Presentation to the 2015 LGBTQ Health Care Speaker Series for knowledgeable providers - Kaiser Permanente. Given from the Kaiser Permanente Center for Total Health, Washington, DC USA
Keynote, 2nd annual Kaiser Permanente LGBTQI Health Symposium. About unconscious/implicit bias, in the setting of transgender person health. Sheraton Universal, Universal City, California
Total Health, Being a Transgender ally and Unconscious bias HLTH 471 - univ...Ted Eytan, MD, MS, MPH
Presentation to HLTH 471 - Women's Health - at University of Maryland, Shady Grove, with faculty Sabrina Matoff-Stepp, PhD., on the social determinants of health for transgender individuals and transgender women specifically + a view into the Kaiser Permanente Center for Total Health, in Washington, DC USA
Presentation to Kaiser Permanente Government Relations Workshop November 6, 2015, Pasadena California, covering the Kaiser Permanente Center for Total Health, Social Innovation, and the KPLantern Project.
"Resilient people and companies face reality with staunchness, make meaning of hardship instead of crying out in despair, and improvise solutions from thin air. Others do not. This is the nature of resilience, and we will never completely understand it" - Harvard Business Review 2002
Social Justice, Social Media, and Family MedicineMike Sevilla
Mike Sevilla, MD & Jay Lee, MD, MPH presentation on July 26, 2012 at the American Academy of Family Physicians National Conference of Family Medicine Residents and Medical Students
Keynote, 2nd annual Kaiser Permanente LGBTQI Health Symposium. About unconscious/implicit bias, in the setting of transgender person health. Sheraton Universal, Universal City, California
Total Health, Being a Transgender ally and Unconscious bias HLTH 471 - univ...Ted Eytan, MD, MS, MPH
Presentation to HLTH 471 - Women's Health - at University of Maryland, Shady Grove, with faculty Sabrina Matoff-Stepp, PhD., on the social determinants of health for transgender individuals and transgender women specifically + a view into the Kaiser Permanente Center for Total Health, in Washington, DC USA
Presentation to Kaiser Permanente Government Relations Workshop November 6, 2015, Pasadena California, covering the Kaiser Permanente Center for Total Health, Social Innovation, and the KPLantern Project.
"Resilient people and companies face reality with staunchness, make meaning of hardship instead of crying out in despair, and improvise solutions from thin air. Others do not. This is the nature of resilience, and we will never completely understand it" - Harvard Business Review 2002
Social Justice, Social Media, and Family MedicineMike Sevilla
Mike Sevilla, MD & Jay Lee, MD, MPH presentation on July 26, 2012 at the American Academy of Family Physicians National Conference of Family Medicine Residents and Medical Students
Suicide Prevention Experts Convene in Washington DCDavid Covington
Last year, over 45 thousand people died by suicide in the U.S., one person every 11.7 minutes, while over a million people attempted suicide. With suicide rates in the U.S. steadily climbing, suicide remains the 10th leading cause of death in the US, the American Association of Suicidology (AAS) recognizes that the only way to impact this serious public health issue is to draw from scientific research and initiate implementation of effective strategies. We anticipate over 1,500 attendees to this year’s conference in the heart of political advocacy, Washington, D.C, April 18 - 21,
2018 at the Hyatt Regency Capitol Hill.
On December 10, 2014, The Kaiser Permanente Center for Total Health and National Center for Transgender Equality are hosting a Community Clinician Roundtable for providers who care for transgender patients in the Washington, DC, MD, VA community. The roundtable will include physicians, nurses, therapists, attorneys, and health care staff who support this population.
Il s'agit d'une présentation powerpoint de la Directrice du Center Of Excellence For Transgender HIV Prevention,UCSF (2009)
Il y est question d'épidémiologie, bien évidemment, dans un contexte où n'existe aux Etats-Unis (comme en France) aucune donnée nationale sur le nombre de personnes trans, et donc encore moins sur le nombre de trans vivant avec le VIH. La présentation donne des pistes de recommandation concernant la production de données épidémiologiques spécifiques.
La présentation est également l'occasion de passer en revue les enjeux et déterminants de santé liés à l'épidémie de VIH chez les trans, et plus largement à leur état de santé.
Objectifs de l'épidémiologie du VIH chez les personnes trans :
- comprendre les tendances épidémiologiques en cours dans les populations transgenres ;
- comprendre les facteurs favorisant le risque de dissémination du VIH parmi les femmes transgenres
(déterminants négatifs) ;
- comprend les facteurs protecteurs contre les "facteurs négatifs du point de vue de la santé" (negative health outcomes) parmi les transgenres (déterminants positifs).
Suicide Prevention Experts Convene in Washington DCDavid Covington
Last year, over 45 thousand people died by suicide in the U.S., one person every 11.7 minutes, while over a million people attempted suicide. With suicide rates in the U.S. steadily climbing, suicide remains the 10th leading cause of death in the US, the American Association of Suicidology (AAS) recognizes that the only way to impact this serious public health issue is to draw from scientific research and initiate implementation of effective strategies. We anticipate over 1,500 attendees to this year’s conference in the heart of political advocacy, Washington, D.C, April 18 - 21,
2018 at the Hyatt Regency Capitol Hill.
On December 10, 2014, The Kaiser Permanente Center for Total Health and National Center for Transgender Equality are hosting a Community Clinician Roundtable for providers who care for transgender patients in the Washington, DC, MD, VA community. The roundtable will include physicians, nurses, therapists, attorneys, and health care staff who support this population.
Il s'agit d'une présentation powerpoint de la Directrice du Center Of Excellence For Transgender HIV Prevention,UCSF (2009)
Il y est question d'épidémiologie, bien évidemment, dans un contexte où n'existe aux Etats-Unis (comme en France) aucune donnée nationale sur le nombre de personnes trans, et donc encore moins sur le nombre de trans vivant avec le VIH. La présentation donne des pistes de recommandation concernant la production de données épidémiologiques spécifiques.
La présentation est également l'occasion de passer en revue les enjeux et déterminants de santé liés à l'épidémie de VIH chez les trans, et plus largement à leur état de santé.
Objectifs de l'épidémiologie du VIH chez les personnes trans :
- comprendre les tendances épidémiologiques en cours dans les populations transgenres ;
- comprendre les facteurs favorisant le risque de dissémination du VIH parmi les femmes transgenres
(déterminants négatifs) ;
- comprend les facteurs protecteurs contre les "facteurs négatifs du point de vue de la santé" (negative health outcomes) parmi les transgenres (déterminants positifs).
This is my presentation for my Final Major Project Proposal and Thesis research done examining potential and fun solutions that the tech workplace can adopt to mitigate unconscious bias that is potentially counteracting diversity efforts and negatively impacting the capacity for innovation.
this slide created to give knowledge about trans gender in india. it also covers the section of indian penal code and supreme court's decision ,related to them.
How to be a better storyteller whiteboard sessionRocketAdmin
If you want to connect with people quickly in your sermons, you've got to use stories. Jesus was a master storyteller and He used stories to illustrate spiritual truths. In this Whiteboard Session, Ben Crawshaw provides practical steps to help you become a better storyteller.
DC NAAAHR Diversity Summit Event Guide 2009 V10 2009 2MITRE
Event guide information for NAAAHR Washington D.C. Chapter hosts in conjunction with Georgetown University a Diversity Summit on 12/10/09 at the National Press Club.
Edgecombe Community CollegeREL 110 Section OL1 World Religion.docxgidmanmary
Edgecombe Community College
REL 110 Section OL1
World Religions
Rev. Stephen A. Herring, Instructor
Midterm Assignment
For our midterm this semester we are going to compose a well- developed essay examining the role of human rights and human responsibilities in one of the eastern religions. The “Eastern Religions” are those of Asia, or the orient, also known as the eastern world.
These are covered in your book in chapters 6, 7, and 8. They are:
· Hinduism
· Buddhism
· Daoism
· Confucianism
· Shinto
For this project you want to develop two basic concepts. These are human rights and human responsibilities. Rights are privileges which belong to every human being simply by virtue of their being a person. Human rights have to do with our deeper understanding of what it means to be human. The way we understand the definition of “a person” shapes the ways we treat one another. The problem is that in various ways we treat people differently depending on which sort of people we are talking about. Across human cultures, we afford more rights to one sort of people and fewer rights to other sorts of people. This makes the whole discussion about human rights very complex and intertwined with our cultural perspective.
Responsibilities are obligations that also come with our being human. In each culture, people are expected to comply with certain expectations. One way to understand any religion is by looking at these rights and responsibilities. Viewed in this way, any religion tells its followers two basic things: “This is who you are.” And “This is what you are expected to do.” As a preacher, I don’t know how many sermons I have given where one of these two themes have been touched upon. “This is who we are, and this is what we are expected to do.”
On the surface this seems very simple, but it rapidly gets all wrapped up in the privileges and expectations that come with each culture. To look into this, we can look at the rights of women in the culture surrounding any given religion. We might also look at the rights of minorities, or people who are at the fringes of the culture. People at the fringes of cultural acceptance are known as “marginalized populations.” Here we are looking at the lives of people who are not accepted by the predominant culture. We can also look at attitudes toward “outsiders”, or people who belong to other cultures or other religions.
So, your assignment is as follows;
Please compose a well-developed essay examining human rights and human responsibilities in one of the eastern religions covered in chapters 6, 7, or 8. Your essay should be at least 3 pages long but not more than 5 pages long. (double spaced) Remember to include a clear works cited page. DO NOT try to copy your response off the internet. Please email me if you have any questions.
Y6
Hongkun Yi
Professor Morris
English 2367
2/27/2020
Organ Donation
The debate on organ donation has different dimensions because of the so ...
Edgecombe Community CollegeREL 110 Section OL1 World Religion.docxtidwellveronique
Edgecombe Community College
REL 110 Section OL1
World Religions
Rev. Stephen A. Herring, Instructor
Midterm Assignment
For our midterm this semester we are going to compose a well- developed essay examining the role of human rights and human responsibilities in one of the eastern religions. The “Eastern Religions” are those of Asia, or the orient, also known as the eastern world.
These are covered in your book in chapters 6, 7, and 8. They are:
· Hinduism
· Buddhism
· Daoism
· Confucianism
· Shinto
For this project you want to develop two basic concepts. These are human rights and human responsibilities. Rights are privileges which belong to every human being simply by virtue of their being a person. Human rights have to do with our deeper understanding of what it means to be human. The way we understand the definition of “a person” shapes the ways we treat one another. The problem is that in various ways we treat people differently depending on which sort of people we are talking about. Across human cultures, we afford more rights to one sort of people and fewer rights to other sorts of people. This makes the whole discussion about human rights very complex and intertwined with our cultural perspective.
Responsibilities are obligations that also come with our being human. In each culture, people are expected to comply with certain expectations. One way to understand any religion is by looking at these rights and responsibilities. Viewed in this way, any religion tells its followers two basic things: “This is who you are.” And “This is what you are expected to do.” As a preacher, I don’t know how many sermons I have given where one of these two themes have been touched upon. “This is who we are, and this is what we are expected to do.”
On the surface this seems very simple, but it rapidly gets all wrapped up in the privileges and expectations that come with each culture. To look into this, we can look at the rights of women in the culture surrounding any given religion. We might also look at the rights of minorities, or people who are at the fringes of the culture. People at the fringes of cultural acceptance are known as “marginalized populations.” Here we are looking at the lives of people who are not accepted by the predominant culture. We can also look at attitudes toward “outsiders”, or people who belong to other cultures or other religions.
So, your assignment is as follows;
Please compose a well-developed essay examining human rights and human responsibilities in one of the eastern religions covered in chapters 6, 7, or 8. Your essay should be at least 3 pages long but not more than 5 pages long. (double spaced) Remember to include a clear works cited page. DO NOT try to copy your response off the internet. Please email me if you have any questions.
Collaborative Writing Project
Peer Review Worksheet
Collaborative Writing Project
Peer Review WorksheetPeer Review Worksheet
Name of aut.
Autism and Life Transitions: Hard Lessons Learned & Taught as a Person-Center...Cheryl Ryan Chan
In December of 2015, I presented this webinar to members of the National Association for Dual Diagnoses (thenadd.org). I've been conducting Person-Centered Plans for 4 years, and over that time I've seen a number of disturbing trends around the lack of understanding and planning for preparedness in transitioning students; in particular, in the areas of independent skill building specific to the anticipated environment, and personal safety skills. I feel it's important to talk about what I've observed and how my team of co-facilitators and I have identified and tackled these issues within the PCP process. I hope that the "lessons learned" will assist people in planning for IEP/ISP goals that can help maximize success. I offer it free to anyone who would like to attend.
Name 1 Student NameProfessor Morris English 2367 .docxgertrudebellgrove
Name 1
Student Name
Professor Morris
English 2367
14 November 2019
Organ Donation: You Can Make a Difference
The national organ transplant waiting list continues to grow larger and larger, day by day,
and we need to take action to decrease the number of patients dying before they receive a
lifesaving organ. Although the idea of everyone receiving a transplant that will save their life is
desirable, it’s practically impossible to save every single person that is on the waiting list. It may
not be possible to reduce the amount of names added to the waiting list everyday, but it is
certainly possible to reduce the amount of people that die each day while waiting for a lifesaving
transplant. Significant research has been done to explain the reason for the continuous shortage
of organ donors and possible solutions have been proposed to put an end to the issue. Majority of
research on organ donation agrees that proper education about donation processes, improved
procurement processes, and donation after circulatory or cardiac death are all potential solutions
to increase the donor pool. Implementation of these ideas is necessary to decrease the amount of
patients dying and to increase the amount of registered donors.
Many people are opposed to and become uncomfortable when the topic of organ donation
arises in conversation. The primary cause of this opposition and fear are the numerous believable
but certainly untrue misperceptions regarding organ donation after deceased. In his TED Talk,
“Giving the Gift of Life through Organ Donation,” transplant surgeon Chris Barry speaks with a
great deal of emotion and knowledge about organ donation after deceased. Dr. Chris Barry lists a
cmorris71
Highlight
Name 2
few of the formidable myths that surround organ donation which include: belief that a person’s
religion does not accept organ donation, doctors will not work as hard to save your life if they
know that you are a registered organ donor, and finally the belief that one is too old to donate
their organs. He states that, “This kind of thinking is killing people.” It’s important for everyone
to be informed about the facts regarding organ donation and to not fall into the trap of the
countless misperceptions. In fact, Paolo Bruzzone, MD provides the facts of religious beliefs on
organ donation in his article, “Religious Aspects of Organ Transplantation,” he confirms that
“No religion formally forbids donation or receipt of organs or is against transplantation from
living or deceased donors.” These myths are recognized and explained in the majority of
research done on organ donation and transplantation. Specifically, the Health Resources and
Services Administration (HRSA) informs the public about the myths and provides the facts about
the myths eliminating any confusion about organ donation and transplantation. The HRSA states
that, “There’s no age limit to organ donation. To date, .
Name 1 Student NameProfessor Morris English 2367 .docxgertrudebellgrove
Name 1
Student Name
Professor Morris
English 2367
14 November 2019
Organ Donation: You Can Make a Difference
The national organ transplant waiting list continues to grow larger and larger, day by day,
and we need to take action to decrease the number of patients dying before they receive a
lifesaving organ. Although the idea of everyone receiving a transplant that will save their life is
desirable, it’s practically impossible to save every single person that is on the waiting list. It may
not be possible to reduce the amount of names added to the waiting list everyday, but it is
certainly possible to reduce the amount of people that die each day while waiting for a lifesaving
transplant. Significant research has been done to explain the reason for the continuous shortage
of organ donors and possible solutions have been proposed to put an end to the issue. Majority of
research on organ donation agrees that proper education about donation processes, improved
procurement processes, and donation after circulatory or cardiac death are all potential solutions
to increase the donor pool. Implementation of these ideas is necessary to decrease the amount of
patients dying and to increase the amount of registered donors.
Many people are opposed to and become uncomfortable when the topic of organ donation
arises in conversation. The primary cause of this opposition and fear are the numerous believable
but certainly untrue misperceptions regarding organ donation after deceased. In his TED Talk,
“Giving the Gift of Life through Organ Donation,” transplant surgeon Chris Barry speaks with a
great deal of emotion and knowledge about organ donation after deceased. Dr. Chris Barry lists a
cmorris71
Highlight
Name 2
few of the formidable myths that surround organ donation which include: belief that a person’s
religion does not accept organ donation, doctors will not work as hard to save your life if they
know that you are a registered organ donor, and finally the belief that one is too old to donate
their organs. He states that, “This kind of thinking is killing people.” It’s important for everyone
to be informed about the facts regarding organ donation and to not fall into the trap of the
countless misperceptions. In fact, Paolo Bruzzone, MD provides the facts of religious beliefs on
organ donation in his article, “Religious Aspects of Organ Transplantation,” he confirms that
“No religion formally forbids donation or receipt of organs or is against transplantation from
living or deceased donors.” These myths are recognized and explained in the majority of
research done on organ donation and transplantation. Specifically, the Health Resources and
Services Administration (HRSA) informs the public about the myths and provides the facts about
the myths eliminating any confusion about organ donation and transplantation. The HRSA states
that, “There’s no age limit to organ donation. To date, ...
Similar to Being a Transgender Ally and Unconscious Bias (20)
Group of slides related to metabolic health, low carbohydrate diets, low carbon diets, the "sustainable diet" and epidemiologic trends shaping the health of our nation.
Second re-submission, 3rd submission total, to Unicode for inclusion in the 2020 Unicode standard, March, 2019, updated March 12, 2019 with additional requested footnote, not reflected in this version (slideshare doesn't allow re-uploads anymore)
Proposal for new valid emoji sequence: Transgender Flag: version 4 for 2019Ted Eytan, MD, MS, MPH
The following is a proposal to the Unicode Consortium for a SWJ sequence, to be recommended for general interchange (RGI). The Transgender Flag would complement the Rainbow Flag as a representation of non-cis gender identities and intersex people. Submitted to the Unicode consortium, March, 2018, for inclusion in the 2019 standard.
2018.02.22 Designing Healthy and Safe Health Care Spaces for LGBTQ PeopleTed Eytan, MD, MS, MPH
Presentation for LGBTQ health series for Kaiser Permanente physicians, nurses, staff, on designing healthy and safe health care facilities for all humans.
Proposal for new valid emoji sequence: Transgender Symbols and Pride FlagTed Eytan, MD, MS, MPH
Version 3, Proposal to Unicode Consortium for Transgender symbol inclusion in 2018 emoji character set. Detailed technical specification included this time.
2016.11.17 Walking at Work: The What, Why & How of Walking MeetingsTed Eytan, MD, MS, MPH
Presentation given with AmericaWalks on November 17, 2016
"Walking is a great way to incorporate more physical activity into your daily routine. One way to make sure you are getting the recommended amount of steps is to turn meetings at work into walking meetings. This webinar explores the what, why and how of walking meetings and learn from examples of businesses and organization that have put them into practice. - See more at: http://americawalks.org/walking-at-work-the-what-why-how-of-walking-meetings-november-17-2016-webinar/#sthash.V97AwZMP.dpuf"
Update of presentation on using social media as a health professional, given to the students of the Kaiser Permanente School of Allied Health Sciences, Richmond, CA, USA
KP in DC : Quest for Total Health (Center for Total Health Overview)Ted Eytan, MD, MS, MPH
Presentation given by myself and Keith Montgomery, Executive Director, about the Kaiser Permanente Center for Total Health to Kaiser Permanente colleagues, December 10, 2015
Presentation given to the Professional Convention Management Association - Capital Chapter, Washington, DC, as part of a program on hosting healthy meetings, at the Kaiser Permanente Center for Total Health
Intro to Kaiser Permanente Center for Total Health and Social InnovationTed Eytan, MD, MS, MPH
The Center for Total Health is Kaiser Permanente's Social Innovation Center. This presentation was given to the American College of Preventive Medicine Corporate Roundtable, meeting in Washington, DC, to introduce the Center, Social Innovation, and Total Health for individuals and communities. Thanks for having me!
Presentation at Transportation Techies, August 20, 2015, at Walk Hack Night on the work of the Kaiser Permanente Center for Total Health to install and analyze data from multiple population sensors, including ones using infrared and computed video technology.
Population sensors have great promise to promote physical activity compared to wearable devices, which can be expensive, impact privacy, and have low uptake and use.
Total Health and Innovation: Demystifying Medicare 2015 Summer AcademyTed Eytan, MD, MS, MPH
Presentation at the Kaiser Family Foundation, Washington, DC USA, National Academy of Social Insurance, in collaboration with the Alliance of Community Health Plans
Walls, Ceilings, Closet Doors (Things Worth Shattering): Total Health and Soc...Ted Eytan, MD, MS, MPH
2015 Update on the Kaiser Permanente Center for Total Health, the Social Innovation Center of Kaiser Permanente, including examples of social movements and interventions that have been born or amplified since 2011.
7 Minute "Shift and Share" Presentation given at "Strength Beyond our Walls" event with RWJF Nurse Executive Fellows, showing the example of a vulnerable population (people who are transgender or gender non-conforming) and hidden strengths (transformational leadership and compassion and acceptance for others)
#transformKP: Total Health and Social Innovation (for Labor Management Partne...Ted Eytan, MD, MS, MPH
Presentation given to the Kaiser Permanente Labor Management Partnership all hands meeting, December 2, 2014, in San Francisco, California. "The Labor Management Partnership (LMP) is the largest and longest-lasting partnership of its kind in the country. Created in 1997, it is based on a series of agreements between the Coalition of Kaiser Permanente Unions, made up of 27 union locals, Kaiser Permanente and the Permanente medical groups in each region. Today, it covers almost 100,000 union members and tens of thousands of managers and physicians."
Introduction to a panel of architects, public heath professionals, and civic leaders about designing for health. Hosted by American Institute of Architects, Washington, DC, on October 8, 2014
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. Intended Learning Outcomes & Disclosure
What does it mean to be an ally & what happens?
What’s unconscious bias and why should I care?
What causes it?
I’m a clinician / leader / citizen - what can I do about it?
Disclosure
I ! Kaiser Permanente!
3. Build Your Best Life Total Health Festival, with Capital Pride, Washington, DC • Kaiser Permanente 2014 Gold Sponsor
I’m an ally
(also a family doctor,
a Permanente physician,
a Kaiser Permanente member,
a Washington, DC resident)
Hi. I’m Ted.
4. We’re here from the future
Kaiser Permanente Center for Total Health
Washington, DC, April 1, 2014
5. So are you.
Kaiser Permanente LGBTQI Health Symposium
Los Angeles, CA • April 13, 2013
6.
7. A father and his son are in a car accident. The
father dies at the scene and the son, badly injured,
is rushed to the hospital. In the operating room,
the surgeon looks at the boy and says, “I can’t
operate on this boy. He is my son.” How can this
be?
8. The brain sees what it wants to see
“there is no immaculate perception”
A father and his son are in a car accident. The
father dies at the scene and the son, badly injured,
is rushed to the hospital. In the operating room,
the surgeon looks at the boy and says, “I can’t
operate on this boy. He is my son.” How can this
be?
Banaji, Mahzarin R.; Greenwald, Anthony G. (2013-02-12). Blindspot: Hidden Biases of Good People (Kindle Locations
1094-1096). Random House Publishing Group.
9. A mother and her daughter are in a car accident.
The mother dies at the scene and the daughter,
badly injured, is rushed to the hospital. In the
operating room, the surgeon looks at the girl and
says, “I can’t operate on this girl. She is my
daughter.” How can this be?
10. The brain sees what it wants to see
“there is no immaculate perception”
Source:http://en.wikipedia.org/wiki/File:Peripheral_drift_illusion_rotating_snakes.svg
11. we use tools to help us see accurately…
Bocce in the Park, Meridian Hill Park, Washington, DC, USA, April 20, 2014
Source: Ted Eytan, MD, http://www.flickr.com/photos/22526649@N03/13957191713
12. Why we’re having this dialogue
ALL of us
– have biases
– are human beings
– want to be the best
for the human
beings we serve
Yes, ALL of us
“We live in a time when discrimination
looks less like a segregated lunch
counter…and more like a doctor failing
to inspire trust in your daughter and
improperly diagnosing her illness” -
Johnson, 2014
“…in a time where discrimination still
looks like a segregated lunch counter
for transgender and LGBTQ people” -
Eytan, 2015
Source: Godsill R, Goff PA, Tropp L, Powelll JA. The Science of Equality Volume 1: Addressing Implicit
Bias, Racial Anxiety, and Stereotype Threat in Education and Health Care. 2014. Available at: http://
perception.org/uncategorized/perception-institute-releases-the-science-of-equality/.
13. How we’re having this dialogue
Use of language
– “discrimination,” “homophobia,” “bias”
– if defensive, notice it and accept the
discomfort of unlearning and
relearning.
– “This requires a desire to know,
motivation to become informed,
willingness to correct mistakes”
Personality lens
– Amiable-amiable with a z versatility
– aka “Double rainbow,” “Glass 3/4 full”
Source: http://www.cookross.com/docs/UnconsciousBias.pdf
14. Drs. Jennifer Slovis, Susanne Watson, and Judy Lively • Community Partner awards
Transgender Law Center Annual Gala, San Francisco, CA • October 3, 2013
http://www.flickr.com/photos/22526649@N03/10327667743
15. Rebecca Goldfader, ARNP • Community Partner awards
Transgender Law Center Annual Gala, San Francisco, CA • October 3, 2013
http://www.flickr.com/photos/22526649@N03/10327667743
16. Explicit Attitudes = aware, endorsed
Ability to claim as our own
– “We oppose discrimination in all
forms”
– “When I look back I want to be
on the right side of history”
Measured by asking
“This ability to examine the
contents of our own minds
and manipulate them is
uniquely human.”
Negative attitudes, relative to whites
Source: Phelan SM, Dovidio JF, Puhl RM, et al. Implicit and explicit weight
bias in a national sample of 4,732 medical students: The medical student
CHANGES study. Obesity (Silver Spring). 2014;22(4):1201–8. Available at:
http://www.ncbi.nlm.nih.gov/pubmed/24375989 [Accessed April 2, 2014].
17. Implicit Attitudes = unconscious, automatic
“Ultimately, we believe our
decisions are consistent with our
conscious beliefs, when in fact, our
unconscious is running the show”
Not accessible through
introspection
Measured indirectly
Noticed directly!
Active area of study in employment,
law, education, medicine, across
industries
Source: Staats C. State of the Science: Implicit Bias Review 2014. Columbus, OH; 2014. Available at: http://kirwaninstitute.osu.edu/
implicit-bias-review/.,http://armylgbt.org.uk/army-reserve-quarterly-features-army-lgbt-conference/; http://www.cbsnews.com/news/
ferguson-policing-eric-holder-implicit-explicit-racial-bias/
Young
Reserve
Officer’s
Workshop
Brno,
Czech Republic
YROW is an annual week-long
programme run by the Interallied
Confederation of Reserve Officers
(CIOR) and is designed to be a
young officer's first international
exposure to colleagues from NATO
and its Partners.
Dates: 29 Jul to 3 Aug 2013.
Location: Brno, Czech Republic
Open to: TA junior officers
(2Lt to Capt)
YROW is sponsored by HQ Army,
eligible for MTDs, and all travel costs
are covered including flights etc.
It consists of a week of seminars,
practical exercises, command tasks
and a lot of social interaction with
about 18 other NATO member states.
A social, interesting, and useful
week of getting to know the
countries you probably will be going
to work with in the future.
Potential candidates will need
a recommendation by their
chain of command and to meet
various criteria.
For further information contact:
Maj Mike Curtis-Rouse R Signals
UKRFA SO2
07747 565 497
mikecurtisrouse@gmail.com
ARQ Summer 2013
“The attendance of those in the chain of
command at the conference demonstrates a
marked and increasing commitment to good
management practices in the Army.
The Army aims to create a working
environment in which everyone can be
authentic about themselves, because
it improves operational effectiveness,”
concludes Major Jenkins.
The next LGBT conference is for all services in
the Armed Forces, and will be organised by
the Royal Navy at MOD Main Building on
28 June 2013.
TA
soldiers from the
Lesbian Gay Bisexual
and Transgender (LGBT)
community met those in the chain of
command at the third annual Army
LGTB conference held in March.
The theme of this year’s conference was
“Cultivating LGBT Talent” to address the fact
that there are few visibly LGBT soldiers or
officers in senior roles despite recent statistics
from Phase 1 and 2 recruits indicating that
around one in six new soldiers joining their
units in 2013 are in this group.
“The concern is that LGBT senior soldiers and
officers feel unable to be open about their
sexual orientation or gender identity, or that
they leave before achieving senior positions,”
explains Major Damian Jenkins, chairman of
the Army LGBT Forum.
“We don’t know how big the Army LGBT
community is, but the first Army-gathered
statistics on gender identity and sexual
orientation of Phase 1 and 2 recruits in 2012
showed that 1.5 per cent of men and 15 per
cent of women leaving the Phase 2 training
were lesbian, gay or bisexual. This means
that around one in six people joining their
new units in 2013 are LGBT.”
Also in the 102-strong audience were
commanding officers, adjutants, trainers,
and medical officers, to learn about unconscious
biases and the effect these have on the
promotion potential of LGBT soldiers
and officers.
Conference
Confronts
Unconscious
Biases
37
UK Army LGTB
Conference, 2013
CBSNews, March, 2015
18. Deb Friesen, MD and Rachael St.Claire, PsyD
Receipt of Human Rights Campain, 100%
Corporate Equality Index Award, April 1,
2014, New York City, NY
National Diversity and Inclusion Conference,
Kaiser Permanente, November 22, 2013, San
Francisco, CA
19. Brenda McComb, PhD
Trustee, Oregon State University (with Provost Sabah Randhawa)
Dean of Graduate Programs, Oregon State University
Professor of Forestry
Trans* Ally
Source: http://oregonstate.edu/leadership/trustees; http://pinterest.com/oregontrans
20. Juliet Greenwood, PhD
Associate Dean for Academic and Student Affairs
Associate Professor, Biochemistry and Biophysics
Oregon State University
Source: Juliet Greenwood, PhD
21. Being an ally in a world less loving
“Edith’s Crisis of Faith”
All in the Family
air date 12/25/1977
Watch: http://j.mp/edithbunkerally
22. It’s hard to be an ally
“Will they want
cross-species
transplants next?”
“Not all
the medical groups
share “Ted’s” point of
view”“Ted, people with
HIV were dying” “I
fully expect the numbers
to increase”
“Ted, are you a t—-y?”
“Wasn’t that
stabbing victim a
sex worker?”
“You’re violating HIPAA”
Source: http://dcist.com/2013/06/transgender_woman_stabbed_up_to_40.php
23. quick answers…
No
I think they believe in science, though
Yes, and we’re saddened by it, too
Yes, more human beings able to live
their lives through better health
If it recruits your humanity, believe that
I am. And, you can never say that word
in front of me again.
Many humans who are (illegally)
denied employment are.
“Receiving anger is a sacred task” -
(Ronald Heifetz, Leadership on the Line)
24. It’s harder to be a patient
“We need
to understand what
our competition is
doing”
“This is
cosmetic / aesthetic
surgery”“Care is very
expensive”
EXCLUSION: “Services, drugs,
or supplies related to sex
transformation”
“Top Surgery is reserved for
breast cancer patients and members
who have purchased the
'Transgender Rider’"
“Top Surgery has not been
universally accepted as treatment
for transgender Dysphoria [sic] - its
considered ‘elective'."
25. What does our history tell us?
Incorrect - AMA H-158.950
Incorrect - Multiple actuarial
analyses declared “de minimis”,
“immaterial”,”insignificant”
Incorrect - AMA H-158.950
Is this Fair Treatment?
– American Medical Association, District of
Columbia, other states, Title VII, and the
Affordable Care Act, Section 1557
– sex discrimination now includes gender
identity and expression
– “in contradiction to the medical
profession’s prized values of equity and
respect”
quick answers…
Sources: American Medical Association H-185.950, Economic Impact Assessment,
Gender Nondiscrimination in Health Insurance, State of California, OCR Transaction
Number: 12-000800, DC Dept of Insurance, Securities and Banking, Affordable Care
Act, Section 1557, Holder, et. al, Appeal No. 0120120821,1. Stroumsa D. The state of
transgender health care: policy, law, and medical frameworks. Am. J. Public Health.
2014;104(3):e31–8. Available at: http://ajph.aphapublications.org/doi/abs/10.2105/
AJPH.2013.301789 [Accessed April 3, 2014].
26. It’s hardest to just be…
http://www.contracostatimes.com/walnut-creek/ci_24475186/walnut-creek-woman-
found-i-680-identified
29. “Black patients are to be treated like everybody else. There is no segregation at our
facilities.”- Henry J. Kaiser (digital display, Kaiser Permanente Center for Total Health, 2011)
30. Help Kaiser Permanente
become a leader in providing
Trans*-inclusive care.
Kaiser Permanente is looking at
transgender, gender-expansive,
and gender non-conforming
person care in a new way, and
we want to partner with you
to create high quality care that
meets you where you’re at.
We are starting an exciting
project that will provide insight
directly to our nurses, doctors,
leaders, and staff to inspire us to
focus on your total health, so you
can focus on a great life. We are
not just looking to provide the
best clinical care possible,
we want to understand and
address your needs, goals, and
what makes you tick.
We are looking for people who
would be interested in any of
the following opportunities. We
are able to offer honorariums for
your participation, and we ensure
the privacy and confidentiality
of what is shared in a safe,
comfortable environment for
you. We treat everything you
share with us with confidentiality,
respect, and empathy.
We are interested in:
• Meeting trans-identified, gender-expansive,
and gender non-conforming people who are,
or have been, Kaiser Permenente members.
• Interviewing you in your home or another
comfortable place for 2-3 hours.
• Interviewing you along with a close
friend or family member so that you can
both provide your perspectives together.
• Learning what it’s like to be you by
shadowing you through part of your day.
• Seeing Kaiser Permenente from your
perspective by shadowing you on a visit.
Who are we? We are the Innovation Consultancy
at Kaiser Permanente. We work with people in
a human-centered, empathic way to understand
their experiences and design new and better
ways for Kaiser Permanente to meet their health
and wellness goals and needs.
Here are the tentative dates for our fieldwork.
If you can’t do these dates, we can be flexible:
February 24-27, March 10-13, March 17-20
Thank you for your interest. For more info, or to
express your interest, please contact
Katherine Duong: katherine.t.duong@kp.org or
Dana Ragouzeos: dana.n.ragouzeos@kp.org
#KPLantern: California / Oregon / Vancouver, BC 2015
Dana Ragazeous, Lead
Scott Heisler, RN, Core Team
Katherine Duong, Co-Lead
Bill Strull, MD, Core Team
Chris McCarthy, KP Innovation Consultancy
Arli Christian, JD, National Center for
Transgender Equality
31. Sylvia Rae Rivera (1951 – 2002) American bisexual transgender activist and trans woman
http://highkixx.com/2012/01/
33. Ruby Jade Corado, Humanist-Transgender woman, Mayor Vince Gray, Washington, DC
October 18, 2014 • http://www.flickr.com/photos/22526649@N03/14958436953
34. with Kapriece Williams, Corado-Walker Wedding, Washington, DC, October 18, 2014
Photo: Lane Hudson, http://www.flickr.com/photos/22526649@N03/15392654087
35. Biology, not intention (mostly)
“since wars begin in the minds of
men, it is in the minds of men
that the defences of peace must
be constructed”
– 1947 constitution of UNESCO – the
United Nations Educational, Scientific
and Cultural Organization
It’s just biology
We’re all biased
That’s boring
It’s what you do with it that matters
Denise Lascar, Trans* Ally, Ruff Plastic Surgery
Washington, DC • October 8, 2013
36. Implicit Association Test (IAT)
Developed 1998
Easily taken at http://projectimplicit.net
KP Learn: “Unconscious bias”
#00643343
Available for bias in age, weight,
gender, sexual orientation
– currently no test for gender identity/
expression
About 5 minutes long
“The IAT has demonstrated enough
reliability and validity that total denial is
implausible” (Kang & Lane, 2010)
Sangeeta Iyer, MD, Internal Medicine Specialist
Transgender services champion
Kaiser Permanente Capitol Hill Medical Center
Washington, DC
39. Tessa Scheller, CRNA
Certified Registered Nurse
Anesthetist
Kaiser Permanente Northwest
Retired 2008
Kaiser Permanente member
advisor, national transgender
champions group (as of 2014)
40. Yes to more.
Yes to more me. More massages. More laughter.
More friends. More intimacy. More sleep. More
water. More bike rides. More visits to a doctor
or therapist. Yes to vitamins. Yes to one more
salad this week. Yes to more dancing. Yes to
more life. Yes to outliving homophobia.Canadian Rainbow Health Coalition
Coalition Santé Arc-en-ciel Canada
crhc
csac
Yes to more.
Yes to more me. More massages. More laughter.
More friends. More intimacy. More sleep. More
water. More bike rides. More visits to a doctor
or therapist. Yes to vitamins. Yes to one more
salad this week. Yes to more dancing. Yes to
more life. Yes to outliving homophobia.
Check in at outlive.ca
Courtesy Transgender Health Information Program, Vancouver Coastal Health Authority • http://transhealth.vch.ca
41. TRS-80 vs iPhone
1000x Speed Difference
Zilog Z80
1.77 MHz
Apple A8
1.4 GHz
"Apple A8 system-on-a-chip" by Henriok
- Own work. Licensed under CC0 via
Wikimedia Commons - http://
commons.wikimedia.org/wiki/
File:Apple_A8_system-on-a-
chip.jpg#mediaviewer/
File:Apple_A8_system-on-a-chip.jpg
43. Conscious vs Unconscious
687,500x Speed Difference - Brain wins!
Source: Stanley D, Phelps E, Banaji M. The Neural Basis of Implicit Attitudes. Curr. Dir. Psychol. Sci. 2008;17(2):164–170.
[Accessed April 1, 2014].
44. Your brain on walking - same pathways (?)
activated
activated
activated
deactivated
it works better
Source: Hillman CH, Erickson KI, Kramer AF. Be smart, exercise your heart: exercise effects on brain and cognition. Nature Reviews. Neuroscience. 2008;9(1):58–65..
Slide created by Ted Eytan, MD | @tedeytan | December, 2012
45. Implicit attitudes influence behavior
Resident Physicians, 2007
– Reduced likelihood to prescribe
thrombolytics for African American patients
associated with implicit bias
– Higher likelihood of prescribing
thrombolytics for African Americans if they
were aware of what the study was
measuring
Survey based study
28% response rate
Source: Green AR, Carney DR, Pallin DJ, et al. Implicit bias among physicians and its prediction of thrombolysis decisions for black and
white patients. J. Gen. Intern. Med. 2007;22(9):1231–8. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?
artid=2219763&tool=pmcentrez&rendertype=abstract [Accessed January 28, 2014], Staats C. State of the Science: Implicit Bias Review
2014. Columbus, OH; 2014. Available at: http://kirwaninstitute.osu.edu/implicit-bias-review/.
Resident Physicians, 2007
46. Impact: hypertension control
Blair, et. al
– Kaiser Permanente &
Denver Health
– 210 Physicians
– 190 Community Members
– 4,794 patients
Clinician Implicit Bias
Quality of clinical
Encounters
Patient's Perceptions
of Physician
Medication
Adherence
Hypertension
Control
Clincian's
Perceptions and
Judgements of
Patient
Treatment
Intensification
Source: Blair I V, Steiner JF, Hanratty R, et al. An Investigation of Associations Between
Clinicians’ Ethnic or Racial Bias and Hypertension Treatment, Medication Adherence and
Blood Pressure Control. J. Gen. Intern. Med. 2014:18–20. Available at: http://
www.ncbi.nlm.nih.gov/pubmed/24549521, Blair I, Steiner J. Clinicians’ implicit ethnic/racial
bias and perceptions of care among black and Latino patients. Ann. Fam. …. 2013:43–52.
Available at: http://www.annfammed.org/content/11/1/43.short [Accessed April 21, 2014].
Blair I V, Havranek EP, Price DW, et al. Assessment of biases against Latinos and African
Americans among primary care providers and community members. Am. J. Public Health.
2013;103(1):92–8. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?
artid=3518332&tool=pmcentrez&rendertype=abstract [Accessed March 29, 2014].
47. Impact: hypertension control
Clinician Implicit Bias
Quality of clinical
Encounters
Patient's Perceptions
of Physician
Medication
Adherence
Hypertension
Control
Clincian's
Perceptions and
Judgements of
Patient
Treatment
Intensification
72 - 82% preference for Whites
Lower if Black, Latino
Black: proportional to implicit bias
No difference: White, Black, Latino
Lower if Black, Latino
NOT related to implicit bias
Lower if Black
NOT related to implicit bias
Source: Blair I V, Steiner JF, Hanratty R, et al. An Investigation of Associations Between Clinicians’ Ethnic or Racial Bias and Hypertension Treatment,
Medication Adherence and Blood Pressure Control. J. Gen. Intern. Med. 2014:18–20. Available at: http://www.ncbi.nlm.nih.gov/pubmed/24549521,
Blair I, Steiner J. Clinicians’ implicit ethnic/racial bias and perceptions of care among black and Latino patients. Ann. Fam. …. 2013:43–52. Available
at: http://www.annfammed.org/content/11/1/43.short [Accessed April 21, 2014]. Blair I V, Havranek EP, Price DW, et al. Assessment of biases against
Latinos and African Americans among primary care providers and community members. Am. J. Public Health. 2013;103(1):92–8. Available at: http://
www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3518332&tool=pmcentrez&rendertype=abstract [Accessed March 29, 2014].
18% - 28% of physicians WITHOUT implicit bias
48. In the health of people who are trans* …
Clinician Implicit Bias
Quality of clinical
Encounters
Patient's Perceptions
of Physician
Treatment
adherence
medically
necessary care
Clincian's
Perceptions and
Judgements of
Patient
Treatment
recommendation
Adapted from Blair I V, Steiner JF, Hanratty R, et al. An Investigation of Associations Between Clinicians’ Ethnic or Racial Bias and
Hypertension Treatment, Medication Adherence and Blood Pressure Control. J. Gen. Intern. Med. 2014:18–20. Available at: http://
www.ncbi.nlm.nih.gov/pubmed/24549521 [Accessed April 12, 2014].
49. In the health of people who are trans* …
Clinician Implicit Bias
Quality of clinical
Encounters
Patient's Perceptions
of Physician
Treatment
adherence
medically
necessary care
Clincian's
Perceptions and
Judgements of
Patient
Treatment
recommendation
"explicit clinician bias ⛔️ denial of coverage
% self administration
"explicit & implicit insurance bias
&no employment
⚠️clinical competence "implicit patient bias
(no preventive care
Source: https://twitter.com/TRANSLATINAS_NY/statuses/304597877425049600; http://www.dailykos.com/story/2014/04/18/1292952/-Illinois-Transwoman-Refused-Medical-
Care-Because-Religious-Freedom?showAll=yes, adapted from Adapted from Blair I V, Steiner JF, Hanratty R, et al. An Investigation of Associations Between Clinicians’ Ethnic or
Racial Bias and Hypertension Treatment, Medication Adherence and Blood Pressure Control. J. Gen. Intern. Med. 2014:18–20. Available at: http://www.ncbi.nlm.nih.gov/pubmed/
24549521 [Accessed April 12, 2014];http://www.metroweekly.com/2015/03/transgender-men-facing-discrimination-in-healthcare/
)little research
*few positive exemplars
50. In the health of their caregivers….
Medical students who are “out”
! 68% : sexual identity
! 34% : gender identity
only up from 44% two decades
ago (sexual identity)
Source: Mansh M, White W, Gee-Tong L, et al. Sexual and Gender Minority Identity Disclosure During Undergraduate Medical Education: “In the Closet” in Medical School. Acad.
Med. 2015;Publish Ah. Available at: http://journals.lww.com/academicmedicine/Fulltext/publishahead/Sexual_and_Gender_Minority_Identity_Disclosure.98848.aspx.
In interacting with residents and
attendings, it is clear through general
conversation and offhand comments that LGBT is
unfamiliar and, at best, a joke. (26-year-old,
third-year, gay, white, male, U.S. MD
student)
On my surgery rotation, we saw a male- to-
female transgender patient who had “do-it-
yourself ” silicone breast implants which had
become infected. He [sic] was treated like a
freak by the residents and attendings behind
closed doors, joking at his [sic] expense. (25-
year-old, third-year, lesbian, white, female,
U.S. MD student)
51. Homophobia
makes me sick.
Canadian Rainbow Health Coalition
Coalition Santé Arc-en-ciel Canada
crhc
csac
Check in at outlive.ca
Homophobia
makes me sick.
No really it does. All that negative messaging
soaks into our skin like toxic radiation. How do
you get rid of it? Easy. Visit outlive.ca for the
little things you can do to take care of yourself.
They’re easy and you’re worth it.
Courtesy Transgender Health Information Program, Vancouver Coastal Health Authority • http://transhealth.vch.ca
52. Alex Scott, National Center for Transgender Equality and Metropolitan Police Department
International Transgender Day of Remembrance • Washington, DC • 11/20/14
53. Where do implicit biases come from?
Accrued and change passively
Documented in children as young as 6 years old
Nature/Nurture : YES
– Our commitment is to be fair regardless
"Wrong information always shown by the media
Negative images is the main criteria
Infecting the young minds faster than bacteria
Kids wanna act like what they see in the cinema"
Black Eyed Peas, Where is the Love (2003)
56. Can we eliminate it? Is it malleable?
“There is a pretty obvious reason for
this: 90% of the mug shots in my local
paper are blacks.”
“What hope is there, however, to
exterminate my acknowledged
implicit bias which is clearly based
on seeing the world the way it
exists (alas)?”
Source: http://annfammed.org/content/11/1/43.full/reply#annalsfm_el_25471
Yes!
+
57. If you don’t like the world the way it is, change it
“Rider” - eliminated
“Exclusions” - eliminated
Medically necessary care,
including surgery, must be
covered, in all plans,
including individual and
group
All DC Government plans
now include medically
necessary care Chester McPherson, Insurance Commissioner
Washington, DC ends discrimination in health insurance
February 27, 2014
58. Caprice Williams, Mayor Vince Gray, Consuela Lopez, Andy Bowen, Washington, DC
March 6, 2014 • http://www.flickr.com/photos/22526649@N03/12998223535
59. Debiasing Techniques that you can should use
Contact
– “Involving equal status, cooperation
to achieve common goals, and
supported by important societal
institutions”– “
– Intergroup
– Extended
– Imagined
Access to positive exemplars
Mindfulness
“If this, then that”
“Life is for Living, Now I Can!” - Beth
Charing Cross GIC, London, GB
60. Ruby Jade Corado • Ted Eytan
Stonewall LGBTQ & Allies Athletic League, Washington, DC USA • February 12, 2015
61. Bianca Rey, Bestselling Author Janet Mock, Melanie Hiller • Washington, DC • Feb 25, 2014
http://www.flickr.com/photos/22526649@N03/12784562863
63. Debiasing Techniques that you should promote
Measure: Implicit Association Test
– Encourage, don’t mandate
Reframe
– From: Discrimination, Protected Class
– To: Fair treatment, Respect
Question
– The illusion of objectivity
64. Don’t forget to listen
Create: The “tell me more” culture
Practice “perspective taking”
Kaiser Permanente Los Angeles Medical Center, May 2, 2014
Photos: Ted Eytan, http://www.flickr.com/photos/22526649@N03/14088671614
65. Exercise
Spend the next 60 seconds imagining
yourself meeting a person who is
transgender for the first time. Imagine
that the interaction is relaxed, positive,
and comfortable
Now, list as many things as you can
about the interaction that you just
imagined
Source: Turner RN, Crisp RJ. Imagining intergroup contact reduces implicit
prejudice. Br. J. Soc. Psychol. 2010;49(Pt 1):129–42. Available at: http://
www.ncbi.nlm.nih.gov/pubmed/19302731 [Accessed March 25, 2014].
66. Catherine White Holman (1954-2009)
pioneer, social worker and
advocate, Vancouver, BC
Marria Townsend, MD, Gail Knudson, MD, Nick, MSIV
Three Bridges Community Health Centre, Vancouver, BC, March 19, 2015
67. Today : A world learning to love better
“Skyzone”
http://j.mp/edithbunkerally
March 15, 2014
Source: http://xfinity.comcast.net/blogs/tv/2014/03/14/exclusive-clip-undercover-boss-
features-transgender-employee/; http://transhealth.vch.ca
Transgender Health Information Program
Vancouver Coastal Health Authority
March 19, 2015
69. Advice from experts
“own the fact the fact that you’re not exceptional. you are in this sweet
spot of judges, lawyers, police, all of whom have bias. If you care, it would
make sense to find out.” - Jerry Kang, JD, Professor of Law, UCLA
April 15, 2014
“Don’t present this as scary. This behavior is malleable
and contextually sensitive.”
- Irene Blair, Phd, Associate Professor, Psychology and
Neuroscience, University of Colorado
April 11, 2014
“If there is one bisexual man in your unit his fitting in
depends on how open to diversity your unit is. It is NOT
based on how hard he tries to fit in.” - Sasha Scott & Damian
Jenkins, UK LGTB Army Forum
June, 2013
70. We’re all misfits with a dream (of better health)
Future gender neutral restroom
Garfield Innovation Center, San Leandro, CA, September 22, 2014
photo: Ted Eytan, http://www.flickr.com/photos/22526649@N03/15144080399,
March on Washington, 50th Anniversary
Washington, DC USA, August 28, 2013
71. Bianca Rey and Melanie HIller, Officers in KP Pride Mid-Atlantic States, Martin Luther King Jr. Memorial Library
Washington, DC, • Feb 25.2014 • http://www.flickr.com/photos/22526649@N03/12791074333
72. Bianca Rey, Bestselling Author Janet Mock, Melanie Hiller • Washington, DC • Feb 25, 2014
http://www.flickr.com/photos/22526649@N03/12784562863
73. Nico Quintana, Rally for Transgender Health Equality, Washington DC • March 30, 2013
https://flic.kr/p/e7nVNC
76. Drs. Jennifer Slovis, Susanne Watson, and Judy Lively • Community Partner awards
Transgender Law Center Annual Gala, San Francisco, CA • October 3, 2013
http://www.flickr.com/photos/22526649@N03/10327667743
77. Stonewall Bocce, Logan Circle, Washington, DC • October 31, 2013
http://www.flickr.com/photos/22526649@N03/12219983155
78. Rebecca Goldfader, ARNP • Community Partner awards
Transgender Law Center Annual Gala, San Francisco, CA • October 3, 2013
http://www.flickr.com/photos/22526649@N03/10327667743
79. Alex Scott, National Center for Transgender Equality and Metropolitan Police Department
International Transgender Day of Remembrance • Washington, DC • 11/20/14
80. Capital Pride, Washington DC • Kaiser Permanente Silver Sponsor • June 8, 2013
http://www.flickr.com/photos/22526649@N03/8997223970
81. Bianca Rey, Melanie Hiller, Ruby Jade Corado, Caprice Williams, Casa Ruby DC
February 25, 2014 • http://www.flickr.com/photos/22526649@N03/12784261603
82. Community leaders Ruby Corado and Melanie Hiller • Washington, DC • March 27, 2014
http://www.flickr.com/photos/22526649@N03/13464925243
83. LGBT Health Awareness Week • March 25, 2013
Kaiser Permanente Center for Total Health
With Paula Woodward (American College of Physicians), Susan Rowe, Margo Williams (ACP)
http://www.flickr.com/photos/22526649@N03/8589989716
84. Rally for Transgender Health Equality, Washington DC • March 30, 2013
http://www.flickr.com/photos/22526649@N03/8603716639
85. Tessa Scheller, CRNA
Certified Registered Nurse
Anesthetist
Kaiser Permanente Northwest
Retired 2008
Kaiser Permanente member
advisor, national transgender
champions group (as of 2014)
86. Ruby Jade Corado • Ted Eytan
Stonewall LGBTQ & Allies Athletic League, Washington, DC USA • February 12, 2015
88. Yes to more.
Yes to more me. More massages. More laughter.
More friends. More intimacy. More sleep. More
water. More bike rides. More visits to a doctor
or therapist. Yes to vitamins. Yes to one more
salad this week. Yes to more dancing. Yes to
more life. Yes to outliving homophobia.Canadian Rainbow Health Coalition
Coalition Santé Arc-en-ciel Canada
crhc
csac
Yes to more.
Yes to more me. More massages. More laughter.
More friends. More intimacy. More sleep. More
water. More bike rides. More visits to a doctor
or therapist. Yes to vitamins. Yes to one more
salad this week. Yes to more dancing. Yes to
more life. Yes to outliving homophobia.
Check in at outlive.ca
Courtesy Transgender Health Information Program, Vancouver Coastal Health Authority • http://transhealth.vch.ca
89. Ruby Jade Corado, D.C. Humanist-Transgender woman, Casa Ruby DC, Washington, DC
February 25, 2014 • http://www.flickr.com/photos/22526649@N03/12784261603
90. Deb Friesen, MD and Rachael St.Claire, PsyD
Receipt of Human Rights Campain, 100%
Corporate Equality Index Award, April 1,
2014, New York City, NY
National Diversity and Inclusion Conference,
Kaiser Permanente, November 22, 2013, San
Francisco, CA
91. Ruby Jade Corado, D.C. Humanist-Transgender woman, Casa Ruby DC, Washington, DC
February 25, 2014 • http://www.flickr.com/photos/22526649@N03/12784261603
92. Baltimore Pride, June 15, 2013, Baltimore, MD, USA
http://www.flickr.com/photos/22526649@N03/9060217825
93. Ruby Jade Corado, D.C. Humanist-Transgender woman, Casa Ruby DC, Washington, DC
February 25, 2014 • http://www.flickr.com/photos/22526649@N03/12784261603
94. Caprice Williams, Mayor Vince Gray, Consuela Lopez, Andy Bowen, Washington, DC
March 6, 2014 • http://www.flickr.com/photos/22526649@N03/12998223535
95. Ruby Jade Corado, Humanist-Transgender woman, Mayor Vince Gray, Washington, DC
October 18, 2014 • http://www.flickr.com/photos/22526649@N03/14958436953
96. Brenda McComb, PhD
Trustee, Oregon State University (with Provost Sabah Randhawa)
Dean of Graduate Programs, Oregon State University
Professor of Forestry
Trans* Ally
Source: http://oregonstate.edu/leadership/trustees; http://pinterest.com/oregontrans
97. Juliet Greenwood, PhD
Associate Dean for Academic and Student Affairs
Associate Professor, Biochemistry and Biophysics
Oregon State University
Source: Juliet Greenwood, PhD
98. Bianca Rey, Bestselling Author Janet Mock, Melanie Hiller • Washington, DC • Feb 25, 2014
http://www.flickr.com/photos/22526649@N03/12784562863
99. Lane Hudson, Community Leader, and Ruby Jade Corado, D.C. Humanist-Transgender
woman Washington, DC • March 27, 2014
http://www.flickr.com/photos/22526649@N03/13465159024
102. Catherine White Holman (1954-2009)
pioneer, social worker and
advocate, Vancouver, BC
Marria Townsend, MD, Gail Knudson, MD, Nick, MSIV
Three Bridges Community Health Centre, Vancouver, BC, March 19, 2015