FPM 50 syllabus FALL 2014 Final 10 1 14 PDF

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FPMU 50 Fall 2014

FPMU 50

Primary Care and Public Health Fall 2014; Tues/Thurs 8:00-9:20 AM BSB 2100 Course Units: 4

Michelle Johnson, MD Department of Family and Preventive Medicine GTA Office: University Ctr. 202 room 402 GTA: Priya Bhat-Patel GTA Email: [email protected] GTA Office Hours: Tuesday Noon-1

Instructor Office: University Ctr. 202, Room 402 Email: [email protected] Instructor Office Hours: Thursday 11am-Noon

Prerequisites: None Course Description: This course explores historical and current interactions, achievements and challenges of primary care and public health. It will explore the intersections of these two systems by analyzing the impact of common medical conditions such as obesity, diabetes, mental health disorders and others on individuals, their families, communities and society.

Student Learning Outcomes: On completion of this course, you should be able to: 1. Define primary care, its role in healthcare systems and the need for integration of primary care and public health 2. Compare and contrast the disciplines and priorities of primary care and public health and identify shared priorities such as improving population health, disease prevention, screening, and health promotion 3. Define key concepts such as incidence, prevalence, health disparities, social determinants of health, health risk factors, burden of disease, prevention and screening and apply these terms to relevant health issues 4. Describe the role of primary care, including advocacy and policy change, in addressing pressing public health issues such as health disparities, mental health, family planning and pregnancy, addiction and immunizations 5. Describe the major causes of morbidity and mortality in the United States such as diabetes, coronary artery disease and cancer and explain how the interactions between primary care and public health affect the health outcomes of persons, families, and the population as a whole 6. Describe the importance of the patients perspective of living with a medical illness and how the patient’s experience with and access to community/societal resources may affect health behaviors and/or outcomes 7. Describe career options that combine training and experience in primary care and public health

Course Format: This course will consist mainly of class-based lectures given by Family Medicine physicians from the Department of Family and Preventive Medicine in the School of Medicine. All of the lectures will supplement the required reading and many of the lectures will incorporate interactive activities and discussions. There will be a session in which patients will speak to the class about their experiences and perspectives of living with

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FPMU 50 Fall 2014

health conditions and a session where health professionals will speak to the class about career options in clinical medicine and public health. The focus of the first half of the course is on common personal and population health issues and it will cover diverse topics such as mental health, sexually transmitted infections, family planning, and immunizations among others. The focus of the second half of the course is on chronic diseases and the major causes of morbidity and mortality in the United States such as diabetes, heart disease, cancer and dementia. The power points for the lectures will be posted on the course website on ted.ucsd.edu before the lecture whenever possible.

Assessment and Grading The course grade will be based on 7 written assignments, 3 in-class activities/assignments and performance on the in-class mid-term exam and in-class cumulative final exam as below. All grades will be posted on TED and it is the students responsibility to check their grade on TED and contact the instructor or the TA with any concerns within 24 hours after the grading is posted. No exceptions.

Assessment

Details

Points

Designed to assess Student Learning Outcome #

1. Assignments

There will be 7 writing assignments throughout the quarter, worth 10-12 points depending on the assignment. There is approximately one assignment per week and you will submit your assignment on TED by 8am on the due date. More information about the assignments is provided later in the syllabus and detailed information about the assignments will be posted on TED. These will help you think critically about the lectures and assigned reading. No late assignments will be accepted (see below).

72 points total

1,2,3,4,5,7

2. Completion of inclass activities

There will be 3 in-class activities/assignments that will review and synthesize the material. The dates of the activities are on the syllabus and there are NO makeups for missed activities (see below). Each worth 5 points. Multiple choice, true/false and short answer exam covering material from the first 5 weeks Multiple choice and true/false cumulative final TOTAL:

15 points total

1,2,3,4,5,6

3. Mid-Term Exam 4. Final Exam

70 120 277

1,2,3,4,6 1,2,3,5,6, 7

Final Letter grades will be determined using the scale below. There is NO extra credit in this course and no final grade curves or sliding scales will be implemented. There are no exceptions! A = ≥93% B = 83.0-86.9 C = 73.0-76.9% A- = 90.0-92.9% B- = 80.0-82.9% C- = 70.0-72.9% B+ = 87.0-89.9% C+ = 77.0-79.9% D = 60.0%-69.9% If you are taking this course for Cr/NC, CR = ≥70.0%

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F = < 59.9%

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Course policy on absences and missed assessments 

  

Make-up examinations are NOT given without prior approval! If you absolutely cannot be in class for a mutually-agreed upon valid reason when an exam is scheduled, it is your responsibility to contact me at least 1-week prior to the scheduled exam with valid documentation for missing the exam. If you miss a scheduled exam due to a university-scheduled event, you must provide me with documentation from a university faculty or staff member (i.e., written documentation on university letterhead signed by the faculty/staff member) 1-week prior to the exam. Failure to provide documentation prior to the exam will result in a zero. If you miss a scheduled exam due to a personal event, valid documentation must be provided (i.e., written documentation: doctor/parent, plane ticket; jury duty summons) 1-week prior to the exam. If an examination is missed for any other reason, it is your responsibility to get in touch with me within 24 hours of the missed exam or a grade of zero will be automatically given for the examination. If you add the course late, you will have ONE WEEK to complete all missed assignments from the day you add the course. There are no make ups for in-class activities/assignments. If you miss an in-class activity/assignments because you were not in class, you will not be able to make it up. No exceptions. Late assignments will NOT be accepted under any circumstances (except approved accommodations for students with disabilities).

Expectations/Class rules Students are expected to:  Attend every class session and be on time  Prepare for each class by reviewing the assigned reading  Complete and submit all assignments on TED on time (before 8am on the due date)  Check ted.ucsd.edu for course announcements as well as to check their grade after posting of grades for assignments, quizzes, exams, etc. It is the students responsibility to contact the instructor and/or TA within 24 hours if there is a concern or issue about a posted grade.  Contribute to a positive learning environment in the classroom  Act with academic integrity (see more information below)  Turn off or set to vibrate all mobile phones  Use computers/tablets to take notes only  Follow all course rules for exams: Backpacks (including cell phones) in front of the class, bring ID, etc.  Follow course rules for emails: Emails from students to the TA or instructor will be answered within 24 hours on weekdays and will not be answered on the weekends.

Accommodations for Students with Disabilities If you have a documented disability and anticipate needing accommodations in this course, please make arrangements to meet with me within the first week of the course. Please request that the Office for Students with Disabilities (OSD) send you an Authorization for Accommodation (AFA) letter verifying your disability. You will receive the appropriate accommodations from the day that you provide me with the signed AFA letter. Course accommodations cannot be applied retroactively (e.g., after an examination/assignment).

Academic Integrity: All work submitted in this course must be your own and produced exclusively for this course. It is your responsibility to know what constitutes academic misconduct at UCSD. UCSD’s definition of academic misconduct can found here: http://students.ucsd.edu/academics/academic-integrity/defining.html and the official university policy on the Integrity of Scholarship can be found here: http://students.ucsd.edu/_files/Academic-Integrity/Policy-on-Integrity-of-Scholarship_eff-fall2009.pdf. Academic misconduct of any kind will not be tolerated in this course and will be reported to the Office of Academic Integrity. Any misconduct on an exam or assignment will automatically result in a “zero” and will be reported to the Office of Academic Integrity. If you suspect another student of academic misconduct, you are strongly encouraged to report it.

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Software may be used in this course to detect plagiarism. Students agree that by taking this course all required papers may be subject to submission for textual similarity review for the detection of plagiarism. All submitted papers will be included as source documents in the reference database of a program solely for the purpose of detecting plagiarism of such papers. Your papers will be submitted in such a way that no identifying information about you is included. You may request that your papers not be submitted to a database for the detection of plagiarism. However, if you make this request you will be required to provide documentation to substantiate that the papers are your original work and do not include plagiarized material.

Course Outline Schedule and topics are tentative and may be revised with ample notice.

Fall Quarter

Topic and Lecturer

Thurs Oct 2

Introduction to Primary Care and Public Health (Johnson)

Tues Oct 7

Understanding Health Determinants and Disparities (Johnson)

Thurs Oct 9

Primary Care’s Role in the US Healthcare System and its role in population health (Kallenberg)— Assignment # 1 DUE

Tues Oct 14 Thurs Oct 16 Tues Oct 21 Thurs Oct 23 Tues Oct 28 Thurs Oct 30 Tues Nov 4 Thurs Nov 6 Tues Nov11 Thurs Nov 13 Tues Nov 18 Thurs Nov 20 Tues Nov 25 Thurs Nov 27 Tues Dec 2 Thurs Dec 4 Tues Dec 9 Thurs Dec 11 Tues Dec 16

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Family Planning and Pregnancy (Barounis) Sexually Transmitted Infections including HIV(Gin)—Assignment # 2 DUE Immunizations (Rosenblum) Mental Health and Depression (Lister)—Assignment # 3 DUE Addiction (Lindeman) Patient Panel (Johnson)—Assignment # 4 DUE and In-class assignment Review Session and in-class activity and assignment (Johnson) Midterm NO CLASS because of Veteran’s Day Respiratory Diseases (asthma and emphysema) and Respiratory infections (Influenza) (Slater) Diabetes, Cholesterol and Obesity (Morn) High Blood Pressure and Kidney Disease (Gutierrez)—Assignment # 5 DUE Heart Disease and Stroke (Lillie) NO CLASS because of Thanksgiving holiday Cancer (Osborne)—Assignment # 6 DUE Dementia and End of Life Issues (Norcross) Health Professionals Panel (Johnson) Wrap-up and in-class activity and assignment (Johnson)—Assignment # 7 DUE 8-11 CUMULATIVE FINAL EXAM

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Required Materials: Each lecture will have required reading materials that should be read before the lecture. The reading materials will consist of chapters from textbooks, articles, published reports, and websites. They are available on the Biomedical library course reserves at http://libraries.ucsd.edu/resources/course-reserves. Required reading may be tested on exams and quizzes even if not covered in lecture. If you are not on campus you must connect to the UCSD VPN to access course reserves. More information about connecting to the UCSD VPN can be found here: http://libraries.ucsd.edu/resources/coursereserves/course-reserves-from-off-campus.html. The password for the course page is mj50. If you are having any issues with the VPN, please contact ACMS: (858) 534-3227 or [email protected]. There is NO required textbook. Assigned Reading for FPM 50 Fall 2014 Date Topic and Lecturer 10/2/14

Introduction to Primary Care and Public Health (Johnson)

Assigned Reading

1. Institute of Medicine. Report Brief: Primary Care and Public Health Exploring Integration to Improve Population Health. 2012 March. Available at http://www.iom.edu/~/media/Files/Report%20Files/2012/Primary-Care-and-PublicHealth/Primary%20Care%20and%20Public%20Health_Revised%20RB_FINAL.pdf Accessed August 18, 2014 th

2. Rakel RE, Rakel DP. Textbook of Family Medicine, 8 edition. 2011. Chapter 6 “Preventive Health care” pages 73-76, 92-95 10/7/14

Health Disparities (Johnson)

1.Institute of Medicine. Report Brief: Unequal Treatment: What healthcare providers need to know about racial and ethnic disparities in healthcare. March 2002 Available at: http://www.iom.edu/~/media/Files/Report%20Files/2003/Unequal-Treatment-ConfrontingRacial-and-Ethnic-Disparities-in-Health-Care/Disparitieshcproviders8pgFINAL.pdf Accessed August 18, 2014 2. New York Times. Tackling a Racial Gap in Breast Cancer Survival. December 2013. Available at http://www.nytimes.com/2013/12/20/health/tackling-a-racial-gap-in-breastcancer-survival.html?pagewanted=all&_r=0 Accessed August 18, 2014

10/9/14 Primary Care (Kallenberg)

1. Rakel RE, Rakel DP. Textbook of Family Medicine, 8th edition. 2011. Chapter 1“The Family Physician”

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Family Planning and Pregnancy (Barounis)

10/16/14 Sexually Transmitted Infections (Gin) 10/21/14 Immunizations (Rosenblum) 10/23/14

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Mental Health and Depression (Lister)

1.Guttmacher Institute. Moving Forward: Family Planning in the Era of Health Reform. 2014. Available at http://www.guttmacher.org/pubs/family-planning-and-health-reform.pdf Accessed August 18, 2014. Read ONLY the Executive Summary and Chapter 1. 2.Department of Health and Human Services, Office on Women’s Health. Birth Control Methods Frequently Asked Questions. Available at http://womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.pdf Accessed August 18, 2014 th 1. Rakel RE, Rakel DP. Textbook of Family Medicine, 8 edition. 2011. Chapter 3 pages 2527 (pages on biopsychosocial model), chapter 16 pages 218-219, 222, 224 (Infectious disease, pages on chlamydia, HPV only) and chapter 17 pages 248-250 (HIV epidemiology, modes of transmission and relative risk only) 1. Offit PA, Bell LM. Vaccines: What you should know. Third Edition. Hoboken, NJ: John Wiley & Sons, Inc, 2003. Part one only pages 3-27. 2. Offit, PA. Deadly Choices: How the anti-vaccine movement threatens us all. New York, NY: Basic Books, 2011. Introduction pages xi – xviii only 1. Katz DL et al. Jekel's Epidemiology, Biostatistics, Preventive Medicine and Public Health. Fourth Edition. Philadelphia, PA: Elsevier Saunders, 2013 Chapter 21 “Mental and Behavioral Health”, pages 252-263

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FPMU 50 Fall 2014 10/28/14 Addiction (Lindeman) 10/30/14

11/4/14 11/6/14 11/11/14 11/13/14

11/18/14

Patient Panel and introduction to chronic disease (Johnson) In Class Activity and Review Session (Johnson) MIDTERM EXAM NO CLASS Respiratory Diseases (asthma and emphysema) and Respiratory infections (Influenza) (Slater) Diabetes, Obesity and lipids (Morn)

11/20/14

1. McLellanAT, Lewis DC, O’Brien CP, Kleber HD. Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance and Outcomes Evaluation. JAMA. 2000; 284(13):1689-1695 1. Rakel RE, Rakel DP. Textbook of Family Medicine, 8th edition. 2011. Chapter 3 “Psychosocial Influences on Health” n/a n/a th

1. Rakel RE, Rakel DP. Textbook of Family Medicine, 8 edition. 2011. Chapter 18 pages 261, 268-276 (COPD and asthma) and chapter 16 pages 210-212 (influenza) th

1. Rakel RE, Rakel DP. Textbook of Family Medicine, 8 edition. 2011. Chapter 34, pages 731-744 and 753-754 (diabetes) and chapter 26, 802-817 (obesity) 1. Baumgarten M and Gehr T. Chronic Kidney Disease: Detection and Evaluation. AmFam Phys. 2011; 84:1138-1148.

High Blood Pressure and Kidney Disease (Gutierrez)

2. Schoolwerth A, Engelgau M, Hostetter T, et al. Chronic Kidney Disease: A Public Health Problem That Needs a Public Health Action Plan. Public Health Research, Practice, and Policy. 2006 April; Vol 3(2): 1-6. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1563984/pdf/PCD32A57.pdf Accessed Sept 4, 2014 3. Wang T and Ramachandran. Epidemiology of Uncontrolled Hypertension in the United States. Circulation. 2005;112: 1651-1662 1. Go AS et al. Executive Summary: Heart Disease and Stroke Statistics-2014 Update: A Report From the American Heart Association. Circulation. 2014; 129:399-410

11/25/14

Heart Disease and Stroke (Lillie)

2.Center for Disease Control. Heart Disease and Stroke Prevention: Addressing the Nation’s Leading Killers. 2011. Available at http://www.cdc.gov/chronicdisease/resources/publications/aag/pdf/2011/Heart-Disease-andStroke-AAG-2011.pdf Accessed September 4, 2014 3. CDC Grand Rounds: The Million Hearts Initiative. MMWR Dec 21, 2012. Vol 61 (50): pages 1017-1021 Available at http://www.cdc.gov/mmwr/pdf/wk/mm6150.pdf Accessed Sept 4, 2014

11/27/14

NO CLASS

12/2/14

Cancer (Osborne)

12/4/14 12/9/14

Dementia and End of Life Issues (Norcorss) Health Professional Panel (Johnson)

12/11/14 In Class Activity and Course wrap up (Johnson) 12/16/14

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Final 8-11am

1. California Dialogue on Cancer. California’s Comprehensive Cancer Control Plan 20112015. Pages 3-37, 40, 44, 48, 50, 52-58 Available at http://www.cdph.ca.gov/programs/cdsrb/Documents/CDOC/PDF/CaliforniaCancerPlan20112015_Download.pdf Accessed August 18, 2014 NOTE: you are NOT responsible for memorizing numbers in the charts, only general patterns of incidence and mortality among the most common types of cancers in different racial and gender groups 2. Huffington Post. PSA: Please Stop Asking (for Trouble!). October 2011. Available at http://www.huffingtonpost.com/david-katz-md/psa-testing_b_1000852.html Accessed August 18, 2014 1. Schneider. Introduction to Public Health. Third Edition. Jones and Bartlett Publishers, 2011. Chapter 28 “Public Health and the Aging Population” n/a 1.Centers for Disease Control. Ten Great Public Health Achievements in the 20th Century. September 4, 2014 Available at: http://www.cdc.gov/about/history/tengpha.htm 2. Centers for Disease Control. Leading Causes of Death. Available at: http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm Accessed Sept 4, 2014 n/a

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A Note About Writing Assignments for FPM 50 An important goal of this course is to develop your writing skills so that you can communicate health information clearly to individuals, groups, and the media. It is important to be able to summarize and synthesize key information from a single source or from...