1) The report highlights that while progress has been made in reducing adolescent deaths from preventable causes like pregnancy complications and measles, HIV now causes more adolescent deaths.
2) Adolescence is a crucial life stage for establishing health behaviors that impact lifelong health. Many mental health disorders and risk factors for noncommunicable diseases emerge during this period.
3) A comprehensive approach is needed to address the diverse determinants of adolescent health across multiple levels, from the individual to policies, and require coordination between health and other sectors.
The Sixth Stocktaking Report accounts for both progress made and setbacks identified in the last two years. Globally countries have made more inroads on new HIV infections among children since 2011 than in the previous decade, but the rate of slowing new infections isn't yet on track to meet Millennium Development Goal 6 by its 2015 deadline.
Fourteen years ago I was asked to prepare the following document. After it was completed, the contractor asked me to re-do it because they had made a mistake in the age they wanted covered. [They seemed to believe the information was too sensitive politically] and buried the report. I'm submitting it here now to learn what the LinkedIn audience thinks. Is it time to update it?
UN SDG # 3 : Good Health and Well being
The goal III, aims to address all the major health priorities with regard to child and maternal health, end of communicable diseases, reducing the number of non-communicable diseases cases, ease of access to safe and affordable medicines and vaccines and ensure universal health coverage (UHC), to help build productive and resilient communities. Despite making rapid strides in improving the health and well being through innovation, new drug discoveries and R&D, health care inequality does persist over access. Earlier Millennium Development Goals (MDGs) from 2000-2015, focussed on specific health conditions of maternal and child health, communicable diseases viz; HIV/AIDS, other diseases like Tuberculosis, vector borne diseases like Malaria. What MDGs lacked was focus with regard to entire health system and how they cater to health services for overall health and wellbeing. SDGs 2030 agenda from 2015-2030 , has set the target towards focus on Universal Health Coverage (UHC), which includes access to health services and with financial risk protection.
Research data from more than 50 countries confirm that there exist strong protective factors against health compromising behaviours in adolescents. This knowledge will help us to balance the traditional focus on risk factors and support the development of interventions that strengthen protective factors in adolescents themselves, in their relations with adults and their wider environment.
The document makes the case for concerted action on adolescent health, it explains CAH's "4S framework" to strengthen the response of the health sector to adolescents, CAH's systematic approach to scaling up health service provision to adolescents, and the rationale and objectives of CAH's work in focus countries.
It is intended for staff from other departments in WHO working on health issues of relevance to adolescents (e.g. reproductive health or mental health), staff in WHO's Regional and Country Offices, staff in other organizations supporting efforts or working themselves to improve the health of adolescents, and policy makers and programme managers in ministries of health.
[[INOSR ES 11(2)134-147 Evaluation of the Infant Mortality rate at Ishaka Adv...PUBLISHERJOURNAL
Evaluation of the Infant Mortality rate at Ishaka Adventist Hospital Bushenyi District
Mugaaga Paul
Department of Clinical Medicine Kampala International University, Uganda.
________________________________________ABSTRACT
Infant mortality is defined as the death of an infant before his or her first birthday, mainly caused by dehydration, diseases, congenital malformations and infections. The main objective of this study was to establish the determinants of infant mortality in Ishaka Adventist Hospital (IAH) in the months of April- July 2017, in Ishaka municipality in Bushenyi district. A descriptive cross sectional study design was used to determine the determinants of infant mortality in the study area. Majority of respondent (98%) were female and among them, 25.5% reported to have lost at least an infant and most of these respondents (70%) were married while 5% were widowed and among these, 40% reported to have lost an infant. Religiously, majority of the respondents (80%) were Christians, while 13% were Muslim and 7% constituted other religions including paganism, which showed the greatest infant mortality rate (71.4%). Most of the respondents (65%) attained primary level of education while 5% did not go to school at all, and the highest infant mortality rate (40%) was reported among these. The respondents who reported to have had preterm births appeared to have a higher infant mortality rate (65%) than those who did not report preterm births. A higher infant mortality rate (32.2%) was realized among respondents who reported their infants to have had such co-morbidities than those who didn’t report any co-morbidities like malaria and also a higher infant mortality rate (50%) was realized among infants who had not exclusively breastfed. Majority of respondents (80%) did not have children with birth defects while only 20% had children with birth defect, and a higher infant mortality rate of 70% was realized among these. Demographically, infant mortality rate is high among teenagers, the unemployed, the widowed, the pagans, and the uneducated. Direct determinants of infant mortality rate included preterm birth, birth defects, comorbidities and failure to breastfeed exclusively. Proximate determinants associated with infant mortality rate included teenage pregnancies, source of water, means of delivery and irregular immunization. Exclusive breast feeding for 6 months, mass immunization campaign up to grass root, intensive health education on health seeking behaviors and highlighting on dangers associated with risky behaviors and high quality monitoring and evaluation for quick action particularly for emergencies. There is also need for intersectional collaboration and initiation of income generating activities to boost their standards of living.
Keywords: Infant mortality, Breastfeeding, Morbidity, Determinants, Respondents.
Sharing from USAID:
The U.S. Agency for International Development (USAID) is pleased to announce the release of its “Annual Progress Report to Congress: Global Health Programs FY 2014.” The report presents a summary of USAID’s key global health accomplishments during the previous fiscal year. From improving children’s nutrition to supporting antiretroviral treatment for millions of individuals, USAID programs had a great impact in 2014.
As the largest investor in global health, USAID is leading efforts to improve and save lives worldwide. In partnership with countries, non-governmental organizations, the faith-based community, and the private sector, the Agency is reaching people with the greatest need in the most remote areas. USAID works to further President Barack Obama’s vision to end extreme poverty through its ongoing contributions to ending preventable child and maternal deaths, creating an AIDS-free generation and protecting communities from infectious diseases.
International Child Protection Consultant
Child Protection Safety Net Project
Albania
Capitalization of Work: Learning from Experience
March 2013
N. Beth Bradford, MA
Protocolo para el diagnóstico precoz de la enfermedad celíacaCristobal Buñuel
Grupo de trabajo del Protocolo para el diagnóstico precoz de la enfermedad celíaca. Protocolo para el
diagnóstico precoz de la enfermedad celíaca. Ministerio de Sanidad, Servicios Sociales e Igualdad.
Servicio de Evaluación del Servicio Canario de la Salud (SESCS); 2018.
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The Sixth Stocktaking Report accounts for both progress made and setbacks identified in the last two years. Globally countries have made more inroads on new HIV infections among children since 2011 than in the previous decade, but the rate of slowing new infections isn't yet on track to meet Millennium Development Goal 6 by its 2015 deadline.
Fourteen years ago I was asked to prepare the following document. After it was completed, the contractor asked me to re-do it because they had made a mistake in the age they wanted covered. [They seemed to believe the information was too sensitive politically] and buried the report. I'm submitting it here now to learn what the LinkedIn audience thinks. Is it time to update it?
UN SDG # 3 : Good Health and Well being
The goal III, aims to address all the major health priorities with regard to child and maternal health, end of communicable diseases, reducing the number of non-communicable diseases cases, ease of access to safe and affordable medicines and vaccines and ensure universal health coverage (UHC), to help build productive and resilient communities. Despite making rapid strides in improving the health and well being through innovation, new drug discoveries and R&D, health care inequality does persist over access. Earlier Millennium Development Goals (MDGs) from 2000-2015, focussed on specific health conditions of maternal and child health, communicable diseases viz; HIV/AIDS, other diseases like Tuberculosis, vector borne diseases like Malaria. What MDGs lacked was focus with regard to entire health system and how they cater to health services for overall health and wellbeing. SDGs 2030 agenda from 2015-2030 , has set the target towards focus on Universal Health Coverage (UHC), which includes access to health services and with financial risk protection.
Research data from more than 50 countries confirm that there exist strong protective factors against health compromising behaviours in adolescents. This knowledge will help us to balance the traditional focus on risk factors and support the development of interventions that strengthen protective factors in adolescents themselves, in their relations with adults and their wider environment.
The document makes the case for concerted action on adolescent health, it explains CAH's "4S framework" to strengthen the response of the health sector to adolescents, CAH's systematic approach to scaling up health service provision to adolescents, and the rationale and objectives of CAH's work in focus countries.
It is intended for staff from other departments in WHO working on health issues of relevance to adolescents (e.g. reproductive health or mental health), staff in WHO's Regional and Country Offices, staff in other organizations supporting efforts or working themselves to improve the health of adolescents, and policy makers and programme managers in ministries of health.
[[INOSR ES 11(2)134-147 Evaluation of the Infant Mortality rate at Ishaka Adv...PUBLISHERJOURNAL
Evaluation of the Infant Mortality rate at Ishaka Adventist Hospital Bushenyi District
Mugaaga Paul
Department of Clinical Medicine Kampala International University, Uganda.
________________________________________ABSTRACT
Infant mortality is defined as the death of an infant before his or her first birthday, mainly caused by dehydration, diseases, congenital malformations and infections. The main objective of this study was to establish the determinants of infant mortality in Ishaka Adventist Hospital (IAH) in the months of April- July 2017, in Ishaka municipality in Bushenyi district. A descriptive cross sectional study design was used to determine the determinants of infant mortality in the study area. Majority of respondent (98%) were female and among them, 25.5% reported to have lost at least an infant and most of these respondents (70%) were married while 5% were widowed and among these, 40% reported to have lost an infant. Religiously, majority of the respondents (80%) were Christians, while 13% were Muslim and 7% constituted other religions including paganism, which showed the greatest infant mortality rate (71.4%). Most of the respondents (65%) attained primary level of education while 5% did not go to school at all, and the highest infant mortality rate (40%) was reported among these. The respondents who reported to have had preterm births appeared to have a higher infant mortality rate (65%) than those who did not report preterm births. A higher infant mortality rate (32.2%) was realized among respondents who reported their infants to have had such co-morbidities than those who didn’t report any co-morbidities like malaria and also a higher infant mortality rate (50%) was realized among infants who had not exclusively breastfed. Majority of respondents (80%) did not have children with birth defects while only 20% had children with birth defect, and a higher infant mortality rate of 70% was realized among these. Demographically, infant mortality rate is high among teenagers, the unemployed, the widowed, the pagans, and the uneducated. Direct determinants of infant mortality rate included preterm birth, birth defects, comorbidities and failure to breastfeed exclusively. Proximate determinants associated with infant mortality rate included teenage pregnancies, source of water, means of delivery and irregular immunization. Exclusive breast feeding for 6 months, mass immunization campaign up to grass root, intensive health education on health seeking behaviors and highlighting on dangers associated with risky behaviors and high quality monitoring and evaluation for quick action particularly for emergencies. There is also need for intersectional collaboration and initiation of income generating activities to boost their standards of living.
Keywords: Infant mortality, Breastfeeding, Morbidity, Determinants, Respondents.
Sharing from USAID:
The U.S. Agency for International Development (USAID) is pleased to announce the release of its “Annual Progress Report to Congress: Global Health Programs FY 2014.” The report presents a summary of USAID’s key global health accomplishments during the previous fiscal year. From improving children’s nutrition to supporting antiretroviral treatment for millions of individuals, USAID programs had a great impact in 2014.
As the largest investor in global health, USAID is leading efforts to improve and save lives worldwide. In partnership with countries, non-governmental organizations, the faith-based community, and the private sector, the Agency is reaching people with the greatest need in the most remote areas. USAID works to further President Barack Obama’s vision to end extreme poverty through its ongoing contributions to ending preventable child and maternal deaths, creating an AIDS-free generation and protecting communities from infectious diseases.
International Child Protection Consultant
Child Protection Safety Net Project
Albania
Capitalization of Work: Learning from Experience
March 2013
N. Beth Bradford, MA
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Grupo de trabajo del Protocolo para el diagnóstico precoz de la enfermedad celíaca. Protocolo para el
diagnóstico precoz de la enfermedad celíaca. Ministerio de Sanidad, Servicios Sociales e Igualdad.
Servicio de Evaluación del Servicio Canario de la Salud (SESCS); 2018.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
5. 1
Health for the world’s adolescents
A second chance in the second decade
What must we do to improve and maintain the health of the world’s one billion
adolescents? Health for the world’s adolescents is a World Health Organization
(WHO) report fully addressing that question across the broad range of health
needs of people ages 10–19 years. It was presented to Member States at the
2014 World Health Assembly in follow-up to its 2011 Resolution 64.28, Youth
and health risks.
Health for the world’s adolescents is a dynamic, multimedia, online report
(who.int/adolescent/second-decade). It describes why adolescents need
specific attention, distinct from children and adults. It presents a global overview
of adolescents’ health and health-related behaviours, including the latest data
and trends, and discusses the determinants that influence their health and
behaviours. It features adolescents’ own perspectives on their health needs.
The report brings together all WHO guidance concerning adolescents across
the full spectrum of health issues. It offers a state-of-the-art overview of four
core areas for health sector action:
• providing health services
• collecting and using the data needed to advocate, plan and monitor health
sector interventions
• developing and implementing health-promoting and health-protecting
policies and
• mobilizing and supporting other sectors.
The report concludes with key actions for strengthening national health sector
responses to adolescent health.
The website will be the springboard for consultation with a wide range of
stakeholders leading to a concerted action plan for adolescents.
The report seeks to focus high-level attention on health in the crucial adolescent
years and to provide the evidence for action across the range of adolescent
health issues. Thus, it addresses primarily senior and mid-level staff of ministries
of health and health sector partners, such as nongovernmental organizations,
United Nations organizations and funders. It will likely interest many others,
too – for example, advocates, service providers, educators and young people
themselves.
The report has benefited from the contribution and inputs of WHO experts
at country, regional and global levels and across health issues including use
of alcohol and other psychoactive substances, HIV, injuries, mental health,
nutrition, sexual and reproductive health, tobacco use and violence.
This document highlights key aspects of the report Health for the world’s
adolescents.
7. 3
tract infections rank second and fourth among causes of death among 10–14-year-olds.
Combined with meningitis, these conditions account for 18% of all deaths in this age group,
little changed from 19% in 2000.
Rising rate of deaths due to HIV. In contrast
to reductions in maternal deaths and measles
mortality, estimates suggest that numbers of
HIV deaths are rising in the adolescent age
group. This increase occurred predominantly in
the African Region, at a time when HIV-related
deaths were decreasing in all other population
groups. It may reflect improvements in the response to paediatric HIV, with infected
children surviving into the second decade of life, or it may reflect limitations in current
knowledge of and estimation of survival times for HIV-positive children in adolescence.
There is good evidence on the poor quality of, and retention in, services for adolescents
indicating the need for improved service delivery. In addition, improved data are needed
on HIV mortality and survival times in the age groups 5–14 years.
While much remains to be done in pursuit of
the unfinished agendas of MDGs 4, 5 and 6
(combat HIV/AIDS, malaria and other diseases),
many countries have made significant progress.
Precisely because of the remarkable achievements
in decreasing deaths during the first decade of
life in many high- and middle-income countries,
mortality in the second decade is now greater than mortality in the first decade (with the
exception of the first year of life). Countries need to sustain these achievements in child
health by investing in the health of adolescents.
Health during adolescence has an impact across the life-course
The life-course provides an important perspective for public health action. Events in one
phase of life both affect and are affected by events in other phases of life. Thus, what
happens during the early years of life affects adolescents’ health and development, and
health and development during adolescence in turn affect health during the adult years
and, ultimately, the health and development of the next generation.
Effective interventions during adolescence protect public health investments in child
survival and early child development. At the same time, adolescence offers an opportunity
to rectify problems that have arisen during the first decade. For example, interventions
during adolescence may decrease the adverse long-term impacts of violence and abuse
in childhood or of under-nutrition and prevent them from undermining future health.
Achieving MDGs 4, 5 and 6 requires greater focus on the adolescent phase of the life-
course. Further lowering rates of adolescent pregnancy will be central to reducing
maternal mortality and to improving child survival, since the younger the mother, the higher
the mortality rate among newborns. This has been one of the important achievements
in adolescent health of the past two decades – significant reductions in adolescent
pregnancy rates in a number of countries, for example, Canada, England and the United
States of America. HIV prevention and decreasing HIV-related deaths also depend on
reaching adolescents.
HIV is now the number 2
cause of death among
adolescents.
Countries need to sustain
improvements in child
health by investing in the
health of adolescents.
9. Road injury
HIV/AIDS
Self-harm
Lower respiratory infections
Interpersonal violence
Diarrhoeal diseases
Drowning
Meningitis
Epilepsy
Endocrine, blood,
immune disorders
Number of deaths
0 20000 40000 60000 80000 100000 120000 140000
Male Female
Unipolar depressive disorders
Road injury
Iron-deficiency anaemia
HIV/AIDS
Self-harm
Back and neck pain
Diarrhoeal diseases
Anxiety disorders
Asthma
Lower respiratory infections
DAIYs (in millions)
0 2 4 6 8 10 12 14
Male Female
5
Figure. 1. Top 10 causes of death among adolescents by sex
Figure. 2. Top 10 causes of DALYs lost among adolescents by sex
DALYs = disability-adjusted live years lost
11. 7
Combining forces for adolescent health
Over the past two decades, WHO has supported the development and synthesis of
evidence for action on adolescent health. It has used this evidence base to produce
policy and programme support tools addressing many of the problems and behaviours
that undermine adolescents’ health.
Numerous factors protect or undermine adolescents’ health, having their impact at many
different levels (Figure. 3):
• at an individual level – for example, age, gender, knowledge, skills and empowerment;
• at the level of families and peers, where adolescents have most of their close
relationships;
• in their communities and through the organizations that provide adolescents with
services and opportunities, such as schools and health facilities; and
• more distally, through cultural practices and norms, through the mass media and
digital interactive media, and through social determinants, including policies and
political decisions about the distribution of resources and power and the exercise of
human rights.
Figure. 3. The determinants of adolescent health and development:
an ecological model
Macro
Structural
Environment
Organizational
Community
Interpersonal
Individual
National wealth, income
disparities, war/social
unrest, effects of
globalization
Policies and laws,
racism, equity, gender
attitudes, discrimination
Physical environment
(built environment,
urban/rural, water and
sanitation, pollution),
socio-cultural environment,
biological environment
(epidemiology), media
Community values and
norms, community
networks and support,
social cohesion,
community and religious
leaders
Roads, schools
(availability, ethos), health
facilities (availability,
appropriateness),
opportunities
(for work, for play)
Family, friends (peer
support), teachers, social
networks – expectations,
conflict, financial and
social capital
Age, gender, education,
knowledge, skills, self-
efficacy, expectations
12. 8
Many sectors must participate. Therefore, to have a
significant impact on mortality, disability and illness during
the adolescent years, the health sector must strengthen
collaboration with other sectors and actors. Preventing
deaths from maternal causes or from interpersonal
violence, for example, is not just a matter of improving
adolescents’ knowledge and skills. Many other factors
also contribute to these deaths: the negative attitudes
and harmful actions of parents and peers; lack of good-
quality schools and health services; an absence of positive community values; and
social conditions and services such as prescriptive gender attitudes and expectations;
poverty; coercive sex; easy access to psychoactive substances and the presence of
peers with anti-social values. Addressing these environmental and social factors requires
coordinated response from many sectors. Similarly, reducing road injuries, the top cause
of mortality in 10–19-year-olds, will require actions from range of sectors, from education
to transportation.
The media, including interactive media such as the Internet and mobile phones, is a sector
with the important potential to provide information and influence values and norms that
strengthen the health of adolescents.
Commonality among risk and protective factors. Adolescents’ various health problems
and behaviours often have similar risk factors and similar protective factors. For example,
parents and schools can play particularly important roles in protecting adolescents
from a range of health-compromising behaviours and conditions, including unsafe sex,
substance use, violence and mental health problems.
Among all the sectors that play critical roles in adolescent health, education is key. Not
only is education important in itself, but schools are also a setting where adolescents
can receive skills-based health education and, sometimes, services. Furthermore, the
social environment or ethos of the school can contribute positively to physical and mental
health. It is in the interest of the education sector for adolescents to be healthy, because
they are better able to learn and benefit from their years in school.
Universal health coverage for adolescents
Adolescents are one of the groups that existing health services serve least well. As
countries work towards universal health coverage, in the context of the post-2015 agenda,
it will be important to ensure that the adolescent segment of the population receives
adequate attention.
Although the provision of health services per se is unlikely to prevent many of the major
causes of death and disease in adolescence, health services do have a key role to play
in responding to and treating health problems and health-
related behaviours and conditions that arise during the
second decade. They should also be able to provide
information and respond to adolescents’ and parents’
concerns about adolescent development.
Prevention of adolescent pregnancy, HIV prevention,
treatment and care and the provision of HPV vaccines
are important entry points for improving the provision of
Effective responses to
support adolescent health and
development require a range
of actors and sectors.
Now health services need
to move beyond adolescent
pregnancy and HIV to address
the full range of adolescents’
health and development needs.
13. 9
health services to adolescents. Now health services need to move beyond these issues
to address the full range of adolescents’ health and development needs.
All of the health services elements and interventions currently addressed in WHO guidelines
have been brought together in Health for the world’s adolescents (see Figure 4). Some
are specific to adolescents, while others are also important for other population groups.
The interventions included reflect a life-course perspective: Some deal with adolescents’
current problems (e.g. the management of existing health conditions), while others seek
to prevent disease both during and beyond adolescence (e.g. addressing risk factors for
noncommunicable diseases).
Countries will need to prioritize these services and interventions based on a range of
factors, including the main health problems facing their adolescents and the capacity of
the health system.
More coverage with more services. In addition to the need for services that respond
to a wider set of health problems, there is also a need to expand coverage. This can be
done both through existing mainstream services and in other settings that are close to
adolescents, such as schools, and by using new technologies – for example, mobile
phones.
All of these considerations will be important to the health sector’s focus on the adolescent
years as it moves towards the goal of universal health coverage. Progress will require
renewed attention to the training of health workers to ensure, for example, that all health
professionals graduate with knowledge of adolescent health and development and the
implications for clinical practice. Cost barriers must be overcome: Pooled, prepaid sources
Figur 4. Health services and interventions addressed in WHO guidelines
• HIV testing and
counselling
• Voluntary medical male
circumcision in countries
with HIV generalized
epidemic
• PMTCT
• ART treatment
• Contraceptive information
and services
HIV
• Care in pregnancy, childbirth
and postpartum period for
adolescent mother and
newborn infant
• Contraception
• Prevention and management
of sexually transmitted
infections
• Safe abortion care
SRH/Maternal care
• Assessment and
management of alcohol use
and alcohol use disorders
• Assessment and
management of drug use
and drug use disorders
• Screening and brief
interventions for hazardous
and harmful substance use
during pregnancy
Substance use
• Management of conditions
specifically related to stress
• Management of emotional
disorders
• Management of behavioural
disorders
• Management of adolescents
with developmental disorders
• Management of other significant
emotional or medically
unexplained complaints
• Management of
self-harm/suicide
Mental health
• Health education of adolescents,
parents and caregivers regarding
physical activity
Physical activity
• Cessation support and
treatment
Tobacco control
• Tetanus
• Human papillomavirus
• Measles
• Rubella
• Meningococcal infections
• Japanese encephalitis
• Hepatitis B
• Influenza
Immunization
• Management of common
complaints and conditions
• HEADS* assessment
Integrated management
of common conditions
• Intermittent iron and folic
acid supplementation
• Health education of
adolescents, parents and
caregivers regarding
healthy diet
• BMI-for-age assessment
Nutrition
• Assessment and management of
adolescents that present with
unintentional injuries
• Assessment and management
alcohol-related unintentional
injuries
• First-line support when an
adolescent girl discloses
violence
• Health education on intimate
partner violence
• Identification of intimate partner
violence
• Care for survivors of intimate
partner violence
• Clinical care for survivors of
sexual assault
Violence and injury
prevention
*HEADS is an acronym for Home, Education/Employment, Eating,
Activity, Drugs, Sexuality, Safety, Suicide/Depression
15. 11
Policies play a key role in protecting adolescents’ health
Health sector efforts must go beyond interventions directed to individual
adolescents. While it remains important to ensure that adolescents have
knowledge, skills, and access to health services, interventions that support
parents, make schools health-promoting and focus on changing negative social
values and norms are also key. Policies and laws that facilitate and mandate
interventions to prevent exposure to harm – for example, policies to decrease
road traffic injuries and use of harmful substances such as tobacco – also are
essential.
Most countries have committed to international conventions that recognize
adolescents’ right to the highest attainable standard of health, and the
Committee on the Rights of the Child now has General Comments that
focus on adolescents and on health. These provide guidance and support
for governments and health sector partners to develop national policies and
laws benefiting adolescents that are based on human rights and public health
principles.
Issue-specific health policies – for example, policies directed to tobacco or
HIV – need to consider adolescents explicitly. In addition, some policies need
to be specifically designed with adolescents in mind – for example, those
ensuring that adolescents have access to information and services and that
deal effectively with issues of confidentiality and informed consent.
Analysis in Health for the world’s adolescents finds that policies and their
implementation vary widely among regions. For example, in terms of restricting
or prohibiting the marketing of food and non-alcoholic beverages to children
and adolescents, most countries in the European Region implement such
policies, while in other regions only a few countries have implemented WHO’s
recommendations. Policies are only as effective as their implementation,
however, so it is necessary to have adequate systems to monitor relevant
actions. The decline in consumption of sugar-sweetened beverages among
adolescents in many European Region countries, also reflected in the report,
may be a sign of success of these policies.
Broader policies are needed. Like the content of health services, national health
policies need to go beyond sexual and reproductive health, where they have
tended to focus, and to respond to the spectrum of adolescents’ health problems and
health-related behaviours. Among national health policy documents from 109 countries
reviewed for this report, 84% give some attention to adolescents. In three-quarters of
them the focus is on sexual and reproductive health (including HIV/AIDS); approximately
one-third address tobacco and alcohol use among adolescents; and one-quarter address
mental health.
Health for the world’s adolescents is the first time that policies promoted by WHO that
have implications for adolescent health have been brought together in one report from
throughout the Organization.
17. 13
Moving beyond the status quo
Currently, adolescents are receiving much
attention, and a real sense of urgency is growing
that more action is needed now. We understand
the physical, emotional and cognitive changes
taking place during adolescence and their
implications for policies and programmes. We
know a great deal about adolescents’ health and
health-related behaviours through improvements
in data collection and analysis. We understand
the determinants underlying poor health and
health-compromising behaviours. We have an
increasingly strong evidence base for action and clarity about the ways in which public
health and human rights are complimentary. We have experience using entry points
that bring political commitment and resources, such as the HPV vaccine, voluntary
medical male circumcision, tobacco and alcohol pricing policies, and crash helmets for
motorcyclists.
Adolescents have taken the
photos in the report, and their
thoughts and reflections on
the issues raised in Health
for the world’s adolescents
appear throughout.
18. 14
But there are still facets of the status quo that we must move beyond:
Beyond the myths. There are still many myths about adolescents that obstruct
accelerated action: that they are healthy and therefore do not need much attention; that
the only real problems that they face are related to sexual and reproductive health; that
the evidence base is weak and we do not really know what to do. None of this is true.
Beyond mortality. Deaths in adolescence are important, and no adolescent should
die from a cause that is preventable or treatable. But for public health more generally,
more attention needs to go to preventing the health-compromising behaviours (e.g. use
of tobacco, alcohol and drugs, unsafe sex) and conditions (e.g. depression, obesity) that
arise during adolescence and have a long-term impact on health across the life-course.
Beyond the individual. We know individual-level interventions directed to a few
health issues will not be enough to decrease adolescents’ all-cause mortality. Health
services and adolescents’ own knowledge and skills are important, but these alone will
not be enough. Structural, environmental, and social changes are essential. Substantially
reducing adolescent mortality will require, among other changes, more support for parents
and schools and policies and programmes that protect adolescents’ health.
Beyond single-problem thinking. Many of the behaviours and conditions that
undermine the health of adolescents, and will continue to undermine their health as adults
and the health of their children, have common determinants and are linked. We need to
find more effective ways to move out of single health problem silos and focus more on
interventions that address the determinants of multiple risk behaviours.
Beyond business as usual. As countries move towards universal health coverage,
ensuring that adolescents receive adequate consideration is essential. There are many
untappedresourcestoimproveandmaintainthehealthofadolescents,includinginteractive
media and technologies – and adolescents are at the centre of such developments.
Beyond aspirations. A human rights-based approach stresses the obligations of
governments. Setting clear goals and targets and monitoring progress gives focus to
these obligations. Consensus is needed on a set of measurable and achievable goals and
targets, which countries can select and adapt, that include both girls and boys and that
go beyond sexual and reproductive health.
Now is the time to build on the successes and lessons of past decades and to pick up the
pace of action to improve the health of adolescents. Certainly, we need more data and a
stronger evidence base for interventions, but there is much that we can do now.
19.
20. Department of Maternal, Newborn, Child and Adolescent Health
20 Avenue Appia
1211 Geneva 27, Switzerland
Tel +4122 791 3281
Fax +4122 791 4853
Email: mncah@who.int
Website: www.who.int/maternal_child_adolescent
In the second decade of the millennium we have many opportunities to
improve health in the second decade of life.
Health for the world’s adolescents is the basis for a call to action to
countries and partners to accelerate action and increase accountability.
There is a place for comments on the WHO/MCA website (see below)
as well as information about how stakeholders can contribute to action.
WHO/FWC/MCA/14.05