when my waters broke? That was a huge mistake. This is all a mistake, I wanted to scream. This is not happening. This cannot be my life. This is my husband next to me, with so much love in his eyes, so much despair, and so much hope. I realized it was really happening. When Axel was born, I couldn’t successfully push him out of me. I thought this would be easier. How can a 700g baby be tough to push out? Well, it was not easy. I think I pushed hard, but my OB seemed not to think so. The whole team was counting, encouraging, telling me this was serious. Maybe I was not pushing because I did not want her to come out. This was NOT a happy moment; this was one of the worse moments of my life. This was failure. A big maternal blaaaaaaaaaaah in broad florescent light for everybody to see. I felt her coming out, heard a little cry and closed my eyes. I saw Gene right there, our great colleague who was a neonatal fellow at the time. I knew Violette was well taken care of. He took her into the resuscitation room. Keith and I both knew what was happening out there. At least Gene was not vomiting and asking for ice. He intubated her when she was stable, gave her surfactant to open up her lungs and took her to the NICU. She needed only room air to breathe, 21 per cent oxygen, what healthy human beings need. I did not want to see her. I wanted to disappear. I wanted to be alone.

Keith went to collect Axel from my mom’s place, and I was taken to the prenatal ward. I was so grateful to go there. I had been in the team recommending that all mothers of very sick babies be admitted there after birth, so they did not have to be exposed to the bright balloons, the damned joy and happiness of the other mothers, the first meconiums, the crying fullterm
monsters, and the chattering, smiling, noisy relatives. I was with the waiting ones and the sick ones. It was silent. I went to sleep.

May 22nd. This is the day I learned the definition of emptiness. I did not feel pain, sad emotions. I felt nothing – such a big black hole, a void. I was empty; nothing had any meaning. I learned the definition of nothing, of meaninglessness, the meaning of meaninglessness.

A mother who is really a mother is never free.

Honoré de Balzac


To find out more about Breathe, Baby, Breathe!, click here.

Annie Janvier is a professor of Paediatrics and Clinical Ethics at the University of Montreal, and a Neonatologist, clinical ethicist and researcher at CHU Sainte-Justine.

Phyllis Aronoff and Howard Scott won the 2018 Governor General’s Literary Award for their translation of Descent into Night by Edem Awumey.

Communication and the Human Experience

Due for release this February, Introducing Communication is a new textbook featuring discussions on issues and challenges associated with mass globalization and new technologies. This smart and sophisticated text encourages students to reflect on how these consequences and implications come to bear on how we live and communicate. Author Amardo Rodriguez explains why his new textbook can be used in any introductory communication course.


By Amardo Rodriguez

Every fall, I teach the introductory communication course at Syracuse University. It is a large lecture course and a core requirement for our majors and minors. In preparing to teach this course a few years ago, I read every introductory communication textbook I could track down, both in print and out of print. What I found was simply striking. Nearly all the textbooks focused on only one perspective of communication – viewing communication in terms of messages. The reason for this is most likely because this is how the National Communication Association defines communication.

However, there are many other ways to define communication that are much more amenable to a world where divergence is increasingly more valued than convergence. We can, for instance, view communication in terms of problem-solving, as in helping us navigate and appreciate our diversity and complexity. From this view, communication becomes a problem-solving activity.

Suffice it to say, I never had any intention or ambition to write an introductory communication textbook. Initially, I was only seeking to develop a textbook for my introductory communication class, as I could find none – either in print or out of print – that could do what I believe any introductory textbook should ultimately do, which is to give new students a rigorous and comprehensive survey of the diversity of perspectives, heritages, and concepts that define a discipline.

Over the last five years I have committed myself to creating a textbook that my students will find both challenging and enlightening, meaning one that is intellectually rigorous and culturally fascinating. What has ultimately come from all of this writing and rewriting is an introductory communication textbook that I am confident many instructors and students across the US, Canada, and the world will find just as intellectually rigorous and culturally fascinating.

Introducing Communication covers eight different perspectives and introduces an array of concepts from around the world. It discusses why the study of communication is important in terms of deepening our understanding of the human condition, enlarging how we frame and resolve human problems and struggles, and appreciating the different perspectives that communication brings to the study of the human experience.

This introductory communication textbook also highlights the consequences and implications that come with different ways of defining, understanding, and studying communication, and it presents a robust and rigorous examination of these different consequences and implications. The book is ideally suited for persons who teach any kind of introductory communication course and are looking for a text that is theoretically rigorous, intellectually expansive, and pedagogically elegant.

My textbook is different to other introductory communication textbooks in three important ways:

I. It introduces students to a diversity of perspectives that I am yet to find in any other introductory communication textbook. I highlight how these different perspectives fundamentally expand and deepen our understanding of communication.

II. It highlights communication issues and challenges that are impacting peoples from around the world as our spaces and distances collapse and implode. For instance, I discuss how the proliferation of new kinds of technology is contributing to the demise of the world’s linguistic diversity.

III. It introduces students to communication concepts from all corners of the world and showcases the contributions of different cultures and peoples to our understanding of communication. I discuss concepts from African cultures, Middle Eastern cultures, Asian cultures, and Indigenous cultures. The book functions as a global introductory communication textbook by moving beyond the Western bias that permeates every introductory communication textbook and still fundamentally defines our understanding of communication knowledge.

This textbook could be used in any corner of the world without the instructor having to worry about promoting or propagating Western biases. In fact, the book looks critically at the Western hegemon that shapes how we define communication knowledge. It would therefore be ideal for any instructor looking for a textbook that introduces students to a global view of communication.

I have been using early versions of this textbook in my own large lecture class for the past five years and obsessively revising and polishing the text based on student feedback. The feedback has always been positive in terms of the book being accessible and interesting. The unsolicited comments from students have also been encouraging. Here is one humbling example:

Dear Professor Rodriguez, I want to start by thanking you for writing this textbook. I usually do not do the reading for any of the classes I take, but when the time came to read your textbook, I learned something new about myself. . . . I have learned that if something seems so out of the ordinary for me, it may make total sense to someone else. . . . If someone were to ask me for help to define communication, I would just hand them the textbook and tell them to read it. There are so many perspectives I learned that I didn’t even know existed. Thank you, Professor Rodriguez, for enlightening me. Keep on doing what you’re doing because not only have you enlightened me, you have enlightened many others.”

In addition to the book itself, I believe professors will find the Instructor’s Manual to be quite valuable. It has many supplementary readings from The New York Times that will help students appreciate how the concepts and perspectives found in the book expand and deepen our understanding of current events around the world. It also has relevant TED Talks, classroom discussion questions, and suggested essay questions. The accompanying Test Bank includes multiple-choice questions that reinforce key concepts and ideas. Like the book, I wrote these instructors’ materials with my students in mind, and I hope they will be useful to you and your students as well.

Unpacking the Everyday

Newly released from UTP, Power and Everyday Practices, Second Edition is an innovative text that provides undergraduate students with tools to think sociologically through the lens of everyday life. In this post, the authors explain the book and why they encourage students to turn their social worlds inside out and explore alternatives to the dominant social order.


By Deborah Brock, Aryn Martin, Rebecca Raby, and Mark P. Thomas.

Our new book Power and Everyday Practices, Second Edition encourages students to explore everyday practices that are familiar and that might, at first glance, seem benign: online shopping, using a credit card, buying a cup of coffee, even taking an online quiz. By “everyday” we mean the practices that are a part of people’s commonplace and taken-for-granted activities. But people’s everyday activities reflect, reproduce, and sometimes challenge a wide range of power relations. In Power and Everyday Practices, Second Edition we will encourage you to ask questions about these kinds of practices. We ask how: How are everyday occurrences connected to the social organization of power? How are gender, class, race, citizenship and age shaped and reflected in many such taken-for-granted practices? How are the goods that we are buying produced, and by whom? How do practices such as travelling, shopping, and getting a credit card reflect and reproduce power, even creating our very sense of who we are? We also address the why questions that these examples will no doubt bring to mind: Why are certain patterns of consumption encouraged and facilitated? And who benefits from these patterns?

For example, even that café latte some cherish as an everyday ritual reflects a geography, history, and economy of power relations. These relations become visible when we begin to study where coffee beans come from, who grows and harvests them, how they come to be ground and sold in drinks, and how they are marketed to the North American consumer. The choice to buy a cup of coffee— including what kind of coffee and where it is bought—is a practice embedded in a global web of power relations. The places we shop, the products we buy, and the websites we visit are all a part of a system of consumption that links us to people, places, and things that seem very distant from our own lives.

We ask students to explore popular culture and mass media to understand how they are permeated with power relations: selling certain kinds of images, promoting individualized self-improvement, cultivating desires that support a consumer culture, and through these practices, reproducing power relations of race, gender, heterosexuality, ability, and a narrow concept of beauty. How are we pressured to try to shape ourselves to better fit a presumed ideal?

The chapters in this textbook address the diverse power relations embedded in such everyday objects and practices. They complicate objects and practices that many of us take for granted and offer new, sometimes unsettling ways of thinking about them. They illustrate how a cup of coffee is never just a cup of coffee and why a quiz is never just a quiz. When we begin to examine everyday objects and practices in this way, we also begin a process of “unpacking the centre.”

Most sociological textbooks do not directly investigate what we will refer to here as the centre. It is much more common for them to analyze social deviance through the lens of the normative social order, or to focus on what happens to people who exist at the margins: the racialized, the colonized, the so-called sexual “minorities,” the poor, and so on. Some scholars have instead focused on studying the centre in order to develop a more comprehensive understanding of how power relations are organized. They “unpack” the centre—just like taking apart a piece of mechanical equipment—in order to find out how it works. To focus almost exclusively on the deviant or the marginalized without interrogating the centre is to risk reproducing a pattern that defines the margins as the location of the problem.

For example, we think it imperative to conduct sociological research on same-gender sexuality in order to document the forms of systemic and attitudinal inequality that marginalize people because of their sexual desires and practices. However, when scholars focus on same-gender sexuality while ignoring the social construction of heterosexuality, we continue to name same-gender attraction, including being gay, lesbian or bisexual as, in effect, the problem for sociological inquiry, even though our objective may be to explain why these forms of sexuality should not be considered a problem. Heterosexuality is able to maintain its privileged position as the normal and natural form of sexual expression.  The binary two-gender system is another way in which our relation to ourselves and others is normatively, and narrowly, organized. Yet this system de-legitimates or erases a vast array of possibilities for living one’s life. Why the insistence that there are only two genders, when they limit possibilities for so many of us, and substantial numbers of people refuse to be contained by them?  Whiteness is another social characteristic that occupies the centre. Academic and public accounts of racism commonly focus on the impact of racism on people of colour, and ignore the social construction of whiteness and the relations of power and privilege connected to whiteness. The social organization of whiteness, however, is an important part of practices of racialization and the problems of racism. Racism is also perpetuated when those who occupy the centre fail to acknowledge systematic historic and current racial and cultural ideas and practices that are deeply connected to colonialism and the marginalization of Indigenous peoples.

This approach to studying the social organization of everyday objects and practices draws attention to what sociologists have long referred to as patterns of social inequality. We are interested in power primarily because of the ways it produces and sustains inequalities between social groups. We do not, however, simply focus on patterns of social inequality as the outcome of power. While themes of inequality are certainly present in the chapters in this book, our approach seeks to understand the social organization of dominant power relations in terms of the ways in which these power relations shape both broad patterns of inequality and everyday experiences. In other words, we do not simply aim to document different levels of socioeconomic status, as stratification theorists often do (Aronowitz 2003); rather, we are interested in the social relations that produce and reproduce the “normal,” the dominant, and the “centre.” This means our analysis focuses on understanding relationships between social processes, social groups, and individuals as they live their daily lives.

To unpack the centre is to explore the taken for granted features of dominant forms of social organization. It is the most difficult to see that a centre exists when you occupy it— for example, when you are white, heterosexual, a citizen, or someone with an ample secure income. It is not so difficult when you are an Indigenous person, a non-citizen, do not identify as straight, are racialized, or are in some way minoritized. We want you to become particularly aware of the ways in which centuries of colonization have placed the descendants of colonizers in a position of assumed ownership of the homelands of Indigenous peoples, for which they typically never ceded title. Finally, the experiences of migrant workers reveal how citizenship and national belonging are part of the centre, even while they might wish such acceptance for themselves. In Power and Everyday Practices, Second Edition we aim to show how these active and ongoing social processes are integral to everyday life.


Want to learn more from Power and Everyday Practices, Second Edition?

  • Purchase your copy of the book.
  • Read an exclusive chapter.
  • Email us at requests@utorontopress.com to request exam or desk copies of this or any other UTP title. Please be sure to include the course name and number, start date, and estimated enrollment.

Deborah Brock is an associate professor in the Department of Sociology at York University.

Aryn Martin is an associate professor in the Department of Sociology at York University.

Rebecca Raby is a professor in the Department of Child and Youth Studies at Brock University.

Mark P. Thomas is an associate professor in the Department of Sociology at York University.

Work Your Career: How Can I Be Productive?

As summer winds down, are you prepared to tackle the term? Work Your Career authors Loleen Berdahl and Jonathan Malloy share an excerpt from their helpful guide, offering practical advice on how you can get (and stay) organized.


Excerpt taken from Work Your Career, by Loleen Berdahl and Jonathan Malloy. 

Professionalism means doing what you say you will do and by when you say you will do it. You cement your professional reputation by getting things done—and done well, on or ahead of schedule. This requires the ability to manage time, resources, and energy to make this happen, over and over. By carefully managing your time and your projects, you will be more thorough, meet deadlines, and avoid accidentally missing steps.

Most productivity and time management tips are written for business audiences. The target reader works at a desk managing projects with clear, looming deadlines and has a boss who is highly interested in the worker delivering something (reports, analyses, new code, corporate strategies, etc.) by a specific date. No deliverable, no profit, and soon no job for the employee. These books tend to assume that the reader needs more time—sweet, uninterrupted blocks of time—to work on something with clear parameters and built-in boundaries.

PhD students face a very different challenge. While taking classes, you have various paper deadlines to balance and possible teaching or research assistant responsibilities. After classes are done, you are trying to coordinate reading literature with dissertation-related writing, more teaching or research work, a panel that you are organizing, and so on. But these responsibilities are typically done within a context of large amounts of unstructured time. The illusion of abundant time can be overwhelming, and the projects themselves get more challenging. Scholarly life is full of theoretical and empirical rabbit holes and blind alleys that can drain your time and energy. Again, dissertations in the social sciences and humanities lean toward the model of “go away and think,” and students are provided with limited direct guidance and supervision. Not only is this a route to inefficiency and years of drift, it also undermines the building of professional habits and demeanour.

Deliberately building project management skills increases your prospects for career success. And like other aspects of professionalism, it requires careful attention. Fulfilling your project commitments, and doing so in a way that allows you to retain some degree of quality of life, won’t necessarily happen naturally. Four basic steps that you tailor to your personal energy patterns and circumstances can ensure that you are achieving your goals while maintaining quality of life.

Step 1: Make a list of what needs to be done

Quite often, people try to just keep everything straight in their heads. The problem is that it is easy to forget things or to remember them inaccurately. The solution is simple: To determine what needs to be done, you need to get organized by writing a list of everything you have committed to and the associated deadlines.

“Wait,” you might be saying, “this is rather obvious.” Of course it is. But just like “eat right and exercise” is obvious but frequently ignored advice for healthy living, the practice of listing commitments and deadlines remains a habit that many PhD students have yet to adopt. If you have already done so, good for you: You have our full permission to enjoy a well-deserved sense of self-satisfaction. For our more mortal readers, let’s get down to business. Start with a large “brain dump” of commitments for a specific time period. (The academic semester is a good place to start.) Are you taking classes? If so, check each class syllabus and then list all of the readings, papers, exams, lab projects, presentations, and other class tasks, noting the associated dates. Are you working as a teaching assistant? Again, check the class syllabus and list all of the class tutorials, exam dates, paper dates, and other TA-related responsibilities and their dates. Are you working as a research assistant? Working on a conference paper? Do you have committee responsibilities? Other responsibilities that we have failed to mention? Do your best to think of everything you have to do over a specified time period, and then scan both your calendar and your email to see if there is anything you have missed. The more complete your list, the better. List complete? Excellent. Now just reorganize the list by due date and you have a clear picture of what needs to be done.

What do I do if I have taken on too much?

Feeling overwhelmed is awful. The panic in your chest, the feeling that you are going to let people down, that you will need to do nothing but work and more work for weeks or months, the associated anxiety and insomnia … It is the worst. And the fears that are associated with it are often well based: If you are someone who fails to meet commitments, who is constantly behind on timelines and long on excuses, it reflects poorly on your professionalism. At a certain point people may start to perceive you as either unreliable, incompetent, or both.

If the amount you have on your plate is not realistic relative to the time available, you need to identify where you can make changes. Are there any committed times that could be reduced? Is working fewer hours in your part-time job, or getting help with family responsibilities, or reducing commute times an option? (You may be tempted to cut back on sleep, fitness, or personal hygiene. Please don’t.) Chances are good that your ability to make change in the committed time part of the equation is quite low. So then you must ask, are there any projects on your list that you don’t really need to do at this point in time? Or are there some steps within the projects that can be removed or streamlined?

Ideally, you can solve your overload problem well in advance: You can tell people that you will need to decline a particular opportunity for now, or that you will need to have someone work with you to complete it, or that you will do it for a later deadline. These conversations can require a certain degree of bravery, but it is better to be upfront with people as early as possible rather than disappoint or anger them at a later stage. On the plus side, the discomfort of disentangling yourself from overcommitment may serve you well in the long run as you instinctively avoid taking on too much in the future.

As we have said at several points in this book, be attuned to your mental health and wellness. Seek balance and support networks; check in regularly with a counsellor or other source of assistance. Everyone feels stressed and overwhelmed sometimes; learn to ask for help in identifying when it is too much, and seek the support you need.

Step 2: Break activities down into smaller tasks, distinguishing between high- and low-energy tasks

Start with the list that you created in step 1. Now look carefully to see how you can break the items down into discrete tasks. For example, the paper due on October 31 requires numerous individual steps to complete it: creating an outline, searching the library database for relevant sources, reading these sources, writing a first draft, editing the draft, writing a second draft, completing the bibliography, and so forth. This detailed list allows you to create target completion dates to keep you on track and, importantly, to manage your time and energy strategically.

When you look at the more detailed list, it should be apparent that some tasks (such as writing, reading, or data analysis) must be done when you are at your peak, and other tasks (such as editing a bibliography) can be done when your energy levels are lower. By clearly labelling tasks as high or low energy, you can strategically assign the high-energy tasks to those time periods during which you are usually highly productive, creative, and energetic, and assign the low-energy tasks to the times when you are usually a bit spent out. (At this point in your life, you probably have a good idea of which times are which for you; if you are not sure, just pay attention to your energy levels for a few days.) Your goal is to protect your high-energy periods for high-energy work, and restrict all low-energy work and other activities (like dental appointments and coffee meetings) to low-energy times; to do this, you need to clearly label the tasks.

Step 3: Block work time into your calendar

The trick to getting things done (and done well and on time) is to schedule the work times into your calendar and to respect these times. Remember, an unstructured schedule and its illusion of endless time is your enemy; imposing structure on your days is necessary. Doing so is simple:

1. Block off all committed times (classes, work hours, commute times, sleep, fitness, family responsibilities, etc.) in your calendar.

2. For each task and project, estimate the number of hours you will need. Because most things take longer than you assume, and to provide cushion in case of unanticipated events (illness, transit strikes, broken water heaters, etc.), increase this number by 50 per cent.

3. Working back from the deadline, schedule task-specific working time in your calendar, assigning high-energy tasks to the high-energy time slots.

Now, in doing this process, you may be prone to optimism (“I don’t need to increase the project hours. My original estimates are realistic.”). We understand. But imagine—just as a thought exercise— that we are right that things tend to take longer than anticipated and that life sometimes throws curveballs. Blocking the extra time into your calendar allows you to quickly identify if you have taken on too much and then make needed adjustments. Of course, if your original estimates are accurate, there is risk of turning down opportunities that you could have completed. For this reason, we suggest that you treat the thought exercise as just that. But if your gut is telling you that you might have taken on too much, respect that and proceed cautiously.

Be strategic in how you enter things into your calendar. It is imperative that you save your high-quality times for high-quality tasks. The most important thing to schedule is your writing time. Social science and humanities doctoral programs involve a lot of writing: Most courses involve written assignments, and after courses are done there is (in most traditional programs) the dissertation proposal, the dissertation itself, and other writing that you seek to complete. Writing should therefore be paramount in your schedule, and we strongly suggest regularly scheduled short writing sessions (e.g., every Monday, Wednesday, and Friday from 9 to 11 a.m., or every Monday to Friday from 1 to 2 p.m.). This approach, admittedly, goes against the typical academic binge-writing style, in which the author procrastinates and then completes all the writing tasks within a large block of time, like a second-year student cramming for a final exam. To be sure, there can be a time for binge writing. But like binge eating and binge television watching, it has both short-term satisfactions and long-term consequences, and inevitably the former exceed the latter. Regularly scheduled writing may not fully eliminate the need for occasional binge writing, but it can reduce it (and the associated stress) dramatically.

To make the best use of high-energy time, you need to consciously batch together low-quality tasks (e.g., getting books from library, checking citations and bibliographies) and commit to addressing them only during low-energy periods in the day. Email in particular can suck up time and energy with little payoff. Make a decision to file email into a batch folder that you will address at a prescheduled low-energy time; during your high-quality work times respond only to email that, if not addressed immediately, may result in someone bursting into flames.

How can I take advantage of unexpected time?

Most weeks include a fair bit of relatively useless time. Sometimes this time is structured into your schedule (commuting time or time sitting on the pool deck while your child takes a swim class) and at other points it is unanticipated (time waiting outside your supervisor’s office because his department meeting is running long). Sometimes it can be good to just stop, take a breath, and relax looking at online cat videos (so cute!). But sometimes it is nice to make use of this time, and you can plan ahead for these opportunities by ensuring your writing projects are accessible through the mobile device you are undoubtedly carrying. The three-minute note here and the five-minute idea there will actually add up to paragraphs, and the perennially growing file creates within you a sense that the project is moving, while eliminating the frustrating “start up” time that can occur if you don’t work on a project regularly. If you adopt this practice, you will start to see small windows of time as bonus time. A friend is late to meet you for coffee? Great, you can edit your introduction! Your child has a 30-minute gymnastics class that you sit through every Monday night? Awesome, you can aim to write 150 words each time. This approach needs to be tempered; you should never feel that every second must be used efficiently. But if you can tackle some tasks during found time, you can free up more time for other things in the future. Which, we must stress, could include a run by the river, or beer with a friend.

Step 4: Work your calendar

Ah, plans. Like fitness schedules and New Year’s resolutions, making them is the easy part. But the execution, well, that takes discipline. And this is where the difference between the professionals and the others shows itself.

Scheduled writing is often the most challenging commitment to keep—which is ironic, since this single activity is most associated with a PhD student’s success (or lack thereof). Honouring your scheduled writing commitment as much as you would honour a class, meeting, or other work obligation is the sign of a true professional. But it can be hard: While thinking about writing is exhilarating, and reflecting on completed writing is satisfying, the in-between period—you know, the actual writing—invokes a broad array of emotions, not all of which are pleasant. As well, the more theoretical and interpretive your work is, the more likely it is that writing is the primary or even sole activity itself, as opposed to gathering and analyzing empirical, documentary, or archival data and then writing about it, making writing even more paralyzing.

Many writing problems occur because people are trying to plan, write, and edit simultaneously. To get around this, start with a clear outline and then focus your daily efforts on small units within the outline. Allow yourself to put ideas in point form, making notes to yourself in the draft to be dealt with at a later time (e.g., “insert three to four sentences about Jones et al. here,” “add citations”). Avoid the temptation to edit as you go along so that your creative thoughts, which will generate the innovative ideas that matter to your work and your discipline, are not impaired by your more critical editorial thoughts. Aim to get a full first draft completed before you turn to editing the work. The more you focus on small sections and just getting ideas down, the more your writing time can actually be allocated to … writing.

Working your writing time—treating it like the heart of your job—is key to your professional success. It can be tempting to schedule something else in the writing time slot “just this once,” or to fail to use the time wisely when you are in it. And it can be tempting to use low-quality tasks as “short” breaks during your productive periods (“this paragraph isn’t really going anywhere … I’ll work on my passport renewal form”). Remember that tasks expand to fill the time available, and the task might end up killing your productivity for the day. The small writing time investments add up to significant results. And the more frequently one does something, the easier it becomes, as both the runner and the smoker can attest. Use the power of habit and routine to your advantage. To further your progress, consider establishing a writing group that provides support and creates a sense of accountability.

Making it a practice to repeat these four steps will develop your professional image. You will get projects done on time, giving others the sense that you are on top of things and take your work seriously. People will notice that you are organized and competent, and they will respect you for this. Plus, you will have time to join them for a squash game or coffee.


Loleen Berdahl is Professor at the University of Saskatchewan, and co-author of Work Your Career: Get What You Want from Your Social Sciences or Humanities PhD.

Jonathan Malloy is Professor at Carleton University, and co-author of Work Your Career: Get What You Want from Your Social Sciences or Humanities PhD.

Understanding What Works: New Book Explores Health Innovations from Around the World

Drawing on the analysis of over one thousand organizations engaged in health market innovations, Private Sector Entrepreneurship in Global Health is a valuable resource for researchers and students in management, global health, medicine, development studies, health economics, and anthropology, as well as program managers, social impact investors, funders, and policymakers interested in understanding approaches emerging from the private sector in health care.

In this post, the editors of Private Sector Entrepreneurship in Global Health discuss the Toronto Health Organization Performance Evaluation (T-HOPE), a group they co-founded back in 2007. They reflect on the outcomes of that group, and discuss why ongoing commitment to improvements in human health is as important now as it was 50 years ago.


This book is the culmination of more than a decade of collaborative work conducted at the University of Toronto, in partnership with colleagues around the world through our group, the Toronto Health Organization Performance Evaluation (T-HOPE). The work published here began when co-editors Onil Bhattacharyya and Anita McGahan joined the faculties of Medicine and Management, respectively, in 2007. We engaged students from each of our disciplines to examine the medical and management innovations of pioneering organizations from the private sector – both social enterprises and non-profits. This led to insights about how some private sector pioneers applied management techniques in finance, operations, and marketing to achieve breakthroughs in health outcomes in resource-limited settings.

In 2010, Will Mitchell and Kathryn Mossman joined the team, and we partnered with Results for Development (R4D) to explore how broad health outcome measures contrasted with the organization-level process and profitability metrics that were customary in our fields of medicine and management. The field needed criteria that reflected differences in the strategies, sustainability, and scale of the innovative organizations that we sought to assess. We wanted to develop a reliable framework that was widely applicable to assess the effectiveness of organizational choices.

To accomplish this, we engaged with a committed, inquisitive, and capable group of students from medicine, social science, public health, management, and global affairs. The T-HOPE team worked on a series of projects focused on understanding how organizations around the globe are innovating to improve healthcare, particularly for the poor. In everything we did, we sought to adhere to strong scholarship while translating our research to findings that would be useful in practice and policy.

This book reflects the outcome of that decade-long effort. Key themes include:

  • Managing trade-offs between access, quality, and efficiency: Credible and feasible measures to guide strategy are essential to create health value in new ways and to apply innovative approaches.
  • Localization: New tools that reflect local needs and local resource constraints are available to support innovative organizations, especially those that seek to address the specific concerns of small communities.
  • Reverse innovation: There are growing opportunities to learn from different contexts and apply innovations from other parts of the world, including diffusion from resource-constrained contexts, in higher-income countries such as Canada.
  • Technological leverage: Digital health tools can improve access and empower patients and providers.
  • Sustainability: Sustaining impactful health innovations requires innovative financing, partnerships, and approaches to cost structure.
  • Scaling: Scaling up innovative approaches begins with generating demand, and is fulfilled by excellence in execution.
  • Management is central to healthcare: Many of the problems facing healthcare are management problems, creating the potential to revolutionize healthcare through innovative approaches to the central management issues of organizational processes, finance, and marketing.
  • Public-private complementarity: Critically, health innovators from the public and private sectors must work together to coordinate and integrate care to maximize impact.

 

Our core message is simple: private sector organizations, including for-profit social enterprises and non-profit NGOs, play a large role in delivering healthcare in many countries. Harnessing the capabilities and activities of these organizations can help achieve sustainable healthcare for those who need it most. A range of organizations in the private sector have implemented technical, organizational, and management innovations that provide healthcare and promote health in a range of settings. These innovations can inform healthcare in other settings.

While we see public sector agencies and initiatives as essential to the planning and sustainability of health care globally, we also acknowledge that public sector organizations face resource limits, political challenges, organizational constraints, and other barriers that can limit their impact. In turn, we highlight the value that private sector organizations can bring to health globally – by testing and scaling new models that fill gaps in care, and by acting as a source of replicable solutions in other settings. Private-sector organizations can extend the reach and impact of public organizations. Through greater coordination, collaboration, and integration, public and private providers can work together to ensure that quality care is accessible to those who need it most around the world.

Globally, a great deal has been accomplished during the past half century to improve healthcare and strengthen health systems. On average, average life expectancy has increased by 20 years since 1960, while infant mortality dropped by 35 children per 1,000 births since 1990. Despite this success, huge gaps in access and quality remain in all countries – both on average and in the lives of individuals. Indeed, improvements in many countries have plateaued, and in some cases even been reversed, during the past decade. Moreover, health challenges that once were isolable now have global implications – the cross-border diffusion of the Ebola virus is one obvious example. Ongoing commitment to improvements in human health is as important now as it was 50 years ago.


Anita M. McGahan is University Professor and George E. Connell Professor of Organizations and Society at the University of Toronto, where she is appointed at the Rotman School, the Munk School, the Physiology Department of the Medical School, and the Dalla Lana School of Public Health.

Kathryn Mossman is Associate Director of Research and Strategy at iD. As an anthropologist and research consultant, her areas of interest include global health, gender and immigration, knowledge translation, insights and strategy, and organizational effectiveness.

Will Mitchell is the Anthony S. Fell Chair in New Technologies and Commercialization at the Rotman School of Management of the University of Toronto. He studies business dynamics in markets around the world.

Dr. Onil Bhattacharyya is a family physician and the Frigon Blau Chair in Family Medicine Research at Women’s College Hospital. He is an Associate Professor in the Department of Family and Community Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto.