"Designing a Learning Health Organization for Collective Impact" was my presentation given at the California HealthCare Foundation (CHCF) Health Care Leadership Program final seminar and graduation. Congratulations to the amazing fellow graduates!!!
Developing comprehensive health promotion - MedCrave Online PublishingMedCrave
As the global prevalence of obesity and chronic diseases continues to rise, the need for effective health promotion programs is imperative. Whilst research into effectiveness of health promotion programs is needed to improve population health outcomes, translation of these research findings into policy and practice is crucial. Translation requires not only efficacy data around what to implement, but also information on how to implement it.
http://medcraveonline.com/MOJPH/MOJPH-02-00007.pdf
Quality
Degree of adherence to pre-established criteria or standards.
Not an easy subject to get quality healthcare services.
Quality management
Doing the right thing, at the right time, for the right person, and having the best quality result.
4 main components:
Quality planning
Quality control
Quality assurance
Quality improvement
Focused on product/service quality & means to achieve it
Developing comprehensive health promotion - MedCrave Online PublishingMedCrave
As the global prevalence of obesity and chronic diseases continues to rise, the need for effective health promotion programs is imperative. Whilst research into effectiveness of health promotion programs is needed to improve population health outcomes, translation of these research findings into policy and practice is crucial. Translation requires not only efficacy data around what to implement, but also information on how to implement it.
http://medcraveonline.com/MOJPH/MOJPH-02-00007.pdf
Quality
Degree of adherence to pre-established criteria or standards.
Not an easy subject to get quality healthcare services.
Quality management
Doing the right thing, at the right time, for the right person, and having the best quality result.
4 main components:
Quality planning
Quality control
Quality assurance
Quality improvement
Focused on product/service quality & means to achieve it
Needs Analysis of Primary Care Physicians and Other Providers in Terms of Obe...Clinical Tools, Inc
Tanner, B. Needs Analysis of Primary Care Physicians and
Other Providers in Terms of Obesity Training. Poster
presented Overcoming Obesity: Diagnose. Personalize.
Treat. Conference of the American Society of Bariatric
Physicians, September 12, 2014 Austin Texas.
Introduction of the NZ Health IT Plan enables better gout management - Reflections of an early adopter. Presented by Peter Gow, Counties Manukau DHB, at HINZ 2014, 12 November 2014, 11.37am, Plenary Room
Bea Brown | a locally tailored intervention to improve adherence to a clinica...Sax Institute
Bea Brown gave a presentation on her research for the Sax Institute at the University of Sydney for the School of Public Health's 2013 research presentation day.
Escalating healthcare costs, heightened awareness of medical errors, and a higher-than-ever number of insured Americans have drawn attention to the need for quality improvement in US healthcare. Today, many efforts around patient outcomes and safety, care coordination, efficiency, and cost-cutting are underway and care redesign initiatives are being evaluated to guide future healthcare quality improvements. The following tips may aid you in your healthcare improvement efforts.
Strengthen Dissemination, Implementation and Improvement ScienceUCLA CTSI
DII Science at UCLA: Launching a New Initiative (October 25, 2013)
Presented by: Brian Mittman, Moira Inkelas, Stefanie Vassar, Ibrahima Sankare, Arturo Martinez, Arleen Brown
The UCLA CTSI Dissemination, Implementation and Improvement (DII) Science Initiative has three main goals.
1) Expand UCLA’s competitiveness for DII funding and publication opportunities
2) Position UCLA CTSI for future renewal
3) Enhance societal impact and benefits of UCLA research and improve health care quality, health behaviors and health outcomes in Los Angeles County and beyond
The DII vision is to ensure that:
- Results of clinical studies are put into practice in Southern California to benefit diverse populations
- Local providers take part in studies of how to implement, spread and scale findings and innovations
- Research, implementation and dissemination occur seamlessly by design
- Delivery systems can work with researchers to develop system solutions
- Researchers can find delivery systems and/or provider networks with which to partner on implementation-oriented funding proposals and studies
Iu Ahrq Hai Assessment Ctr Presentation Feb 22 2010 FinalBrad Doebbeling
75. Healthcare Associated Infections: Assessment Center Findings , Invited Talk, NCQIP, Agency for Healthcare Research and Quality, Bethesda, MD, February 22, 2010.
The best of clinical pathway redesign - practical examples of delivering bene...NHS Improvement
The examples here showcase just some of the innovations that have enabled thousands of patients to enjoy better health and well-being thanks to practicalservice improvements implemented on various clinical pathways
Apresentação realizada no I Seminário Internacional de Atenção às Condições Crônicas, pela diretora do Programa da Gestão de Doenças Crônica dos Serviços Sanitários De Alberta/Canadá, Sandra Delon.
Belo Horizonte, 11 de novembro de 2014
Needs Analysis of Primary Care Physicians and Other Providers in Terms of Obe...Clinical Tools, Inc
Tanner, B. Needs Analysis of Primary Care Physicians and
Other Providers in Terms of Obesity Training. Poster
presented Overcoming Obesity: Diagnose. Personalize.
Treat. Conference of the American Society of Bariatric
Physicians, September 12, 2014 Austin Texas.
Introduction of the NZ Health IT Plan enables better gout management - Reflections of an early adopter. Presented by Peter Gow, Counties Manukau DHB, at HINZ 2014, 12 November 2014, 11.37am, Plenary Room
Bea Brown | a locally tailored intervention to improve adherence to a clinica...Sax Institute
Bea Brown gave a presentation on her research for the Sax Institute at the University of Sydney for the School of Public Health's 2013 research presentation day.
Escalating healthcare costs, heightened awareness of medical errors, and a higher-than-ever number of insured Americans have drawn attention to the need for quality improvement in US healthcare. Today, many efforts around patient outcomes and safety, care coordination, efficiency, and cost-cutting are underway and care redesign initiatives are being evaluated to guide future healthcare quality improvements. The following tips may aid you in your healthcare improvement efforts.
Strengthen Dissemination, Implementation and Improvement ScienceUCLA CTSI
DII Science at UCLA: Launching a New Initiative (October 25, 2013)
Presented by: Brian Mittman, Moira Inkelas, Stefanie Vassar, Ibrahima Sankare, Arturo Martinez, Arleen Brown
The UCLA CTSI Dissemination, Implementation and Improvement (DII) Science Initiative has three main goals.
1) Expand UCLA’s competitiveness for DII funding and publication opportunities
2) Position UCLA CTSI for future renewal
3) Enhance societal impact and benefits of UCLA research and improve health care quality, health behaviors and health outcomes in Los Angeles County and beyond
The DII vision is to ensure that:
- Results of clinical studies are put into practice in Southern California to benefit diverse populations
- Local providers take part in studies of how to implement, spread and scale findings and innovations
- Research, implementation and dissemination occur seamlessly by design
- Delivery systems can work with researchers to develop system solutions
- Researchers can find delivery systems and/or provider networks with which to partner on implementation-oriented funding proposals and studies
Iu Ahrq Hai Assessment Ctr Presentation Feb 22 2010 FinalBrad Doebbeling
75. Healthcare Associated Infections: Assessment Center Findings , Invited Talk, NCQIP, Agency for Healthcare Research and Quality, Bethesda, MD, February 22, 2010.
The best of clinical pathway redesign - practical examples of delivering bene...NHS Improvement
The examples here showcase just some of the innovations that have enabled thousands of patients to enjoy better health and well-being thanks to practicalservice improvements implemented on various clinical pathways
Apresentação realizada no I Seminário Internacional de Atenção às Condições Crônicas, pela diretora do Programa da Gestão de Doenças Crônica dos Serviços Sanitários De Alberta/Canadá, Sandra Delon.
Belo Horizonte, 11 de novembro de 2014
Evidence-Informed Public Health Decisions Made Easier: Take it one Step at a ...Health Evidence™
An afternoon workshop - held in partnership with the National Collaborating Centre for Methods and Tools - at the Ontario Public Health Convention April 7, 2011
CORE Group Fall Meeting 2010. The Program Assessment Guide, Structuring Contextual Knowledge and Experience to Improve the Design, Delivery and Effectiveness of Nutrition Interventions.
Healthy People 2020Healthy People was a call to action and an.docxpooleavelina
Healthy People 2020
Healthy People was a call to action and an attempt to set health goals for the United States for the next 10 years.
Healthy People 2000 established 3 general goals:
Increase the span of healthy life.
Reduce health disparities.
Create access to preventive services for all.
Healthy People 2010 introduced 2 general goals:
Increase quality and years of healthy life.
Eliminate health disparities.
Practical Policy for Preventive Services
The U.S. health care system faces significant challenges that clearly indicate the urgent need for reform.
There is broad evidence that Americans often do not get the care they need even though the United States spends more money per person on health care than any other nation in the world.
Preventive care is underutilized, resulting in higher spending on complex, advanced diseases.
Practical Policy for Preventive Services
Patients with chronic diseases too often do not receive proven and effective treatments such as drug therapies or self management services to help them more effectively manage their conditions.
These problems are exacerbated by a lack of coordination of care for patients with chronic diseases.
Reforming our health care delivery system to improve the quality and value of care is essential to address escalating costs, poor quality, and increasing numbers of Americans without health insurance coverage.
Why policies need to be developed?
Basic needs are not being met (e.g., People are not receiving the health care they need)
People are not being treated fairly (e.g., People with disabilities do not have access to public places)
Resources are distributed unfairly (e.g., Educational services are more limited in neighborhoods of concentrated poverty)
Why policies need to be developed?
Current policies or laws are not enforced or effective (e.g., The current laws on clean water are neither enforced nor effective)
Proposed changes in policies or laws would be harmful (e.g., A plan to eliminate flextime in a large business would reduce parents' ability to be with their children)
Existing or emerging conditions pose a threat to public health, safety, education, or well-being (e.g., New threats from terrorist activity)
Marjory Gordon’s Functional Health Patterns
Marjory Gordon was a nursing theorist and professor who created a nursing assessment theory known as Gordon's functional health patterns.
It is a method to be used by nurses in the nursing process to provide a more comprehensive nursing evaluation of the patient.
Gordon's functional health pattern includes 11 categories which is a systematic and standardized approach to data collection.
List of Functional Health Patterns
1. Health Perception – Health Management Pattern
describes client’s perceived pattern of health and well being and how health is managed.
2. Nutritional – Metabolic Pattern
describes pattern of food and fluid consumption relative to metabolic need and pattern indicators of loca ...
Master of Public Health (MPH) Orientation20161Welc.docxwkyra78
Master of Public Health (MPH) Orientation
2016
1
Welcome Message!
Hello, and welcome to the first course in your public health degree program.
Your dynamic online classroom will provide you with ample opportunities to interact with your fellow students while you gain knowledge from a career-relevant curriculum in your chosen field.
Our professors are expert practitioners, with real-world experience in the health care industry, so you’ll learn from individuals who know what it’s like to be you.
Whether your focus is on health care system management,
health policy, or health economics, you’ve found a place to
Gain the knowledge you need to succeed.
Welcome aboard, and good luck to you as you begin your
academic journey with us.
Program Director: Dr. Samer Koutoubi
2
MPH Mission Statement
The mission of the American Public University System (APUS) Master’s of Public Health (MPH) program is:
to prepare and educate students to promote health and well-being as public health practitioners through excellence in teaching, research, and service in preparation for leadership opportunities in a diverse and global society through a student-focused learning environment.
3
MPH Program’s Values
Lifelong Learning - commitment to life-long professional and personal development.
Compassion - promote empathy and concern for the well-being of others.
Critical Thinking - foster purposeful reflective judgment.
Diversity - promote student and faculty populations regardless of gender, race, religion, ethnicity, sexual orientation or identity, or social standing.
Innovation - seek imaginative and effective solutions to challenges.
Professionalism and Integrity - adhere to professional codes of conduct.
Respect - commitment to the overarching principles of the dignity and worth of individuals.
4
MPH Program’s Goals
The goals for the APUS MPH program are:
Instruction: Provide current, relevant education and professional development through a curriculum based on public health competencies in an innovative learning environment.
Research: Encourage and promote faculty and student research in the field of public health in order to enhance the skills, knowledge, and expertise of faculty and students.
Service: Support ongoing faculty and student service in local, regional, and international public health organizations and communities of practice.
5
Full-time Public Health Faculty
NameGraduate Degrees EarnedDiscipline of Graduate DegreesInstructional Area(s)Research InterestRobert CarterPhD
MPH Biomedical Sciences
Epidemiology
BiostatisticsBiostatistics
Epidemiology
Emergency Management
QuarantineCardiovascular and respiratory pathophysiology
Biostatistics Donna BartonPhD
MPH Public Health
BiostatisticsBiostatistics
EpidemiologyWomen’s Health
Cardiovascular DiseaseEbun EbunlomoPhD
MPH
Community Health Sciences
Health Behavior and Health Education
Health Services Administration
Community Health
Epidemiology.
ITS IMPORTANT TO MEET THE COMPETENCES (Thats how they evaluate the mariuse18nolet
ITS IMPORTANT TO MEET THE COMPETENCES (That's how they evaluate the work).
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
(IMPORTANT) -Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
(IMPORTANT) -Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
(IMPORTANT) -Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
(IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
Preparation
Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment.
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients.
As a member of the nurse team, you have been asked to develop
one
component
of the clinic.
The hospital leadership established these objectives ...
Population Health Data Science, Complexity, and Health Equity: Reflections fr...Tomas J. Aragon
Annual Population Health Sciences Colloquium at the Stanford Center for Population Health Sciences on October 26, 2015.
This one-day program will showcase population health sciences research from the Stanford community and experts around the world.
This one-day program will showcase population health sciences research from the Stanford community and experts around the world. The PHS Initiative aims to bring together basic, translational and clinical scientists, along with researchers from disciplines across the entire University, to provide resources and facilitate collaborations focused on population-level questions, data and approaches.
We have an exciting full-day session with keynote speakers - Lloyd Minor, Dean of the Stanford School of Medicine; Muin Khoury, Associate Director of Epidemiology and Genomics Research Program at NCI; and Tomas Aragon, Director of Population Health Division at the San Francisco Department of Public Health - and some time to do the vital work of growing our center.
The High Achieving Governmental Health Department in 2020 as the Community Ch...Tomas J. Aragon
This paper was prepared by RESOLVE as part of the Public Health Leadership Forum with funding from the Robert Wood Johnson Foundation. John Auerbach, Director of Northeastern University’s Institute on Urban Health Research, also put substantial time and effort into authoring the document with our staff. The concepts put forth are based on several working group session (See Appendix B for members) and are not attributable to any one participant or his/her organization.
Preparing for Microbial Threats to Health: What Every Professional Should KnowTomas J. Aragon
In this presentation I introduce the "SFDPH Population Health Division Controlling Infectious Diseases Model." This model integrates concepts from understanding transmission mechanisms, transmission dynamics, and transmission containment. The Model is most useful when facing novel microbial threats and we need simple framework for public health action.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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!
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Are There Any Natural Remedies To Treat Syphilis.pdf
Designing a Learning Health Organization for Collective Impact
1. Designing a Learning Health Organization for Collective Impact
Tomas J. Aragon, MD, DrPH
Health Ocer, City and County of San Francisco
Director, Population Health Division (PHD)
San Francisco Department of Public Health
University of California, Berkeley
School of Public Health
October 3, 2014
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 1 / 18
2. Acknowledgments
Barbara A. Garcia, MPA, Director of Health, SFDPH
CHCF Healthcare Leadership Program Sta and Cohort 12!!!
California HealthCare Foundation (CHCF)
Healthcare Leadership Program, UC San Francisco
SFDPH Population Health Division sta
SFDPH Quality Improvement Programs
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 2 / 18
3. Overview
1 Problem statement
2 Project description
3 Goal and objectives
4 Outputs and outcomes
5 Lessons learned
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 3 / 18
4. Problem statement
Challenges and Opportunities
Challenges
Increasing complexity
Public Health Accreditation
Health and socioeconomic inequities
Aging and epidemic of chronic diseases
Patient Protection and Aordable Care Act
Opportunities
Public Health Accreditation
Patient Protection and Aordable Care Act
Collective impact for community transformation
Integration of epidemiology, quality improvement, and complexity science
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 4 / 18
6. nition and underlying causes
The San Francisco Department of Public Health, Population Health Division (PHD) is limited
in its ability to ful
7. ll its mission to protect and improve community health and health equity.
PHD faces special challenges:
a legacy of categorical funding and autonomous silos,
no system for performance management and continuous quality improvement,
new public health accreditation requirements,
implementation of the Aordable Care Act,
fragmented services, and
limited focus and capability to address complex community health problems and social
determinants.
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 5 / 18
8. Problem statement
San Francisco's old public health division, 2011
Population Health and Prevention
Categorical silos
No division training program
No division strategic planning
No division quality improvement
No division performance management
POPULATION HEALTH PREVENTION
Community Health Promotion
and Prevention
Public Health Preparedness
and Emergency Response
Environmental Health and
Occupational Safety
Public Health Laboratories
Emergency Medical Services
STD Prevention and Control
Tuberculosis Control
Communicable Disease
Control and Prevention
HIV Prevention
HIV Epidemiology
Bridge HIV (Research)
Tomás J. Aragón, MD, DrPH
Health Officer Director
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 6 / 18
9. Project description
REACH|for Results, Equity, and Accountability for Community Health
Leveraging concepts from
organization development and design,
continuous quality improvement,
leadership and management, and
complexity science,
we reorganized the Population Health Division under a new continuous improvement
framework we call REACH|for Results, Equity, and Accountability for Community Health.
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 7 / 18
10. Goal and objectives
Goal
A high performing, learning health organization that successfully implements collective
impact approaches to complex community health problems.
Output-oriented objectives: By July, 2013:
1 Population Health Division Organization Design Framework (ODF)
2 Design and implementation of new REACH framework:
1 Criteria for Performance Excellence (CPE)
2 Four Strategic Questions (4SQ)
3 Results-based management (RBM)
4 Health Equity X (HEX) model
Outcome-oriented objectives: By July, 2014:
The conduct of high-priority health equity projects with continuous improvement in population
health (lag) and performance (lead) indicators using the new REACH framework.
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 8 / 18
11. Outputs and outcomes
Output: Population Health Division Organization Design Framework
Public health accreditation
Four P's of public health
Physiology vs. anatomy
(organization chart)
Horizontal integration
KNOWLEDGE MANAGEMENT: Surveillance, Epidemiology, and Research Branch
STRATEGIC PLANNING: Office of Policy, Planning, and Quality Improvement
DISASTERS
(Preparedness)
- - -
Emergency
Preparedness
and Response
Branch
HEALTHY PLACES
(Protection)
- - -
Environmental
Health Branch
HEALTHY PEOPLE
(Promotion)
- - -
Community
Health Equity
and Promotion
Branch
DISEASES
(Prevention)
- - -
Disease
Prevention
and Control
Branch
OPERATIONS FOCUS: Office of Operations, Finance, and Grants Management
WORKFORCE FOCUS: Center for Learning and Innovation
COMMUNITY
PARTNERS
- - -
Health Systems
Schools
etc.
GUIDED BY STRATEGIC VISION
AND ACTION PLANS
1. Safe and Healthy Living Environments
2. Healthy Eating and Physical Activity
3. Access to Quality Care and Services
4. Black / African American Health
5. Maternal, Child, and Adolescent Health
6. Health for People at Risk or Living with HIV
Assessment
Policy Development
Assurance
Governance,
Administration,
and Systems
Management
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 9 / 18
12. Outputs and outcomes
Output: Criteria for Performance Excellence|Baldrige House
Predictive of high performance
Pillars of leadershp results
Knowledge integration
Decision support
Guided by Strategic Vision
and Action Plans
Influenced by Challenges and Opportunities
2. Strategic Planning
Decision-making
5. Workforce
Development
1. Leadership 7. Results
3. Customer
Value
6. Lean Thinking
Process Innovation
4. Knowledge Integration and Decision Support
Supported by Values (respect, continuous improvement, teamwork, excellence)
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 10 / 18
13. Outputs and outcomes
Outputs: In
uence of the Baldrige CPE on the Organization Design
Baldrige Criteria Examples of organization design achievements
1. Leadership Executive team leadership academy
2. Strategic planning Result-based strategic planning for accreditation
3. Customer focus Community Health Equity and Promotion Branch
Disease Prevention and Control Branch
4. Knowledge integration and
decision support
Integrated surveillance and epidemiology unit
Integrating all disease surveillance systems
Continuous Decision Improvement (CDI) curriculum
5. Workforce focus Center for Learning and Innovation
6. Process management Oce of Equity and Quality Improvement
7. Results Collective impact using results-based management
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 11 / 18
14. Outputs and outcomes
Output: Four Strategic Questions (4SQ)
The practice of asking four strategic questions with all important activities. Promotes a
culture of strategy awareness and results-based accountability, but in an accessible way that
values sta creativity.
4SQ
1 What are we trying to accomplish and why?
(strategic intent)
2 How do we measure success?
(scorecard)
3 What other conditions must exist?
(assumptions and risks)
4 How do we get there?
(action planning)
Example
Daily planning
Planning meetings
Project management
Quality Improvement
Structured decision making
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 12 / 18
15. Outputs and outcomes
Output: Results-based management (RBM) for collective impact
RBM
Results chain
Results matrix
Collective impact
1 Common agenda
2 Shared measurement
3 Continuous improvement
of mutually-reinforcing
activities
Outcomes
C
Outputs
C
es)
1
What are we trying to Accomplish and why?
(strategic intent)
2
How do we
measure Success?
(scorecard)
3
What other conditions
must exist?
(assumptions risks)
4
How do we
get there?
(action planning)
ENDS
Impact
indicators
Performance
measures:
Outcome
indicators
Output
indicators
Process
indicators
MEANS
Results-based
planning,
working
from ends
to means
(a)
(b)
(c)
(d)
4SQ
RBM
Future
State
Current
State
Processes Processes Processes
Inputs C Plan-Do-Study-Act (PDSA)
1. Project management
2. Continuous improvement
3. Test, Learn, Improve, Spread
Goal (common agenda)
Collective Impact
Outcomes
B
Outputs
B
es)
Inputs B
Outcomes
A
Outputs
A
es)
Inputs A
Partner A Partner B Partner C
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16. Outputs and outcomes
Output: Health Equity X (HEX) model
The HEXa;b model is used for planning and managing eorts to achieve
results for challenges and opportunities embedded in complex social
systems, including for health equity, quality improvement, and collective
impact.
1 People (mental models, belief systems, cultural norms, isms)
2 Policy (social, organizational, institutional)
3 Place (neighborhoods, schools, work, open spaces)
4 Program (programs, agencies, or service systems)
5 Provider (teacher, employer, landlord, minister)
6 Patient (student, employee, tenant, follower)
Patient
Program
People
Provider
Place
Policy
Health
Equity
a HEX model was inspired by BARHII (http://www.barhii.org) and Dr. Tony Iton
b A hexateron is a geometric object with 6 vertices, 15 edges, 20 triangle faces, 15 tetrahedral cells
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 14 / 18
17. Outputs and outcomes
Outcome: The new Population Health Division!
July 2014: First anniversary of PHD reorganization which was recognized by the National
Association of County and City Health Ocials (NACCHO) as a standout on the issue of
health department leadership and transformation in the new public health era Invited to
present at NACCHO National Conference in Atlanta, Georgia, July 2014.
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18. Outputs and outcomes
Outcome: Peer-reviewed publication (in press), 2014
Journal of Public Health Management and Practice
TJA aliation includes CHCF Health Care Leadership Program!
Tomas J. Aragon, MD, DrPH (SFDPH) Designing a Learning Health Organization October 3, 2014 16 / 18
19. Outputs and outcomes
Outcome: Black/African American Health Initiative launched April, 2014
SF Health Network and Population Health Division
1 Collective impact
2 Workforce development
3 Cultural humility training
Collective impact
1 Heart health | Healthy Hearts San Francisco
2 Behavioral health (focus: alcohol)
3 Women's Health (focus: breast cancer)
4 Sexual Health (focus: chlamydia)
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20. Lessons learned
Lessons learned: focus on team-based leadership with . . .
. . . continuous improvement in
1 practice of cultural humility,
2 creation extension of trust, and
3 practice of shared decision making.
From my research, experience, and practice,
the key path to a learning organization is by
improving humility, trust, and shared decision
making. With cultural humility we increase
self-awareness of our biases, we engage in
self-re
ection to put these aside, we redress
power imbalances, and learn from every human
interaction. Humility and humble inquiry
creates trust, enabling shared decision making
which requires cooperation (trust and
humility).
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