Web based, standardized IT system enabled the hospitals of Turkey transferring medical supplies which are unneeded and exceeded. Policy implementations in hospital level resulted significant savings in national level. This study presents system, results and conclusions.
Turkey Health System is presented with various aspects and with last 10 years focus. Transformations, developments and amendments are the main topic. Graphs, data and charts are used to demonstrate the changes.
The study on social impact of free health service in Sri LankaRavi Kumudesh
Study on social impact of free health service in Sri Lanka
Ravi Kumudesh(kumudeshr@gmail.com)
Statistical data and the sense of community show a gap of total health expenditure and public health expenditure. This gap shows the problem of sustainability of free health and has created several problems on patients who visit the government hospital for their healthcare needs and health development in community.
This study is focused to clear out the disparity of the health policy by identifying the obstacles to obtain free healthcare facilities from state sector healthcare institutions, and to clarify evidently the circulation of additional amount of money in health service other than public health expenditure creating problems of free health service.
Questioner was the instrument used in primary data collection. Responses were analyzed with income levels. Availability of hospital facilities, mode of spending, utility of private and government health facilities, aptitude on current health trends and prevention healthcare were surveyed. Secondary data analysis also carried out based on WHO reports, reports of Ministry of Health and other international reports.
Primary data indicated inadequate facilities in state hospitals. Out of admitted patients 72% were requested some drugs and laboratory tests from outside. Every respondent spends some amount of money monthly for their health needs, even among low income levels. Only 21% was alert on preventive health care. Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. It includes both people with high income levels as well as low income levels. Secondary data analysis could justify the present situation of the country health. Public health expenditure share of total health expenditure is always less than 50%.
The research realized that all income levels utilize private sector for their health care needs. Most of people who utilize the private sector pay their bills out of pocket. These evidences show the disparity of free health policy and the nature of persisting health care service. Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service.
HealthCare System in Thailand:Past -
Present and Where is the Future ?
Dr. Pradit Sintavanarong
Minister of Ministry of Public Health, Thailand
ริชมอนด์ 11-10-56
Turkey Health System is presented with various aspects and with last 10 years focus. Transformations, developments and amendments are the main topic. Graphs, data and charts are used to demonstrate the changes.
The study on social impact of free health service in Sri LankaRavi Kumudesh
Study on social impact of free health service in Sri Lanka
Ravi Kumudesh(kumudeshr@gmail.com)
Statistical data and the sense of community show a gap of total health expenditure and public health expenditure. This gap shows the problem of sustainability of free health and has created several problems on patients who visit the government hospital for their healthcare needs and health development in community.
This study is focused to clear out the disparity of the health policy by identifying the obstacles to obtain free healthcare facilities from state sector healthcare institutions, and to clarify evidently the circulation of additional amount of money in health service other than public health expenditure creating problems of free health service.
Questioner was the instrument used in primary data collection. Responses were analyzed with income levels. Availability of hospital facilities, mode of spending, utility of private and government health facilities, aptitude on current health trends and prevention healthcare were surveyed. Secondary data analysis also carried out based on WHO reports, reports of Ministry of Health and other international reports.
Primary data indicated inadequate facilities in state hospitals. Out of admitted patients 72% were requested some drugs and laboratory tests from outside. Every respondent spends some amount of money monthly for their health needs, even among low income levels. Only 21% was alert on preventive health care. Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. It includes both people with high income levels as well as low income levels. Secondary data analysis could justify the present situation of the country health. Public health expenditure share of total health expenditure is always less than 50%.
The research realized that all income levels utilize private sector for their health care needs. Most of people who utilize the private sector pay their bills out of pocket. These evidences show the disparity of free health policy and the nature of persisting health care service. Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service.
HealthCare System in Thailand:Past -
Present and Where is the Future ?
Dr. Pradit Sintavanarong
Minister of Ministry of Public Health, Thailand
ริชมอนด์ 11-10-56
150217 mapping of health financing schemes rwanda_2014Alex Hakuzimana
A dissertation in partial fulfillment of requirements for my degree of Master of Science in Public Health at the Institute of Tropical Medicine (ITM) of Antwerp during the 2013/2014 academic year
Determinants and Impact of Household's Out-Of–Pocket Healthcare Expenditure i...Economic Research Forum
Ebaidalla Mahjoub Ebaidalla - University of Khartoum
Mohammed Elhaj Mustafa - University of Kassala
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Health care in Turkey consists of a mix of public and private health services. Turkey has universal health care under its Universal Health Insurance (Genel Sağlık Sigortası) system. Under this system, all residents registered with the Social Security Institution (SGK) can receive medical treatment free of charge in hospitals contracted to the SGK
Occupational health and primary health care in ThailandHealth and Labour
Presentation by dr. Siriruttanapruk from the ministry of public health of Thailand at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Presentation for Conference Opportunity Arabia 10 in Manchester on October 4th 2013. This presentation outlines the health care sector in the Kingdom of Saudi Arabia and business opportunities there.
Facts & Figures for Healthcare Market in Thailand. Including information on the universal healthcare program, hospitals segment, key trends to impact hospital sector, five force analysis for private hospital, drug market value and medical device market value.
Vibrant Gujarat Summit Profile on Healthcare Sector investmentVibrant Gujarat
To be the network of finest public healthcare institutions in the state of Gujarat, providing quality medical care services with the state of the art technology with easy accessibility, affordability & equity to the people of Gujarat & beyond.
Medical services are meant for curative care via diagnosis and treatment. Medical Relief services mainly are centred in the urban areas of the state and are delivered through the following hospitals, which are the leading hospitals at the district and State Infrastructure hospitals, the sub‐district level for all the districts.
Improving Efficiency to Achieve Health System Goals in Botswana: Background P...HFG Project
Health outcomes have improved in Botswana over the last few decades. These successes have come at the same time as overall macroeconomic growth, with annual Gross Domestic Product (GDP) growth averaging around 6 percent between 2010 and 2015 (IMF 2015), and Human Development Index ranking above the regional average. These improvements originate in a strong health service delivery system. In 2008, Botswana’s public health system included 338 health posts and 277 health clinics, sufficient to ensure that at least 80 percent of the population has coverage of essential, high-impact services. Management of these services was initially done by the Ministry of Local Government but has been transferred to district health teams under the Ministry of Health (MOH). As of 2008, Botswana’s public health system also had 17 primary hospitals, 14 district hospitals, two referral hospitals, and one mental health hospital; these hospitals are managed by the central government.
This is an assignment for ITTP Special Topic in IT Engineering. Within this presentation, I try to propose e-health as term project.
E-health is important for Indonesia.
Aami hitech mu impact on the future on HC ITAmy Stowers
Relate the components of The HITECH Act and Meaningful Use to health management technology
Identify whether existing systems meet requirements
Communicate technology needs and request feedback from end users for a smooth transition
Implement best practices to move people and systems forward under these new requirements
150217 mapping of health financing schemes rwanda_2014Alex Hakuzimana
A dissertation in partial fulfillment of requirements for my degree of Master of Science in Public Health at the Institute of Tropical Medicine (ITM) of Antwerp during the 2013/2014 academic year
Determinants and Impact of Household's Out-Of–Pocket Healthcare Expenditure i...Economic Research Forum
Ebaidalla Mahjoub Ebaidalla - University of Khartoum
Mohammed Elhaj Mustafa - University of Kassala
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Health care in Turkey consists of a mix of public and private health services. Turkey has universal health care under its Universal Health Insurance (Genel Sağlık Sigortası) system. Under this system, all residents registered with the Social Security Institution (SGK) can receive medical treatment free of charge in hospitals contracted to the SGK
Occupational health and primary health care in ThailandHealth and Labour
Presentation by dr. Siriruttanapruk from the ministry of public health of Thailand at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Presentation for Conference Opportunity Arabia 10 in Manchester on October 4th 2013. This presentation outlines the health care sector in the Kingdom of Saudi Arabia and business opportunities there.
Facts & Figures for Healthcare Market in Thailand. Including information on the universal healthcare program, hospitals segment, key trends to impact hospital sector, five force analysis for private hospital, drug market value and medical device market value.
Vibrant Gujarat Summit Profile on Healthcare Sector investmentVibrant Gujarat
To be the network of finest public healthcare institutions in the state of Gujarat, providing quality medical care services with the state of the art technology with easy accessibility, affordability & equity to the people of Gujarat & beyond.
Medical services are meant for curative care via diagnosis and treatment. Medical Relief services mainly are centred in the urban areas of the state and are delivered through the following hospitals, which are the leading hospitals at the district and State Infrastructure hospitals, the sub‐district level for all the districts.
Improving Efficiency to Achieve Health System Goals in Botswana: Background P...HFG Project
Health outcomes have improved in Botswana over the last few decades. These successes have come at the same time as overall macroeconomic growth, with annual Gross Domestic Product (GDP) growth averaging around 6 percent between 2010 and 2015 (IMF 2015), and Human Development Index ranking above the regional average. These improvements originate in a strong health service delivery system. In 2008, Botswana’s public health system included 338 health posts and 277 health clinics, sufficient to ensure that at least 80 percent of the population has coverage of essential, high-impact services. Management of these services was initially done by the Ministry of Local Government but has been transferred to district health teams under the Ministry of Health (MOH). As of 2008, Botswana’s public health system also had 17 primary hospitals, 14 district hospitals, two referral hospitals, and one mental health hospital; these hospitals are managed by the central government.
This is an assignment for ITTP Special Topic in IT Engineering. Within this presentation, I try to propose e-health as term project.
E-health is important for Indonesia.
Aami hitech mu impact on the future on HC ITAmy Stowers
Relate the components of The HITECH Act and Meaningful Use to health management technology
Identify whether existing systems meet requirements
Communicate technology needs and request feedback from end users for a smooth transition
Implement best practices to move people and systems forward under these new requirements
AAMI_HITECH MU: Impact on the Future of HC ITAmy Stowers
Relate the components of The HITECH Act and Meaningful Use to health management technology
Identify whether existing systems meet requirements
Communicate technology needs and request feedback from end users for a smooth transition
Implement best practices to move people and systems forward under these new requirements
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
Kalite iyileştirmeyi sürekli hale getirmek, hedeflerle girdiler ve liderlik arasında bağlar ve etkileşimler oluşturmak için kalite iyileştirme sistemlerine ihtiyacımız var.
Hastanelerimize özgü kalite iyileştirme sistemleri oluşturmak için yol haritaları ve stratejiler belirlemeliyiz.
Uyarlanabilir öğretim ve alıştırma ortamlarının, değişik öğretim durumlarına uyum sağlayabilmesi ve farklı öğretim stratejilerinin kullanılabildiği bir yapıda olması gerekmektedir. Bilgisayar destekli öğretimin, değişen öğretim durumlarına kolay ve hızlı biçimde uyarlanabilen uygun bir öğretim tasarım kuramı ile tasarlanması, bu tür öğretim ortamlarının etkililiğini artıracaktır. Bundan dolayı bu araştırma, Öğretim Etkinlikleri Kuramı’na göre tasarlanan öğretim yazılımı ile öğrenme stillerine uyarlanabilen alıştırma yazılımının öğrencilerin akademik başarısına olan etkilerini ortaya koymak amacıyla yapılmıştır.
İlker Sezer Tezi 2011 Uyarlanabilir Uyarlanır Hipermedya e-öğrenmeMustafa Said YILDIZ
Bu araştırma kapsamında uyarlanır hipermedya tasarımının genel özellikleri sunulmuş ve güncel bazı uyarlanır hipermedya geliştirilme modelleri incelenmiştir. Ayrıca, uyarlanır ve uyarlanabilir hipermedya sistemleri avantaj ve dezavantajları karşılaştırılmıştır. Bu karşılaştırma sonucuna göre uyarlanır hipermedya sistemleri ile geleneksel uyarlanabilir hipermedya uygulamalarının olumlu yönlerini birleştiren faydalı bir metot ortaya koymaya yönelik örnek bir uygulama geliştirilmiştir. Bu uygulamada uyarlanır hipermedyaların en fazla uygulama alanı buldukları eğitsel uyarlanır hipermedya sistemi ve eğitim konusu olarak da yabancı dil (İngilizce) eğitimi seçilmiştir. Geliştirilen uygulama yabancı dil eğitiminde bazı dilbilgisi konularının öğrenilmesine destek sağlamaktadır.
Bir doktora tezi olan bu çalışma, matematik öğretiminde sözel
matematik problemlerini kişiselleştirmenin öğrenci başarısına etkisinin olup olmadığını, (varsa) bu etkinin bilgisayar ve sınıf ortamına göre değişip
değişmediğini belirlemek amacıyla yapılmış bir araştırmadır. Araştırma 2006-2007 Öğretim Yılında, dört alt gruptan (Bilgisayar Ortamında Kişiselleştirilmiş, Bilgisayar Ortamında Kişiselleştirilmemiş, Sınıf Ortamında Kişiselleştirilmiş ve Sınıf Ortamında Kişiselleştirilmemiş) oluşan 90 ilköğretim yedinci sınıf öğrencisi üzerinde gerçekleştirilmiştir. Deneysel işlem öncesinde öğrencilerin başarısı üzerinde etkisi olabileceği düşünülen matematiğe yönelik tutum ve bilgisayara yönelik tutumları birer ölçek ile öğrencilerin önbilgileri ise bir bilgi testi (KR20= .82) kullanılarak belirlenmiştir. “Harfli ifadeler” konusunun işlendiği derslerde sözel problemlerden oluşan öğretim materyalleri kullanılmıştır. Sınıf ortamında yapılan öğretim uygulamasında basılı materyaller aracılığı ile kişiselleştirilmiş ve kişiselleştirilmemiş problemler kullanılmıştır. Bilgisayar ortamında yapılan uygulamada ise öğrencilerin bir web sitesinden erişebildiği kişiselleştirilmiş ve kişiselleştirilmemiş problemler
kullanılmıştır. Deneysel işlem iki hafta (sekiz ders saati) sürdürülmüştür.
Deneysel işlem sonrasında öğrencilere ön teste paralel bir bilgi testi (KR20=.83) son test olarak uygulanmıştır. Araştırma amaçları doğrultusunda başarı değişkeni ile ilgili verilerin çözümlenmesinde tek faktör için tekrarlı ölçümler için ANOVA testi, matematiğe ve bilgisayara yönelik tutumların analizi amacıyla ise verilerin durumuna göre ilişkisiz ölçümler için ANOVA testi ya da Kruskal Wallis H Testi uygulanmıştır.
Araştırma bulguları grubun bütünü itibariyle öğrencilerin ön test – son test puan ortalamaları arasındaki farkın anlamlı olduğunu, buna karşılık kişiselleştirilmiş ve kişiselleştirilmemiş materyali kullanan öğrenci gruplarının son test puanları arasındaki fark ile bilgisayar ve sınıf ortamında öğrenim gören grupların son test puanları arasındaki farkların anlamlı olmadığını göstermiştir. Başka bir deyişle ve kendi sınırlılıkları içinde bu araştırma kişiselleştirme ve ortam değişkenlerinin öğrenci başarısı üzerinde etkili olmadığını ortaya koymuştur.
Yalın yönetime dönüşüm için adımlar ve hastanelerde yalın yönetim sistemi'nin bazı uygulamalarına yer verilen sunum CNR HealthExpo Kasım 2016'da sunuldu. Kaynak Thedacare white paper'lar
Evde Sağlık Hizmetlerinde Kalite, Kanada, ABD, İngiltere ve Avustralya'dan yapı, metodoloji, kullanılan indikatörler ve kalite boyutları çerçevesinde örneklerle sunulmuştur.
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.
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.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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
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
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
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.
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
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. Content
•
•
•
•
•
•
•
Turkey and health status indicators
Turkey Health System and reforms
Increase in health expenditure
CRMS (Centralized Resource Management System)
Case Study : Two problems, solutions and effects
Contribution of IT system to implementation
Conclusion
3. Turkey at a glance
Population 2013:
75,627,384
Population Growth Rate:
1.3%
Area total:
302,535 sq mi
Density:
239.8/sq mi
GDP(PPP) per capita:
$15,001
HDI(2013):
0.722 (high)
Growth Rate (2010):
9.5%
Inflation Rate:
7.4%
Unemployment Rate: (2012)
9.2%
4. The Health Transformation
Program
• Started (2003),
• Health reforms by Ministry of Health (MoH)
• Objectives: to increase access to healthcare
services and to improve efficiency.
• Triggered administrative and financial
reforms.
5. Life expectancy at birth
Predicted by WHO for Turkey by 2025
(WHO report of 1998)
Average 75
Achieved by Turkey 2011
Female 76.8, Male 71.8.
Maternal Mortality Rate
a decline by 75%
Infant Mortality Rate
(per 100,000 live births)
a decline by 79%
2003
61
47
2011
14.5
9.9
Per 100,000 live births
6.
7. Some quotes on success
•
Health Transformation Program
seems to represent “good
practice” in the development
and implementation of major
health system reforms and
preliminary indications are that
it has been successful. (OECD
report, 2010)
•
“Based on the overall information
available from the latest national
health accounts and Household
Budget Surveys, it appears that the
Turkish health system performs quite
well in terms of equity and financial
protection, both in absolute terms and
relative to other countries.” (OECD
Review of Health Systems Report)
The lessons from Turkey are that with political commitment and a flexible,
results oriented approach, Health Systems Strengthening interventions can
be successfully implemented to have an important impact on the
performance of the health sector. (World Bank Report, Sarbani Chakraborty
Lessons from the Turkish Experience, Dec 2009, Volume 12)
8. • Turkey and health status indicators
• Turkey Health System and reforms
•
•
•
•
•
Increase in health expenditure
CRMS (Centralized Resource Management System)
Case Study : Two problems, solutions and effects
Contribution of IT system to implementation
Conclusion
9. Before Reforms
Dispersed and fragmented Social
Security and Hospital Systems
Bag-Kur (1971)
Social Insurance Agency of Self- Self-employed
employed - SISE
SSK (1946)
Social Security Association –
SSA
Blue Collar workers
Emekli Sandigi (1950)
Pension Fund for Civil Servants
– PCS
Civil Servants
Yesil Kart (1992)
Green-Card
(uninsured people)
10. Before Reforms
Dispersed and fragmented social
security and hospital system
SSA Hospitals
SSA Hospitals
SISE
patient
SSA
patients
PCS
PCS
patients
patients
Military
patients
Limited
number
of patient
MoH Hospitals
MoH Hospitals
University
Hospitals
Military
Hospitals
Private
Hospitals
11. Unification of dispersed and fragmented social security
system
All social security institutions
united under SSI (2005),
General Health Insurance could
be created.
Green Card as an instrument of
Social Policy covered needy and
uninsured people from
catastrophic health expenditures.
GC
12. Unification of Public Hospitals
Ownership of all
SSA’s hospitals were
transferred to the
MoH. Hence, with
this final step
unification process of
the reform has been
completed. (law: 5502)
13. After Reforms
All patient groups that are covered by
General Health Insurance could get service
from either MoH, university or private
hospitals
Civil servants are allowed to
benefit from private health
institutions. (Protocol signed
between MoH and the Ministry
of Finance, (April 2003)
A protocol signed that enables
Members of SISE, PCS and GC to
benefit from SSA hospitals, and
members of SSA to benefit from
MoH (public) hospitals. (July
2003)
General Health Insurance could
be implemented for all citizens
by January 2012
MoH
MoH
Hospitals
Hospitals
All patient
groups with
General
Health
Insurance
University
Hospitals
witit
wh
hcco
o-pp
- aa
yym
mee
nnt
t
Military
Hospitals
Private
Hospitals
14. • Turkey and health status indicators
• Turkey Health System and reforms
• Increase in health expenditure
•
•
•
•
CRMS (Centralized Resource Management System)
Case Study : Two problems, solutions and effects
Contribution of IT system to implementation
Conclusion
15. Total health expenditure (% of) GDP
6.1
7
6
5
4
3
2.4
2.4
2
1
0
1980
1985
1990
1995
2000
2005
2007
2008
16. Health Expenditure in Turkey
Investments
Investments
%9
%9
Other
Other
%51
%51
Turkey Statistics Institute Bulletin, Number: 34, February 18, 2011,
Hospitals
Hospitals
%40
%40
17. Ownership status by hospital beds
2011
Private
% 17
2004
University
% 19
MoH
% 64
18. Number of beds (2011)
Private
Private
%17
%17
University
University
% 19
% 19
MoH
MoH
%64
%64
19. • Turkey and health status indicators
• Turkey Health System and reforms
• Increase in health expenditure
• CRMS (Centralized Resource Man. System)
• Case Study : Two problems, solutions and effects
• Contribution of IT system to implementation
• Conclusion
21. Interconnected IT systems
(Stocks-Accounting-Human Resources)
CRMS is a resource
management system
which operates in
conjunction with 2 other
IT systems:
SAS - Uniform
Accounting System
HRMS -Human
Resources Management
System)
22. Reasons for initiating the CRMS
•• To transfer hospital records from manual to
To transfer hospital records from manual to
digital
digital
•• To build a central inventory management system
To build a central inventory management system
•• To standardize data entry for all hospitals
To standardize data entry for all hospitals
To assure
To assure
more reliable -more reliable
transparent
transparent
system
system
23. CRMS
Centralized Resource Management System
•
•
•
•
•
•
•
web based,
Integrates hospital IT systems;
centralized monitoring and control
policy making
in more than 1000 health facilities
by more than 7000 users
since 2009.
24. Advanced functions of
CRMS system
• Hospitals could make price inquiries before purchasing, could
learn about purchasing prices of other hospitals and their
providers
• MoH and hospitals had opportunity of making macro analysis
for hospital inventories,
• MoH and hospitals could plan inventories more accurately.
• MoH could implement macro policies more conveniently.
25. •
•
•
•
Turkey and health status indicators
Turkey Health System and reforms
Increase in health expenditure
CRMS (Centralized Resource Management System)
• Case Study : Two problems, solutions and effects
• Contribution of IT system to implementation
• Conclusion
26. INVENTORY PROBLEM-1 SOLUTIONS
High stock levels in the hospital
system in general
1. Controlling and managing
stock levels
2. Transferring to other
hospitals
29. Excess stock transfer process
Hospitals which
MoH regulation:
MoH regulation:
has excess stock
“Maximum stock in
“Maximum stock in
made
hospitals limited to the
hospitals limited to the
declaration by
need over three months”
need over three months”
system
Hospitals
made inquiry
before
purchasing
Hospitals
could access
each other’s
“excess
stock”
information
Transfer
between
hospitals
started
30. Stock level reached
maximum. Implementation
started
1200
Initial results
Stabilization of stock level
1000
800
600
million TL
400
First months. Sharp
decrease in stock level
200
0
Feb-08
May-08
Aug-08
Nov-08
Feb-09
May-09
33. Result #1: Amount of materials
transferred within system
Transfers of materials which exceeded maximum stock limit
2009
44,024,213 US $
2010
42,067,765 US $
2011
29,516,233 US $
2012
27,623,826 US $
2013 (first 9 months)
48,750,505 US $
Total
191,982,542 US $
35. Unneeded stock transfer process
MoH wanted health
MoH wanted health
facilities to share
facilities to share
information about their
information about their
supplies that are not
supplies that are not
needed
needed
Hospitals which
has unneeded
stock recorded
information to
system
Other
Hospitals
made inquiry
before
purchasing
Hospitals
could access
each other’s
“exceeding
stock”
information
Transfer
between
hospitals
started
36. Result #2: Amount of materials
transferred
Transfer of materials which are no more needed
2009
64,035,219 US $
2010
22,939,795 US $
2011
35,519,535 US $
2012
36,664,240 US $
2013 first 9 months
27,684,419 US $
Total
186,843,208 US $
37. •
•
•
•
•
Turkey and health status indicators
Turkey Health System and reforms
Increase in health expenditure
CRMS (Centralized Resource Management System)
Case Study : Two problems, solutions and effects
• Contribution of IT system to implementation
• Conclusion
38. How CRMS works?
Hospital records
information about their
unneeded or exceeded
stocks
Hospital which receives
the demand for its
materials call back in 5
days
Hospital which needs
material sends
request to other
hospitals which has
exceeded or
unneeded stock,
40. Unneeded and over stock materials can be monitored
by hospital and MoH
41. Hospital that needs material has to make an inquiry for
unneeded or over stock materials from other hospitals before
purchasing
42. Conclusions
• A reliable, standardized and central inventory system is
generated with integration of separate hospital systems.
• System enabled inventory planning, making analysis for
hospital inventories, implementing macro policies.
• Transferring unneeded and exceeded stocks between
hospitals was a macro policy implementation which became
possible with CRMS.
• This policy implementation reached its targets with efficient
use of system.
I’ll share a case study from Turkey about a system improve
I’ll start with some general information from Turkey. Turkey is a country with 75 million population, over 300 thousand square miles area and 15000 dollars GDP per capita. Growth rate is over 9 percent for several years with stabile inflation and unemployment rates below 10 percent in recent years.
When we start to speak about health system in Turkey, we need to say something about Health Transformation Program which is started in 2003. It aimed to increase access and improve efficiency. HTP implementation triggered administrative and financial reforms in Turkey which includes our case study.
Improvements in Health Status with some well-known indicators. Life expectancy which is predicted as 75 year by 2025 in World Health Organization Report is already achieved by 2011. Another important indicators accompanied this indicator. Maternal Mortality declined by 75 percent and Infant Mortality reduced by 79 percent only in 9 years.
This success became the subject of many international evaluation reports prepared by World Health Organization, World Bank and OECD experts.
Health System reforms are evaluated as “good practices” in terms of equity and financial protection. Political commitment and result oriented approach of Turkey government is praised to be a lesson for other country efforts
The most important characteristic(and also a problem) of hospital system before Health Transformation Program Reforms was its dispersed and fragmented nature. In insurance side, there were four different agencies for different facets of insurers.
These four agencies provided service to their insurance holders from different type of health facilities. Self employed people and blue collar workers were using Social Insurance Agency hospitals while civil servants using Ministry of Health Hospitals. Military patients to Military hospitals and limited number of patients to Private hospitals.
Two unification were made by reform. One for insurance side and the other for hospital ownerships side. First unification against that dispersed and fragmented structure was for insurance system. All social security institutions gathered united under General Health Insurance in 2005
In provider side, Social Security Institution hospitals joined to Ministry of Health and single umbrella covered public hospitals except Universities.
After reforms All patient groups which are recently covered by single insurance body (General Health Insurance) could get the healthcare service from either MoH, University, Military and Private Hospitals
During the reforms Total expenditure of health as a percentage of GDP escalated. It was still under the OECD average, but far high from the beginning of reform. From 2.4 to 6.1
At that point, when we look the components of health expenditure, we will see Hospitals’ share with 40 percent.
Dispersed characteristic of hospital system changed by years and by 2011 MoH hospitals dominated the sector.
By year 2011, 64 percent of hospitals were in MoH ownership, while Universities has 19, Private hospital has 17 percent. Hospital sector and particularly public hospitals which has the greatest share of health expenditure became the primer subject of policies, implementations and saving efforts.
Then we can say hospital has the biggest share in health expenditure and MoH hospitals has the biggest share in hospital sector. Savings in MoH hospitals matters.
----- Meeting Notes (2/23/14 11:51) -----
Hospitals has the biggest share in health expenditure
MoH hospitals has the biggest share in hospital sector
Saving in MoH hospitlas matters
Increasing health expenditure focused MoH’s efforts on cost containment policies.
Unification of public hospitals enabled interconnected IT systems.
Improvements in Hospital IT systems needed.
CRMS, SAS and HRMS were started in 2009.
This three IT systems are operated in interconnection for stocks, human resources and accounting in more than 800 hospitals and totally more than 1000 health facilities.
Reasons while generating CRMS were shifting to standardized digital recording, integrating inventory management systems of hospitals and by that means reaching a reliable and transparent system.
CRMS is an integrated web based system which gives MoH the ability of monitoring, controlling and policy making over more than 1000 health facility inventory systems.
With advanced functions of CRMS, hospitals and MoH can make price inquiries, macro analysis and they could plan for future usage.
MoH could implement macro policies.
Two problems are determined and two solutions are enforced to solve them.
First problem was high stock levels in hospital inventories. Controlling the stock levels is adopted as policy
FIRST SECOND SOLUTIONS SEPARATE
Other problem was waste of the unused materials. We had needy hospitals use the unneeded materials and medicines of other hospitals
Hospitals obtains all of materials at the beginning of the fiscal year and takes over the stocking responsibility
Hospitals confronts with huge amounts of stocks.
That means increases in inventory costs (with large warehouses and expiration)
Solution was determined as controlling intakes (not to accept whole material in a single time) and fixing stock levels in a certain level)
MoH regulation: “Maximum stock in hospitals limited to the need over three months”
Hospitals which has excess stock made declaration by system
Hospitals made inquiry before purchasing
Hospitals could access each other’s “excess stock” information
Transfer between hospitals started
Stock amounts escalated until the start of implementation.
In first months of implementation a sharp decrease in stock levels could be monitored.
Then a stabilization period started.
In yearly basis for medical supplies we can see decreases and stabilization for stock level while total purchases are increasing
Data for medicines demonstrates a parallel tendency. Decrease in stock level while total purchase increases.
That means per capita decreases for either materials or medicines
Transfers made because if exceeded stocks is totally more than 190 million dollars in nearly 5 years
Hospitals had an unneeded stock problem.
Ineffective estimation of material needs, Diverse supply requests from physicians(physicians who don’t want to use material requested), High physician circulation rates. Unforeseeable changes in material usage
That was other source of waste and that unneeded stocks must be used before expiration.
Solution was determined as having other hospitals use unneeded stock before it goes to waste
MoH wanted 1004 health facilities to share information about their supplies that are not needed
Hospitals which has unneeded stock made declaration by system
Hospitals made inquiry before purchasing
Hospitals could access each other’s “excess stock” information
Transfer between hospitals started
Nearly after 5 years amounts of unneeded materials were totally 186 million dollars.
Hospital which receives the demand for its materials calls back in 5 days
Stock price, amount and other details are recorded to system.
Unneeded and exceeding materials and medicines can be monitored by other hospitals and MoH. Here unneeded stocks are orange, exceeding stocks are red labeled.
Hospitals has to make inquiry for other hospitals’ unneeded and exceeding stocks before they purchase
Hospital inventories are integrated with standardized central system.
System enabled planning, making analysis and implementing macro analysis.
Unneeded and exceeding stock transfer policy is made possible by contributions of CRMS