The document summarizes the Environmental Public Health Tracking Network, which collects and analyzes environmental hazard, exposure, and health effect data. It began as a recommendation in a 2000 report. The network is funded by the CDC and involves state and local environmental and health agencies. It provides data through secure portals for public health professionals and researchers. Utah's network involves numerous state agencies and data sources. It securely provides indicators like elevated blood lead levels to help identify risks and protect health.
The National End of Life Care Intelligence Network (NEoLCIN): report of the first year
Using intelligence to improve end of life care
17 June 2011 - National End of Life Care Programme / National End of Life Care Intelligence Network (NEoLCIN)
The NEoLCIN aims to improve the collection and analysis of data about end of life care services. It provides information to government, service providers, commissioners and researchers on adults approaching the end of life and on the quality, volume and costs of care provided to them.
This document highlights what the network has achieved in its first year of operation.
The National End of Life Care Intelligence Network (NEoLCIN): report of the first year
Using intelligence to improve end of life care
17 June 2011 - National End of Life Care Programme / National End of Life Care Intelligence Network (NEoLCIN)
The NEoLCIN aims to improve the collection and analysis of data about end of life care services. It provides information to government, service providers, commissioners and researchers on adults approaching the end of life and on the quality, volume and costs of care provided to them.
This document highlights what the network has achieved in its first year of operation.
Health Datapalooza IV: June 3rd-4th, 2013
Datalab
Moderator:
Todd Park, Chief Technology Officer, United States
Damon Davis, Health Data Initiative Program Director, Department of Health and Human Services
Speakers:
Susan Queen, Director, Division of Data Policy, Office of the Assistant Secretary for Planning and Evaluation
Steve Cohen, Director, Center for Financing, Access and Cost Trends, Agency for Healthcare Research & Quality
Rick Moser, National Institutes of Health
Victor Lazzaro, Performance & Data Analytics Manager, Office of the National Coordinator for Health IT
Niall Brennan, Director of the Office of Information Products and Data Analytics, Center for Medicare and Medicaid Services
Miya Cain, Office of the Assistant Secretary, Administration for Children and Families, US Department of Health and Human Services
Edward Salsberg, Director, National Center for Health Workforce Analysis, Health Resources and Services Administration
Robert Post, Environmental Protection Agency (EPA)
Eugene Hayes, the Substance Abuse and Mental Health Services Administration (SAMHSA)
Jim Craver, Center for Disease Control and Prevention (CDC)
David Forrest, Senior Advisor, Health and Human Services Office of the Chief Technology Officer
Tania Allard, Director of Intergovernmental Affairs & Special Projects, New York State Department of Health
Steven Edwards, Environmental Protection Agency
Steve Emrick, National Library of Medicine
Carol A. Gotway Crawford, Director of Behavioral Surveillance, Centers for Disease Control
This perennial favorite breakout session is back! This is the best opportunity to meet some of the federal government data experts who champion action in improving public access to information to catalyze innovation. Come learn how to use assets from the Department of Health & Human Services (HHS), the Department of Agriculture (USDA), the Environmental Protection Agency (EPA) and more. Each agency in the federal government is staffed by experts who are well versed in the information resources available from their division on data.gov (administrative data, survey data, research data, medical/scientific content, etc.) The Datalab will also feature opportunities for one-on-one meet-ups with data experts for “deep dives” into agency’s resources. Participants can join live demonstrations and check out new data resources and tools. The goal of the session is to give innovators and entrepreneurs an overview of new, updated, and emerging datasets that can be used to support new applications and services.
This is the slide deck from the first lecture of the Consumer Health Informatics and Web 2.0 in Healthcare course at Nova Southeastern University. The course is taught by CCHIR faculty and guest lecturers. This deck is from the pharmacy version of the course.
Hospital Pricing Issues Cost Employers MoneyMark Gall
This five-year study details the wide variation of hospital prices for the same procedure in the same town. It considers the impact on the costs of private insurance plans from insurance companies including CIGNA, Anthem, Aetna and United HealthCare. See highlights on pages 1 through 6.
Implementing a Population Health Model (Hon Pak)Ashleigh Kades
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Module 3: Oral Health Data Tools and StatisticsKelley Minars
The updated version of this tutorial can be found here: http://www.slideshare.net/uthsclib/module-3-oral-health-data-tools-and-statistics-1724970
Module 3 of the Oral Health Tutorial, a production of UT HSC Libraries.
This module focuses on data tools and statistics. View this tutorial to develop a basic understanding of the types of statistics and data sets that are available related to oral health and to identify health related web sources with statistics.
This tutorial is copyright Lara Sapp and Julie Gaines. Uploaded with permission.
Publicado originalmente en http://www.slideshare.net/EugeneBorukhovich/open-health-data-qualitative-overview
Extraordinaria presentación sobre la aplicación de Open Data en Salud ejemplos y casos de éxito en varios paises.
Health Datapalooza IV: June 3rd-4th, 2013
Datalab
Moderator:
Todd Park, Chief Technology Officer, United States
Damon Davis, Health Data Initiative Program Director, Department of Health and Human Services
Speakers:
Susan Queen, Director, Division of Data Policy, Office of the Assistant Secretary for Planning and Evaluation
Steve Cohen, Director, Center for Financing, Access and Cost Trends, Agency for Healthcare Research & Quality
Rick Moser, National Institutes of Health
Victor Lazzaro, Performance & Data Analytics Manager, Office of the National Coordinator for Health IT
Niall Brennan, Director of the Office of Information Products and Data Analytics, Center for Medicare and Medicaid Services
Miya Cain, Office of the Assistant Secretary, Administration for Children and Families, US Department of Health and Human Services
Edward Salsberg, Director, National Center for Health Workforce Analysis, Health Resources and Services Administration
Robert Post, Environmental Protection Agency (EPA)
Eugene Hayes, the Substance Abuse and Mental Health Services Administration (SAMHSA)
Jim Craver, Center for Disease Control and Prevention (CDC)
David Forrest, Senior Advisor, Health and Human Services Office of the Chief Technology Officer
Tania Allard, Director of Intergovernmental Affairs & Special Projects, New York State Department of Health
Steven Edwards, Environmental Protection Agency
Steve Emrick, National Library of Medicine
Carol A. Gotway Crawford, Director of Behavioral Surveillance, Centers for Disease Control
This perennial favorite breakout session is back! This is the best opportunity to meet some of the federal government data experts who champion action in improving public access to information to catalyze innovation. Come learn how to use assets from the Department of Health & Human Services (HHS), the Department of Agriculture (USDA), the Environmental Protection Agency (EPA) and more. Each agency in the federal government is staffed by experts who are well versed in the information resources available from their division on data.gov (administrative data, survey data, research data, medical/scientific content, etc.) The Datalab will also feature opportunities for one-on-one meet-ups with data experts for “deep dives” into agency’s resources. Participants can join live demonstrations and check out new data resources and tools. The goal of the session is to give innovators and entrepreneurs an overview of new, updated, and emerging datasets that can be used to support new applications and services.
This is the slide deck from the first lecture of the Consumer Health Informatics and Web 2.0 in Healthcare course at Nova Southeastern University. The course is taught by CCHIR faculty and guest lecturers. This deck is from the pharmacy version of the course.
Hospital Pricing Issues Cost Employers MoneyMark Gall
This five-year study details the wide variation of hospital prices for the same procedure in the same town. It considers the impact on the costs of private insurance plans from insurance companies including CIGNA, Anthem, Aetna and United HealthCare. See highlights on pages 1 through 6.
Implementing a Population Health Model (Hon Pak)Ashleigh Kades
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Module 3: Oral Health Data Tools and StatisticsKelley Minars
The updated version of this tutorial can be found here: http://www.slideshare.net/uthsclib/module-3-oral-health-data-tools-and-statistics-1724970
Module 3 of the Oral Health Tutorial, a production of UT HSC Libraries.
This module focuses on data tools and statistics. View this tutorial to develop a basic understanding of the types of statistics and data sets that are available related to oral health and to identify health related web sources with statistics.
This tutorial is copyright Lara Sapp and Julie Gaines. Uploaded with permission.
Publicado originalmente en http://www.slideshare.net/EugeneBorukhovich/open-health-data-qualitative-overview
Extraordinaria presentación sobre la aplicación de Open Data en Salud ejemplos y casos de éxito en varios paises.
This qualitative overview of the Open Health Data initiatives is meant to showcase the importance of open health data, social as well as economic impacts across US, UK and a select set of Western European countries. This overview is not meant to be a comprehensive report on all the global initiatives, funding models and tracking of open health data. There are tremendous efforts across the globe to change our global healthcare system and we believe that open health data is one of the keys to bridge the gap between digital citizens & governments. Also, please note that if your country, initiative or product was not mentioned, it is in no way meant to diminish the impact of the efforts. Please feel free to share, discuss and contribute to the list of ongoing efforts and initiatives on one of our global communities or on openhealthdata.org.
Module 3 of the Oral Health Tutorial, a production of UT HSC Libraries.
This module focuses on data tools and statistics. View this tutorial to develop a basic understanding of the types of statistics and data sets that are available related to oral health and to identify health related web sources with statistics.
This tutorial is copyright Lara Sapp and Julie Gaines.
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataBrian Ahier
Increasingly, consumers are taking a more active role in managing and generating their own health data. For example, consumers are researching their health conditions and diagnosing themselves online. Consumers are also uploading their information into personal health records and apps that allow them to manage and analyze their data, and utilizing connected health and fitness devices that regularly collect information about them and transmit this information to other entities.
The movement of health data outside the traditional medical provider context has many potential benefits; however, it also raises potential privacy concerns. The seminar will address questions such as:
What types of websites, products, and services are consumers using to generate and control their health data, and how are consumers using them?
Who are the companies behind these websites, products, and services, what are their business models, and what does the current marketplace look like?
How can consumers benefit from these companies’ websites, products, and services?
What actions are these companies taking to protect consumers’ privacy and security?
What do consumers expect from these companies regarding privacy and security protections?
Do consumers differentiate between these companies and those that offer traditional medical products and services that are covered by HIPAA?
What restrictions, if any, do advertising networks and others impose on tracking of health data?
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
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.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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
17. Unit Patient with elevated blood lead Geographic Scope Utah Geographic Coordinates West: -114.042925 East: -109.041501 North: 42.001718 South: 36.997693 Geographic scale Zip codes Time Period 2002-2006 Updated Annually Time Scale Single years Rationale The Utah Blood Registry (UBLR) within the Utah Department of Health functions to identify residents of Utah with elevated blood lead levels. The UBLR provides risk assessment to help the individual limit and remove their risk of lead exposure. The UBLR serves as a resource for physicians, hospitals, local health departments, and researchers. The UBLR provides blood lead data to national agencies for generating national statistics and to state and local agencies for identifying high risk areas. The UBLR provides an educational and data resource for physicians, nurses, and other institutions to help protect Utah’s population. Use of the Measure Limitations of the Measure Data Sources Blood lead data is provided to the Utah Department of Health, Utah Blood Lead Registry, from laboratories, hospitals, health clinics and physicians. Utah Population Estimates Committee (UPEC) and the Governor’s Office of Planning and Budget (GOPB), 2008 Baseline Economic and Demographic Projections (Revised on 7-23-2008).
18. Reporting Protocols Under the Injury Reporting Rule R386-703, specific to the injury of an Elevated Blood Lead (≥ 10µg/dL), a reportable injury evaluated or treated at a hospital shall be reported by that hospital. Reportable injuries not evaluated at a hospital shall be reported by the involved physician, nurse, other health care practitioner, medical examiner, or laboratory administrator. Each case of injury shall be reported to the Utah Department of Health or to the local health department responsible for the geographic area where the injury occurred. The local health officer shall forward all original reports to the Utah Department of Health. Because the Utah Blood Lead Registry falls under the definition of a public health entity, the Injury Reporting Rule takes precedence over the recent legislation called HIPAA, the Health Insurance Portability and Accountability Act. For more information regarding public health, including blood lead reporting and HIPAA, please go to the Centers for Disease Control and Prevention website at: http://www.cdc.gov/od/science/regs/privacy/index.htm Additional Details to consider All population estimates and projections apply to July 1 of the selected year. Citation Blood lead data provided by the Utah Department of Health is funded in part by a contract with the National Institute for Occupational Safety and Health and the Centers for Disease Control and Prevention, Preventive Block Grant Award. Contact Metadata created by: Health Program Specialist Environmental Epidemiology Program Utah Department of Health PO Box 142104 Salt Lake City, UT 84114-2104 801-538-6191 [email_address] http://health.utah.gov/epi/enviroepi/ Creation Date August 13, 2009
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Editor's Notes
Thanks for coming and for your interest in EPHT I am presenting about this network right now because after about 6 years of planning, we are launching this network both statewide as well as nationally this summer. Hopefully this network will be a useful resource for all of you.
The Pew Environmental Health Commission wrote “America’s Env. Health Gap…” in September 2000. The report noted a need to shift some focus to environmental health problems and hazards. It described an environmental health gap, meaning that there is a lack of basic information on environmental Health hazards which can help find links to some diseases, detect trends in public health status, measure health issues as well as plan and evaluate public health programs.
Thus the Environmental Public Health Tracking Program was created Data warehouse that is expected to launch in the Fall of 2008 This program consists of the ongoing collection, integration, analysis, interpretation, and dissemination of data on three important topics: Environmental hazards Exposures to those hazards The related health effects
This program is primarily funded and created by the CDC Utah is one of the states that is involved in this project, along with 16 other state and city agencies. The map to the right shows the states involved in EPHT in blue There are four Universities of Public Health across the nation that are also involved. These are shown with a purple star. Also, a variety of professional and non-government groups are involved and interested in EPHT such as Utah Physicians for a Healthier Environment and the Utah Environmental Health Association
As stated earlier, the EPHT Network will include 3 main types of data. These are hazard data, exposure data, and health effects data. hazards data can be found in air, water, soil, food, and other parts of the environment. The general categories of hazards that may be included are: •Chemical agents, e.g pesticides; •Physical agents, e.g., radon; •Biomechanical stressors; and •Biologic toxins, e.g., those from harmful algal bloom. Exposure data comes from a variety of data sources such as consumption rates, environmental modeling or biomonitoring An example of environmental modeling is measuring the amount of a certain pollutant in the air and then estimating the amount of that pollutant is inhaled or absorbed based on the concentration. This is usually done through computer or mathematical models Biomonitoring data comes from directly measuring the amount of a chemical in a person’s body. This can be done through blood or urine samples. Health effects data comes from traditional public health surveillance efforts, such as disease registries, vital statistics data, annual health surveys, and hospital discharge data. While these sources provide good results, greater data standardization and availability will increase the efficiency and effectiveness of the network. Example. The environmental hazard arsenic is thought to be related to health problems. Through biomonitoring data we have found that arsenic in drinking water is associated with bladder cancer.
The Utah EPHTN collects, codes and standardizes data from many different organizations that track environmental hazards, exposures, and health outcomes. Here is a list of partnerships that provide data to Utah’s EPHTN.
There will be four portals that will be accessible Two state portals: one secure, one for the public. The state will be using a very successful system that is already in place: IBIS-PH and Secure IBIS Two national portals: one secure, one for the public Queries: Cancer Registry>Single years>age-adjusted rate>2005>breast>choose census tracts (Draper) Birth Defect>quick selection>count>2006>all>all groups>hypoplastic left heart syndrome>all types>all counties>display by county Hospitalizations>myocardial infarction>hospital discharges>county of hospital visits>11/1/06-3/1/07>all myocardial infarction>all ages>both male and female>choose zip codes (84321, 84341, 84322)>view by time interval
It connects us with data partners and with potential data-users
These are the laws that cover the data. The first two have penalties that include up to $10,000 per violation. HIPAA’s penalties are up to $25,000 per year.
Putting these in place, we’ve had to incorporate them into our data sharing agreements. So, we’re currently working with each of our data partners to amend the DSA’s.
This is what we have available right now
Metadata aids data discovery! Because public health professionals can’t see all of this, we are working to put up metadata – or descriptive data notes – about each dataset.
The Secure IBIS-PH Access Request is very different for research projects and for public health professionals [It is purposely much easier for health professionals] For public health professionals they can select a topic and a geography. For research projects, they can select a topic, a geographic area and a geographic unit (for aggregation), a time period and a time unit (for aggregation), demographic characteristics or environmental pollutants to be studied and the unit for their stratification. The Access Request contains this information, too: They explain how they intend to keep the data secure. They also list all the members of their research project or their public health program. The Data-use Agreement Form and the Secure IBIS-PH Access Agreement Form are where they agree to all the security requirements. EACH PERSON involved in the research project or in the public health program must turn in a signed copy.
The public health professionals’ process is somewhat quicker than the process for research projects.
1. To show progress, security, etc. – depends on memorandum of instruction 2. Access is limited to those who have signed a Data-use Agreement 3. Publications and presentations must be reviewed by the SRB at least 30 days in advance. Review of publications and presentations won’t be for quality. It will be for correct use of data (confidentiality, interpretation) and appropriate acknowledgement of the data owner. 4. Review will also ensure the data is being used for the purposes for which it was requested. The final point ensures that only the requested research topic is being researched AND that public health officials are only using it in work-related ways (not research projects)