PHC 6016: Social Epidemiology
GENERAL INFORMATION
DESCRIPTION
This is an upper level graduate course focusing on social epidemiology – the study of social factors in the
distribution and determinants of conditions in a population. This includes the association of social factors
with disease, the impact of the social environment on health status, the mechanisms by which these factors
are linked to actual pathological and disease processes, and health policies and model of health promotion
which may impact health outcomes. This course explores the epidemiological aspects of health and medical
care of the poor and disadvantaged population groups.
OBJECTIVES
Upon completion of this course, the student will be able to
1. Understand the conceptual basis and role of social epidemiology in public health
2. Describe the association of demographic and social factors with health and disease
3. Describe the roles of stress, social change and social status as potential determinants
of health and disease
4. Critically read published research articles
5. Discuss health promotion, social intervention and health policy modalities to improve
health outcomes.
M
MPH CORE / CONCENTRATION-SPECIFIC COMPETENCIES
This course will assist students in developing the following MPH core competencies:
COMPETENCY
Identify key sources of data for use in epidemiologic
studies
Critically evaluate reports of epidemiologic studies
COURSE OBJECTIVE
1, 2, 3
3, 4
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
Given a health problem, choose and implement an
appropriate epidemiologic study design
1, 3
COURSE PREREQUISITES
PHC6000 Introduction to Public Health Epidemiology
REQUIRED TEXTBOOK
Berkman LF, Kawachi I, Eds. Social Epidemiology. New York: Oxford University Press
Inc., 2000. ISBN-13 978-0-19-508331-6.
Fadiman, A. The Spirit Catches You and You Fall Down. Farrar, Straus and Giroux, 1998.
978-0374525644
Fadiman is assigned to give context to social epidemiology in a tangible and human
way. The book helps to illuminate the social context for disease at an individual
and population level. The book is meant to inspire and engage.
Additional required readings are listed on the syllabus by date of each class.
OTHER RECOMMENDED SOURCES OF INFORMATION
Texts
Marmot M, Wilkinson RG, Eds. Social Determinants of Health. 2nd Ed. Oxford, Great Britain: Oxford
University Press, 2006.
Oakes JM, Kaufman JS. Eds. Methods in Social Epidemiology. 1st Ed. San Francisco, CA: John Wiley &
Sons, Inc, 2006.
Web Resources
1. The following document is downloadable at no charge: Centers for Disease Control & Prevention.
Principles of Epidemiology. 3rd Edition. Atlanta: U.S. Department of Health and Human Services.
http://www.cdc.gov/training/products/ss1000/ss1000-ol.pdf
2. http://www.who.int (World Health Organization Homepage)
3. http://www.cdc.gov (Centers for Disease Control and Prevention)
4. http://www.census.gov (US Census Bureau)
5. http://www.nlm.nih.gov (National Library of Medicine: Medline)
6. http://www.doh.state.fl.us (Florida Department of Health)
9. http://www.healthypeople.gov (U.S. Department of Health and Human Services)
10. http://www.census.gov (U.S. Census)
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
CLASS POLICIES AND PROCEDURES
The class will meet once per week for two hours, 40 minutes with a 10-15 minute break in the middle of
the session. This course will involve reading, critical thinking, analysis, and debate. The class sessions
will consist of lectures, discussions, and oral presentations. Students will be responsible for reading all
assignments prior to class and for being prepared to critique and discuss the readings. The instructor will
use the lecture sessions for an overview, critical analysis and evaluation of each topic.
Disability
The University provides reasonable accommodations and services to all students on a nondiscriminatory
basis consistent with legal requirements as outlined in the Americans with Disabilities Act as Amended
(ADAAA) of 2008 and the Rehabilitation Act as Amended. . If you have disability and/or need special
assistance during the course or exams, please make arrangements through the Office of Disability Services
(305-348-4131). More information about the accommodation process is available at
http://drc.fiu.edu/index.php
EVALUATION AND GRADING
Students will be evaluated on the following basis:
Class participation
Paper and paper presentation
Leading discussion of article
Final exam
20%
45% (25% paper; 20% presentation)
10%
25%
Grading Scale
A
AB+
B
BC+
92.6 – 100
89.6 – 92.5
86.9 – 89.5
82.6 – 86.5
79.6 – 82.5
76.6 – 79.6
C
CD+
D
DF
72.6 – 76.5
69.6 – 72.5
66.9 – 69.5
62.6 – 66.5
59.6 – 62.5
< 59.5
Participation: Participation will be evaluated based on classroom attendance and participation in class
(student participating fully in discussions, demonstrating that he or she has read the assigned materials).
Two absences are granted for each student (excused or unexcused).
Term paper: For the term paper you will select a topic discussing the relationship of a particular social
factor to health outcome(s) (i.e. the effect of social capital on child abuse, the effect of discrimination on
premature birth, etc). The subject chosen should be narrow enough to do an in-depth analysis but broad
enough to utilize a minimum of 8 peer-reviewed references.
The paper will have three parts. In the first part you will describe the epidemiologic data regarding the
relationship of the social factor to the health outcome. In the second part, you will identify and support at
least one theory to answer the questions “how.” That is, what are the pathways in which the social factor
impacts the health outcome? You will provide evidence for and against the theory as a plausible
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
explanation of why the social factor impacts health. You should also answer the questions: What remains to
be learned about this subject? What types of studies are needed? In the third part, you will discuss policies
that would impact the social factor such that the health outcome would improve. You may discuss
successful policies that have been implemented, if they exist.
The paper should be 10-15 double-spaced pages long not including tables, figures or references. You
should also write an abstract which is not included in the page limit. You must choose your topic by
February 2nd and bring to the library session a list of at least 3 peer-reviewed journal articles. You can ask
the librarian for assistance in refining the search during that session.
Use APA style for referencing. You will turn in your paper to Turnitin.com. Turnitin.com will give you a
score of the amount of overlap of your writing with references. Your score must be less than 30%
(excluding the bibliography). Therefore, you should turn it in to Turnitin.com at least a week prior to your
paper being due. If the score is over 30%, you will have to revise the paper by improving your
paraphrasing. You can then resubmit the paper to turnitin.com. I will not consider any paper with a score
higher than 30%. To be considered on time, your paper must be turned into me (in a paper and electronic
form) no later than March 8th. You will lose 10 points per day after your paper is due. Exceptions are only
for serious illnesses (e.g. hospitalization) that you or a family member has, and exceptions will only be
granted with proper documentation. A copy of the evaluation form that will be used to grade your paper
will be posted on the class web site.
If you need assistance with your writing, please visit FIU’s Writing Lab. See the Writing Lab’s website for
details about the services that are provided: http://www.fiu.edu/~understu/learning/lab-writing.html.
For those students that need help with proper citation of sources, please see the following:
 http://owl.english.purdue.edu/owl/
 http://support.library.ewu.edu/reference/tutorial/flash/citation.html
 http://library.fiu.edu/AboutUs/DepartmentsServices/ReferenceDepartment/LibraryInstructionServi
ces/LibraryResearchAids/PlagiarismPrevention/tabid/364/Default.aspx.
Oral Presentation: The oral presentation will summarize the results of your paper. The oral presentation
should take no longer than 15 minutes. You should use Powerpoint software, and on the day of your
presentation bring a hardcopy of your presentation (6 slides to a page) for the instructor. Send by e-mail an
electronic copy on the day of your presentation so that it can be uploaded to the class website. A laptop
and projector will be available for you on the date of the presentation. A copy of the evaluation form that
will be used to grade your presentation will be posted on the class web site.
To prepare the presentation, consult the following website:
Population Reference Bureau. How to effectively present data. Tips on slide preparation available
at http://www.prb.org/pdf/ConnectingPeopleSect3.pdf
Leading class discussion: Students in groups of 2 will be assigned as discussion leaders for one of the
articles in the syllabus. Groups may choose their article. The articles that may have student-led
discussions are designated by an asterix in the syllabus. The assigned leaders will prepare questions for
their classmates to answer. These questions must be e-mailed to the instructor no later than one week prior
to class. For each day late 10 points is taken off of the leaders’ grades. Questions should include general
questions such as “What was the rationale for the study?” “What were the study’s hypotheses?” “What
methods did the authors use to test the hypotheses?” “Were the methods appropriate?” “What were the
author’s main conclusions?” “Did the results support the authors’ conclusions?” “What were the
limitations of the study?” “How could these have been better addressed in the study’s design or
implementation?” “What does the study add to the literature?” The leaders should add additional
questions relevant to the topic. The leaders should lead the class through the interpretation of each
table/figure and be prepared to provide any background information about epidemiologic methods or
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
statistical tests that their classmates may not be familiar with. It is expected that each discussion should
take about a half hour. The leaders’ grades will be dependent on the timely submission of questions to the
instructor and classmates, the degree of familiarity of the leaders with the article, and the level of
preparedness of the leaders.
Final exam: The exam will test students’ knowledge of social determinants of health. The questions will
be written around the objectives that will be given for each lecture. In addition, questions will be written
around the contextual objectives of the Fadiman book. The format will be primarily essay and short
answer.
FIU HONOR CODE
Florida International University is a community dedicated to generating and imparting knowledge through
excellent teaching and research, the rigorous and respectful exchange of ideas and community service. All
students should respect the right of others to have an equitable opportunity to learn and honestly to
demonstrate the quality of their learning. Therefore, all students are expected to adhere to a standard of
academic conduct, which demonstrates respect for themselves, their fellow students, and the educational
mission of the University. All students are deemed by the University to understand that if they are found
responsible for academic misconduct, they will be subject to the Academic Misconduct procedures and
sanctions, as outlined in the Student Handbook.
Misconduct includes: Cheating – The unauthorized use of books, notes, aids, electronic sources; or
assistance from another person with respect to examinations, course assignments, field service reports,
class recitations; or the unauthorized possession of examination papers or course materials, whether
originally authorized or not. Plagiarism – The use and appropriation of another’s work without any
indication of the source and the representation of such work as the student’s own. Any student who fails to
give credit for ideas, expressions or materials taken from another source, including internet sources, is
responsible for plagiarism. All students are expected to abide by the Florida International University
Honor Code. Any violation will be reported.
In addition, for this course, students are required to sign an honour code at the end of all assignments and
exams. The honour code should state “I have neither given nor received any unauthorized aid on this
[assignment, exam]”. Please sign after the statement.
Student conduct
Students are responsible for knowing and complying with all FIU Policies and Regulations which are
listed in the Student Handbook and also at the following link: http://policies.fiu.edu/files/740.pdf.
The following are excerpts:
Reason for the policy:
“Graduate students at Florida International University are expected to adhere to the highest standards of
integrity in every aspect of their lives. Honesty in academic matters is part of this obligation. Academic
integrity is the adherence to those special values regarding life and work in an academic community. Any
act or omission by a graduate student which violates this concept of academic integrity and undermines the
academic mission of the University shall be defined as academic misconduct and shall be subject to the
procedures and penalties that follow.”
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
Definition of academic misconduct:
Academic misconduct is defined as the following intentional acts or omissions committed by any FIU
graduate student:
“Cheating: The unauthorized use of books, notes, aids, electronic sources; or unauthorized use of on-line
exams, library materials or assistance from another person with respect to examinations, course
assignments, field service reports, class recitations; or the unauthorized possession of examination papers
(or on-line examinations) or course materials, whether originally authorized or not. Any student helping
another cheat may be found guilty of academic misconduct”
Plagiarism: The deliberate use and appropriation of another's work without any indication of the source
and the representation of such work as the student's own. Any student, who fails to give credit for ideas,
expressions or materials taken from another source, including internet sources, is guilty of plagiarism. Any
student helping another to plagiarize may be found guilty of academic misconduct.
Misrepresentation: Intentionally lying to a member of the faculty, staff, administration, or an outside
agency to gain academic advantage for oneself or another, or to misrepresent or in other ways interfere with
the investigation of a charge of academic misconduct.
Misuse of Computer Services: The unauthorized use of any computer, computer resource or computer
project number, or the alteration or destruction of computerized information or files or unauthorized
appropriation of another's program(s).
Bribery: The offering of money or any item or service to a member of the faculty, staff, administration or
any other person in order to commit academic misconduct.
Conspiracy and Collusion: The planning or acting with one or more fellow students, any member of the
faculty, staff or administration, or any other person to commit any form of academic misconduct together.
Falsification of Records: The tampering with or altering in any way of any academic record used or
maintained by the University.
COURSE SCHEDULE AND ASSIGNMENT
DATE
TOPIC
ASSIGNMENT
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
INTRODUCTION
Readings: Chapter 1 of text
Objectives: The student will be able to
 Describe instructor’s expectations of
students during course
 Contrast traditional epidemiology
with social epidemiology
 List social determinants of health
 Contrast idea of society with that of
culture
 List some key concepts in social
epidemiology
Read prior to this class
o Krieger N. A glossary of
social epidemiology. J
Epidemiol Community Health
2001;55:693-700.
http://jech.bmj.com/content/5
5/10/693.full.pdf
o Krieger N. Theories for social
epidemiology in the 21st
century. International J
Epidemiol 2001;30:668-677.
Available at:
http://ije.oxfordjournals.org/c
gi/reprint/30/4/668
SOCIAL EPIDEMIOLOGY
THEORIES
Objectives: The student will be able to
 Compare and contrast psychosocial,
ecosocial, and social production of
disease and/or political economy of
health theories
 Describe the contribution of a lifecourse perspective to the
understanding social factors effects
on health phenomena
SOCIAL EPIDEMIOLOGY METHODS
Objectives: The student will be able to
 Explain how a multilevel analysis
differs from an ecologic analysis
 Give an example of when a theory
would lend itself to individual-level
analysis vs. ecologic analysis
 Give an example of a compositional
and a contextual explanation for the
distribution of a disease

List of 3 peer-reviewed journal
articles due. Bring to the library
session and ask questions to help
refine your search.

Read prior to this class
o
Chapter 13 of text
o
Hemmingway H, Shipley M,
Mullen MJ. Social and
psychosocial influences on
inflammatory markers and
vascular function in civil
servants (The Whitehall II
Study). Am J Cardiol
2003;92:984-987. Article on
reserve.
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
REVIEW OF MEDLINE SEARCHING
AND SOCIAL BIOLOGY
MEETING IN ACH3 ROOM 212 WITH
LIBRARIAN

List of 3 peer-reviewed journal
articles due. Bring to the library
session and ask questions to help
refine your search.
Objectives: The student will be able to
 Define stress within the context of
social epidemiology
 Describe short term effects of the
sympatho-adrenal and HPA pathways
 Discuss at least two examples of how
psychosocial factors may lead to
cardiovascular disease via a biologic
pathway
 Distinguish between direct and
indirect pathways of how
psychosocial factors may lead to
cardiovascular disease
 Conduct a literature search using
several different Medline search
engines

Read prior to this class
o
Chapter 13 of text
o
Hemmingway H, Shipley M,
Mullen MJ. Social and
psychosocial influences on
inflammatory markers and
vascular function in civil
servants (The Whitehall II
Study). Am J Cardiol
2003;92:984-987. Article on
reserve.
MEASURING SOCIOECONOMIC
POSITION


Chapter 2 of text
Glymour MM, Avendano M, Haas
S, Berkman LF. Lifecourse social
conditions and racial disparities in
incidence of first stroke. Ann
Epidemiol 2008;18:904-912.
Available on reserve.
Oakes JM, Rossi PH The
measurement of SES in health
research: current practice and steps
toward a new approach. 2003; Soc
Sci Med 56:769-84.
Available on reserve.
Objectives: The student will be able to
 Define and interpret measures of
socio-economic position (SEP)
 Discuss limitations of SEP measures

Note: Assigning of papers for leaders to
present to class.
INCOME INEQUALITY AND HEALTH
Objectives: The student will be able to
 Discuss the evidence for income
inequality affecting health
 Describe pathways by which income
inequality may affect health
 Compare and contrast the Gini
Coefficient and Robin Hood Index
 Critically review a meta-analytic
study



Chapter 4
*Kondo N, Sembajwe G, Kawachi
I, et al. Income inequality,
mortality, and self-rated health:
meta-analysis of multilevel
studies. Brit Med J
2009;3339:b4471. Available at:
http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC2776131/pdf/bmj.b44
71.pdf
Suggest having read Fadiman
Chap 1-8
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
RACE/ETHNICITY CLASSIFICATIONS

Objectives: The student will be able to
 Compare and contrast the terms race
and ethnicity
 Explain how data on race are
collected in the US Census and on
birth and death certificates
 Discuss limitations of race and ethnic
classifications
 Discuss advantages and
disadvantages of the use of race and
ethnicity in analyses of health
problems




Bhopal R, Donaldson L. White,
European, Western, Caucasian, or
What? Inappropriate labeling in
research on race, ethnicity, and
health. Am J Public Health 1998;
88(9):1303-7. Available at:
http://ajph.aphapublications.org/cg
i/reprint/88/9/1303?ck=nck
Goodman AH. Why genes don’t
count (for racial differences in
health). Am J Public Health 2000;
90(11):1699-1702. Available at:
http://ajph.aphapublications.org/cg
i/reprint/90/11/1699.pdf
Fullilov MT. Comment:
abandoning “Race” as a variable in
public health research—an idea
whose time has come Am J Public
Health 1998; 88(9):1297-1298.
http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC1509076/pdf/amjph0
0021-0009.pdf
Kaplan JB, Bennet T. Use of race
and ethnicity in biomedical
publication JAMA 2003;
289(20):2709-2716. Available at
http://jama.amaassn.org/cgi/reprint/289/20/2709
Kaufman JS, Cooper RS.
Commentary: considerations for
use of racial/ethnic classifications
in etiologic research. 2001; Am J
Epidemiol 154:291-8. Available
at
http://aje.oxfordjournals.org/cgi/re
print/154/4/291
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
DISCRIMINATION AND
HEALTH
Objectives: The student will be able to
 Discuss aspects of discrimination that
should be considered when measuring
discrimination in epidemiologic
studies
 Describe pathways in which
discrimination can be embodied
 Given a scenario, illustrate how three
different epidemiologic approaches
could be used to explore the
relationship between discrimination
and health
 Interpret the index of dissimilarity







WORK
Objectives: The student will be able to
 Discuss importance of work for
individuals
 Explain models of job demandcontrol and effort-reward imbalance
 Describe policy implications for
evidence of psychosocial work
conditions associated with health
Chapter 3
*Borrell C, Muntaner C, GilGonzalez D, et al. Perceived
discrimination and health by
gender, social class, and country of
birth in a Southern European
country. Preventive Medicine
2009,
doi:10.1016/j.ypmed.2009.10.016.
Available on reserve.
*Cooper RS, Kennelly JF, DurazoArizu R, Hyun-Joo Oh, HF,
Kaplan G, Lynch J. Relationship
between premature mortality and
socioeconomic factors in black and
white populations of US
metropolitan areas. Public Health
Reports 2001;116:464-473.
Available at:
http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC1497360/pdf/120426
10.pdf
*Collins J: Very low birthweight
in African American Infants: the
role of maternal exposure to
interpersonal racial discrimination.
Am J Public Health 2004;94:21322138. Available at:
http://ajph.aphapublications.org/cg
i/reprint/94/12/2132.pdf
*Trivedi AN, Ayanian JZ.
Perceived discrimination and use
of preventive health services. J
Gen Intern Med 2006;21:553-558.
Available at:
http://www3.interscience.wiley.co
m/cgibin/fulltext/118582813/PDFSTAR
T
Chapters 5 and 6 of text
*Hasselhorn H, Tackenberg P,
Peter R. Effort-reward imbalance
among nurses in stable countries
and in countries in transition. Int J
Occup Environ Health
2004;10:401-408. Available on
reserve.
-
No class. Spring Break
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
SOCIAL SUPPORT




NEIGHBORHOODS: SOCIAL AND
PHYSICAL ENVIRONMENT
Objectives: The student will be able to
 List characteristics of neighborhood
to consider in studies of
neighborhood and health
 Discuss how housing is related to
neighborhood and SEP
 Compare and contrast the terms
social cohesion and social capital




Chapter 7 of text
*Goodwin JS, Hunt WC, Key CR,
Samet JM. The effect of marital
status on stage, treatment and
survival of cancer patients. JAMA
1987;258(21):3125-3130.
Available at http://jama.amaassn.org/cgi/reprint/258/21/3125?c
k=nck.
*Richmond CAM, Ross NA,
Egeland GM. Social support and
thriving health: a new approach to
understanding the health of
indigenous Canadians. Am J
Public Health 2007;97:1827-1833.
Available at
http://ajph.aphapublications.org/cg
i/reprint/97/10/1827.
Suggest having read Fadiman
Chap 9-14
Chapters 8 and 14 of text
*Browning CR, Cagney KA.
Neighborhood structural
disadvantage, collective efficacy,
and self-rated physical health in an
urban setting. 2002; Journal of
Health and Social Behavior
2002;43:383-399. Available on
reserve.
*Cohen D, Spear S, Scribner R,
Kissinger P, Mason K, Wildgen J.
Broken windows and the risk of
gonorrhea. Am J Public Health
2000;90(2):230-6.
http://ajph.aphapublications.org/cg
i/reprint/90/2/230?view=long&pmi
d=10667184
*Sampson RF, Raudenbusch SW,
Earls F. Neighborhoods and
violent crime: a multilevel study of
collective efficacy. Science 1997;
277:918-924. Available at:
http://www.sciencemag.org/cgi/rep
rint/277/5328/918.pdf.
ORAL PRESENTATIONS
ORAL PRESENTATIONS
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.
HEALTH AND SOCIAL POLICY
Objectives: The student will be able to
 Discuss the political and social
challenges in creating social policy
that favors good health
 Explain the role of epidemiologists in
advancing social policies that favor
good health


Chapter 16 of text
Suggest having read Fadiman
Chap 15-19
FINAL
NOTE
The schedule and reading assignments are subject to change, but you will be given at least 1 week notice.
Suggestions for students to be successful in course:
1) Be prepared by doing the readings for each class session and participate fully.
2) Organize study time around objectives listed in syllabus as well as those presented for each class
session.
3) Meet with the instructor if having difficulties understanding the material, or meeting the demands
of the course.
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PHC 6016 – Social Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the
content of this course as deemed appropriate by the Instructor based upon students’ needs. With advanced
notice some papers may be replaced with others.