The document outlines the preliminary agenda for a Latin American expert consensus meeting on neuropathic pain management. The 2-day meeting will involve experts discussing neuropathic pain
This document provides an agenda and information for an education conference that includes discussions on changing learning and students, essential elements of 21st century learning, and exploring a learning department website to find resources related to the conference topics and deadlines.
This slidedeck was presented during the Europeand Honeywell User group in november 2015. It oulines the approach and factors in deploying cloud solutions in a metals and mining company. Traditionally this industry has a slow adoption of new technologies and cloud services
The first piece of marketing collateral produced under Renovation Concepts exciting new brand.
A great resource for home owners and buyers looking to give their properties a facelift and looking for interior design ideas.
Petacular Pouts is an online pet boutique that sells customer favorite pet products. The website www.petacularboutique.com offers pet owners a selection of pet items that have proven popular with other customers. The document promotes the pet boutique and its customer recommended products available for purchase on its website.
El documento describe el proceso de recepción del sonido por el oído. Las vibraciones del aire pasan por el conducto auditivo y hacen vibrar el tímpano, transmitiendo la vibración a los huesos del oído medio. Luego pasa a los fluidos del oído interno, generando ondas de presión que activan los pelos ciliares y envían impulsos nerviosos al cerebro, donde se percibe el sonido.
Data collection and interpretation SBL1023SHAKINAZ DESA
This document provides information on data collection, analysis, interpretation, and presentation for experimental reports. It discusses analyzing data using relevant software, interpreting experimental results, discussing limitations, and using graphical and written formats to present findings. Key points include using analysis to describe, summarize, identify relationships and differences between variables, and forecast outcomes, as well as interpreting results by determining what was learned, expected, and surprising in order to draw conclusions.
This document provides an agenda and information for an education conference that includes discussions on changing learning and students, essential elements of 21st century learning, and exploring a learning department website to find resources related to the conference topics and deadlines.
This slidedeck was presented during the Europeand Honeywell User group in november 2015. It oulines the approach and factors in deploying cloud solutions in a metals and mining company. Traditionally this industry has a slow adoption of new technologies and cloud services
The first piece of marketing collateral produced under Renovation Concepts exciting new brand.
A great resource for home owners and buyers looking to give their properties a facelift and looking for interior design ideas.
Petacular Pouts is an online pet boutique that sells customer favorite pet products. The website www.petacularboutique.com offers pet owners a selection of pet items that have proven popular with other customers. The document promotes the pet boutique and its customer recommended products available for purchase on its website.
El documento describe el proceso de recepción del sonido por el oído. Las vibraciones del aire pasan por el conducto auditivo y hacen vibrar el tímpano, transmitiendo la vibración a los huesos del oído medio. Luego pasa a los fluidos del oído interno, generando ondas de presión que activan los pelos ciliares y envían impulsos nerviosos al cerebro, donde se percibe el sonido.
Data collection and interpretation SBL1023SHAKINAZ DESA
This document provides information on data collection, analysis, interpretation, and presentation for experimental reports. It discusses analyzing data using relevant software, interpreting experimental results, discussing limitations, and using graphical and written formats to present findings. Key points include using analysis to describe, summarize, identify relationships and differences between variables, and forecast outcomes, as well as interpreting results by determining what was learned, expected, and surprising in order to draw conclusions.
Possible Interview Questions And Topics (Baker Street)lewisspain
This document provides guidance to prepare for a job interview in the UK as a nurse. It outlines 7 key areas of focus for the interview: 1) background and expectations, 2) clinical and nursing experience, 3) professional associations, 4) theoretical and practical nursing knowledge, 5) management skills, 6) care of patients, and 7) health and safety. It also includes vocabulary words to study and common questions and topics that may come up. The document advises being prepared to discuss nursing responsibilities and care in depth, as the profession has more prestige in the UK with a holistic care model. Do not mention wanting short-term training or going only to improve English.
1.1_GME_ Core Skills_DIfferentialDiagnosis_Principles of differential diagnos...MyThaoAiDoan
The document discusses developing a differential diagnosis by collecting patient data, identifying key features, creating a problem summary, generating hypotheses, and prioritizing diagnoses. It describes using a pattern recognition or analytic approach and provides steps for developing a differential including acquiring data, identifying features, creating a summary, synthesizing findings, and generating a prioritized list of diagnoses.
Consumer Bahavior-1 a Marketing Plan prerequisite by www.marketingPlanNOW.comwww.marketingPlanMODE.com
This presentation is about consumer research as a preparatory phase to consumer behavior. Besides planning a vision, strategy, tactics and standards, consumer reserch is introduced. Terms such as internal or external research, primary and secondary research are involved in addition to projective techniques, questionnaires, samples, sampeling, etc.
The document provides an introduction to problem-based learning (PBL) through a tutorial on fibromyalgia. It outlines the steps of PBL as presenting the problem, separating facts from unknown facts, research, group analysis, and solution generation. It then guides the user through applying these steps to a case study on a client named Karen Sanders who is experiencing fibromyalgia symptoms. The tutorial covers researching the disease process, potential frames of reference and assessment tools, and developing a treatment plan with goals and modalities.
Advanced Health Assessment NURS 6830 Spring 2021.docxwrite22
This document provides an overview and instructions for the Advanced Health Assessment NURS 6830 Spring 2021 course. It includes sections on conducting a patient health history, documenting a SOAP note, performing a self-reflection, and guidelines for physical exams of various body systems. Students will interview a virtual patient to complete a health history, document subjective and objective findings in a SOAP note, and reflect on their performance to improve clinical skills.
This document discusses the importance of experiential and reflective learning for primary care physicians. It describes Kolb's experiential learning cycle and different levels of reflection. It also discusses portfolio-based learning and provides examples of content to include, such as learning logs, reflections on patient cases and educational events. The document provides guidance on identifying learning needs through methods like PUNs and DENs (patient unmet needs and doctor's educational needs), audits, and significant event analysis. Finally, it discusses how to develop a personal development plan to address identified learning needs through various learning activities and resources.
Moving Towards Patient-Centered Treatment Guidelines for Knee and Hip OAOARSI
The document provides an overview of guidelines for treating knee and hip osteoarthritis (OA) developed by the Center for Treatment Comparison and Integrative Analysis (CTCIA). The guidelines aim to provide patient-centered recommendations for three OA phenotypes (knee, hip, polyarticular) and five comorbidity groups. Core treatments are identified for each phenotype. Primary and secondary treatments are recommended for each phenotype-comorbidity combination based on expert panel voting using the GRADE framework. The guidelines identify core non-pharmacologic and pharmacologic treatments and make recommendations on their use for different OA presentations and comorbidities.
Assignment QuestionWith the client you selected in mind, address.docxrock73
Assignment Question
With the client you selected in mind, address in a client termination summary (without violating HIPAA regulations) the following:
· Identifying information of client (e.g., hypothetical name and age)
· Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
· Total number of sessions, including number of missed sessions
· Whether termination was planned or unplanned
· Presenting problem
· Major psychosocial issues
· Types of services rendered (e.g., individual, couple/family therapy, group therapy)
· Overview of treatment process
· Goal status (goals met, partially met, unmet)
· Treatment limitations (if any)
· Remaining difficulties and/or concerns
· Recommendations
· Follow-up plan (if indicated)
· Instructions for future contact
· Signatures
ANSWER
· Identifying information of client (e.g., hypothetical name and age)
Patient RA is a 42years old Caucasian male unemployed retired army.
· Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end.
Client contacted the therapist on November 24th 2020.
The therapy began on November 30th year 2020.
Duration is 12 sessions twice per week.
Therapy will end on February 8th year 2021.
· Total number of sessions, including number of missed sessions.
Twelve sessions
Attended eleven sessions and missed one session.
· Whether termination was planned or unplanned
Termination was planned from the beginning of the therapy.
· Presenting problem
I need help on how to cope with my anxiety problem and PTSD.
· Major psychosocial issues
Anxiety, molestation, flashbacks, dissociative amnesia, irritable behavior and anger, feelings of detachment, hypervigilance when in crowds, problem with concentration, sleep disturbance.
· Types of services rendered (e.g., individual, couple/family therapy, group therapy)
Individual therapy, group therapy rendered.
· Overview of treatment process
Thorough medical examination or thorough initial evaluation done.
Psychotherapy done for example education about relaxation and simple relaxation exercises, coping skills taught, hypnotherapy performed, PE, CPT, SIT.
Medications prescribed by the psychiatrist.
Self-help.
· Goal status (goals met, partially met, unmet)
Goals met.
· Treatment limitations (if any)
The only treatment limitation is EMDR (Eye Movement Desensitization and Reprocessing) not able to perform because the therapist not expert in it.
· Remaining difficulties and/or concerns
The remaining concerns is ability of my client to be more comfortable with others and crowds.
For his sleep pattern to improve more.
· Recommendations
Educated my client about how to maintain the gains made during times of stress and explore expectations about accessing resources in the future.
Reach out and ask others for help in order to relieve some of the stresses of daily life.
To be able to put more energy into his emotional healing process.
J ...
5 Vital Tips to Help Reduce Readmissions in HospitalsJuran Global
This document provides tips for reducing hospital readmissions. It discusses the importance of accurately analyzing the root causes of readmission problems using valid data and proven methods like Six Sigma. The first tip is that there are no "magic bullets" and organizations need to properly diagnose issues before implementing solutions. Additional tips include engaging a multi-functional team to address readmissions and ensuring leadership support. Data analysis methods like process mapping and cause-and-effect diagrams are recommended to identify factors contributing to excess readmissions. Overall the document emphasizes the need for rigorous problem analysis over quick fixes in order to successfully reduce readmission rates.
Desarrollo por GRADE de la Gúia de práctica de Encefalopatía hipóxico-isquemi...Javier González de Dios
The document describes the development of a clinical practice guideline (CPG) on the management of perinatal hypoxic-ischemic encephalopathy (HIE) using the GRADE methodology. The main strengths identified were establishing recommendations in a transparent way and incorporating family opinions. Some difficulties included the long time required, prioritizing questions, needing new meta-analyses due to limited evidence, and synthesizing evidence into single recommendations. Using GRADE allowed formulating recommendations on specific therapeutic or diagnostic actions with strong or weak levels. The authors hope the experience will help others develop new CPGs.
Este documento habla sobre la importancia de la nutrición balanceada y el ejercicio regular para manejar el sobrepeso. Explica que una combinación adecuada de alimentos saludables y actividad física diaria es fundamental para mantener un peso saludable y prevenir enfermedades relacionadas con la obesidad. También proporciona recomendaciones específicas sobre la cantidad de calorías y ejercicio recomendados para niños.
Clínica Ciudad del Mar, es una institución que asume la calidad como eje fundamental de su quehacer clínico y administrativo, con el propósito de ser la mejor alternativa de salud de regiones
Clínica Ciudad del Mar, es una institución que asume la calidad como eje fundamental de su quehacer clínico y administrativo, con el propósito de ser la mejor alternativa de salud de regiones
Este documento resume las etapas típicas del desarrollo fonético y del lenguaje en niños, así como los trastornos del habla que pueden ocurrir. Explica que el habla y el lenguaje se desarrollan de forma gradual, comenzando con vocalizaciones y balbuceos en los primeros meses, y progresando a palabras y oraciones más complejas con la edad. También describe cuatro niveles de gravedad para los trastornos del lenguaje, que van desde un retraso leve en el área fonológica
Este documento habla sobre cómo realizar ejercicios para estimular el cerebro y mejorar la memoria a través de las neurotrofinas. Recomienda hacer "pilates para el cerebro" estirando y sorprendiendo las neuronas con actividades nuevas e inesperadas que involucren las emociones y los sentidos para aumentar la producción de neurotrofinas y fortalecer las conexiones cerebrales. También sugiere modificar la rutina diaria y aprender nuevas habilidades para mantener el cerebro activo.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Possible Interview Questions And Topics (Baker Street)lewisspain
This document provides guidance to prepare for a job interview in the UK as a nurse. It outlines 7 key areas of focus for the interview: 1) background and expectations, 2) clinical and nursing experience, 3) professional associations, 4) theoretical and practical nursing knowledge, 5) management skills, 6) care of patients, and 7) health and safety. It also includes vocabulary words to study and common questions and topics that may come up. The document advises being prepared to discuss nursing responsibilities and care in depth, as the profession has more prestige in the UK with a holistic care model. Do not mention wanting short-term training or going only to improve English.
1.1_GME_ Core Skills_DIfferentialDiagnosis_Principles of differential diagnos...MyThaoAiDoan
The document discusses developing a differential diagnosis by collecting patient data, identifying key features, creating a problem summary, generating hypotheses, and prioritizing diagnoses. It describes using a pattern recognition or analytic approach and provides steps for developing a differential including acquiring data, identifying features, creating a summary, synthesizing findings, and generating a prioritized list of diagnoses.
Consumer Bahavior-1 a Marketing Plan prerequisite by www.marketingPlanNOW.comwww.marketingPlanMODE.com
This presentation is about consumer research as a preparatory phase to consumer behavior. Besides planning a vision, strategy, tactics and standards, consumer reserch is introduced. Terms such as internal or external research, primary and secondary research are involved in addition to projective techniques, questionnaires, samples, sampeling, etc.
The document provides an introduction to problem-based learning (PBL) through a tutorial on fibromyalgia. It outlines the steps of PBL as presenting the problem, separating facts from unknown facts, research, group analysis, and solution generation. It then guides the user through applying these steps to a case study on a client named Karen Sanders who is experiencing fibromyalgia symptoms. The tutorial covers researching the disease process, potential frames of reference and assessment tools, and developing a treatment plan with goals and modalities.
Advanced Health Assessment NURS 6830 Spring 2021.docxwrite22
This document provides an overview and instructions for the Advanced Health Assessment NURS 6830 Spring 2021 course. It includes sections on conducting a patient health history, documenting a SOAP note, performing a self-reflection, and guidelines for physical exams of various body systems. Students will interview a virtual patient to complete a health history, document subjective and objective findings in a SOAP note, and reflect on their performance to improve clinical skills.
This document discusses the importance of experiential and reflective learning for primary care physicians. It describes Kolb's experiential learning cycle and different levels of reflection. It also discusses portfolio-based learning and provides examples of content to include, such as learning logs, reflections on patient cases and educational events. The document provides guidance on identifying learning needs through methods like PUNs and DENs (patient unmet needs and doctor's educational needs), audits, and significant event analysis. Finally, it discusses how to develop a personal development plan to address identified learning needs through various learning activities and resources.
Moving Towards Patient-Centered Treatment Guidelines for Knee and Hip OAOARSI
The document provides an overview of guidelines for treating knee and hip osteoarthritis (OA) developed by the Center for Treatment Comparison and Integrative Analysis (CTCIA). The guidelines aim to provide patient-centered recommendations for three OA phenotypes (knee, hip, polyarticular) and five comorbidity groups. Core treatments are identified for each phenotype. Primary and secondary treatments are recommended for each phenotype-comorbidity combination based on expert panel voting using the GRADE framework. The guidelines identify core non-pharmacologic and pharmacologic treatments and make recommendations on their use for different OA presentations and comorbidities.
Assignment QuestionWith the client you selected in mind, address.docxrock73
Assignment Question
With the client you selected in mind, address in a client termination summary (without violating HIPAA regulations) the following:
· Identifying information of client (e.g., hypothetical name and age)
· Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
· Total number of sessions, including number of missed sessions
· Whether termination was planned or unplanned
· Presenting problem
· Major psychosocial issues
· Types of services rendered (e.g., individual, couple/family therapy, group therapy)
· Overview of treatment process
· Goal status (goals met, partially met, unmet)
· Treatment limitations (if any)
· Remaining difficulties and/or concerns
· Recommendations
· Follow-up plan (if indicated)
· Instructions for future contact
· Signatures
ANSWER
· Identifying information of client (e.g., hypothetical name and age)
Patient RA is a 42years old Caucasian male unemployed retired army.
· Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end.
Client contacted the therapist on November 24th 2020.
The therapy began on November 30th year 2020.
Duration is 12 sessions twice per week.
Therapy will end on February 8th year 2021.
· Total number of sessions, including number of missed sessions.
Twelve sessions
Attended eleven sessions and missed one session.
· Whether termination was planned or unplanned
Termination was planned from the beginning of the therapy.
· Presenting problem
I need help on how to cope with my anxiety problem and PTSD.
· Major psychosocial issues
Anxiety, molestation, flashbacks, dissociative amnesia, irritable behavior and anger, feelings of detachment, hypervigilance when in crowds, problem with concentration, sleep disturbance.
· Types of services rendered (e.g., individual, couple/family therapy, group therapy)
Individual therapy, group therapy rendered.
· Overview of treatment process
Thorough medical examination or thorough initial evaluation done.
Psychotherapy done for example education about relaxation and simple relaxation exercises, coping skills taught, hypnotherapy performed, PE, CPT, SIT.
Medications prescribed by the psychiatrist.
Self-help.
· Goal status (goals met, partially met, unmet)
Goals met.
· Treatment limitations (if any)
The only treatment limitation is EMDR (Eye Movement Desensitization and Reprocessing) not able to perform because the therapist not expert in it.
· Remaining difficulties and/or concerns
The remaining concerns is ability of my client to be more comfortable with others and crowds.
For his sleep pattern to improve more.
· Recommendations
Educated my client about how to maintain the gains made during times of stress and explore expectations about accessing resources in the future.
Reach out and ask others for help in order to relieve some of the stresses of daily life.
To be able to put more energy into his emotional healing process.
J ...
5 Vital Tips to Help Reduce Readmissions in HospitalsJuran Global
This document provides tips for reducing hospital readmissions. It discusses the importance of accurately analyzing the root causes of readmission problems using valid data and proven methods like Six Sigma. The first tip is that there are no "magic bullets" and organizations need to properly diagnose issues before implementing solutions. Additional tips include engaging a multi-functional team to address readmissions and ensuring leadership support. Data analysis methods like process mapping and cause-and-effect diagrams are recommended to identify factors contributing to excess readmissions. Overall the document emphasizes the need for rigorous problem analysis over quick fixes in order to successfully reduce readmission rates.
Desarrollo por GRADE de la Gúia de práctica de Encefalopatía hipóxico-isquemi...Javier González de Dios
The document describes the development of a clinical practice guideline (CPG) on the management of perinatal hypoxic-ischemic encephalopathy (HIE) using the GRADE methodology. The main strengths identified were establishing recommendations in a transparent way and incorporating family opinions. Some difficulties included the long time required, prioritizing questions, needing new meta-analyses due to limited evidence, and synthesizing evidence into single recommendations. Using GRADE allowed formulating recommendations on specific therapeutic or diagnostic actions with strong or weak levels. The authors hope the experience will help others develop new CPGs.
Este documento habla sobre la importancia de la nutrición balanceada y el ejercicio regular para manejar el sobrepeso. Explica que una combinación adecuada de alimentos saludables y actividad física diaria es fundamental para mantener un peso saludable y prevenir enfermedades relacionadas con la obesidad. También proporciona recomendaciones específicas sobre la cantidad de calorías y ejercicio recomendados para niños.
Clínica Ciudad del Mar, es una institución que asume la calidad como eje fundamental de su quehacer clínico y administrativo, con el propósito de ser la mejor alternativa de salud de regiones
Clínica Ciudad del Mar, es una institución que asume la calidad como eje fundamental de su quehacer clínico y administrativo, con el propósito de ser la mejor alternativa de salud de regiones
Este documento resume las etapas típicas del desarrollo fonético y del lenguaje en niños, así como los trastornos del habla que pueden ocurrir. Explica que el habla y el lenguaje se desarrollan de forma gradual, comenzando con vocalizaciones y balbuceos en los primeros meses, y progresando a palabras y oraciones más complejas con la edad. También describe cuatro niveles de gravedad para los trastornos del lenguaje, que van desde un retraso leve en el área fonológica
Este documento habla sobre cómo realizar ejercicios para estimular el cerebro y mejorar la memoria a través de las neurotrofinas. Recomienda hacer "pilates para el cerebro" estirando y sorprendiendo las neuronas con actividades nuevas e inesperadas que involucren las emociones y los sentidos para aumentar la producción de neurotrofinas y fortalecer las conexiones cerebrales. También sugiere modificar la rutina diaria y aprender nuevas habilidades para mantener el cerebro activo.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- 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 the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Drdegiorgis
1. April 89 2008
Hotel Radisson, Bogotá
LatinAmerican Expert Consensus on
Neuropathic Pain Management
Preliminary Agenda
2. Preliminary Agenda (I)
LatinAmerican Expert Consensus on Neuropathic Pain Management,
Bogota, April 8th9th of 2008
n April 7th Arrival of participants
n 20:00 “Get together” and welcome dinner at the Hotel Radisson
n April 8th: First Day consensus meeting (Salón Roble)
n 8:30 – 9:00 Welcome and Methodology
Neuropathic Pain Management Dr. Eduardo Ibarra
n 9:00 –10:00 Neuropathic Pain Treatment in Europe Dr. J.J. Hernandez
n European Guidelines for Neuropathic Pain Treatment
n Experience with Versatis (lidocaine patch)
n 10:00 – 10:15 Break
n 10:15 – 11:00 Neuropathic Pain Treatment in US Dr. LeonCasasola
n Clinical experience in US
n Experience with lidocaine patch
n 11:00 Moderated group work in different expert panels
n Pain Assessment, Treatment recommendations, Monitoring
n 13:00 – 14:00 Lunch
3. Preliminary Agenda (II)
LatinAmerican Expert Consensus on Neuropathic Pain Management,
Bogota, April 8th9th of 2008
n Cont. April 8th:
n 14:00 16:00 Continuation of group work
n 16:00 18:00 (app.) Presentations and discussion of first results of the 6
working groups in the working rooms using the pin walls
n 20:00 Dinner (Restaurant Ochenta Sillas)
n April 9th: Second day consensus meeting
n 09:00 – 12:00 Continuation of group work and finalization of the
results into checklists
n 12:00 – 13.00 Bringing the results in a presentable format, suitable
for understanding and consensus finding
n 13:00 – 14:00 Lunch
n 14:00 17:30 Report in plenum: results and discussion
Consensus findings in plenum
n 17:30 – 18:00 Closing remarks and farewell
n 20:00 Dinner (Restaurant Harry & Sassón)
n April 10th: Departure or staying for the Colombian Pain Congress
6. Target of the Meeting
n Develop a set of recommendations for assessment and
treatment of neuropathic pain
n For the routine situation at the GP practice
n With checklists on the most important facts
n Develop first draft of recommendations (algorithm) for
Latin America
n Basis
n Given NP diagnosis
n Recently published clinical guidelines and studies
n What we shall not do in the workshop
n Revise clinical guidelines (this is a “homework” previous to the
meeting)
n Assess differences in the different health care systems
8. Organisation of the Meeting
n Overall sequence
n Introduction
n Work group Group works (in parallel)
n Topic 1: Pain Assessment
n Topic 2: Therapy recommendations
n Topic 3: Checklist for monitoring
n Consensus
9. Principal structure and topics
History
Examination
Investigation Topic 1: Pain assessment
yes
Red Flags? Exit point
no
Therapy
decisions Topic 2: Therapy recommendations
Follow up
Topic 3: Checklist for monitoring
10. Topics and Working groups
History Working group A
Examination
1 Working group B
Investigation
yes
Red Flags? Exit point Working group C
no
Drug treatment Working group D
Therapy
2 decisions
Nonpharmacological Working group E
treatment
Follow up Working group F
3
11. Meeting: Work group participants
WG Theme Participants
A NP definition and
Clinical history
B Examinations and
investigations
C Red flags
D Drug treatment
E Nonpharmacological
treatment
F Monitoring
12. Flow of the group work (example history)
Literature, Guidelines
Knowledge and skills of
the WG
(34 participants)
Description (text) of history
What should be asked?
Appropriate? Plenary audit Consensus
Check list
13. Meeting: Work group topics
n Topic 1: Pain Assessment
n Working groups A, B, C
n A= History
n B= Examinations and investigations
n C= Red flags
n Topic 2 : Therapy recommendations
n Working groups D, E
n D: Drug treatment
n E: Nonpharmacological treatment
n Topic 3: Monitoring
n Working group F
15. Group work 1:
Pain Assessment
Objectives (for each group):
describe the information needed to objectify
neuropathic pain and red flags
n History
n What information is needed to know that there is probably
neuropathic pain
n Examinations an investigations
n Which examinations/investigations will confirm for neuropathic
pain?
n Red flag procedures
n Which red flags should the GP know? How to recognize a red flag?
n History
n Examinations
n Investigations
16. Elements of the assessment phase
C
Red
Decision step Information
flags
A History What to ask for?
Examination What to examine
B
Investigation What to invest?
17. Topic 1: Pain Assessment
n Read the literature
n List all the relevant information you can think of
n Check the list on completeness
n Check the list on appropriateness for the goal of the assessment
(reduction to the essential information)
n Method: Brainstorming on the pin wall
n the group members name elements of the list
n one person is writing on the pin wall
n one person in the group is checking in parallel
whether all nominations are written down
n Do not !!!
n criticize any nomination
n discuss any item
n look for any topic
n After completion of the brainstorming
n check your results on appropriateness
n Make changes step by step
n Finalize in a presentable check list format
18. Topic 2: Therapy recommendations
Working groups D, E
n Group D: Drug treatment of neuropathic pain
Ø Peripheral focal and multifocal
Ø Peripheral generalized
Ø CNS induced
Ø Mixed Pain Syndrome
n Group E: Non pharmacological treatment of neuropathic pain
Ø Peripheral focal and multifocal
Ø Peripheral generalized
Ø CNS induced
Ø Mixed Pain Syndrome (neuropathic + nociceptive)
19. Topic 2: Therapy recommendations
Objectives:
give your therapy recommendations for each type of
neuropathy in a priority list, with literature references
n Therapy
n Drug
n Non pharmacological
n Literature reference
n Please name the supportive literature
20. Group work 2:
Therapy recommendations
Type Treatment recommendation Literature
n Gabapentin
Peripheral focalized n Topical Lidocaine Finnerup…
NP n Pregabalin Dworkin….
n …
21. Topic 2: Therapy recommendations
n Fill the left column: 4 neuropathic pain types
n Read the literature
n Assign possible therapies to the NP type
n Assign the literature
n Brainstorm on recommendation/prioritizing
n How effective?
n How safe?
n Nature and frequency of adverse events?
n Method: Brainstorming on the pin wall
n the group members name elements in the list
n one person is writing on the pin wall
n one person in the group is checking in parallel
whether all nominations are written down
n Do not !!!
n criticize any nomination
n discuss any item
n look for any topic
n After completion of the brainstorming
n check your results
n Make changes step by step
n Finalize in a presentable format
22. Group work 3: Monitoring
Objectives:
what information should be collected for monitoring the
patient?
n History
n Examinations
n Investigations
n Report as check lists
n Add literature references
23. Topic 3: Monitoring
n Read the literature
n Write down all the information you will use for monitoring
n History
n Examinations
n Investigations
n Brainstorm on appropriateness
n What is really relevant to know?
n Which validated patient questionnaire could be used?
n Assign the supportive literature
n Method: Brainstorming on the pin wall
n the group members name elements in the list
n one person is writing on the pin wall
n one person in the group is checking in parallel
whether all nominations are written down
n Do not !!!
n criticize any nomination
n discuss any item
n look for any topic
n After completion of the brainstorming
n check your results
n Make changes step by step
n Finalize in a presentable format
24. General rules for working in a working group
n Read the literature
n First write down all the items relevant for your topic
n Then brainstorm on appropriateness (what could be missed)
n Check constantly on the goal of your task, to stay on track
n “ Small is beautiful”
n Decide on who should present the result
n Method: Brainstorming on the pin wall
n the group members name the topics for the list
n one person is writing on the pin wall
n one person in the group is checking in parallel
whether all nominations are written down
n Do not !!!
n criticize any nomination
n discuss any item
n look for any topic
n After completion of the brainstorming
n check your results again on completeness
n Make changes item by item
n Finalize your result in a computerpresentable format
25. Consensus
n Present the result of the 6 working groups
n Discuss the result for last comments
n Ask for agreement:
n If agreement is >= 80% : consensus
n If agreement is < 80% : ask who disagrees, ask for
arguments, adapt if wanted the result and vote again;
proceed when consensus has been achieved
n Follow the procedure for the next work group
results