On 12th December 2013, Dr Hannan (GP / family physician) along with Marilyn Gollom (patient) presented this talk to Health 2.0 Manchester. You can watch the talk by going to http://www.htmc.co.uk/pages/pv.asp?p=htmc0519.
Question of Quality Conference 2016 - Patient Experience - Customer InsightsHCA Healthcare UK
Whilst clinical outcomes are often regarded as the strongest marker of quality, it is not the only variable in a patient’s definition of a quality care experience.
In this session the definition of ‘quality’ to private patients will be explored using recent research on patient experience. The speakers will look at the different ways healthcare providers can effectively communicate their ‘quality’ offer to patients.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavior...HxRefactored
This panel is comprised of parents who’ve lost their children to addiction, a parent whose son is in recovery, and individuals themselves in long-term recovery. We will hear directly from them about their struggles, the impact on individuals and families dealing with addiction, as well as their opinions on where the system could benefit from solutions. The addiction issue is complex and would benefit from solutions in many areas. We invite you to join us to hear first hand.
As patient engagement (aka consumer engagement) earns attention, the question increasingly arises: “Where do we start? What can we do?” More specifically, “What do we mean when we say ‘patient engagement’?” The Patient Activation Measure is a powerful tool for understanding where someone's at and how to interact with them differently.
In 2012 I spoke to this outstanding organization in York, PA, in Robert Wood Johnson Foundation's Aligning Forces for Quality program. Now we're getting back together to see how their work and the patient engagement and empowerment movement have both progressed, and what's next. First exploratory meeting.
Objective
Introduce principles and review strategies for supporting healthcare professionals impacted by adverse patient safety events. By the end of the session the participant will be able to:
1.Relate to the impact of a patient safety adverse event on the provider, based on a personal story provided by a healthcare professional.
2.Describe the potential impact of traumatic experiences on the health and well-being of healthcare professionals.
3.Identify key elements of an effective program for supporting caregiver coping with adverse patient safety events.
4.Explain how a just culture promotes peer to peer support of the second victim.
WATCH: http://bit.ly/1HxceIf
Question of Quality Conference 2016 - Patient Experience - Customer InsightsHCA Healthcare UK
Whilst clinical outcomes are often regarded as the strongest marker of quality, it is not the only variable in a patient’s definition of a quality care experience.
In this session the definition of ‘quality’ to private patients will be explored using recent research on patient experience. The speakers will look at the different ways healthcare providers can effectively communicate their ‘quality’ offer to patients.
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavior...HxRefactored
This panel is comprised of parents who’ve lost their children to addiction, a parent whose son is in recovery, and individuals themselves in long-term recovery. We will hear directly from them about their struggles, the impact on individuals and families dealing with addiction, as well as their opinions on where the system could benefit from solutions. The addiction issue is complex and would benefit from solutions in many areas. We invite you to join us to hear first hand.
As patient engagement (aka consumer engagement) earns attention, the question increasingly arises: “Where do we start? What can we do?” More specifically, “What do we mean when we say ‘patient engagement’?” The Patient Activation Measure is a powerful tool for understanding where someone's at and how to interact with them differently.
In 2012 I spoke to this outstanding organization in York, PA, in Robert Wood Johnson Foundation's Aligning Forces for Quality program. Now we're getting back together to see how their work and the patient engagement and empowerment movement have both progressed, and what's next. First exploratory meeting.
Objective
Introduce principles and review strategies for supporting healthcare professionals impacted by adverse patient safety events. By the end of the session the participant will be able to:
1.Relate to the impact of a patient safety adverse event on the provider, based on a personal story provided by a healthcare professional.
2.Describe the potential impact of traumatic experiences on the health and well-being of healthcare professionals.
3.Identify key elements of an effective program for supporting caregiver coping with adverse patient safety events.
4.Explain how a just culture promotes peer to peer support of the second victim.
WATCH: http://bit.ly/1HxceIf
HXR 2016: Designing to Support Mental Health -Scott R. Cousino, myStrengthHxRefactored
Scott R. Cousino is the CEO and co-founder of myStrength, Inc., a digital behavioralhealth company delivering innovative, scalable solutions for healthcare payers andproviders. myStrength's evidence-based resources uniquely empowerconsumers with interactive web and mobile applications to manage and overcomedepression, anxiety, substance use disorder, and soon chronic pain.
On November 17, 2015 the ICU Collaborative Faculty held a National Call to determine the 2016 National Improvement Initiative. Two topics were presented: Dr. Yoanna Skrobik advocated on the side of Pain, Agitation and Delirium. Dr. Claudio Martin and Cathy Mawdsley advocated for working on End of Life Care. Callers voted at the end of the call and chose the new topic led by Dr. Skrobik: Managing “PAD” in your ICU patient: assessment, treatment and prevention.
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘...NHS Improving Quality
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘Making Measurement Better’ How well things are going and how to make it better’ presented by Sean Manning, NHS England
"Quality in action...for every patient, every time" by Derek FeeleyNHSScotlandEvent
n this opening plenary session of the NHSScotland Event 2011, Derek Feely talks about progress on quality. Along with Jason Leitch, Derek reflects on some of the challenges facing the service and how NHSScotland would respond. He also celebrates some of the successes over the last year across NHSScotland.
Chief Allied Health Professions Officer’s Conference 2016
Workshop 3: Integrated Care – Chair Lindsey Hughes
iCares – population based delivery of care. Ruth Williams, Clinical Directorate Lead, Community and Therapies Clinical Group. Sandwell and West Birmingham Hospitals NHS Trust.
Patient engagement is viewed by many to be a critical component of achieving safe healthcare. The question becomes how best to engage all patients - the public - in the effort towards increasing safer healthcare practices. Other prevention efforts have effectively engaged the public in achieving significant cultural shifts in attitudes and actions. The campaign to decrease smoking is one such example. For instance, anti-smoking efforts have made it unacceptable to smoke with your children in the car. The efforts toward increasing patient safety could benefit from the lessons learned in the anti-smoking campaigns.
2.2 Develop the team - nursing - Julie Belton.NHS England
Develop the team - nursing. Developing nursing roles in primary care. Reviewing a wide range of initiatives including from Manchester, Gateshead and Hanwell. Julie Belton, Director, Cuckoo Lane Healthcare.
HXR 2016: Designing to Support Mental Health -Scott R. Cousino, myStrengthHxRefactored
Scott R. Cousino is the CEO and co-founder of myStrength, Inc., a digital behavioralhealth company delivering innovative, scalable solutions for healthcare payers andproviders. myStrength's evidence-based resources uniquely empowerconsumers with interactive web and mobile applications to manage and overcomedepression, anxiety, substance use disorder, and soon chronic pain.
On November 17, 2015 the ICU Collaborative Faculty held a National Call to determine the 2016 National Improvement Initiative. Two topics were presented: Dr. Yoanna Skrobik advocated on the side of Pain, Agitation and Delirium. Dr. Claudio Martin and Cathy Mawdsley advocated for working on End of Life Care. Callers voted at the end of the call and chose the new topic led by Dr. Skrobik: Managing “PAD” in your ICU patient: assessment, treatment and prevention.
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘...NHS Improving Quality
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘Making Measurement Better’ How well things are going and how to make it better’ presented by Sean Manning, NHS England
"Quality in action...for every patient, every time" by Derek FeeleyNHSScotlandEvent
n this opening plenary session of the NHSScotland Event 2011, Derek Feely talks about progress on quality. Along with Jason Leitch, Derek reflects on some of the challenges facing the service and how NHSScotland would respond. He also celebrates some of the successes over the last year across NHSScotland.
Chief Allied Health Professions Officer’s Conference 2016
Workshop 3: Integrated Care – Chair Lindsey Hughes
iCares – population based delivery of care. Ruth Williams, Clinical Directorate Lead, Community and Therapies Clinical Group. Sandwell and West Birmingham Hospitals NHS Trust.
Patient engagement is viewed by many to be a critical component of achieving safe healthcare. The question becomes how best to engage all patients - the public - in the effort towards increasing safer healthcare practices. Other prevention efforts have effectively engaged the public in achieving significant cultural shifts in attitudes and actions. The campaign to decrease smoking is one such example. For instance, anti-smoking efforts have made it unacceptable to smoke with your children in the car. The efforts toward increasing patient safety could benefit from the lessons learned in the anti-smoking campaigns.
2.2 Develop the team - nursing - Julie Belton.NHS England
Develop the team - nursing. Developing nursing roles in primary care. Reviewing a wide range of initiatives including from Manchester, Gateshead and Hanwell. Julie Belton, Director, Cuckoo Lane Healthcare.
20131212 salford royal experience an epr 10 years on, implementing ep rs at...amirhannan
Madeleine Neve, IM & T lead at Salford Royal Hospital presents at Health 2.0 Manchester meeting. See http://www.htmc.co.uk/pages/pv.asp?p=htmc0519 to watch talk
On 12th December 2013, Dr Hannan (GP / family physician) along with Marilyn Gollom (patient) presented this talk to Health 2.0 Manchester. You can watch the talk by going to http://www.htmc.co.uk/pages/pv.asp?p=htmc0519.
As new payment models emerge that emphasize value over volume, providers are being compelled to look more closely at how to motivate patients—especially those with multiple chronic conditions—to actively manage their care, make better decisions and change behaviors. This editorial webinar will explore the relationships between engagement and improved health outcomes, greater patient satisfaction and better resource utilization. Our panel of experts will share proven strategies for building patients' confidence, disseminating self-management tools and making the best use of your care team.
Farla Medical, one of the UK's largest supliers of medical technologies, commodities and consumables shared best practices from the UK. Including in infection prevention and control, tooling HRH and improving heath service delivery efficiencies.
Five Data-driven Patient Empowerment StrategiesHealth Catalyst
Data plays a big role toward empowering patients to become more involved in their care. With data, digital tools, and education, patient empowerment can act like a blockbuster drug to produce exceptional outcomes.
Data empowers patients five ways:
Promotes patient engagement.
Produces patient-centered outcomes.
Helps patients practice self-care.
Improves communication with clinicians.
Leads to faster healing and independence.
Clinicians using creative, innovative care strategies, and patients with access to the right tools and technology, can produce remarkable results in terms of cost, health outcomes, and experience.
How to Bust Clinical Trial Myths and Increase Participation - mdgroupmdgroup
In order for the public to benefit from ground-breaking medical research, well-attended clinical trials are vital. What holds potential participants back from participating in trials?
News from the Coal Face: There’s light at the end of the tunnel. Presented by Dr Andrew Miller, General Practitioner, at HINZ 2014, 11 November 2014, 4.30pm, Marlborough Room
The mismatch between information that people need and what we provide them withCILIP
Jane Fox (Programme Manager – The Information Standard, NHS England) and Jonathan Berry's (National Policy Lead – Health Literacy, NHS England) presentation at the CILIP 2017 Conference in Manchester #CILIPConf17
This session will be an interactive workshop session to explore the mismatch between the information that is produced in health and care and the level at which the target audience need it to be. The session will share real life examples of the problems, share good practice and introduce tools and techniques to help drive up not only the quality but the functionality of information for the public. Whether you commission, produce or want to be able to signpost to good quality information this session will equip you with what you need to know and what’s out there to help you. Although based on experiences in health and care information this will be of relevance to anyone that relies on consumer information that people can not only understand but also act on.
Study and survey results indicate that digital can best be deployed by healthcare and life sciences/pharmaceuticals practitioners and companies to offer "warm" treatment that encourages and empowers patients in order to yield excellent health outcomes and operational efficiencies.
Patient engagement is a critical element of successful transitions of care. Without it, patients are improperly educated about their condition and inadequately prepared to self-manage.
Healthcare organizations need effective and scalable ways of engaging patients post-discharge.
iWantGreatCare's 7th National Symposium - Building fantastic staff morale, improving quality and reducing costs - took place on Tuesday 21st June at The King's Fund, London.
NHS leaders share their experiences of how they are building excellence in their Trust, reducing costs and growing staff morale by listening to the voice of the patient.
View the slides from these well-regarded delegates:
Alwen Williams, Chief Exective, Barts Health NHS Trust
David Behan, Chief Executive, Care Quality Commission
Dr Nadeem Moghal, Medical Director, Barking, Havering and Redbridge University Hospitals NHS Trust
Liz Mouland, Chief Nurse, First Community Health and Care
Jeremy Howick, clinical epidemiologist and philosopher
Similar to 20131210 Electronic Health Records - Is the NHS ready? What about patients (20)
20221112 Over the Horizon Challenges to GP partnership.pptxamirhannan
Talk delivered at the British Association of Pakistani General Practitioners in Nottingham 12th November 2022 exploring the Partnership model and what can we do to improve things
20220314 patient access to records and Understanding from April 2022amirhannan
This was a zoom call done on 14th March 2022 detailing why we at Haughton Thornley Medical Centres (HTMC) started to give patients full access to their GP electronic health record and understanding in 2004, what we did and still do, how we did it, what the challenges are that we are facing now in General Practice, the importance of the Partnership of Trust, the practice-based web portal www.htmc.co.uk, how we support understanding by sign-posting to trusted information from the practice, our explicit consent process, what we mean by Responsible Sharing, a description of the consent process that all patients wanting access to their records must complete, some dos and dont's when writing in the notes, how to deal with 3rd Party data (not just redaction), what other providers can do to help when sending notes to GP surgeries including do you need to send everything?, an introduction to the Information Governance strategy for Greater Manchester Combined Authority that has recently been ratified and finally a dedication to Ingrid Brindle who recently passed away and was the Chair of Haughton Thornley Patient Participation Group
20220314 Patient access to records and understanding from April 2022amirhannan
This was a zoom call done on 14th March 2022 detailing why we at Haughton Thornley Medical Centres (HTMC) started to give patients full access to their GP electronic health record and understanding in 2004, what we did and still do, how we did it, what the challenges are that we are facing now in General Practice, the importance of the Partnership of Trust, the practice-based web portal www.htmc.co.uk, how we support understanding by sign-posting to trusted information from the practice, our explicit consent process, what we mean by Responsible Sharing, a description of the consent process that all patients wanting access to their records must complete, some dos and dont's when writing in the notes, how to deal with 3rd Party data (not just redaction), what other providers can do to help when sending notes to GP surgeries including do you need to send everything?, an introduction to the Information Governance strategy for Greater Manchester Combined Authority that has recently been ratified and finally a dedication to Ingrid Brindle who recently passed away and was the Chair of Haughton Thornley Patient Participation Group
Dr Krishna Kasaraneni - Primary Care Networksamirhannan
Dr Krishna Kasaraneni talks about the challenges and opportunities of Primary Care Networks and what this means for General Practice and the wider healthcare system
20190712 Health Records Citizens and Genes - Amir Hannanamirhannan
Dr Amir Hannan introduces the conference and its aims with a story from his practice about a couple wanting access to their electronic health records, sharing the latest data from the GP survey and what progress we still need to make to enable many more people to be able to access their electronic health records and gain a better understanding of their healthcare needs
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- 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
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
20131210 Electronic Health Records - Is the NHS ready? What about patients
1. Electronic Patient Record- is NHS
ready? How about patients?
Dr Amir Hannan (@amirhannan)
Marilyn Gollom
Jacqueline Gladwin
2. Ten Golden Rules of Continuous Improvement
1. Problems create opportunities
2. The impossible is a paradigm – change your mind to change
your performance
3. Ask why five times to get to the real answer
4. Eliminate excuses, do it right the first time
5. Correct errors immediately
6. Involve everyone – we are smarter as a group than a single
individual
7. Reconsider rigid thoughts, situations change
8. Think simple, not perfect solutions
9. Use your mind more than your money
10. The Goal: Continuous improvement over delayed perfection
With thanks to Trevor Fossey
3. 4 Ps to Success
Patients and the Public
Paradigm Shift in Healthcare
Partnership of Trust
44. Many GP Practices have had the capability for some years now to be
able to:
• Book and cancel appointments on-line
• Update personal information (eg phone no)
• View and order repeat medications
• Send messages to the practice
• Access test results and letters
• View a summary of the medical records
• View the full medical record
…but much of this functionality is not yet widely utilised
44
45. The Evidence shows that where Access to Records is enabled:
Patientslike it!
Record sharing is safe
It improves Patient-Practice relationships
Patients use it intelligently to:
Save their own time
Save the doctors time,
Make the system safer and more efficient
It does not increase litigation
It appears to improve outcomes with less use of health services
It helps patients feel more in control of their health and their care
45
46. CLINICAL PERSPECTIVE
PRACTICE PERSPECTIVE
•
•
•
•
•
•
•
•
Many GPs are sceptical
Where this is working, the clinicians tell
us that it supports patient
empowerment, ownership and
engagement.
Practice experience is that this change
has not been revolutionary, as they
feared!
Access develops patients’ responsibility
& interest in their own health.
It enables patients to bring accurate data
to consultations.
It supports modern consultations, which
are often about conditions which have
no end point e.g. Osteoarthritis,
Diabetes, Dementia, Depression – and
the patients attitude to the condition is
paramount.
Access helps with some basic patient
needs – such as checking what was
agreed at the consultation.
•
•
•
•
•
•
•
•
•
Record access is safer: patients choose to
share their record with A+E when they get
suddenly ill, or with carers who can care
for them better with better information.
Compliance and self care improve
Patients feel more in control of their care
and more informed
On-line services save the practice – and
the patient, time – giving the practice
‘Time to Care’
The Practice is less prone to hold
erroneous data
Access provides a marketable asset
It provides an investment in the
relationship with their patients
Fits with the spirit of current NHS thinking
Less inefficiency – patients can take
referral letters to out-patients or list of
allergies to out of hours providers
Tap into patients desire for health
47. Challenges for enabling patient access to records and understanding
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What are the knowledge, skills and attitudes to support this for patients and the public, carers, clinicians,
managers, legislators, students and educationalists and others?
How do we encourage nurses and other allied health professionals to take an interest in this?
Morale is low and will this push staff away from wanting to do their job?
Do we have time to do this?
Where will the money come to support this?
What help is there to do Records Access?
Is the technology good enough to role this out more widely?
Is there a risk of increased litigation?
Where is the evidence that it improves outcomes or is this the right thing to do ?
Is there a standardised way of rolling this out ?
Enabling understanding is not easy but not that difficult either
Need to move clinical mindset away from fixers to facilitators of shared decision making and self care
Whose interest is it to improve health literacy?
Are we ready to do this yet at scale?
What about the Digital Divide?
Is there evidence that patients, clinicians or managers want this?
Whose role is it to drive this forwards – DoH / NHS England / CCGs / policy makers / clinicians /
managers / patients / carers / 3rd Sector / the Press / Twitter etc etc etc
What do you need to make this work for you and your family?
