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By: L. Jensgar, M.B. B.CH., M.B.B.Ch., Ph.D.

Clinical Director, State University of New York Downstate Medical Center College of Medicine

Staff were encouraged to in treatment buy lotensin 10 mg with visa complete one module per month symptoms type 1 diabetes order lotensin cheap online, and upon completion medicine wheel colors discount lotensin 5 mg with mastercard, will be required to take the post-test. Those who had not attended the Bridges into Health and Healthcare training in April 2018, were asked to complete the same pre-test prior to starting to complete the training series. A second post-test survey will be deployed to all Title V staff upon completion of the full Health Equity Training Curriculum. Scores will then be analyzed to evaluate if curriculum successfully increased staff knowledge and understanding of health equity concepts, as well as their comfort and ability to integrate that information into their routine work. While doing research on available training resources, Health Equity Team Members identified an opportunity to supplement the online training modules with an in-person option for the "Bridges Out of Poverty" training. On April 13, 2018 a one-day, intensive training focused on building knowledge and understanding among all Title V staff of the complex institutional and interpersonal dynamics of accessing health and health care in America, especially for lower income individuals, was held. Focused on establishing an initial baseline of staff competency, this pre-test included 10 questions designed to assess the level of understanding and self-efficacy Title V staff have in addressing issues related to health equity. This survey was collected before the start of the Bridges training and was analyzed to develop a baseline pre-test score for the collective Title V staff. The purpose of the book club is to offer a non-threatening venue in which issues related to health disparities can be discussed by a diverse group of interested members to increase awareness and understanding. As of March 2018, the book club has read and discussed two books: the Immortal Life of Henrietta Lacks by Rebecca Skloot and the Hillbilly Elegy: A memoir of a Family and Culture in Crisis by J. An important component of health equity is ensuring a connection and understanding of the priorities, needs and opinions of the communities served. In the past year, Title V staff continued to focus on using the Community Listening Session model to gather information from members of the priority population to inform the development of programs and activities. In the summer of 2018, under the leadership of Governor Cuomo to address the significant disparities related to maternal mortality, Title V staff conducted seven community listening sessions across the state in the summer of 2018. Following this analysis, listening sessions were planned for Buffalo, Syracuse, Albany, Bronx, Brooklyn, Harlem and Queens. Community participants included recently and currently pregnant women and families, with an emphasis on engaging black women who have experienced an adverse birth outcome. The listening sessions, entitled "Voice Your Vision ­ Share Your Birth Story", lasted between two and three hours and included on-site child care. The listening sessions were organized to allow participants to drive the focus of each conversation. Loosely centered around four topics (planning for pregnancy, pregnancy, childbirth, and the postpartum period), facilitators introduced each topic and kept participants on topic while scribes at each table captured participant feedback in real time. Participants were engaged in a discussion on the barriers and issues impacting their birth experiences. After the discussion, participants shared important points discussed during the process. At the conclusion of these sessions, the written record of participant feedback, taken by scribes, was analyzed and summarized to produce a statewide report identifying overarching themes. This report summarizes what participants reported at the listening sessions and is currently under review. Poor communication with health care providers (especially feeling providers were not listening to them, that they were not given enough time with providers, and that few providers reflected their lived experience). And common suggestions for addressing the racial disparities in maternal mortality included: More black and Hispanic health care professionals, reflective of the community. Train health care professionals on the impact of implicit bias on health care outcomes. Increase availability of community services and resources, for example, community health worker services and home visiting services. Across all seven listening sessions, participants asked for better understanding of the reasons why black women have poorer pregnancy health outcomes, and acknowledgement of the impact of race and racism on those outcomes. Participants asked for action to address the racial disparities in maternal mortality, and particularly focused on how health care systems and practices may perpetuate continued racial inequities. Participants asked for the elimination of barriers that prevent women from getting quality health care services and asked for increased supports needed to help with a healthy pregnancy. The Title V program continues to play a major leadership role in the development of these performance measures. Broadly covering the complex and systemic factors contributing to racial inequities in health outcomes (esp. The Title V program recognizes the value and importance of understanding and addressing health equity to improve the health and wellness of all New Yorkers and will continue efforts to ensure all families have access to quality primary and preventive health services.

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A normal distribution is symmetrical; so the mean and standard deviation are sufficient to symptoms 6 weeks pregnant generic lotensin 5 mg on line describe its shape treatment 02 buy lotensin 5mg online. The mean plus or minus one standard deviation (x ± s) includes approximately 66% of the measurements in a normal distribution; the mean plus or minus two standard deviations (x ± 2s) includes approximately 95% of the measurements medicine 3604 order lotensin 10 mg visa, and the mean plus or minus three standard deviations (x ± 3s) includes approximately 99% of the measurements (Figure 24. Thus, only 1% of a normally distributed population lies outside the range of (x ± 3s). There is an inverse relation between egg number and weight: hens that lay more eggs produce smaller eggs. When two characteristics are correlated, a change in one characteristic is likely to be associated with a change in the other. Correlations between characteristics are measured by a correlation coefficient (designated r), which measures the strength of their association. To determine how these characteristics are correlated, we first obtain the covariance (cov) of x and y: 1s 2s 3s ­3s ­2s ­1s x Phenotype cov xy = (x i - x)(yi - y) n -1 (24. The correlation coefficient (r) is obtained by dividing the covariance of x and y by the product of the standard deviations of x and y: r= cov xy sx s y (24. For instance, both the number and the weight of eggs produced by hens are important to the poultry industry. These two characteristics are not A correlation coefficient can theoretically range from -1 to +1. A positive value indicates that there is a direct association between the variables (Figure 24. A positive correlation exists for human height and weight: tall people tend to weigh more. A negative correlation coefficient indicates that there is an inverse relation between the two variables (Figure 24. Quantitative Genetics 669 the absolute value of the correlation coefficient (the size of the coefficient, ignoring its sign) provides information about the strength of association between the variables. A coefficient of -1 or +1 indicates a perfect correlation between the variables, meaning that a change in x is always accompanied by a proportional change in y. Correlation coefficients close to -1 or close to +1 indicate a strong association between the variables: a change in x is almost always associated with a proportional increase in y, as seen in Figure 24. On the other hand, a correlation coefficient closer to 0 indicates a weak correlation: a change in x is associated with a change in y but not always (Figure 24. A correlation of 0 indicates that there is no association between variables (Figure 24. A correlation coefficient can be computed for two variables measured for the same individual, such as height (x) and weight (y). A correlation coefficient can also be computed for a single variable measured for pairs of individuals. For example, we can calculate for fish the correlation between the number of vertebrae of a parent (x) and the number of vertebrae of its offspring (y), as shown in Figure 24. A correlation between two variables indicates only that the variables are associated; it does not imply a cause-andeffect relation. Correlation also does not mean that the values of two variables are the same; it means only that a change in one variable is associated with a proportional change in the other variable. For example, the x and y variables in the following list are almost perfectly correlated, with a correlation coefficient of 0. Here, the numbers of vertebrae in mothers and offspring of the fish Zoarces viviparus are compared. A positive correlation exists between the body weight of parents and the body weight of their offspring; this correlation exists in part because genes influence body weight, and parents and children have genes in common. Because of this association between parental and offspring phenotypes, we can predict the weight of an individual on the basis of the weights of its parents. This technique plays an important role in quantitative genetics because it allows us to predict the characteristics of offspring from a given mating, even without knowledge of the genotypes that encode the characteristics. Note that the y values are about 10 times as large as the corresponding x values; so, although x and y are correlated, they are not identical. The distinction between correlation and identity becomes important when we consider the effects of heredity and environment on the correlation of characteristics. Regression Correlation provides information only about the strength and direction of association between variables. However, we often want to know more than just whether two variables are associated; we want to be able to predict the value of one variable, given a value of the other.

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What are some of the major differences in the ways in which genetic information is organized in the genomes of prokaryotes compared with eukaryotes? How do the following genomic features of prokaryotic organisms compare with those of eukaryotic organisms? A group of 250 scientists sequenced and analyzed the genomes of 12 species of Drosophila (Drosophila 12 Genomes Consortium treatment 10 buy genuine lotensin on-line. Data on genome size and number of protein-encoding genes from this study are given in Table 20 treatment of hemorrhoids purchase lotensin american express. How does this result compare with the relation between genome size and number of genes across all eukaryotes? A scientist determines the complete genomes and proteomes of a live cell and a muscle cell from the same person medications narcolepsy purchase 10 mg lotensin otc. Would you expect bigger differences in the genomes or proteomes of these two cell types? What are some characteristics of ribosomal sequences that make them useful for determining what species are present? Some synthetic biologists have proposed creating an entirely new, free-living organism with a minimal genome, the smallest set of genes that allows for replication of the organism in a particular environment. This genome could be used to design and create, from "scratch," novel organisms that might perform specific tasks such as the breakdown of toxic materials in the environment. What, if any, social and ethical concerns might be associated with the construction of an entirely new organism with a minimal genome? In spite of its long association with human culture, the origins of domesticated donkeys have been uncertain. What little archeological evidence is available suggests that donkeys were domesticated approximately 5000 years ago-about the same time as the domestication of horses. Domesticated donkeys are clearly related to other asses, which include two subspecies of African wild asses, the Nubian wild ass (E. Which of these asses gave rise to donkeys and where domestication took place have, until recently, been unclear. To study the genetic origin of donkeys, Beja-Pereira and his colleagues obtained tissue from domestic donkeys in 52 countries throughout the Old World and from African wild asses and Asian half asses. All the domestic donkeys clustered within the African wild-ass group, indicating that donkeys evolved from the wild asses rather than from the half asses. Another interesting feature indicated by the analysis was that donkeys appear to have at least two distinct origins from African wild asses, as revealed by the fact that some donkeys cluster with the Somalian wild asses and other donkeys cluster with the Nubian wild asses. This finding suggests that at least two independent domestication events took place. There was also significantly more genetic diversity in the domestic donkeys of North Africa than in the donkeys of other regions of the world. The clear affinity between domestic donkeys and African wild asses, coupled with the finding of greater diversity among North African donkeys, suggests that donkey domestication took place at least twice in Africa. Much evidence indicates that the first farm animals-sheep and goats-were domesticated in the Middle East. Donkeys are the only ungulate known to have been domesticated solely in Africa, highlighting the important role North Africa played in early population expansion and trade throughout the Old World. We begin by briefly considering the structures of mitochondria and chloroplasts, the inheritance of traits encoded by their genes, and the evolutionary origin of these organelles. Mitochondrion and Chloroplast Structure Mitochondria are tubular structures that are from 0. In mitochondria, the inner membrane is highly folded; embedded within it are the enzymes that catalyze electron transport and oxidative phosphorylation. Chloroplasts have a third membrane, called the thylakoid membrane, which is highly folded and stacked to form aggregates called grana. New mitochondria and chloroplasts arise by the division of existing organelles-divisions that take place throughout the cell cycle and are independent of mitosis and meiosis. Paternal inheritance of organelles is common in gymnosperms (conifers) and in a few angiosperms (flowering plants). Replicative segregation Individual cells may contain from dozens to hundreds of organelles, each with numer- 21.

He proposed that these kernels resulted from an unstable mutation: a mutation in Ty elements in yeast Ty (for transposon yeast) elements are a family of common retrotransposons found in yeast; many yeast cells have 30 copies of Ty elements (Figure 11 medications during pregnancy buy lotensin 5mg cheap. The study of variegated corn led Barbara McClintock to treatment 30th october 5mg lotensin discover transposable elements symptoms 9dp5dt order lotensin on line amex. McClintock discovered that the cause of the unstable mutation was a gene that moved. She noticed that chromosome breakage in maize often occurred at a gene that she called Dissociation (Ds) but only if another gene, the Activator (Ac), also was present. Ds and Ac exhibited unusual patterns of inheritance; occasionally, the genes moved together. McClintock called these moving genes controlling elements, because they controlled the expression of other genes. Ds elements are Ac elements with one or more deletions that have inactivated the transposase gene (Figure 11. Unable to transpose on their own (nonautonomous), Ds elements can transpose in the presence of Ac elements because they still possess terminal inverted repeats recognized by Ac transposase. Each kernel in an ear of corn is an individual, originating as an ovule fertilized by a pollen grain. A pigmentencoding allele at one of these loci can be designated C, and an allele at the same locus that does not confer pigment can be designated c. A kernel with genotype cc will be color- less-that is, yellow or white (Figure 11. A Ds element, transposing under the influence of a nearby Ac element, may insert into the C allele, destroying its ability to produce pigment (Figure 11. An allele inactivated by a transposable element is designated by a subscript "t"; so, in this case, the allele would be Ct. After the transposition of Ds into the C allele, the kernel cell has genotype Ctc. This kernel will be colorless (white or yellow), because neither the Ct allele nor the c allele confers pigment. As the original one-celled maize embryo develops and divides by mitosis, additional transpositions may take place in some cells. In any cell in which the transposable element excises from the Ct allele and moves to a new location, the C allele is rendered functional again: all cells derived from those in which this event has taken place will have the genotype Cc and be purple. The presence of these pigmented cells, surrounded by the colorless (Ctc) cells, produces a purple spot or streak (called a sector) in the otherwise yellow kernel (Figure 11. The size of the sector varies, depending on when the excision of the transposable element from the Ct allele takes place. If excision is early in development, then many cells will contain the functional C allele and the pigmented sector will be large; if excision is late in development, few cells will have the functional C allele and the pigmented sector will be small. Most functional P elements 312 Chapter 11 (a) Genotype cc: no transposition 1 Cells with genotype cc produce no pigment. C Purple kernel c (d) Genotype C tc C tc /Cc: mosaic (transposition during development) 9 An Ac element produces transposase. Conclusion: Variegated corn kernels result from the excision of Ds elements from genes controlling pigment production during development. Each P element possesses terminal inverted repeats and generates flanking direct repeats at the site of insertion. The role of this repressor in controlling transposition is demonstrated dramatically in hybrid dysgenesis, which is the sudden appearance of numerous mutations, chromosome aberrations, and sterility in the offspring of a cross between a P+ male fly (with P elements) and a P- female fly (without them). Hybrid dysgenesis arises from a burst of transposition when P elements are introduced into a cell that does not possess them. In a cell that contains P elements, a repressor in the cytoplasm inhibits transposition. When a P+ female produces eggs, the repressor protein is incorporated into the egg cytoplasm, which prevents further transposition in the embryo and thus prevents mutations from arising. However, a P- female does not produce the repressor protein; so none is stored in the cytoplasm of her eggs. Sperm contain little or no cytoplasm, so a P+ male does not contribute the repressor protein to his offspring.