The document discusses international standards for patient summaries. It provides an overview of existing initiatives to standardize patient summaries and the potential benefits these could provide. It describes the Joint Initiative Council's (JIC) work developing an international standard for patient summaries, including establishing working groups to define use cases, identify relevant standards, and provide implementation guidance. The JIC aims to deliver a standardized patient summary within one year by leveraging existing work from other standards development organizations.
EVIDENCE-BASED CPGs FOR HEMATOLOGY - ONCOLOGY UNIT, KING SAUD UNIVERSITY HOPSITALS
Saudi Arabia, Riyadh
King Saud University Hospitals
CPGs Committee
Quality Management Dept
CPGs Program
By YASSER SAMI AMER
What is the difference between development and adaptation of clinical practice guidelines? This was presented by Dr. Yasser Amer during the 2nd Regional Workshop for CPG adaptation, Tunis, Tunisia May 24-26 2016
Link:
https://www.facebook.com/media/set/?set=a.481589005298936.1073741852.215244758600030&type=1&l=67dff997c7
Illustration on how the CPGs Adaptation Program has helped in quality improvement through compliance with national and international accreditation standards.
EVIDENCE-BASED CPGs FOR HEMATOLOGY - ONCOLOGY UNIT, KING SAUD UNIVERSITY HOPSITALS
Saudi Arabia, Riyadh
King Saud University Hospitals
CPGs Committee
Quality Management Dept
CPGs Program
By YASSER SAMI AMER
What is the difference between development and adaptation of clinical practice guidelines? This was presented by Dr. Yasser Amer during the 2nd Regional Workshop for CPG adaptation, Tunis, Tunisia May 24-26 2016
Link:
https://www.facebook.com/media/set/?set=a.481589005298936.1073741852.215244758600030&type=1&l=67dff997c7
Illustration on how the CPGs Adaptation Program has helped in quality improvement through compliance with national and international accreditation standards.
Part 1. An overview on implementation of CPGs
Part 2. CPGs & HTAs
Presented during the 2nd Regional Workshop for CPG Adaptation, Tunis, Tunisia May 24-26 2016
A collaborative between INA Sante, WHO-EMRO, KSU
10-Year Orthopedics and Spine Forecast: Factors Impacting DemandWellbe
What’s in store for the next 10 years of orthopedics and spine service lines?
Kristi Crowe, Associate Vice President and Orthopedic service line leader at Sg2 will review future demand for orthopedics and spine services nationally, key factors impacting this demand, and opportunities to build your access channels and differentiate your orthopedics and spine services to capture growth.
About the Speaker:
As a member of Sg2’s Center for Strategic Planning, Kristi Crowe leads Sg2’s intelligence and analytics in orthopedics and works with leadership teams to improve growth and performance across the care continuum. She also leads the development of orthopedics service line–oriented publications and educational offerings and speaks nationally at a variety of physician and health care leadership conferences.
With 18 years of clinical, management, and consulting health care experience, Kristi brings a variety of strategic skills to Sg2, which have included physician alignment strategies, volume growth initiatives, and performance enhancement for orthopedic services.
Before joining Sg2, Kristi worked in orthopedic service line consulting for Accelero Health Partners, a fully owned subsidiary of Zimmer. While at Accelero, Kristi established and executed strategic plans for the musculoskeletal service line and led the organization’s internal spine and outcomes development initiatives. Working as the liaison between hospital administration and physicians, Kristi facilitated completion of higher level physician engagement strategies such as comanagement agreements. Earlier in her career, Kristi worked as a physical therapist in inpatient, outpatient and management positions.
She graduated summa cum laude with bachelor’s and master’s degrees in physical therapy from the University of North Dakota.
She is a member of the Healthcare Financial Management Association and American Society for Quality, and maintains her Colorado license to practice physical therapy.
The patient handoff is a contemporaneous, interactive process of passing patient-specific information from one caregiver to another to ensure the continuity and safety of patient care. It is well recognized that the handoff is a point of vulnerability where valuable patient information can be distorted and omitted [1, 2]. A plethora of studies in the nursing literature have identified a variety of problems, including incomplete or inaccurate information [3-6], uneven quality [7], repeated interruptions and lack of anticipatory guidance [8]. Many reports have focused on characterizing the weaknesses with non-operative patient handovers, the use of handoff checklists and aviation safety models for specific groups of patients [1,5,9], and the pre- and post-implementation comparisons. [10-12] However, few studies have focused on prospective cohort studies validating and testing patient information management systems such as smart-templates in the setting of handover quality. [10]
Electronic templates containing patient information help to standardize the type of information conveyed during interactions, discourages ambiguous findings,[13] improves provider satisfaction and improves continuity of care.[14] Within the department, we developed the transfer template (T2) to address the issues in provider workflow and efficiency. With the press of a button, the T2 template automatically extracts live information from the anesthetic record, pertinent fields from the PAC note and laboratory values from IView, and provides a concise output of these relevant details.
Rapid review of endoscopy services - NHS ImprovementNHS Improvement
Rapid review of endoscopy services
NHS Improvement Jan 2012 shares emerging learning from front line services and identifies areas of good practice in addition to highlighting some key challenges that endoscopy departments are encountering today
Overview of Evidence-Based Practice Guidelines Initiatives in the Hospitals of Two Universities in the Middle East and North Africa Countries: Alexandria University Faculty of Medicine and University Hospitals and King Saud University College of Medicine and Medical City
Health technology assessment (HTA) is familiar as technique for gauging the value of specific medical technologies or approaches to care. As Adrian Towse points out, however, HTA has a much broader, ‘macro’ role in contributing to the efficiency of health care systems and supporting universal health coverage. This is particularly crucial in the face of increasing demands and limited budgets.
An introduction on Evidence-Based Clinical Practice Guidelines in Health Care Organizations
Brief on Alexandria Center for EBCPGs in Alexandria University Hospitals, Egypt
By Dr. Yasser Sami Abdel Dayem Amer, MBBCh, MS 2013
Special Thanks to
Prof Dr Mahmoud Elzalabany
Prof Dr Tarek Omar
Prof Dr Nabil Dowidar
Prof Dr Afaf Gaber
This session was conducted as a part of the 6th Resident Professional Development Course titled "Evidence-Based Medicine" in 9th SEPT 2015 at College of Medicine, King Saud University
Part 1. An overview on implementation of CPGs
Part 2. CPGs & HTAs
Presented during the 2nd Regional Workshop for CPG Adaptation, Tunis, Tunisia May 24-26 2016
A collaborative between INA Sante, WHO-EMRO, KSU
10-Year Orthopedics and Spine Forecast: Factors Impacting DemandWellbe
What’s in store for the next 10 years of orthopedics and spine service lines?
Kristi Crowe, Associate Vice President and Orthopedic service line leader at Sg2 will review future demand for orthopedics and spine services nationally, key factors impacting this demand, and opportunities to build your access channels and differentiate your orthopedics and spine services to capture growth.
About the Speaker:
As a member of Sg2’s Center for Strategic Planning, Kristi Crowe leads Sg2’s intelligence and analytics in orthopedics and works with leadership teams to improve growth and performance across the care continuum. She also leads the development of orthopedics service line–oriented publications and educational offerings and speaks nationally at a variety of physician and health care leadership conferences.
With 18 years of clinical, management, and consulting health care experience, Kristi brings a variety of strategic skills to Sg2, which have included physician alignment strategies, volume growth initiatives, and performance enhancement for orthopedic services.
Before joining Sg2, Kristi worked in orthopedic service line consulting for Accelero Health Partners, a fully owned subsidiary of Zimmer. While at Accelero, Kristi established and executed strategic plans for the musculoskeletal service line and led the organization’s internal spine and outcomes development initiatives. Working as the liaison between hospital administration and physicians, Kristi facilitated completion of higher level physician engagement strategies such as comanagement agreements. Earlier in her career, Kristi worked as a physical therapist in inpatient, outpatient and management positions.
She graduated summa cum laude with bachelor’s and master’s degrees in physical therapy from the University of North Dakota.
She is a member of the Healthcare Financial Management Association and American Society for Quality, and maintains her Colorado license to practice physical therapy.
The patient handoff is a contemporaneous, interactive process of passing patient-specific information from one caregiver to another to ensure the continuity and safety of patient care. It is well recognized that the handoff is a point of vulnerability where valuable patient information can be distorted and omitted [1, 2]. A plethora of studies in the nursing literature have identified a variety of problems, including incomplete or inaccurate information [3-6], uneven quality [7], repeated interruptions and lack of anticipatory guidance [8]. Many reports have focused on characterizing the weaknesses with non-operative patient handovers, the use of handoff checklists and aviation safety models for specific groups of patients [1,5,9], and the pre- and post-implementation comparisons. [10-12] However, few studies have focused on prospective cohort studies validating and testing patient information management systems such as smart-templates in the setting of handover quality. [10]
Electronic templates containing patient information help to standardize the type of information conveyed during interactions, discourages ambiguous findings,[13] improves provider satisfaction and improves continuity of care.[14] Within the department, we developed the transfer template (T2) to address the issues in provider workflow and efficiency. With the press of a button, the T2 template automatically extracts live information from the anesthetic record, pertinent fields from the PAC note and laboratory values from IView, and provides a concise output of these relevant details.
Rapid review of endoscopy services - NHS ImprovementNHS Improvement
Rapid review of endoscopy services
NHS Improvement Jan 2012 shares emerging learning from front line services and identifies areas of good practice in addition to highlighting some key challenges that endoscopy departments are encountering today
Overview of Evidence-Based Practice Guidelines Initiatives in the Hospitals of Two Universities in the Middle East and North Africa Countries: Alexandria University Faculty of Medicine and University Hospitals and King Saud University College of Medicine and Medical City
Health technology assessment (HTA) is familiar as technique for gauging the value of specific medical technologies or approaches to care. As Adrian Towse points out, however, HTA has a much broader, ‘macro’ role in contributing to the efficiency of health care systems and supporting universal health coverage. This is particularly crucial in the face of increasing demands and limited budgets.
An introduction on Evidence-Based Clinical Practice Guidelines in Health Care Organizations
Brief on Alexandria Center for EBCPGs in Alexandria University Hospitals, Egypt
By Dr. Yasser Sami Abdel Dayem Amer, MBBCh, MS 2013
Special Thanks to
Prof Dr Mahmoud Elzalabany
Prof Dr Tarek Omar
Prof Dr Nabil Dowidar
Prof Dr Afaf Gaber
This session was conducted as a part of the 6th Resident Professional Development Course titled "Evidence-Based Medicine" in 9th SEPT 2015 at College of Medicine, King Saud University
Inversión en colciencias vs inversión en congresistassamycas88
ver como es la mala inversión que tiene nuestro país en cuanto la ciencia y los congresistas que en muchos casos ayudan es a dañar mas el país en vez de mejorarlo como la ciencia
Population Stratification Made Easy, Quick, and Transparent for AnyoneHealth Catalyst
One of the fundamental tasks when creating a population health initiative is to identify the right patients for the right interventions. The challenge with identifying patients is two-fold—there isn’t a one-size-fits all stratification method; and, current stratification tools prove to be inflexible, “black box” solutions that require time-consuming, technical expertise to customize the algorithms. Many commonly used stratification methods also fail to take advantage of the whole-patient picture, using the limited data sources that are available.
To address these challenges, Health Catalyst developed the Population Builder™️: Stratification Module; a fast, adaptable tool that allows for rapid and transparent stratification of patient groups based on predefined, yet easy to customize, populations and then provides the architecture to integrate the stratified populations into the population health workflow.
Based on the existing Population Builder tool, the Stratification Module consists of several population health building blocks that users can mix and match to create purpose-driven, transparent, and customizable populations to fit their needs. The building blocks save users the time and effort of creating the raw materials required for effective stratification by providing industry standard, evidence-based definitions for over 6,000 value sets, 21 predefined chronic condition registries, ED utilization (combined claims and clinical data), transition of care, and predictive risk models all in one tool. In addition, the power of AI is made accessible and easy with Health Catalyst-developed risk algorithms that are targeted to specific interventions.
View the Population Builder: Stratification Module webinar to learn more about its functionality, understand the customization process, observe a unique framework that integrates claims and clinical data, and make it easy to consume customized data sources, so that your algorithms include all of your available patient data.
In this webinar you can expect to:
- Learn how Population Builder: Stratification Module is used to combine data from multiple data sources—including claims and clinical data—to stratify based on a “whole patient picture.”
- Get a glimpse of the predefined stratification content that is packaged within the Population Builder: Stratification Module.
- Understand how the Population Builder: Stratification Module allows non-technical experts to quickly and transparently create sophisticated stratification algorithms.
- See how “published” patient lists, or registries, are created within Population Builder: Stratification Module and accessible by the DOS ecosystem.
Integrate RWE into clinical developmentIMSHealthRWES
With greater application of RWE throughout the pharmaceutical
lifecycle, learnings are emerging that offer guidance for
approaches to derive the maximum value. This article captures
the author’s experience at a leading international biotech, with
insights for smoothing RWE assimilation into clinical
development and realizing the benefits it brings.
Presenter Prof Stephen Duckett Director, Health Program, Grattan Institute
Date: April 2021
Event: ABF 2021 Conference
The 'Introduction to activity based funding' video aims to provide all health professionals with access to the essential introductory information on activity based funding by covering various themes such as pricing and funding, costing, classifications and data collection.
The presentation provides an overview of:
1. the various ways in which health care can be funded and their strengths and weaknesses
2. the key elements of an activity based funding (ABF) system
3. the funding flows for healthcare in Australia including the role of the national efficient price (NEP) and the national efficient cost (NEC).
View the recording of this presentation here: https://www.youtube.com/watch?v=4MvZcrqgK7U
www.ihacpa.gov.au
www.abfconference.com.au
--
Note: In August 2022, the Independent Hospital Pricing Authority (IHPA) was renamed to the Independent Health and Aged Care Pricing Authority (IHACPA) when its functions expanded to include the provision of costing and pricing advice on aged care services and the agency.
During the workshop, the Trillium II project was presented to the audience as well as the state of patient summaries in Denmark and the US. Furthermore, the results of a survey on use of patient summaries in disaster and relief situations were presented.
The purpose of the workshop was to promote the project and the Global Community for Digital Health Innovation and collect feedback on the participants’ attitude towards patient summaries.
The workshop participants were invited to discuss which patient summary use cases they considered most relevant for the Trillium II project to focus on and how an international patient summary should be governed.
Anne Casey RN MSc FRCN
Editor, Paediatric Nursing
Royal College of Nursing Adviser on Information Standards
Clinical Domain Lead, NHS Information Standards Board for Health and Social Care
(17/10/08, Plenary session 2)
Structure and development of a clinical decision support system: application ...komalicarol
Clinical decision requires to infer great, diverse and not suitably
organized quantity of information and having low time to decide.
The therapeutic choice is fundamental to formulate a strategy to
avoid complications and to achieve favorable results, being more
important in some specialties. In addition, medical decision-makers are overloaded with clinical tasks, have an intense work rate and
are subject to a great demand, and are prone to greater tiredness.
In this sense, computer tools can be extremely useful, as can deal
with a lot of information in much less time than decision-makers.
Thus, the existence of a tool that assists them in decision-making
is of crucial importance
Healthy Savings. Medical Technology and the Economic Burden of DiseaseRevital (Tali) Hirsch
As America ages and sedentary lifestyles and unhealthy diets become more common, experts agree the nation is suffering a sharp rise in the prevalence of chronic disease. As the 21st century unfolds, technology – in the form of advanced diagnostic and therapeutic devices -- can meet the need for early detection and more effective management of illness. Some researchers, however, have questioned whether the overall benefit of technical advances outweighs the costs -- a question this report definitively answers.
Accordingly, researchers at the Milken Institute undertook a comprehensive, quantitative documentation of medical technology's impact on the economic burden of disease. The study also projects how future innovation in this sector would affect the health care system and the larger economy -- a positive benefit of more than $23 billion a year for the United States.
The study takes a systematic approach to documenting the full costs and broader economic benefits of health care investments by examining innovations pertaining to four prevalent causes of disability and death: heart disease, diabetes, colorectal cancer, and musculoskeletal disease. The report considers therapeutics and diagnostic devices that are widely used and have substantially affected the lives of patients as well as the overall U.S. economy. Among the 10 devices or device-based procedures studied are pacemakers, insulin infusion pumps, colonoscopies, and joint replacement surgery.
The data demonstrate that the use of medical technology brings considerable economic benefits. These are seen in both aggregate savings in treatment expenditures and prevention as well as the reduction of "indirect impact" through larger contributions to the economy.
Connected health data meets the people: Diversity, Standards, and Trustchronaki
Using health data in a connected world requires new competencies, a personal digital health compass calibrated to individual personalities and needs. Patients and clinicians able to collect and manage data, data-operational informatics professionals able to analyze data, and cutting-edge researchers, innovators, and educators able to apply knowledge, will take learning health systems to the next level.
In this EFMI-HL7 event using innovative technology and surprises to engage the audience, we will discuss strategies for empowering and activating people to engage, share and use their health data. We will point to diversity, trust and open standards like HL7 FHIR to open up access and capacities to manage data safely for patients, care-givers, and the health system.
The Maturing Telemedicine Infrastructure in Denmark: Building the Human Capital, Morten Bruun-Rasmussen, CEO MEDIQ
Health Professional Education in Biomedical & Health Informatics: the EFMI AC2 approach, Professor John Mantas, University of Athens, Greece, EFMI Past President
Digital health literacy: a necessity for Activating Citizens, Professor Anne Moen, University of Oslo, Norway, VP for IMIA, European Federation for Medical Informatics
“Internet of People”: Elements of Trust and Risk, Eva Turk, DNVGL.
Workforce meets volumes of electronic information: Why and how HL7 FHIR creates value for stakeholders in learning health systems. Doug Fridsma, President and CEO, American Medical Informatics Association, US
eHealth Practice in Europe: where do we stand?chronaki
eHealth as the use of Information and communication technologies in the practice of health care comprises Electronic health records, Healthcare information exchange cross-jurisdictions, Personal health records, Telehealth, telemedicine and remote monitoring.
There are several efforts to reflect and measure the practice of eHealth including efforts by the OECD and WHO, but in general there is little reported sharing of health data particularly with patients. Specific barriers frequently mentioned are supporting policies and coherent widely implemented standards.
The presentation discusses relevant efforts and programs supported by the European Commission such as the eHealth DSI, eStandards, ASSESS CT, and openMedicine aiming at large scale eHealth adoption It calls for engagement of European Society, its national societies, and its members.
In search of a Digital Health CompassPatient Empowerment chronaki
Presentation of the digital health compass in the Portuguese eHealth Summer Week with Anne Moen (U of Oslo), Catherine Chronaki (HL7), Rita Mendes (SPMS). Great moderation by Constantino Sakellarides, ENSP.
In search of a digital health compass: My data, my decision, our powerchronaki
Knowledge is power. Despite extensive investments in digital health technology, navigating the health system online is challenging for most citizens. Also for eHealth, the “Inverse Care Law” proposed by Hart in 1971, seems to apply. Availability of good medical or social care services and tools online, varies inversely with the need of the population. The low adoption of eHealth services, and persistent disparities in health triggers a call for multidisciplinary action.
Barriers and challenges are not to be underestimated. Culture, education, skills, costs, perceptions of power and role, are essential for multidisciplinary action. This comes together in digital health literacy, which ought to become an integral part to navigate any health system. Patients living with an implanted device or coping with persistent, chronic disease such as diabetes, as well as citizens engaged in self-care, caring for an elderly relative, a neighbor, or their child with illness or deteriorating health, need a digital health compass.
The panel will engage the audience to elaborate on a vision for this personal, digital health compass and drive advancement in health informatics and digital health standards. The transformative power of health data fueled by targeted digital health literacy interventions can be leveraged by open, massive, and individualized delivery. This way, digital health literate, confident patients and citizens join health professionals, researchers and policy makers to address age-related health and wellness changes to shape the emerging precision medicine and population health initiatives.
From a panel in the eHealthweek 2016. http://www.ehealthweek.org/ehome/128630/hl7-efmi-sessions/
Towards an international Patient Summary Standardchronaki
Starting from Trillium Bridge, this presentation delivered in the Dutch eHealthWeek 2016, in the EU/US MoU session reflects on the past, present and future activities towards an international patient summary.
First eStandards conference Panel of the European SDO Platformchronaki
Introduction to panel where Standards Developing Organization and National Competence Centers discuss the scope of the European SDO platform reflecting on earlier presentations.
First eStandards conference Industry Panelchronaki
Introduction and questions to the Industry Panel at the first eStandards conference: next steps towards standardization in large scale eHealth deployment
eHealth Consumers in the Age of Hyper-Personalizationchronaki
Where the Internet of Things meets healthcare we see a plethora of tools, gadgets, and apps that promise to improve life, health, and independence. As patients, family members ofr friends, we are subsumed under the term "eHealth consumers”. For us it is increasingly hard to navigate in the unfolding digital reality dominated by new gadgets, and fragmented information, data, and knowledge we don’t control. More personalized and targeted products, services, and content could alleviate this. In this slide deck we are specifically focusing on challenges and opportunities for personalization in view of varying eHealth literacy, lifestyle and health goals.
First eStandards conference Healthcare Executives Panel: Vanja Pajicchronaki
This is the introduction to a panel in the first eStandards conference aiming to bring together with Hospital CIOs, actors in the healthcare system: representative of payers, health professionals to get a sense of the issues with interoperability in largescale eHealth deployment. This is the perspective of the payer dealing with cross-border issues
First eStandards conference Healthcare Executives Panel: Bernd Bernardchronaki
This is the introduction to a panel in the first eStandards conference aiming to bring together with Hospital CIOs, actors in the healthcare system: representative of payers, health professionals to get a sense of the issues with interoperability in largescale eHealth deployment. This is the perspective of the CIO of a large hospital.
First eStandards conference Healthcare Executives Panel: Domingos Pereirachronaki
This is the introduction to a panel in the first eStandards conference aiming to bring together with Hospital CIOs, actors in the healthcare system: representative of payers, health professionals to get a sense of the issues with interoperability in largescale eHealth deployment. Here Domingos Silva Pereira provides the perspective of the CIO in a large Portuguese hospital.
First eStandards conference Healthcare Executives Panel Dipak Kalrachronaki
This is the introduction to a panel in the first eStandards conference aiming to bring together with Hospital CIOs, actors in the healthcare system: representative of payers, healthprofessionals to get a sense of the issues with interoperability in largescale eHealth deployment. Here Prof. Dipak Kalra provides the perspective of a health professional
First eStandards conference Healthcare Executives Panel Introductionchronaki
This is the introduction to a panel in the first eStandards conference aiming to bring together with Hospital CIOs, actors in the healthcare system: representative of payers, healthprofessionals to get a sense of the issues with interoperability in largescale eHealth deployment.
1st eStandards conference: next steps for standardization in large scale eHea...chronaki
This is a presentation on the role of tools for eHealth standards that would accelerate standards development and adoption for large scale eHealth deployment that is affordable and sustainable. More at www.estandards-project.eu
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. OVERVIEW
Introduction to the International Patient Summary (PS) Standard
Surprise and confusion
Organisational Perspective
Pain and Gain (possible costs)
Healthcare Perspective
Pain and Gain (possible benefits)
Standardisation Perspective
International?
Interest
Initiatives
Personal Summary (PS, sic) “A View from a Mountain”
3. INTERNATIONAL PATIENT
SUMMARY STANDARDS
There are none… so, a very short presentation!
A little surprising?
There are so many variants and different types of
‘summary’ (e.g. discharge summaries, handovers)
Patient Summaries are part of the healthcare fabric,
commonplace and even mundane
There are many local implementations, some
national, and even regional in operation
Some of these have been well established for years
Standardisation is arguably more efficient if the thing
to be elevated to a standard already exists and is
proven to work in practice, so an ideal target?
A little confusing, and the confusion explains why!
4. ORGANISATIONAL & VENDOR
COSTS
THE LEGACY
CHALLENGE…
Return of investment is
important and there is no desire
to change, particularly if
something is currently working
Worse still, the ubiquitous and
pervasive nature of the
‘summary’ means widespread
disruption and upheaval from
any change
What is the incentive to
change?
…
THE ‘GREEN FIELD’
OPPORTUNITY…
Adopting and fast tracking
something that others have
got to work
Avoiding vendor lock-in,
avoiding past mistakes, gaining
economies of scale
Minimise risk, costs and
opening up new markets
…
5. HEALTHCARE BENEFITS*
PATIENT PERSPECTIVE
Improving Patient Safety -
supporting more informed
prescribing by providing timely
access to accurate information
Improving the Efficiency of Patient
Care - reducing the time, effort
and resources required to obtain
this information
Improving the Effectiveness of
Patient Care - supporting the
delivery of appropriate care to
patients
Improving Patient Experience -
reducing repetition whilst
supporting patient recall and
those with difficulties
CLINICIAN PERSPECTIVE
Improving Decision Support – removing
uncertainty by giving the clinician
instant access to additional and reliable
information to better inform their
decision
Improving prescribing/medicating
practise- identifying medication
discrepancies and reducing errors
Improving clinician productivity-
reducing the time taken to treat the
patient without duplication of
effort/tests
Improving overall management -
Patients are less likely to need to be
referred to another service
*adapted from Summary Care Record, HSCIC website, 2016
6. THE STANDARDISATION
PERSPECTIVE
The cross-border value/ International debate
The interest of the SDO community
The Initiatives (particularly JIC) will be discussed
7. AN INTERNATIONAL STANDARD
FOR PATIENT SUMMARY?
International:
Making the PS Structure & Content available for global use
(independent of whether the demand is for cross-border or within a
national state, or locally across organisations)
Interest:
There are powerful stakeholder requirements for SDOs to get this
done NOW, e.g. eHN, EU, EU-US, US Meaningful Use …
It is not rocket science, and implementations exist, albeit not in an
‘idealised form’, therefore it should not too difficult…
It is not ‘Big Data’; it has all the advantages of being ‘Little Data’!
Even so,
“The value of data lies in their use.”
“Data have no value or meaning in isolation”
“They can be assets or liabilities or both.”
“The information necessary to interpret data is specific to the problem”
8. PS: ‘LITTLE DATA’ BUT NOT EASY!
“Data exist within a knowledge infrastructure- an ecosystem
comprising stakeholders, technologies, organisations, objects and
relationships between them.”
“Data and their uses are proliferating far faster than privacy law or
information policy can catch up…”
“Moving data over networks involves a delicate balance of security,
rights, protections, interoperability, and policy.”
”Documenting data in ways to make them useful for others to
discover, retrieve, interpret and reuse is … difficult”
Extracts from “Big Data, Little Data, No Data” by Christine L. Borgman
9. SRO INITIATIVES
Assume the audience has more knowledge about
the European initiatives, so
eHN Patient Summary Guidelines v2
EU projects (e.g. epSOS, Trillium Bridge, eStandards)
More explanation here on the following:
Meaningful Use… Clinical Summaries
HL7 INTERPAS project
ISO TC215 Reference Standards Portfolios (Bundles)
Clinical Imaging
JIC Standards Sets
Patient Summary for unplanned/emergency Care
10. INPUT/SUPPORT TO SDO
INITIATIVES
eHN Patient Summary Guidelines v2
EU projects (e.g. epSOS, Trillium Bridge,
eStandards)
Meaningful Use… Clinical Summaries
(a little more detail follows on the nuances and
differences between the EU and US initiatives)
11. ELIGIBLE PROFESSIONAL MEANINGFUL USE
CORE MEASURES MEASURE 12 OF 13 STAGE
1(2014 DEFINITION) LAST UPDATED: MAY 2014
Definition of Terms Clinical Summary – An after-visit summary that
provides a patient with relevant and actionable information and
instructions
(containing the patient name, provider’s office contact
information, date and location of visit, an updated medication list,
updated vitals, reason(s) for visit, procedures and other
instructions based on clinical discussions that took place during
the office visit, any updates to a problem list, immunizations or
medications administered during visit, summary of topics
covered/considered during visit, time and location of next
appointment/testing if scheduled, or a recommended
appointment time if not scheduled, list of other appointments and
tests that the patient needs to schedule with contact information,
recommended patient decision aids, laboratory and other
diagnostic test orders, test/laboratory results and symptoms. )
12. NOTES…
The ellipses on the previous slide, flag the
differences
The ellipses on the next slide show that the idea
of packaging/bundling tools and rules are fairly
commonplace…
13. CERTIFICATION CRITERIA*
§170.314(E)(2) CLINICAL SUMMARY
(i) Create. Enable a user to create a clinical summary for a patient in human
readable format and formatted according to the standards adopted at …
(ii) Customization. Enable a user to customize the data included in the clinical
summary.
(iii) Minimum data from which to select. EHR technology must permit a user to
select, at a minimum, the following data when creating a clinical summary:
(A) Common MU Data Set** (which, for the human readable version, should
be in their English representation if they associate with a vocabulary/code set)
(B) The provider’s name and office contact information; date and location
of visit; reason for visit; immunizations and/or medications administered during
the visit; diagnostic tests pending; clinical instructions; future appointments;
referrals to other providers; future scheduled tests; and recommended patient
decision aids.
*Additional certification criteria may apply. … HL7 Implementation Guide for
CDA Release 2: IHE Health Story Consolidation. The use of the “unstructured
document” document-level template is prohibited. *Additional standards
criteria may apply. ..
14. INTERNATIONAL PATIENT
SUMMARY TEMPLATE (2013)
The goal of this project is to identify
minimally required clinical data with
associated vocabulary subsets for
patient clinical summary, and to build
international templates based on HL7
CDA R2 standard with vocabulary
subsets to support data elements within
those templates.
Now relaunched as INTER PA S (2015)
15. THE ISO AND JIC INITIATIVES
INTERPAS wishes to be done with the target of it
becoming an HL7/ISO standard.
Either INTERPAS will be an input to the JIC work, or
more probably due to its expected completion
date of 2017, JIC might provide a way to provide
a guidance framework for when it is
implemented.
16. ISO TC215 REFERENCE STANDARDS
PORTFOLIO (RSP) FOR CLINICAL
IMAGING USE CASES
17. ISO TC215 RSP
It is on Clinical Imaging, and therefore content-
wise it is not relevant;
However, the value for considering it, is because
the structure of the ISO bundle and the
development process is expected to be
complementary to the JIC work.
Both initiatives are prototypical.
The ISO RSP will be published and normative,
whereas the JIC Standards Sets will be an
informative, authoritative recommendation.
19. JIC SAN FRAN DECLARATION,
2015
The JIC will contribute to better
global patient health outcomes by
providing strategic leadership in
the specification of sets of
implementable standards for
health information sharing.
20. JIC STANDARDS SET – PATIENT
SUMMARY
The first Use Case was agreed to be the Patient Summary
since many nations are undertaking this work and SDOs are
involved at different levels but not always coordinated
Use Case (initial high level description)
A physician (i.e. Healthcare actor) wants relevant patient
data to address the healthcare matter of the patient
(subject of care) with legitimate access and use of relevant
summary patient data at the point and time of care,
irrespective of where and how it is held
21. JIC EARLY PROTOTYPE PROCESS
High-level
Topic
Use Case
Descriptions
Standards
content,
tools & rules
= Standards
Set
22. ADAPTED DEFINITION OF A JIC
STANDARDS SET (SS)
A coherent collection of
[referenced] standards and
standards artefacts that
support a specific use case
23. ORGANISATION OF THE JIC
DEVELOPMENT OF PS STANDARDS
SET
JIC SS-CG
SG1: Detailed Use
Case Development
SG2: Standards
Identification &
Analysis
SG3: Implementation
& Guidance
Document
Development
SG4: Conformity
Assessment
24. WORK STEPS AND TASK GROUPS
Activities/Steps Leads
Group 1 Detailed use case development
- Clinically focused group
- Use case format
Elizabeth Keller
Group 2 Standards identification and analysis
- Standards categorization approach(draft)
- Template for a JIC Standards Set (draft)
Don Newsham
Group 3 Implementation and guidance document development Stephen Kay
Group 4 Conformity Assessment
- Initial framework pending work of groups 1 & 2
Mike Nusbaum
Gaps and overlaps identification Coordination
Group
Standards set recommendations / gap action Coordination
group and JIC
members
26. KEY POINTS ABOUT THE WORK
JIC is well placed for this work since JIC can draw
directly on resources from SDOs and ensure
coordination and collaboration
JIC is developing 2 key products
recommendations for the Patient Summary Standard Set
a methodology for developing further JIC Standards Sets
JIC are not developing products but leveraging
existing work which is already either developed or
in development – e.g. Trillium Bridge, epSoS and
INTERPAS (HL7)
JIC is targeting one year for completion of the
Patient Summary Standards Set – end of 2016
27. PARTICIPATION FROM THE
COMMUNITY
A JIC Foundation and Scope report for Patient Summary
Standards Set – 1 October 2015, sets out initial approach being
taken and is identified as work in progress - JIC website. Updated
version after JIC meeting, May 2016
FAQs on JIC website which will be regularly updated
Set of slides summarising the work which will be updated – JIC
website
Draft plan and resource requirements will be maintained and
updated as the work progresses
Contact the Standards Set coordination group through the JIC
website or Jane Millar jmi@ihtsdo.org
http://www.jointinitiativecouncil.org
29. CRETE’S 2ND HIGHEST MOUNTAIN
A small party from the eStandards’ consortium
decided to reach the top to witness a sunrise.
The party included the author who had assumed
that the land rovers provided at the beginning
would continue by road to the summit or near
by…Wrong!
I went so far, but did not reach the summit; I had
time to reflect on the differences between the
all-singing, all-dancing EHR in all of its glory, as
opposed to a much more discrete, but
nevertheless a mundane and commonplace
object, made beautiful.
30. BROAD VIEW EN ROUTE TO THE EHR
Are we there yet? Not there just yet… rocks all the way up…