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The upstream signaling pathway is triggered by the binding of a signaling molecule, a ligand, to a receiving molecule, a receptor. Receptors and ligands exist in many different forms, and only recognize/bond to particular molecules. Upstream extracellular signaling transduce a variety of intracellular cascades. Receptors and ligands are common upstream signaling molecules that dictate the downstream elements of the signal pathway. A plethora of different factors affect which ligands bind to which. The terms upstream and downstream oil and gas production refer to an oil or gas company's location in the supply chain. Upstream production companies identify, extract, or produce raw materials, while downstream production companies are closer to the end user or consumer.� Here's a look at upstream and downstream oil and gas production, their individual functions, and what role they play in the broader supply chain. Upstream Oil and Gas Production. Upstream oil and gas production and operations identify deposits, drill wells, and recover raw materials from underground. The terms �upstream� and �downstream� refer to two different, but equally important, aspects of marketing. We covered the key differences between the two in an article published in called �Upstream vs Downstream Marketing; Why do so many companies focus solely on downstream marketing?�. As a quick recap, upstream marketing is focused on strategy and the long-term market situation, while downstream marketing looks at tactics, activity and supporting the company�s sales team with their objectives. Distinguishing these types of marketing activity can help further develop the connection betwe.

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Learn more about this course. Downstream, midstream and upstream determinants Social determinants of health. View transcript. If we think of a flowing river and people falling into that river we could spend all of our time pulling people out of the river treating them. This is similar to a healthcare system that is predominantly reliant on tertiary hospitals.

If we were to walk further up the river there are still people in the river, but a local person is throwing in life saving equipment that will help them to float. This is similar to work in primary care where people are provided with preventative medication such as hypotensive treatment or supported to stop smoking.

However, if we were to move further upstream, we may find that the reason people are falling into the river is because the bridge is broken or perhaps the path is too near the cliff edge. So, by moving upstream and repairing the bridge or moving the path people it is hoped can remain safe. This upstream approach can be equated to preventative work on policy to improve our environment, food supply and education, for example, which all have a positive impact on our health.

So now that you have explored the concept of moving health upstream lets look at a model of the social determinance of health. The Dahlgren and Whitehead model displays the multi factorial nature of health. It is also known as the policy rainbow. At the centre we have aspects that are not readily amenable to change such as age, sex and hereditary factors.

From here the rainbow moves to help us consider issues that are modifiable. Lifestyle factors such as diet, tobacco use, alcohol use and physical activity are influenced not purely by choice but also the social and community networks in which we live. For example, if we live in an area where most people smoke, we might consider this is a norm and be more likely to smoke. At the top level of general socio economic cultural and environmental conditions you can see from the policy rainbow the multitude of different elements that impact on our health, such as education, water and sanitation and healthcare services.

These issues have a profound impact on our health and require the organised efforts of society to ensure that there is a systematic industrial scale approach to all of these issues. Health is, therefore, not just about lifestyle.

People who live in poor socio economic circumstances are more likely to be in poorer health that results in premature death than those living in higher socio economic groups. Evidence shows that prolonged stress as a result of unemployment damages peoples health. Worldwide there is a clear social gradient on health with the poorer in society facing the biggest burden of premature mortality and morbidity.

In some countries, people can still live until they are over 80 years of age in others less than 45 years. Therefore, if we are to improve health we need to ensure there is a system wide approach to intervention. System wide incorporates all elements of the national and local health systems to improve health outcomes. Closing the gap in a generation by the World Health Organisation identified the need to address this social injustice by improving daily living conditions by ensuring equity from the start with a comprehensive approach to early years support for children, healthy places, healthy people to ensure that health is central to governments and planning, fair employment and decent work, social protection policies to support income levels, universal healthcare, tackle the inequitable distribution of power, money and resources and measure and understand the problem and assess the impact of action.

As a nurse, it is therefore, important to understand not only the patient presents to you but to think about the impact that their social determinance may have on their health. Do you routinely ask patients questions about lifestyle, social and community networks, socio economic cultural and environmental conditions? What about the needs of the population that you work for? Share this post. So far we have explored the important contribution you can make as a nurse to public health and also you have started to explore your understanding of health and what it means to you.

In the discussion, share your area of nursing practice e. Want to keep learning? This content is taken from Coventry University online course,. This content is taken from Coventry University online course. See other articles from this course.

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