Advance care planning: "Let's get talking"MS Trust
This presentation by Dr Jo Poultney, Dr Sarah MacLaran, and Dr Julia Grant looks at advance care planning and how to support patients to express their preferences about care: what they do and don't want to happen and the people important to them.
It was presented at the MS Trust Annual Conference in November 2014.
Start the Discussion: The Importance of Advance DirectivesSummit Health
We will discuss the importance of planning ahead about end-of-life decisions, provide useful information about how to prepare advance directives, and distribute sample forms.
Advance care planning: "Let's get talking"MS Trust
This presentation by Dr Jo Poultney, Dr Sarah MacLaran, and Dr Julia Grant looks at advance care planning and how to support patients to express their preferences about care: what they do and don't want to happen and the people important to them.
It was presented at the MS Trust Annual Conference in November 2014.
Start the Discussion: The Importance of Advance DirectivesSummit Health
We will discuss the importance of planning ahead about end-of-life decisions, provide useful information about how to prepare advance directives, and distribute sample forms.
Last semester's lecture on truth telling and breaking bad news to patients. It was presented by Dr Ghaiath Hussein for Farabi Medical College medical students.
Our goal is to cover the wide areas of overlap and similarities between the two disciplines, and to also make the differences between the two clearer for you.
An abridged version of a presentation I delivered to a group of interns in Perth, Western Australia, introducing them to palliative care in the hospital setting
Lecture 14 & 15 truth telling & breaking bad news (BBN)Dr Ghaiath Hussein
Truth telling & breaking bad news (BBN) in the practice of medicine. The ethical principles and the practical skills needed for breaking unfavourable news, with emphsis on the Islamic aspects and the practice in Saudi Arabia
Communication of prognosis has multiple barriers to achieve shared understanding between patient and clinician. In this slide deck designed for Hospice and Palliative Medicine fellows, I look at some key studies and applied techniques to best address talking about 'How long do I have, doc?'
This slide deck does not cover how to formulate a prognosis.
Presented at Kansas City University of Osteopathic Medicine 10/27/15 in Lecture Series in Bioethics. See live presentation here: https://www.youtube.com/watch?v=Dr3g3PeVKeo
With the cost of Long Term Care Insurance continuing to rise, advisors look for new ways to deliver meaningful solutions to address the needs of the clients at death… and during their lives. We’ll take a closer look at what’s going on in the LTC Marketplace, and what solutions are appropriate to meet the needs of your high net worth clients.
Last semester's lecture on truth telling and breaking bad news to patients. It was presented by Dr Ghaiath Hussein for Farabi Medical College medical students.
Our goal is to cover the wide areas of overlap and similarities between the two disciplines, and to also make the differences between the two clearer for you.
An abridged version of a presentation I delivered to a group of interns in Perth, Western Australia, introducing them to palliative care in the hospital setting
Lecture 14 & 15 truth telling & breaking bad news (BBN)Dr Ghaiath Hussein
Truth telling & breaking bad news (BBN) in the practice of medicine. The ethical principles and the practical skills needed for breaking unfavourable news, with emphsis on the Islamic aspects and the practice in Saudi Arabia
Communication of prognosis has multiple barriers to achieve shared understanding between patient and clinician. In this slide deck designed for Hospice and Palliative Medicine fellows, I look at some key studies and applied techniques to best address talking about 'How long do I have, doc?'
This slide deck does not cover how to formulate a prognosis.
Presented at Kansas City University of Osteopathic Medicine 10/27/15 in Lecture Series in Bioethics. See live presentation here: https://www.youtube.com/watch?v=Dr3g3PeVKeo
With the cost of Long Term Care Insurance continuing to rise, advisors look for new ways to deliver meaningful solutions to address the needs of the clients at death… and during their lives. We’ll take a closer look at what’s going on in the LTC Marketplace, and what solutions are appropriate to meet the needs of your high net worth clients.
Unfortunately, researchers tell us that most Americans have not executed all of the appropriate estate planning documents. Many people don't act because they DON’T KNOW where to begin. This presentation explains the basics, and it may inspire you to finally take action for the benefit of your family if you are currently unprepared.
What Is Estate Planning: Commonly Asked Questions and AnswersJennifer Vermillion
Estate planning is the process through which you make choices about what you want to happen to you and your property should you die or become incapacitated. Learn more about estate planning in this presentation.
Parents with Minor Children Estate PlanningRobert Nash
If you have minor children, or children of any age with special needs, estate planning takes on a heightened importance. Learn more about estate planning for parents with minor children in this presentation.
Estate Planning involves carefully considered decisions regarding your estate and property, your future and also the future of your children. A great estate plan is your opportunity to thoughtfully leave your assets to those whom you value and feel should benefit from your years of hard work and wealth accumulation. The questions you ask yourself initially will guide your entire estate planning process. This presentation discusses what questions you need to ask yourself as you begin the estate planning process. If you have questions about your estate plan, please contact us on 1800 770 780 or ohl@owenhodge.com.au.
Who will have access to your digital legacy when you become incapacitated or upon your death? Looks at the emerging field of estate planning for digital assets.
From the Oklahoma law firm Cazes Roberts, PC:
A concise yet practical review of what Oklahoma estate planning is, why some would want to do Oklahoma Estate Planning and the tools used in Oklahoma Estate Planning.
Depending on the exact estate in question various different types of legal devices could be utilized. In this presentation we are going to look at the core components of a basic estate plan.
This is the handout for a 60 minute workshop with roleplay for the KUMC Palliative Medicine Fellowship lecture series. There is no accompanying slideset as this was a small group workshop.
Please contact with questions and see this disclaimer. This is not medical advice.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
A good death examines dying and death from a design and user experience perspective. The project re imagines legal forms such as living wills and durable power of attorney to improve the emotionally complex process of End of Life planning. The project challenges it’s users to explore and create end of life experiences. It considers the role of interactive technologies and strives to design a dynamic and unique experience-based journey through EoL decisions to encourage more open, comfortable, and
proactive End of Life planning. A Good Death is a toolkit that aims to clarify difficult choices and encourage dialogue among families and friends. The project leverages the comfort, privacy, and flexibility of online spaces to reduce the stigma of death offline. The project responds to the legal and economic forces that shape these decisions as well as the cultural and religious beliefs that define an individual’s role in their own death and dying experience.
PSY605 End-of-Life Case Scenarios Case 1 Roger is a healt.docxwoodruffeloisa
PSY605 End-of-Life Case Scenarios
Case 1: Roger is a healthy 62-year-old African American male with a wife and four grown children.
While out on his morning jog two weeks ago, he was hit by a drunk driver. Roger has been left paralyzed
from the neck down, and he is no longer able to perform basic life-sustaining functions such as eating or
breathing without the help of machines. Because he can no longer talk or use his hands to write, his
communication is limited to moving his head in simple “yes” or “no” responses when asked a question.
His living will was last updated 25 years ago when his youngest child was born. The will indicates that
Roger would like to receive life-saving treatments in these types of events. However, when prompted by
doctors, nurses, and the hospital-appointed social worker regarding his current wishes, he seems to be
communicating that he does not want to continue living in his current state.
Case 2: Geri is a 38-year-old single mother. Her son, Gabe, is 17 years old and a junior in high school.
After experiencing some headaches and changes in mood over the past several weeks, Geri finally visited
a neurosurgeon a week ago. During that visit, it was discovered that she has an inoperable brain tumor.
Her life expectancy is 6 to 8 months. In addition to fears about her own impending death, Geri is very
worried about how to best provide for and take care of her son. She cannot decide if she should continue
working full-time to make sure that Gabe’s expenses are taken care of, or if it is best to take this
remaining time off to enjoy with her son. Once she is gone, she does not know if she should send Gabe to
live with an aunt who lives several states away for his final year of high school, or if she should allow
him to live with a friend in their neighborhood and grant custody to that parent so Gabe could continue
living and going to school where he is most comfortable. She is also at a loss as to how to explain this
situation to Gabe in a way that he will understand so that both of them will be able to move forward.
Fact Sheet onFact Sheet onFact Sheet onFact Sheet onFact Sheet on
End-of-Life CareEnd-of-Life CareEnd-of-Life CareEnd-of-Life CareEnd-of-Life Care
WHAT ARE OLDER ADULTS’ MENTAL HEALTH NEEDS
NEAR THE END OF LIFE?
The US Supreme Court agreed that Americans should expect palliative care,
which combines active and compassionate therapies to comfort and support
individuals and families nearing the end of life. End of life is defined as that
time period when health care providers would not be surprised if death
occurred within about 6 months. Older Americans with chronic illness think
about how they would prefer their lives to end, and want a “good death”
without burdensome pain, symptoms and technology.
Most deaths (70%) occur in those aged 65 and older. Older adults want better discussions,
information, and a chance to influence decisions about their care—w ...
DQ 1 Response 1 As health care is advancing, there have been man.docxelinoraudley582231
DQ 1 Response 1
As health care is advancing, there have been many essential right concerning patients. The process of dying is very complex and it consequences are complicated. If one dies, the individual will not come back again. Therefore, individual with living will may promote care providers’ guideline to their destiny. It will prevent any litigation that may affect the care provider and the organization. Healthcare industry has now got involved or it is now involving spiritual treatment. Spiritual health care may have close relationship with end of life. The essential aspect to spiritual health care may include emotions, feelings, and assumptions of an individual. Therefore, it is very important to guide such essential concerning patient desire to have evidence. Sometimes patient do not want their family members to witness such desire because of the emotional consequences. Every patient knows the kind of pain their feeling and if this individual desire to end this suffering, others may not understand. Hence parent and family of a patient should not interfere in such situation. I can imagine a patient with a serious accident and is subjected to life support machine based on the patient’s unresponsive reaction. This patient has gone through treatment day and night for more than years. Such situation worsens the patient pain and suffering but who else can feel what the patient is feeling? Parent should decide on what they would do to their child regardless. In my opinion, the child will depend on the parent to survive living healthy. It would be very painful if the parent income -wise is poor. Which will lead the child to go through painful life. Therefore, parent knows their situation at hand and they need to make their own decision regardless.
Reference
Balk, E. D: Closing the gaps on efforts to improve healthcare quality at the end-of-life.
Russell, D: Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life by the Committee on Approaching Death: Addressing Key End of Life Issues. Washington, DC: National Academies Press, 2014. 638 pages.
Response 2
Assess the ethical issues surrounding end-of-life decisions. How has the living will affected medical response and why is this important for guiding end-of-life decisions? Should families be able to impact how and if a person's living will is carried out? Should parents have the right to choose to end the life of their child if the child has Down Syndrome?
Living wills are very important. They are legal documents that lay out decisions that the patient has made for their health care in the event that they are unable to make decisions anymore. Decisions that are made could include if the patient wants to be resuscitated or kept on life support. Furthermore, a living will can have the patients in regards to pain management or organ donation. (Mayo Clinic Staff, 2017) This is way if the patient’s family or friends do not agree it goes back to the patient’s .
At the end of the presentation, you will be able to:
Identify, Describe and Discuss, How Clients and Families Come to your Practice
Identify Describe and Discuss Addiction, Mental Health, Trauma, Chronic Pain and Process Disorders
Identify how Trauma, Shame, Guilt, Humiliation, Embarrassment, Grief and Loss Effect Ones Story about themselves
Identify how Growing Up in An Alcoholic Family can effect one
Review evidence based strategies
Identify and Differentiate trauma as both objective and subjective and how it effects people over the life span
Recognize how trauma can be precipitating factor which leads to a substance use disorder and vice versa the activities one engages in the midst of a substance use disorder can be traumatic
Identify and Describe Addiction per ASAM new definition
Describe and Discuss Qualitative Methods of Inquiry and Family Mapping as a Way into Story
Similar to As You Wish: Advance Care Planning (20)
A slideshow that explains end of life decision making, including living wills, health care powers of attorney, and other helpful tools. Includes information on end of life laws in Delaware.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
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APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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
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.
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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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
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
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Role of Mukta Pishti in the Management of Hyperthyroidism
As You Wish: Advance Care Planning
1. Sheila Grant, RN, BSN, CHPN Vice President Hospice & Palliative Care Network of Delaware
2.
3. 1900 2000 Age at Death 46 Years 81 Years Leading Causes Infection Accident Childbirth Cancer Heart Disease Stoke/Dementia Disability before Death Unusual & Brief On Average, > 4 Years Costs Low & Affordable Very High & Long Periods