National Academies of Science and Medicine: Intertwined Epidemics: Opioid and...Dan Ciccarone
This presentation explores the current heroin overdose epidemic;how it evolved out of the prescription pill epidemic and how changes in heroin supply are creating regional differences in heroin overdose.
Daniel Blaney-Koen, American Medical Association, presented on The Nation's Opioid Epidemic: Are we Asking the Right Questions? at the State Legislative Conference on November 6, 2015.
National Academies of Science and Medicine: Intertwined Epidemics: Opioid and...Dan Ciccarone
This presentation explores the current heroin overdose epidemic;how it evolved out of the prescription pill epidemic and how changes in heroin supply are creating regional differences in heroin overdose.
Daniel Blaney-Koen, American Medical Association, presented on The Nation's Opioid Epidemic: Are we Asking the Right Questions? at the State Legislative Conference on November 6, 2015.
New Castle County police announced a new approach to fighting
the heroin epidemic with components of a similar strategy initiated
by police in Gloucester, Massachusetts.
Stop Selling Heroin is the creation of one individual, Christian Johnathan Hosford Jr. Upon returning to his hometown of Villas, NJ in 2013, Hosford was informed of the death of a high school friend that overdosed on heroin. The same evening, Hosford was informed that another friend of his was in a coma that was also the result of a heroin overdose. Outraged and hurt by his loss Hosford decided to take action against the NJ heroin epidemic. Hosford believes that the key to change is family and community. His idea is to approach Drug dealers and drug users through their friends and family members. By increasing awareness throughout Cape May County, Hosford hopes to encourage confidence and unity among the victims of heroin abuse, and to provide and connect them support groups and resources.
Implementing an electronic charting system in a healthcare facility, barriers to change, and organizational plan for change. speaker notes are indepth.
Looking for a solution to the workers' compensation opioid abuse? Check out Modern Medical's proactive program. Opioid Defense Manager™, protecting your employees, the physicians and you.
Using the 2011 Definition of Addiction of the American Society of Addiction Medicine as well as its historical roots, attendees will learn how addiction is not just about alcohol or other drugs, but it’s about brains; and how it’s not just about mesolimbic reward circuitry, but is about the role of other brain regions in the relationship that persons with addiction develop with sources of reward and relief.
National Drug Early Warning (NDEWS) webinar: A more dangerous heroin: Emergin...Dan Ciccarone
This presentation, to an international web audience, was presented alongside one by Dr Wilson Compton, Deputy Director of the National Institute on Drug Abuse. Sponsored by NDEWS, it explores the structural reasons for the emerging heroin overdose epidemic and ways to address it.
Join Mary Kirkwood, MD, psychiatrist, to learn more about addiction medicine and how Agnesian HealthCare is prepared to help the heroin epidemic in our county.
Hear from two recovering heroin addicts about their journey and how Agnesian HealthCare is supporting them on their path to recovery.
Intro to Prevention: Psychopharmacology Guest LectureJulie Hynes
Current A&D Conditions in lane County: And why we need prevention. Guest lecturer: Julie Hynes, MA, RD, CPS - PreventionLane at Lane County Public Health
An Essential Drug List, also known as a core drug list or medication list, is a carefully selected inventory of medications that are deemed essential for addressing the most prevalent health conditions within a specific population or country. It serves as a key component of national drug policies and pharmaceutical programs, ensuring the availability, accessibility, and affordability of essential medicines. The list is typically developed based on rigorous criteria, taking into consideration the medications' safety, efficacy, cost-effectiveness, and suitability for primary healthcare settings.
Rational Drug Therapy refers to the systematic and evidence-based approach to prescribing medications, aiming to maximize therapeutic benefits while minimizing the risk of adverse effects. It involves following established therapeutic guidelines and clinical protocols to ensure that medications are prescribed in a manner that is appropriate for the patient's condition, taking into account factors such as age, weight, co-existing conditions, drug interactions, and individual response. Rational drug therapy promotes the use of medications based on sound scientific evidence, emphasizing the principles of efficacy, safety, and cost-effectiveness to optimize patient outcomes and improve overall healthcare quality.
This presentation describes the objectives, approach and application of Drug Utilization studies in Pharmacotherapeutics. This emphasizes on how to conduct a drug utilization studies.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
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.
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
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.
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.
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.
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
CDC Initiatives & Priorities to Address the Prescription Drug Overdose Crisis by Grant Baldwin, PhD, MPH
1. Grant Baldwin, PhD, MPH
December 1, 2015
CDC Initiatives & Priorities to
Address the Prescription
Drug Overdose Crisis
National Center for Injury Prevention and Control
Division of Unintentional Injury Prevention
2. HHS Secretary’s Opioid Initiative
Focus on three priority areas that tackle the opioid crisis and significantly impact
those struggling with substance use disorders to help save lives
Providing training and educational resources
to assist health professionals in making
informed prescribing decisions
1
Increasing use of Naloxone
Expanding the use of Medication-Assisted
Treatment
2
3
3. Three Pillars of CDC’s Work
Improve data quality and track trends
Strengthen state efforts by scaling up effective public
health interventions
Supply healthcare providers with resources to
improve patient safety
4. Improving the quality & timeliness of opioid
overdose surveillance
WHAT WE’RE DOING
Generate near real-time surveillance of
emergency department visits related to drug
overdoses
Improve surveillance of EMS transports
related to drug overdoses
WHY WE’RE DOING IT
An early warning of large increases or
decreases of drug overdoses to better
target prevention efforts
Better understand changing demographic
patterns of drug overdoses
5. Prevention for States (PfS)
Provides states guidance and resources
to prevent prescription drug overdoses
by addressing problematic opioid
prescribing
Builds on the success of the Prevention
Boost – Funding Opportunity
16 states funded with average award
ranging from $750K to $1M
Funding to states with high burden and
readiness to act
Focus on high impact, data driven
activities and give states flexibility to
tailor their work
6. Expand or improve proactive PDMP reporting
Expand/maximize PDMPs as a surveillance system
Implement mandatory PDMP registration or use
Reduce PDMP data collection interval
Evaluate existing PDMP practices*
Enhance Patient Review and Restriction (PRR)
capacity
Enhance other health insurer/system practices*
Develop and apply metrics for inappropriate
prescribing
Identify high-risk groups among the insured
Conduct cost analyses
Identify effective benefit design strategies
Disseminate best practices info for insurers
Provide technical assistance to high burden
communities and counties*
Evaluate laws/policies/regulations implemented
in states, including their impact on heroin and
prescription drug abuse/overdose
Disseminate information on effective
laws/policies/regulations
Funding
Surveillance
expertise
TA on policy &
program
development
Evaluation
guidance
Dissemination
of best
practices
Short (1 year)
Policy/Program
Development
Medium (1−3 years)
Behavior Change
Authority to send proactive
reports
Mandatory registration & use
Reduced data collection interval
(e.g., real time reporting)
Increased use of standard PDMP
reports for surveillance and
other purposes
Long (3−5 years)
Health Outcomes
Increase enrollment in PRR
programs
Implemented robust drug
utilization review programs
Implemented enhanced drug
formularies
Revised policy on Medication
Assisted Treatment (MAT)
Evidence of effectiveness for
pain clinic laws
Evidence of effectiveness for
clinical guidelines/rules
Evidence of effectiveness for
licensure boards enforcement
policies and practices
Evidence of effectiveness for
immunity/naloxone laws
Increased use of PDMPs
Decreased rate of high-dose (>100
MME/day) opioid Rxs
Decreased rate of dangerous drug
combinations
Decreased prescribing patterns
inconsistent with guidelines/rules
Increased # of patients on MAT
Decreased use of methadone for
pain
Increased law enforcement and
licensure boards using PDMP data
Increased enforcement actions
against outlier providers
Decreased number of pill mills
Fewer drug diversion
cases
Increased opioid
substance abuse
treatment admissions
(ultimately want
decrease)
Improvement in
treatment of pain
Decreased drug
overdose death rate
Decreased rate of ED
visits due to controlled
prescription drugs
Decreased doctor shopping rate
Reduced barriers to seeking help
and responding with naloxone to
an overdose
Enhanced adoption of opioid
prescribing guidelines*
Increased number of patients
enrolled in PRR programs
Reduced number of providers and
MME/day among PRR enrollees
Increased use of claims reviews to
identify outlier providers
**High-Risk
Prescribing/
Patient
Behaviors
• High-dose opioids
(>100 MME/day)
• Multiple providers
• Co-prescribing of
opioids and
benzodiazepines
• Lack of access to
substance abuse
treatment
Enhance and Maximize PDMPs
Improve Insurer/Health System
Mechanisms
Evaluate Laws/Policies/Regulations
PDMPS
Insurers/Health Systems
Strengthened Evidence
Providers
Insurers/Health Systems
Oversight/Enforcement
LOGIC MODEL
Prescription Drug Overdose: Prevention for States and Prevention Boost*
Targeting High-Risk Prescribers and High-Risk Patients**
Patients
State-Level OutcomesOutputs/Strategies***Inputs
*These activities are being conducted through PFS only – all other
activities are conducted through both Boost and PFS.
***Through PFS, states can propose Rapid Response Projects that
break new ground in any of these areas.
7. Enhance and
Maximize
PDMPs
Community or
Health System
Interventions
State Policy
Evaluation
Rapid Response
Projects
Move toward universal PDMP
registration and use
Make PDMPs easier to use and
access
Move toward a real-time PDMP
Expand and improve proactive
reporting
Conduct public health
surveillance with PDMP
Implement or improve opioid prescribing
interventions for insurers, health systems,
or pharmacy benefit managers. This
includes:
Prior authorization,
prescribing rules, academic
detailing, CCPs, PRRs,
Enhance adoption of
opioid prescribing
guidelines
Allow states to move on quick,
flexible projects to respond to
changing circumstances on the
ground and move fast to
capitalize on new prevention
opportunities.
Build evidence base
for policy prevention
strategies that work
like pain clinic laws
and regulations, or
naloxone access
laws
Prevention for States Program
COMPONENTS
1 2
34
10. Process Used to Develop the Guidelines
GRADE Method
Multi-staged development with stakeholder input
Projected release in January 2016
11. Opioid Prescribing
Guideline
Intended for primary care
providers.
Will apply to patients >18
years old in chronic pain
outside of end-of-life care
Clinical Practices Addressed
in the Guidelines
Determining when to initiate or continue
opioids for chronic pain
Opioid selection, dosage, duration,
follow-up, and discontinuation
Assessing risk and addressing harms of
opioid use
12. Research priorities: Insurer, health system,
and pharmacy benefit manager strategies
Which insurance and pharmacy benefit
manager interventions change prescribing
behaviors most effectively (e.g., drug
utilization review, patient review and
restriction, prior authorization)?
Which of these interventions are most cost-
effective?
What are the effective ways that state public
health departments can engage insurers and
pharmacy benefit managers to foster adoption
of these interventions?
13. Research priorities: State policies and
strategies
What are the impacts of innovative, untested
policies and strategies at the state level?
Which PDMP strategies (e.g., mandatory
registration) enhance use and produce the
greatest impacts?
What are the cost implications and cost savings
of identified policy changes?
How can communications campaigns influence
physician opioid prescribing and patient opioid
use?
14. Research priorities: Risk and protective
factors for prescription drug and heroin mortality
How can PDMP, coroner, medical examiner,
and law enforcement data be used to identify
risk and protective factors for drug overdose?
What are the patterns of co-use of prescription
opioids and heroin, injection of opioids, and
overdose?
Does controlled substance prescribing,
including opioid pain reliever prescribing,
increase risk for heroin overdose?
15. Research priorities: Clinical practice
guidelines and coordinated care plans
What are the clinical decision support needs,
barriers, and effective approaches to
promoting guideline adherence in primary
care?
What factors facilitate adoption of coordinated
care plans in health systems?
What are the patient and health system
impacts of guideline, clinical decision support,
and coordinated care plan implementation?
http://www.cdc.gov/injury/researchpriorities/More Information:
16. For more information please contact Centers for
Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-
6348
E-mail: cdcinfo@cdc.gov Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not
necessarily represent the official position of the Centers for Disease Control
and Prevention.