Breakout 3.4 How to support the psychological needs of patients with COPD - Karen Heslop
Respiratory Nurse Consultant/NIHR Clinical Academic Research Fellow
RVI Newcastle upon Tyne
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Polyvagal theory case vingette (health-ptsd-microagressions)Michael Changaris
This slide deck explores a hypothetical clinical case through the lens of poly-vagal theory, micro-aggressions, somatic experiencing and neurodevelopment sequencing.
Relationship between heat in the head and goal frustrationinventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Polyvagal theory case vingette (health-ptsd-microagressions)Michael Changaris
This slide deck explores a hypothetical clinical case through the lens of poly-vagal theory, micro-aggressions, somatic experiencing and neurodevelopment sequencing.
Relationship between heat in the head and goal frustrationinventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Concept of Neurosis and Psychosis. Differences between these psychiatric disorders. It is an important topic for students belongs disciplines such as psychiatry, psychology, psychiatric nursing and psychiatric social work.
Post-Traumatic Stress Disorder: New and Alternative Treatment MethodsRichard Stephens
A presentation on new and alternative treatment methods for Post-Traumatic Stress Disorder with a brief overview of Post-Traumatic Stress Disorder and treatment as usual.
A critique of outcome research in psychotherapy, and a proposal that more weight should be put on the ability fo therapists and clients to continue in relationships for as long as therapy remains active and mutative
primary care management of the returning veteran with PTSDgreytigyr
primary care management of the returning veteran with PTSD Overview on issues and approach in promary care to recognition and management of patients, veterans, and soldiers with PTSD and TBI.
A growing access for cancer patients to seeking supportTanzil Al Gazmir
Being handed a cancer diagnosis is like taking a trip to a lonely planet. The psychological trauma can equal or exceed the physical pain the patient goes through. So many people have made varying attempts to show their support for victims of cancer and some time ago, Karen Marshall, a legal blogger wrote a post he captioned ‘Picking Your Support Team’.
Concept of Neurosis and Psychosis. Differences between these psychiatric disorders. It is an important topic for students belongs disciplines such as psychiatry, psychology, psychiatric nursing and psychiatric social work.
Post-Traumatic Stress Disorder: New and Alternative Treatment MethodsRichard Stephens
A presentation on new and alternative treatment methods for Post-Traumatic Stress Disorder with a brief overview of Post-Traumatic Stress Disorder and treatment as usual.
A critique of outcome research in psychotherapy, and a proposal that more weight should be put on the ability fo therapists and clients to continue in relationships for as long as therapy remains active and mutative
primary care management of the returning veteran with PTSDgreytigyr
primary care management of the returning veteran with PTSD Overview on issues and approach in promary care to recognition and management of patients, veterans, and soldiers with PTSD and TBI.
A growing access for cancer patients to seeking supportTanzil Al Gazmir
Being handed a cancer diagnosis is like taking a trip to a lonely planet. The psychological trauma can equal or exceed the physical pain the patient goes through. So many people have made varying attempts to show their support for victims of cancer and some time ago, Karen Marshall, a legal blogger wrote a post he captioned ‘Picking Your Support Team’.
This slideshow is a tour of Cancer Awakens - www.cancerawakens.com - showcasing how our site, newsletter and social media channels support the cancer community.
Heart rate variability and social dysfunctionDaniel Quintana
These are the slides from the presentation that I gave at the Australian Association for Cognitive Behavioral Therapy (AACBT) Conference in Queensland, Australia on the 17th of October, 2012.
Breakout 3.4 Asthma and psychological problems - Mike ThomasNHS Improvement
Breakout 3.4 Asthma and psychological problems - Mike Thomas
Professor of Primary Care Research, University of Southampton
Chief Medical Advisor, Asthma UK
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Chronic illness health psychologist Alison Wearden talks about how stress effects our health and our recovery from illness, and specialist physiotherapist Phil Langridge talks about breathlessness and what we can do to control it.
Graham Atherton discusses gardening for those with allergies, the signs of heart disorder to be aware of if you are taking itraconazole and advice on travel.
EVERYTHING YOU NEED TO KNOW ABOUT ANXIETYsneharathod39
An example of a mental health condition is an anxiety disorder. It is difficult to get through your day when you are anxious. Feelings of anxiety, panic, and fear, as well as sweating and a rapid heartbeat, are symptoms. Medication, hypnotherapy, and cognitive behavioral therapy are three options for treatment. The best treatment plan for you can be created by your healthcare provider.
Breakout 4.5 Preventing Oxygen Toxicity: a whole system approach - Prof Tony ...NHS Improvement
Breakout 4.5 Preventing Oxygen Toxicity: a whole system approach - Prof Tony Davison
Co-Respiratory Lead East of England
Co-Chair and Co-author BTS Emergency Oxygen Guideline
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4.4 End of Life Care in Respiratory Disease ~ What we did in Solihul...NHS Improvement
Breakout 4.4 End of Life Care in Respiratory Disease ~ What we did in Solihull Sandy Walmsley, Helen Meehan Solihull Community Services Joint Respiratory Clinical Leads
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4.3 Building a caring future - Liz NormanNHS Improvement
Breakout 4.3 Building a caring future - Liz Norman
Lung Improvement Programme – Transforming Acute Care Senior Respiratory Nurse Specialist
NHS London Respiratory Team Lead
Consultant Respiratory Physician, Whittington Health & NHS Islington
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4.3 How to manage… exacerbations of COPD, asthma and… in hospital - ...NHS Improvement
Breakout 4.3 How to manage… exacerbations of COPD, asthma and… in hospital - Delivering high value integrated care with KREDIT? Dr Louise Restrick
NHS London Respiratory Team Lead
Consultant Respiratory Physician, Whittington Health & NHS Islington
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4.2 Optimise not maximise for better value COPD and asthma care - No...NHS Improvement
Breakout 4.2 Optimise not maximise for better value COPD and asthma care - Noel Baxter
Co-lead NHS London Respiratory Team
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and a...NHS Improvement
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and asthma clinic - Clare Watson
Medicines Management Pharmacist (NHS Hampshire)
Independent Prescriber (Victoria Practice, Aldershot)
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 4.1 Finding the missing millions - David HalpinNHS Improvement
Breakout 4.1 Finding the missing millions - David Halpin
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 3.5 ‘Dying for a fag’ The hypoxic patient actively smoking – case st...NHS Improvement
Breakout 3.5 ‘Dying for a fag’ The hypoxic patient actively smoking – case study - Sue Smith
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 3.3 Achieving Excellence Across Primary & Secondary Care - Sarah Kea...NHS Improvement
Breakout 3.3 Achieving Excellence Across Primary & Secondary Care - Sarah Kearney
BLF Respiratory Nurse - Isle of Wight Respiratory Clinical Network
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 3.3 Pro-active management - Stephen GaduzoNHS Improvement
Breakout 3.3 Pro-active management - Stephen Gaduzo
GP, Stockport
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 3.2 Managing Multimorbidity in Practice - Dr Kevin Gruffydd-JonesNHS Improvement
Breakout 3.2 Managing Multimorbidity in Practice - Dr Kevin Gruffydd-Jones
Box Surgery Wilts
Member PCRS(UK)
Respiratory Lead RCGP
Member of NICE COPD
Guidelines Committee and
Asthma/COPD Clinical
Standards Committees
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 3.1 How to…… Diagnose earlier and accurately: spirometry and history...NHS Improvement
Breakout 3.1 How to…… Diagnose earlier and accurately: spirometry and history taking - Chris Loveridge
Respiratory Practice Nurse Spirometry Clinical Lead
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
Breakout 2.5 Service improvement for everyone - Catherine BlackabyNHS Improvement
Breakout 2.5 Service improvement for everyone - Catherine Blackaby
National Improvement Lead
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
Follow us on: Pinterest
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
Breakout 3.4 How to support the psychological needs of patients with COPD - Karen Heslop
1. How to support the psychological needs
of patients with COPD
Karen Heslop MSc PGD in CBT BSc (Hons)
Respiratory Nurse Consultant/NIHR Clinical Academic Research Fellow
RVI Newcastle upon Tyne
The Newcastle upon Tyne
Hospital NHS Trust
Introduction
Umbrella term for chronic bronchitis and emphysema
Affects over 3 million people in UK
30,000 deaths per year
Costly (£1 billion on health care costs)
Morbidity and suffering – patients and families
1
2. Burden of COPD
“When I can’t get my breath I think I am going to
die”
“I thought it was my last breath”
“I can walk about 5 yards. Sometimes I just sit &
cry…you get depressed… anyone would”.
“In the past I had a gun at home during the
amnesty I handed it in. If I still had it, I would
have considered shooting myself as I get very
depressed”
Copyright K Heslop 18/02/2013
Psychological Difficulties in COPD
Higher rates of anxiety symptoms than those with cancer,
heart failure or other medical conditions
Poorer survival
Health care utilization
Longer hospitalisation
Persistent smoking
Increased symptoms
Poorer physical and social functioning
Excessive use of medication (Ng, 2007)
Decline rehabilitation (Angle & Baum, 1997)
18/02/2013
2
3. Anxiety & Panic in COPD
38 % Anxiety symptoms (NICE, 2010)
60% in Newcastle
Higher than with cancer, heart failure or other medical
conditions
Catastrophic thoughts & impending danger.
Often unrecognised and untreated.
Mistaken from worsening COPD.
Significant predictor of the frequency of hospital admissions
for acute exacerbations of COPD (Yohannes, 2000).
Copyright K Heslop 18/02/2013
Depression
Absence of positive affect (loss of interest & enjoyment in ordinary things &
experiences) & low mood
2-3 times more common in patients with chronic illnesses such as COPD
40% of patients.
Chronic physical health can cause and exacerbate depression
Patients tend to present with physical symptoms e.g. pain
Attention shifts to physical health problem & depression may be overlooked
Only a minority of patients discuss psychological problems (9% WHO, 1995)
Treatment helps improve quality of life and life expectancy
(NICE 2009)
18/02/2013
3
4. Treatment of Anxiety & Depression (NICE, 2011, 2009)
Specialist
review
High intensity
psychological interventions
Combined treatments
Referral if needed
Low intensity psychological interventions
Combined treatments (moderate)
Referral if needed
Screening, Assessment, support, psycho-education,
active monitoring, physical exercise programme , peer
support, referral if needed
Treatment of anxiety & depression
Self help – written information based on CBT principles
e.g. NTW Mental Health Trust leaflets on Anxiety &
Panic attacks
Exercise
Pulmonary rehabilitation
CBT
Pharmacological treatment if moderate to severe
More research
4
5. What is Cognitive Behaviour Therapy?
A psychological intervention - usually short term
Concentrates on the current difficulties
Problem and solution focused
Techniques directed at developing a shared
understanding of problem
It’s about change
Not suitable for everyone
Assessing What’s Happening
Environment/Trigger
Physical
Behaviour Thoughts
Feelings
Past experience - assumptions, attitudes, past learning
18/02/2013
5
6. Techniques
Case Study
68 Year old Male
Severe COPD
Ex –smoker
Previous coal miner
Very anxious
Main difficulties SOB & panic attacks
Declined pulmonary rehabilitation
Very supportive family
BAI 63 BDI 10
Copyright K Heslop 18/02/2013
6
7. Hot Cross Bun
Situation
Activity or thoughts
Physical
SOB +++, Sweating, heart races Thoughts
Behaviour
I’m going to die
This is my last breath
Avoids activity if pos
Sits down
Turns on Fan
Shouts for wife for support
Emotions
Frightened
Guilty
Anxious (BAI 63)
Copyright K Heslop
Depressed (BDI 10) 18/02/2013
Treatment
Education re COPD/panic attacks/depression
Strategies :–
planning & pacing activities
distraction
breathing control
activity diary
problem solving
Follow up by telephone in 4 weeks!
Copyright K Heslop 18/02/2013
7
8. Outcome
BAI 0 / BDI 0
Never felt better
Breathing better
Plans things
Doing more physical activity & going out more
Feels more positive
Learnt a lot in last 4 weeks
No relapse 3 years later
PhD Research Study
Anxiety &Thoughts
Breathless Panic
Frightening
Depression
Reduced Respiratory
Anxiety
/Panic
Anxiety
Activity
Depression
Cycle
Training
Hospital Admissions Quality of Life
The Newcastle upon Tyne
Karen Heslop 21/9/2010 Hospital NHS Foundation Trust
8