Greg was diagnosed with bladder cancer after ignoring symptoms like blood in his urine. He shares his story to advocate for men's health and early detection. Statistics show bladder cancer is more common and deadly for men. There are three main types of bladder cancer and Greg believes he had transitional cell carcinoma. Men often get health information from the internet but may have trouble wading through large amounts of information. Resources need to target men of different generations. Greg hopes sharing his experience will help nurses support men's health.
Simulating Real World Pedestrian Accidents : PhD DefenceDr Mark Howard
The construction and evaluation of pedestrian accident simulations with a reference C class vehicle are described in detail. The influence of accident conditions and the expected ranges of various quantitative pedestrian injury and motion measures are identified. Vehicle impact velocity, pedestrian size and stance have significant influences on these measures. Therefore it is not possible to state, for instance, that under all accident conditions, one vehicle impact location is likely to cause lower injury measures than another is. There is a clear increase in pedestrian measures (e.g. head velocity, HIC, tibia acceleration, knee bending) with a large increase in impact velocity (i.e. 25 to 40 km/h). However, some measures (e.g. HIC) do not necessarily increase with a small increase in impact velocity (e.g. 25 to 30 km/h) because of the new pedestrian motion (e.g. a new head impact location). Large differences exist between the 6 year old pedestrian and adult pedestrian model measures (e.g. larger post head impact motion but smaller HIC and tibia acceleration) and pedestrian stance has a complex influence on all measures with few overall trends.
Pedestrian protection headlamp, bumper system and hood system concepts are developed in biomechanical, analytical and numerical component models. These concepts are used to construct and subsequently benchmark, with pedestrian accident simulations, two modified vehicle models that incorporate different combinations of the technologies. Both the absolute measures and ranges of the measures from the reference vehicle simulations are compared. There are large differences between the pedestrian measures from the reference and modified vehicles but much smaller differences between the modified vehicles. Impacts with the modified vehicles cause the largest differences in pedestrian motion at 40 km/h, for the 6 year old pedestrian, in stance ‘A’, in the early (up to 20 ms) and late (after 140 ms) stages of the accident simulations. Although the modified vehicles reduce pedestrian injury measures for some of the accident conditions, neither of them reduce all measures for all of the conditions. However, significant improvements in experimental sub system measures [EEVC 1998] are achieved with a prototype modified vehicle that incorporates some of the technologies.
This document provides an economic update for the 7 Rivers region. It includes data on consumer sentiment, home prices, housing market indicators like average sale prices and days on market, foreclosure rates, building permits, employment levels and declines, unemployment rates and durations, state and regional employment changes by industry, sales tax revenue, and income inequality nationally and locally. The data show the impacts of recessions in 2001, 2007-2009, and trends over time. Overall it analyzes key economic indicators to assess the current state of the regional and local economies.
The document discusses the Bass diffusion model for modeling the adoption of new products or innovations over time. It shows how the innovation and imitation rates can affect the shape of adoption curves. Sample categories are given with their average innovation and imitation rates. Graphs show the number of new customers and cumulative customers over time for different combinations of rates.
This document summarizes the management of urinary bladder cancer. It discusses staging, histopathologic types, and treatment options for non-muscle invasive and muscle invasive bladder cancer as well as metastatic disease. Standard first-line chemotherapy for metastatic bladder cancer includes gemcitabine and cisplatin or MVAC. Newer chemotherapy regimens and agents are also discussed.
Brent James, M.D., M. Stat. Executive Director, Institute for Health Care Delivery Research Intermountain Healthcare Keynote Presentation. Six clinical areas studied over 2 years:
- transurethral prostatectomy (TURP)
- open cholecystectomy
- total hip arthroplasty
- coronary artery bypass graft surgery (CABG)
- permanent pacemaker implantation
- community-acquired pneumonia
pulled all patients treated over a defined time period
across all Intermountain inpatient facilities - typically 1 year
identified and staged (relative to changes in expected utilization)
- severity of presenting primary condition
- all comorbidities on admission
- every complication
- measures of long term outcomes
compared physicians with meaningful # of cases
(low volume physicians included in parallel analysis, as a group)
The document discusses Australia's health system and reforms. It shows that Australia ranks high for health expenditure per capita compared to other OECD countries, both publicly and privately. Major causes of disease burden are projected to increase, such as cancer and cardiovascular disease. Reforms include establishing Medicare Locals to better coordinate primary care, developing e-health records, and releasing clinical guidelines to improve practices for conditions with high disease burden.
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, for the Australiasian college for Emergency Medicine 27th Annual Scientific Meeting - Canberra
Colorectal cancer is a major public health problem. Screening can detect cancers early and reduce mortality, but many people are not being screened. Improving screening rates through physician recommendations and developing new screening technologies may help reduce the burden of this disease.
Simulating Real World Pedestrian Accidents : PhD DefenceDr Mark Howard
The construction and evaluation of pedestrian accident simulations with a reference C class vehicle are described in detail. The influence of accident conditions and the expected ranges of various quantitative pedestrian injury and motion measures are identified. Vehicle impact velocity, pedestrian size and stance have significant influences on these measures. Therefore it is not possible to state, for instance, that under all accident conditions, one vehicle impact location is likely to cause lower injury measures than another is. There is a clear increase in pedestrian measures (e.g. head velocity, HIC, tibia acceleration, knee bending) with a large increase in impact velocity (i.e. 25 to 40 km/h). However, some measures (e.g. HIC) do not necessarily increase with a small increase in impact velocity (e.g. 25 to 30 km/h) because of the new pedestrian motion (e.g. a new head impact location). Large differences exist between the 6 year old pedestrian and adult pedestrian model measures (e.g. larger post head impact motion but smaller HIC and tibia acceleration) and pedestrian stance has a complex influence on all measures with few overall trends.
Pedestrian protection headlamp, bumper system and hood system concepts are developed in biomechanical, analytical and numerical component models. These concepts are used to construct and subsequently benchmark, with pedestrian accident simulations, two modified vehicle models that incorporate different combinations of the technologies. Both the absolute measures and ranges of the measures from the reference vehicle simulations are compared. There are large differences between the pedestrian measures from the reference and modified vehicles but much smaller differences between the modified vehicles. Impacts with the modified vehicles cause the largest differences in pedestrian motion at 40 km/h, for the 6 year old pedestrian, in stance ‘A’, in the early (up to 20 ms) and late (after 140 ms) stages of the accident simulations. Although the modified vehicles reduce pedestrian injury measures for some of the accident conditions, neither of them reduce all measures for all of the conditions. However, significant improvements in experimental sub system measures [EEVC 1998] are achieved with a prototype modified vehicle that incorporates some of the technologies.
This document provides an economic update for the 7 Rivers region. It includes data on consumer sentiment, home prices, housing market indicators like average sale prices and days on market, foreclosure rates, building permits, employment levels and declines, unemployment rates and durations, state and regional employment changes by industry, sales tax revenue, and income inequality nationally and locally. The data show the impacts of recessions in 2001, 2007-2009, and trends over time. Overall it analyzes key economic indicators to assess the current state of the regional and local economies.
The document discusses the Bass diffusion model for modeling the adoption of new products or innovations over time. It shows how the innovation and imitation rates can affect the shape of adoption curves. Sample categories are given with their average innovation and imitation rates. Graphs show the number of new customers and cumulative customers over time for different combinations of rates.
This document summarizes the management of urinary bladder cancer. It discusses staging, histopathologic types, and treatment options for non-muscle invasive and muscle invasive bladder cancer as well as metastatic disease. Standard first-line chemotherapy for metastatic bladder cancer includes gemcitabine and cisplatin or MVAC. Newer chemotherapy regimens and agents are also discussed.
Brent James, M.D., M. Stat. Executive Director, Institute for Health Care Delivery Research Intermountain Healthcare Keynote Presentation. Six clinical areas studied over 2 years:
- transurethral prostatectomy (TURP)
- open cholecystectomy
- total hip arthroplasty
- coronary artery bypass graft surgery (CABG)
- permanent pacemaker implantation
- community-acquired pneumonia
pulled all patients treated over a defined time period
across all Intermountain inpatient facilities - typically 1 year
identified and staged (relative to changes in expected utilization)
- severity of presenting primary condition
- all comorbidities on admission
- every complication
- measures of long term outcomes
compared physicians with meaningful # of cases
(low volume physicians included in parallel analysis, as a group)
The document discusses Australia's health system and reforms. It shows that Australia ranks high for health expenditure per capita compared to other OECD countries, both publicly and privately. Major causes of disease burden are projected to increase, such as cancer and cardiovascular disease. Reforms include establishing Medicare Locals to better coordinate primary care, developing e-health records, and releasing clinical guidelines to improve practices for conditions with high disease burden.
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, for the Australiasian college for Emergency Medicine 27th Annual Scientific Meeting - Canberra
Colorectal cancer is a major public health problem. Screening can detect cancers early and reduce mortality, but many people are not being screened. Improving screening rates through physician recommendations and developing new screening technologies may help reduce the burden of this disease.
This document discusses the downsides of micromanaging, including higher employee turnover, reduced creativity and motivation, and increased burnout for both employees and managers. Micromanaging wastes time, annoys employees, and damages trust, while also making it difficult for managers to see the big picture and scale effectively. Overall, micromanaging leads to unhealthy anxiety and resentment in the workplace.
This document provides an overview of a presentation on lateral kindness given by Greg Riehl. It begins with a land acknowledgment recognizing the traditional Indigenous lands. It then discusses the presenter's conflict of interest statement and learning objectives, which are to describe lateral kindness, explore unconditional positive regard, bullying and the role of victim, and share experiences supporting the Platinum Rule of treating others as they want to be treated. The presentation then discusses stories from the presenter's nursing career working with different communities and situations.
Spring Semester Research for Evidence-Based Nursing Practice (PSYN-300-001)griehl
This document provides an overview of considerations for conducting respectful research with Indigenous communities. It emphasizes the importance of the four R's - Respect, Relevance, Reciprocity and Responsibility. Researchers should work collaboratively with Elders, knowledge keepers and community members. Principles like Ownership, Control, Access and Possession (OCAP) are important to discuss before beginning research. Storytelling approaches and two-eyed seeing can help bring both Western and Indigenous ways of knowing together. Cultural competence, awareness of privilege, and being willing to feel uncomfortable are also discussed as part of being an ally in research.
Assessing equity and diversity within the canadian healthcare systemgriehl
This presentation discussed assessing equity and diversity within the Canadian healthcare system. It covered topics such as acknowledging traditional Indigenous lands, learning objectives around inclusion and diversity, exploring concepts like tone policing and the differences between gender and sex. Examples of creating safe spaces through Indigenous art and awareness months were provided. The presentation also discussed concepts like cultural safety, the importance of asking patients "What matters to you?" and recognizing one's own privilege as an ally working with Indigenous communities.
Privileged perspectives working with vulnerable marginalized populations in ...griehl
Learn about personal experiences working with marginalized/vulnerable people, who are those people? And what have they taught me?
Memorable experiences lead me to embrace the Platinum Rule
I will describe the bronze silver gold platinum rules
What do nurse leaders need to know working with Indigenous communitiesgriehl
This document provides information for nurse leaders working with Indigenous communities. It discusses the importance of recognizing different worldviews and Indigenous leadership structures. It also outlines principles for being an effective ally, including recognizing one's own privilege, focusing on action over identity, and allowing Indigenous communities to decide who is an ally. The document emphasizes collaboration, communication, respect, and being community-guided in one's work.
Guide to acknowledging Indigenous Peoples, Land, and Traditional Territorygriehl
The goal of this speaker series is to encourage all faculty and staff to acknowledge, where appropriate, the Indigenous peoples, on whose land, and traditional territory we live, learn, and work. Acknowledgment by itself before a meeting, printed in an email or a course outline, is a small gesture, but it becomes more powerful and meaningful when coupled with personal statements, authentic local knowledge and relationships and informed action
topics of discussion:
Research ethical considerations
Sex vs Gender
Indigenous World view and ways of knowing
Sharing/talking circle
Land based teachings
Two eyed seeing
Strength based vs deficit based
Research Ethics Boards
The document summarizes Sexual and Reproductive Health Awareness Week from February 11-15, 2019. It discusses promoting positive approaches to sexual relationships and maintaining sexual health throughout life. It notes sexually transmitted infections are a public health concern in Canada, with increasing rates of chlamydia, gonorrhea and syphilis among youth and older adults. The document encourages Canadians to reflect on how sexual health impacts overall well-being and stresses the importance of sexual health education.
FNIM cultures in Saskatchewan Practical Nursing November 28 2019griehl
This document provides an overview of a presentation on First Nations, Inuit and Métis (FNIM) cultures in Saskatchewan. The presentation discusses key concepts like the medicine wheel, cultural competence, reflective practice and land acknowledgments. It encourages learning about residential schools and their impact, as well as Treaty rights and Indigenous health services. Storytelling is used to illustrate concepts. The goal is to help attendees broaden their understanding of applying the Platinum Rule of treating others how they want to be treated when working with diverse clients.
Moving from lateral violence to lateral kindness regional nursing workshopgriehl
This document provides information about moving from lateral violence to lateral kindness in nursing. It discusses how stories from working in health care can illustrate different perspectives and challenges. Types of bullying behaviors are outlined, including social, verbal, physical, and cyber bullying. Common forms of lateral violence among nurses are listed as non-verbal innuendo, verbal affronts, undermining activities, and more. The document emphasizes developing respectful relationships and addressing the root causes of hurt and anger to prevent lateral violence.
This document summarizes a class on diversity in healthcare. The objectives are for students to gain awareness of cultural awareness, cultural safety, and cultural competency in healthcare as well as gender in healthcare. Key topics discussed include cultural awareness, sensitivity, knowledge, competence, humility, and safety. The importance of understanding one's own culture and biases is emphasized. Definitions of family, sex, and gender are also provided.
Social justice affects people's lives and health in major ways. It determines people's chances of illness and premature death. There are large disparities in life expectancy and health between those who live in parts of the world where social justice is lacking and those who live in areas with greater social justice. Ensuring social justice for all is critical to improving people's health and extending their lifespans.
Global Perspectives working with Marginalized/Vulnerable Populations in a glo...griehl
This document provides an outline for a presentation by Greg Riehl on working with marginalized populations in a global context. The learning outcomes include understanding Riehl's experience working with these groups, who he enjoys working with and what they have taught him, and memorable experiences that led him to embrace the Platinum Rule of treating others how they want to be treated. The presentation will describe the bronze, silver, gold, and platinum rules and hopes attendees can see patients and clients through a new lens.
In the eyes of our patients and families we are often the heroes of healthcare. But in our own eyes, or the eyes of our peers, we are often ‘just a nurse’. I have been a part of the nursing family for 3 decades and have had the privilege and honour to be with people on all aspects of their journeys through life and death. The challenges of being a nurse are only outweighed by the rewards of the profession and is why I remain dedicated to the next generation of nurses.
Sexual and Reproductive Health Awareness Week from February 11-15, 2019 aims to raise awareness about the importance of sexual health for Canadians. Sexual health involves having positive and respectful relationships free from stigma, coercion or violence. Maintaining good communication and sexual health also means preventing sexually transmitted infections through condom use or testing. However, rates of infections like chlamydia, gonorrhea, and syphilis are rising in Canada, especially among youth and older adults. Untreated infections can lead to long-term health issues. The government is working to address sexually transmitted infections by improving access to testing, treatment, support, and reducing stigma.
Moving from lateral violence to lateral kindness practical nursing feb 15 2019griehl
This document discusses lateral violence and bullying in the workplace. It defines lateral violence as behaviors between colleagues that create a hostile work environment, such as gossiping, criticism, intimidation, and racism. The document explores the characteristics of bullies, victims, bystanders, and upstanders. It provides strategies for dealing with lateral violence, such as using respectful communication and promoting dignity and respect. The goal is to move from lateral violence to lateral kindness in the workplace.
Working and learning well with each other moving to lateral kindness cnur 305...griehl
This document discusses strategies for addressing lateral violence and bullying in the workplace. It begins by defining lateral violence as poorly expressed anger that can manifest through gossiping, criticism, intimidation, racism and physical harm. It then outlines 10 common forms of lateral violence including non-verbal innuendo, verbal affronts, undermining activities, withholding information, and sabotage. The document also discusses different types of bullies like narcissistic, accidental and serial bullies. It emphasizes promoting dignity and respect to prevent bullying and provides a communication model for addressing problematic behaviors.
Breaking Barriers: Exploring the Future in Rural and Community Nursinggriehl
This document summarizes a presentation given by Greg Riehl about his experiences working as a nurse in rural and remote areas of Canada. Some of the key points discussed include the importance of recognizing one's own privileges and cultural background, understanding concepts like cultural safety and continuity, and advocating in a way that empowers communities rather than acting on their behalf. Riehl emphasizes listening to understand different cultural perspectives and allowing communities to lead in determining their own health needs and solutions.
The document discusses what social justice means, noting that it is a matter of life and death that affects people's lives and health. It states that life expectancy and health have increased in some parts of the world but failed to improve in others. Overall, social justice determines the way people live and their chances of illness and premature death.
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
This document discusses the downsides of micromanaging, including higher employee turnover, reduced creativity and motivation, and increased burnout for both employees and managers. Micromanaging wastes time, annoys employees, and damages trust, while also making it difficult for managers to see the big picture and scale effectively. Overall, micromanaging leads to unhealthy anxiety and resentment in the workplace.
This document provides an overview of a presentation on lateral kindness given by Greg Riehl. It begins with a land acknowledgment recognizing the traditional Indigenous lands. It then discusses the presenter's conflict of interest statement and learning objectives, which are to describe lateral kindness, explore unconditional positive regard, bullying and the role of victim, and share experiences supporting the Platinum Rule of treating others as they want to be treated. The presentation then discusses stories from the presenter's nursing career working with different communities and situations.
Spring Semester Research for Evidence-Based Nursing Practice (PSYN-300-001)griehl
This document provides an overview of considerations for conducting respectful research with Indigenous communities. It emphasizes the importance of the four R's - Respect, Relevance, Reciprocity and Responsibility. Researchers should work collaboratively with Elders, knowledge keepers and community members. Principles like Ownership, Control, Access and Possession (OCAP) are important to discuss before beginning research. Storytelling approaches and two-eyed seeing can help bring both Western and Indigenous ways of knowing together. Cultural competence, awareness of privilege, and being willing to feel uncomfortable are also discussed as part of being an ally in research.
Assessing equity and diversity within the canadian healthcare systemgriehl
This presentation discussed assessing equity and diversity within the Canadian healthcare system. It covered topics such as acknowledging traditional Indigenous lands, learning objectives around inclusion and diversity, exploring concepts like tone policing and the differences between gender and sex. Examples of creating safe spaces through Indigenous art and awareness months were provided. The presentation also discussed concepts like cultural safety, the importance of asking patients "What matters to you?" and recognizing one's own privilege as an ally working with Indigenous communities.
Privileged perspectives working with vulnerable marginalized populations in ...griehl
Learn about personal experiences working with marginalized/vulnerable people, who are those people? And what have they taught me?
Memorable experiences lead me to embrace the Platinum Rule
I will describe the bronze silver gold platinum rules
What do nurse leaders need to know working with Indigenous communitiesgriehl
This document provides information for nurse leaders working with Indigenous communities. It discusses the importance of recognizing different worldviews and Indigenous leadership structures. It also outlines principles for being an effective ally, including recognizing one's own privilege, focusing on action over identity, and allowing Indigenous communities to decide who is an ally. The document emphasizes collaboration, communication, respect, and being community-guided in one's work.
Guide to acknowledging Indigenous Peoples, Land, and Traditional Territorygriehl
The goal of this speaker series is to encourage all faculty and staff to acknowledge, where appropriate, the Indigenous peoples, on whose land, and traditional territory we live, learn, and work. Acknowledgment by itself before a meeting, printed in an email or a course outline, is a small gesture, but it becomes more powerful and meaningful when coupled with personal statements, authentic local knowledge and relationships and informed action
topics of discussion:
Research ethical considerations
Sex vs Gender
Indigenous World view and ways of knowing
Sharing/talking circle
Land based teachings
Two eyed seeing
Strength based vs deficit based
Research Ethics Boards
The document summarizes Sexual and Reproductive Health Awareness Week from February 11-15, 2019. It discusses promoting positive approaches to sexual relationships and maintaining sexual health throughout life. It notes sexually transmitted infections are a public health concern in Canada, with increasing rates of chlamydia, gonorrhea and syphilis among youth and older adults. The document encourages Canadians to reflect on how sexual health impacts overall well-being and stresses the importance of sexual health education.
FNIM cultures in Saskatchewan Practical Nursing November 28 2019griehl
This document provides an overview of a presentation on First Nations, Inuit and Métis (FNIM) cultures in Saskatchewan. The presentation discusses key concepts like the medicine wheel, cultural competence, reflective practice and land acknowledgments. It encourages learning about residential schools and their impact, as well as Treaty rights and Indigenous health services. Storytelling is used to illustrate concepts. The goal is to help attendees broaden their understanding of applying the Platinum Rule of treating others how they want to be treated when working with diverse clients.
Moving from lateral violence to lateral kindness regional nursing workshopgriehl
This document provides information about moving from lateral violence to lateral kindness in nursing. It discusses how stories from working in health care can illustrate different perspectives and challenges. Types of bullying behaviors are outlined, including social, verbal, physical, and cyber bullying. Common forms of lateral violence among nurses are listed as non-verbal innuendo, verbal affronts, undermining activities, and more. The document emphasizes developing respectful relationships and addressing the root causes of hurt and anger to prevent lateral violence.
This document summarizes a class on diversity in healthcare. The objectives are for students to gain awareness of cultural awareness, cultural safety, and cultural competency in healthcare as well as gender in healthcare. Key topics discussed include cultural awareness, sensitivity, knowledge, competence, humility, and safety. The importance of understanding one's own culture and biases is emphasized. Definitions of family, sex, and gender are also provided.
Social justice affects people's lives and health in major ways. It determines people's chances of illness and premature death. There are large disparities in life expectancy and health between those who live in parts of the world where social justice is lacking and those who live in areas with greater social justice. Ensuring social justice for all is critical to improving people's health and extending their lifespans.
Global Perspectives working with Marginalized/Vulnerable Populations in a glo...griehl
This document provides an outline for a presentation by Greg Riehl on working with marginalized populations in a global context. The learning outcomes include understanding Riehl's experience working with these groups, who he enjoys working with and what they have taught him, and memorable experiences that led him to embrace the Platinum Rule of treating others how they want to be treated. The presentation will describe the bronze, silver, gold, and platinum rules and hopes attendees can see patients and clients through a new lens.
In the eyes of our patients and families we are often the heroes of healthcare. But in our own eyes, or the eyes of our peers, we are often ‘just a nurse’. I have been a part of the nursing family for 3 decades and have had the privilege and honour to be with people on all aspects of their journeys through life and death. The challenges of being a nurse are only outweighed by the rewards of the profession and is why I remain dedicated to the next generation of nurses.
Sexual and Reproductive Health Awareness Week from February 11-15, 2019 aims to raise awareness about the importance of sexual health for Canadians. Sexual health involves having positive and respectful relationships free from stigma, coercion or violence. Maintaining good communication and sexual health also means preventing sexually transmitted infections through condom use or testing. However, rates of infections like chlamydia, gonorrhea, and syphilis are rising in Canada, especially among youth and older adults. Untreated infections can lead to long-term health issues. The government is working to address sexually transmitted infections by improving access to testing, treatment, support, and reducing stigma.
Moving from lateral violence to lateral kindness practical nursing feb 15 2019griehl
This document discusses lateral violence and bullying in the workplace. It defines lateral violence as behaviors between colleagues that create a hostile work environment, such as gossiping, criticism, intimidation, and racism. The document explores the characteristics of bullies, victims, bystanders, and upstanders. It provides strategies for dealing with lateral violence, such as using respectful communication and promoting dignity and respect. The goal is to move from lateral violence to lateral kindness in the workplace.
Working and learning well with each other moving to lateral kindness cnur 305...griehl
This document discusses strategies for addressing lateral violence and bullying in the workplace. It begins by defining lateral violence as poorly expressed anger that can manifest through gossiping, criticism, intimidation, racism and physical harm. It then outlines 10 common forms of lateral violence including non-verbal innuendo, verbal affronts, undermining activities, withholding information, and sabotage. The document also discusses different types of bullies like narcissistic, accidental and serial bullies. It emphasizes promoting dignity and respect to prevent bullying and provides a communication model for addressing problematic behaviors.
Breaking Barriers: Exploring the Future in Rural and Community Nursinggriehl
This document summarizes a presentation given by Greg Riehl about his experiences working as a nurse in rural and remote areas of Canada. Some of the key points discussed include the importance of recognizing one's own privileges and cultural background, understanding concepts like cultural safety and continuity, and advocating in a way that empowers communities rather than acting on their behalf. Riehl emphasizes listening to understand different cultural perspectives and allowing communities to lead in determining their own health needs and solutions.
The document discusses what social justice means, noting that it is a matter of life and death that affects people's lives and health. It states that life expectancy and health have increased in some parts of the world but failed to improve in others. Overall, social justice determines the way people live and their chances of illness and premature death.
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
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.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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
3. Objectives
Share my story – it is one Describe why men do not
of denial and reflects seek health care
broader issues of men’s
health in general. Recognize that we all have
I hope to share my a role to play, especially
thoughts and reflection on women!
my ongoing journey so
nurses can support and Plan for action
advocate for the health of
men in their lives.
5. Nurse becomes the patient
This was difficult for me
My story, in a ‘nut’ shell
You might need your earmuffs
6. Knowledge does not = Behaviour change
Men's health is My story is a typical
important. We know example of the
that knowledge does importance of
not always impact communication in
behaviour change, so health and
what can we, as nurses, relationships, and
partners, leaders, do to working through denial
support men’s health. and fear.
Communication with
health professionals &
your family/friends
8. What do Canadian stats tell us?
Type of cancer New cases Cases per 100,000
Total M W Tota M W
l
Prostate 26500 26500 — — 121 —
Lung 25600 13300 12300 54 62 49
Colorectal 13300 13000 10300 49 60 40
Breast 22900 200 22700 50 1 96
NHL 7800 4300 3500 17 20 14
Bladder 7,800 5,800 2,000 16 27 8
ww.cancer.ca/~/media/CCS/Canada%20wide/Files%20List/English%20files%20heading/PDF%20-%20Policy%20-%20Canadian%20Cancer%20Statistics%20-%20English/Canadian%20Cancer%20Statistics%202012%20-%20English.ashx
‡ Ontario does not currently report in situ bladder cases.
9. What do Canadian stats tell us?
Type of cancer New cases Cases per 100,000
Total M W Total M W
Prostate 26500 26500 — — 121 —
Lung 25600 13300 12300 54 62 49
Colorectal 13300 13000 10300 49 60 40
Breast 22900 200 22700 50 1 96
NHL 7800 4300 3500 17 20 14
Bladder 7,800 5,800 2,000 16 27 8
ww.cancer.ca/~/media/CCS/Canada%20wide/Files%20List/English%20files%20heading/PDF%20-%20Policy%20-%20Canadian%20Cancer%20Statistics%20-%20English/Canadian%20Cancer%20Statistics%202012%20-%20English.ashx
‡ Ontario does not currently report in situ bladder cases.
10. What do Canadian stats tell us?
Type Deaths Deaths per 100,000
Total M W Total M W
Lung 20,10 10,80 9,400 42 50 36
0 0
Colorectal† 9,200 5,000 4,200 19 23 15
Breast 5,200 55 5,100 11 <0.5 19
Pancreas 4,300 2,100 2,100 9 10 8
Prostate 4,000 4,000 — — 19 —
Non-Hodgkin Lymphoma 2,800 1,500 1,300 6 7 5
Leukemia 2,600 1,500 1,100 5 7 4
Stomach 2,100 1,350 790 4 6 3
Bladder 2,100 1,450 670 4 7 2
11. What do Canadian stats tell us?
Type Deaths Deaths per 100,000
Total M W Total M W
Lung 20,10 10,80 9,400 42 50 36
0 0
Colorectal† 9,200 5,000 4,200 19 23 15
Breast 5,200 55 5,100 11 <0.5 19
Pancreas 4,300 2,100 2,100 9 10 8
Prostate 4,000 4,000 — — 19 —
Non-Hodgkin Lymphoma 2,800 1,500 1,300 6 7 5
Leukemia 2,600 1,500 1,100 5 7 4
Stomach 2,100 1,350 790 4 6 3
Bladder 2,100 1,450 670 4 7 2
12. Three Types of Bladder Cancer
Transitional cell Who knew, to this day I
carcinoma have no idea, but if I had
Squamous cell carcinoma to guess, I would think it
Adenocarcinoma was transitional cell
carcinoma
Greg’s type of Cancer?
15. Bladder cancer search??? On the internets
About 10,300,000 results (0.14 seconds)
People have to wade through a lot of information
Men, especially, can be a bit impatient, and maybe even lack attention
We need to develop resources that make sense and are targeted at
different generations
http://www.nih.gov/news/pr/aug2007/nci-29.htm
16. Bladder Cancer Canada
Sunday, Sept 23, 2012 the Bladder Cancer Canada 5K Awareness Walk
takes place right across Canada!!!!!!!!!
www.bladdercancercanada.org/main.php?lan=1
17. patientslikeme
At PatientsLikeMe, people with every type of condition are
coming together to share their health experiences, find patients
like them and learn how to take control of their health. The
result is improved care for patients as well as an acceleration
of real-world medical research.
http://en.wikipedia.org/wiki/PatientsLikeMe
18. Totally Unrelated
Networking, who cares!!! I was asked to do a
presentation on networking for Federal Employees
who were affected by the latest round of cuts from
the Dear Leader.
I related my bladder cancer story, somewhere in my
presentation, linked to the patientslikeme site
A lady approached me afterwards, and wanted to
talk to me about her brother, who was diagnosed
with bladder cancer and was refusing to go for
surgery.
19. The Good - Bad Rule
Most people overestimate Words like asthma, radon,
the lethality of cancer, diabetes are much less
there are actually a lot scary but can be more
more dangerous things in lethal.
life that could kill you. Emotions have a huge
Some people simply hear influence on our actions
the word cancer, or as men.
tumor, or surgery, and Most men repress our
they either stop listening emotions & do not
or they freak out a bit. communicate effectively
with our families &
friends or health
professionals.
21. The difference between men & women’s health
Health for girls/women starts earlier than ever.
HPV vaccinations
PAP test - a letter comes in the mail
BSE?
Health for boys/men starts when?
Most likely in the emergency ward
TSE? Not likely
PSA?
When you are 40 the glove comes out.
Traditionally, boys and men are taught that they should be self-reliant, control their
emotions, and maintain a strong image by denying pain or weakness.
22. Complete physical – Primary Care
Does this even happen for most men?
My GP said I could talk about one issue, maybe two.
The worried well go more often than the rest of us.
Men rarely seek medical attention, and when they
do, it should be taken seriously.
Culture plays a lot in this.
Being male should not mean poorer health status.
Episodic health care does not work in the long run.
False evidence appearing real = FEAR
23. What is up with men?
Men seem to invest more resources in getting bigger and
stronger early on in their lives. But women are geared for
endurance in life. Women are typically shorter and
smaller than men. Use fewer of your own resources and
you will live longer, it seems.
We see it in animals: the earthworm lives four times as
long if it doesn’t eat or have sex.
http://www.telegraph.co.uk/health/8566594/Why-do-men-die-younger-than-women.html
25. So why do men die before their wives?
Because they want to . . .
26. What to do?
We need to improve Men disregard symptoms
overall communication and present later –
We need to improve the possibly connected to that
dialogue between men risk-taking behaviour,
and their families and more likely denial, fear, or
caregivers within the culture.
health system We all have to get men to
Major illnesses need to be communicate more about
detected faster. their health – if not with a
Women are still the nurse or doctor, then with
friends, buddies, or on the
gatekeepers!!!!!!
inter-web.
27. What things do I specifically do?
I speak
I volunteer Stars of Hope Dance Gala
I tell my story
Movember
I involve my family,
friends, and co-workers
I could do more
riehldance@hotmail.com
I am optimistic
28. What’s next for me, or the man in your life?
Urinary Incontinence? BPH???? I think I
have this already????
EDOMG Note to self . . . . . .
The Lower Urinary Circumcision
Tract Symptoms old& young
(LUTS) HIV Recommendations
Urology consults
30. Greg Riehl RN BScN MA
Contact
information Email: gregriehl@sasktel.net
Editor's Notes
In 2012 SK had 180 new cases of Bladder Cancer in men, and 45 deaths in Males were linked to Bladder Ca
In 2012 SK had 180 new cases of Bladder Cancer in men, and 45 deaths in Males were linked to Bladder Ca Men are overrepresented in all cancers, except breast cancer. For some men numbers don’t mean much, but percentages do.
6% of all new cases of cancer are Bladders Ca, and 3.6% of all cancer deaths are from bladder ca In Quebec, because of the registry’s dependence on hospital data, the numbers of prostate, melanoma and bladder cases are believed to be underreported. The large interprovincial differences seen in bladder cancer incidence rates are likely due to differences in reporting of in situ cases, particularly in Ontario, where such cases were not collected until recently and were not available for this publication. In 2012 SK had 180 new cases of Bladder Cancer in men, and 45 deaths in Males were linked to Bladder Ca ‘ Men have a 14.9 per cent risk of dying of cancer before the age of 75 - for women the risk is 9.1 per cent. And 143.1 per 100,000 men die from cancer each year compared to 87.2 per 100,000 women.’ http://www.telegraph.co.uk/health/8566594/Why-do-men-die-younger-than-women.html
There are three types of bladder cancer that begin in cells in the lining of the bladder. These cancers are named for the type of cells that become malignant (cancerous): Transitional cell carcinoma : Cancer that begins in cells in the innermost tissue layer of the bladder. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells. This is the most common type of bladder cancer. Squamous cell carcinoma : Cancer that begins in squamous cells , which are thin, flat cells that may form in the bladder after long-term infection or irritation. Adenocarcinoma: Cancer that begins in glandular (secretory) cells that may form in the bladder after long-term irritation and inflammation .
Depends how old you are. Bladder cancer hits men at an average age of…………. Some men will obviously go to their GPs, if they have one. Some men will look on the internet.
Fear is the most effective way of gluing a memory in place. I had no prior knowledge of ‘bladder cancer’ seemed quite odd really. I knew about lung cancer from my mom’s experience and from patients I looked after in the hospital. Most older men, get the horror stories from their buddies on coffee row. And most of these gentlemen, don’t believe you can have a positive experience in the hospital, with surgery, especiatlly when someone starts putting things into your body, where things are naturally supposed to be coming out. A lot of time people are happy within their group, this is their comfort zone. If someone had a bad experience with surgery or cancer, then chances are likely everyone will know about it, and this will directly influence their decisions.
http://www.nih.gov/news/pr/aug2007/nci-29.htm
Patientslikeme
Some things are inherently good, and some things are inherently bad.
men are less likely to have contact with the health care system and are not receiving timely advice on health measures that could improve both longevity and quality of life. http://www.bcmj.org/articles/development-men%E2%80%99s-health-program-do-we-need-new-approach-bc