Lung and Large Intestine are both metal elements according to five element theory and both fall within the spring months according to the neijing cosmological organ clock and as such share some general functions.
However, their differences are potent: the lung is represented as the pressurized bow in which the arrow is waiting to be shot. In contrast, the large intestine is the arrow that has left the bow. Lung is represented by the tiger who waits in his cave, demonstrating power through its stillness, ready to pounce at any moment. Large intestine, on the other hand, is the rabbit who bounds endlessly and recreates with abandon.
One of the more palpable analogies we learned about the large intestine was that of a political leader. Lung is the official who stands in the background, ruling with calmness and only exerting force when necessary. Large Intestine is the charismatic dictator who claims equality, claims to be a populist leader, while achieving his objectives by dictatorial means. As with any organ system, there can be a healthy and unhealthy representation; a healthy Large Intestine representation in this analogy might be Jesus or Confucius, whereas the pathological representation is Adolf Hitler, the ultimate dictator.
The theme of “dominance within equality” is captured in other symbolic systems as well; as mentioned the Large Intestine time on the organ clock refers to the 2nd month of spring, the time when the insects come out. Notably, it is the time of the Chinese vernal equinox; the time when the length of the day vs. night are exactly equal. However, the tidal hexagram that corresponds to the large intestine time, hexagram 34, has 4 yang lines underneath 2 yin lines, indicating that the yin yang balance has already been tipped in favor of yang.
Another flavor of large intestine that was emphasized to us highly was its crudeness, its crassness, its bluntness. If there was a company made up of 12 people, each who represented one organ network, the large intestine would be the person who got fed up with the lack of progress of the group. The crudeness is furthermore a corollary to the large intestine’s connection to the material world - “the equation of shit [from the large intestine] and stuff” is not coincidental in this view.
...read more
Tuesday, October 27, 2009
Sunday, October 11, 2009
Saturday, October 10, 2009
intro to homeopathy: a brief review
(This entry is inspired by my first experience with homeopathy today with Dr. Matthew Zorn.)
In our homeopathy class we're learning about the history of the discovery of homeopathy as well as the fundamental tenets. I wanted to hold off on writing about it until I had a little better grasp of it. Briefly, here are some of the ideas we've been learning (bear in mind that I'm stating this as ideas that are presented to us, not necessarily beliefs that I have):
Law of similars- homeopathy is based on the premise that if a substance can cause certain symptoms in healthy people, it can also cure those same symptoms in sick people. The reasons or explanations for it are essentially unknown, and considered to be less important considering that it just works.
One cure- although any individual may present a multitude of symptoms, there is always just one remedy required which can address the precise imbalance of that individual.
Symptoms- are manifestations of disease that are most useful in determining the root cause of the disease. They are not limited to physical symptoms; sometimes the mental symptoms will elucidate the patient's disease picture the best. Keynote symptoms are the special, note-worthy characteristics of a particular illness (or remedy).
Dilutions- the idea has only been introduced to us briefly, as the "least interesting thing in homeopathy [and often the most misconstrued]".
more to come... ...read more
In our homeopathy class we're learning about the history of the discovery of homeopathy as well as the fundamental tenets. I wanted to hold off on writing about it until I had a little better grasp of it. Briefly, here are some of the ideas we've been learning (bear in mind that I'm stating this as ideas that are presented to us, not necessarily beliefs that I have):
Law of similars- homeopathy is based on the premise that if a substance can cause certain symptoms in healthy people, it can also cure those same symptoms in sick people. The reasons or explanations for it are essentially unknown, and considered to be less important considering that it just works.
One cure- although any individual may present a multitude of symptoms, there is always just one remedy required which can address the precise imbalance of that individual.
Symptoms- are manifestations of disease that are most useful in determining the root cause of the disease. They are not limited to physical symptoms; sometimes the mental symptoms will elucidate the patient's disease picture the best. Keynote symptoms are the special, note-worthy characteristics of a particular illness (or remedy).
Dilutions- the idea has only been introduced to us briefly, as the "least interesting thing in homeopathy [and often the most misconstrued]".
more to come... ...read more
Friday, October 9, 2009
Thursday, October 8, 2009
cosmology week 3: the lung
This lecture continued the ideas of different symbolic systems of chinese organ classification and began an in depth look at lung symbology and function.
Heiner first described another metaphorical system that is used in Chinese medicine to describe the organ functions; comparing the 12 organs to 12 major rivers in China. For example, the Sheng river is the only river in China that flows East to West and is representative of the liver's characteristic of "going against the flow", and overcoming obstacles. The Ji river is a small river that crosses the murky Yellow river and yet remains pure on the other side and represents the heart's spiritual orientation and function (the murkiness representing the material world).
On the other hand, the lung is represented by the yellow river, which brings water and fertilizer (clay) and distributes it throughout its banks. The river is representative of the lung's function of being the master and distributor of chi.
The lung can be described in many ways- here are some of the overarching phrases Heiner used to describe it:
"master of chi"
"distributor of middle burner energy"
"distributes chi like a shower nozzle"
"responsible for standard setting"
"peace keeper"
"uplifting, expanding energy"
"more concerned with physical body than any other organ"
"invigorator that patches up the system"
"concerned with instincts"
The lung is understood through many different symbolic systems, each of which captures a different aspect / characteristic. The element associated with the lung is metal ("going down", "purity", "money issues"), whereas the conformation is taiyin ("earth", "dampness"). The tidal hexagram for lung is hexagram 11, which represents the intercoursing of heaven and earth (yang is on the bottom and yin is on top).
Although it is commonly understood to be associated with Autumn, according to classical Neijing cosmology, the lung is associated with the first months of spring. Looking at the Chinese understanding of what occurs during this time we can gather more information about the lung's function:
"yang first emerges"
"life is starting to re-awaken"
"fish being drawn to the surface of the ice"
"still cold but beginning to warm up"
"beginning of all circulation of time and space"
more to come...
...read more
Heiner first described another metaphorical system that is used in Chinese medicine to describe the organ functions; comparing the 12 organs to 12 major rivers in China. For example, the Sheng river is the only river in China that flows East to West and is representative of the liver's characteristic of "going against the flow", and overcoming obstacles. The Ji river is a small river that crosses the murky Yellow river and yet remains pure on the other side and represents the heart's spiritual orientation and function (the murkiness representing the material world).
On the other hand, the lung is represented by the yellow river, which brings water and fertilizer (clay) and distributes it throughout its banks. The river is representative of the lung's function of being the master and distributor of chi.
The lung can be described in many ways- here are some of the overarching phrases Heiner used to describe it:
"master of chi"
"distributor of middle burner energy"
"distributes chi like a shower nozzle"
"responsible for standard setting"
"peace keeper"
"uplifting, expanding energy"
"more concerned with physical body than any other organ"
"invigorator that patches up the system"
"concerned with instincts"
The lung is understood through many different symbolic systems, each of which captures a different aspect / characteristic. The element associated with the lung is metal ("going down", "purity", "money issues"), whereas the conformation is taiyin ("earth", "dampness"). The tidal hexagram for lung is hexagram 11, which represents the intercoursing of heaven and earth (yang is on the bottom and yin is on top).
Although it is commonly understood to be associated with Autumn, according to classical Neijing cosmology, the lung is associated with the first months of spring. Looking at the Chinese understanding of what occurs during this time we can gather more information about the lung's function:
"yang first emerges"
"life is starting to re-awaken"
"fish being drawn to the surface of the ice"
"still cold but beginning to warm up"
"beginning of all circulation of time and space"
more to come...
...read more
Wednesday, October 7, 2009
Friday, October 2, 2009
chinese cosmology week 2: symbolic systems
In this lecture we continued on symbols in Chinese medicine and the different symbolic systems used to understand the 12 chinese organs (which, again, are not referring to the physical organs in our body necessarily, but are "symbolic representations of functional vibrations"). Although there are a wealth of such systems in this medicine, we focused mainly on the 5 element, 6 conformation, and 12 organ network systems.
The 5 element system pairs yin with yang organs together into 5 groupings. Wood: associated with spring and the organs liver and gall bladder. Fire: associated with summer and the organs heart and small intestine. Also associated with pericardium and triple burner. Earth is associated with late summer, also the transition between seasons- and the organs spleen and stomach. Metal is associated with fall and the organs lung and large intestine. Water is associated with winter and the organs kidney and bladder.
On the other hang, the 6 conformation system pairs yin-yin and yang-yang organs together and proponents claim it is more classical because of its origins in the Shang Han Lun. These six conformations can be thought of as six different positions on a sine wave curve, the upper part of the curve representing "yang" and the lower representing "yin". Yang starts off with taiyang, which is represented by the small intestine and bladder organs. Next is yang ming, which is the stomach and liver. Shaoyang is the last yang pairing, gall bladder and triple burner. Taiyin is the first yin pairing- lung and spleen, followed by jue yin (liver and pericardium) and shao yin (heart and kidney).
The twelve organ network system is considered in classical chinese medicine to be the superior framework to operate on because it incorporates both the 5 and the 6 model, which are in a sense complementary to each other, equally necessary. In this system the 12 organs can be drawn out on the borders of a circle subdivided into 12 sections. This makes it easy to visualize the organs' specific relationships to time; both the 12 months of the year as well as 12 groupings of 2 hours within each day. More to come.
...read more
The 5 element system pairs yin with yang organs together into 5 groupings. Wood: associated with spring and the organs liver and gall bladder. Fire: associated with summer and the organs heart and small intestine. Also associated with pericardium and triple burner. Earth is associated with late summer, also the transition between seasons- and the organs spleen and stomach. Metal is associated with fall and the organs lung and large intestine. Water is associated with winter and the organs kidney and bladder.
On the other hang, the 6 conformation system pairs yin-yin and yang-yang organs together and proponents claim it is more classical because of its origins in the Shang Han Lun. These six conformations can be thought of as six different positions on a sine wave curve, the upper part of the curve representing "yang" and the lower representing "yin". Yang starts off with taiyang, which is represented by the small intestine and bladder organs. Next is yang ming, which is the stomach and liver. Shaoyang is the last yang pairing, gall bladder and triple burner. Taiyin is the first yin pairing- lung and spleen, followed by jue yin (liver and pericardium) and shao yin (heart and kidney).
The twelve organ network system is considered in classical chinese medicine to be the superior framework to operate on because it incorporates both the 5 and the 6 model, which are in a sense complementary to each other, equally necessary. In this system the 12 organs can be drawn out on the borders of a circle subdivided into 12 sections. This makes it easy to visualize the organs' specific relationships to time; both the 12 months of the year as well as 12 groupings of 2 hours within each day. More to come.
...read more
chinese cosmology week 1: philosophical introduction
The first class in the cosmology series by Heiner Fruehaf. He basically laid out the philosophical foundations for the material we're about to study; ideas that are both relatively foreign to "western" thinking as well as integral to the Chinese medicine framework.
One of the central ideas was of the nature of reality and man and the idea of "levels of reality": This map of reality has 5 realms which start with the dao, which can be thought of as the world before it was manifested; the ultimate energetic and ethereal realm. On the opposite end is Qi, the material world (the character for Qi is a vessel surrounded by 4 dogs which might represent the guarding of earthly possessions). In the middle is the realm called Xiang, halfway in between the realms of energy and matter. This is the realm in which chinese medicine operates in.
Hierarchies of thought, of energy, reality thus play an integral role in the medicine. "Energy informs matter" and thus the root of any physical manifestation can be considered to be a primarily energetic and spiritual phenomenon. The highest level of physician, "Shang Gong", can operate and influence the patient on this energetic level, where the lowest type of physician, "xia gong", has only the capability to practice "cook book medicine", looking up specific remedies for physical symptoms without necessarily addressing the underlying energetic cause.
Because the very nature of reality is so elusive in this worldview, the study of Chinese Medicine makes great use of symbols. The organs as specified in Chinese medicine are not the literal structures in the body but rather symbolic descriptions of functional energetic patterns. Thus, "every cell has a liver". Each organ is described with several different symbolic frameworks in order to shed light on different facets of its nature.
...read more
One of the central ideas was of the nature of reality and man and the idea of "levels of reality": This map of reality has 5 realms which start with the dao, which can be thought of as the world before it was manifested; the ultimate energetic and ethereal realm. On the opposite end is Qi, the material world (the character for Qi is a vessel surrounded by 4 dogs which might represent the guarding of earthly possessions). In the middle is the realm called Xiang, halfway in between the realms of energy and matter. This is the realm in which chinese medicine operates in.
Hierarchies of thought, of energy, reality thus play an integral role in the medicine. "Energy informs matter" and thus the root of any physical manifestation can be considered to be a primarily energetic and spiritual phenomenon. The highest level of physician, "Shang Gong", can operate and influence the patient on this energetic level, where the lowest type of physician, "xia gong", has only the capability to practice "cook book medicine", looking up specific remedies for physical symptoms without necessarily addressing the underlying energetic cause.
Because the very nature of reality is so elusive in this worldview, the study of Chinese Medicine makes great use of symbols. The organs as specified in Chinese medicine are not the literal structures in the body but rather symbolic descriptions of functional energetic patterns. Thus, "every cell has a liver". Each organ is described with several different symbolic frameworks in order to shed light on different facets of its nature.
...read more
Friday, September 18, 2009
naturopathic philosophy II: can drugs be nourishing?
We had an tangential but relevant discussion in our philosophy class today about how naturopaths view pharmaceuticals... The context was a discussion / introduction to the core principles of naturopathic therapy and the therapeutic order of treatment strategies. Mark Davis, a third year ND student (who will probably save the world one day) brought up a question, after a discussion of how pharmaceuticals or synthetic substances in general were in a "higher" level (in the schema laid out for us, the higher levels represented more invasive, acute, and allopathic measures), because of not being fundamentally supportive or nourishing to the body. "Can't drugs or synthetic substances ever be nourishing?"
Resistance to the question was immediate and widespread; this struck and puzzled me. Arguments were presented:
mark's arguments (and others)
we should be wary of supporting an ambiguous, dogmatic bias against synthetic drugs, present in the statement "drugs are never nourishing", because:
-herbs or plant extracts can be both as potent as any synthetic drugs
-herbs or plant extracts can easily be used in an invasive, "allopathic" way that doesn't treat the root cause of disease
-in certain cases, drugs can be used in low doses to elicit ultimately therapeutic and therefore nourishing effects, even if the immediate effect of the drug might be to suppress or to interfere with natural biochemical processes
-vitamins and other supplements that are commonly prescribed by naturopaths are not all completely plant derived; many of these are synthesized and are considered to have nourishing effects; where is the distinction?
counter arguments (from the teacher and others)
there is an important distinction which should be maintained between naturally derived substances and synthetically derived substances. we should always seek to use naturally derived ones when possible because:
-the process of extracting medicinal substances from plants is fundamentally different than the process of synthesizing new medicinal substances in the laboratory because oftentimes the naturally derived extracts have other compounds from the plant which can produce concurrent reactions. in other words, natural products might have a more holistic effect on the body.
-synthetic drugs might be used effectively to alleviate an acute condition, but there is always the danger that the person's biochemical makeup will become dependent on the drug (it was admitted that the same argument applies to natural products)
-pharmaceuticals operate by suppressing or hijacking one body process and often cause severe side effects in another process. natural products generally operate by supporting, rather than interrupting, natural body processes.
Mark was able to articulate his ideas briefly before a barrage of counter-arguments were presented-- many of these were simply counter-sentiments, not actually addressing the issue but more just personal anecdotes of the ill-effects of pharmaceuticals. The resistance to even considering the question was a little alarming, although understandable given what kind of school we're in. What I'm getting at is: the idea and the argument were interesting, but the idea about the idea was even more interesting. Why the immediate negative reactions? Why the blanket-hatred of allopathy and pharmaceuticals? What is the incentive to not even consider these ideas?
In any case, it was a great discussion and a nice way to end the week. First week of second year over.
...read more
Resistance to the question was immediate and widespread; this struck and puzzled me. Arguments were presented:
mark's arguments (and others)
we should be wary of supporting an ambiguous, dogmatic bias against synthetic drugs, present in the statement "drugs are never nourishing", because:
-herbs or plant extracts can be both as potent as any synthetic drugs
-herbs or plant extracts can easily be used in an invasive, "allopathic" way that doesn't treat the root cause of disease
-in certain cases, drugs can be used in low doses to elicit ultimately therapeutic and therefore nourishing effects, even if the immediate effect of the drug might be to suppress or to interfere with natural biochemical processes
-vitamins and other supplements that are commonly prescribed by naturopaths are not all completely plant derived; many of these are synthesized and are considered to have nourishing effects; where is the distinction?
counter arguments (from the teacher and others)
there is an important distinction which should be maintained between naturally derived substances and synthetically derived substances. we should always seek to use naturally derived ones when possible because:
-the process of extracting medicinal substances from plants is fundamentally different than the process of synthesizing new medicinal substances in the laboratory because oftentimes the naturally derived extracts have other compounds from the plant which can produce concurrent reactions. in other words, natural products might have a more holistic effect on the body.
-synthetic drugs might be used effectively to alleviate an acute condition, but there is always the danger that the person's biochemical makeup will become dependent on the drug (it was admitted that the same argument applies to natural products)
-pharmaceuticals operate by suppressing or hijacking one body process and often cause severe side effects in another process. natural products generally operate by supporting, rather than interrupting, natural body processes.
Mark was able to articulate his ideas briefly before a barrage of counter-arguments were presented-- many of these were simply counter-sentiments, not actually addressing the issue but more just personal anecdotes of the ill-effects of pharmaceuticals. The resistance to even considering the question was a little alarming, although understandable given what kind of school we're in. What I'm getting at is: the idea and the argument were interesting, but the idea about the idea was even more interesting. Why the immediate negative reactions? Why the blanket-hatred of allopathy and pharmaceuticals? What is the incentive to not even consider these ideas?
In any case, it was a great discussion and a nice way to end the week. First week of second year over.
...read more
Monday, September 14, 2009
CPD I: dermatology lecture I
This was the first lecture of second year, from the major class of this year: clinical physical diagnosis (CPD). We dove into dermatology and the diagnosis of different skin lesions. First we talked about different factors to consider when diagnosing a lesion, such as appearance, time factors, spreading, sensation, change, previous treatment. In general the questions of diagnosis seem to fall under the categories: What is it? How did it develop? What's been done to treat it? What are other internal or hereditary factors to consider? What are some external or environmental factors to consider? What do the other organ systems in the body indicate?
Then we talked about the actual classification of different skin lesions. "Primary morphology" refers to the particular type of skin lesions, such as a bullae, papule, macule, scaling, erosion, etc. "Secondary morphology" refers to the overall shape / distribution of the lesions, such as linear, annular, nummular, serpiginous. Other factors used to distinguish between lesions are: color, texture, location, clinical manifestations. Here are examples of what different colors indicate:
Red: erythema
Orange: hypercarotenemia
Yellow: jaundice
Green: pseudomonas
Violet: port wine stain
Grey/Blue: anemia
Black: melanocyte pathology or arterial insufficiency.
Some other terms to know:
Nummular: circular lesions with lighter center
Verrucous: Irregular texture
Lichenification: thickened texture
Induration: deeper lichenification
A number of tests are available to distinguish between these lesions, such as biopsies, KOH test (for yeast, fungus), wood's lamp (UV light which detects certain fungal infections), diascopy (glass slide test for blanching), immunoflourescence test, ESR, ANA tests.
We started looking at Acne Vulgaris and Rosacea, two common skin pathologies. Acne vulgaris is commonly caused by androgen hormones or bacterial interaction with the skin, which leads to the obstruction of the pilosebaceous unit, which leads to different lesions such as comedones, nodules, papules, cysts, pustules, and purulent sacs. It can have similar manifestations to perioral dermatitis, drug eruptions, and rosacea.
Rosacea, on the other hand, is a different pathology which can start with flushing of the skin, and can progress to telangectasia (tortuous vessels), papules/pustules, and at its worst, rhinophyma (excess collagen deposition and hyperplasia of sebaceous glands). The differential diagnosis for rosacea: SLE, discoid lupus, acne, drug eruptions, perioral dermatitis.
...read more
Then we talked about the actual classification of different skin lesions. "Primary morphology" refers to the particular type of skin lesions, such as a bullae, papule, macule, scaling, erosion, etc. "Secondary morphology" refers to the overall shape / distribution of the lesions, such as linear, annular, nummular, serpiginous. Other factors used to distinguish between lesions are: color, texture, location, clinical manifestations. Here are examples of what different colors indicate:
Red: erythema
Orange: hypercarotenemia
Yellow: jaundice
Green: pseudomonas
Violet: port wine stain
Grey/Blue: anemia
Black: melanocyte pathology or arterial insufficiency.
Some other terms to know:
Nummular: circular lesions with lighter center
Verrucous: Irregular texture
Lichenification: thickened texture
Induration: deeper lichenification
A number of tests are available to distinguish between these lesions, such as biopsies, KOH test (for yeast, fungus), wood's lamp (UV light which detects certain fungal infections), diascopy (glass slide test for blanching), immunoflourescence test, ESR, ANA tests.
We started looking at Acne Vulgaris and Rosacea, two common skin pathologies. Acne vulgaris is commonly caused by androgen hormones or bacterial interaction with the skin, which leads to the obstruction of the pilosebaceous unit, which leads to different lesions such as comedones, nodules, papules, cysts, pustules, and purulent sacs. It can have similar manifestations to perioral dermatitis, drug eruptions, and rosacea.
Rosacea, on the other hand, is a different pathology which can start with flushing of the skin, and can progress to telangectasia (tortuous vessels), papules/pustules, and at its worst, rhinophyma (excess collagen deposition and hyperplasia of sebaceous glands). The differential diagnosis for rosacea: SLE, discoid lupus, acne, drug eruptions, perioral dermatitis.
...read more
Monday, August 17, 2009
Milestones: Capital Letters
I've decided to abandon my old ways of capitalizing rebellion and take one more small step towards my professional transformation. From now on I will be capitalizing letters that deserve to be capitalized. Thank you Derek Andre.
...read more
...read more
Thursday, August 13, 2009
interview: gabriel weiss
gabriel weiss is a reverse dual degree student at NCNM (he's completed his MSOM and finishing his last year of ND studies). he is also the owner of the bamboo grove salon, a community art space and teahouse that hosts martial arts classes, art exhibits, go tournaments, music performances, and tango classes. here's the interview we did today...
what's your background and how did you come to study naturopathy and chinese medicine?
i was originally studying chinese medicine; but i've always been interested in the two different ways of looking at the world- the (for lack of a better word) chinese way, and the western way. i was pre-med at Reed College and went over to China and when i came to Reed after some other things i was a fine arts and chinese major. as i was finishing up at Reed, we had to read the yellow emporer's classic of internal medicine and do some translation. that's when i thought, "i want to study chinese medicine". but then i got this watson fellowship, so it wasn't until i returned from that that i finished all my prereq's, and then ended up at NCNM.
so what was your experience like at NCNM? what were the strengths and weaknesses of the program as you experienced them?
the strengths are all of these amazing practitioners- i know the ones in the Chinese medicine program better since i've completed that program at this point. each of them has their own approach to treating and diagnosing disease, even though it's consistent with the main principles of the medicine. so sitting in class with each person you get a different perspective on the medicine and disease.
and the basic science classes are pretty amazing i think. they tried to create it in such a way that you'd sit there and they'd tell you all the information. which might be the weakness, they don't give you enough time to just read and absorb the stuff on your own. which is my preferred way of learning, i'd rather read from the book and get the basis and go to the lecture and have it be more interactive. but at the same time it was also very interesting to just hear it all said in countless excellent courses-- you could always raise your hand and ask a question for the most part.
at NCNM, who have you learned the most from and what would you say you learned from them?
you know, you learn the most from your own study, if that makes sense-- your own effort to understand and comprehend it. there's really noone who can do that for you. that being said, in the chinese medicine department dr. Fruehaf really spearheads a particular vision that's very comprehensive-- so if i had to pick a person it would probably be him.
what was the most powerful energetic experience you had at NCNM?
probably my first year practicing qigong in master wu's qigong class- at the end of the form he does this thing where he transmits the qi. that was pretty amazing because i could really feel it. besides that, in acupuncture techniques class, dr. qin was demonstrating acupuncture techniques on me and it was just amazing-- he could move the qi up and down... i couldn't believe it. that was probably the strongest medicine-related experience i've had.
you're a dual degree student, you run the bamboo grove salon, you're a stonemason, an accomplished painter, and you're a father and a husband. how do you do all this without getting stressed? do you have any tips for multitasking?
it's like anything; it's like push hands in taiji-- you do it until you're tired, and then you find a more efficient way to do it. and then you keep doing it and get more tired and stop using your muscles and start trying to move with it. i think life's like that too, you can't swallow it all at once, you have to take little steps. life has a way of teaching you how to adapt.
...breathe, just try to keep breathing. just deal with what's in front of you. i think that's the other thing-- and i'm not necessarily recommending changing what anyone's doing-- but you can spend a lot of energy long before you need to actually spend any energy. you can spend a lot of energy on something that's coming up that may only require something very simple being done. so if you leave a lot of time to do something in, you're probably going to spend more time and energy on it. i know at reed college i really gave myself indigestion trying to take in everything, really trying to cover the whole canvas with details. but then by the end i was trying to capture things as quickly and efficiently as possible.
was it difficult to raise a child while in school? do you have any regrets about the timing of raising a child?
well i don't have any regrets about the timing of that or really about anything else. i think it's difficult to have all the time you want to have with your family. but what are you going to do? if i dropped out of school to raise my daughter i'd still have to continue schooling at some point. i do spend a lot of time with her in the evenings, pretty much try to be there. it's OK, it could be better. i'd like to just be at home, just be in the woods-- that would be great. i'd love that.
can you talk about the process of setting up the bamboo grove salon? what are the difficulties you encountered?
it's been a slow progression. i had one space in this same building, downstairs, that was just my studio and stonemasonry shop- that allowed my business to grow while i kept painting and studying. i had a couple of exhibits down there, a couple of events before i moved to part of this larger upstairs space when the tao of tea took over the rest of the downstairs space. that gave me the ability to start bringing other people in, other events and stuff. so that allowed it to grow more- and the space adjoining ours opened up so we expanded into that as well.
this has allowed us to have more people involved and grow. it's kind of one of those things where you expand and are forced to try and fill the space; then it gets too full and you have to expand again. so it's like growth pains on either end.
the difficulty... i don't know what the single particular difficulty has been. there's just been regular every day difficulties, like the light goes off or the toilet needs to be fixed. it's all been a "one step at a time" type thing.
what is your ultimate dream professionally and personally-- if you were to look back on your deathbed what would you like to have accomplished?
oh i have no idea. professionally, no idea. personally, i'm just like anyone else-- i like to have the people that i love around me and be able to look back and feel like i was more of a plus than a minus. professionally, i can only project; it would be strange to try and think that far ahead. i hope i can't think that far ahead! we'll just have to see.
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Thursday, July 2, 2009
music: insomnia
a improvised piece from the meditation series, set to videos by brooke halgren in north dakota and by me in forrest park (in portland's backyard).
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...read more
Friday, June 19, 2009
Wednesday, June 17, 2009
guest post: vaccines
from the mind of Erin Friedman Sharman, fellow ND1:
This blog post is not to be taken as criticizing or condemning vaccines, as vaccines have helped to eradicate debilitating and horrifying diseases. Rather, it serves to educate on the less advertised negative effects associated with vaccines.
Before my education at NCNM I had never thought to question the safety, reason or timing of vaccines. Although I had questioned many other government mandated occurrences, vaccines had always been presented by my community and physician as safe and as an unquestionable milestone in a child’s life. Here are a few basic facts regarding vaccines:
Vaccines are not simply a killed or altered pathogen, most vaccines have various additives to enhance the immune performance or sterilize, kill and preserve the vaccine. These additives are often ill understood and under-studied resulting in negative side effects. Perhaps the most “famous” of the additives has been thimerosal (contains Mercury) which was taken out of all childhood vaccines from 1999-2004.
The Center for Disease Control and Prevention (CDC) vaccine schedule is created for the most vulnerable of all children, and thus subjects the children with the most protective immunity (and even complete immunity in some cases) to the dangers found in vaccines. For example, passive immunity to Haemphilus influenze B can be conferred through a mother’s breast milk.
The CDC schedule is based on childhood wellness visits, the majority in the first year of life, as this is the most guaranteed and frequented period of healthcare visits in a child’s life. In doing so, the schedule does not correlate to the development of the child’s immune system, largely incompatible to an appropriate immune response until AFTER the first year of life.
In light of the above, I have come to believe that the CDC vaccine schedule does not parallel the advances in scientific understanding of human development nor does it take into consideration the risks, health and socioeconomic standing of each child. I encourage all interested parties, especially those undertaking the enormity of parenting in the near future to consult the advice of a Naturopathic physician well versed in the art of vaccination, as each vaccine has its own complex matrix encompassing patient family history, environmental factors and a multitude of other risk factors. One should also become familiar with the CDC’s website (http://www.cdc.gov/vaccines/) on vaccines, your state’s laws concerning vaccines and their exemption, and the Adverse Reporting System for Vaccines (http://vaers.hhs.gov/)
The following chart summarizes the major differences between the CDC based vaccine schedule and the Naturopathic Vaccine Schedule:
A neutral and reliable source for more information can be found at John Hopkins Bloomberg School of Public Health: http://www.vaccinessafety.edu ...read more
This blog post is not to be taken as criticizing or condemning vaccines, as vaccines have helped to eradicate debilitating and horrifying diseases. Rather, it serves to educate on the less advertised negative effects associated with vaccines.
Before my education at NCNM I had never thought to question the safety, reason or timing of vaccines. Although I had questioned many other government mandated occurrences, vaccines had always been presented by my community and physician as safe and as an unquestionable milestone in a child’s life. Here are a few basic facts regarding vaccines:
Vaccines are not simply a killed or altered pathogen, most vaccines have various additives to enhance the immune performance or sterilize, kill and preserve the vaccine. These additives are often ill understood and under-studied resulting in negative side effects. Perhaps the most “famous” of the additives has been thimerosal (contains Mercury) which was taken out of all childhood vaccines from 1999-2004.
The Center for Disease Control and Prevention (CDC) vaccine schedule is created for the most vulnerable of all children, and thus subjects the children with the most protective immunity (and even complete immunity in some cases) to the dangers found in vaccines. For example, passive immunity to Haemphilus influenze B can be conferred through a mother’s breast milk.
The CDC schedule is based on childhood wellness visits, the majority in the first year of life, as this is the most guaranteed and frequented period of healthcare visits in a child’s life. In doing so, the schedule does not correlate to the development of the child’s immune system, largely incompatible to an appropriate immune response until AFTER the first year of life.
In light of the above, I have come to believe that the CDC vaccine schedule does not parallel the advances in scientific understanding of human development nor does it take into consideration the risks, health and socioeconomic standing of each child. I encourage all interested parties, especially those undertaking the enormity of parenting in the near future to consult the advice of a Naturopathic physician well versed in the art of vaccination, as each vaccine has its own complex matrix encompassing patient family history, environmental factors and a multitude of other risk factors. One should also become familiar with the CDC’s website (http://www.cdc.gov/vaccines/) on vaccines, your state’s laws concerning vaccines and their exemption, and the Adverse Reporting System for Vaccines (http://vaers.hhs.gov/)
The following chart summarizes the major differences between the CDC based vaccine schedule and the Naturopathic Vaccine Schedule:
A neutral and reliable source for more information can be found at John Hopkins Bloomberg School of Public Health: http://www.vaccinessafety.edu ...read more
Sunday, June 7, 2009
organ systems III: exercise physiology
this lecture by Dr. Frangos, PT ND, focused on the effects of exercise on the body. we looked at both how the body responds acutely to exercise, as well as how the body adapts long term to regular endurance exercise. acute effects of exercise on the heart include a increase in cardiac output (CO) mainly due to increased heart rate, with only a slight increase in stroke volume (SV), which is dependent on myocardial contractility. regular endurance exercise also increases CO, which is mainly due to increased SV from increased myocardial contractility. other adaptive effects on the heart include a lower resting heart rate and increased maximal oxygen intake. exercise's acute effects on the lungs mainly revolve around an increase in ventilation rate (exercise intensity has a linear relationship with ventilation rate up until moderate intensities, beyond which the relationship becomes supralinear), but also includes an increase in alveolar ventilation for both rate and volume.
hormone release also markedly shifts with exercise, mainly to facilitate efficient utilization of glucose in skeletal muscle. sympathetic stimulation causes release of stress hormones such as epinephrine and cortisol, and insulin release is decreased so that glucose is available in the blood for metabolism. also, thyroid hormones such as T3 and T4 are increased so that metabolism can increase. repeated endurance training causes adaptive changes such as increased insulin receptors on cells, which increases the efficiency of glucose uptake in endurance athletes.
exercise affects skeletal muscle by increasing blood flow to muscle, body temperature due to contraction, and use of creatine phosphate / glycogen to form ATP. additionally, during intense exercise, lactic acid is produced in the muscles and can contribute to a metabolic acidosis, which can be compensated by excreting CO2 through ventilation. sustained endurance exercise increases the oxidative capacity of skeletal muscle through more mitochondria, as well as increasing the size of myofibrils through increased synthesis of myofilaments, and increased fast oxidative-type muscle fibers.
questions
acute effects of exercise on different systems...
1. describe the acute effects of exercise on the heart.
2. what are the increases in HR and SV attributed to?
3. describe the difference in SV and HR as exercise intensity increases to maximum.
4. describe the effect of exercise on mean arterial pressure.
5. describe the acute effects of exercise on the lungs.
6. describe the function of minute ventilation rate vs. exercise intensity.
7. describe the function of the lungs in maintaining pH during exercise.
8. describe how exercise affects hormone release.
9. how does exercise affect thyroid related hormones?
10. describe the effects of exercise on skeletal muscle.
11. describe the acute effects of exercise on metabolism.
12. describe how exercise affects GI function.
adaptive effects of exercise on different systems...
13. how does the heart adapt to endurance exercise?
14. how does endurance training affect hormone release?
15. how does endurance training affect skeletal muscle?
16. how does endurance training affect metabolism?
17. how does endurance training affect bone and connective tissue?
answers
1. drastic increase in CO due to increased HR (small increase in SV) and increased venous return from skeletal muscle pumps and respiratory pump.
2. increased HR due increased sympathetic stimulation of SA node and decreased parasympathetic. increased SV due to increased myocardial contractility.
3. HR continues to max, but SV plateaus relatively early.
4. increases slightly; CO is increased but total peripheral resistance is decreased.
5. increased ventilation rate, increased alveolar ventilation (rate and volume)
6. a linear relationship at low to moderate intensities, then a supralinear relationship.
7. high intensity exercise produces lactic acid in the muscles, which causes metabolic acidosis; the lungs compensate for this by increasing ventilation and excreting CO2 from the blood.
8. causes an increase in hormones related to stress (cortisol, EP, glucagon, GH) due to sympathetic stimulation. also causes a decrease in insulin release (so that glucose can be used as fuel).
9. increased TSH, T4, T3, which stimulates metabolism.
10. increased bloodflow from increased CO, increased body temperature from increased contraction, and increased use of creatine phosphate/glycogen to form ATP.
11. increased liver supply of glucose via glycogenolysis. increased lipolysis causes increase in glycerol and free fatty acids. increased utilization of free fatty acids.
12. decrease in blood flow to GI tract. slower gastric emptying and intestinal absorption. increased caloric expenditure and thus increased appetite.
13. increased contractility of myocardium increases CO, and increased mitochondria increases oxidative capacity. increased efficiency lowers resting heart rate. also, increased maximal oxygen uptake.
14. increased insulin receptor density on cells increases sensitivity to insulin and allows for increased efficiency of glucose transport into muscles.
15. increased mitochondria causes increased oxidative capacity. hypertrophy of muscle fibers due to increased synthesis of myofilaments. increased number of fast oxidative fibers. increased synthesis of glycolytic enzymes. increased capillaries surrounding muscles. finally, increased myoglobin synthesis.
16. improved GI function (motility and elimination in particular), increased BMR, increased endurance from usage of fatty acids, increased WBC count leads to better immune function.
17. decreased chance of injury due to increased strength and density of tissues. decreased joint pain.
...read more
hormone release also markedly shifts with exercise, mainly to facilitate efficient utilization of glucose in skeletal muscle. sympathetic stimulation causes release of stress hormones such as epinephrine and cortisol, and insulin release is decreased so that glucose is available in the blood for metabolism. also, thyroid hormones such as T3 and T4 are increased so that metabolism can increase. repeated endurance training causes adaptive changes such as increased insulin receptors on cells, which increases the efficiency of glucose uptake in endurance athletes.
exercise affects skeletal muscle by increasing blood flow to muscle, body temperature due to contraction, and use of creatine phosphate / glycogen to form ATP. additionally, during intense exercise, lactic acid is produced in the muscles and can contribute to a metabolic acidosis, which can be compensated by excreting CO2 through ventilation. sustained endurance exercise increases the oxidative capacity of skeletal muscle through more mitochondria, as well as increasing the size of myofibrils through increased synthesis of myofilaments, and increased fast oxidative-type muscle fibers.
questions
acute effects of exercise on different systems...
1. describe the acute effects of exercise on the heart.
2. what are the increases in HR and SV attributed to?
3. describe the difference in SV and HR as exercise intensity increases to maximum.
4. describe the effect of exercise on mean arterial pressure.
5. describe the acute effects of exercise on the lungs.
6. describe the function of minute ventilation rate vs. exercise intensity.
7. describe the function of the lungs in maintaining pH during exercise.
8. describe how exercise affects hormone release.
9. how does exercise affect thyroid related hormones?
10. describe the effects of exercise on skeletal muscle.
11. describe the acute effects of exercise on metabolism.
12. describe how exercise affects GI function.
adaptive effects of exercise on different systems...
13. how does the heart adapt to endurance exercise?
14. how does endurance training affect hormone release?
15. how does endurance training affect skeletal muscle?
16. how does endurance training affect metabolism?
17. how does endurance training affect bone and connective tissue?
answers
1. drastic increase in CO due to increased HR (small increase in SV) and increased venous return from skeletal muscle pumps and respiratory pump.
2. increased HR due increased sympathetic stimulation of SA node and decreased parasympathetic. increased SV due to increased myocardial contractility.
3. HR continues to max, but SV plateaus relatively early.
4. increases slightly; CO is increased but total peripheral resistance is decreased.
5. increased ventilation rate, increased alveolar ventilation (rate and volume)
6. a linear relationship at low to moderate intensities, then a supralinear relationship.
7. high intensity exercise produces lactic acid in the muscles, which causes metabolic acidosis; the lungs compensate for this by increasing ventilation and excreting CO2 from the blood.
8. causes an increase in hormones related to stress (cortisol, EP, glucagon, GH) due to sympathetic stimulation. also causes a decrease in insulin release (so that glucose can be used as fuel).
9. increased TSH, T4, T3, which stimulates metabolism.
10. increased bloodflow from increased CO, increased body temperature from increased contraction, and increased use of creatine phosphate/glycogen to form ATP.
11. increased liver supply of glucose via glycogenolysis. increased lipolysis causes increase in glycerol and free fatty acids. increased utilization of free fatty acids.
12. decrease in blood flow to GI tract. slower gastric emptying and intestinal absorption. increased caloric expenditure and thus increased appetite.
13. increased contractility of myocardium increases CO, and increased mitochondria increases oxidative capacity. increased efficiency lowers resting heart rate. also, increased maximal oxygen uptake.
14. increased insulin receptor density on cells increases sensitivity to insulin and allows for increased efficiency of glucose transport into muscles.
15. increased mitochondria causes increased oxidative capacity. hypertrophy of muscle fibers due to increased synthesis of myofilaments. increased number of fast oxidative fibers. increased synthesis of glycolytic enzymes. increased capillaries surrounding muscles. finally, increased myoglobin synthesis.
16. improved GI function (motility and elimination in particular), increased BMR, increased endurance from usage of fatty acids, increased WBC count leads to better immune function.
17. decreased chance of injury due to increased strength and density of tissues. decreased joint pain.
...read more
Saturday, June 6, 2009
music: introducing the meditation series
the third in the series of musical meditations i've been doing here at NCNM (they'll all be recorded after this point). audio recorded separately will also be a track in the upcoming album, "equilibrium". enjoy!
...read more
...read more
microbio: epidemiology and public health
this lecture introduced some basic concepts about epidemiology and public health. epidemiology is the study of how, why, where, when diseases are transmitted within populations and public health is concerned with preventing the transmission of disease within populations. some common measures that are used as tools in epidemiology are incidence and prevalence- how many new cases of a disease there are compared to the people at risk, and the number of old and new cases of a disease compared to the people at risk, respectively. incidence rate looks at the incidence divided by "people-years", which is a measure of the summed up at-risk years of an entire population. average risk or incidence proportion is another measure which is used and is the cases of disease occurrence divided by the population size. finally, "incidence odds" is the number of people with a certain outcome vs. the number who don't get the outcome.
there are different types of epidemiology which use different approaches to study disease transmission in populations. descriptive epidemiology makes use of descriptive factors such as location, time, patient characteristics in order to investigate time courses of disease and chains of transmission. the most prominent (and one of the first) example is John Snow in 1854 discovering that a cholera outbreak was traced back to a single well in Soho England. analytical epidemiology makes use of descriptive data as well, and also looks at retrospective studies to establish etiology of disease transmission (and thus can sometimes be used in place of Koch's postulates). experimental epidemiology forms hypotheses based on descriptive or analytical data and performs tests involving treatment or intervention (and thus can sometimes have ethical issues). lastly, hospital epidemiology deals with nosocomial infections exclusively, including the iatrogenic cases in which disease occurs directly due to treatment, and from cases in which the disease is transmitted from patient to patient.
diagnostic testing is an important facet of epidemiology; as it is the method of acquiring data, it is vitally important to scrutinize as well. the quality of a particular diagnostic test in assessing disease is gauged by the two variables: validity (whether the test actually yields accurate results) and reliability (whether these results can be repeated). sensitivity of a test is defined as the percentage of people with the disease that test positive for that disease. specificity is the percentage of people without the disease that test negative for the disease. conversely, a positive predictive value is the percentage of people who have positive test results that actually have the disease and negative predictive value is the percentage of people who test negative and don't have the disease.
a brief discussion about error and bias in collecting epidemiological (or any) data. while random error is due to statistical aberrations that are expected in small sample sizes, systematic error is due to a fundamental flaw in the mechanism for collecting data and thus can not be eliminated by large sample sizes. confounding bias is when two populations that are being compared have some innate difference between them that does not for a fair comparison. selection bias is the error introduced by a study when the methods for selecting participants of a study favor certain groups. information bias is a misclassification of the study participants with respect to disease or exposure status.
questions
introduction...
1. define epidemiology.
2. epidemiological factors were originally limited to infectious diseases but now include...
3. public health is concerned with...
4. all epidemiological studies should have...
incidence and prevalence...
5. define "incidence".
6. what is the "incidence rate"?
7. what is the second most common measure of disease occurrence?
8. what is the third most common measure of disease occurrence?
9. what type of data does an incidence case control study use?
10. define "prevalence".
11. define the following descriptions of prevalence: endemic, sporadic, epidemic, pandemic.
different types of epidemiology...
12. what characteristics of disease occurrence does descriptive epidemiology make use of? what is a prominent example of descriptive epidemiology at work in uncovering a cholera outbreak?
13. describe analytical epidemiology.
14. describe experimental epidemiology.
15. describe hospital epidemiology.
diagnostic testing...
16. what are two abstract measures that gauge the quality of a particular diagnostic test?
17. define "sensitivity" in terms of the quality of a particular diagnostic test.
18. ...specificity.
19. ...positive predictive value.
20. ...negative predictive value.
21. what are some characteristics of a disease that is worthwhile for diagnostic screening?
22. what is the difference between random error and systematic error?
23. what is confounding bias?
24. what is selection bias?
25. what is information bias?
answers
1. the study of how, where and when diseases occur within populations.
2. car accidents, cigarette smoking, lead poisoning, injury, etc.
3. prevention of disease in populations.
4. source or study population and risk period.
5. number of new cases of a disease / number of people at risk for that disease.
6. disease occurrence / number of "person-years" (the population size times years at risk)
7. average risk or incidence proportion: cases of disease occurrence / population size.
8. incidence odds: number who get outcome / number who don't get outcome.
9. retrospective data, which can be less expensive and resource heavy than a regular prospective study.
10. number of old cases + number of new cases / number of people at risk.
11. endemic: when disease occurs continually or regularly. sporadic: a few scattered cases. epidemic: greater frequency than endemic, more cases than historical statistics indicate. pandemic: simultaneous epidemic on more than 1 continent.
12. location, time, patient characteristics; looks at time course of disease and investigates chains of transmission. prominent example is John Snow, who in 1854 helped trace the source of a cholera outbreak to contaminated water from a single well in Soho, England by talking to local residents and analyzing statistics from the water delivery company.
13. makes use of descriptive data and retrospective studies. may be used in place of koch's postulates in establishing etiology.
14. hypothesizes based on descriptive or analytical data and performs tests (can be treatment or intervention based).
15. studies nosocomial infections exclusively. exogenous infection is derived from an agent outside of patient. endogenous infection comes from patient. iatrogenic infection is the direct result of medical procedure.
16. validity and reliability.
17. percentage of people with disease with positive test results for that disease.
18. percentage of people without disease with negative test results for that disease.
19. percentage of people with positive test results who have the disease.
20. percentage of people with negative test results who don't have the disease.
21. a disease with a high burden of human suffering, effective early intervention, a high risk population, has an effective and feasible diagnostic method.
22. random error is the natural deviation that occurs from predicted values which is statistically expected with low sample sizes, whereas systematic error's basis is a lack of validity in the tools of discernment used in the study and thus cannot be corrected for with larger sample sizes.
23. a bias which affects studies of cause and effect; when exposed and non-exposed groups are not comparable due to inherent diferrences in background or risk factors.
24. a bias that arises because of the particular way in which participants in a study are selected.
25. a misclassification of the study participants with respect to disease or exposure status.
...read more
there are different types of epidemiology which use different approaches to study disease transmission in populations. descriptive epidemiology makes use of descriptive factors such as location, time, patient characteristics in order to investigate time courses of disease and chains of transmission. the most prominent (and one of the first) example is John Snow in 1854 discovering that a cholera outbreak was traced back to a single well in Soho England. analytical epidemiology makes use of descriptive data as well, and also looks at retrospective studies to establish etiology of disease transmission (and thus can sometimes be used in place of Koch's postulates). experimental epidemiology forms hypotheses based on descriptive or analytical data and performs tests involving treatment or intervention (and thus can sometimes have ethical issues). lastly, hospital epidemiology deals with nosocomial infections exclusively, including the iatrogenic cases in which disease occurs directly due to treatment, and from cases in which the disease is transmitted from patient to patient.
diagnostic testing is an important facet of epidemiology; as it is the method of acquiring data, it is vitally important to scrutinize as well. the quality of a particular diagnostic test in assessing disease is gauged by the two variables: validity (whether the test actually yields accurate results) and reliability (whether these results can be repeated). sensitivity of a test is defined as the percentage of people with the disease that test positive for that disease. specificity is the percentage of people without the disease that test negative for the disease. conversely, a positive predictive value is the percentage of people who have positive test results that actually have the disease and negative predictive value is the percentage of people who test negative and don't have the disease.
a brief discussion about error and bias in collecting epidemiological (or any) data. while random error is due to statistical aberrations that are expected in small sample sizes, systematic error is due to a fundamental flaw in the mechanism for collecting data and thus can not be eliminated by large sample sizes. confounding bias is when two populations that are being compared have some innate difference between them that does not for a fair comparison. selection bias is the error introduced by a study when the methods for selecting participants of a study favor certain groups. information bias is a misclassification of the study participants with respect to disease or exposure status.
questions
introduction...
1. define epidemiology.
2. epidemiological factors were originally limited to infectious diseases but now include...
3. public health is concerned with...
4. all epidemiological studies should have...
incidence and prevalence...
5. define "incidence".
6. what is the "incidence rate"?
7. what is the second most common measure of disease occurrence?
8. what is the third most common measure of disease occurrence?
9. what type of data does an incidence case control study use?
10. define "prevalence".
11. define the following descriptions of prevalence: endemic, sporadic, epidemic, pandemic.
different types of epidemiology...
12. what characteristics of disease occurrence does descriptive epidemiology make use of? what is a prominent example of descriptive epidemiology at work in uncovering a cholera outbreak?
13. describe analytical epidemiology.
14. describe experimental epidemiology.
15. describe hospital epidemiology.
diagnostic testing...
16. what are two abstract measures that gauge the quality of a particular diagnostic test?
17. define "sensitivity" in terms of the quality of a particular diagnostic test.
18. ...specificity.
19. ...positive predictive value.
20. ...negative predictive value.
21. what are some characteristics of a disease that is worthwhile for diagnostic screening?
22. what is the difference between random error and systematic error?
23. what is confounding bias?
24. what is selection bias?
25. what is information bias?
answers
1. the study of how, where and when diseases occur within populations.
2. car accidents, cigarette smoking, lead poisoning, injury, etc.
3. prevention of disease in populations.
4. source or study population and risk period.
5. number of new cases of a disease / number of people at risk for that disease.
6. disease occurrence / number of "person-years" (the population size times years at risk)
7. average risk or incidence proportion: cases of disease occurrence / population size.
8. incidence odds: number who get outcome / number who don't get outcome.
9. retrospective data, which can be less expensive and resource heavy than a regular prospective study.
10. number of old cases + number of new cases / number of people at risk.
11. endemic: when disease occurs continually or regularly. sporadic: a few scattered cases. epidemic: greater frequency than endemic, more cases than historical statistics indicate. pandemic: simultaneous epidemic on more than 1 continent.
12. location, time, patient characteristics; looks at time course of disease and investigates chains of transmission. prominent example is John Snow, who in 1854 helped trace the source of a cholera outbreak to contaminated water from a single well in Soho, England by talking to local residents and analyzing statistics from the water delivery company.
13. makes use of descriptive data and retrospective studies. may be used in place of koch's postulates in establishing etiology.
14. hypothesizes based on descriptive or analytical data and performs tests (can be treatment or intervention based).
15. studies nosocomial infections exclusively. exogenous infection is derived from an agent outside of patient. endogenous infection comes from patient. iatrogenic infection is the direct result of medical procedure.
16. validity and reliability.
17. percentage of people with disease with positive test results for that disease.
18. percentage of people without disease with negative test results for that disease.
19. percentage of people with positive test results who have the disease.
20. percentage of people with negative test results who don't have the disease.
21. a disease with a high burden of human suffering, effective early intervention, a high risk population, has an effective and feasible diagnostic method.
22. random error is the natural deviation that occurs from predicted values which is statistically expected with low sample sizes, whereas systematic error's basis is a lack of validity in the tools of discernment used in the study and thus cannot be corrected for with larger sample sizes.
23. a bias which affects studies of cause and effect; when exposed and non-exposed groups are not comparable due to inherent diferrences in background or risk factors.
24. a bias that arises because of the particular way in which participants in a study are selected.
25. a misclassification of the study participants with respect to disease or exposure status.
...read more
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