The document provides an overview of the ASAM (American Society of Addiction Medicine) model for assessing patients and determining appropriate levels of care for substance use treatment. It describes the six dimensions that are used to evaluate patients' needs, including intoxication/withdrawal, medical conditions, mental health, motivation, relapse risk, and social environment. Treatment is individualized based on a patient's severity levels across these dimensions. The document also outlines the five basic levels of substance use treatment in the ASAM model, from outpatient to inpatient care. It emphasizes that treatment planning involves ongoing reassessment of patient needs and progress.
http://www.ASAMcriteria.org
This slide presentation provides an overview of what is new in The ASAM Criteria, Third Edition, including a new title, new sections, new terminology, as well as improved functionality and design. Releasing along with the book will be a new enhanced web-based version as well as The ASAM Criteria Software.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Most people do not enter into relationships with the intention of sabotaging it, yet that is exactly what ends up happening. In this presentation, we explore, in depth, certain behaviors that commonly sabotage relationships, how they are actually protective for the "saboteur" and what can be done to address them.
Anxiety disorders in children and teens can have serious effects on health, self-esteem, social well-being, and of course on academic performance. But they’re often difficult to detect. In this webinar, our researchers examine the factors that contribute to anxiety disorders in kids and how to recognize the signs, as well as the latest insights on treatment and prevention.
Watch the full webinar recording at https://explore.ucalgary.ca/overcoming-anxiety-schools
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA A single counseling CEU course is available at https://www.allceus.com/member/cart/index/product/id/393/c/ or the complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Tim Welsh
Trauma is a common occurrence in the lives of homeless individuals and can have a significant impact on one’s
ability to function. This training will help participants identify signs of trauma and ways in which they can engage
in trauma-informed practice with clients
http://www.ASAMcriteria.org
This slide presentation provides an overview of what is new in The ASAM Criteria, Third Edition, including a new title, new sections, new terminology, as well as improved functionality and design. Releasing along with the book will be a new enhanced web-based version as well as The ASAM Criteria Software.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Most people do not enter into relationships with the intention of sabotaging it, yet that is exactly what ends up happening. In this presentation, we explore, in depth, certain behaviors that commonly sabotage relationships, how they are actually protective for the "saboteur" and what can be done to address them.
Anxiety disorders in children and teens can have serious effects on health, self-esteem, social well-being, and of course on academic performance. But they’re often difficult to detect. In this webinar, our researchers examine the factors that contribute to anxiety disorders in kids and how to recognize the signs, as well as the latest insights on treatment and prevention.
Watch the full webinar recording at https://explore.ucalgary.ca/overcoming-anxiety-schools
Based on TIP 57: Trauma-Informed Care in Behavioral Health Services|SAMHSA A single counseling CEU course is available at https://www.allceus.com/member/cart/index/product/id/393/c/ or the complete Trauma Informed Care Training Certificate are available at https://www.allceus.com/member
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Tim Welsh
Trauma is a common occurrence in the lives of homeless individuals and can have a significant impact on one’s
ability to function. This training will help participants identify signs of trauma and ways in which they can engage
in trauma-informed practice with clients
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Examine ways to use problem solving skills to reduce distress. Identify the 4 problem solving options and techniques to implement them. Explore ways to teach theses skills in group settings to clients with mental health and addiction issues.
PROFESSOR DAVID NUTT - PSYCHEDELIC ASSISTED PSYCHOTHERAPY – NEW NEUROSCIENTIF...iCAADEvents
The world is entering a new phase of psychiatric treatments. After the psychotherapy and medical treatment phases in the last century, we are at the start of the phase where we use drugs to assist and empower psychotherapeutic processes. The origins of this exciting new development are the massive growth of neuropsychopharmacology, particularly in relation to the use of psychedelics (e.g. LSD, Psilocybin) and entactogens (e.g. MDMA). New research on the impact of these drugs on brain functions show clear impacts on brain processes that contribute to maladaptive behavioural processes. Parallel research has demostrated e cacy for psilocybin and MDMA in disorders such as resistant depression and PTSD. In this ground-breaking talk, Professor Nutt will cover these remarkable new developments and show how they may be used more broadly in psychiatry/psychotherapy in the future.
Mental Health and Mental Illness should be known to everyone. Unfortunately, it is still a stigma and not many people would talk about it, let alone learn about it.
I hope that this could spread information and awareness especially to the younger generations who are not taught about this.
Mental Health, Illness, Stigma and Awareness Strategies Aaradhana Reddy
Mental health, Illness, Health definitions, psychology, mental health professionals, Global scenario and Indian Scenario of Mental Illness prevalence, statistics, Common Mental Disorders, Stigma against Mental illness, Awareness, strategies to reduce stigma
Review:
Stages-of-Change Model
Goals of Brief Intervention
Components of Brief Interventions and Effective Brief Therapy
Essential Knowledge and Skills for Brief Interventions
When To Use Brief Therapy
Approaches to Brief Therapy
Components of Effective Brief Therapy
Cognitive Behavioral (CBT)
Cognitive Processing
Trauma Focused CBT
Brief Strategic/Interactional
Brief Humanistic/Existential
Brief Psychodynamic
Brief Family therapy
Time Limited Group Therapy
Serenity Clinic is Mental Health Disorder clinic for the people who are suffers from the mental disorder problems in their life such as Anxiety Disorder, Addiction and Substance, Mood Disorder etc. Dr. Anjali Nagpal is Psychiatrist in Delhi.
NBCC, NAADAC, CAADAC, CBBS, Florida approved continuing education series in mental health, substance abuse and dual disorders counseling for nurses, counselors, therapists, social workers and addictions professionals.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Goal setting is integral to treatment planning and helping clients learn how to make changes in their lives. This presentation walks you through some basics of goal setting and motivational enhancement suitable for licensed mental health and addictions professionals and coaches.
★★You can sign up to earn CE credits for the on-demand replay at: https://www.allceus.com/member/cart/index/product/id/521/c/ ★★
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Unlimited Counseling CEUs for $59 https://www.allceus.com/
Specialty Certificate tracks starting at $89 https://www.allceus.com/certificate-tracks/
Live Webinars $5/hour https://www.allceus.com/live-interactive-webinars/
Patreon: https://www.patreon.com/CounselorToolbox Help us keep the videos free for everyone to learn by becoming a patron.
Pinterest: drsnipes
https://www.youtube.com/user/allceuseducation
Nurses, addiction and mental health counselors, social workers and marriage and family therapists can earn continuing education credits (CEs) for this and other course at:
View the New Harbinger Catalog and get your 25% discount on their products by entering coupon code: 1168SNIPES at check out
AllCEUs has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6261. Programs that do not qualify for NBCC Credit are clearly identified. AllCEUs is solely responsible for all aspects of the programs.
AllCEUs is also approved as an education provider for NAADAC, the States of Florida and Texas Boards of Social Work and Mental Health/Professional Counseling, the California Consortium for Addiction Professionals and Professions. Our courses are accepted in most states through those approvals.
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Examine ways to use problem solving skills to reduce distress. Identify the 4 problem solving options and techniques to implement them. Explore ways to teach theses skills in group settings to clients with mental health and addiction issues.
PROFESSOR DAVID NUTT - PSYCHEDELIC ASSISTED PSYCHOTHERAPY – NEW NEUROSCIENTIF...iCAADEvents
The world is entering a new phase of psychiatric treatments. After the psychotherapy and medical treatment phases in the last century, we are at the start of the phase where we use drugs to assist and empower psychotherapeutic processes. The origins of this exciting new development are the massive growth of neuropsychopharmacology, particularly in relation to the use of psychedelics (e.g. LSD, Psilocybin) and entactogens (e.g. MDMA). New research on the impact of these drugs on brain functions show clear impacts on brain processes that contribute to maladaptive behavioural processes. Parallel research has demostrated e cacy for psilocybin and MDMA in disorders such as resistant depression and PTSD. In this ground-breaking talk, Professor Nutt will cover these remarkable new developments and show how they may be used more broadly in psychiatry/psychotherapy in the future.
Mental Health and Mental Illness should be known to everyone. Unfortunately, it is still a stigma and not many people would talk about it, let alone learn about it.
I hope that this could spread information and awareness especially to the younger generations who are not taught about this.
Mental Health, Illness, Stigma and Awareness Strategies Aaradhana Reddy
Mental health, Illness, Health definitions, psychology, mental health professionals, Global scenario and Indian Scenario of Mental Illness prevalence, statistics, Common Mental Disorders, Stigma against Mental illness, Awareness, strategies to reduce stigma
Review:
Stages-of-Change Model
Goals of Brief Intervention
Components of Brief Interventions and Effective Brief Therapy
Essential Knowledge and Skills for Brief Interventions
When To Use Brief Therapy
Approaches to Brief Therapy
Components of Effective Brief Therapy
Cognitive Behavioral (CBT)
Cognitive Processing
Trauma Focused CBT
Brief Strategic/Interactional
Brief Humanistic/Existential
Brief Psychodynamic
Brief Family therapy
Time Limited Group Therapy
Serenity Clinic is Mental Health Disorder clinic for the people who are suffers from the mental disorder problems in their life such as Anxiety Disorder, Addiction and Substance, Mood Disorder etc. Dr. Anjali Nagpal is Psychiatrist in Delhi.
NBCC, NAADAC, CAADAC, CBBS, Florida approved continuing education series in mental health, substance abuse and dual disorders counseling for nurses, counselors, therapists, social workers and addictions professionals.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Goal setting is integral to treatment planning and helping clients learn how to make changes in their lives. This presentation walks you through some basics of goal setting and motivational enhancement suitable for licensed mental health and addictions professionals and coaches.
★★You can sign up to earn CE credits for the on-demand replay at: https://www.allceus.com/member/cart/index/product/id/521/c/ ★★
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Unlimited Counseling CEUs for $59 https://www.allceus.com/
Specialty Certificate tracks starting at $89 https://www.allceus.com/certificate-tracks/
Live Webinars $5/hour https://www.allceus.com/live-interactive-webinars/
Patreon: https://www.patreon.com/CounselorToolbox Help us keep the videos free for everyone to learn by becoming a patron.
Pinterest: drsnipes
https://www.youtube.com/user/allceuseducation
Nurses, addiction and mental health counselors, social workers and marriage and family therapists can earn continuing education credits (CEs) for this and other course at:
View the New Harbinger Catalog and get your 25% discount on their products by entering coupon code: 1168SNIPES at check out
AllCEUs has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6261. Programs that do not qualify for NBCC Credit are clearly identified. AllCEUs is solely responsible for all aspects of the programs.
AllCEUs is also approved as an education provider for NAADAC, the States of Florida and Texas Boards of Social Work and Mental Health/Professional Counseling, the California Consortium for Addiction Professionals and Professions. Our courses are accepted in most states through those approvals.
ASAM adalah molekul yang mengandung atom – atom hidrogen yang dapat melepaskan ion hidrogen dalam larutan
Ion hidrogen adalah proton tunggal bebas yang dilepaskan dari atom hidrogen. dikenal sebagai asam.
contoh asam adalah asam hidroklorida ( HCL ), yang berionasi dalam air membentuk ion- ion hidrogen ( H+ ) dan ion klorida ( CL- ) demikian juga, asam karbonat ( H2CO3) berionisasi dalam air membentuk ion H+ dan ion bikarbonat ( HCO3-).
Basa adalah ion atau molekul yang menerima ion hidrogen.
contoh, ion bikarbonat ( HCO3-), adalah suatu basa karena dia dapat bergabung dengan satu ion hidrogen untuk membentuk asam karbonat ( H2CO3). Demikian juga ( HPO4 ) adalah suatu basa karena dia dapat menerima satu ion hidrogen untuk membentuk ( H2PO4 ).
A DSM 5 Update: Substance - Related And Addictive DisordersChat 2 Recovery
Within the next year, most insurance providers will be expecting all claims to include the new DSM-5 nomenclature. It is imperative for all mental health professionals to be comfortable with the new diagnostic criteria and recording procedures. This presentation provides participants with a clear understanding of the revisions made in the category of Substance - Related and Addictive Disorders from the DSM-IV to the DSM-5.
Topics presented by Nick Lessa, CEO of Inter-Care: an addiction treatment program in New York City.
Includes:
Changes in the diagnostic criteria from the DSM–IV to the DSM-5
The distinction between Substance Use Disorders and the Substance - Induced Disorders
Recording procedures for Substance Related Disorders
Clinical Psychology Case Formulation and Treatment Planning: A PrimerJames Tobin, Ph.D.
The aim of this primer is to support the learning of clinical case conceptualization and treatment planning for graduate students in clinical psychology, other trainees in the mental health professions, and early-career psychologists and mental health workers.
Since its original inception, Clinician Group has continually expanded its battery of assessment solutions and added new features (such as benchmarking and a comparison modules). With Clinician Group, our assessment solutions have become a preeminent provider of psychological, Annual Wellness Visits and Neurocognitive Assessment programs with services expanding to therapists, general practitioners, researchers and a host of other medical professionals.
Clinician Group help to improve Nationwide Access and the Quality of Health Care Services by providing Innovative New Electronic Assessments and Specialty Healthcare Providers across all geographic regions. Their main goal is to promote Total Patient Care while opening the seeds of communication between the patient and their healthcare provider.
The Impact of Utilization Review and Documentation - Halloween EditionJohn Raymond
UR and Documentation, now more than ever play an integral role in reimbursement for services. Learn how good UR practices and documentation can improve your claims cycle.
Chap 6-Standard Treatment Guideline.pptxssuser35e86c1
Standard treatment guidelines (STGs) outline the recommended treatment options for a specific disease or medical condition (e.g., HIV and AIDS) or a range of medical conditions. Along with essential medicines lists (EMLs) and formularies, STGs help promote rational medicine use.
To be considered credible,
guidelines should—
• Be based on a systematic review of existing
evidence
• Be developed by a knowledgeable,
multidisciplinary group of experts and
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
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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!
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.
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
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.
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
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
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. Objectives
o To provide an introductory overview of the
six dimensions of ASAM Patient
Placement Criteria
o To describe the ASAM Levels of Care
o To explain how the ASAM Assessment
supports treatment planning
3. Overview of Key
Elements
• The assessment is multi-dimensional
• Each dimension is given a severity rating
• The severity ratings determine what areas
will be the focus of treatment (treatment
priorities)
• Treatment Assessments and Plans must be
individualized and tailored to that specific
client.
4. What is ASAM?
• American Society of Addiction
Medicine
• ASAM has developed Patient
Placement Criteria (PPC) for specific
levels of care for substance disorder
treatment
5. Six Dimensions Help to Classify and
Assess Treatment Need and Placement
• 1: Intoxication and withdrawal potential
• 2: Biomedical conditions and complications
• 3: Emotional behavioral conditions and
complications
• 4: Readiness for change
• 5: Relapse potential
• 6: Recovery environment
7. 1: Acute intoxication and/or
withdrawal potential
• What risk is associated with the patient’s
current level of acute intoxication?
• Is there significant risk of severe withdrawal
symptoms or seizures, based on the patient’s
previous withdrawal history and current use?
• Are there current signs of withdrawal?
• Does the patient have supports to assist in
ambulatory detoxification, if medically safe?
8. 2: Biomedical
conditions/complications
• Are there current physical illnesses, other
than withdrawal, that need to be addressed
because they create risk or complicate
treatment?
• Are there chronic conditions that affect
treatment?
9. 3: Emotional, behavioral or
cognitive conditions and
complications
• Are there current psychiatric illnesses or
psychological, behavioral, emotional, or cognitive
problems that need to be addressed because they
create risk or complicate treatment?
• Do any emotional, behavioral or cognitive problems
appear to be an expected part of the addictive
disorder or do they appear to be autonomous?
• Even if connected to the addiction, are they severe
enough to warrant specific mental health treatment?
• Is the patient able to manage the activities of daily
living?
• Can s/he cope with any emotional, behavioral or
10. 4: Readiness for Change
• Expect resistance to treatment
• Treatment resistance should not exclude a
person from receiving treatment
• It is the degree of readiness to change that
helps to determine the setting and intensity
of motivational strategies needed
• What things, if any, can be leveraged to help
enhance the patient’s readiness to change?
11. 5: Relapse, Continued Use
or Continued Problem
Potential
• Is the patient in immediate danger of continued
severe mental health distress and or AOD use?
• Does the patient have any recognition or
understanding of, or skills in coping with, his or her
addictive or mental disorder in order to prevent
relapse, continued use or continued problems such
as suicidal behavior?
• How severe are the problems or further distress that
may continue or reappear if the patient is not
successfully engaged in treatment at this time?
• How aware is the patient of relapse triggers, ways to
cope with cravings to use, and skills to control
12. 6: Recovery / Living
Environment
• Do any family members, significant others, living
situations, or school or work situations pose a threat
to the patient’s safety or engagement in treatment?
• Does the patient have supportive friendships,
financial resources, and educational or vocational
resources that can increase the likelihood of
successful treatment?
• Are there legal, vocational, social service agency or
criminal justice mandates that may enhance the
person’s motivation for engagement in treatment?
• Are there transportation, housing, childcare, or
employment issues that need to be clarified or
13. Severity Levels
• High Severity=Immediate need for treatment
on the dimension being assessed (as in
today, it is an emergency)
• Medium Severity=Treatment needs to
address this within the next two weeks
• Low Severity= Treatment needs to address
this within the next three months.
15. Continuum of Care
ASAM describes treatment as a continuum
marked by five basic levels of care n ideal
ASAM continuum includes these levels of
care:
• Level 0.5 - Early Intervention
• Level I- Outpatient Services (OP)
• Level II - Intensive Outpatient Services
• Level III - Residential/Medically Monitored
Inpatient Services
• Level IV - Medically Managed Intensive Inpatient
Services (MM/IP)
16. Level 0.5: Early
Intervention
• Provides services for those who are
deemed to be at risk or those for
whom enough information is not
available to document a substance
use disorder.
• This is different from “prevention”
services.
17. Level I: Outpatient
Treatment
• Professionally-directed evaluation, treatment and
recovery services
• Delivered in a variety of settings
• Provided in regularly scheduled sessions
• Following a defined set of policies, procedures or
medical protocols
• Services address major lifestyle, attitudinal, and
behavioral issues that have the potential to
undermine the goals of treatment or inhibit the
individual’s ability to cope with major life tasks
without the non-medical use of alcohol or other
drugs.
18. Level II: Intensive
Outpatient Treatment /
Partial Hospitalization
• Outpatient services that delivers treatment during
the day, before or after school or work, in the
evenings or on weekends for 6 hours (for
adolescents) of structured programming
• Provides essential education and treatment
components about substance-related mental health
problems
• Leaves room for “real-world” application of new skills
• Can arrange fore medical and psychiatric
consultation, medication management, and 24-hour
crisis services
19. Level III: Residential/Medically
Monitored Inpatient Services
• A planned regimen of care in a 24-
hour facility staffed by addiction and
mental health professionals.
• Highly structured with clearly-defined
policies and procedures
• Serve individuals who need safer,
more stable living environments in
order to develop their recovery skills
20. Level III: Residential/Medically
Monitored Inpatient Services
(con’t)
• Encompasses four types of programs
• Decimal numbers appearing after the ASAM level of care are
used to indicate the graduated intensity of levels of care
o Level III.1: Clinically-Managed Low-Intensity Residential
Treatment
o Level III.3: Clinically-Managed Medium-Intensity Residential
Treatment
o Level III.5: Clinically-Managed High-Intensity Residential
Treatment
o Level III.7: Medically-Monitored Inpatient Treatment
21. Level IV: Medically Managed
Intensive Inpatient Services
(MM/IP)
• Provides a planned regimen of 24-hour medically directed
evaluation, care and treatment of mental and substance-related
disorders in an acute care inpatient setting.
• Staffed by addiction-credentialed physicians, including
psychiatrists, as well as other mental health- and addiction-
credentialed clinicians.
• Provides care to patients whose MH and substance-related
problems are so severe that they require primary biomedical,
psychiatric and nursing care.
• Treatment is provided 24-hours/day and the full resources of a
general acute-care hospital or psychiatric hospital are available
to allow for the treatment of any co-occurring biomedical
conditions that need to be addressed.
22. Exceptions to the PPC
• Three factors that can override patient-treatment
match, with regard to levels of service:
o Lack of availability of appropriate, criteria-
selected care
o Failure of the patient to progress at a given level
of care, so as to warrant a reassessment of the
treatment plan
o State laws regulating practice of medicine or
licensure of a facility requiring criteria different
from these.
23. Treatment Assessment
• Purpose: To identify the client’s
specific area of concern (presenting
problems) and to determine the level
of severity in each area of concern.
• The treatment assessment helps the
counselor identify the client’s
immediate needs and provides a basis
for treatment.
24. Goals of Treatment
• Treatment should be individually tailored and guided
by an individualized treatment plan that is
developed in consultation with the client.
• The clinician’s referrals and recommendations
should be based on how that treatment and its
duration will affect client outcome and problem
resolution.
• The treatment goals should determine the methods,
intensity, frequency and types of services provided,
i.e. “In the process of completing a comprehensive
evaluation, making a placement decision is the last
step.”
25. Progress Through
Treatment
• As the person moves through treatment in any level
of service, his or her progress in all six dimensions
should be continually assessed.
• Degree of problem resolution or improvement in
treatment determines movement between levels of
care as the treatment plan is re-assessed.
• “Treatment failure” does not need to be a
prerequisite for approval of admission to a higher
level of care.
27. Individualized Problem
Statement Includes:
• One Issue for each problem statement
• Briefly Stated
• For the correct dimension
• Stated as a problem that needs
improvement
• Stated as a correctable negative
consequence that is specific to this client
• What does the client think the problem is?
29. Individualized Goal
Statements Will:
• Be brief
• Relate the goal to the problem
• Relate the problem statement to the
goal which leads to the action plan
(strategies)
• Be appropriate to the client’s stage of
change
• What does the client want?
30. Short-Term Goals
• An expected result which takes a short time
to achieve
• Related to the identified clinical problem
• Stated in measureable terms
• Use action verb to illustrate direction of
change
• One goal per statement
• Appropriate to the client’s stage of change
• Provides guidelines for the direction of care
31. Individualized Action
Plan includes:
• Action steps must be directly related to the
matching problem statement
• Action steps must be stated in measurable terms
(observable, recordable, reportable and verifiable)
• Action steps must be stated as actions/tasks that
the client is willing and able to do
• Action steps must be specific to this client
• Action steps are realistic and achievable by this
particular client
• What is the client motivated to actually do?
32. Plan of Treatment:
• Describes the services or actions to meet the
stated goal
• Specifies the frequency of treatment interventions
or services
• Has a reasonable time for achievement
• Identifies who is responsible for the action or
strategy (client or staff or?)
• Takes into account the client’s degree of motivation
by applying appropriate strategies that specific to
the client’s stage of change.
33. Steps for Writing Short-
term Goals and
Strategies
• Write a problem for the client and ask what
about this is unique to this individual?
• Write a specific short-term goal
• Ask yourself: what behavior/action would
help this client achieve this goal, keeping in
mind the stage of change
• Make sure the strategy is observable so you
can track progress
• Is this something the client is willing and able
to do in the time specified?
34. Sample Strategies for
Treatment Plans:
• List two reasons the court sent you to treatment
• Write down the most recent thing that got you in
trouble when you were using alcohol or drugs
• What will happen if you don’t comply with probation
and report this to the treatment group
• List the pros and cons of your continuing to use
• Attend a meeting and see if you can relate to
anyone’s story. Report back to group.
• Share in group what has helped to prevent
relapsing and get other suggestions
• Any others?