Exercise Doak Bloss slide exerpt--For IPHA September 12, 2019 presentation
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Towards a Critical Health Equity Research Stance: Why Epistemology and Method...
Towards a Critical Health Equity Research Stance: Why Epistemology and Method...Jim Bloyd, DrPH, MPH
Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies—namely, photovoice and critical ethnography— that, pursuant to critical approaches, prioritize dismantling social–structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.Links to Recommended Readings from June 4, 2020 presentation “Work With Organ...
Links to Recommended Readings from June 4, 2020 presentation “Work With Organ...Jim Bloyd, DrPH, MPH
Links to Recommended Readings from June 4, 2020 presentation “Work With Organizers to Build People Power for Health Equity” by Jim Bloyd, MPH, Regional Health Officer, Cook County Department of Public Health (IL) jbloyd@cookcountyhhs.org Presented as part of “Covid-19 and Health Equity: A Policy Platform and Voices from Health Departments” by Human Impact Partners, co-sponsored by APHA, ASTHO, Big Cities Health Coalition, HealthBegins, and NACCHO. (Links current as of June 12, 2020 prepared by Jim)Senators call for investigation into Pulaski County jail amid COVID-19 outbreak
News article published May 30, 2020 "The senators’ letter follows the efforts of several health-justice advocates to implore the Illinois Department of Public Health to take a more active role in managing the outbreak in Pulaski County. Those individuals, which include representatives from the Collaborative for Health Equity Cook County and the Health & Medicine Policy Research Group, Chicago-based health justice organizations, DePaul University and the University of Illinois Chicago School of Public Health, are circulating a petition that demands IDPH make site visits to ICE detention sites across Illinois, and specifically the facility in Pulaski County, to ensure compliance with care plans and infectious disease control."
A 5-Year Retrospective Analysis of Legal Intervention Injuries and Mortality ...
A 5-Year Retrospective Analysis of Legal Intervention Injuries and Mortality ...Jim Bloyd, DrPH, MPH
There has been a public outcry for the accountability of law enforcement agents who kill and injure citizens. Epidemiological surveillance can underscore the magnitude of morbidity and mortality of citizens at the hands of law enforcement. We used hospital outpatient and inpatient databases to conduct a retrospective analysis of legal interventions in Illinois between 2010 and 2015. We calculated injury and mortality rates based on demographics, spatial distribution, and cause of injury. During the study period, 8,384 patients were treated for injuries caused during contact with law enforcement personnel. Most were male, the mean age was 32.7, and those injured were disproportionately black. Nearly all patients were treated as outpatients, and those who were admitted to the hospital had a mean of length of stay of 6 days. Most patients were discharged home or to an acute or long-term care facility (83.7%). It is unclear if those discharged home or to a different medical facility were arrested, accidentally injured, injured when no crime was committed, or injured when a crime was committed. Surveillance of law enforcement-related injuries and deaths should be implemented, and injuries caused during legal interventions should be recognized as a public health issue rather than a criminal justice issue.Life Expectancy and Mortality Rates in the United States, 1959-2017
Importance: US life expectancy has not kept pace with that of other wealthy countries and is now decreasing.
Objective: To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends.
Evidence: Life expectancy data for 1959-2016 and cause-specific mortality rates for 1999-2017 were obtained from the US Mortality Database and CDC WONDER, respectively. The analysis focused on midlife deaths (ages 25-64 years), stratified by sex, race/ethnicity, socioeconomic status, and geography (including the 50 states). Published research from January 1990 through August 2019 that examined relevant mortality trends and potential contributory factors was examined.
Findings: Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.
Conclusions and Relevance: US life expectancy increased for most of the past 60 years, but the rate of increase slowed over time and life expectancy decreased after 2014. A major contributor has been an increase in mortality from specific causes (eg, drug overdoses, suicides, organ system diseases) among young and middle-aged adults of all racial groups, with an onset as early as the 1990s and with the largest relative increases occurring in the Ohio Valley and New England. The implications for public health and the economy are substantial, making it vital to understand the underlying causes.
Revisiting the Corporate and Commercial Determinants of Health
We trace the development of the concept of the corporate determinants of health. We argue that these determinants are predicated on the un- checked power of corporations and that the means by which corporations exert power is increasingly unseen.
We identify four of the ways corporations influence health: defining the dominant narra- tive; setting the rules by which society, especially trade, oper- ates; commodifying knowledge; and undermining political, so- cial, and economic rights.
We identify how public health professionals can respond to these manifestations of power. (Am J Public Health. 2018;108: 1167–1170. doi:10.2105/AJPH. 2018.304510)
Public Health, Politics, and the Creation of Meaning: A Public Health of Cons...
Public Health, Politics, and the Creation of Meaning: A Public Health of Cons...Jim Bloyd, DrPH, MPH
"The creation of meaning may be an unfamiliar role for public health, but one whose import comes into sharp relief when we recognize the inevitability of the political at the heart of what we do."Recommended
Towards a Critical Health Equity Research Stance: Why Epistemology and Method...
Towards a Critical Health Equity Research Stance: Why Epistemology and Method...Jim Bloyd, DrPH, MPH
Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies—namely, photovoice and critical ethnography— that, pursuant to critical approaches, prioritize dismantling social–structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.Links to Recommended Readings from June 4, 2020 presentation “Work With Organ...
Links to Recommended Readings from June 4, 2020 presentation “Work With Organ...Jim Bloyd, DrPH, MPH
Links to Recommended Readings from June 4, 2020 presentation “Work With Organizers to Build People Power for Health Equity” by Jim Bloyd, MPH, Regional Health Officer, Cook County Department of Public Health (IL) jbloyd@cookcountyhhs.org Presented as part of “Covid-19 and Health Equity: A Policy Platform and Voices from Health Departments” by Human Impact Partners, co-sponsored by APHA, ASTHO, Big Cities Health Coalition, HealthBegins, and NACCHO. (Links current as of June 12, 2020 prepared by Jim)Senators call for investigation into Pulaski County jail amid COVID-19 outbreak
News article published May 30, 2020 "The senators’ letter follows the efforts of several health-justice advocates to implore the Illinois Department of Public Health to take a more active role in managing the outbreak in Pulaski County. Those individuals, which include representatives from the Collaborative for Health Equity Cook County and the Health & Medicine Policy Research Group, Chicago-based health justice organizations, DePaul University and the University of Illinois Chicago School of Public Health, are circulating a petition that demands IDPH make site visits to ICE detention sites across Illinois, and specifically the facility in Pulaski County, to ensure compliance with care plans and infectious disease control."
A 5-Year Retrospective Analysis of Legal Intervention Injuries and Mortality ...
A 5-Year Retrospective Analysis of Legal Intervention Injuries and Mortality ...Jim Bloyd, DrPH, MPH
There has been a public outcry for the accountability of law enforcement agents who kill and injure citizens. Epidemiological surveillance can underscore the magnitude of morbidity and mortality of citizens at the hands of law enforcement. We used hospital outpatient and inpatient databases to conduct a retrospective analysis of legal interventions in Illinois between 2010 and 2015. We calculated injury and mortality rates based on demographics, spatial distribution, and cause of injury. During the study period, 8,384 patients were treated for injuries caused during contact with law enforcement personnel. Most were male, the mean age was 32.7, and those injured were disproportionately black. Nearly all patients were treated as outpatients, and those who were admitted to the hospital had a mean of length of stay of 6 days. Most patients were discharged home or to an acute or long-term care facility (83.7%). It is unclear if those discharged home or to a different medical facility were arrested, accidentally injured, injured when no crime was committed, or injured when a crime was committed. Surveillance of law enforcement-related injuries and deaths should be implemented, and injuries caused during legal interventions should be recognized as a public health issue rather than a criminal justice issue.Life Expectancy and Mortality Rates in the United States, 1959-2017
Importance: US life expectancy has not kept pace with that of other wealthy countries and is now decreasing.
Objective: To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends.
Evidence: Life expectancy data for 1959-2016 and cause-specific mortality rates for 1999-2017 were obtained from the US Mortality Database and CDC WONDER, respectively. The analysis focused on midlife deaths (ages 25-64 years), stratified by sex, race/ethnicity, socioeconomic status, and geography (including the 50 states). Published research from January 1990 through August 2019 that examined relevant mortality trends and potential contributory factors was examined.
Findings: Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.
Conclusions and Relevance: US life expectancy increased for most of the past 60 years, but the rate of increase slowed over time and life expectancy decreased after 2014. A major contributor has been an increase in mortality from specific causes (eg, drug overdoses, suicides, organ system diseases) among young and middle-aged adults of all racial groups, with an onset as early as the 1990s and with the largest relative increases occurring in the Ohio Valley and New England. The implications for public health and the economy are substantial, making it vital to understand the underlying causes.
Revisiting the Corporate and Commercial Determinants of Health
We trace the development of the concept of the corporate determinants of health. We argue that these determinants are predicated on the un- checked power of corporations and that the means by which corporations exert power is increasingly unseen.
We identify four of the ways corporations influence health: defining the dominant narra- tive; setting the rules by which society, especially trade, oper- ates; commodifying knowledge; and undermining political, so- cial, and economic rights.
We identify how public health professionals can respond to these manifestations of power. (Am J Public Health. 2018;108: 1167–1170. doi:10.2105/AJPH. 2018.304510)
Public Health, Politics, and the Creation of Meaning: A Public Health of Cons...
Public Health, Politics, and the Creation of Meaning: A Public Health of Cons...Jim Bloyd, DrPH, MPH
"The creation of meaning may be an unfamiliar role for public health, but one whose import comes into sharp relief when we recognize the inevitability of the political at the heart of what we do."Cook County Department of Public Health at APHA 2019
Cook County Department of Public Health staff who are presenters, moderators, and secondary authors at the annual meeting of the American Public Health Association are pictured. Their presentations are listed by Session number. The meeting attracts over 12,000 participants and is health in Philadelphia, PA from November 2nd to November 6th, 2019. #APHA2019 @PublicHealth @APHAAnnualMtg
Linda Rae Murray Voices From The Field transcript
This transcript is useful for a small group exercise when participants are listening to Dr. Linda Rae Murry discuss her critique of the Ten Essential Services as a frame popular in the USA for describing what public health is and should do. It was used along with a worksheet to successfully generate small group discussion on September 12, 2019. Available at RootsofHealthInequity.org
Exercise Linda Murray Voices of Public Health questions worksheet Used Septem...
Exercise Linda Murray Voices of Public Health questions worksheet Used Septem...Jim Bloyd, DrPH, MPH
This was one of two 20-minute exercises used by Jim Bloyd and Rachel Rubin with a 30-minute slide presentation. The exercises generated discussion among groups of 2-3 people. The group also listened to the audio of Dr. Murray's 6-minute statement, and followed along reading a transcript of the statement. Both the audio and the transcript are available at RootsofHealthInequity.org of NACCHO.Roots of Health Inequity Dialogues: Designing Staff Development to Strengthen...
Roots of Health Inequity Dialogues: Designing Staff Development to Strengthen...Jim Bloyd, DrPH, MPH
Presentation and 3 20-minute exercises prepared for the annual conference of the Illinois Public Health Association, September 12, 2019 in Springfield, Illinois, USA. Abstract: The Cook County Department of Public Health (CCDPH) used the National Association of County and City Health Officials' online course for the public health workforce Roots of Health Inequity, to accomplish three goals: change the way staff think about public health; change the way staff practice public health; and apply health equity principles to the daily work. Chief Operating Officer Terry Mason, MD, required all staff to participate in the training.
Increasing the integration of a health equity approach by first training staff on health equity and how it is relevant to their work was a priority of the agency strategic plan, as well as a QI and Workforce Development priority for CCDPH.
Components of the CCDPH Roots of Health Inequity Dialogues include the creation of 1small groups for in-person discussion; a leadership committee; training staff as facilitators; evaluation; a commitment to dialogue. The small group-approach accomplished two things: dialogue and discussion were maximized, while disruption of regular duties and health department functions was minimized.
Reliance on staff to facilitate dialogues strengthened leadership for health equity within the health department, and eliminated the need for external facilitation. In addition, the “insider” knowledge of the Facilitators—most of whom have years of experience working at CCDPH---ensured that dialogue leaders understood the institutional culture, and increased the likelihood that the dialogues will be able to examine real barriers as well as opportunities to practice transformation. Selected References for Further Reading on Equity and Health
Books, articles, and online resources for people attending screenings of COOKED: Survival by zipcode film. vJuly21, 2019.
Chicago Panels Details COOKED documentary Film July 12-25, 2019
This is a list of the panels and panelists for the July 12-25 2019 screenings of COOKED in Chicago, Illinois at the Gene Siskel Film Center, 164 N. State St., Chicago, Illinois. USA
Wage theft is a threat to community health and well-being. Wage theft is a pu...
Wage theft is a threat to community health and well-being. Wage theft is a pu...Jim Bloyd, DrPH, MPH
Fact sheet, April 2017 by Collaborative for Health Equity Cook County, Chicago, Illinois.New approaches for moving upstream how state and local health departments can...
New approaches for moving upstream how state and local health departments can...Jim Bloyd, DrPH, MPH
Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are “upstream” drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on “downstream” behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators’ role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities.Editorial: Evidence based policy or policy based evidence? by Michael Marmot
A simple prescription would be to review the scientific evidence of what would make a difference, formulate policies, and implement them—evidence based policy making. Unfor- tunately this simple prescription, applied to real life, is simplistic. The relation between science and policy is more complicated. Scientific findings do not fall on blank minds that get made up as a result. Science engages with busy minds that have strong views about how things are and ought to be.
Can health equity survive epidemiology? Standards of proof and social determi...
Can health equity survive epidemiology? Standards of proof and social determi...Jim Bloyd, DrPH, MPH
Objective. This article examines how epidemiological evidence is and should be used in the context of increasing concern for health equity and for social determinants of health.
Method. A research literature on use of scientific evidence of “environmental risks” is outlined, and key issues compared with those that arise with respect to social determinants of health.
Results. The issue sets are very similar. Both involve the choice of a standard of proof, and the corollary need to make value judgments about how to address uncertainty in the context of “the inevitability of being wrong,” at least some of the time, and to consider evidence from multiple kinds of research design. The nature of such value judgments and the need for methodological pluralism are incompletely understood.
Conclusion. Responsible policy analysis and interpretation of scientific evidence require explicit consideration of the ethical issues involved in choosing a standard of proof. Because of the stakes involved, such choices often become contested political terrain. Comparative research on how those choices are made will be valuable.Towards a politics of health
The importance of public policy as a determinant of health is routinely acknowledged, but there remains a continuing absence of mainstream debate about the ways in which the politics, power and ideology, which underpin public policy influence people's health. This paper explores the possible reasons behind the absence of a politics of health and demonstrates how explicit acknowledgement of the political nature of health will lead to more effective health promotion strategy and policy, and to more realistic and evidence-based public health and health promotion practice
REDSACOL ALAMES ante la intromision imperial [REDSACOL ALAMES facing imperial...
REDSACOL ALAMES ante la intromision imperial [REDSACOL ALAMES facing imperial...Jim Bloyd, DrPH, MPH
Statement from the Red de Salud Colectiva of the Asociacion Latinoamericana de Medicina Social y Salud Colective (Latin American Association of Social Medicine and Collective Health) distributed February 1, 2019 on the ALAMES list serve by Oscar Feo Isturiz, physician, specialist in public health and occupational health, and retired professor at the University of Carabobo, Venezuela. He advises the Ministries of Health of El Salvador and Bolivia. He is on the Consultative Committee of ALAMES.A Chicago case example of public health professionals allying with community ...
A Chicago case example of public health professionals allying with community ...Jim Bloyd, DrPH, MPH
Inspired by the Guide to Public Health Actions for Immigrant Rights, a coalition of health workers and community allies in Chicago have been organizing to pressure the Cook County Health and Hospitals System (CCHHS) to meet six demands to Protect Immigrant Health Now! Two promotoras de salud-Community Health Workers-from Enlace Chicago provided testimony at the September 1, 2017 meeting of the CCHHS Board,
marking a milestone in this campaign. Four additional leaders of the Public Health Woke coalition will join the two promotoras on the panel. They will describe the coalition’s collection of new data, use of the Thunderclap social media tool, relationship-building, analysis of local power structures, and the ethical duties of public health professionals in the context of mass deportation. The Co-Founder and Executive Director of Arab- American Family Services will describe her experience as an ally, and the importance of centering immigrant voices in the fight for sanctuary health care for immigrants and all marginalized people; The role of Cook County Commissioner Jesús ‘Chuy’ García’s 7th District Health Task Force will be
described; A Past-President of APHA (faculty at UIC School of Public Health and National Collaborative for Health Equity Board Member) will discuss the historical commitment of Cook County, Illinois, to provide health care to all people; and a leader with the Collaborative for Health Equity Cook County will moderate and guide one participatory activity. This session will emphasize audience participation & dialogue.
More info go to CHECookCounty.org Follow @CHECookCountySign On Public Letter-Minimum Wage Cook County, IL October 2018
CHE Cook County served as the public health organization which distributed a sign on letter on its letterhead in October 2018 calling on municipal governments in Cook County, Illinois, to abide by the County ordinance raising the minimum wage. Many home-rule municipalities have chosen to opt out of the ordinance. Community organizers from Centro de Trabajadores Unidos and Arise also worked on this campaign. The Chicago Sun Times published the letter as an op-ed on November 19, 2018, signed by Dr.s Linda Rae Murray and David A. Ansell.
Police-Related Deaths and Neighborhood Economic and Racial/Ethnic Polarizatio...
Police-Related Deaths and Neighborhood Economic and Racial/Ethnic Polarizatio...Jim Bloyd, DrPH, MPH
Objectives.
To estimate the association between rates of police-related deaths and neighborhood residential segregation (by income, race/ethnicity, or both combined) in the United States.
Methods. We identified police-related deaths that occurred in the United States (2015 –2016) using a data set from the Guardian newspaper. We used census data to estimate expected police-related death counts for all US census tracts and to calculate the Index of Concentration at the Extremes as a segregation measure. We used mul-tilevel negative binomial models for the analyses.
Results. Overall, police-related death rates were highest in neighborhoods with the
greatest concentrations of low-income residents (vs high-income residents) and resi-
dents of color (vs non-Hispanic White residents). For non-Hispanic Blacks, however, the risk was greater in the quintile of neighborhoods with the highest concentration of non-Hispanic White residents than in certain neighborhoods with relatively higher concentrations of residents of color (the third and fourth quintiles).
Conclusions. Neighborhood context matters—beyond individual race/ethnicity—for understanding, preventing, and responding to the occurrence of police-related deaths. Public Health Implications.
Efforts to monitor, prevent, and respond to police-related deaths should consider neighborhood context, including levels of segregation byincome and race/ethnicity. (Am J Public Health. Published online ahead of print January 24, 2019: e1–e7. doi:10.2105/AJPH.2018.304851)
People power and the fight for health equity
How do we build power for the policies needed to achieve health equity, and to dismantle structural racism and other root causes of health inequities? Who are allies in this struggle for social justice? Who is the opposition and what do they gain from the status quo? Using #OneFairWage and Protect Immigrant Health Now! as examples, answers to these questions will be proposed by a leader of the Collaborative for Health Equity Cook County (www.CHECookCounty.org), part of the National Collaborative for Health Equity. A group dialogue will follow.
Monthly talk of the Center for Community Health Equity. Featuring James Bloyd, MPH (Cook County Department of Public Health) Tuesday, January 22 at 12:00pm to 1:00pm
Rush University Medical Center, Cohen Building - Field Auditorium, 1st floor 1735 W. Harrison, Chicago, Illinois
Presentation on January 22, 2019 to the Center for Community Health Equity at the Rush University Medical Center by James E. Bloyd, MPH, of the Collaborative for Health Equity Cook County, and the Cook County Department of Public Health. Topics included evidence of inequitable distribution of health and well-being; theoretical explanations of health inequity from Hawai'i State Department of Public Health and the World Health Organization; the Collaborative for Health Equity Cook County's (www.checookcounty.org) work on the minimum wage and Protect Immigrant Health Now!;
Role of US Health Care in causing poverty and health inequities among health care sector workers through a racist and sexist wage structure (Himmelstein & Venkataramani 2018). Includes references.
Examining the Impact of Structural Racism on Food Insecurity: Implications fo...
Examining the Impact of Structural Racism on Food Insecurity: Implications fo...Jim Bloyd, DrPH, MPH
Food insecurity is defined as "a household-level economic and social condition of limited or uncertain access to adequate food." While, levels of food insecurity in the United States have fluctuated over the past 20 years; disparities in food insecurity rates between people of color and whites have continued to persist. There is growing recognition that discrimination and structural racism are key contributors to disparities in health behaviors and outcomes. Although several promising practices to reduce food insecurity have emerged, approaches that address structural racism and discrimination may have important implications for alleviating racial/ethnic disparities in food insecurity and promoting health equity overall. Authors: Angela Odoms-Young, M. A. BruceCollaborating for Equity and Justice: Moving Beyond Collective Impact
By ARTHUR T. HIMMELMAN, BILL BERKOWITZ, BRIAN D. CHRISTENS, FRANCES DUNN BUTTERFOSS, KIEN S. LEE, LINDA BOWEN, MEREDITH MINKLER, SUSAN M. WOLFE, TOM WOLFF AND VINCENT T. FRANCISCO | January 9, 2017 Non-Profit Quarterly
The United States has historically struggled with how to treat all its citizens equitably and fairly while wealth and power are concentrated in a very small segment of our society. Now, in the face of growing public awareness and outcry about the centuries-long injustices experienced by African Americans, Native Americans, new immigrants, and other marginalized groups, we believe that our nation urgently needs collaborative multisector approaches toward equity and justice. For maximum effectiveness, these approaches must include and prioritize leadership by those most affected by injustice and inequity in order to effect structural and systemic changes that can support and sustain inclusive and healthy communities. Traditional community organizing and working for policy change will supplement the collaborative approach. We believe that efforts that do not start with treating community leaders and residents as equal partners cannot later be reengineered to meaningfully share power. In short, coalitions and collaborations need a new way of engaging with communities that leads to transformative changes in power, equity, and justice.
Affirmatively Furthering Fair Housing: A platform for health equity advocates
Panel presentation May 12, 2017 by Jim Bloyd, MPH, Regional Health Officer, Cook County Department of Public Health at the Chicago Metropolitan Fair Housing Convening: Advancing Regional Prosperity, taking place at the Federal Reserve Bank of Chicago, 230 South LaSalle Street, Chicago, Illinois, 60604.
Living and dying at the crossroads: racism, embodiment, and why theory is ess...
Living and dying at the crossroads: racism, embodiment, and why theory is ess...Jim Bloyd, DrPH, MPH
Theory is essential to understanding evidence, and fulfilling the responsibility of public health to confront health inequities.Couples presenting to the infertility clinic- Do they really have infertility...
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
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.
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Cook County Department of Public Health at APHA 2019
Cook County Department of Public Health staff who are presenters, moderators, and secondary authors at the annual meeting of the American Public Health Association are pictured. Their presentations are listed by Session number. The meeting attracts over 12,000 participants and is health in Philadelphia, PA from November 2nd to November 6th, 2019. #APHA2019 @PublicHealth @APHAAnnualMtg
Linda Rae Murray Voices From The Field transcript
This transcript is useful for a small group exercise when participants are listening to Dr. Linda Rae Murry discuss her critique of the Ten Essential Services as a frame popular in the USA for describing what public health is and should do. It was used along with a worksheet to successfully generate small group discussion on September 12, 2019. Available at RootsofHealthInequity.org
Exercise Linda Murray Voices of Public Health questions worksheet Used Septem...
Exercise Linda Murray Voices of Public Health questions worksheet Used Septem...Jim Bloyd, DrPH, MPH
This was one of two 20-minute exercises used by Jim Bloyd and Rachel Rubin with a 30-minute slide presentation. The exercises generated discussion among groups of 2-3 people. The group also listened to the audio of Dr. Murray's 6-minute statement, and followed along reading a transcript of the statement. Both the audio and the transcript are available at RootsofHealthInequity.org of NACCHO.Roots of Health Inequity Dialogues: Designing Staff Development to Strengthen...
Roots of Health Inequity Dialogues: Designing Staff Development to Strengthen...Jim Bloyd, DrPH, MPH
Presentation and 3 20-minute exercises prepared for the annual conference of the Illinois Public Health Association, September 12, 2019 in Springfield, Illinois, USA. Abstract: The Cook County Department of Public Health (CCDPH) used the National Association of County and City Health Officials' online course for the public health workforce Roots of Health Inequity, to accomplish three goals: change the way staff think about public health; change the way staff practice public health; and apply health equity principles to the daily work. Chief Operating Officer Terry Mason, MD, required all staff to participate in the training.
Increasing the integration of a health equity approach by first training staff on health equity and how it is relevant to their work was a priority of the agency strategic plan, as well as a QI and Workforce Development priority for CCDPH.
Components of the CCDPH Roots of Health Inequity Dialogues include the creation of 1small groups for in-person discussion; a leadership committee; training staff as facilitators; evaluation; a commitment to dialogue. The small group-approach accomplished two things: dialogue and discussion were maximized, while disruption of regular duties and health department functions was minimized.
Reliance on staff to facilitate dialogues strengthened leadership for health equity within the health department, and eliminated the need for external facilitation. In addition, the “insider” knowledge of the Facilitators—most of whom have years of experience working at CCDPH---ensured that dialogue leaders understood the institutional culture, and increased the likelihood that the dialogues will be able to examine real barriers as well as opportunities to practice transformation. Selected References for Further Reading on Equity and Health
Books, articles, and online resources for people attending screenings of COOKED: Survival by zipcode film. vJuly21, 2019.
Chicago Panels Details COOKED documentary Film July 12-25, 2019
This is a list of the panels and panelists for the July 12-25 2019 screenings of COOKED in Chicago, Illinois at the Gene Siskel Film Center, 164 N. State St., Chicago, Illinois. USA
Wage theft is a threat to community health and well-being. Wage theft is a pu...
Wage theft is a threat to community health and well-being. Wage theft is a pu...Jim Bloyd, DrPH, MPH
Fact sheet, April 2017 by Collaborative for Health Equity Cook County, Chicago, Illinois.New approaches for moving upstream how state and local health departments can...
New approaches for moving upstream how state and local health departments can...Jim Bloyd, DrPH, MPH
Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are “upstream” drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on “downstream” behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators’ role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities.Editorial: Evidence based policy or policy based evidence? by Michael Marmot
A simple prescription would be to review the scientific evidence of what would make a difference, formulate policies, and implement them—evidence based policy making. Unfor- tunately this simple prescription, applied to real life, is simplistic. The relation between science and policy is more complicated. Scientific findings do not fall on blank minds that get made up as a result. Science engages with busy minds that have strong views about how things are and ought to be.
Can health equity survive epidemiology? Standards of proof and social determi...
Can health equity survive epidemiology? Standards of proof and social determi...Jim Bloyd, DrPH, MPH
Objective. This article examines how epidemiological evidence is and should be used in the context of increasing concern for health equity and for social determinants of health.
Method. A research literature on use of scientific evidence of “environmental risks” is outlined, and key issues compared with those that arise with respect to social determinants of health.
Results. The issue sets are very similar. Both involve the choice of a standard of proof, and the corollary need to make value judgments about how to address uncertainty in the context of “the inevitability of being wrong,” at least some of the time, and to consider evidence from multiple kinds of research design. The nature of such value judgments and the need for methodological pluralism are incompletely understood.
Conclusion. Responsible policy analysis and interpretation of scientific evidence require explicit consideration of the ethical issues involved in choosing a standard of proof. Because of the stakes involved, such choices often become contested political terrain. Comparative research on how those choices are made will be valuable.Towards a politics of health
The importance of public policy as a determinant of health is routinely acknowledged, but there remains a continuing absence of mainstream debate about the ways in which the politics, power and ideology, which underpin public policy influence people's health. This paper explores the possible reasons behind the absence of a politics of health and demonstrates how explicit acknowledgement of the political nature of health will lead to more effective health promotion strategy and policy, and to more realistic and evidence-based public health and health promotion practice
REDSACOL ALAMES ante la intromision imperial [REDSACOL ALAMES facing imperial...
REDSACOL ALAMES ante la intromision imperial [REDSACOL ALAMES facing imperial...Jim Bloyd, DrPH, MPH
Statement from the Red de Salud Colectiva of the Asociacion Latinoamericana de Medicina Social y Salud Colective (Latin American Association of Social Medicine and Collective Health) distributed February 1, 2019 on the ALAMES list serve by Oscar Feo Isturiz, physician, specialist in public health and occupational health, and retired professor at the University of Carabobo, Venezuela. He advises the Ministries of Health of El Salvador and Bolivia. He is on the Consultative Committee of ALAMES.A Chicago case example of public health professionals allying with community ...
A Chicago case example of public health professionals allying with community ...Jim Bloyd, DrPH, MPH
Inspired by the Guide to Public Health Actions for Immigrant Rights, a coalition of health workers and community allies in Chicago have been organizing to pressure the Cook County Health and Hospitals System (CCHHS) to meet six demands to Protect Immigrant Health Now! Two promotoras de salud-Community Health Workers-from Enlace Chicago provided testimony at the September 1, 2017 meeting of the CCHHS Board,
marking a milestone in this campaign. Four additional leaders of the Public Health Woke coalition will join the two promotoras on the panel. They will describe the coalition’s collection of new data, use of the Thunderclap social media tool, relationship-building, analysis of local power structures, and the ethical duties of public health professionals in the context of mass deportation. The Co-Founder and Executive Director of Arab- American Family Services will describe her experience as an ally, and the importance of centering immigrant voices in the fight for sanctuary health care for immigrants and all marginalized people; The role of Cook County Commissioner Jesús ‘Chuy’ García’s 7th District Health Task Force will be
described; A Past-President of APHA (faculty at UIC School of Public Health and National Collaborative for Health Equity Board Member) will discuss the historical commitment of Cook County, Illinois, to provide health care to all people; and a leader with the Collaborative for Health Equity Cook County will moderate and guide one participatory activity. This session will emphasize audience participation & dialogue.
More info go to CHECookCounty.org Follow @CHECookCountySign On Public Letter-Minimum Wage Cook County, IL October 2018
CHE Cook County served as the public health organization which distributed a sign on letter on its letterhead in October 2018 calling on municipal governments in Cook County, Illinois, to abide by the County ordinance raising the minimum wage. Many home-rule municipalities have chosen to opt out of the ordinance. Community organizers from Centro de Trabajadores Unidos and Arise also worked on this campaign. The Chicago Sun Times published the letter as an op-ed on November 19, 2018, signed by Dr.s Linda Rae Murray and David A. Ansell.
Police-Related Deaths and Neighborhood Economic and Racial/Ethnic Polarizatio...
Police-Related Deaths and Neighborhood Economic and Racial/Ethnic Polarizatio...Jim Bloyd, DrPH, MPH
Objectives.
To estimate the association between rates of police-related deaths and neighborhood residential segregation (by income, race/ethnicity, or both combined) in the United States.
Methods. We identified police-related deaths that occurred in the United States (2015 –2016) using a data set from the Guardian newspaper. We used census data to estimate expected police-related death counts for all US census tracts and to calculate the Index of Concentration at the Extremes as a segregation measure. We used mul-tilevel negative binomial models for the analyses.
Results. Overall, police-related death rates were highest in neighborhoods with the
greatest concentrations of low-income residents (vs high-income residents) and resi-
dents of color (vs non-Hispanic White residents). For non-Hispanic Blacks, however, the risk was greater in the quintile of neighborhoods with the highest concentration of non-Hispanic White residents than in certain neighborhoods with relatively higher concentrations of residents of color (the third and fourth quintiles).
Conclusions. Neighborhood context matters—beyond individual race/ethnicity—for understanding, preventing, and responding to the occurrence of police-related deaths. Public Health Implications.
Efforts to monitor, prevent, and respond to police-related deaths should consider neighborhood context, including levels of segregation byincome and race/ethnicity. (Am J Public Health. Published online ahead of print January 24, 2019: e1–e7. doi:10.2105/AJPH.2018.304851)
People power and the fight for health equity
How do we build power for the policies needed to achieve health equity, and to dismantle structural racism and other root causes of health inequities? Who are allies in this struggle for social justice? Who is the opposition and what do they gain from the status quo? Using #OneFairWage and Protect Immigrant Health Now! as examples, answers to these questions will be proposed by a leader of the Collaborative for Health Equity Cook County (www.CHECookCounty.org), part of the National Collaborative for Health Equity. A group dialogue will follow.
Monthly talk of the Center for Community Health Equity. Featuring James Bloyd, MPH (Cook County Department of Public Health) Tuesday, January 22 at 12:00pm to 1:00pm
Rush University Medical Center, Cohen Building - Field Auditorium, 1st floor 1735 W. Harrison, Chicago, Illinois
Presentation on January 22, 2019 to the Center for Community Health Equity at the Rush University Medical Center by James E. Bloyd, MPH, of the Collaborative for Health Equity Cook County, and the Cook County Department of Public Health. Topics included evidence of inequitable distribution of health and well-being; theoretical explanations of health inequity from Hawai'i State Department of Public Health and the World Health Organization; the Collaborative for Health Equity Cook County's (www.checookcounty.org) work on the minimum wage and Protect Immigrant Health Now!;
Role of US Health Care in causing poverty and health inequities among health care sector workers through a racist and sexist wage structure (Himmelstein & Venkataramani 2018). Includes references.
Examining the Impact of Structural Racism on Food Insecurity: Implications fo...
Examining the Impact of Structural Racism on Food Insecurity: Implications fo...Jim Bloyd, DrPH, MPH
Food insecurity is defined as "a household-level economic and social condition of limited or uncertain access to adequate food." While, levels of food insecurity in the United States have fluctuated over the past 20 years; disparities in food insecurity rates between people of color and whites have continued to persist. There is growing recognition that discrimination and structural racism are key contributors to disparities in health behaviors and outcomes. Although several promising practices to reduce food insecurity have emerged, approaches that address structural racism and discrimination may have important implications for alleviating racial/ethnic disparities in food insecurity and promoting health equity overall. Authors: Angela Odoms-Young, M. A. BruceCollaborating for Equity and Justice: Moving Beyond Collective Impact
By ARTHUR T. HIMMELMAN, BILL BERKOWITZ, BRIAN D. CHRISTENS, FRANCES DUNN BUTTERFOSS, KIEN S. LEE, LINDA BOWEN, MEREDITH MINKLER, SUSAN M. WOLFE, TOM WOLFF AND VINCENT T. FRANCISCO | January 9, 2017 Non-Profit Quarterly
The United States has historically struggled with how to treat all its citizens equitably and fairly while wealth and power are concentrated in a very small segment of our society. Now, in the face of growing public awareness and outcry about the centuries-long injustices experienced by African Americans, Native Americans, new immigrants, and other marginalized groups, we believe that our nation urgently needs collaborative multisector approaches toward equity and justice. For maximum effectiveness, these approaches must include and prioritize leadership by those most affected by injustice and inequity in order to effect structural and systemic changes that can support and sustain inclusive and healthy communities. Traditional community organizing and working for policy change will supplement the collaborative approach. We believe that efforts that do not start with treating community leaders and residents as equal partners cannot later be reengineered to meaningfully share power. In short, coalitions and collaborations need a new way of engaging with communities that leads to transformative changes in power, equity, and justice.
Affirmatively Furthering Fair Housing: A platform for health equity advocates
Panel presentation May 12, 2017 by Jim Bloyd, MPH, Regional Health Officer, Cook County Department of Public Health at the Chicago Metropolitan Fair Housing Convening: Advancing Regional Prosperity, taking place at the Federal Reserve Bank of Chicago, 230 South LaSalle Street, Chicago, Illinois, 60604.
Living and dying at the crossroads: racism, embodiment, and why theory is ess...
Living and dying at the crossroads: racism, embodiment, and why theory is ess...Jim Bloyd, DrPH, MPH
Theory is essential to understanding evidence, and fulfilling the responsibility of public health to confront health inequities.More from Jim Bloyd, DrPH, MPH (20)
Cook County Department of Public Health at APHA 2019
Cook County Department of Public Health at APHA 2019
Exercise Linda Murray Voices of Public Health questions worksheet Used Septem...
Exercise Linda Murray Voices of Public Health questions worksheet Used Septem...
Roots of Health Inequity Dialogues: Designing Staff Development to Strengthen...
Roots of Health Inequity Dialogues: Designing Staff Development to Strengthen...
Selected References for Further Reading on Equity and Health
Selected References for Further Reading on Equity and Health
Chicago Panels Details COOKED documentary Film July 12-25, 2019
Chicago Panels Details COOKED documentary Film July 12-25, 2019
Wage theft is a threat to community health and well-being. Wage theft is a pu...
Wage theft is a threat to community health and well-being. Wage theft is a pu...
New approaches for moving upstream how state and local health departments can...
New approaches for moving upstream how state and local health departments can...
Editorial: Evidence based policy or policy based evidence? by Michael Marmot
Editorial: Evidence based policy or policy based evidence? by Michael Marmot
Can health equity survive epidemiology? Standards of proof and social determi...
Can health equity survive epidemiology? Standards of proof and social determi...
REDSACOL ALAMES ante la intromision imperial [REDSACOL ALAMES facing imperial...
REDSACOL ALAMES ante la intromision imperial [REDSACOL ALAMES facing imperial...
A Chicago case example of public health professionals allying with community ...
A Chicago case example of public health professionals allying with community ...
Sign On Public Letter-Minimum Wage Cook County, IL October 2018
Sign On Public Letter-Minimum Wage Cook County, IL October 2018
Police-Related Deaths and Neighborhood Economic and Racial/Ethnic Polarizatio...
Police-Related Deaths and Neighborhood Economic and Racial/Ethnic Polarizatio...
Examining the Impact of Structural Racism on Food Insecurity: Implications fo...
Examining the Impact of Structural Racism on Food Insecurity: Implications fo...
Collaborating for Equity and Justice: Moving Beyond Collective Impact
Collaborating for Equity and Justice: Moving Beyond Collective Impact
Affirmatively Furthering Fair Housing: A platform for health equity advocates
Affirmatively Furthering Fair Housing: A platform for health equity advocates
Living and dying at the crossroads: racism, embodiment, and why theory is ess...
Living and dying at the crossroads: racism, embodiment, and why theory is ess...
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Prix Galien International 2024 Forum Program
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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Physiology of Special Chemical Sensation of Taste
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
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BENIGN PROSTATIC HYPERPLASIA.BPH. BPHpdf
The prostate is an exocrine gland of the male mammalian reproductive system
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RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
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Physiology of Chemical Sensation of smell.pdf
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
The Normal Electrocardiogram - Part I of II
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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