This presentation offers insight into the policy challenges that inhibit health equity.
Bob Gardner, Director of Policy
Steve Barnes, Policy Analyst
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Advancing Health, Health Equity and Opportunities for Children and Youth in T...Wellesley Institute
This presentation examines the ways in which to advance health and health equity for children and youth during difficult times.
Bob Gardner, Director of Policy
Steve Barnes, Policy Analyst
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Building Equity and Social Determinants of Health into 'Healthy Communities' ...Wellesley Institute
This presentation provides critical insights on how build equity and healthy communities.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Drawing Out Links: Health Equity, Social Determinants of Health and Social Po...Wellesley Institute
This presentation provides insight on health equity, social determinants of health and social policy.
Bob Gardner, Director of Policy
Steve Barnes, Policy Analyst
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Building on the Evidence: Advancing Health Equity for Priority PopulationsWellesley Institute
This presentations offers critical insights on how to advance health equity for priority populations.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Making Evaluations Matter for 'Wicked' Policy Problems; Supporting Strategy, ...Wellesley Institute
This presentation provides critical insights on supporting strategy, policy and interventions that drive health equity.
Bob Gardener, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation provides insight on how to translate health equity into action.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity into Action: The Potential of Health Equity Impact Asse...Wellesley Institute
This presentation provides a critical analysis of the potential of a health equity impact assessment.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Advancing Health, Health Equity and Opportunities for Children and Youth in T...Wellesley Institute
This presentation examines the ways in which to advance health and health equity for children and youth during difficult times.
Bob Gardner, Director of Policy
Steve Barnes, Policy Analyst
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Building Equity and Social Determinants of Health into 'Healthy Communities' ...Wellesley Institute
This presentation provides critical insights on how build equity and healthy communities.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Drawing Out Links: Health Equity, Social Determinants of Health and Social Po...Wellesley Institute
This presentation provides insight on health equity, social determinants of health and social policy.
Bob Gardner, Director of Policy
Steve Barnes, Policy Analyst
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Building on the Evidence: Advancing Health Equity for Priority PopulationsWellesley Institute
This presentations offers critical insights on how to advance health equity for priority populations.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Making Evaluations Matter for 'Wicked' Policy Problems; Supporting Strategy, ...Wellesley Institute
This presentation provides critical insights on supporting strategy, policy and interventions that drive health equity.
Bob Gardener, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation provides insight on how to translate health equity into action.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity into Action: The Potential of Health Equity Impact Asse...Wellesley Institute
This presentation provides a critical analysis of the potential of a health equity impact assessment.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity into Action: Policy Change and Community Mobilization t...Wellesley Institute
This presentation offers critical insights on policy change and community mobilization.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Acting on Social Determinants and Health Equity: An Equity Toolkit for Public...Wellesley Institute
This presentation examines the relationship between the social determinants of health and health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity in Canada: From Strategy to Action and ImpactWellesley Institute
This presentation provides insight on health equity and public action in Canada.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation talks about the importance of health equity during difficult times.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation offers insight on how to build health equity.
Dr. Cory Neudorf
CMHO, Saskatoon Health Region
Assistant Professor at the University of Saskatoon
Driving Health Equity into Action: Strategy, Ideas, and Tools for Midwifery M...Wellesley Institute
This presentation provides a strategy, ideas and tools for the midwifery movement.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health Equity Strategy, Interpretation and Other Levers for Driving ChangeWellesley Institute
This presentation outlines effective ways to create change within your community.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity into Action: Hospital Planning and DeliveryWellesley Institute
This presentation provides insight on hospital planning and delivery.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation provides insight on how to drive health equity into action at a community level.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity into Action: Planning Strategy to Address Complex Socia...Wellesley Institute
This presentation provides insight on the importance of a planning strategy to address complex social determinants of health.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Review on the effect of regular physical exercise on the diabetic peripheral ...Dr. Anees Alyafei
A narrative review on how regular physical exercise could affect diabetic peripheral neuropathy.
Regular physical exercise has an effective influence on the control and improvement of peripheral neuropathy.
The Health System as a Determinant of HealthRenzo Guinto
Lecture given during the pre-APRM workshop on Social Determinants of Health and Global Health Equity, September 12, 2012, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur
A Health Equity Toolkit: Towards Health Care Solutions For AllWellesley Institute
This presentation offers health solutions that will help create a more equitable system.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Barriers and facilitators for regular physical exercise among adult females n...Dr. Anees Alyafei
What stimulates and prevents females from regular physical exercise. Updated Comprehensive narrative review.
https://www.researchgate.net/publication/341220204_Citation_AlYafei_A_Albaker_W_2020_Barriers_and_Facilitators_for_Regular_Physical_Exercise_among_Adult_Females_Narrative_Review_2020
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
Beginning in 2014 and continuing through 2017, Native American Health Center’s SBHCs incorporated social determinants of health questions into screening tools used with students. This presentation will provide an update on implementing these screening questions, specifically the challenges and strategies to responding effectively when students identify a need. The importance of leveraging internal resources, partnering with community agencies and building connections with school staff will be addressed in relation to specific identified needs. Models of clinic staff role expansion and internal capacity building, along with other challenges and adaptations will be shared as tools for helping participants plan for and engage in incorporating screening and evaluations of these important health indicators into their practices.
Driving Health Equity into Action: Policy Change and Community Mobilization t...Wellesley Institute
This presentation offers critical insights on policy change and community mobilization.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Acting on Social Determinants and Health Equity: An Equity Toolkit for Public...Wellesley Institute
This presentation examines the relationship between the social determinants of health and health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity in Canada: From Strategy to Action and ImpactWellesley Institute
This presentation provides insight on health equity and public action in Canada.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation talks about the importance of health equity during difficult times.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation offers insight on how to build health equity.
Dr. Cory Neudorf
CMHO, Saskatoon Health Region
Assistant Professor at the University of Saskatoon
Driving Health Equity into Action: Strategy, Ideas, and Tools for Midwifery M...Wellesley Institute
This presentation provides a strategy, ideas and tools for the midwifery movement.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health Equity Strategy, Interpretation and Other Levers for Driving ChangeWellesley Institute
This presentation outlines effective ways to create change within your community.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity into Action: Hospital Planning and DeliveryWellesley Institute
This presentation provides insight on hospital planning and delivery.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation provides insight on how to drive health equity into action at a community level.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity into Action: Planning Strategy to Address Complex Socia...Wellesley Institute
This presentation provides insight on the importance of a planning strategy to address complex social determinants of health.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Review on the effect of regular physical exercise on the diabetic peripheral ...Dr. Anees Alyafei
A narrative review on how regular physical exercise could affect diabetic peripheral neuropathy.
Regular physical exercise has an effective influence on the control and improvement of peripheral neuropathy.
The Health System as a Determinant of HealthRenzo Guinto
Lecture given during the pre-APRM workshop on Social Determinants of Health and Global Health Equity, September 12, 2012, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur
A Health Equity Toolkit: Towards Health Care Solutions For AllWellesley Institute
This presentation offers health solutions that will help create a more equitable system.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Barriers and facilitators for regular physical exercise among adult females n...Dr. Anees Alyafei
What stimulates and prevents females from regular physical exercise. Updated Comprehensive narrative review.
https://www.researchgate.net/publication/341220204_Citation_AlYafei_A_Albaker_W_2020_Barriers_and_Facilitators_for_Regular_Physical_Exercise_among_Adult_Females_Narrative_Review_2020
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
Beginning in 2014 and continuing through 2017, Native American Health Center’s SBHCs incorporated social determinants of health questions into screening tools used with students. This presentation will provide an update on implementing these screening questions, specifically the challenges and strategies to responding effectively when students identify a need. The importance of leveraging internal resources, partnering with community agencies and building connections with school staff will be addressed in relation to specific identified needs. Models of clinic staff role expansion and internal capacity building, along with other challenges and adaptations will be shared as tools for helping participants plan for and engage in incorporating screening and evaluations of these important health indicators into their practices.
This presentation offers critical insight on the potential of LHINs.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Community Engagement: Effective and Equitable Health PlanningWellesley Institute
This presentation provides critical insight on equitable health planning.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Thriving in Turbulent Times: Maximizing Your Success in the New Social Enviro...Wellesley Institute
This presentation looks at social innovation and social entrepreneurship models as opportunities for organizations to survive and thrive.
Rick Blickstead, CEO of the Wellesley Institute
Michael Shapcott, Director of Housing and Innovation
Aerin Guy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
De energieke Sluis. Lunchlezing op 11 juni 2015.
Een pleidooi voor:
1) energiebesparende techniek (m.n elektromechanisch bewegingswerk: tot 80% besparing!)
2) systematisch inventariseren van mogelijkheden voor opwekking op en rond sluizen
3) streven naar nul-energie sluizen vanaf 2020
4) streven naar netto energie leverende sluizen na 2025
5) net balancering: eerst door demand management, later ook opslag in 't watersysteem;
6) beter benutten mogelijkheden van een sluis als logistieke knoop
Housing and Homelessness: A Look at 21 Ontario Cities and CommunitiesWellesley Institute
This presentation explores issues concerning housing and homelessness in 21 Ontario cities and communities.
Michael Shapcott, Senior Fellow
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation offers critical insights on thinking and acting on health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation offers ways to leverage a health equity strategy in order to inspire public action.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Driving Health Equity for Kids: From the Earliest Years to Transforming the S...Wellesley Institute
This presentation provides the history of health equity for children and how we need to transform the system.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Advancing Health Equity: Building on Community-Based InnovationWellesley Institute
This presentation offers insights on how to advance health equity by building on community-based innovation.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Acting on Social Determinants and Health Equity: Opportunities and Promising ...Wellesley Institute
This presentation looks at the opportunities and practices that establish an effective public health system.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation provides critical insight on ways in which to enhance health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health Equity Impact Assessment Workshop: Healthy Connection Wellesley Institute
This presentation provides insights on health equity.
Anthony Mohamed, Aboriginal Health CAP
St. Michael's Hospital
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health Equity into Policy Action: A Policy Conversation at MOHLTCWellesley Institute
This presentation provides critical insights on how to transform health equity into policy action.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health Equity Impact Assessment: A Tool for Driving Equity into Action Wellesley Institute
This presentation provides insight on how to drive equity into action.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health Equity into Action: Building on Partnerships and CollaborationsWellesley Institute
This presentation offers insight on how to put health equity into action by building on partnerships and collaborations.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
'Wicked' Policy Challenges: Tools, Strategies and Directions for Driving Ment...Wellesley Institute
This presentation provides critical insights on how to drive mental health and health equity strategy into action.
Bob Gardner, Director of Policy
Nimira Lalani
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation examines the ways in which health promotion can impact policy.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation examines the ways in which local action can achieve health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Social Determinants of Health Inequalities: Roadmap for Health EquityWellesley Institute
This presentation discusses the social determinants of health inequities and provides a roadmap for health equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation offer critical insight on health promotion and how it can effectively impact policy.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health economics is the study of how scarce resources are allocated among :-
Alternative uses for the care of sickness and the promotion
Maintenance and improvement of health
It include the study of how health care and health related services , their costs & benefits and health itself are distributed among
Individuals
Groups in society
It is defined as the application of the theories, concepts and techniques of economics to the health sector.
The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health.
What makes some people healthy and others unhealthy?
How can we create a society in which everyone has a chance to live a long, healthy life?.
Emphasizing an ecological approach to disease prevention and health promotion.
An ecological approach focuses on both individual-level and population-level determinants of health and interventions.
The key determinants of health in the Region, including the social determinants, food and nutrition, the physical environment and risk factors related to lifestyle.
Very basic determinants of health are
Social determinants
Physical environment
Education factors
Employment
Unemployment
Child health development
Biological and genetic endownment
Similar to 'Wicked' Policy Challenges: Planning, Tools, and Directions for Driving Health Equity into Action (19)
This presentation suggests that housing and homelessness are not just concerns for the city centre. It looks at how housing insecurity is deep and persisting; how poor housing effects people, communities, the economy and government; the diminishing federal investments in housing; and our lack of a comprehensive national plan.
Michael Shapcott, Director of Housing and Innovation
http://www.wellesleyinstitute.com/
Follow us on twitter @wellesleyWI
This presentation examines social housing and housing needs in Toronto and Canada.
Michael Shapcott, Director of Housing and Innovation
www.wellesleyinstitute.com
Follow us on twiter @wellesleyWI
Ending Homelessness in Kingston and Across Canada: What's the Plan?Wellesley Institute
This presentation examines the steps necessary to end homelessness in Kingston and Canada.
Michael Shapcott, Director of Housing and Innovation
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation focuses on the links between good housing and good health, and the critical role that federal investments play in assuring that all Canadians have access to good quality, healthy and affordable housing.
Michael Shapcott, Director of Housing and Innovation
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Getting to Yes: Overcoming Barriers to Affordable Family-friendly Housing in ...Wellesley Institute
This presentation examines the barriers that inhibit many people from accessing affordable and family-friendly housing in inner Melbourne, Australia.
Carolyn Whitzman, Professor of Urban Planning
The University of Melbourne
This presentation examines the link between quality cancer care and equity.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
State of homelessness infographic.
Stephen Gaetz, Jesse Donaldson, Tim Richter, & Tanya Gulliver (2013): The State of Homelessness in Canada 2013. Toronto: Canadian Homelessness Research Network Press.
This presentation looks at which indicators point to deep and persistent housing insecurity and homelessness and the opportunities for social change.
Michael Shapcott, Director of Housing and Innovation
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Housing Insecurity and Homelessness: What Should Be Done?Wellesley Institute
This presentation provides an overview of the erosion of federal housing funding over the past two decades and surveys the current policy landscape.
Michael Shapcott, Director of Housing and Innovation
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation introduces complexity and systems thinking, and how they relate to the social determinants of health.
Aziza Mahamoud, Research Associate, Systems Science and Population Health
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Health Equity for Immigrants and Refugees: Driving Policy ActionWellesley Institute
This presentation discusses health equity for immigrants and refugees.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation provides facts about legalized gaming in Canada and situates these facts within the larger discussion on the negative impacts of Casinos on our health.
Jim Cosgrave, Professor of Sociology
Trent University
This presentation looks at the negative health impacts of a Casino in Toronto.
Dr. David McKeown, Toronto's Medical Officer of Health
Toronto Public Health
Building Inclusive Cities: Planning Tools that promote the Right to the CityWellesley Institute
This presentation looks at the ways in which cities can be inclusive and examines interesting projects happening around the globe.
Carolyn Whitzman, Professor of Urban Planning
University of Melbourne
Person-Centred Care, Equity and Other Building Blocks For Excellent Care For AllWellesley Institute
This presentation examines the building blocks for excellent care.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Realizing the Potential of Health Equity Impact AssessmentWellesley Institute
This presentations offers critical insight into the potential of an health equity impact assessment.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
This presentation commemorates the 100 year anniversary of the opening of the Wellelsey hospital in 1912.
Sue Williams, Co-Chair Wellesley Institute
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Concept Mapping of Photo Voices: Neighbourhood and HealthWellesley Institute
This presentation illustrates how one's neighbourhood influences their personal and family's health and wellbeing.
Nasim Haque, MD, DrPH
Director of Community Health
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
'Wicked' Policy Challenges: Planning, Tools, and Directions for Driving Health Equity into Action
1. ‘Wicked’ Policy Challenges: Planning, Tools,
and Directions for Driving Health Equity
Strategy Into Action
Bob Gardner and Steve Barnes
CIHR Strategic Training Program in Public Health Policy
Theory to Action Forum
February 1, 2012
2. Key Messages
• health disparities are pervasive and damaging
• will set out how these disparities can be addressed through
comprehensive health equity strategy
• acting on health equity within the health system
• building equity into all planning and delivery
• targeting some programs and resources for equity impact
• aligning equity with key system drivers
• embedding equity in performance management and service delivery
• and well beyond healthcare -- tackling the underlying roots of
health inequality in the wider social determinants of health
• through community-based innovation, cross-sectoral collaborations and
fundamental social and policy change to reduce inequality
• community and political mobilization to demand and drive the necessary
policy changes
2
3. The Problem to Solve = Health
Disparities in Ontario
•there is a clear gradient in health
in which people with lower
income, education or other
indicators of social inequality and
exclusion tend to have poorer
health
•+ major differences between
women and men
•the gap between the health of
the best off and most
disadvantaged can be huge – and
damaging
•impact and severity of these
inequities can be concentrated in
particular populations
3
5. Impact of Health Inequities II
• not just a gradient of health and impact on quality
of life
• inequality in how long people live
• difference btwn life expectancy of top and bottom
income decile = 7.4 years for men and 4.5 for women
• more sophisticated analyses add the pronounced
gradient in morbidity to mortality → taking account of
quality of life and developing data on health adjusted
life expectancy
• even higher disparities btwn top and bottom = 11.4
years for men and 9.7 for women
Statistics Canada Health Reports Dec 09
5
6. Foundations of Health Disparities Roots Lie in
Social Determinants of Health
•clear research consensus that roots
of health disparities lie in broader
social and economic inequality and
exclusion
•impact of inadequate early
childhood development, poverty,
precarious employment, social
exclusion, inadequate housing and
decaying social safety nets on health
outcomes is well established here
and internationally
•we need comprehensive strategy to
drive policy action and social change
across these determinants
February 9, 2012 |
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8. SDoH As a Complex Problem
Determinants interact and
intersect with each other in a
constantly changing and
dynamic system
In fact, through multiple
interacting and inter-
dependent economic, social
and health systems
Determinants have a
reinforcing and cumulative
effect on individual and
population health
8
9. Three Cumulative and Inter-Connecting Levels
in Which SDoH Shape Health Inequities
1. because of inequitable access to 1. gradient of health in which more
wealth, income, education and disadvantaged communities have
other fundamental determinants poorer overall health and are at
of health → greater risk of many conditions
2. also because of broader social and 2. some communities and
economic inequality and populations have fewer capacities,
exclusion→ resources and resilience to cope
with the impact of poor health
3. because of all this, disadvantaged 3. these disadvantaged and
and vulnerable populations have vulnerable communities tend to
more complex needs, but face have inequitable access to services
systemic barriers within the health and support they need
and other systems →
9
10. Health Inequities = ‘Wicked’ Problem
• health inequities and their underlying social determinants of health are classic
‘wicked’ policy problems:
• shaped by many inter-related and inter-dependent factors
• in constantly changing social, economic, community and policy environments
• action has to be taken at multiple levels -- by many levels of government,
service providers, other stakeholders and communities
• solutions are not always clear and policy agreement can be difficult to achieve
• effects take years to show up – far beyond any electoral cycle
• have to be able to understand and navigate this complexity to develop solutions
• we need to be able to:
• identify the connections and causal pathways between multiple factors
• articulate the mechanisms or leverage points that will drive change in these
pathways and in population health as a whole
• analyze the policy changes needed to act on these levers
• specify the short, intermediate and long-term outcomes expected and the
preconditions for achieving them.
February 9, 2012 10
11. Think Big, But Get Going
• challenge = health inequities can seem so
overwhelming and their underlying social determinants
so intractable → can be paralyzing
• think big and think strategically, but get going
• make best judgment from evidence and experience
• identify actionable and manageable initiatives that can
make a difference
• experiment and innovate
• learn lessons and adjust – why evaluation is so crucial
• gradually build up coherent sets of policy and program
actions – and keep evaluating
• need to start somewhere:
• focus today is on public health policy
• good planning is one essential pre-condition for driving
action on health equity
11
12. Health Equity = Reducing Unfair
Differences
• Health disparities or inequities are differences in health outcomes that
are avoidable, unfair and systematically related to social inequality and
disadvantage
• This concept:
• is clear, understandable and actionable
• identifies the problem that policies will try to solve
• is also tied to widely accepted notions of fairness and social justice
• The goal of health equity strategy is to reduce or eliminate socially and
institutionally structured health inequalities and differential outcomes
• A positive and forward-looking definition = equal opportunities for good
health
• Equity is a broad goal, including diversity in background, culture, race
and identity
13. Planning For
Complexity of SDoH
Need to look at how
these other systems
shape the impact of
SDoH:
•access to health
services can mediate
harshest impact of
SDoH to some degree
•community resources
and resilience are impt
POWER Study: Gender and
Equity Health Indicator Framework
February 9, 2012 |
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14. Equity Into Health System: Why
even though roots of health disparities lie in far wider
social and economic inequality
1. it’s in the health system that the most disadvantaged
in SDoH terms end up sicker and needing care
• equitable healthcare and support can help to mediate the harshest
impact of the wider social determinants of health on health
disadvantaged populations and communities
2. in addition, there are systemic disparities in access
and quality of healthcare that need to be addressed
• people lower down the social hierarchy can have poorer access to
health services, even though they may have more complex needs
and require more care
• unless we address inequitable access and quality, healthcare and
community support services could make overall disparities even
worse
14
15. Equity Into Health System: How
• goal is to ensure equitable health regardless of social
position
• can do this through a multi-pronged strategy:
1. building health equity into all health care planning and delivery
• doesn’t mean all programs are all about equity
• but all take equity into account in planning their services and outreach
2. aligning equity with system drivers and priorities
3. embedding equity in provider organizations’ deliverables, incentives
and performance management
4. targeting some resources or programs specifically to addressing
disadvantaged populations or key access barriers
• looking for investments and interventions that will have the highest impact
on reducing health disparities or enhancing the opportunities for good
health of the most vulnerable
5. while thinking up-stream to health promotion and addressing the
underlying determinants of health
February 9, 2012 15
16. Into Practice Through Equity-Focused Planning
• addressing health disparities in service delivery and planning
requires a solid understanding of:
• key barriers to equitable access to high quality care
• the specific needs of health-disadvantaged populations
• gaps in available services for these populations
• need to understand roots of disparities:
• i.e. is the main problem language barriers, lack of coordination among
providers, sheer lack of services in particular neighbourhoods, etc.
• which requires good local research and detailed information – speaks
to great potential of community-based research
• involvement of local communities and stakeholders in planning and
priority setting is critical to understanding the real local problems
• requires an array of effective and practical equity-focused
planning tools
16
17. Equity-Focused Planning Tools
1. quick check to ensure equity is 1. simple equity lens
considered in all service
delivery/planning
2. take account of disadvantaged
populations, access barriers and 2. Health Equity Impact
related equity issues in program Assessment
planning and service delivery
3. assess current state of provider 3. equity audits and/or HEIA
organization
4. determine needs of communities 4. equity-focused needs
facing health disparities assessment
5. assess impact of
programs/interventions on 5. equity-focused evaluation
health disparities and
disadvantaged populations
17
18. Health Equity Impact Assessment
• analyzes potential impact of program or policy change on health
disparities and/or health disadvantaged populations
• generally designed for planning forward
• as easy-to-use tool to ensure equity factors are taken into account in
planning new services, policy development or other initiatives
• but experience here and in other jurisdictions identified other uses:
• for strategic and operational planning
• for assessing whether programs should be re-aligned or continued
• more generally, discussions around HEIA provide a way to ensure
equity is incorporated into routine planning throughout an
organization
• increasing attention to this potential – from WHO, through
most European strategies, PHAC, to Ontario
18
19. HEIA In Ontario
• first piloted and refined in Toronto in 2009 by MOHTLC, Toronto Central LHIN and
WI, and in several LHINs afterwards
• final version of template and workbook released by Ministry in 2011 see their
page at http://www.health.gov.on.ca/en/pro/programs/heia/background.aspx
• growing use within health:
• HEIA is being used in Toronto Central and other LHINs
• by many hospitals and other providers across Toronto
• Toronto Central has required HEIA within recent funding application processes
for Aging at Home, and refreshing hospital equity plans
• primers on HEIA and a variant Mental Health Wellbeing Impact Assessment,
many Wellesley workshops and other resources can be found on page at
http://www.wellesleyinstitute.com/policy-fields/healthcare-reform/roadmap-
for-health-equity/heath-equity-impact-assessment
• Equity Assessment Framework being developed and piloted by Public Health
Ontario – geared to public health settings and standards
19
20. Applying HEIA: First, Scope the Issue Through
an Equity Lens
• simple equity lens that can be broadly applied =
• could the policy, program or initiative have a differential or
inequitable impact on different groups?
• use this for scoping stage = whether there are inequitable differences is a
research and evidence question
• so, first action item from HEIA scoping = if we don’t know → find out
• highlights importance of collecting better equity-relevant data across
the system and by every provider
• can use proxy data from postal code = neighbourhood characteristics
from census data
• can use case studies and small-scale interview/chart review studies
• can rely on provider experience and community perceptions at this
scoping stage
• if evidence is yes → then drill down using HEIA template
20
21. HEIA Analysis
1. analyze how the planned program or initiative affects
health equity for particular populations
• list of health disadvantaged populations – not exhaustive
• potential impact on social determinants of health
2. assess potential positive and negative impacts of the
initiative on the population(s)
3. develop strategies to build on positive and mitigate negative
impacts
4. plan how implementation of the initiative will be monitored
to assess its impact
February 9, 2012 |
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23. HEIA Into Practice: Lessons Learned
• from implementation so far and many workshops – can’t be prescriptive
in using tool
• doesn't matter so much what kind of document results
• real value is pulling people together to plan and analyze equity
• real impact comes from using HEIA to help embed equity into the
working culture of organizations
• another lesson learned is that effective implementation does require
capacities
• easier in large organizations with planning resources
• but, even with limited resources and correspondingly more limited
scope – can still be very useful exercise
• need to realize that HEIA will serve different purposes in different
organizations:
• different kinds of policies and policy contexts
• depends upon organizational experience with equity planning and implementation
24. Lessons Learned II: Adjust Purposes and Use to
Context
• for LHINs and Province, HEIA is one lever to help:
• ensure equity is routinely taken into account in health care planning and delivery
• equity gets embedded in providers’ organizational planning and practice
• especially important for health service providers who are not experienced with
equity
• could also be important for non-health organizations to begin to take population
health impact of their policies into account
• and for HSPs who are experienced and committed to equity or who work with
disadvantaged populations, HEIA can help to:
• ensure the full complexities of community challenges and capacities are considered
• identify sub-populations, specific barriers or other issues that can easily be missed
• can help clarify assumptions – what is exactly is meant by community? what are
the success conditions for the particular program in that particular community
context?
24
25. Scenario: Developing a Drop-in Program in a Poor
Neighbourhood
•what make-up of this community? •needs assessment and gap analysis
• are all poor? → prioritize mix of services
• what kinds of jobs? →outreach to build on existing services
• diversity along ethno-cultural , and respected organizations
language and immigration lines →where to base the new service that is
• what languages are spoken and most convenient and effective
preferred? •translate material into appropriate
• asset and strength-based, not just languages
challenges and barriers •take SDoH into account in service
•what SDoH differences within planning/delivery
community? •thinking about reach as well – who isn’t
•what physical, environmental and other signing up or getting the services they
issues need to be considered – e.g. few need?
parks, rail line or highways? •innovative options such as peer
•what mental health and related health ambassadors/navigators
and social services currently exist?
25
26. Need Clear Theory of
not just
Change for Equity- taking individual
Focused Planning account of programs but
social coordination,
constraints & partnerships &
conditions collaboration
26
27. enhanced access up-stream heath
to primary care conditions &
& health opportunities
promotion for improve fastest
most for those in
disadvantaged greatest need
27
28. Beyond Planning: Embed Equity in System
Performance Management
• clear consensus from research and policy literature, and
consistent feature in comprehensive policies on health equity
from other countries:
• setting targets for reducing access barriers, improving health
outcomes of particular populations, etc
• developing realistic and actionable indicators for service delivery
and health outcomes
• tying funding and resource allocation to performance
• closely monitoring progress against the targets and indicators
• disseminating the results widely for public scrutiny
• need comprehensive performance measurement and
management strategy
• then choose appropriate equity targets, indicators and incentives
28
29. Beyond Planning II: Into Overall
Strategy
1. building health equity into all health care planning and delivery
• so all take equity into account in planning their services and outreach
2. embedding equity in provider organizations’ deliverables, incentives
and performance management
3. aligning equity with system drivers and priorities – chronic
conditions, emergency wait times, ALCs, quality improvement
4. targeting some resources or programs specifically to addressing
disadvantaged populations or key access barriers
• planning and impact assessment is key to identifying interventions that will
have the highest impact on reducing health disparities or enhancing health
of the most vulnerable
• and public health focus on priority populations
5. while thinking up-stream to health promotion and addressing the
underlying determinants of health
• HEIA can help build understanding of SDoH into healthcare planning
February 9, 2012 |
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30. Case Study: City of Toronto Budget
• Applied a policy-orientated HEIA to three key
policy and program changes proposed by the
city:
• reducing child care funding and subsidies;
• eliminating the Hardship Fund; and
• limiting the development of affordable housing to
completing only what has already been approved
and funded.
February 9, 2012 30
32. Child Care
• High-quality child care is a strong determinant of
school-readiness and of overall child
development.
• Reducing access affects people in low wage jobs,
people on social assistance, women, and recent
immigrants
• Building on the positive:
• Equity targets (age and location) already exist in child
care planning
• Equity targets should be extended to include those
disadvantaged within the current system
February 9, 2012 |
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33. Child Care cont…
• Mitigating the negative:
• Confirm provincial funding before reducing municipal
funding
• Equity objectives:
• Reducing number of children on waitlist for subsidized
spaces
• Reduce differential between children from vulnerable
populations and the most advantaged populations by
50% over 5 years
• Reduce differential in school readiness between
children from vulnerable populations and the most
advantaged populations by 50% over 5 years
February 9, 2012 |
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34. Were we successful?
• City council voted to restore funding in a range of
areas, and the Mayor and Budget Committee took
some cuts off the table
• But we cannot know whether our HEIA influenced
these decisions
• huge number of other community and policy organizations
were working to influence this process
• This is the challenge of evaluating HEIA
• We can easily look back at the process, but evaluating
impact is more complex
• e.g. health impact of program changes takes years to show
up + how to separate effect of particular program changes
and other factors
February 9, 2012 |
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35. Key Messages
• health disparities are pervasive and deep-seated – but can’t
let that paralyze us
• do need a comprehensive and coherent health equity
strategy – but don’t wait for perfect strategy
• think big and think strategically – but get going
• build equity into health system:
• into strategic priorities, align with quality agenda and system
priorities, embed in routine planning and performance management
• into front-line planning and delivery where you practice
• no magic blueprint -- experiment and innovate -- and build on
learnings and success
35
36. Key Messages II: Equity-Focused Planning
• to drive action, we need comprehensive and innovative strategy, but we
also need focused planning
• not just for effective implementation, but also to:
• raise awareness of equity as vital issue
• embed and operationalize equity in organizational structures and
working cultures
• build momentum for broad policy and social change
→where practical and actionable tools and processes come in
• one promising and ready-to-go planning tool = Health Equity Impact
Assessment -- experiment and innovate with it
37. Appendix
• indicators, data and other success conditions
• Wellesley Health Equity Roadmap
February 9, 2012 |
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38. Success Condition: Effective Equity Targets
• innovative work underway to develop equity indicators – but don’t need
to wait
• build equity into existing targets:
• reducing diabetes incidence is prov and LHIN priority
→ equity target = reduce differences in incidence, complications and rates of
hospitalization between populations or areas
• a good service target has been proposed for diabetes = high/increasing % of
people who get best standard care
→ reduce differences by gender, income, ethno-cultural background
• need to drill down in specific areas that have high equity impact:
→ ensuring access and use of primary health care does not vary inequitably by
income level, immigration status, neigbourhood, gender, race, etc.
• many programs assess their services through client satisfaction surveys
and look for high and improving satisfaction
→ reduce any differences in satisfaction by gender, income, ethno-cultural
background, etc.
38
39. Challenges: Equity Targets That Work
• can’t just measure activity:
• number or % of priority pop’n that participated in program
• need to measure health outcomes – even when impact only shows up in long-
term
• so if theory of change for health program begins with enabling more exercise
or healthier eating – then we measure that initial step
• need to assess reach
• who isn’t signing up? who needs program/support most?
• who stuck with program and what impact it had on their health – and how this
varies within the pop’n
• and assess impact through equity lens
• need to differentiate those with greatest need = who programs most need to
support and keep to have an impact
• then adapt incentives and drivers
• develop weighting that recognizes more complex needs and challenges of
most disadvantaged, and builds this into incentive system
39
40. Success Condition = Better Data
•looking abroad for promising practices =
Public Health Observatories in UK
• consistent and coherent collection and
analysis of pop’n health data
• specialization among the Observatories
– London focuses on equity issues
•interest/development in Western Canada
•national project to develop health
disparity indicators and data
•Toronto PH is addressing complexities of
collecting and using race-based data
•key direction = explore potential of
equity/SDoH data for Ontario
•pilot project in 3 Toronto academic
hospitals to collect equity data
40
41. Wellesley Roadmap for Action on the
Social Determinants of Health
1. look widely for ideas and inspiration from jurisdictions with comprehensive
health equity policies, and adapt flexibly to Canadian, provincial and local needs
and opportunities;
2. address the fundamental social determinants of health inequality – macro policy
is crucial, reducing overall social and economic inequality and enhancing social
mobility are the pre-conditions for reducing health disparities over the long-
term;
3. develop a coherent overall strategy, but split it into actionable and manageable
components that can be moved on;
4. act across silos – inter-sectoral and cross-government collaboration and
coordination are vital;
5. set and monitor targets and incentives – cascading through all levels of
government and programme action;
41
42. Wellesley Roadmap II
6 rigorously evaluate the outcomes and potential of programme initiatives and
investments – to build on successes and scale up what is working;
7 act on equity within the health system:
• making equity a core objective and driver of health system reform – every bit
as important as quality and sustainability;
• eliminating unfair and inefficient barriers to access to the care people need;
• targeting interventions and enhanced services to the most health
disadvantaged populations;
8 invest in those levers and spheres that have the most impact on health
disparities such as:
• enhanced primary care for the most under-served or disadvantaged
populations;
• integrated health, child development, language, settlement, employment, and
other community-based social services;
42
43. Wellesley Roadmap III
9 act locally – through well-focussed regional, local or neighbourhood cross-
sectoral collaborations and integrated initiatives;
10 invest up-stream through an equity lens – in health promotion, chronic care
prevention and management, and tackling the roots of health disparities;
11 build on the enormous amount of local imagination and innovation going on
among service providers and communities across the country;
12 pull all this innovation, experience and learning together into a continually
evolving repertoire of effective programme and policy instruments, and into a
coherent and coordinated overall strategy for health equity.
43
44. Following Up
• these speaking notes and further resources on
policy directions to enhance health equity, health
reform and the social determinants of health are
available on our site at
http://wellesleyinstitute.com
• email is bob@wellesleyinstitute.com
• we would be interested in any comments on the
ideas in this presentation and any information or
analysis on initiatives or experience that address
health equity
44
Editor's Notes
getting more specific on concrete impact of health disparities on quality of livesactivities of ¼ of low income people are limited by pain = 2X than high income
In: that's impact on daily livesthat type of impact adds up over people's lives
reinforcing nature of social determinants on health disparitiesreally impt for key strategy = crucial part of managing diabetes esp. is good nutrition
previousdata shows complex and reinforcing nature of social determinants on health disparitiespractical implications = health promotion and CDPM has to take SDoH into account
when we’re working with particular populations or neighbourhoods – need to think at all these levels and their inter-connectionfor today: particular populations are worse off in terms of SDOH – precarious workers, homeless – face worse healthdisadvantage can be concentrated in particular places -- poor or racialized neighbourhoods – and over the generations in particular groups – long-term poor
which highlights the crucial importance of context
all of these require good planning
Sick Kids analysis of patients by neighbourhood income levelneed to match tools to purpose
need to match tools to purpose – isn’t one ‘magic’ tool for all situationscan adapt to particular care and disciplinary settings
tool --- better to think of as a process
highlights looking for unintended consequences
which is equity-orientated by def’nthis is about need to drill down to complexities and specificsfor place-based = need to take account of built and social environment
check: realist or developmental evl’n, concept of t of c?