Annual Population Health Sciences Colloquium at the Stanford Center for Population Health Sciences on October 26, 2015.
This one-day program will showcase population health sciences research from the Stanford community and experts around the world.
This one-day program will showcase population health sciences research from the Stanford community and experts around the world. The PHS Initiative aims to bring together basic, translational and clinical scientists, along with researchers from disciplines across the entire University, to provide resources and facilitate collaborations focused on population-level questions, data and approaches.
We have an exciting full-day session with keynote speakers - Lloyd Minor, Dean of the Stanford School of Medicine; Muin Khoury, Associate Director of Epidemiology and Genomics Research Program at NCI; and Tomas Aragon, Director of Population Health Division at the San Francisco Department of Public Health - and some time to do the vital work of growing our center.
Towards a Critical Health Equity Research Stance: Why Epistemology and Method...Jim Bloyd, DrPH, MPH
Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies—namely, photovoice and critical ethnography— that, pursuant to critical approaches, prioritize dismantling social–structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.
Equity is the absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification. "Health equity” or “equity in health” implies that ideally, everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential.
Quality Of Life, Spirituality and Social Support among Caregivers of Cancer P...iosrjce
Caregiving can be both rewarding and challenging. Literature suggests that family caregivers may
experience increased symptoms of psychological and social malfunctioning. However, it may also provide one
with opportunities to renew relationships or feel connected to a higher power. The current study is an attempt to
investigate how caregiving influences a person’s general wellbeing. The sample consisted of 25 caregivers of
cancer patients and 25 appropriately matched control.World Health Organization- QOL (1991),
Multidimensional Scale of Perceived Social Support by Zimet, et al (1988) and Spiritual Perspective Scale by
Reed (1986) were used to asses QOL, Social support and spirituality respectively. The obtained data was
analyzed in SPSS using independent sample t-test. Results indicated a significant difference between Caregivers
and the control group on QOL, spirituality and social support.
Zero Suicide in Healthcare International Declaration (March 2016)David Covington
A diverse group of 50 peer leaders, government policy makers, and healthcare providers from 13 countries convened for Atlanta 2015: An International Declaration and Social Movement. Invited guests included “Zero Suicide” advocates and pioneers as well as others committed to suicide prevention and better healthcare.
Public Health Association of South Africa (PHASA) poster presentation of the "Theoretical underpinnings of promotion campaigns for
medical male circumcision HIV prevention interventions in sub-Saharan Africa"
Social support among the Caregivers of Persons Living with Cancerinventionjournals
:The social support emphasize as the support given to any person in a troublesome or burdensome situation by family members, relatives as well as resources exerted by social connections, is effective in promoting physical health and feeling oneself good. The present study consisted of 300 caregivers of persons with cancer was selected based on simple random sampling, and with inclusion and exclusion criteria. Those patients satisfying the inclusion and exclusion criteria and attending both outpatient and inpatient services of cancer specialty hospital in KIDWAI Bangalore, Karnataka were selected randomly. The data was collected from the patients & caregivers of persons living with cancer who fulfill the inclusion/exclusion criteria were taken up for the study after their consent. Multidimensional Scale of Perceived Social Support (Zimet et al, 1998) was administered to understand Perceived Social Support. The interviews and the instruments were administered by research experts.The Results suggest that there were poor social support found in caregivers of married, female, belong to rural domicile, illiterate, and,caregivers who were not heard about the treatment of cancer.
Advancing the field of cultural competency by providing the first structural competency certificate program in the country. Online, on-demand and FREE, including free continuing education credits. Live trainings coming soon. Give me a call!
Suicide Prevention Experts Convene in Washington DCDavid Covington
Last year, over 45 thousand people died by suicide in the U.S., one person every 11.7 minutes, while over a million people attempted suicide. With suicide rates in the U.S. steadily climbing, suicide remains the 10th leading cause of death in the US, the American Association of Suicidology (AAS) recognizes that the only way to impact this serious public health issue is to draw from scientific research and initiate implementation of effective strategies. We anticipate over 1,500 attendees to this year’s conference in the heart of political advocacy, Washington, D.C, April 18 - 21,
2018 at the Hyatt Regency Capitol Hill.
Towards a Critical Health Equity Research Stance: Why Epistemology and Method...Jim Bloyd, DrPH, MPH
Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies—namely, photovoice and critical ethnography— that, pursuant to critical approaches, prioritize dismantling social–structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.
Equity is the absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification. "Health equity” or “equity in health” implies that ideally, everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential.
Quality Of Life, Spirituality and Social Support among Caregivers of Cancer P...iosrjce
Caregiving can be both rewarding and challenging. Literature suggests that family caregivers may
experience increased symptoms of psychological and social malfunctioning. However, it may also provide one
with opportunities to renew relationships or feel connected to a higher power. The current study is an attempt to
investigate how caregiving influences a person’s general wellbeing. The sample consisted of 25 caregivers of
cancer patients and 25 appropriately matched control.World Health Organization- QOL (1991),
Multidimensional Scale of Perceived Social Support by Zimet, et al (1988) and Spiritual Perspective Scale by
Reed (1986) were used to asses QOL, Social support and spirituality respectively. The obtained data was
analyzed in SPSS using independent sample t-test. Results indicated a significant difference between Caregivers
and the control group on QOL, spirituality and social support.
Zero Suicide in Healthcare International Declaration (March 2016)David Covington
A diverse group of 50 peer leaders, government policy makers, and healthcare providers from 13 countries convened for Atlanta 2015: An International Declaration and Social Movement. Invited guests included “Zero Suicide” advocates and pioneers as well as others committed to suicide prevention and better healthcare.
Public Health Association of South Africa (PHASA) poster presentation of the "Theoretical underpinnings of promotion campaigns for
medical male circumcision HIV prevention interventions in sub-Saharan Africa"
Social support among the Caregivers of Persons Living with Cancerinventionjournals
:The social support emphasize as the support given to any person in a troublesome or burdensome situation by family members, relatives as well as resources exerted by social connections, is effective in promoting physical health and feeling oneself good. The present study consisted of 300 caregivers of persons with cancer was selected based on simple random sampling, and with inclusion and exclusion criteria. Those patients satisfying the inclusion and exclusion criteria and attending both outpatient and inpatient services of cancer specialty hospital in KIDWAI Bangalore, Karnataka were selected randomly. The data was collected from the patients & caregivers of persons living with cancer who fulfill the inclusion/exclusion criteria were taken up for the study after their consent. Multidimensional Scale of Perceived Social Support (Zimet et al, 1998) was administered to understand Perceived Social Support. The interviews and the instruments were administered by research experts.The Results suggest that there were poor social support found in caregivers of married, female, belong to rural domicile, illiterate, and,caregivers who were not heard about the treatment of cancer.
Advancing the field of cultural competency by providing the first structural competency certificate program in the country. Online, on-demand and FREE, including free continuing education credits. Live trainings coming soon. Give me a call!
Suicide Prevention Experts Convene in Washington DCDavid Covington
Last year, over 45 thousand people died by suicide in the U.S., one person every 11.7 minutes, while over a million people attempted suicide. With suicide rates in the U.S. steadily climbing, suicide remains the 10th leading cause of death in the US, the American Association of Suicidology (AAS) recognizes that the only way to impact this serious public health issue is to draw from scientific research and initiate implementation of effective strategies. We anticipate over 1,500 attendees to this year’s conference in the heart of political advocacy, Washington, D.C, April 18 - 21,
2018 at the Hyatt Regency Capitol Hill.
The High Achieving Governmental Health Department in 2020 as the Community Ch...Tomas J. Aragon
This paper was prepared by RESOLVE as part of the Public Health Leadership Forum with funding from the Robert Wood Johnson Foundation. John Auerbach, Director of Northeastern University’s Institute on Urban Health Research, also put substantial time and effort into authoring the document with our staff. The concepts put forth are based on several working group session (See Appendix B for members) and are not attributable to any one participant or his/her organization.
Presentation by Camara Jones, MD, MPH, PhD at the 2009 Virginia Health Equity Conference.
Dr. Jones presents the “Cliff Analogy” for understanding four levels of health intervention: medical care, secondary prevention, primary prevention, and addressing the social determinants of health. She described how health disparities arise on three levels (differences in quality of care, differences in access to care, and differences in underlying exposures and opportunities) and expand the “Cliff Analogy” to illustrate the relationship between addressing the social determinants of health and addressing the social determinants of equity, which is a fifth level of health intervention.
She identifies racism as one of the social determinants of equity and a fundamental cause of “racial”/ethnic health disparities in the United States, with racism defined as a system of structuring opportunity and assigning value based on the social interpretation of how one looks, which is what we call “race.” She described how racism impacts health on three levels (institutionalized, personally-mediated, and internalized) and animate understanding of these levels of racism with her “Gardener’s Tale” allegory.
Finally, using data from the “Reactions to Race” module on the 2004 Behavioral Risk Factor Surveillance System, she examined the relationship between responses to “How do other people usually classify you in this country?” and self-rated general health status to provide evidence of the impacts of racism on health. Dr. Jones challenges us to broaden the scope of our public health interventions by asking the question “How is racism operating here?” and then working to create a system in which ALL people are highly valued and ALL people are able to develop to their full potential.
الخلايا الجذعية وتطبيقاتها
الاستنساخ وعلاقته مع الخلايا الجذعية
استنساخ البشر واخر ابحاثها
2014
استنساخ النعجة دولي
كيفية اجراء الاستنساخ
هل يمكن استنساخ البشر ؟؟
New approaches for moving upstream how state and local health departments can...Jim Bloyd, DrPH, MPH
Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are “upstream” drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on “downstream” behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators’ role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities.
Running Head FINDINGS USED TO MAKE PUBLIC HEALTH PLANNING AND POL.docxcowinhelen
Running Head: FINDINGS USED TO MAKE PUBLIC HEALTH PLANNING AND POLICY DECISIONS 5
Findings Used to Make Public Health Planning and Policy Decisions
Unit 4 - HA560
March 28, 2016
There has been increased concern among policy makers, scientists and communities that health is greatly affected by a number of factors that occur in a person’s lifetime and in multi levels. Prevention is sententious to curb occurrence of any disease within the population, and it has to come first even if access to quality healthcare services is provided. To adequately promote health and prevent diseases, certain policies and factors need to be addressed mostly factors that are related to health behaviors.
Social psychology is all about understanding individuals’ behavior specifically in a social setting. Basically, social psychology focuses on factors that influence people to behave in certain ways in presence of others. The two greatest contributors in the field of social psychology were Allport (1920) and Bandura (1963). To begin with, according to Allport; he argued that the interaction of individuals with others or the presence of social groups can encourage the development of certain behaviors (Kassin, 2014). This is what Allport referred to as social facilitation, in his research he identified that an audience will facilitate the performance of an actor in a well learnt and understood task; however the performance of the same actor will decrease in performance on difficult tasks which are newly learnt, and this is contributed by social inhibition. The second contributor in the field of social psychology is Bandura (1963), in his work he developed a notion that behavior in the social world could be possibly modeled, and this is what he referred to as social learning theory. He gave his explanation with three groups of children who were watching a video where in the video an adult showed aggressiveness towards a “bobo doll” and the adults who displayed such behavior were awarded by another adult or were just punished. Therefore Bandura found that children who saw the adult being rewarded were found to be more likely to imitate that adult’s behavior.
Certain theories plays important roles in health assessment, and a theory is defined as a collection of concepts in specific area of concern or interest in the world that need explanations, intervening and prediction. Theories need to be backed up with evidence that tend to explain why things will happen in relation to current situations, and followed with some actions to turn situations in certain desirable ways. Health assessment can be defined as a plan of care that recognizes specific person’s health needs and how such needs will be addressed by healthcare system or any other health institutions (Jarvis, 2008). Generally, health assessment is the evaluation of health status through examination of physical and psychological concerns after looking at the health history of the victim assess ...
Running Head FREE RADICAL THEORY OF AGING 1 .docxjeanettehully
Running Head: FREE RADICAL THEORY OF AGING 1
Research Article Summary:
Free Radical Theory of Aging
University of Maryland Baltimore County
FREE RADICAL THEORY OF AGING 2
Theories of aging are important aspects of understanding the aging process. The
theories give society different methods to understand how and why aging occurs, even
though not all of the theories are accurate. Most theories of aging have some sort of
research that back them, unlike personal experiences or educated guesses. Theories of
aging change our perception of adults and aging by giving us an understanding of the
process of aging. If we are able to better understand how aging occurs and why it occurs,
society is more likely to accept the process and accept elders. Theories of aging are
relevant to those who work with older adults because theories can help workers focus on
specific aspects of aging to increase care. An example is our knowledge of the
immunological theory. As we age our immune system deteriorates leaving elders more
susceptible to disease; workers can attempt to improve sanitation of elder care to decrease
risk of diseases. The quality of programs and services of older adults can be improved by
the theories because they allow for a better understanding of the development of older
adults, which allows caretakers to improve their approaches to care.
The biological theory of free radicals contributes to the physical aspect of aging.
Free radicals are waste products produced by cells, specifically, molecules of ionized
oxygen that have an extra electron (Moody & Sasser, 2014, p. 21). The free radicals
cause damage because they bond with proteins and other structures in the body, which
can inactivate them and make them unable to function. The amount of free radicals in the
body increase as people age. This causes mutations, damage to organs, and ultimately the
symptoms we see as aging. The body does create antioxidants, which are protection
against free radicals; they find and destroy the free radicals, preventing damage of cells
FREE RADICAL THEORY OF AGING 3
(Moody & Sasser, 2014, p. 62). Although it is thought that consuming antioxidants will
slow aging, studies have only shown minimal effects (Moody & Sasser, 2014, p. 62).
Schöttker et al. (2015) studied if free radicals were associated with mortality,
more specifically the association of derivatives of reactive oxygen metabolites (d-ROMs)
and total thiol levels (TTL) with mortality from all causes, cardiovascular disease, and
cancer. The study was conducted on two groups. The first group was Health, Alcohol and
Psychosocial Factors in Eastern Europe (HAPIEE) from Poland, Czech Republic, and
Lithuania. The second group was an eight year follow up from Epidemiologische Studie
zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer
Erkrankungen in d ...
Series294 www.thelancet.com Vol 380 July 21, 2012L.docxklinda1
Series
294 www.thelancet.com Vol 380 July 21, 2012
Lancet 2012; 380: 294–305
Published Online
July 18, 2012
http://dx.doi.org/10.1016/
S0140-6736(12)60898-8
This is the fi fth in a Series of
fi ve papers about physical activity
*Members listed at end of paper
University of Texas Health
Science Center, Houston School
of Public Health, and University
of Texas at Austin Department
of Kinesiology and Health
Education, Austin, TX, USA
(Prof H W Kohl 3rd PhD);
Canadian Fitness and Lifestyle
Research Institute, Ottawa, ON,
Canada, and School of Public
Health, University of Sydney,
Sydney, NSW, Australia
(C L Craig MSc); UCT/MRC
Research Unit for Exercise
Science and Sports Medicine,
Department of Human Biology,
Faculty of Health Sciences,
University of Cape Town, Cape
Town, South Africa
(Prof E V Lambert PhD); Tokyo
Medical University, Department
of Preventive Medicine and
Physical Activity 5
The pandemic of physical inactivity: global action for
public health
Harold W Kohl 3rd, Cora Lynn Craig, Estelle Victoria Lambert, Shigeru Inoue, Jasem Ramadan Alkandari, Grit Leetongin, Sonja Kahlmeier, for the
Lancet Physical Activity Series Working Group*
Physical inactivity is the fourth leading cause of death worldwide. We summarise present global eff orts to counteract
this problem and point the way forward to address the pandemic of physical inactivity. Although evidence for the
benefi ts of physical activity for health has been available since the 1950s, promotion to improve the health of populations
has lagged in relation to the available evidence and has only recently developed an identifi able infrastructure, including
eff orts in planning, policy, leadership and advocacy, workforce training and development, and monitoring and
surveillance. The reasons for this late start are myriad, multifactorial, and complex. This infrastructure should continue
to be formed, intersectoral approaches are essential to advance, and advocacy remains a key pillar. Although there is a
need to build global capacity based on the present foundations, a systems approach that focuses on populations and
the complex interactions among the correlates of physical inactivity, rather than solely a behavioural science approach
focusing on individuals, is the way forward to increase physical activity worldwide.
The pandemic of physical inactivity should be a
public health priority
Theoretically, prioritisation for public health action is
informed largely by three factors: the prevalence and
trends of a health disorder; the magnitude of the risk
associated with exposure to that disorder; and evidence
for eff ective prevention and control. A practice or
behaviour that is clearly related to a health disorder, is
prevalent, and is static or increasing in its prevalence
should be a primary target for public health policy for
disease prevention and health promotion. Too often,
however, the inertia of tradition, pressure .
The First session in the Epidemiology Lecture Series
Defining Epidemiology. Keywords in the definition. Aims of Epidemiology, Epidemiological Approach & Reasoning
1
Literature Review Assignment
STUDENT NAME
Class
Date
2
Part A: Annotated Bibliography
Article 1: Immigration as a Social Determinant of Health
Castañeda, H., Holmes, S. M., Madrigal, D. S., Young, M.-E. D., Beyeler, N., & Quesada, J.
(2015). Immigration as a Social Determinant of Health. Annual Review of Public
Health, 36(1), 375–392. doi: 10.1146/annurev-publhealth-032013-182419
Abstract
Although immigration and immigrant populations have become increasingly important foci in
public health research and practice, a social determinants of health approach has seldom been
applied in this area. Global patterns of morbidity and mortality follow inequities rooted in
societal, political, and economic conditions produced and reproduced by social structures,
policies, and institutions. The lack of dialogue between these two profoundly related
phenomena—social determinants of health and immigration—has resulted in missed
opportunities for public health research, practice, and policy work. In this article, we discuss
primary frameworks used in recent public health literature on the health of immigrant
populations, note gaps in this literature, and argue for a broader examination of immigration as
both socially determined and a social determinant of health. We discuss priorities for future
research and policy to understand more fully and respond appropriately to the health of the
populations affected by this global phenomenon.
Annotated Bibliography
The article reports on the importance of identifying social determinants and the effects of
socially determined structures among immigrant populations in the United States. The study
identifies ways in which immigrants health outcomes are based on biases due to using
3
information based on group behaviors instead of on an induvial case. The impact of migrant and
immigrant individuals, physical and mental health in these communities’ changes as social,
economic, and political policies take place. This article is helpful in that broadens the
immigration experience including more central factors than just language, income, or education
as the cause of all health related problems in this community. But to show factors of power
structures and the ability to put in place effective health interventions that respond to direct
causes of poor or declining health in these populations.
Article 2: Fear by Association: Perceptions of Anti-Immigrant Policy and Health Outcomes
Vargas, Edward & Sanchez, Gabriel & Juárez, Melina. (2017). Fear by Association: Perceptions
of Anti-Immigrant Policy and Health Outcomes. Journal of Health Politics, Policy and
Law. 42. 3802940. 10.1215/03616878-3802940.
Abstract
The United States is experiencing a renewed period of immigration and immigrant policy
activity as well as heightened enforcement of such policies. This intensified activity can affect
various aspects of im ...
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
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
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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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
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ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Population Health Data Science, Complexity, and Health Equity: Reflections from a Local Health Official
1. Population Health Data Science, Complexity, and
Health Equity: Reflections from a Local Health Official
Tom´as J. Arag´on, MD, DrPH
Health Officer, City and County of San Francisco
Director, Population Health Division (PHD)
San Francisco Department of Public Health
Adjunct Faculty, UC Berkeley School of Public Health
Keynote Address: Stanford Center for Population Health Sciences
Annual PHS Colloquium an October 26, 2015
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 1 / 30
2. Overview
1 Introduction and background
2 Population health data science
3 Transforming complex social systems
4 Tackling population health inequities
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 2 / 30
3. Introduction and background
Causes of Premature Deaths in Men & Women
San Francisco, 2003–2004 (How do we explain health inequities and resilience?)
Age-adjusted Expected Years of Life Lost (eYLL): Male (left), Female (right); Black (colored
red), Latino, × Asian/PI, + White; Source: Arag´on TJ, et al. PubMed ID: 18402698
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 3 / 30
4. Introduction and background
Some definitions
Health (WHO 1946)
Health is a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity.
Public Health (IOM 1988)
Public health is what we, as a society, do collectively to assure the
conditions in which people can be healthy.
Population Health (TJA 2015)
A systemsa framework for studying and improving the health of
populations through collective action and learning.
a
Complexity or complex adaptive systems
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 4 / 30
5. Introduction and background
Health includes the 8 dimensions of wellness
Source: http://www.samhsa.gov/wellness-initiative
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 5 / 30
6. Population health data science
More definitions
Population Health (TJA 2015)
A systemsa framework for studying and improving the health of
populations through collective action and learning.
a
Complexity or complex adaptive systems
Data science
Data science is the art and science of transforming data into actionable
knowledge.
Population health data science (TJA 2015)
Population health data science is the art and science of transforming
health relevant data into actionable knowledge.
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 6 / 30
7. Population health data science
Population Health Data Science
Describe—Discover—Predict—Advise
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 7 / 30
8. Transforming complex social systems
Complexity and why it matters
What is a complex adaptive system?
1 A population of diverse agents, all of which are
2 connected, with behaviors and actions that are
3 interdependent, and that exhibit
4 adaptation and learning.
Why do we care? Complex systems . . .
are ambiguous, deceptive, unpredictable
are difficult to direct and control (adaptation, resistance)
can self-organize and locally optimize (silos, tribes)
can evolve along divergent pathways (pathway dependence)
can produce phase transitions (“tipping points”) (e.g., epidemics)
can produce emergent phenomenon (e.g., herd immunity)
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 8 / 30
9. Transforming complex social systems
Conceptualizing systems (selected approaches)
Causal loop diagrams
Agent-based models
Social network models
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 9 / 30
10. Transforming complex social systems
Creating causal loop diagram (immunization example)
Incidence of Immunity
Inducing Infection
neg
Community Immunity
posBalancing
feedback loop
Delay
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 10 / 30
11. Transforming complex social systems
Causal loop diagram of childhood immunization system
Number of
Vaccinations
Incidence of Vaccine
Preventable Diseases
neg
pos
Number of Vaccine
Adverse Effects
pos
Complexity of the
Immunization Schedule
pos
Demand for
Vaccinations
pos
Parental Concerns About
Vaccine Adverse Effects
pos
pos
neg
Community
Immunity
pos
pos
Parental and Community
Concerns About Vaccine
Preventable Diseases
pos
pos
Providers Adhering to
Recommended
Immunization Schedule
Delay
Development, Approval,
and Promulgation of
New Vaccines
pos
pos
pos
pos
pos
pos
Logistical Burden on
Health Care System
pos
pos
Demand for Reduced,
Alternative Schedules
pos
neg
pos
Vaccine Advisory Boards
Vaccine Manufacturers
Professional Associations
Academic Researchers
Public Health Authorities
Patient Advocacy groups
Source: TJA
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 11 / 30
12. Transforming complex social systems
Networking modeling of epidemics using R
Source: http://www.reed.edu/reed_magazine/march2012/articles/features/
morris/morris.html
Network Modeling for Epidemics (Dr. Martina Morris, University of Washington):
http://statnet.csde.washington.edu/EpiModel/nme/index.html
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 12 / 30
13. Transforming complex social systems
Public health tools for improving population health
Source:Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 13 / 30
14. Transforming complex social systems
Population health tools for improving population health
Source:Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 14 / 30
15. Transforming complex social systems
Public health tools for improving population health
Source:Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 15 / 30
16. Transforming complex social systems
Collective impact fulfills five criteria1
1 Common Agenda: All participants have a shared vision for change including
a common understanding of the problem and a joint approach to solving it.
2 Shared Measurement: Collecting data and measuring results consistently
ensures efforts remain aligned and participants hold each other accountable.
3 Mutually Reinforcing Activities: Participant activities must be
differentiated while still being coordinated through a mutually reinforcing
plan of action.
4 Continuous Communication and Improvement: Consistent and open
communication is needed across the many players to build trust, assure
mutual objectives, and continuously improve.
5 Backbone Organization: Collective impact requires a separate
organization(s) with staff to serve as the backbone for the entire initiative
and coordinate participating organizations and agencies.
1
Adapted from http://www.fsg.org
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 16 / 30
17. Transforming complex social systems
What is Health Equity X (HEX) model
HEXa,b
is used for planning and managing
efforts to achieve results for challenges and
opportunities embedded in complex social
systems, including for quality improvement,
health equity, and collective impact.
1 People (mental models, belief
systems, cultural norms, “isms”)
2 Policy (social, organizational)
3 Place (neighborhood, school, work,
open space)
4 Program (program, agency, or service
system)
5 Provider (teacher, doctor, priest)
6 Patron (patient, client, customer)
Patron
Program
People
Provider
Place
Policy
Health
Equity
a
HEX model was inspired by BARHII (http://www.barhii.org) and Dr. Tony Iton (See Pubmed ID: 25423053)
b
A hexateron is a geometric object with 6 vertices, 15 edges, 20 triangle faces, 15 tetrahedral cells
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 17 / 30
18. Transforming complex social systems
Public health tools for improving population health
Source:Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 18 / 30
19. Transforming complex social systems
Public health tools for improving population health
Source:Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 19 / 30
20. Tackling population health inequities
Causes of Premature Deaths in Men & Women
San Francisco, 2003–2004 (How do we explain health inequities and resilience?)
Age-adjusted Expected Years of Life Lost (eYLL): Male (left), Female (right); Black (colored
red), Latino, × Asian/PI, + White; Source: Arag´on TJ, et al. PubMed ID: 18402698
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 20 / 30
21. Tackling population health inequities
Neural connections in early childhood
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 21 / 30
22. Tackling population health inequities
Executive function and self-regulation
Depends on working memory, mental flexibility, self-control
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 22 / 30
23. Tackling population health inequities
Adverse Childhood Experiences (ACEs) Pyramid
Source: Center for Youth Wellness (http://www.centerforyouthwellness.org)
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 23 / 30
24. Tackling population health inequities
Trauma-informed, Intergenerational Life Course Model
The effects of trauma (toxic stress) are transmitted from one generation to the next
A newborn child rises to better
health over his or her life
course by multilevel,
interdependent forces that
promote safe, nurturing
relationships for healthy
neurodevelopment, prevent
toxic stress, protect against
unavoidable toxic stress, and
prepare children to be resilient.
Children ages 0 to 5 are totally
dependent on adult caregivers
for the 4Ps, and are most
vulnerable to the lifelong
effects of toxic stress that alter
brain, body, and behavior
leading to health inequities.
Source: TJA 2015
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 24 / 30
25. Tackling population health inequities
Toxic Stress! Childhood Roots of Adult Health Inequities
Re-conceptualizing Early Childhood Policies and Programs to Strengthen Lifelong Health
Source: Center for the Developing Child at http://developingchild.harvard.edu/
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 25 / 30
26. Tackling population health inequities
Health Equity X (HEX) model
1 People (mental models, belief
systems, cultural norms, “isms”)
2 Policy (social, organizational)
3 Place (home, neighborhood,
schools, work, parks)
4 Program (programs, agencies,
or service systems)
5 Provider (caregiver, teacher,
doctor, priest)
6 Parents (clients, customers,
patients)
Parents
Program
People
Provider
Place
Policy
Child
(age 0-5)
a
HEX model was inspired by BARHII (http://www.barhii.org) and Dr. Tony Iton (See Pubmed ID: 25423053)
b
A hexateron is a geometric object with 6 vertices, 15 edges, 20 triangle faces, 15 tetrahedral cells
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 26 / 30
27. Tackling population health inequities
Ensuring the childhood roots of health equity
Trauma-Informed Public Health Approach for Adults and Children
1 Prevent (toxic stress)
2 Protect (from toxic stress)
3 Prepare (by building resiliency skills)
4 Promote (healthy/enrichment opportunities)
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 27 / 30
28. Tackling population health inequities
Summary
1 Population health data science
Start backwards (understand individual and group decision-making!)
Focus on actionable knowledge (Adivse–Predict–Discover–Describe)
Focus on human-centered design (“precision public health”)
2 Transforming complex social systems
Understand complex adaptive systems (requires humility)
Transform self, teams, organizations, communities (in that order:
requires continuous improvement, taking risks, learning from failures)
3 Tackling population health inequities
Inter-generational transmission of trauma
Toxic stress alters brain, body, and behavior
Life course of trauma, racism, and discrimination
4Ps of public health: prevent, protect, prepare, promote
6Ps of HEX model: people, policy, place, program, provider, parents
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 28 / 30
29. Tackling population health inequities
The Raising of America (Documentary)
Early Childhood and the Future of Our Nation
http://www.raisingofamerica.org/
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 29 / 30
30. Tackling population health inequities
Selected Bibliography
1 Trying Hard Is Not Good Enough: How to Produce Measurable Improvement of
Customers and Communities (2009), by Mark Friedman
(http://amzn.com/1439237867). Covers practical and tested framework for
implementing and improving collective impact projects.
2 The Practice of Adaptive Leadership: Tools and Tactics for Changing Your
Organization and the World (2009), by Ronald A. Heifetz et al.
(http://amzn.com/1422105768). Covers practical, powerful, and inspiring
approach to leading change in complex environments.
3 Complex Adaptive Systems: An Introduction to Computational Models of Social
Life (2007), by John H. Miller, et al. (http://amzn.com/0691127026).
4 Network Modeling for Epidemics (2015), by Martina Morris, et al.
(http://statnet.csde.washington.edu/EpiModel/nme/index.html). Online
resource for learning how to use R for modeling social networks and epidemics.
5 Population Health Data Science with R (2015, manuscript in progress), by Tom´as
J. Arag´on. (https://leanpub.com/u/medepi). Covers how to use R for
population health analyses. Also visit http://medepi.com.
Tom´as J. Arag´on, MD, DrPH (SFDPH) PHDS, Complexity, & Health Equity October 26, 2015 30 / 30