The Australian Gay Community Periodic Survey (1998-2010) tells us that 1 in 8 sexually active gay men have never tested. Michael Atkinson (WA AIDS Council) talks about a strategy to address barriers to testing and to promote testing culture - the MClinic. This presentation was given at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations within their own practices and clinics. This Webinar is the second in a three part series featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) initiative on Jail Linkages, as they share lessons learned and advice for others hoping to create or expand similar programs.
Learn how to build a new jail linkage program and what to consider for expanding an existing one. Jail Linkages SPNS grantees—including Dr. Timothy Flanigan of Miriam Hospital, Alison Jordan of New York City Department of Health and Mental Hygiene, and Dr. Ann Avery of Care Alliance Health Center describe the steps their programs took to implement their respective jail linkage programs, and provide advice for others hoping to replicate this work.
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations within their own practices and clinics. This Webinar is the first in a three part series featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) Enhancing Linkages to HIV Care & Services in Jail Settings Initiative (Jail Linkages Initiative), as they share lessons learned and advice for others hoping to create or expand similar programs.
Explore how to secure buy-in and foster partnerships within correctional settings, as well as how to navigate the “culture of corrections.” Hannah Zellman of Philadelphia FIGHT, a SPNS Jail Linkages grantee, will present alongside Dr. Linda Rose Frank and Debra D’Alessandro of the PA/MidAtlantic AIDS Education and Training Center about the work their organizations have done individually and collaboratively in the corrections setting.
Improving Aboriginal and Torres Strait Islander cancer screening rates in NNS...Cancer Institute NSW
Northern NSW (NNSW) LHD was awarded a $20,000 grant from the Cancer Institute NSW to increase breast and cervical cancer screening in Aboriginal women and cancer screening in Aboriginal men in the Northern NSW region.
Long run effects of temporary incentives on medical care productivity in Arge...RBFHealth
A presentation by Pablo Celhay, Paul Gertler, Paula Giovagnoli and Christel Vermeersch, delivered at the RBF Health Seminar, On the Road to Effective Universal Health Coverage: What’s New in Argentina’s Use of Performance Incentives? on June 11, 2015.
This webinar will shift the focus from WHAT you are doing with your improvement efforts, instead shedding light on the importance of HOW you are doing it!
HIV Index Testing: The USAID DISCOVER-Health Project Experience in Zambia JSI
This was presented by Kalasa Mwansa during the Index Testing & Partner Notification for HIV Epidemic Control webinar on April 11th, 2019. The USAID DISCOVER- Health Project Experience aims to increase the use of high quality, integrated health services in specific target groups, and to provide integrated health products and services in a sustainable manner. In addition, it aims to contribute to HIV epidemic control and provides HIV index testing at every ART site.
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations within their own practices and clinics. This Webinar is the second in a three part series featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) initiative on Jail Linkages, as they share lessons learned and advice for others hoping to create or expand similar programs.
Learn how to build a new jail linkage program and what to consider for expanding an existing one. Jail Linkages SPNS grantees—including Dr. Timothy Flanigan of Miriam Hospital, Alison Jordan of New York City Department of Health and Mental Hygiene, and Dr. Ann Avery of Care Alliance Health Center describe the steps their programs took to implement their respective jail linkage programs, and provide advice for others hoping to replicate this work.
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations within their own practices and clinics. This Webinar is the first in a three part series featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) Enhancing Linkages to HIV Care & Services in Jail Settings Initiative (Jail Linkages Initiative), as they share lessons learned and advice for others hoping to create or expand similar programs.
Explore how to secure buy-in and foster partnerships within correctional settings, as well as how to navigate the “culture of corrections.” Hannah Zellman of Philadelphia FIGHT, a SPNS Jail Linkages grantee, will present alongside Dr. Linda Rose Frank and Debra D’Alessandro of the PA/MidAtlantic AIDS Education and Training Center about the work their organizations have done individually and collaboratively in the corrections setting.
Improving Aboriginal and Torres Strait Islander cancer screening rates in NNS...Cancer Institute NSW
Northern NSW (NNSW) LHD was awarded a $20,000 grant from the Cancer Institute NSW to increase breast and cervical cancer screening in Aboriginal women and cancer screening in Aboriginal men in the Northern NSW region.
Long run effects of temporary incentives on medical care productivity in Arge...RBFHealth
A presentation by Pablo Celhay, Paul Gertler, Paula Giovagnoli and Christel Vermeersch, delivered at the RBF Health Seminar, On the Road to Effective Universal Health Coverage: What’s New in Argentina’s Use of Performance Incentives? on June 11, 2015.
This webinar will shift the focus from WHAT you are doing with your improvement efforts, instead shedding light on the importance of HOW you are doing it!
HIV Index Testing: The USAID DISCOVER-Health Project Experience in Zambia JSI
This was presented by Kalasa Mwansa during the Index Testing & Partner Notification for HIV Epidemic Control webinar on April 11th, 2019. The USAID DISCOVER- Health Project Experience aims to increase the use of high quality, integrated health services in specific target groups, and to provide integrated health products and services in a sustainable manner. In addition, it aims to contribute to HIV epidemic control and provides HIV index testing at every ART site.
Understanding how the Measurement and Monitoring of Safety Framework can form board understanding and help align strategic and operational approach to patient safety.
Full details: https://goo.gl/XyqTQA
Deep Dive Into Telehealth Adoption Covid 19 and Beyond | Doreen Amatelli ClarkVSee
For more info: visit https://bit.ly/3pt6hp2
How has telehealth adoption changed following the pandemic and what are the implications for the future of telehealth? Join market research expert and owner of Way to Goal, Doreen Amatelli-Clark to talk about her latest findings from her COVID-19 study, covering surveys and in-depth interviews with doctors and healthcare practitioners from around the world.
Provided to you by: https://vsee.com
Healthcare Associated Infections: Challenges, Solutions and Future PrioritiesNHSScotlandEvent
A valuable opportunity for delegates to talk freely about some of the difficulties they face in tackling HAI and to learn and share positive initiatives that have been undertaken across NHSScotland.
The Pink Sari Project: Challenging the future of how we develop campaigns and...Cancer Institute NSW
Women aged 50-74, from Indian and Sri Lankan Backgrounds have been identified by the Cancer Institute NSW as having one of the lowest rates of breast screening in NSW. To address this issue, the NSW Multicultural Health Communication Service together with the NSW Refugee Health Service and an interdisciplinary team of researchers from the University of Technology Sydney applied for and was successful in getting an Evidence to Practice from the Cancer Institute NSW in 2014.
The 2015 Patient Safety Champion Awards are presented by HealthCareCAN and Canadian Patient Safety Institute with support from Patients for Patient Safety Canada.
WATCH: http://bit.ly/1U06qKn
“Tu Decides” App and the Increase of Effective Contraceptive Use Among Adoles...YTH
Worldwide the use of mobile phones among young people is dramatically increasing. Even in remote places, young people are using their phones not only as a way of communication but also to look for information. Because of this, IPPF ‘s Member Association in Bolivia has worked with young people to develop a sexual and reproductive health app to complement its routine services. We have also developed and are evaluating a contraceptive intervention delivered through the app to increase use and acceptability of effective contraception among young people. This session will cover the youth-centered design of the app and service delivery aspects of the project, as well as the experience of collaborating with researchers to ensure robust evidence generation. This session will be of interest to those working in inclusive technology projects, researchers, health and public health providers and implementers working in adolescent health and sexual and reproductive health.
Qualitative Research in Results-Based Financing: The Promise and The RealityRBFHealth
A presentation by Kerina Kielmann and Fabian Cataldo, delivered at the RBF Health Seminar, Qualitative Research in RBF: The Promise and The Reality on February 18, 2015.
These posters were presented by Sydney Sexual Health Centre staff at the 2017 Australasian HIV & AIDS Conference in Canberra.
Topics included:
- Joint Care Planning in an Urban Publically Funded Sexual Health Centre: A New Case Management Model
- The Sexual Health Counsellors Association of NSW (SCAN): a Statewide Organisation for Sexual Counsellors in Publically Funded Sexual Health Centres
- Co-production as Model for the Facilitation of Learning About Challenges Faced by Those with Diverse Genders, Sexes and Sexualities
- Difficulties in Engaging Thai and Chinese Sex Workers in Smoking Cessation: a Cautionary Tale
- Unnecessary Examinations: What Would Be Missed if we Avoid Genital Exams for Women with Uncomplicated Vaginal Discharge?
Understanding how the Measurement and Monitoring of Safety Framework can form board understanding and help align strategic and operational approach to patient safety.
Full details: https://goo.gl/XyqTQA
Deep Dive Into Telehealth Adoption Covid 19 and Beyond | Doreen Amatelli ClarkVSee
For more info: visit https://bit.ly/3pt6hp2
How has telehealth adoption changed following the pandemic and what are the implications for the future of telehealth? Join market research expert and owner of Way to Goal, Doreen Amatelli-Clark to talk about her latest findings from her COVID-19 study, covering surveys and in-depth interviews with doctors and healthcare practitioners from around the world.
Provided to you by: https://vsee.com
Healthcare Associated Infections: Challenges, Solutions and Future PrioritiesNHSScotlandEvent
A valuable opportunity for delegates to talk freely about some of the difficulties they face in tackling HAI and to learn and share positive initiatives that have been undertaken across NHSScotland.
The Pink Sari Project: Challenging the future of how we develop campaigns and...Cancer Institute NSW
Women aged 50-74, from Indian and Sri Lankan Backgrounds have been identified by the Cancer Institute NSW as having one of the lowest rates of breast screening in NSW. To address this issue, the NSW Multicultural Health Communication Service together with the NSW Refugee Health Service and an interdisciplinary team of researchers from the University of Technology Sydney applied for and was successful in getting an Evidence to Practice from the Cancer Institute NSW in 2014.
The 2015 Patient Safety Champion Awards are presented by HealthCareCAN and Canadian Patient Safety Institute with support from Patients for Patient Safety Canada.
WATCH: http://bit.ly/1U06qKn
“Tu Decides” App and the Increase of Effective Contraceptive Use Among Adoles...YTH
Worldwide the use of mobile phones among young people is dramatically increasing. Even in remote places, young people are using their phones not only as a way of communication but also to look for information. Because of this, IPPF ‘s Member Association in Bolivia has worked with young people to develop a sexual and reproductive health app to complement its routine services. We have also developed and are evaluating a contraceptive intervention delivered through the app to increase use and acceptability of effective contraception among young people. This session will cover the youth-centered design of the app and service delivery aspects of the project, as well as the experience of collaborating with researchers to ensure robust evidence generation. This session will be of interest to those working in inclusive technology projects, researchers, health and public health providers and implementers working in adolescent health and sexual and reproductive health.
Qualitative Research in Results-Based Financing: The Promise and The RealityRBFHealth
A presentation by Kerina Kielmann and Fabian Cataldo, delivered at the RBF Health Seminar, Qualitative Research in RBF: The Promise and The Reality on February 18, 2015.
These posters were presented by Sydney Sexual Health Centre staff at the 2017 Australasian HIV & AIDS Conference in Canberra.
Topics included:
- Joint Care Planning in an Urban Publically Funded Sexual Health Centre: A New Case Management Model
- The Sexual Health Counsellors Association of NSW (SCAN): a Statewide Organisation for Sexual Counsellors in Publically Funded Sexual Health Centres
- Co-production as Model for the Facilitation of Learning About Challenges Faced by Those with Diverse Genders, Sexes and Sexualities
- Difficulties in Engaging Thai and Chinese Sex Workers in Smoking Cessation: a Cautionary Tale
- Unnecessary Examinations: What Would Be Missed if we Avoid Genital Exams for Women with Uncomplicated Vaginal Discharge?
At the 2016 CCIH Annual Conference, Evan Novalis of IMA World Health discusses the organization's efforts to integrate its HIV/AIDS programs with cervical cancer screening and care.
Geoff Honnor (ACON) redefines wellness in an evolving HIV epidemic, as well as discussing the context of the UN Goals for reducing HIV transmission 2010-2015 and the ACON response.
This presentation was given at the AFAO Positive Services Forum 2012.
NJCRI is New Jersey’s largest and most comprehensive HIV/AIDS community-based organization. Our mission is “to help people with HIV/AIDS and those at risk for HIV/AIDS.” We conduct state-wide HIV clinical trials, and HIV treatment, care and prevention services in the Greater Newark Area. Populations we serve include youth and adults, men and women, men who have sex with men, people who acquire or who are at risk for HIV through injection drug use, and others.
NJCRI also seeks to address the concerns and disparities of access to health care faced by minority populations. Some of the non-HIV related services we offer include behavioral research, chronic illness management education, street outreach, substance abuse treatment, transportation, food pantry, and technical assistance to other community-based organizations. Approximately 5,000 people avail themselves of our free and confidential services each year.
discusion 1As I mentioned in my introduction, I manage two OBGYN p.docxowenhall46084
discusion 1
As I mentioned in my introduction, I manage two OBGYN practices at the University of Kentucky. One of those practices is located in Rowan County, in a small town called Morehead, KY. In the community, our clinic is one of only two OBGYN practices.
In addition, many of the surrounding rural counties are without OBGYN physicians. Therefore, many of our patients make a lengthy commute to see one of our providers. Fortunately, Morehead does have a hospital that is equipped with labor and deliver services. The next closest hospital or OBGYN high risk specialist is over an hour’s drive away on the main UK campus in Lexington, KY. Recognizing the lack of services, and the difficulty of travel for our patients, we started offering telehealth in 2013 to expand access of care and improve the quality of care for our high risk OB patients with the Blue Angels program.
All patients who are considered as having a high risk pregnancy are offered a telehealth consult with a high risk OBGYN specialist from Lexington via telehealth with the Blue Angels program. This consultation occurs during the patient’s routine ultrasound. The exam room is equipped with a large 55 inch monitor that allows the physician to see both the patient and the ultrasound that is being performed by the sonographer, in real time. This allows the provider and the patient to communicate as if they were face to face in an office visit.
From 2015-2016, 1,863 patients participated in the Blue Angels program - a 62% growth in patient volume from the previous year. Deliveries and NICU referrals from the area to Lexington grew almost 40% from 2013-2016.
The set up cost for telehealth was minimal in comparison to the progress and benefits being made in our high risk patients.
According to the document “The Role of Telehealth in an Evolving Health Care Environment”, telehealth allows rural areas to increase quality of care and patient volumes, reduce emergency department visits and hospital readmissions, and offer specialty care at a lower cost, not to mention saving the patients time, money, and traveling to Lexington.
Other methods of web-based communication tools have also proven to help manage complex health care needs by providing virtual access to multiple specialty providers. In a pilot study, researchers developed the “Loop”, a secure online communication tool that allowed patients to communicate with multiple members of a health care team. The study proved the “Loop” to be successful in providing effective medical team collaboration with patients. Similar in design and access, patient portals allow for patients to get medical information, appointments, and prescriptions all in the click of a computer. In the article “Patient Web Portals, Disease Management, and Primary Prevention”, the authors state that web portals have been shown to increase patient adherence to medical regimens, and have improved the overall efficiency and quality of health care.
Patient-centered .
This presentation on AFAO's recent work with Culturally and Linguistically Diverse (CALD) communities was given by Michael Frommer at the SiREN Symposium in Perth, June 2016.
Scott McGill discusses ASHM's plan for developing online health promotion resources for people from CALD backgrounds. This presentation was given at AFAO's HIV and Mobility Forum in May 2016.
Darryl O’Donnell, Executive Director of AFAO, outlines changes to the organisation and sets out its priorities for 2016/17. In this context, he invited input on AFAO's future policy work from from participants at AFAO's HIV and Mobility Forum on 30 May 2016.
This presentation on key strategies for addressing HIV among people from CALD communities and people who travel to high prevalence countries was given by Corie Gray from Curtin University and CoPAHM at AFAO'S HIV and Mobility Forum on 30 May 2016.
This presentation on a directory of HIV health promotion programs and resources that engage with people from CALD communities was given by Jill Sergeant from AFAO at AFAO'S HIV and Mobility Forum on 30 May 2016.
This presentation on findings from a trial of providing HIV medication to people not eligible for Medicare was given by Tony Maynard from the National Association of People With HIV Australia (NAPWHA) at AFAO'S HIV and Mobility Forum on 30 May 2016.
This presentation on HIV diagnoses among people from CALD communities was given by Praveena Gunaratnam from the Kirby Institute at AFAO'S HIV and Mobility Forum on 30 May 2016.
Drawing upon HIV surveillance data and the Seroconversion Study, this presentation explores reasons for late diagnosis of HIV and barriers to testing among gay men and other MSM in Australia. The presentation was given by Phillip Keen from the Kirby Institute at AFAO's National Gay Men's HIV Health Promotion Conference in April 2016.
In 2015, AFAO developed a directory of health promotion programs and resources related to HIV and culturally and linguistically diverse communities. This presentation outlines how the directory was developed and can be used. This presentation was given by Jill Sergeant at AFAO's National Gay Men's HIV Health Promotion Conference in April 2016.
A report on findings from the AHOD Temporary Resident Access Study, which looked at access to HIV treatments for people not eligible for Medicare. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
Lea Narciso from SA Health discusses the changing epidemic in South Australia, which now includes an increasing number of people born overseas, and the government's policy response. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
This Report Card provides an overview of national momentum on HIV and mobility, highlighting areas with strong momentum and areas that are limited. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
ComePrepd is the Queensland AIDS Councils (QuAC) new campaign for pre-exposure prophylaxis (PrEP) which aims to encourage open discussion in the gay community. This presentation discusses the design of the campaign and its various stages. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
Alison Coelho from the Centre for Culture, Ethnicity and Health describes a program which partnered with faith & community leaders around preventing BBV/STI transmission in migrant and refugee communities. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
An overview of how the 2 Spirits Program at the Queensland AIDS Council adapts a western health promotion framework into a cultural framework to engage Aboriginal & Torres Strait Islander communities around HIV and sexual health. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
This presentation on the priorities and challenges for the HIV response in Aboriginal and Torres Strait Islander communities was given by Michael Costello-Czok (Executive Officer – Anwernekenhe National HIV Alliance - ANA) at the AFAO Members Forum - May 2015.
This presentation on the expansion of AFAO's African communities project to encompass other CALD and mobile populations was given by Jill Sergeant, AFAO Project Officer, at the AFAO Members Forum - May 2015.
This presentation on using a systems approach to improve understandings of peer-based health promotion programs was given by Dr Graham Brown, Australian Research Centre for Sex, health and Society (ARCSHS), at the AFAO Members Forum - May 2015.
This presentation on what social research indicates will be effective anti-stigma interventions was given by Prof John de Wit, Centre for Social REsearch in Health (CSRH), at the AFAO Members Forum - May 2015.
More from Australian Federation of AIDS Organisations (20)
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
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
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Barriers & motivations to HIV testing
1. Introduction
Name: Michael Atkinson
Organisation & Project: WAAC – Coordinator M Clinic
Topic: The Role of Peer Educators in addressing Barriers & Motivations to HIV
Testing
The goal of infectious diseases screening is to test the asymptomatic population, find cases before they
become symptomatic or are passed on; treat them and in doing prevent spread amongst high risk groups.
A key objective of sexual health screening is for high risk populations to test appropriately according to their
sexual health behaviour. A regular testing pattern needs to be established according to number of partners
and types of behaviour including UAI and sharing injecting equipment.
Asymptomatic screening can reasonably seem paradoxical to those being tested. Without symptoms there is
no strong call to action and potentially little or no perceived benefit. For example, at your average sexual
health clinic with a HIV yield of 1% ‐ 99 out of 100 people leave the clinic with little more to show than relief
or piece of mind.
Therefore, for screening to work we need to make it as easy as possible by removing physical, structural and
psycho‐social barriers. We need to provide accessible services, ideally including a variety of options that
work to engage different testers.
On the surface the testing process is not particularly complex (slide #1):
• One makes an appointment
• They make their way to the clinic
• Talk about their sexual behaviour
• Provide specimens
• Return for their results
• Schedule next appointment
• And on it goes…
However, if testing is truly this easy why does the Australian Gay Community Periodic Survey (1998 ‐ 2010)
tell us that 1 in 8 sexually active gay men have never tested?
Gay Men’s HIV Health Promotion Conference 2012 | 1
2. ‐ These rates are much higher for Under 30 year olds.
The reality is people can encounter a range of complex personal, lifestyle, social and psychological factors
that intervene in the testing process (slide #2):
• Stigma and discrimination associated with HIV status and sexuality –
‐ I recall a client who took ten years to test after a night of passion. He said he wasn’t prepared to deal
with a positive HIV result – his main concern being the shame associated with telling his family. The client
spoke about the significant impact this decision had on his sex life and frame of mind over the 10 years. The
client tested negative and left the clinic a very different person.
• Anxiety – most clients experience some degree of anxiety at some point along the testing process –
whether it’s fear of needles or swabs, having to do the pre‐test discussion, or getting the result. Some level
of anxiety can actually work as a positive motivator to test ‐ however we have certainly witnessed our share
of clients who put off testing due to anxiety.
• Guilt & shame – guilt for having potentially infecting others, and we also still regularly talk with
clients who express shame about having been a “bad” gay citizen for slipping up and enjoying UAI.
• Relationship dynamics – notions of trust
• Lifestyle barriers ‐ people are busier than ever
• Physical barriers – distance from services
• Culture and religion
The M clinic was set up specifically to address barriers to testing and to promote testing culture (slide #3).
• Community setting
• Gay Friendly ‐ Staffed by a mix of peer and clinical staff
• Same day appointments
• Convenient open times and location
• Free & quick service
• Attractive branding
• Neutral setting ‐ increase MSM comfort
• Good parking and public transport
• Confidential
Establishing a community based screening facility is quite an involved undertaking. Luckily for me, WAAC has
a long history of providing community based screening services which hugely assisted with the process of
establishing the M Clinic:
Gay Men’s HIV Health Promotion Conference 2012 | 2
3. 1) We have ran an outreach clinic in the 2 sex on promises venues for the last 21 years; and
2) We have run an asymptomatic clinic from the WAAC office in West Perth for the last 5 years.
Essentially the M Clinic arose from these two projects where a lot of the leg work was already done. WAAC
had formed excellent working relationships with laboratory service providers, the Department of Health,
contact tracers, numerous physicians in the sexual health sector and most importantly the client group.
They had already established the testing algorithm, the risk assessment tool and policy guidelines all of
which Have been adapted to the M Clinic setting.
Today, the M Clinic is a screening clinic with all the usual bells & whistles much like tertiary and other clinics.
The key point of difference at the M Clinic is the engagement of qualified peers (gay men) who are involved
in all aspects of the clinics operation which works to ensure the service is acceptable to the target group
(slide #4):
• Clinic coordination
• Service delivery
– Reception: greet clients, triage, informal education
– Pre‐test discussion: hand over to nurse/doctor
– Post‐test discussion: education and referral, giving positive results
– Specimen collection
– Treatment
• Administration and Data Collection
• Clinical Governance including research
Peer educators are trained to conduct pre & post‐test discussions, which involve motivational interviewing
techniques that are used to address the aforementioned motivational barriers that can interfere with
establishing appropriate testing regimes, and to some extent impact risk behaviour.
Peer Educators make clients feel comfortable by providing no judgement and an intrinsic understanding
which allows clients to talk openly about an age old sensitive subjects – including sex, mental health,
substance use etc.
Since establishment in July 2010 the M Clinic has reported the highest number HIV notifications among
MSM from a single clinic in WA. We have diagnosed 18 cases in a 17 month period. Since November 2011
the M Clinic has diagnosed 50% of WAs MSM HIV cases. We started 2012 with an alarming 9 diagnoses in 9
Gay Men’s HIV Health Promotion Conference 2012 | 3
4. weeks – all of which were incident cases. WAAC has responded by teaming up with the Kirby Institute to
explore whether this recent surge in HIV infections is due to changes in risk behaviour and/or testing
behaviours – of interest we are keen to establish the role of the community or peer model in identifying this
high case load.
As a part of the research, the Department of Health provided an analysis of all MSM HIV infections in WA
between 1 July 2012 and March 31 2012. One conclusion relates to the reasons for testing:
Newly diagnosed MSMs were more likely to test at the M Clinic than any other setting
because of risky behaviour – suggesting that the men preferred to talk to a peer about their
behaviour.
It is also the goal of peer educators to create a positive spin to get people into an appropriate testing
regime. Being members of the community helps peer educators to appeal to client’s sense of altruism and
to contribute to community and public health outcomes.
Peers are also involved in developing appropriate social marketing concepts which aim to influence
normative testing behaviour. Peers use their understanding of their community to develop messages that
promote the benefits of testing with a view to changing their views of testing norms.
Anecdotal evidence and feedback some clients suggests they see it as a ‘badge of honour’ to test regularly
and contribute to the community good.
In summary, the peer model is an empowering approach in and of itself, which translates to the community
in a positive way. A peer lead service speaks volumes to the clientele.
The M Clinic has attracted strong support from the community and is generating excellent yields. At the
moment we are participating in several research projects (Namely the WA Sexual Health Services Survey
being conducted by the Kirby Institute), that will potentially validate the effectiveness of the
community/peer model. In the mean time I will be bold to say I believe the peer model works (biased
much). However, I am not claiming we have found the panacea for testing and am quick to say that I also
believe the model does not suit everyone.
It would be convenient for service providers if gay men were a homogenous group and we could develop a
one‐size‐fits‐all service. I don’t believe this is possible. One thing WAAC has learnt over the years is there are
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