This document discusses Combat Stress, a veterans' mental health charity founded in 1919 to treat shell shock in World War 1 veterans. It provides 3 residential PTSD treatment services and community outreach teams. High numbers of veterans are unable to access PTSD treatment due to substance use issues, which are exacerbated by the role of alcohol in armed forces culture. Combat Stress works to fill this gap through funding from the National Lottery and LIBOR. The document also discusses the challenges veterans face with mental health issues, substance abuse, homelessness, and incarceration. It outlines Combat Stress' partnerships with various NHS and criminal justice organizations to provide case management and outreach to hard-to-reach veterans, especially those involved in the criminal
Some slides I put together about some differences between Reacts eco system and Angular2.
Hopefully you can use this information and links to help you decide what framework/ecosystem is best for you.
Some slides I put together about some differences between Reacts eco system and Angular2.
Hopefully you can use this information and links to help you decide what framework/ecosystem is best for you.
Inclusion health and lived experience, pop up uni, 3pm, 2 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Inclusion health and lived experience, pop up uni, 3pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Presented April 2016. A review of available health data on veterans living in North Central Texas (third largest population of veterans in the United States). Presentation includes data on veterans and mental health, substance abuse and sexual health outcomes. Also includes a review of comorbidities among veterans living with HIV, and a sample of evidence concerning the interrelationship between mental health and incarceration. Finally, a source for help - Veterans Coalition of North Central Texas as a resource for veterans and their families needing access to mental health services and a strong social support community.
iCAAD London 2019 - Clarinda Cuppage and Lou Lebentz - NUMBING THE PAIN: CHI...iCAADEvents
Childhood sexual abuse (CSA) has seemed at the forefront of many news items recently and increasingly out there in the public domain. The statistics quoted in the UK are 1 in 4 women and 1 in 6 men are survivors, higher in other countries such as the USA. Indeed, most of our addiction clients tend to present with underlying trauma, many as a result of CSA. So as clinicians and treatment providers how do we deal with this epidemic in terms of numbers and the resultant increased disclosures and presentations?
80% of the world’s population is denied access to morphine – while 20% consume almost all of it.
It is hard to think of a greater injustice that has largely arisen from the misunderstanding and fear of international drug policy
This is why IDHDP launched its campaign “Striving for equity in the treatment of pain.”
WHO CC for Training and Policy on Access to Pain Relief, India
Side Event - International Doctors for Healthier Drug Policies
Commission on Narcotics Drugs, UN, Vienna
Drug Treatment Systems in Russian Hospitals and Prisons: Inefficient and lack...IDHDP
Drug Treatment Systems in Russian Hospitals and Prisons: Inefficient and lacking in evidence
Prof. Vladimir Mendelevich, MD, PhD
Kazan State Medical University
Russian Federation
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.
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.
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 Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- 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
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
1. Dave Marsden, - Combat Stress,
Seconded from Newcastle, Tyneside
and Northumberland NHS
2. • Veterans’ Mental Health Charity
• Founded 1919 – WW1 Shell Shock
• 3 residential PTSD treatment services
• Community Outreach Teams (Welfare, Mental Health, Occupational
Therapy).
• High numbers unable to access PTSD (and other MH) treatment due
to substance use.
• Exacerbated by role of alcohol in the culture of the armed forces.
• How to fill that gap?
• National Lottery and LIBOR funding.
2
COMBAT STRESS
3. The Challenge in CJ work.
• Veterans are widely considered to be the largest
occupational group in the UK prison system.
• Estimates vary between 5 - 17% of the population
• Probation figures also patchy
• No clearly targeted/funded interventions (VIC etc)
– Home Office, HMIP and Forces in Mind Probation study
trying to clarify the situation.
• “The Veteran Question”
4. • In the Armed Forces, some 13% of those deployed to operations in Iraq
and Afghanistan are thought to suffer from significant alcohol disorders.
• More likely than the general public to be
– Homeless
– In prison
– Isolated
– Having undiagnosed mental health conditions, including PTSD
– Unaware of, or not engaged with services
– Poor transitional support historically
– Shame
– Identity challenges
– 12 years
4
The Challenge.
5. • Signpost Recovery-
Forth Valley
• Glasgow Addiction
Services NHS
• Newcastle,
Tyneside and
Northumberland
NHS
• Warrington-NHS
• St Helens
• Salford-NHS
• Trafford-NHS
• Lancashire-HMP
• Wiltshire-Turning
Point
• Portsmouth-NHS
and A&E
6. 6
Case Management not Treatment
• Assertive outreach and inreach
• Overcoming pride and stigma
• Advocacy
• Access to psychiatrists and psychologists
• Negotiating Pathways
• Raising Awareness of Veteran issues – getting them to
ask the question
• Hard to reach services, not hard to reach service users.
8. • One of the first pilots
• Drawing on my experience of the Tower Project in
Blackpool, but adapting the approach to veterans
• Equal focus on case management and awareness
raising/education/care pathway development
• Real Assertive Outreach – never give up.
• “Warrior Down” mentality
• Many veterans involved with the CJ system
8
Partnership with NNT NHS
9. • Build links with CJ Services
– Probation
– CRC’s
– Police
– Courts
– Prisons
• Attendance at Mappa
• More informed sentencing packages/sentence management
• The veteran question
• Increased attendance
• Less escalation
• Substance Misuse and MH improvements
• Prison based service
• Still a long way to go.
9
Criminal Justice work.
10. • Veteran on Licence and Public Protection Order
• Disengaged from Substance Misuse Services (opiate dependent and homeless)
• Discharged from I/P MH services (PTSD and Self Harm)
• Frequent non attender at probation – hence referral
• Engaged by our service
• Housed
• Reinstated by Substance Misuse – with considerable support
• Regular 4 way meetings at probation
• Engaged with Finchale College (Veteran specific)
• Escalation (and prison) avoided
• Re engaged with Services
• PTSD and MH issues being addressed
• Undertaking apprenticeship.
• Back in touch with family.
10
Case Study
Apologies from Dave
Overview
Combat Stress
The challenges
The Model
CJ application of the model
Case Study
60% of referrals for PTSD to Combat Stress as a whole include Alcohol or Drug Issues
How to solve the problem of non engagement of Veterans.
Where are there high concentrations of veterans within the UK?
What services are already established within these areas?
Which are the most suitable services to host specialist Nurses looking to engage Veterans?
At present we have 10 pilot sites covering a wide range of services across the UK.
In both city centre and Rural locations.
NHS addiction services
Third sector addiction services (Turning point, Signpost recovery).
A&E dept, hospital wards.
Prison
SA
Jigsaw. Breaking the Cycle. Meeting Veterans in the community. Places we go-football, community centres, hospitals.
Identify Veterans Champions in organisations-supported by AF Community Covenant
Healthcare-GPs, A&E, BBV services, Dentists, Needle exchange
Criminal justice-Police, prisons, Custody suites
Housing-hostel, local councils
Local community resources
Peer support
Veterans services
Veterans themselves
Families- 1st line of treatment, strong treatment allies
We do not discharge for non attendance/compliance – cant discharge people who present for a service demonstrating exactly the behaviours one would expect from someone with both PTSD and Alcohol dependence.
Isolation
Found it difficult to leave the house
Supported through this – support gradually tapering off as he engaged with other activities and support networks.
Not all one sided though – the veteran gained from our involvement – services gained from learning more about the specific issues veterans face and, from a personal perspective its………………………………………
