Presentation to the first East of England Public Health conference, Radison Hotel, Stagnated. 30th October 2018 181029 east of england presentation vr 2
ISIS, crop failure and no antibiotics; training for the future of the public'...John Middleton
Looking at international conflict, planetary health threats and the One Health and ecological public health approaches and the training we will need to create the public health practitioners and researchers for the year 2040 160526 middletonj aspher final2
Presentation to the Norfolk Medical and Surgical Society, January 21st 2022 on the current state of the pandemic worldwide and in the UK and other global and planetary threats to health and how to 'plan for an outbreak of health'
20220125middleton medchi
Presentation for the Grand European Symposium: Training, Research and Innovation in the Europe of Health”, on September 30th 2021, The Sorbonne Grand Amphitheater
210923 middletonj sorbonne vr2
Die Zukunft ist rosig, die Zukunft ist die öffentliche GesundheitJohn Middleton
The future's bright, the future is public health. Presentation to the MPH students introductory course Bielefeld University School of public Health, October 11th 2021. 211011 2 middleton j bielefeld main
The best job in the world: A past, and a future in public health John Middleton
A description of my career in public health today including lessons from local, national and international public health and the current COVID-19 pandemic. Presentation for the Coventry University BSc in public health employability course, October 25th 2021.
211025 middleton coventry final
Public health systems and the health of the public (full)John Middleton
A combined slideshow comprising two presentations made by John Middleton, President of the Uk Faculty of Public Health, at the 2nd Arab Public Health Conference , Casablanca, April4-6th 2019. this includes the short plenary presentation on the future role of public health and slides of the role of the UK faculty of public Health from a lunchtime workshop, April 4th 2019.190405 ar pha middletonj vr 3 full final
ISIS, crop failure and no antibiotics; training for the future of the public'...John Middleton
Looking at international conflict, planetary health threats and the One Health and ecological public health approaches and the training we will need to create the public health practitioners and researchers for the year 2040 160526 middletonj aspher final2
Presentation to the Norfolk Medical and Surgical Society, January 21st 2022 on the current state of the pandemic worldwide and in the UK and other global and planetary threats to health and how to 'plan for an outbreak of health'
20220125middleton medchi
Presentation for the Grand European Symposium: Training, Research and Innovation in the Europe of Health”, on September 30th 2021, The Sorbonne Grand Amphitheater
210923 middletonj sorbonne vr2
Die Zukunft ist rosig, die Zukunft ist die öffentliche GesundheitJohn Middleton
The future's bright, the future is public health. Presentation to the MPH students introductory course Bielefeld University School of public Health, October 11th 2021. 211011 2 middleton j bielefeld main
The best job in the world: A past, and a future in public health John Middleton
A description of my career in public health today including lessons from local, national and international public health and the current COVID-19 pandemic. Presentation for the Coventry University BSc in public health employability course, October 25th 2021.
211025 middleton coventry final
Public health systems and the health of the public (full)John Middleton
A combined slideshow comprising two presentations made by John Middleton, President of the Uk Faculty of Public Health, at the 2nd Arab Public Health Conference , Casablanca, April4-6th 2019. this includes the short plenary presentation on the future role of public health and slides of the role of the UK faculty of public Health from a lunchtime workshop, April 4th 2019.190405 ar pha middletonj vr 3 full final
Planning for an outbreak of health? Lessons from the COVID-19 pandemicJohn Middleton
Planning for an outbreak of health? Lessons from the COVID-19 pandemic Presentation to a meeting of the Alliance International Science Organisations,Univversity fo Belgrade and Chinese Academy of Sciences, online, September 23rd 2021
210923 middletonj anso conference beograd
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
COVID-19: What went right, what went wrong and how do we learn from this? John Middleton
Look at UK English and European experience during the COVID-19 pandemic. Successes and failures. Presentation for a meeting of the Centre for Health and Development (CHAD) University of Staffordshire. Centre via recorded lecture, Thursday, 28 October 2021 12:00 211027 4 definitive middleton chad conference final
Video presentation also to be available online
Public health lowdown, with the Solent Delta blues John Middleton
A presentation to the Southampton University Medical School Division of Public Health on current issues in public health and the public health stem, including reference to my experience as a Southampton graduate and Solent delta blues musician 180611 middletonj southampton vr2
A review of global health issues, highlighted by the COVID-19 pandemic and suggestions for improvement of health in a post pandemic world. Presentation for the Mongolian National University of Medicine School of public Health, April 16th 2021
210415 long version middleton j mongolia ph conference
Planning for an outbreak of health? Lessons from the COVID-19 pandemicJohn Middleton
Presentation for Jagellonian University Krakov, Poland, Institute of Public Health 30th anniversary celebration congress, October 708th 2021. 211007 middletonj krakow vr 2
law is a body of norms
(or rules of conduct) of binding force and effect, specified
and enforced by a recognised authority. Law is used to
create rights and duties, which should be applied fairly
and consistently throughout society
Where there is no vision the people perishJohn Middleton
A presentation of the work of the Faculty of public Health and the place of rights, values, ethics and law in improving the health of the public. 181102 middletonj scottish conference final
The future belongs to young people ...
and it is us who will be affected most by the decisions we take today on Aids/HIV epidemic, climate change, food, energy, environmental degradation, economic stability and the continuing challenge of world poverty.
Such decisions will influence the shape and quality of our future lives and could even dictate how long we will live. So it is very important that us, as individuals and as a group, take a keen interest in these issues now – and make absolutely sure our views are heard.
_____________________________
I heard about this contest from an email from Slideshare.
The best job in the world: practising public health, past, present, future John Middleton
Presentation to University of Maastricht, International Masters in Public Health leadership and management course, December 14th 2018. 181214 middletonj maastricht
Public health policy development in developing countries Ruby Med Plus
Public Health policy development in developing countries is addressed by four policy questions:
1. Does the introduction of a health policy at national, international level imply corresponding improvement in the quality of health of a country/population?
2. For effective health systems with efficient outcome: should health related policies be locally/nationally or internationally motivated (initiated)?
3. Should developing countries rely on the West for changes in the health of their population?
4. What is the impact of health policies adopted at the international scene on the health of populations in developing countries?
The public's health and the public health systemJohn Middleton
Presentation on current issues for the UK Faculty of Public Health, for the North East Faculty Local Area Committee, May 31st 2018. 180531 middletonj durham final
Planning for an outbreak of health? Lessons from the COVID-19 pandemicJohn Middleton
Planning for an outbreak of health? Lessons from the COVID-19 pandemic Presentation to a meeting of the Alliance International Science Organisations,Univversity fo Belgrade and Chinese Academy of Sciences, online, September 23rd 2021
210923 middletonj anso conference beograd
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
COVID-19: What went right, what went wrong and how do we learn from this? John Middleton
Look at UK English and European experience during the COVID-19 pandemic. Successes and failures. Presentation for a meeting of the Centre for Health and Development (CHAD) University of Staffordshire. Centre via recorded lecture, Thursday, 28 October 2021 12:00 211027 4 definitive middleton chad conference final
Video presentation also to be available online
Public health lowdown, with the Solent Delta blues John Middleton
A presentation to the Southampton University Medical School Division of Public Health on current issues in public health and the public health stem, including reference to my experience as a Southampton graduate and Solent delta blues musician 180611 middletonj southampton vr2
A review of global health issues, highlighted by the COVID-19 pandemic and suggestions for improvement of health in a post pandemic world. Presentation for the Mongolian National University of Medicine School of public Health, April 16th 2021
210415 long version middleton j mongolia ph conference
Planning for an outbreak of health? Lessons from the COVID-19 pandemicJohn Middleton
Presentation for Jagellonian University Krakov, Poland, Institute of Public Health 30th anniversary celebration congress, October 708th 2021. 211007 middletonj krakow vr 2
law is a body of norms
(or rules of conduct) of binding force and effect, specified
and enforced by a recognised authority. Law is used to
create rights and duties, which should be applied fairly
and consistently throughout society
Where there is no vision the people perishJohn Middleton
A presentation of the work of the Faculty of public Health and the place of rights, values, ethics and law in improving the health of the public. 181102 middletonj scottish conference final
The future belongs to young people ...
and it is us who will be affected most by the decisions we take today on Aids/HIV epidemic, climate change, food, energy, environmental degradation, economic stability and the continuing challenge of world poverty.
Such decisions will influence the shape and quality of our future lives and could even dictate how long we will live. So it is very important that us, as individuals and as a group, take a keen interest in these issues now – and make absolutely sure our views are heard.
_____________________________
I heard about this contest from an email from Slideshare.
The best job in the world: practising public health, past, present, future John Middleton
Presentation to University of Maastricht, International Masters in Public Health leadership and management course, December 14th 2018. 181214 middletonj maastricht
Public health policy development in developing countries Ruby Med Plus
Public Health policy development in developing countries is addressed by four policy questions:
1. Does the introduction of a health policy at national, international level imply corresponding improvement in the quality of health of a country/population?
2. For effective health systems with efficient outcome: should health related policies be locally/nationally or internationally motivated (initiated)?
3. Should developing countries rely on the West for changes in the health of their population?
4. What is the impact of health policies adopted at the international scene on the health of populations in developing countries?
The public's health and the public health systemJohn Middleton
Presentation on current issues for the UK Faculty of Public Health, for the North East Faculty Local Area Committee, May 31st 2018. 180531 middletonj durham final
Keynote presentation for a multidisciplinary conference on public health concerns national and local , and with a focus on the NHS plan, the Secretary of States Vision for Prevention and the anticipated Green paper on prevention. 190430 middletonj living well, living longer
O futuro é brilhante - a saúde pública do futuroJohn Middleton
The future's bright, the future is public health
Keynote presentation to the 25th anniversary celebration of the Instituto De Saude Publica Da Universidade Do Porto (ISPUP) meeting, January 10th 2020.
200110 middletonj porto final
Presentation for the Associação de Estudantes da Escola Nacional de Saúde Pública da Universidade NOVA de Lisboa (AEENSP_NOVA) April 20th 2021 210420 long version middleton j aeensp
Global health is an important new term, and an important new concept. The Institute of Medicine refers to global health as "health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions."
OBJECTIVES OF GLOBAL HEALTH CARE
Why should medical students learn about global health
CONTINUE…
Public health, medicine, and nursing: parts of the same puzzle
CHALLENGES IN GLOBAL HEALTH CARE
THE KEY CONCEPTS IN RELATION TO GLOBAL HEALTH
. THE DETERMINANTS OF HEALTH
CONTINUE..
CONTINUE..
Continue…
2. The Measurement of Health Status
CONTINUE..
CULTURE AND HEALTH
CONTINUE..
4. The global burden of disease
5. Key Risk Factors for Various Health Conditions
CONTINUE..
Trends in Global Deaths 2002-30
HEALTH PATTERNS IN RESOURCE POOR COUNTRIES
HEALTH PATTERNS IN RESOURCE RICH COUNTRIES
Sharing the information.Network formation
REFERENCES
THANK YOU
Presentation by Jo Ward, North West Social Prescribing Network Co-Chair: Social Prescribing Network and creative health agenda at the Health, wellbeing and the environment event on Monday 28 January 2019 at The Isla Gladstone Conservatory, Liverpool
public health beyond borders: Driving change with evidence introductionJohn Middleton
Introductory remarks for the first plenary of the FPH Public health conference, Telford International Convention Centre, @0th june 2017.
170620 middleton j public health conference key note vr3
Politics and profession in promoting and protecting health : who is doing wh...John Middleton
A review of roles and actions of politicians, and professionals to promote and protect health and deliver a health and care system
171002 middleton j zagreb
Croatian Healthy Cities Conference October 2nd, 3rd 2017
Similar to Big sky thinking: leadership for public health from the East of England (20)
20240412 middletonj ASPHER war curriculum.pptxJohn Middleton
A short presentation for the ASPHER webinar, for Global Public Health Week 73. ASPHER’s Core Curriculum Programme (CCP): what are the needs for teaching the role of public health in preventing and responding to armed conflict?
Prevention, Recovery, Rehabilitation
A life in public health, influences and chunesJohn Middleton
A presentation for the Associaiton of Schools of public Health in the European Region, ASSETS summer school, Brussels, July 3-6th 2023. covering a career in public health, major influences on my practice, and musical references to public health 20230711 middletonj assets very final.pptx
A healthy state? Geopolitical threats to safety and health John Middleton
A presentation to the first European conference of Law Enforcement and Public Health, Umea Sweden, May 22nd-24th 2023; on geopolitical trends and concerns for policing and public health improvement
20230625 middletonj LEPH UMEA healthy State delivered presentation.pptx
A presentation for the ASPHER and University of Bielefeld in the series, 'Public Health in the Times of War '
20221125-4.5 final delivered militarism and health.pptx
20221125-4.5 final delivered militarism and health.pptx
The perspective on Public Health Curricula Accreditationand international r...John Middleton
A presentation on the work of ASPHER the Association of Schools of public Health in the European Region, and APHEA, the Agency for Public Health Education Accreditation, for the congress National Des Medicine Saude Public (Portugal, November 3rd 2022)
ASPHER's ambition in climate change and health educationJohn Middleton
A presentation for the launch of the ASPHER Climate change and health education EU Health Policy Platform network 202207 ASPHER middletonj climate change and health long version.pptx
Climate change as a high risk factor for health John Middleton
Presentation for the World Committee for lifelong learning (CMA) 4th conference debate at the Cite Des Metiers, Paris, June 22nd 2022
20220622 CMA middletonj climate change and health long version.pptx
A presentation on my life in public health and vaccinations- from measles in the West Midlands of England, 1983-2014 to COVID-19 in Europe, 2020-now, implications for the public health community and vaccines manufactures including the vaccine TRIPS waiver. Presentation to a Spanish public health and vaccines forum, October 18th 2021 211018 middleton spanish vaccines and industry presentation 1 version recorded
The urgent need to train students to be global advocates and activists : plan...John Middleton
Presentation for the Escuela de Salud Pública de México (ESPM), part of the Instituto Nacional de Salud Pública (INSP). 100 year celebration, April 22nd 2021. INSP210422 middletonj insp vr3
The best job in the world: practicing public health, past present and futureJohn Middleton
Practicing public health, past present and future. annual lecture to the Maastricht Global Public Health Leadership students course. with an extended additional section on the year 2020 in pandemic and lessons 201211 middletonj maaastricht
Planning for an outbreak of health: Lessons from the pandemic for the health ...John Middleton
What does the experience of COVID-19 pandemic tell us about the state of the health of the public, and the public health system? A presentation for the webinar UAE University, College of Medicine and Life Science, Institute of Public health
The best job in the world: practising public health, past, present and future. John Middleton
Lecture for the International Masters course in public Health leadership. Lecture similar to previously delivered in Maastricht 2018, 2019, but with new extension on experiences of the pandemic 2020.
201211 middletonj maaastricht
Equity, Politics and Hypocrisy. Lessons from other countries and the case for...John Middleton
Presentation on corporate failings of British government in managing the COVID-19 pandemic in the UK, March-September 2020.
200910 middletonj vr3 corporate manslaughter
''Evidence-based crime reduction and 'plausibility'John Middleton
An archive slide show presented to Safer Sandwell Partnership 13th November 2006. The slide presentation informed the partnership strategy for crime reduction, emphasising partnership interventions such as methadone maintenance therapy and diversion of offenders to treatment services, early years education and designing out crime, safer places. Additional efforts recognised to be needed were to tackle alcohol related crime
Equity, Politics and Hypocrisy. Lessons from other countries and the case for...John Middleton
A presentation of the national disaster of the COVID-19 pandemic in the UK (especially England) A combination of political dogma, incompetence, negligence and corruption, and a brief consideration of corporate manslaughter. 200910 middletonj vr3 corporate manslaughter
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Big sky thinking: leadership for public health from the East of England
1. www.fph.org.uk
Big sky thinking: leadership in public health
from the East of England
Professor John Middleton, President, UK
Faculty of Public Health
2. Who we are and what we do
• The United Kingdom Faculty of Public Health is a faculty of
the three Royal Colleges of Physicians of London, Edinburgh
and Glasgow (Physicians and Surgeons)
• FPH is a membership organisation for nearly 4,000 public
health professionals across the UK and around the world
• We also have a growing number of student, associate and
international members in more than 80 different countries
To improve and protect the public’s health:
through standards, advocacy, training and
knowledge
www.fph.org.uk
3. ‘Don’t just fight for
the profession of
public health fight
for the public’s
health’
Public health
professionals are not
here to make
decisions easier, it is
to make things better
4. 330/10/2018
1)The public’s health: global burden of disease, multi
morbidity, NHS plan, Brexit
2) Violence conflict and public health at home and abroad
3) Planetary health: environment, loss of biodiversity, food
and ecosystems balance, climate change.
4) The public health system : the Faculty role today
5) the Faculty strategy to 2025
6) new challenges for public health training
7) new challenge for the public health professional.
8) Big sky thinking - East of England at the forefront of
public health
9. Globally, mortality rates have decreased across all age groups
over the past five decades, with the largest improvements
occurring among children younger than 5 years. However, at the
national level, considerable heterogeneity remains in terms of
both level and rate of changes in age-specific mortality;
increases in mortality for certain age groups occurred in some
locations.
Countries have saved more lives over the past decade,
especially among children under age 5, but persistent health
problems, such as obesity, conflict, and mental illness, comprise
a “triad of troubles,” and prevent people from living long, healthy
lives.
Total deaths in children younger than 5 years decreased from
1970 to 2016, and slower decreases occurred at ages 5–24
years. By contrast, numbers of adult deaths increased in each 5-
year age bracket above the age of 25 years.
Global burden of disease study, 2017
16. The epidemiology of violence
Evidence-based violence prevention: a life course
approach
Asset based community development
Primary, secondary &tertiary prevention role of the
public health community as primary preventers of violent conflict,
through healthy public policies and tackling major social inequalities in
health; and as early reactors, mitigaters and responders to violence.
New public mental health approaches
A role for public health in conflict resolution with
aid agencies, political scientists, theologians and international lawyers
A role for public health educational bodies
A leadership and partnership role for public
health
www.fph.org.uk/uploads/Violence%20report.pdf
Areas of action for the public health
community in preventing violence
17. Crucial importance of early years, the first
1001 days and adverse childhood
experiences
An evidence based approach – Good systematic reviews re
early years interventions, parenting training, youth
mentoring; good modelling of alcohol pricing, control of
access and enforcement.
A life course approach- new concerns about adverse
childhood experiences (ACES) impacts on violent
behaviours, poor communication and poor mental health in
later life
A public mental health approach- linked to ACEs, the
neurobiological hardwiring of young brains in the first 1001
days; Reinforcing positive mental attributes: self-confidence,
self-esteem, self-expression and positive communication
A public health approach to violence prevention
Early Death
Social, Emotional and
Learning Problems
Adopt Health Harming
Behaviours and Crime
Disrupted Nervous, Hormonal
and Immune Development
ACEs Adverse
Childhood Experiences
Non Communicable Disease, Disability,
Social Problems, Low Productivity
LifeCourse
Death
Birth
Adverse Childhood Experiences (ACEs): impacts across
the life course. adapted from Felitti et al, 1998
29. Aleksandrowicz et al., PLoS ONE 2016
Systematic review on impacts of shifting from current
(Western) diets to more environmentally sustainable
dietary patterns:
Environmental
Impact
Relative differences compared to
current diets
Healthy dietary
guidelines
Vegetarian diets
Greenhouse gas
emissions
12% reduction 31% reduction
Land use 20% reduction 51% reduction
Water Use 6% reduction 37% reduction
34. My presidency
Build local authority relationships
Build relationships in health and public health
services in four nations of the UK
Do things jointly where possible - policy statements,
conferences
Implement new curriculum: personal effectiveness
and values and ethics; rebuild health protection and
health care public health
Develop member involvement
Ensure solid member services, build special interests
Develop faculty governance
Pursue 12 asks of the Manifesto
Planetary health
A Public health curriculum for young people
Brexit, drugs, air pollution, AMR, violence
prevention
36. FPH workforce strategy 2018
1. FPH will champion the unique value of Public Health
Specialists and work with employers, commissioners, decision-
makers and other stakeholders to ensure the specialist role is
understood, recognised, valued and deployed to best effect to
meet employer needs, the needs of an efficient health system
and the needs of the public
2 - FPH will ensure that a flexible Public Health Specialist
workforce is trained, developed and strengthened to meet
employer and the public’s health needs in the future
3 - FPH will work with partners to ensure clear and appropriate
data is available on the current workforce and to ensure that
effective longer term workforce planning is undertaken
4 - FPH will work in partnership with the public health
community to support the development of an effective public
health practitioner workforce and enable the wider workforce to
deliverimprovements to the public’s health
37. 3630/10/2018
5) the Faculty strategy to 2025
Outline to Board November 2018
Evolutionary
Enablers :
Partnerships
Membership
International
Finance
Activities :
Advocacy,
Standards,
Knowledge,
Workforce
38. This is a looming disaster and
priority is to limit damage
40. Brexit policy programme: Three areas
of focus short-listed
1. Protecting the European Centre for Disease
Prevention and Control (ECDC) (and other key
institutions)
2. The Great Repeal Bill – FPH calls on the
Government to introduce a ‘do no harm…and
do better’ clause
3. Free Trade and Investment Agreements, a
transitional agreement and World Trade
Organization rules
41.
42. ‘Do No Harm’ Lord Warner Public Health
amendment to the EU Withdrawal bill
64 Health organisations support, representing over 1 million health workers
43. ‘Do No Harm’ Lord Warner Public Health
amendment to the EU Withdrawal bill
At Report stage Lord Duncan made clear to the House that “the
effect of Article 168 in the domestic law of this country before exit
will continue after exit by virtue of Clause 4…Article 168…will be
available in the future to UK courts to draw upon, both its
elements and its interpretation, and those elements will be
available afterwards…we are now in a good position to offer
certainty.”
47. ‘Valuing public health’: Three areas of
focus short-listed
1. Making the case for prevention (return on
investment; affordability; value for money; a call
for the ‘radical upgrade to be made real)
2. Investing more in prevention through the NHS (
including secondary prevention; rebuilding health
care public health)
3. Investing for outcomes (Developing the public
health outcomes dashboard, assuring the future
of public health investment)
48. NHS 10 Year Plan
National expectations : Prevention: Alcohol, smoking, diet.
But FPH Health Foundation workshop: Health of staff; strategic and
local leadership, capacity building in health-care related public
health
Then priority services and client groups Early years, tobacco,
alcohol
https://www.fph.org.uk/media/1918/nhs-plan-fph-response.pdf30/10/2018 47
50. • Middleton J, ISIS, crop failure and no anti-biotics: what training will we
need for future public health? European J Public Health 2016;
https://eurpub.oxfordjournals.org/content/26/5/735
• Middleton J, Saunders P. 20 years of local ecological public health: the
experience of Sandwell in the English West Midlands
http://www.sciencedirect.com/science/article/pii/S0033350615003303
• Public health and trade
• Public health law, rights, ethics, values
• Genomics
• New technology
6) new challenges for public health training
7) new challenges for the public health professional.
62. www.fph.org.uk
Suffolk – ‘Anchors, Anvils and Hammers of Inclusive Growth’
Abdul Razaq - Director of Public Health & Protection,
Suffolk County Council
Inclusi
ve
Growth
Health
and
Care
64. Public health and the EU post
Brexit
A country fit to live in…
where
Britain can power itself ? and
House itself ? and
Employ itself ?
http://www.campaigncc.org/sites/data/files/D
ocs/one_million_climate_jobs_2014.pdf
MiddletonJ The public's health and the public health system 180530
65. http://www.bmj.com/conten
t/357/bmj.j2676
Inequalities in health cost
£65bn (€74bn; $83bn) in lost
productivity and taxes and
increased benefits payments
plus
£5.5bn for direct NHS
treatment in 2010.5
MiddletonJ 'Public health low down with the Solent Delta
Blues’
74. • Middleton J, ISIS, crop failure and no anti-biotics: what training will we need for
future public health? European J Public Health 2016;
https://eurpub.oxfordjournals.org/content/26/5/735
• Middleton J, Weiss M. Still holding on: public health in the UK after Brexit.
Euroheathnet journal 2016; 22:no 4: 33-35. (ISSN 1356–1030)
http://www.euro.who.int/__data/assets/pdf_file/0010/325945/Eurohealth-V22-N4-
2016.pdf?ua=1
• Middleton J. Public health in England in 2016—the health of the public and the
public health system: a review Br Med Bull (2017) 1-16. DOI:
https://doi.org/10.1093/bmb/ldw054 and
http://academic.oup.com//bmb/article/doi/10.1093/bmb/ldw054/2871226/Public-health-
in-England-in-2016the-health-of-the?guestAccessKey=8f7a33a1-bdbf-4db4-948c-
fd6b6293a259
• Middleton J, Saunders P. 20 years of local ecological public health: the
experience of Sandwell in the English West Midlands
http://www.sciencedirect.com/science/article/pii/S0033350615003303
75. • Saunders P, Middleton J. Sustainability and transformation
plans for the NHS in England: radical or wishful thinking?
BMJ 2017;356:j1043 Available at:
http://www.bmj.com/content/356/bmj.j1043/rr-1 (accessed
May 25th 2017) and paper published short version:
Saunders P, Middleton J, Lloyd S. Survey of directors of
public health suggests that STPs may be falling short of
ambition. BMJ 2017; 357 doi:
https://doi.org/10.1136/bmj.j2552 (Published 25 May 2017)
Cite this as: BMJ 2017;357:j2552 Available at:
http://www.bmj.com/content/357/bmj.j2552?rss=1&utm_sou
rce=feedburner&utm_medium=feed&utm_campaign=Feed
%3A%20bmj/recent%20%28Latest%20from%20BMJ%29&v
ariant=short&sso= (accessed May 25th 2017)
• Middleton J. Public health and the general election 2017.
https://www.lgcplus.com/services/health-and-care/public-
health-and-the-general-election-2017/7017915.article
• Middleton J. Time to put health at the heart of all policies.
BMJ 2017; 357:
http://www.bmj.com/content/357/bmj.j2676?sso.
76. • Quantz D, Jenkin D, Stevenson E, Pencheon D,
Middleton J. Sustainable development in public
health consultant education. The Lancet Planetary
Health, DOI: http://dx.doi.org/10.1016/S2542-
5196(17)30114-6 Available at :
http://www.thelancet.com/journals/lanplh/article/PIIS
2542-5196(17)30114-6/fulltext (accessed October 6th
2017).
• Bellis M, Hardcastle K, Purkis-Garner A, MiddletonJ.
Interpersonal, collective, and extremist violence are
public health problems BMJ opinion, October 30th 2017.
Available at:
http://blogs.bmj.com/bmj/2017/10/30/interpersonal-
collective-and-extremist-violence-are-public-health-
problems/ accessed November 1st