This is website is (always) a work in progress!
Latest update January 1, 2024.
I am a Professor Emeritus of Epidemiology & Biostatistics and Pediatrics at UCSF and a committed Unitarian Universalist.
Let me know if any of the links don't work: [email protected].
Sustainability Resources
Climate change
- Why Climate Activists Should Care about Healthcare Waste and Overuse, a 2022 commentary in the Journal of Climate Change and Health. Daisy Valdivieso, BA, wrote this with me when she was an intern for the SF Bay PSR Environmental Health Committee
- TN Award-winning lecture for UCSF First-Year Medical Students (recording). (Recorded 3/30/20; 53:55 min.) In addition to climate change, covers a little bit on nuclear weapons and healthcare value and the famous San Mateo Bridge story! Slides for the 2021 lecture are viewable and downloadable here.
- Why "Getting Off the Gas" is the right choice for UCSF, even though our co-generation plants help heat our buildings and water with energy that would be wasted in an off-site fossil fuel power plant.
- Watch: UCSF Medical Grand Rounds on “Climate Change & Health: What Clinicians Need to Know” from January 24, 2013
- Updated set of slides from a similar presentation to the Department of Epidemiology& Biostatistics
April 2017 - UCSF Sustainability Office
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Climate change and food
- Environmental and Health Effects of Meat (PPT)
Presentation given at the UCSF/Pew/PSR/Healthcare Without Harm Balanced Menus Conference.
Cutting down on red meat would be good for both you and the planet.
October 7, 2013 - Resolution urging UCSF not to serve red meat at institutionally sponsored functions (DOC)
Several departments have approved this resolution or a similar one from students in the UCSF School of Medicine Class of 2020 - OK to Eat Red and Processed Meat Again? Not! Article by TN and Mike Martin for the SF and Marin Medical Societies Journal, Nov/Dec 2019.
- Environmental and Health Effects of Meat (PPT)
Overuse of Antibiotics in Animal Agriculture
- Academic Senate Sustainability Committee resolution urging a phase-out purchases of meat raised with nontherapeutic antibiotics
- Antibiotics Overuse in Animal Agriculture: A Call to Action for Health Care Providers
Editorial in American Journal of Public Health by Michael Martin, Sapna Thottathill and TN, October 15, 2015
Healthcare Value
- Safely Doing Less: Videorecording of TN lecture for the UCSF Mini Medical School (UCTV) (Recorded June, 2020, 58 min but can be sped up!)
- Introduction to Evidence-Based Medicine: PPT slides for my niece Jennie Walstrom's Balboa High School Anatomy and Physiology classes.
- Safely Doing Less: A Missing Component of the Patient Safety Dialogue
Paper by Dr. Alan Schroeder, Stephen Harris and me from Pediatrics, 2012 - Reframing the Debate on Health Care Reform by Replacing Our Metaphors by George Annas, 1995. Still one of my favorite articles on sustainability and healthcare.
Reading Medical Literature, Biostatistical Errors, etc. Resources
- How to read the medical literature (DOC)
April 14, 2005 - Recognizing Common Biostatistical Errors (PPT)
2018 Pediatric Academic Societies Fellows’ College presentation with Valerie Flaherman, MD, MPH - How Do We Know What We Know? The Impact of Industry Funding on the Clinical Research Literature (MP4)
TICR lecture - 52 min, highly recommended!
August 2012 - The Best Research Money Can Buy! (PPT slides)
Watch presentation (starts at 2 minutes and 30 seconds)
An updated presentation focused on pediatrics, last given as a webinar to the Academic Pediatrics Association Healthcare Value Special Interest Group
July 12, 2018
Resources written to help the Senior Consulting Resident in the UCSF pediatric clinic lead a monthly one-hour journal club and a teaching conference. Many residents and others have found them helpful.
- Suggestions for Leading a Journal Club (DOC)
June 11, 2007 - Tips on Leading A Teaching Conference (DOCX)
February 4, 2004
Well-baby Nursery Resources
- NCNC Hyperbilirubinemia Treatment Guideline
Have a baby with jaundice? The Northern California Neonatal Consortium has a new guideline with higher thresholds than the AAP/bilitool. - Adventures in Neonatal Jaundice Guideline Development
Pediatric Grand Rounds at William Beaumont Hospital, Royal Oak, MI, September 6, 2022 (via Zoom). The inside story of how we arrived at AAP jaundice treatment guidelines. - Circumcision Information for Parents (2018) (DOCX)
A summary of risks and benefits for evidence-based decision making. - Circumcision Information for Residents (2015) (DOCX)
- Posterior probability of infection given the prior probability (XLSX)
Have a newborn at risk of infection and need help interpreting the CBC?
(e.g., from the Kaiser Sepsis Risk Calculator) and the CBC results.
Based on Combining Immature and Total Neutrophil Counts to Predict Early Onset Sepsis in Term and Late Preterm Newborns (PDF)
Pediatric Infectious Disease Journal
Urinary Tract Infections
- Newman 2011 Pediatrics-UTI Guideline Commentary (PDF)
- Evidence-based Approach to UTI in Infants (PPT)
Presentation from UCSF 44th Annual Advances and Controversies in Pediatrics course
May 15, 2011 - An Ecological Approach to UTI--the famous UTI Hawks and Doves talk. Presentation at the Pediatric Academic Societies 2017.
Unitarian Universalist Sermons and Reflections
I am a committed Unitarian Universalist. Here are some sermons and "pulpit reflections" I've given at UU congregations, especially the Unitarian Universalists of San Mateo (UUSM). I'll probably speak at yours, if you invite me.
- Longevity - Version for UU Palo Alto (DOC). Updated in 2022; see below.
- Will Bill Gates Go to Heaven? (DOCX)
- Healing American Healthcare (PDF)
Sermon to the Unitarian Universalist Fellowship of the North Bay, Napa, CA, April 4, 2004. Still relevant! Only things have gotten worse! - Hiroshima Day Sermon 2005 (DOC).
- Pulpit Reflection: It's Not Easy Being Green (DOC)
- Every Trip To Hayward A Wanted Trip To Hayward! (PDF)
The full, poignant correspondence that tells the story of how a 5-year effort by the UUSM Social Action Committee improved signage on the approach to the Hayward-San Mateo Bridge. - Can Faith Heal the World? (PDF)
April 1, 2007 updated 2017. Reflection on the harms and benefits of religion. - Caring for the Earth and Ourselves (PDF)
Sermon for UUSM, August 5, 2012. Are you grieving for the planet? Read this! More relevant than ever in 2024. - The Most Important Question (PDF)
MP3 - listen to the whole service (70M)
It's: "How should you spend your time?" The answer and more about avoiding climate change despair.
Sermon to UUSM, August 18, 2013 - Embracing Political Diversity? (PDF)
Are polical (at least partly) differences genetic? If so, what are the implications? Sermon for the Unitarian Universalists of San Mateo January 26, 2020. - Longevity Revisited (PDF)
My first sermon (from 1999) updated for 2022.
Nuclear Weapons
I am very concerned about nuclear proliferation, possible nuclear terrorism, and the United States' self-defeating unilateralism in dealing with these threats. If you can get together an audience, I can give a talk or lead a discussion.
Here's a 14 minute video I made for SF Bay PSR on nuclear weapons essentials, which includes the famous BB demonstration, originated by Beyond War.
I wrote Taking a Stand Against Nuclear Proliferation: The Pediatrician’s Role for Pediatrics in 2008, about the need to save the Nuclear Nonproliferation treaty published and a book review of Prescription for Survival by Bernard Lown for the New England Journal of Medicine, also in 2008. I'm active in the San Francisco Bay Physicians for Social Responsibility chapter and national PSR.
Here are the slides and recording of my most recent talk called "What Health Professionals Need to Know about Nuclear Weapons" for ZSFG Pediatric Grand Rounds January 2, 2024. The "Speaker Notes" document the source of the slides and provide additional information; feel free to use any of the slides in your own talks. Unfortunately, Zoom's noise reduction removed the sound of the BBs hitting the bucket ("original sound" next time!). You can hear and see it better in the 14-minute video I made for PSR at the top of this section, starting at minute 7:54.
If you only have 2 minutes, you can watch this video, which appears to be by documentarian Neil Halloran.
Nuclear weapons could be launched by accident. Play a fun but scary game of nuclear roulette at the Union of Concerned Scientists.
Productivity Resources
Productivity files (ZIP)
Some productivity tips, some handy Stata .ado files, and statcalc.exe (an old favorite from CDC) which is a very quick and easy way to analyze 2x2 tables and estimate sample size.
Interval Likelihood ratios: If you have an ordered categorical variable and dichotomous outcome (e.g., disease y/n) the Stata ado file tablr.ado and its help file written by Juan Carlos La Guardia will generate interval likelihood ratios and their confidence intervals. See Evidence-Based Diagnosis Book above Chapter 3. Download tablr.ado and tablr.hlp. You need to move them to the directory where your ado files are stored.