Severe coeliac disease leads to the characteristic symptoms of pale, loose and greasy stool (steatorrhoea), weight loss or failure to gain weight (in young children). People with milder coeliac disease may have symptoms that are much more subtle and occur in other organs rather than the bowel itself. Finally, it is possible to have coeliac disease without any symptoms whatsoever. Many adults with subtle disease only have fatigue or anaemia.

Gastrointestinal

The diarrhoea that is characteristic of coeliac disease is (chronic) pale, voluminous and malodorous. Abdominal pain and cramping, bloatedness with abdominal distension (thought to be due to fermentative production of bowel gas) and mouth ulcers may be present. As the bowel becomes more damaged, a degree of lactose intolerance may develop. Frequently, the symptoms are ascribed to irritable bowel syndrome (IBS), only later to be recognised as coeliac disease; a small proportion of patients with symptoms of IBS have underlying coeliac disease, and screening for coeliac disease is recommended for those with IBS symptoms.

Coeliac disease leads to an increased risk of both adenocarcinoma (small intestine cancer) and lymphoma of the small bowel (enteropathy-associated T-cell lymphoma or EATL). This risk returns to baseline with diet. Longstanding and untreated disease may lead to other complications, such as ulcerative jejunitis (ulcer formation of the small bowel) and stricturing (narrowing as a result of scarring with obstruction of the bowel).

Malabsorption-related

The changes in the bowel make it less able to absorb nutrients, minerals and the fat-soluble vitamins A, D, E, and K.

* The inability to absorb carbohydrates and fats may cause weight loss (or failure to thrive/stunted growth in children) and fatigue or lack of energy.

* Anaemia may develop in several ways: iron malabsorption may cause iron deficiency anaemia, and folic acid and vitamin B12 malabsorption may give rise to megaloblastic anaemia.

* Calcium and vitamin D malabsorption (and compensatory secondary hyperparathyroidism) may cause osteopenia (decreased mineral content of the bone) or osteoporosis (bone weakening and risk of fragility fractures).

* A small proportion have abnormal coagulation due to vitamin K deficiency and are slightly at risk for abnormal bleeding.

* Coeliac disease is also associated with bacterial overgrowth of the small intestine, which can worsen malabsorption or cause malabsorption despite adherence to treatment.

Miscellaneous

Coeliac disease has been linked with a number of conditions. In many cases, it is unclear whether the gluten-induced bowel disease is a causative factor or whether these conditions share a common predisposition.

* IgA deficiency is present in 2.3% of patients with coeliac disease, and in turn, this condition features a tenfold increased risk of coeliac disease. Other features of this condition are an increased risk of infections and autoimmune disease.

* Dermatitis herpetiformis; this itchy cutaneous condition has been linked to a transglutaminase enzyme in the skin, features small-bowel changes identical to those in coeliac disease, and may respond to gluten withdrawal even if there are no gastrointestinal symptoms

* Growth failure and/or pubertal delay in later childhood can occur even without obvious bowel symptoms or severe malnutrition. Evaluation of growth failure often includes coeliac screening.

* Recurrent miscarriage and unexplained infertility.

* Hyposplenism (a small and underactive spleen); this occurs in about a third of cases and may predispose to infection given the role of the spleen in protecting against bacteria

* Abnormal liver function tests (randomly detected on blood tests)

Coeliac disease is associated with a number of other medical conditions, many of which are autoimmune disorders: diabetes mellitus type 1, autoimmune thyroiditis, primary biliary cirrhosis, and microscopic colitis.

A more controversial area is a group of diseases in which anti-gliadin antibodies (an older and non-specific test for coeliac disease) are sometimes detected, but no small bowel disease can be demonstrated. Sometimes, these conditions improve by removing gluten from the diet. This includes cerebellar ataxia, peripheral neuropathy, schizophrenia and autism.

Other grains

Wheat subspecies (such as spelt, semolina and durum) and related species such as barley, rye, triticale and Kamut also induce symptoms of coeliac disease. A small minority of coeliac patients also react to oats. It is most probable that oats produce symptoms due to cross contamination with other grains in the fields or in the distribution channels. Generally, oats are therefore not recommended. Other cereals such as maize (corn), quinoa, millet, sorghum, teff, amaranth, buckwheat, rice, and wild rice are safe for patients to consume. Non-cereal carbohydrate-rich foods such as potatoes and bananas do not contain gluten and do not trigger symptoms.

Adapted from the Wikipedia article Coeliac disease, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Protein Sparing Modified Fast, or PSMF, is a total fast modified by the intake of circa 1.2-1.5 grams of protein per kilogram of ideal body weight (IBW) and fluids, vitamin and mineral supplementation.

PSMF was designed in the late 1970s as a diet for a rapid weight loss for the morbidly obese. PSMF is a type of very low calorie diet with dehydration being a health concern, hence fluids, vitamin and mineral (potassium and sodium) supplementation is necessary and doctor’s supervision is recommended. PSMF diets consist in foods that are naturally rich in good-quality protein and particularly low in fats (chicken breast, egg white, ham, cottage cheese).

PSMF as a diet recently became very popular due to its remastered version known as the Dukan diet and is also, less commonly, used by bodybuilders.

Adapted from the Wikipedia article Protein Sparing Modified Fast, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue. It can occur unintentionally due to an underlying disease or can arise from a conscious effort to improve an actual or perceived overweight or obese state.

Adapted from the Wikipedia article Weight loss, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Surgery is a medical technology consisting of a physical intervention on tissues.

As a general rule, a procedure is considered surgical when it involves cutting of a patient’s tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy, may be considered surgery if they involve “common” surgical procedure or settings, such as use of a sterile environment, anesthesia, antiseptic conditions, typical surgical instruments, and suturing or stapling. All forms of surgery are considered invasive procedures; so-called “noninvasive surgery” usually refers to an excision that does not penetrate the structure being excised (e.g. laser ablation of the cornea) or to a radiosurgical procedure (e.g. irradiation of a tumor).

Types of surgery

Surgical procedures are the commonly categorized by urgency, type of procedure, body system involved, degree of invasiveness, and special instrumentation.

Elective surgery is done to correct a non-life-threatening condition, and is carried out at the patient’s request, subject to the surgeon’s and the surgical facility’s availability. Emergency surgery is surgery which must be done quickly to save life, limb, or functional capacity. Exploratory surgery is performed to aid or confirm a diagnosis. Therapeutic surgery treats a previously diagnosed condition.

Amputation involves cutting off a body part, usually a limb or digit. Replantation involves reattaching a severed body part. Reconstructive surgery involves reconstruction of an injured, mutilated, or deformed part of the body. Cosmetic surgery is done to improve the appearance of an otherwise normal structure. Excision is the cutting out of an organ, tissue, or other body part from the patient. Transplant surgery is the replacement of an organ or body part by insertion of another from different human (or animal) into the patient. Removing an organ or body part from a live human or animal for use in transplant is also a type of surgery.

When surgery is performed on one organ system or structure, it may be classed by the organ, organ system or tissue involved. Examples include cardiac surgery (performed on the heart), gastrointestinal surgery (performed within the digestive tract and its accessory organs), and orthopedic surgery (performed on bones and/or muscles).

Minimally invasive surgery involves smaller outer incision(s) to insert miniaturized instruments within a body cavity or structure, as in laparoscopic surgery or angioplasty. By contrast, an open surgical procedure requires a large incision to access the area of interest. Laser surgery involves use of a laser for cutting tissue instead of a scalpel or similar surgical instruments. Microsurgery involves the use of an operating microscope for the surgeon to see small structures. Robotic surgery makes use of a surgical robot, such as the Da Vinci or the Zeus surgical systems, to control the instrumentation under the direction of the surgeon.

Terminology

*Excision surgery names often start with a name for the organ to be excised (cut out) and end in -ectomy.

*Procedures involving cutting into an organ or tissue end in -otomy. A surgical procedure cutting through the abdominal wall to gain access to the abdominal cavity is a laparotomy.

*Minimally invasive procedures involving small incisions through which an endoscope is inserted end in -oscopy. For example, such surgery in the abdominal cavity is called laparoscopy.

*Procedures for formation of a permanent or semi-permanent opening called a stoma in the body end in -ostomy.

*Reconstruction, plastic or cosmetic surgery of a body part starts with a name for the body part to be reconstructed and ends in -oplasty. ”Rhino” is used as a prefix for “nose”, so ”rhinoplasty” is basically reconstructive or cosmetic surgery for the nose.

*Reparation of damaged or congenital abnormal structure ends in -rraphy. Herniorraphy is the reparation of a hernia, while perineorraphy is the reparation of perineum.

Description of surgical procedure

At a hospital, modern surgery is often done in an operating theater using surgical instruments, an operating table for the patient, and other equipment. The environment and procedures used in surgery are governed by the principles of aseptic technique: the strict separation of “sterile” (free of microorganisms) things from “unsterile” or “contaminated” things. All surgical instruments must be sterilized, and an instrument must be replaced or re-sterilized if it becomes contaminated (i.e. handled in an unsterile manner, or allowed to touch an unsterile surface). Operating room staff must wear sterile attire (scrubs, a scrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask), and they must scrub hands and arms with an approved disinfectant agent before each procedure.

Prior to surgery, the patient is given a medical examination, certain pre-operative tests, and their physical status is rated according to the ASA physical status classification system. If these results are satisfactory, the patient signs a consent form and is given a surgical clearance. If the procedure is expected to result in significant blood loss, an autologous blood donation may be made some weeks prior to surgery. If the surgery involves the digestive system, the patient may be instructed to perform a bowel prep by drinking a solution of polyethylene glycol the night before the procedure. Patients are also instructed to abstain from food or drink (an NPO order after midnight on the night before the procedure, to minimize the effect of stomach contents on pre-operative medications and reduce the risk of aspiration if the patient vomits during or after the procedure.

In the pre-operative holding area, the patient changes out of his or her street clothes and is asked to confirm the details of his or her surgery. A set of vital signs are recorded, a peripheral IV line is placed, and pre-operative medications (antibiotics, sedatives, etc.) are given. When the patient enters the operating room, the skin surface to be operated on is cleaned and prepared by applying an antiseptic such as chlorhexidine gluconate or povidone-iodine to reduce the possibility of infection. If hair is present at the surgical site, it is clipped off prior to prep application. Sterile drapes are used to cover all of the patient’s body except for the surgical site and the patient’s head; the drapes are clipped to a pair of poles near the head of the bed to form an “ether screen”, which separates the anesthetist/anesthesiologist’s working area (unsterile) from the surgical site (sterile).

Anesthesia is administered to prevent pain from incision, tissue manipulation and suturing. Based on the procedure, anesthesia may be provided locally or as general anesthesia. Spinal anesthesia may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia, the surgical site is anesthetized, but the patient can remain conscious or minimally sedated. In contrast, general anesthesia renders the patient unconscious and paralyzed during surgery. The patient is intubated and is placed on a mechanical ventilator, and anesthesia is produced by a combination of injected and inhaled agents.

An incision is made to access the surgical site. Blood vessels may be clamped to prevent bleeding, and retractors may be used to expose the site or keep the incision open. The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then peritoneum. In certain cases, bone may be cut to further access the interior of the body; for example, cutting the skull for brain surgery or cutting the sternum for thoracic surgery to open up the rib cage.

Work to correct the problem in body then proceeds. This work may involve:

*excision – cutting out an organ, tumor, or other tissue.

*resection – partial removal of an organ or other bodily structure.

*reconnection of organs, tissues, etc., particularly if severed. Resection of organs such as intestines involves reconnection. Internal suturing or stapling may be used. Surgical connection between blood vessels or other tubular or hollow structures such as loops of intestine is called anastomosis.

*ligation – tying off blood vessels, ducts, or “tubes”.

*grafts – may be severed pieces of tissue cut from the same (or different) body or flaps of tissue still partly connected to the body but resewn for rearranging or restructuring of the area of the body in question. Although grafting is often used in cosmetic surgery, it is also used in other surgery. Grafts may be taken from one area of the patient’s body and inserted to another area of the body. An example is bypass surgery, where clogged blood vessels are bypassed with a graft from another part of the body. Alternatively, grafts may be from other persons, cadavers, or animals.

*insertion of prosthetic parts when needed. Pins or screws to set and hold bones may be used. Sections of bone may be replaced with prosthetic rods or other parts. Sometime a plate is inserted to replace a damaged area of skull. Artificial hip replacement has become more common. Heart pacemakers or valves may be inserted. Many other types of prostheses are used.

*creation of a stoma, a permanent or semi-permanent opening in the body

*in transplant surgery, the donor organ (taken out of the donor’s body) is inserted into the recipient’s body and reconnected to the recipient in all necessary ways (blood vessels, ducts, etc.).

*arthrodesis – surgical connection of adjacent bones so the bones can grow together into one. Spinal fusion is an example of adjacent vertebrae connected allowing them to grow together into one piece.

*modifying the digestive tract in bariatric surgery for weight loss.

*repair of a fistula, hernia, or prolapse

*other procedures, including:

:*clearing clogged ducts, blood or other vessels

:*removal of calculi (stones)

:*draining of accumulated fluids

:*debridement- removal of dead, damaged, or diseased tissue

*Surgery has also been conducted to separate conjoined twins.

*Sex change operations

Blood or blood expanders may be administered to compensate for blood lost during surgery. Once the procedure is complete, sutures or staples are used to close the incision. Once the incision is closed, the anesthetic agents are stopped and/or reversed, and the patient is taken off ventilation and extubated (if general anesthesia was administered).

After completion of surgery, the patient is transferred to the post anesthesia care unit and closely monitored. When the patient is judged to have recovered from the anesthesia, he/she is either transferred to a surgical ward elsewhere in the hospital or discharged home. During the post-operative period, the patient’s general function is assessed, the outcome of the procedure is assessed, and the surgical site is checked for signs of infection. If removable skin closures are used, they are removed after 7 to 10 days post-operatively, or after healing of the incision is well under way.

Post-operative therapy may include adjuvant treatment such as chemotherapy, radiation therapy, or administration of medication such as anti-rejection medication for transplants. Other follow-up studies or rehabilitation may be prescribed during and after the recovery period.

Adapted from the Wikipedia article Surgery, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Medical outcomes

Maternal and prenatal health is of particular concern among teens who are pregnant or parenting. The worldwide incidence of premature birth and low birth weight is higher among adolescent mothers. Research indicates that pregnant teens are less likely to receive prenatal care, often seeking it in the third trimester, if at all. The Guttmacher Institute reports that one-third of pregnant teens receive insufficient prenatal care and that their children are more likely to suffer from health issues in childhood or be hospitalized than those born to older women.

However, studies have indicated that young mothers who are given high-quality maternity care have significantly healthier babies than those that do not. Many of the health-issues associated with teenage mothers, many of whom do not have health insurance, appear to result from lack of access to high-quality medical care.

Many pregnant teens are subject to nutritional deficiencies from poor eating habits common in adolescence, including attempts to lose weight through dieting, skipping meals, food faddism, snacking, and consumption of fast food.

Inadequate nutrition during pregnancy is an even more marked problem among teenagers in developing countries. Complications of pregnancy result in the deaths of an estimated 70,000 teen girls in developing countries each year. Young mothers and their babies are also at greater risk of contracting HIV. The World Health Organization estimates that the risk of death following pregnancy is twice as great for women between 15 and 19 years than for those between the ages of 20 and 24. The maternal mortality rate can be up to five times higher for girls aged between 10 and 14 than for women of about twenty years of age. Illegal abortion also holds many risks for teenage girls in areas such as sub-Saharan Africa.

Risks for medical complications are greater for girls 14 years of age and younger, as an underdeveloped pelvis can lead to difficulties in childbirth. Obstructed labour is normally dealt with by Caesarean section in industrialized nations; however, in developing regions where medical services might be unavailable, it can lead to eclampsia, obstetric fistula, infant mortality, or maternal death. For mothers in their late teens, age in itself is not a risk factor, and poor outcomes are associated more with socioeconomic factors rather than with biology.

Socioeconomic and psychological outcomes

Several studies have examined the socioeconomic, medical, and psychological impact of pregnancy and parenthood in teens. Life outcomes for teenage mothers and their children vary; other factors, such as poverty or social support, may be more important than the age of the mother at the birth. Many solutions to counteract the more negative findings have been proposed. Teenage parents who can use family and community support, social services and child-care support to continue their education and get higher paying jobs as they progress with their education.

Impact on the mother

Being a ”young mother” in an industrialized country can affect one’s education. Teen mothers are more likely to drop out of high school. Recent studies, though, have found that many of these mothers had already dropped out of school prior to becoming pregnant, but those in school at the time of their pregnancy were as likely to graduate as their peers. One study in 2001 found that women who gave birth during their teens completed secondary-level schooling 10–12% as often and pursued post-secondary education 14–29% as often as women who waited until age 30.

”Young motherhood” in an industrialized country can affect employment and social class. Less than one third of teenage mothers receive any form of child support, vastly increasing the likelihood of turning to the government for assistance. The correlation between earlier childbearing and failure to complete high school reduces career opportunities for many young women. One study found that, in 1988, 60% of teenage mothers were impoverished at the time of giving birth. Additional research found that nearly 50% of all adolescent mothers sought social assistance within the first five years of their child’s life. A study of 100 teenaged mothers in the United Kingdom found that only 11% received a salary, while the remaining 89% were unemployed. Most British teenage mothers live in poverty, with nearly half in the bottom fifth of the income distribution. Teenage women who are pregnant or mothers are seven times more likely to commit suicide than other teenagers. Professor John Ermisch at the institute of social and economic research at Essex University and Dr Roger Ingham, director of the centre of sexual health at Southampton University – found that comparing teenage mothers with other girls with similarly deprived social-economic profiles, bad school experiences and low educational aspirations, the difference in their respective life chances was negligible.

Teenage Motherhood may actually make economic sense for poorer young women, some research suggests. For instance, long-term studies by Duke economist V. Joseph Hotz and colleagues, published in 2005, found that by age 35, former teen moms had earned more in income, paid more in taxes, were substantially less likely to live in poverty and collected less in public assistance than similarly poor women who waited until their 20s to have babies. Women who became mothers in their teens — freed from child-raising duties by their late 20s and early 30s to pursue employment while poorer women who waited to become moms were still stuck at home watching their young children — wound up paying more in taxes than they had collected in welfare. Eight years earlier, the federally commissioned report “Kids Having Kids” also contained a similar finding, though it was buried: “Adolescent childbearers fare slightly better than later-childbearing counterparts in terms of their overall economic welfare.”

One-fourth of adolescent mothers will have a second child within 24 months of the first. Factors that determine which mothers are more likely to have a closely-spaced repeat birth include marriage and education: the likelihood decreases with the level of education of the young woman – or her parents – and increases if she gets married.

Impact on the child

Early motherhood can affect the psychosocial development of the infant. The occurrence of developmental disabilities and behavioral issues is increased in children born to teen mothers. One study suggested that adolescent mothers are less likely to stimulate their infant through affectionate behaviors such as touch, smiling, and verbal communication, or to be sensitive and accepting toward his or her needs. Another found that those who had more social support were less likely to show anger toward their children or to rely upon punishment.

Poor academic performance in the children of teenage mothers has also been noted, with many of them being more likely than average to fail to graduate from secondary school, be held back a grade level, or score lower on standardized tests. Daughters born to adolescent parents are more likely to become teen mothers themselves. A son born to a young woman in her teens is three times more likely to serve time in prison.

Impact on other family members

Teen pregnancy and motherhood can influence younger siblings. One study found that the younger sisters of teen mothers were less likely to emphasize the importance of education and employment and more likely to accept human sexual behavior, parenting, and marriage at younger ages; younger brothers, too, were found to be more tolerant of non-marital and early births, in addition to being more susceptible to high-risk behaviors. An additional study discovered that those with an older sibling who is a teen parent often end up babysitting their nieces and nephews and that young girls placed in such a situation have an increased risk of getting pregnant themselves.

Social workers play an important role in intervention with families. They work with the families to address common problems and health issues in order to promote a positive outcome for both the family and the baby.

Adapted from the Wikipedia article Teenage pregnancy, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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When the cause of sciatica is due to a prolapsed or lumbar disc herniation 90% of disc prolapses will be resolved with no intervention. Treatment of the underlying cause of the compression is needed in cases of epidural abscess, epidural tumors, and cauda equina syndrome.

Cases of sciatica are treated with different measures. Evidence of the effectiveness of these measures is limited, however. Some of these measures are:

* Anti-inflammatory medications (e.g., NSAIDs or oral steroids. However, NSAIDs are no more effective than placebos for acute sciatica)

* Paracetamol (acetaminophen): limited evidence of effectiveness

* Narcotics: often used if pain is severe

* Physical therapy / Stretching exercises

* Epidural steroid injections provide no long-term improvements in outcomes but do provide some short-term benefits

* Non-surgical spinal decompression

* Massage therapy

* Ultrasound

* Weight loss reduces pressure on Spinal nerve roots

* Acupuncture

Surgery

Surgery speeds the resolution of pain. Two years after surgery, however, surgical and non-surgical management have about the same results; so a patient’s preference can be a valid reason to choose one or the other.

Adapted from the Wikipedia article Sciatica, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Healthy Black Family Project

The Healthy Black Family Project (HBFP) concentrates on several East End neighborhoods of Pittsburgh. This area, called the Health Empowerment Zone, has a high percentage of Black residents and of residents living below the federal poverty line. HBFP works with individuals and families, providing a variety of activities and services to help prevent diabetes and hypertension.

HBFP provides health coaches, lay health advocates, and nutritionists at no cost to help families alter their activity and diet to create and maintain a healthy lifestyle. They offer cooking classes, exercise classes, walking clubs, a smoking cessation program, as well as yoga, tai chi, and meditation classes, all designed to promote a healthy lifestyle and prevent disease.

In addition, HBFP provides genetic counseling to ascertain family health history and any risks that might be associated with it, as well as giving a health risk assessment to create a personal health analysis, and they help individuals learn practical ways to handle chronic disease.

Healthy Black Families Project also implements the “Small Steps, Big Rewards” campaign, inspired by the findings of a NIH sponsored study, HHS’ Diabetes Prevention Program (DDP) clinical trial. This study has shown that individuals with pre-diabetes (those whose blood glucose levels are higher than normal but not yet diabetic), can delay and possibly even prevent type 2 diabetes simply by making moderate changes in diet and exercise that enable them to lose five to seven percent of their body weight. Regular physical activity such as a brisk thirty minute walk five times per week, and modest weight loss could cut the risk of developing type 2 diabetes by more than half in pre-diabetic individuals. These lifestyle changes were shown to be especially successful in individuals over age 65. HBFP has every confidence that these methods will prove effective in Pittsburgh’s neighborhoods.

The Healthy Black Family Project provides the framework for all of these programs, and tracks the progress of the families and individuals who are involved. Approximately 6000 individuals have enrolled in the program.

“The overall goal of the Healthy Black Family Project,” said Dr. Angela Ford, associate director of the center, “is to close the gap in health status between blacks and whites through coordinated community mobilization that is culturally relevant and grounded in a public health approach.”

Take A Health Professional to the People

A serious gap or disparity in health outcomes and access to medical care continues to exist for racial or ethnic groups, despite the efforts of government, community leaders, and healthcare providers. The problem is complex and entrenched, involving policy barriers, as well as cultural, social, and economic issues, and therefore demands fresh, creative solutions.

Take a Health Professional to the People Day is just the sort of innovative solution needed to address this serious disparity problem. Part of the Health Advocates In Reach (HAIR) program, it sends doctors, nurse, pharmacists and health educators into the barber shops and beauty salons of underserved communities to deliver health screenings and health education in a familiar, comfortable environment. Stephen B. Thomas, PhD, the director of CMH explains, “Far too many African Americans have no ‘medical home’ to access health care services, so government programs that promote ‘taking a loved one to the doctor’ are not as effective for this community. Therefore, CMH created Take a Health Professional to the People Day. By focusing our efforts on a single day, we believe we can help generate a greater understanding of the importance of regular health screenings while at the same time reaching people who tend to have the least access to healthcare.”

The Center for Minority Health inaugurated “Take a Health Professional to the People Day in 2002, starting with just three barber shops and salons. The program now includes nine beauty salons and barber shops, and over one hundred health professionals, some of whom continue to work with the shops in an on-going effort to provide health and wellness activities there.

In 2007, CMH linked forces with the Mayo Clinic Urban Immersion Program for ‘Take a Health Professional to the People Day’. Eight Mayo staff members traveled to Pittsburgh to gain valuable experience in delivering health care in a non-traditional setting. Dr. Sherine Gabriel, director of Education Resources for the Mayo Clinic Center for Translational Science Activities (CTSA), states, “We created the Urban Immersion Program in collaboration with Dr. Stephen Thomas and the CMH to help our students, faculty, researchers and physicians learn and apply these innovative community outreach strategies here at Mayo Clinic.”

Health Disparity Working Groups

Health Disparity Working Groups are charged with planning and organizing health promotion activities that will be implemented during National Minority Health Month (NMHM), which occurs every April. Each group in this diverse collection, brought together from the academic community, health providers, health promotion and human service organizations, and community representatives, organizes health promotion events that focus on the seven health disparity priorities of CMH.

These NMHM community-based events and activities are deeply rooted in the history of the Black community. They are modeled on the Health Improvement Week, which under the leadership of Booker T. Washington evolved into the National Negro Health Movement, and was annually observed for 35 years. Local NMHM activities are planned to be of value and interest for the entire family – including health, mental health, and wellness screenings, as well as physical activity and entertainment that features the world famous Double Dutch Divas.

In addition to their responsibilities of planning for NMHM, the Working Groups are also valuable as an ideal forum where materials and ideas related to research studies and the EXPORT Health communication campaign can be field tested. Representing, as they do, a wide-base of constituents and organizations, they also provide a large network for disseminating valuable information to the community.

Healthy Class of 2010

The Healthy Class of 2010 is a multi-year campaign designed to prevent disease and to promote health among students in the Pittsburgh Public Schools. Initiated in the 2003-2004 academic year, targeting those students who entered sixth grade that year, the program has a twofold goal: 1) to enable staff to systematically engage every student who entered sixth grade in 2003 in “active living”; and 2) to increase students’ knowledge, attitudes and healthy choices regarding physical activity, nutrition, and a tobacco-free lifestyle. The program, which partners with the Pittsburgh Public School System and the Allegheny County Health Department, follows the student’s progress toward achieving these goals, tracking them over a seven-year period through the year 2010, when they graduate. The Center for Minority Health is working toward making the Class of 2010 the healthiest students ever to graduate from the Pittsburgh Public School System, to coincide with the deadline set for Healthy People 2010, the nation’s health promotion program.

This unique collaboration between the Center for Minority Health (CMH), Graduate School of Public Health at the University of Pittsburgh, and the Pittsburgh Public Schools, focuses on partnership building between school administrators, teachers, students and their families, and the public health community. This creates a unique opportunity to address community needs of eliminating health disparities by customizing relevant interventions to address student health issues.

Adapted from the Wikipedia article Center for Minority Health, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Books

*”Life Extension: A Practical Scientific Approach” (ISBN 0-446-51229-X, Warner Books, 1982),

*”The Life Extension Companion” (Warner Books),

*”The Life Extension Weight Loss Manual, and Freedom of Informed Choice: FDA v. Nutrient Supplements”, (Common Sense Press, 1993).

Articles

Shaw and Durk Pearson have co-authored numerous articles on “life extension”, cognitive enhancement, anti-aging, weight loss, and other aspects of nutrition. They produce the Durk Pearson & Sandy Shaw Life Extension News.

Adapted from the Wikipedia article Sandy Shaw, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Modern hypnotherapy has been used in a variety of forms, such as regression hypnotherapy (or “hypnoanalysis”) and Ericksonian hypnotherapy.

Hypnosis has been studied clinically with varying success. Applications include:

* pain management

* weight loss

* skin disease

* soothing anxious surgical patients

* psychological therapy

* habit control, a way to relax,

* sports performance.

Self-hypnosis is popularly used to quit smoking and reduce stress, while stage hypnosis can persuade people to perform unusual public feats.

Medical applications

Adapted from the Wikipedia article Hypnosis, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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LighterLife is a weight-loss and weight management programme for people who are clinically obese, equivalent to 42 lbs. or more overweight, and with a body mass index greater than 29. The company was started in 1996 by Bar Hewlett, Sally Rettig and Jackie Cox.

LighterLife follows the model of modern Very-low-calorie diets (VLCDs), which have been used by 20 million people in 30 countries over 20 years.

Adapted from the Wikipedia article LighterLife, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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