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  • 1. HEALTH STUDIES 341: DISEASE PROCESSES Fall 2003 Teaching Team: Dr. Laurie Hoffman-Goetz (instructor) BMH 2321, ext. 3098, lhgoetz@healthy.uwaterloo.ca Office Hours: Wednesday 10:30-12:00; other times by appointment Joe Quadrilatero (TA) BMH 2324, ext. 6018, e-mail: jquadril@ahsmail.uwaterloo.ca Office Hours: To be announced I. COURSE OBJECTIVE The objective of Health Studies 341 is to provide an overview of the biobehavioural basis governing the occurrence of disease in humans, using selected acute and chronic communicable disease cases. This course introduces students to basic immunological concepts in disease processes with a focus on the application of those concepts to public health and population health settings. II. TEXTBOOK Immunology, disease processes, and public health are rapidly advancing fields. Any textbook more than three years old will be seriously dated. Remember that the author typically completes writing a text more than a year before it is published, and the author is relying largely on literature which was written more than a year before that. There is no ideal textbook for this course. There are many textbooks which cover immunology or disease process or public health in comprehensive detail. The textbook selected for the course is Infection, Resistance, and Immunity (2nd Edition) by Julius P. Kreier. It is a well written book that provides a public health perspective on infection, disease process and immunology and is written as a beginning text. The required textbook readings are listed in the syllabus. There will be some sections in the textbook in which the detail is greater than what is covered in class. Specific tables, figures or core concepts that are covered in the text, and not covered in the lectures, will be identified prior to the exam. III. STUDENT EVALUATION Exam 1 October 02, 2003 25 points Exam 2 October 30, 2003 25 points Exam 3 November 25, 2003 25 points Annotated Bibliography November 18, 2003 25 points Examinations There are three (3) exams in this course. These are in-class, closed book exams designed to test your factual knowledge about the substantive information covered in this course. There is no final exam scheduled for this course. The exams will determine (a) whether you did the reading required, (b) whether you have assimilated the core material in lectures and readings, and (c) whether you have thought about the material presented sufficiently to apply that reasoning to cases not explicitly addressed. The material comprising the examinations will be drawn from lectures and, selectively, from the textbook readings. 1
  • 2. Instructions on Annotated Bibliography The purpose of the annotated bibliography is threefold. First, it is designed to introduce you to some aspect of immunology/disease processes at a more in-depth level than that covered by my lectures. This aspect of immunology/disease process must be relevant to human health or public health. Second, it is designed to introduce you to reading the primary scientific literature. Often undergraduate students are asked only to read materials in textbooks and review papers, which present (implicitly or explicitly) the author’s bias and interpretation of the literature. This exercise will provide an opportunity for you to read primary literature and interpret it in a critical fashion. Third, the annotated bibliography exercise is designed to help build competency in writing in a clear and concise style, using a structured, prescribed format. For this exercise, you will prepare an annotated bibliography. An annotated bibliography is a reference list of scientific articles, with each reference followed by a short (250 word) description and evaluation (i.e., the annotation). The objective of an annotated bibliography is to illustrate the relevance, accuracy and quality of the sources cited. An annotated bibliography is not simply an abstract. An abstract is a summary (a description). An abstract lacks the critical, evaluation component. In contrast, an annotation of the article will convey both description and critical thinking. The following Canadian websites provide some useful information about annotated bibliographies: http://www.library.mun.ca/guides/howto/annotated_bibl.php http://www.utoronto.ca/writing/annotatebib.html Topics appropriate for the annotated bibliography. You can select any topic in immunology as long as it has public health, health promotion or human health relevance. For example, you could select hypersensitivity responses to mosquito bites, or an immunological aspect of West Nile Virus, or the role of interleukin-1 in Chronic Fatigue Syndrome, or interleukin-6 and diabetes mellitus, or intestinal lymphocyte dysfunction in autism, or the impact of psychological stress on macrophage phagocytic functions. Your cannot choose articles that are only epidemiological or only clinical in focus (e.g., the epidemiology of malaria, clinical diagnosis of Lyme Disease). It is also not acceptable to choose articles that are only social science or health behaviour in focus. For example, the politics of the Canadian blood banking system or risk communication about SARS are examples of topics that would not be acceptable for the annotation. It is also not acceptable to choose articles that are immunological but which have no direct relevance to human public health. For example, articles on the molecular immunology of the T cell receptor, or expression of cell adhesion molecules on dendritic cells, or natural killer cell receptor signaling would not be suitable for the annotated bibliography. For the topic you select for the annotated bibliography, you must identify 3 articles from the primary scientific literature. You are required to read each of the three articles and prepare an annotated bibliography for each (that is, a separate annotation for each article). All 3 papers selected must be on a single topic in immunology/disease processes. The choice of the topic (again, for example, immunology of AIDS, how exercise affects muscle interleukin-6, role of macrophages in heart disease, how natural killer cells recognize cancer cells, immunology of spontaneous abortion, inflammatory cytokine involvement in the etiology of Alzheimer’s Disease, resistance exercise and leukocytosis) and the selection of scientific papers should be of interest to you. You must discuss the topic with the TA or instructor before you begin your annotated bibliography. Selection of scientific articles. Select three (3) papers for the annotation. Each paper must be from a different author (e.g., John Doe; Jane Doe; Jim Doe). Each paper must be from a different journal (e.g., Science; Journal of Immunology; Canadian Journal of Public Health). You cannot use chapters from textbooks, review articles, letters to an editor of a journal, editorial comments, books, popular 2
  • 3. magazines, newspapers, or internet sites (unless these are from on-line scientific journals). You must use papers from the primary scientific literature. To help you get started on the process of identifying primary literature for your annotation, tutorials at the Davis Centre library will be provided. The following dates and times are available: Monday October 6, Wednesday Oct 8 or Tuesday Oct 14, 4 - 5 p.m. in the DC Library Conference Room. If you are planning to attend a library tutorial, you must sign up for it in advance since space in the conference room is limited. A sign-up sheet will be circulated during the first week of classes. Contents of Annotated Bibliography. Each annotation must be approximately 250 words. You must include the following information in your annotation. • Full list of authors, full title of article, and journal citation (year, journal name, volume, page numbers). Use a consistent style for citation for all 3 annotations. • Two or three sentences about why the study in the article you are annotating was conducted. You must provide a clear and simple question (stated in the form of a question) that identifies the broader relevance of the paper. This is the ‘hook’ to encourage the reader to continue reading the annotation. • Three sentences on background information that is necessary to understand and appreciate the study’s significance. • Two to four sentences (in total) about the methods, design and findings of the study. • Two or three sentences summarizing the general conclusions, including an answer to the question stated at the beginning. • Two to four sentences giving your critical appraisal of the conclusions made by the authors (e.g., do the conclusions make sense given the data? Are the authors forgetting or ignoring some very important variable that could affect the conclusion? Do the conclusions make biological sense, not just statistical sense?). Summary of the annotations (500 words). After the third annotation, you must provide a summary of the three annotations, as structured below. The summary must be well reasoned, carefully argued, and persuasive. The key to a convincing and persuasive argument is a careful choice of the subject area and the articles selected. • Overall conclusion (250 words). Provide an overview of the combined results of all three studies indicating why the issue being addressed is important, timely and/or interesting. You must include a statement about what are the key questions left to be answered or what you think are the next steps in this research area. This overall conclusion must be a critical synthesis and not simply a summary of the findings of the three annotated papers. • Personal reflection (125 words). Provide a short statement about what you thought was most intriguing, interesting or perplexing about the immunological issue or disease process addressed by the three papers and why you thought so. (For reference, the above paragraph on personal reflection includes 35 words) Important Considerations in Preparing Your Annotated Bibliography. • Write the annotated bibliography in your own words. Explain technical terms (e.g., allogeneic) and acronyms (e.g., IL-2) in simple and plain English. Avoid jargon (e.g., the mixed lymphocyte response depends on down regulation of GCII receptors for death domain initiated apoptosis). Write the annotated bibliography and summary as if you were trying to explain it to your parents (or grandparents) in a letter. • If you plan to use direct quotes from the articles, make sure you use full quotation marks (“ “). No more than one quotation per annotation is allowed and no quotation may be longer than 20 3
  • 4. words. • Do not use the authors’ original words. Always restate the information in your own words. • Include a word count (use Word or Wordperfect) at the end of each annotation and at the end of the summary section. If word limits are exceeded, marks will be deducted from the paper. Also, if the word count is significantly below the requirement, marks will be deducted from the paper. • Submission of the annotated bibliography is November 18. Late papers will be penalized with marks deducted: 1 day late: -5 points; 2 days late: -10 points; 3 days late: -15 points, etc. Final Format of Annotated Bibliography • Use 12 point font, single spaced,1 inch margins for the text. Insert two lines between each annotation, between the third annotation and the summary, and between the overall conclusion and the personal reflection. Remember for each annotation to give author names, title of article, and journal citation. This should be in bold text. • Page 1: Your name, student ID, and title of your topic • Page 2: Annotation for paper 1 and annotation for paper 2 • Page 3: Annotation for paper 3 and summary (overall conclusion) • Page 4: Summary (personal reflection) • To save trees, submit your annotated bibliography double sided (i.e., 4 sides; 2 pages) • Photocopies of the abstract (summary) and first page of the introduction for EACH of the three papers you selected must be appended to the annotated bibliography. Failure to provide a clear photocopy of the abstract and first page of each article will result in no mark for the annotated bibliography. Instructor Policy on Missed Examinations Substitute exams (make-ups) are allowed only under exceptional circumstances. All requests for make-up examination must be accompanied by supporting evidence for that request (e.g., physician note). Failure to provide documentation results in a grade of zero (0) for the exam. 4
  • 5. IV. SYLLABUS Date Topic Text Readings 9/09 Introduction and Course Organization; Models of Health and Disease Processes 9/11 Innate Immunity Textbook materials to be read before exam 1: 9/16 9/18 Pages 1-11; 27-59; 162-168 9/23 9/26 9/30 10/02 Exam 1 10/07 Adaptive Immunity Textbook materials to be read before exam 2: 10/09 10/14 Pages 61-94; 105-119; 131-179 10/16 10/21 Immune Responses to Infectious Agents Textbook materials to be read before exam 2: 10/23 Pages 265-282; 435-458 10/28 Transplantation Immunology and HLA Textbook materials to be read before exam 2: Pages 201-222 10/30 Exam 2 11/4 Hypersensitive Reactions: Type I, II, III, IV Textbook materials to be read before exam 3: 11/6 11/11 Pages 181-199 11/13 Case Studies: Tuberculosis; HIV/AIDS Textbook materials to be read before exam 3: 11/18 11/18 Annotated Bibliography Due Pages 304-305, 441-442 11/20 Pages 344-346 11/25 Exam 3 11/27 No Class 5