Commissioner Choucair at the 2014 National Network of Public Health Institutes Open Forum for Quality Improvement in Public Health presentation on "Perfect Timing! The Launch of Healthy Chicago and Our Accreditation Journey" in Kansas City.
The document discusses a medical-legal partnership project that provides legal aid to patients facing legal barriers to good health. Since 2009, the project has helped over 2,800 people, including 690 children and 2,149 adults. It has had a unique and measurable positive impact on the community. The document explores how such partnerships can be expanded to help even more patients and clients.
This document summarizes research conducted for a campaign called "Binge-Free 603" aimed at reducing binge drinking among young adults aged 18-25 in New Hampshire. The research included analyzing alcohol use data from 2007-2015, conducting formative research to identify peer groups at highest risk of binge drinking, and testing campaign strategies. The results informed the development of a campaign website and strategies to engage different peer groups to promote responsible drinking behaviors through sharing personal stories and setting a good example within their social circles. The document concludes by discussing next steps like evaluating campaign outcomes, getting new personal stories, and refining approaches targeting the highest risk "Preppy-Partier" peer group.
Jim Rousey
Office of Health Equity: Vivian Lasley-Bibbs
Division Directors: Dr. Jeff Howard, Dr. Kraig Humbaugh, Marvin Miller,
Kathy Fowler, Trish Okeson, Rosie Miklavcic, Charles Kendell
Champions/Liaisons: See Domain listing
Accreditation Readiness Team: See roster
Cabinet for Health and Family Services, Page 24
Dr. Bechara Choucair, Commissioner for the Chicago Department of Public Health and Dr. Stephanie Whyte, Chief Health Officer for CPS both testified at the Chicago City Council Health and Education Committees on on plans to improve adolescent health through Chicago’s Action Plan for Healthy Adolescents here: http://www.cityofchicago.org/content/dam/city/depts/cdph/CDPH/AHAC_PLAN_Feb32014.pdf
The document is a 2013 year in review report from the Chicago Department of Public Health. It summarizes successes in 2013 related to increasing tobacco taxes, banning flavored tobacco near schools, regulating e-cigarettes, improving access to healthy food and physical activity opportunities, expanding health insurance enrollment and access to care, and reducing communicable diseases. It highlights ongoing partnerships and initiatives to continue making progress on health priorities through policies, public awareness campaigns, and technology in 2014.
Commissioner Choucair presenting the Healthy Chicago public health agenda and how the Chicago Department of Public Health think about health disparities and the recent work addressing health disparities.
The document discusses a medical-legal partnership project that provides legal aid to patients facing legal barriers to good health. Since 2009, the project has helped over 2,800 people, including 690 children and 2,149 adults. It has had a unique and measurable positive impact on the community. The document explores how such partnerships can be expanded to help even more patients and clients.
This document summarizes research conducted for a campaign called "Binge-Free 603" aimed at reducing binge drinking among young adults aged 18-25 in New Hampshire. The research included analyzing alcohol use data from 2007-2015, conducting formative research to identify peer groups at highest risk of binge drinking, and testing campaign strategies. The results informed the development of a campaign website and strategies to engage different peer groups to promote responsible drinking behaviors through sharing personal stories and setting a good example within their social circles. The document concludes by discussing next steps like evaluating campaign outcomes, getting new personal stories, and refining approaches targeting the highest risk "Preppy-Partier" peer group.
Jim Rousey
Office of Health Equity: Vivian Lasley-Bibbs
Division Directors: Dr. Jeff Howard, Dr. Kraig Humbaugh, Marvin Miller,
Kathy Fowler, Trish Okeson, Rosie Miklavcic, Charles Kendell
Champions/Liaisons: See Domain listing
Accreditation Readiness Team: See roster
Cabinet for Health and Family Services, Page 24
Dr. Bechara Choucair, Commissioner for the Chicago Department of Public Health and Dr. Stephanie Whyte, Chief Health Officer for CPS both testified at the Chicago City Council Health and Education Committees on on plans to improve adolescent health through Chicago’s Action Plan for Healthy Adolescents here: http://www.cityofchicago.org/content/dam/city/depts/cdph/CDPH/AHAC_PLAN_Feb32014.pdf
The document is a 2013 year in review report from the Chicago Department of Public Health. It summarizes successes in 2013 related to increasing tobacco taxes, banning flavored tobacco near schools, regulating e-cigarettes, improving access to healthy food and physical activity opportunities, expanding health insurance enrollment and access to care, and reducing communicable diseases. It highlights ongoing partnerships and initiatives to continue making progress on health priorities through policies, public awareness campaigns, and technology in 2014.
Commissioner Choucair presenting the Healthy Chicago public health agenda and how the Chicago Department of Public Health think about health disparities and the recent work addressing health disparities.
In recognition of LGBT Health Awareness Week, CDPH hosted a community discussion on HIV and sexually transmitted infections (STIs) in the LGBT Community at Center on Halsted that included a keynote address from Commissioner Choucair, an overview of CDPH’s 2013 HIV/STI Surveillance Report from Nik Prachand and a panel discussion where local leaders including our own Tarek Mikati outlined how the community can use this information to combat the spread of HIV and STIs.
This document discusses public health initiatives in Chicago. It outlines efforts to increase health insurance enrollment and access preventative services. It also describes how data and analytics are being used to better understand health issues and guide resource allocation. The goal is to take a multi-pronged approach to improve population health through initiatives that address both individual and socioeconomic factors.
Commissioner Choucair presenting on Healthy Chicago at the Gold Humanism Society Lori Ann Roscetti Annual Memorial Lecture on Ethical & Humanitarian Issues in Medicine at Rush University Medical Center
Commissioner Choucair presenting at NACCHO Annual 2014 on "What gets Measured Gets Done: Data Needs, Uses and Innovations in Large Urban Health Departments."
Commissioner Choucair from the Chicago Department of Public Health presenting a lecture course at the University of Chicago Pritzker School of Medicine's Health Care Disparities Lecture Series.
Commissioner Choucair presents Healthy Chicago and Health Care Reform at the University of Chicago MacLean Center's 32nd Interdisciplinary Faculty Seminar Series.
Commissioner Choucair sharing Local Strategies to Address Homelessness in his Susan L. Neibacher Address at the 2014 National Health Care for the Homeless Conference & Policy Symposium in New Orleans.
The document discusses the benefits of meditation for reducing stress and anxiety. Regular meditation practice can help calm the mind and body by lowering heart rate and blood pressure. Making meditation a part of a daily routine, even if just 10-15 minutes per day, can offer improvements to mood, focus, and overall feelings of well-being over time.
The document outlines the process and findings of a community themes and strengths assessment conducted as part of the Healthy Chicago 2.0 initiative. Mixed methods were used to collect data, including an online survey, focus groups, oral histories, and stakeholder conversations. Key themes identified from the assessment included safety, healthy food access, built environment, equity, and education. There were disparities found between different community groups in their perceptions of neighborhood quality, resources, and needs. The assessment will help inform the strategic planning process to improve community health.
Commissioner Choucair presents "Pioneering Community Health" at the 9th Annual YMCA of the USA Healthier Communities Initiatives Learning Institute on November 5, 2014
Dr. Bechara Choucair, Commissioner, Chicago Department of Public Health, giving the keynote for the conference on "Breaking Silos to Reduce Health Disparities: Successful Strategies in a Changing Healthcare System" sponsored by the Robert Wood Johnson Foundation's "Finding Answers: Disparities Research for Change Program."
Commissioner Bechara Choucair Keynote at the National Tobacco Control Conference in Washington, DC on December 3, 2015 discussing Chicago's Tobacco Policies.
Hospital accreditation is a voluntary process that focuses on continuous quality improvement. It provides public commitment to patient safety and quality care. Accreditation standards aim to improve performance over minimum standards. In India, the National Accreditation Board for Hospitals and Healthcare Providers sets accreditation standards and has accredited several major hospitals. Accreditation benefits include improved public trust, safety culture, and systematic quality improvement processes.
Commissioner Choucair presenting on Healthy Chicago and how it addresses the social determinants of health within Healthy Chicago, how the leadership at the top worked to accomplish Healthy Chicago, and a review of Healthy Chicago.
How does housing impact health? Presentation at the Harm Reduction in the House: It Take a Village conference by the Midwest Harm Reduction Institute in June 2012
Panel Discussion: Applying What We Know: Bechara Choucair, M.D., Commissioner...TheAdlerSchool
The document summarizes efforts by the Chicago Department of Public Health to promote health equity and reduce health disparities. [1] It outlines a public health framework that recognizes social and environmental factors as major determinants of health. [2] The department's Healthy Chicago agenda focuses on preventing disease by addressing issues like breastfeeding rates, tobacco use, obesity, and access to healthy foods and aims to engage diverse partners and communities. [3] It highlights accomplishments in these areas and a cross-cutting focus on partnerships, community engagement, and use of data to guide efforts at improving population health and promoting health equity in Chicago.
The document outlines the Healthy Chicago agenda from the Chicago Department of Public Health. It discusses creating a healthy city, neighborhoods, homes, and people through policies, programs, and education. Some key accomplishments include expanding smoke-free housing and workplaces, increasing immunization rates, screening children for health issues like lead exposure, and implementing nutrition standards in schools and daycares. The department plans to continue working on initiatives around asthma, obesity, vaccinations, and making Chicago a healthier city overall.
The document outlines the Healthy Chicago agenda from the Chicago Department of Public Health. It discusses creating a healthy city, neighborhoods, homes, and people through policies, programs, and education. Some key accomplishments include expanding smoke-free housing and workplaces, increasing immunization rates, screening children for health issues like lead exposure, and implementing nutrition standards in schools and daycares. The department plans to continue working on initiatives around asthma, obesity, vaccinations, and making Chicago a healthier city overall.
The Healthy Chicago public health agenda, developed in 2011, serves as a framework for how the Chicago Department of Public Health will improve the health and well-being of Chicagoans. Healthy Chicago’s development was guided by a commitment to health equity and the recognition of the social and environmental influences on population health. During this presentation, the Healthy Chicago public health agenda will be introduced and key activities addressing health equity and the social determinants of health through policy, systems and environmental change, and programming will be discussed.
The document discusses the city of Chicago's strategies to address HIV/AIDS as outlined in the National HIV/AIDS Strategy. It provides statistics on HIV diagnoses and rates in Chicago and outlines the city's goals to reduce new infections, increase access to care for those living with HIV, and reduce HIV-related health disparities. The document details several programs and initiatives the city is undertaking to test more high-risk individuals, link those diagnosed to care, distribute condoms and syringes, and implement prevention campaigns targeted to communities most affected. It also provides an update on the implementation status of various HIV prevention strategies.
In recognition of LGBT Health Awareness Week, CDPH hosted a community discussion on HIV and sexually transmitted infections (STIs) in the LGBT Community at Center on Halsted that included a keynote address from Commissioner Choucair, an overview of CDPH’s 2013 HIV/STI Surveillance Report from Nik Prachand and a panel discussion where local leaders including our own Tarek Mikati outlined how the community can use this information to combat the spread of HIV and STIs.
This document discusses public health initiatives in Chicago. It outlines efforts to increase health insurance enrollment and access preventative services. It also describes how data and analytics are being used to better understand health issues and guide resource allocation. The goal is to take a multi-pronged approach to improve population health through initiatives that address both individual and socioeconomic factors.
Commissioner Choucair presenting on Healthy Chicago at the Gold Humanism Society Lori Ann Roscetti Annual Memorial Lecture on Ethical & Humanitarian Issues in Medicine at Rush University Medical Center
Commissioner Choucair presenting at NACCHO Annual 2014 on "What gets Measured Gets Done: Data Needs, Uses and Innovations in Large Urban Health Departments."
Commissioner Choucair from the Chicago Department of Public Health presenting a lecture course at the University of Chicago Pritzker School of Medicine's Health Care Disparities Lecture Series.
Commissioner Choucair presents Healthy Chicago and Health Care Reform at the University of Chicago MacLean Center's 32nd Interdisciplinary Faculty Seminar Series.
Commissioner Choucair sharing Local Strategies to Address Homelessness in his Susan L. Neibacher Address at the 2014 National Health Care for the Homeless Conference & Policy Symposium in New Orleans.
The document discusses the benefits of meditation for reducing stress and anxiety. Regular meditation practice can help calm the mind and body by lowering heart rate and blood pressure. Making meditation a part of a daily routine, even if just 10-15 minutes per day, can offer improvements to mood, focus, and overall feelings of well-being over time.
The document outlines the process and findings of a community themes and strengths assessment conducted as part of the Healthy Chicago 2.0 initiative. Mixed methods were used to collect data, including an online survey, focus groups, oral histories, and stakeholder conversations. Key themes identified from the assessment included safety, healthy food access, built environment, equity, and education. There were disparities found between different community groups in their perceptions of neighborhood quality, resources, and needs. The assessment will help inform the strategic planning process to improve community health.
Commissioner Choucair presents "Pioneering Community Health" at the 9th Annual YMCA of the USA Healthier Communities Initiatives Learning Institute on November 5, 2014
Dr. Bechara Choucair, Commissioner, Chicago Department of Public Health, giving the keynote for the conference on "Breaking Silos to Reduce Health Disparities: Successful Strategies in a Changing Healthcare System" sponsored by the Robert Wood Johnson Foundation's "Finding Answers: Disparities Research for Change Program."
Commissioner Bechara Choucair Keynote at the National Tobacco Control Conference in Washington, DC on December 3, 2015 discussing Chicago's Tobacco Policies.
Hospital accreditation is a voluntary process that focuses on continuous quality improvement. It provides public commitment to patient safety and quality care. Accreditation standards aim to improve performance over minimum standards. In India, the National Accreditation Board for Hospitals and Healthcare Providers sets accreditation standards and has accredited several major hospitals. Accreditation benefits include improved public trust, safety culture, and systematic quality improvement processes.
Commissioner Choucair presenting on Healthy Chicago and how it addresses the social determinants of health within Healthy Chicago, how the leadership at the top worked to accomplish Healthy Chicago, and a review of Healthy Chicago.
How does housing impact health? Presentation at the Harm Reduction in the House: It Take a Village conference by the Midwest Harm Reduction Institute in June 2012
Panel Discussion: Applying What We Know: Bechara Choucair, M.D., Commissioner...TheAdlerSchool
The document summarizes efforts by the Chicago Department of Public Health to promote health equity and reduce health disparities. [1] It outlines a public health framework that recognizes social and environmental factors as major determinants of health. [2] The department's Healthy Chicago agenda focuses on preventing disease by addressing issues like breastfeeding rates, tobacco use, obesity, and access to healthy foods and aims to engage diverse partners and communities. [3] It highlights accomplishments in these areas and a cross-cutting focus on partnerships, community engagement, and use of data to guide efforts at improving population health and promoting health equity in Chicago.
The document outlines the Healthy Chicago agenda from the Chicago Department of Public Health. It discusses creating a healthy city, neighborhoods, homes, and people through policies, programs, and education. Some key accomplishments include expanding smoke-free housing and workplaces, increasing immunization rates, screening children for health issues like lead exposure, and implementing nutrition standards in schools and daycares. The department plans to continue working on initiatives around asthma, obesity, vaccinations, and making Chicago a healthier city overall.
The document outlines the Healthy Chicago agenda from the Chicago Department of Public Health. It discusses creating a healthy city, neighborhoods, homes, and people through policies, programs, and education. Some key accomplishments include expanding smoke-free housing and workplaces, increasing immunization rates, screening children for health issues like lead exposure, and implementing nutrition standards in schools and daycares. The department plans to continue working on initiatives around asthma, obesity, vaccinations, and making Chicago a healthier city overall.
The Healthy Chicago public health agenda, developed in 2011, serves as a framework for how the Chicago Department of Public Health will improve the health and well-being of Chicagoans. Healthy Chicago’s development was guided by a commitment to health equity and the recognition of the social and environmental influences on population health. During this presentation, the Healthy Chicago public health agenda will be introduced and key activities addressing health equity and the social determinants of health through policy, systems and environmental change, and programming will be discussed.
The document discusses the city of Chicago's strategies to address HIV/AIDS as outlined in the National HIV/AIDS Strategy. It provides statistics on HIV diagnoses and rates in Chicago and outlines the city's goals to reduce new infections, increase access to care for those living with HIV, and reduce HIV-related health disparities. The document details several programs and initiatives the city is undertaking to test more high-risk individuals, link those diagnosed to care, distribute condoms and syringes, and implement prevention campaigns targeted to communities most affected. It also provides an update on the implementation status of various HIV prevention strategies.
Brief background of public health in Chicago followed by description of Healthy Chicago public health agenda followed by accomplishments of the agenda.
The Chicago Department of Public Health plays a crucial role in helping Chicago meet HP2020 goals, including its cardiovascular goals. Chicago’s commissioner of public health, Dr. Bechara Choucair, has a mandate to improve the public’s health includes cardiovascular health promotion and disease prevention and control. This lecture with audience response will describe ongoing efforts toward these goals as well as describe the rationale, methods, and results associated with using social media as bi-directional communication instruments between the Chicago Dept of Public Health and Chicagoans.
The document discusses the future of Franklin County Public Health in Ohio. It outlines the value of public health in preventing disease and promoting community health. Trends driving change include national public health issues requiring specialized responses and reports recommending regionalization and consolidation. The meeting goals were to discuss the value of public health, financial challenges, and a vision for the future with community input. Next steps include an electronic survey and planning session to secure more resources to accomplish the public health mission.
Commissioner Choucair's presentation at the APHA 2013 Annual Meeting in Boston, as part of a panel with Jose Montero, MD, MHCDS, Winston Wong, MD, MS, Steven Woolf, MD, and Paul Jarris, MD, describe recent work in primary care and public health integration, including work building on the IOM report: "Primary Care and Public Health: Exploring Integration to Improve Population Health" name key existing partnerships in building linkages between primary care practitioners and departments of public health Discuss next steps in integration and federal, state, and local public health work.
The document summarizes a community health assessment conducted in Marquette County, Michigan in 2012. It identifies the top three health priorities as: 1) obesity prevention through healthy living and lifestyle changes, 2) substance abuse prevention including reducing tobacco use, and 3) improving access to health resources. A team consisting of local health departments, hospitals, and other organizations conducted extensive research, data analysis, and input from community members to identify these priorities and develop strategies and initiatives to address them over the next three years.
The House of Representatives majority announced priorities for the 2015 legislative session focusing on modernizing government. The priorities include fixing public infrastructure like the electrical grid, public hospital system, and prisons. They also want to facilitate business by ensuring a modernized tax collection system and support for small businesses. Finally, they aim to increase public participation in government by standardizing voting procedures and allowing for more remote participation.
SOCW 410 final review 2015 last class sessionAlicia Beck
The document provides an overview of social welfare policy and services, including the policy process, social insurance programs like Social Security and Medicare, public assistance programs, and health care policy in the United States. It discusses the key stakeholders and issues in each area, such as the debate around social security reform, criticisms of public assistance programs, and efforts to expand health insurance coverage and reduce costs.
The document summarizes Washington State's Healthier Washington initiative, which aims to transform Medicaid (Apple Health) delivery over five years through three main strategies:
1) Integrating physical and behavioral healthcare and moving to value-based payments through Accountable Communities of Health.
2) Providing long-term services and supports to delay need for intensive care.
3) Supporting housing and employment through Medicaid benefits.
A major focus is applying an equity lens to reduce disparities and address social determinants of health like housing, by engaging communities and considering equity in project selection. The goals are better health outcomes while saving costs through a smarter, transformed system.
These slides give an overview of public health and the role of local public health departments in keeping people healthy, presents housing, health and some of the vulnerable populations who are the primary focus of our work, and shows the Healthy Chicago Public Health Agenda - the blueprint for our work at the Chicago Department of Public Health. Lastly, it highlights some of our work and accomplishments with vulnerable groups.
Similar to 2014 National Network of Public Health Institutes Open Forum: The Launch of Healthy Chicago and Our Accreditation Journey (20)
Commissioner Choucair and the Chicago Department of Public Health released Chicago’s Action Plan for Healthy Adolescents, which will guide city-wide efforts to improve the health and well-being of Chicago’s adolescents.
The plan was released at a special event at Jones College Prep High School, bringing together students and community partners from across Chicago to discuss the plan and how best to implement the strategies moving forward.
Chicago's Action Plan for Healthy Adolescents: http://www.cityofchicago.org/content/dam/city/depts/cdph/CDPH/AHAC_PLAN_Feb32014.pdf
Prezi from Release Event: http://bit.ly/HealthyAdolescentsPrezi
http://www.beyoubehealthy.org
The document discusses a new physical education policy adopted by the Chicago Board of Health. It outlines several of Chicago's public health targets, such as increasing physical education minutes in schools, access to healthy foods, and programs to reduce obesity, smoking, and violence. It also provides statistics on Chicago's restaurant industry and annual visitors. The commissioner of the Chicago Department of Public Health encourages partnerships and policies to promote public health through immunizations, health education, and technology.
Commissioner Choucair presents at Northwestern University's Institute for Public Health and Medicine Seminar Series on the state of the health in Chicago and current Chicago Department of Public Health projects.
The document is an agenda for an internship day at the Chicago Department of Public Health led by Commissioner Bechara Choucair. It includes presentations from the Commissioner on public health initiatives in Chicago like increasing flu vaccinations and reducing foodborne illnesses. Interns will learn about CDPH programs and services through discussions of their website, social media presence, and contact information.
Commissioner Choucair presents Healthy Chicago to the Patient-Centered Medicine Scholars Program - M2 Service Learning Program Seminar at the University of Illinois at Chicago's College of Medicine.
The City of Chicago and Department of Public Health announced new COVID-19 safety guidelines including requiring proof of vaccination for indoor dining, fitness and entertainment venues. Businesses must check for proof of full vaccination which begins January 3rd for those 5 and older. Masks are still required for all public indoor settings regardless of vaccination status. The goal is to slow COVID-19 spread and encourage vaccination.
Presentation from December 18, 2013 Chicago Board of Health Meeting by Carl C. Bell, M.D on Neurodevelopmental Disorders Associated with Prenatal Exposure to Alcohol.
The Institute of Medicine of Chicago (IOMC) Panel on Childhood Obesity in Chicago: Causative Factors and Proposed Solutions.
Dr. Choucair, along with Moderator Lisa Laurent, MD, Adam Becker, PhD, MPH, Elif Oker, MD and Karen Walker, MD discuss childhood obesity in Chicago.
How the Chicago Department of Public Health advances Healthy Chicago through technology. Presented by Commissioner Choucair at the APHA 2013 Annual Meeting Code-A-Thon
The document summarizes strategies by the Chicago Department of Public Health to address HIV/AIDS in Chicago. It outlines three goals that align with the National HIV/AIDS Strategy: reducing new infections, increasing access to care for those living with HIV, and reducing health disparities. It provides data on trends in Chicago's HIV epidemic, including high rates of infection among Latino men who have sex with men. The department will focus prevention efforts in communities most impacted and use data to guide its work in partnership with other organizations.
More from Chicago Department of Public Health (10)
Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- 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
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
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
2014 National Network of Public Health Institutes Open Forum: The Launch of Healthy Chicago and Our Accreditation Journey
1. Chicago Department of Public Health
Commissioner Bechara Choucair, M.D.
City of Chicago
Mayor Rahm Emanuel
2. Challenges to Change
• Dwindling local health department resources
– 12% overall decrease in personnel since 2008 for all
LHDs
– Large jurisdictions hit the hardest
• Infrastructure developed over 100 years ago
– Tradition creates inertia that impedes change efforts
• Political environments
– One of several City agencies
– Accountable to both Mayor and City Council
• Interest groups
16. Chicago Department of Public Health
Commissioner Bechara Choucair, M.D.
City of Chicago
Mayor Rahm Emanuel
17. "By having a clear mission with clear
priorities and having a way to measure them
and make sure we are not only setting goals
but achieving them … we will have the
greatest impact on our public health.”
Mayor Rahm Emanuel
18. Chicago Department of Public Health
Commissioner Bechara Choucair, M.D.
City of Chicago
Mayor Rahm Emanuel
IT’S NOT JUST ABOUT
INDIVIDUAL BEHAVIOR
IT’S ABOUT HOW WE
BEHAVE AS A CITY
HEALTHY CHICAGO
Chicago Department of Public Health
These are just some of our current challenges to change:
In its most recent study of about 2,500 local health departments, the National Association of County and City Health Officials found that since 2010, the median
number of employees and FTEs has decreased in LHDs, especially in among LHDs serving large populations, with median numbers of employees and
FTEs decreasing by more than 10 percent for LHDs serving 500,000 people or more.
In Chicago, we face a public health infrastructure that was developed over 100 years ago. There is a long history and lots of tradition. But with that can come a “That’s the way we’ve always done it” attitude, and inertia gets in the way of change efforts.
In Chicago, like anywhere else, you have to consider the political landscape. CDPH is just one of more than 30 agencies demanding resources and support from City Hall. And just like anywhere else in the country, it takes more than just business as usual to keep public health in the spotlight. Also, while I report directly to the Mayor, I also am accountable to 50 City Council members. They are all elected officials and their positions are not always aligned with that of the administration, so this can be somewhat of a balancing act.
Finally, we also have to balance the demands of multiple interest groups against what’s in the best interest of public health.
------
For these types of challenges – sound management is not enough. I can’t just have a department that’s doing a more efficient job at what we’ve done in the past. It’s just not enough. We need to be able to manage change and drive innovation.
And to do that, a framework is required. I have been applying two lenses in efforts to move CDPH from our organizational structure and the delivery of routine health services to agency that innovates.
I’m sure you’re familiar with this graphic of the three core functions of public health and how they relate to the 10 essential services, and serve as the foundation for PHAB standards and measures.
It has often been said that “public health is everything.” But if it’s everything then its really nothing. You have to be grounded in what’s distinctive about public health and how public health adds value. How we do things that nobody else does.
So our vision is grounded in the essential services, which allows us to focus our work on what’s important
I am always challenging my staff to be innovative, but if someone proposes an initiative and it doesn’t logically fit within this framework, then I probably won’t support it.
But even with this model, the story is not fully told. For example, there are many ways one can “monitor health.” We have traditionally done this passively by waiting to receive data from birth and death records or on reportable conditions. But we are currently waiting over 3 years to get death data from the State and historical infant mortality rates do little to inform future interventions and improve public health.
In the past two years we have become much more proactive in strengthening relationships with other providers and identifying new and more timely data. For example, this year we gained access to over 80,000 student health records from the Chicago Public Schools – from this we have developed the most comprehensive report to date on childhood obesity in Chicago. Just as important, through this partnership we have established a strong foundation for future collaboration on our shared priority of children’s health.
The second lens that has influenced my role as a leader, comes from Tom Frieden at the CDC.
This graphic builds on the Essential Services and underscores the need to focus public health efforts more broadly – not just on the health and behaviors of individuals.
This framework shifts us from the old public health model of delivering services to building and monitoring system performance.
By calling on public health practitioners to change the context in which decisions are made and to address socio-economic factors, this framework demands that we focus on systems, policy and environmental changes.
I want to focus on this for a moment because this thinking has really re-defined the way we’re doing business at the Chicago Department of Public Health.
Focus on politics here….
Healthy Chicago was developed using local health data to determine the 12 priorities.
Each priority has multiple measures and targets that we monitor and report on annually.
Staff are held responsible for implementing the strategies to achieve the outcomes.
Every CDPH program collects and reports data on both process and outcome measures that align with Healthy Chicago.
We knew the only way to achieve the goals we set forth in Healthy Chicago was to advance the quality and performance of our work, and PHAB standards and measures are the basis for how we have been and will continue to operate.
Finally, none of our work could be fully realized without the help and contributions of our numerous partners. As you know, collaboration is another benefit of Accreditation.
Partnerships play an immensely important role in all of the Department’s work. We currently are actively engaged with hundreds of different organizations.
And the list just keeps growing….
In a time of limited resources at the local, state, and federal levels, partnerships are especially critical to keeping our work progressing.
Another component of our framework for success of Healthy Chicago, is our focus on performance and quality improvement, and accountability at the department.
When I was appointed by Mayor Daley in December 2009, the performance management system in place was directed by City Hall and consisted of a small team at CDPH who reported department-wide measures monthly. Only a few programs at CDPH were reporting data at this time.
One of my first actions as Commissioner was to establish a formal performance management system at CDPH in the beginning of 2010 that would involve the participation of ALL programs in the department. After receiving funding through CDC’s National Public Health Infrastructure grant, we established a formal Office of Performance & Quality Improvement and hired a Deputy Commissioner to lead PQI efforts through out the department.
The Office of PQI continues to evolve with the addition of full time staff on the PQI TEAM in addition to team members who volunteer their time towards the effort. Most importantly, for the past few years, QI has been the focus. We’ve provided QI training to staff, some of our PQI Team has received Lean Six Sigma and Kaizen training, and all programs in the department have an annual QI project in addition to large scale, cross-cutting, department-wide QI projects lead by the PQI Team.
The backbone of our PQI system at CDPH is the Balanced Scorecard. It gives managers and executives at CDPH a balanced overview of how each program is doing.
We use the four quadrants of public health interventions, outcomes, resource management and community & customer engagement to ensure our programmatic activities are aligned with our organization’s vision and strategies in Healthy Chicago.
Every program at CDPH has performance measures in each of these quadrants. These measures are a mix of process and outcome measures, and together they make up the “dashboard” for each program.
Our PQI system at CDPH is multi-faceted. It’s truly a blend of performance and quality improvement, all with a basis in data.
In addition to the Balanced Scorecard, each program reports monthly on their successes, challenges, support needs and new ideas or activities to the Executive Team. The PQI Team reviews the monthly reports, and quarterly themes the challenges and support needs for the Executive Team to review and develop action items to address each one.
The bi-annual performance sessions give programs the opportunity to have one on one time with me and other members of the Executive Team to discuss their work, challenges, what’s going well, where they need support.
The annual QI presentation allows the programs to share their annual QI project methods and results with the rest of the department, it is a great opportunity for other programs to learn about what’s going on in the department and how other programs are addressing areas of improvement.
The success of our PQI system at CDPH is largely due to the communication and training components, which have allowed us to build a culture of QI across all levels of the department. In my weekly email update to staff, I always include a paragraph or 2 about our ongoing PQI efforts, most often highlighting a program. Also, each month program managers discuss their PQI work with staff at their meetings. CDPH provides ongoing training to our managers and supervisors at least every other month, the PQI Office offers QI training bi-annually as part of the QI Learning Collaborative and soon we’ll be launching an annual online PQI training for every staff member.
CDPH is building culture of quality improvement by infusing QI through all levels of the department from frontline staff to the top. Every person in the department is touched by PQI in some capacity.
Our accreditation journey began in May 2011 as we assessed our accreditation readiness. After we determined, we were ready to being pursuing accreditation, we then started to build our team.
We used an inclusive process to form the Accreditation Team by establishing an application process and asking all staff to apply who were interested.
From the beginning, we framed accreditation as a leadership and development opportunity and a means to further infuse QI through the department, which required all level of staff participation.
In fact only one member of our Executive team serves on the Accreditation Team, we have food sanitarians, public health nurses, nutritionists, epidemiologists, public health educators and program/project managers.
A large part of our journey was spent braining storming examples of documentation to submit, collecting those documents, reviewing documents and filling in gaps of documentation. Through out the process, we learned a lot about what we were doing well, and what we needed to do better.
A key component in our Accreditation process was the mock reviews we held both internally and externally. So although, there was a small team of people focused on accreditation at CDPH, it was truly a department project as staff from all programs and levels participated in some ways. In addition, our partners from other public health agencies, academic institutions and others participated in our external mock review. Both of these reviews were immensely helpful in preparing our documentation.
During the accreditation process, the Accreditation Team spent a lot of time communicating the importance of meeting national standards and making this relevant to individual staff. The process also allowed for cross program collaboration and has started to break down silos across programs at CDPH.
CDPH was accredited by PHAB in August of 2013. This is an outstanding achievement for our department but our work has just begun. Being accredited means that we continue to strive to improve our work and to ensure we are always meeting PHAB standards. In fact, our Accreditation Team is still going strong, making sure that we are meeting the standards and measures, and ensuring that the opportunities for improvement identified during the accreditation process are being addressed.
Leadership, communication and teamwork are CDPH’s greatest asset in achieving and maintaining accreditation, and making us a high performing local health department.
As Commissioner I was completely supportive and understood the reasons why we needed to pursue accreditation, and the significant commitment of time and resources that would be required. I knew, and made clear, that accreditation was and is a top priority for CDPH.
The identification and selection of a dedicated cross-disciplinary team and a strong team leader are also important contributors to our success.
Lastly, communication to staff about accreditation, what it is, why it’s important, how their work is related to the standards and domains was critical to being accredited. Communication to the Executive Team from the Accreditation Team also facilitates our being able to help where needed, so nothing impedes our progress.
Mayor buy-in….HUGE!
At the core of Healthy Chicago is the recognition that the choices and behaviors of individuals are heavily influenced by their environments. We can’t direct people to eat healthier foods when their neighborhoods lack a large grocery store and their corner stores are only selling junk foods and sugar-sweetened beverages. These are burdens that the City must take on.
As many of you know, our Healthy Chicago agenda identifies 12 priority areas.
We started out with 193 strategies, but have added more as we have created opportunities to improve the health of Chicagoans.
We now have 241 Healthy Chicago strategies and 92% of them have either been fully implemented or are currently in progress.
We also have 17 outcome measures with 2020 targets that align with the 12 priority areas.
Now, I’m going to spend some time sharing our success in implementing Healthy Chicago strategies and how this work aligns with the 12 domains of accreditation.
At the bottom of this and upcoming slides, you’ll notice multi-colored bars, which reflect the accreditation domains connected to our work.
For example, our work in tobacco use touches on 7 different domains: assessment, informing & educating, engaging the community, developing policies & plans, enforcing public health laws, promoting access to care and engaging the governance.
In 2013, we had some of our greatest successes in the area of tobacco use and many examples of how partnerships, policy, public awareness can come together to create change.
Lets talk about the historic tobacco tax increase.
In 2013, we had some of our greatest successes in the area of tobacco use and many examples of how partnerships, policy, public awareness can come together to create change.
Lets talk about the historic tobacco tax increase.
In late 2013, the City Council passed a 50 cent tax increase on a pack of cigarettes.
With local, state and federal taxes considered, Chicago now has the highest cigarette tax in the nation at $7.17 a pack.
This is just one area where our partners – many of you here today – came together in a powerful way to fight for groundbreaking change.
Healthy Chicago partners also came together to successfully advocate to address the challenge of flavored tobacco including menthol –
In August, Mayor Emanuel directed the Board of Health to convene town hall meetings to identify solutions to reduce menthol cigarette use among our youth.
Led by our Board president, Dr. Carolyn Lopez, 4 town hall meetings were convened and recommendations were forwarded to the Mayor.
And at it’s December meeting, the Chicago City Council passed an ordinance which banned the sale of flavored tobacco – including menthol – within 500 feet of a school. This was a groundbreaking ordinance - the first of its kind anywhere – federal, state, or local.
Our third tobacco policy success and most hard fought battle concerned e-cigarettes.
Following two contentious committee meetings, in early January, the City Council voted to “stand with public health” and “be on the right side of history,” by regulating electronic cigarettes.
The ordinance will protect Chicago youth by
Requiring e-cigarettes to be placed behind sales counters,
Prohibiting sales to minors
And requiring e-cigarette retailers to obtain a tobacco retail license.
The Council also voted to restrict e-cigarette use by including these devices under Chicago’s Clear Indoor Air Act.
We are increasingly using media not only to reinforce the need to behavior change among our residents, but also to generate support for our policy efforts. We had two targeted campaigns last year – “Burned by Menthol Cigarettes” and “Take Pride, Leave Cigarettes” which addressed the LGBT community.
More Smokers are seeking cessation
All of our tobacco campaigns promote the State-funded Tobacco Quitline and as you can see in this slide, calls for cessation support from Chicagoans have increased recently.
Over 24,000 calls came from Chicagoans last year, an increase of about 10,000 from 2012.
Finally, work continued in 2013 to increase smoke-free environments.
In July, the University of Illinois at Chicago enacted a smoke-free campus policy affecting their 27,000 students, as well a faculty, staff, and hospital patients and visitors.
This latest policy brings the total number of smoke-free institutions of higher education to 5 and the number of smoke-free hospital campuses to seven.
CHA continued its important smoke free work, designating the Dearborn Homes and Sullivan Station smoke-free bringing the total number of smoke-free CHA developments to 6 with 610 smoke-free public housing units.
As you can see from this list of policy changes currently only being considered at the federal level, in 2013 Chicago established itself as a clear leader in tobacco control efforts.
None of these accomplishments would have been possible without the significant efforts of so many partners.
Work to expand access to healthy and affordable food continued in 2013 – let me share just 4 examples.
In January, Chicago’s food plan – A Recipe for Healthy Places – was approved by the City’s Plan Commission. With 6 community-based strategies to support healthy eating, the plan is our official roadmap for city planning and policymaking around food access.
The Plan was developed with significant community input, the leadership of critical partners Department of Planning and Development, Family and Support Services, CDPH, and CLOCC – the Consortium to Lower Obesity in Chicago children.
Also last year, the City joined CPS and the Park District by implementing a Healthy Vending policy affecting machines in all City owned and operated buildings.
The Park District – strengthened their healthy vending policy by offering only low- or no-calorie options in their beverage machines.
The work of Neighbor Capitol and Streetwise continued and in 2013 there were 15 licensed produce carts in the city, with another 15 planned for 2014 .
20 related jobs were created and over 40 people were also trained in retail sales.
And the 4th example of food access work, also includes a job development component. the City’s Farmers for Chicago initiative will initially making available 5 more acres of land for farming. Growing Power will then train local farmers and help them install needed equipment.
The Divvy bike share program was launched in June with an initial 700 bikes and 65 docking stations. By years end,
The fleet had expanded to over 3,000 bikes and 300 docking stations
Over 1.4 Million trips were taken coving more than 3.1 Million miles.
21,207 annual memberships and nearly 212,171 24-hour passes were sold.
On the right side of this slide you can see the before and after of the Dearborn St. Complete Street where a buffered bike lane was created.
Chicago bike riders are now supported by 200 miles of protected, buffered or shared bike lanes, more than 13,000 bike racks, and by 2020, a 645-mile network of biking facilities will provide a bicycle accommodation within one half mile of every Chicagoan.
There is much to talk about with increased opportunities for physical activity, and a lot of this work has been led by our colleagues at the Chicago Department of Transportation.
In April, CDOT released Complete Street design guidelines (part of our Healthy Places initiative) with a primary emphasis on supporting walking, biking, and public transportation.
Our Playstreet program expanded in 2013, with 61 events and over 13,000 participants – twice as many as in 2012.
I want to recognize our Playstreet partners – Blue Cross Blue Shield, Active Transportation Alliance, LISC Chicago, and World Sport Chicago.
Finally in the area of obesity prevention I want to talk about our continued focus on CPS students, under the leadership of our shared chief health officer, Dr. Stephanie Whyte.
CDPH has recently been enjoying a data-sharing partnership with CPS, resulting in what we believe to be the largest scale look at childhood obesity in Chicago. In February of last year, our first join report was focused on the physical exam records of over 59,000 students,
The report – looking at students in kindergarten, 6th and 9th grades, revealed overall obesity prevalence was 25%, with the highest rates among 6th graders.
A subsequent report focused on the most recent health records, found slight reductions in kindergarten obesity at 19%.
CDPH and its partner, Health & Disability Advocates, prepared a report on the uninsured in Chicago to better inform and target efforts at outreach, education and enrollment.
In addition to describing the characteristics of newly eligible Chicagoans in this profile, guidance was also presented on how to best use this information to reach these residents.
I’ll show you some of those efforts to engage and reach Chicagoans next.
As of November, 125,000 applications submitted to state for approval. Officials say the expansion will generate $468 million next year for the county’s health programs, reducing the burden on taxpayers.
Another way CDPH is promoting enrollment is by focusing on children and implementing a Medicaid enrollment program.
Through the All Kids program, Illinois children (≤18 years old, ≤ 300% poverty) qualify for Medicaid and can receive comprehensive care.
Including: physician visits, hospital stays, prescription drugs, vision care, dental care and medical devices (e.g. glasses, asthma inhalers).
However, up to 50,000 CPS students are still uninsured despite CPS efforts.
To reach these children, CDPH issued a Request for Proposals (RFP), which will fund a Lead Organization to coordinate outreach and application completion for at least 5,000 CPS students, which wall lead to enrollment in All Kids. The LO will work with community-based organizations to reach these students.
Grant period: October 2013 – September 2015
Funding available: $350,000-$1,050,000
Our Public Health Infrastructure priority area has many strategies. Today, I’ll focus on our innovation in technology strategy.
We’re at approx 50 health datasets in the open data portal and growing. We are releasing more publicly available data to help spur innovation at the Department as well as in the civic tech and business communities.
Here is a tweet from a Chicago resident that our app discovered and a report was submitted.
These are the themes that have been very important in our work: Partnerships, Policy, Technology and Public Awareness.
Each of these components plays a distinctive and critical role to the success of our work at the Chicago Department of Public Health. However, one component alone does not provide a success, but it is the sum of all these components working together that has and will continue to help us transform the health of Chicago and attain our goal of making Chicago the healthiest city in the nation.
Accreditation is working at CDPH because its providing standards that we can measure ourselves against and continually work to improve upon, developing our workforce and focusing on the customer – the residents of Chicago.
Each of these factors are critical our success as a local health department.