This document provides an agenda for an event on harnessing digital technology for better mental health. The event will include presentations on using digital technology in mental health, the role of technology in youth services, delivering best practices in e-mental health, the policy context and future of e-mental health, and psychological therapies in the digital world. There will also be exhibitions, workshops, and a question time debate. The goal is to discuss how digital tools can help improve mental health services and outcomes.
The Future Of Advertising and How To Make It Work For You TodayAdNerds
This is the session where we get a good go at the future of advertising. But rest assured: we won't be talking about 'vaporware' (i.e.: not too much). But we'll show you how the future is already here. And how you can successfully turn it into a smashing marketing hit today.
The Future Of Advertising and How To Make It Work For You TodayAdNerds
This is the session where we get a good go at the future of advertising. But rest assured: we won't be talking about 'vaporware' (i.e.: not too much). But we'll show you how the future is already here. And how you can successfully turn it into a smashing marketing hit today.
Everyday, brands are exploring new ways of engaging conversations with their consumers. And Mobile, the fastest growing media, is one of them.
Is Mobile really all about males? What about women? What do they want to hear from brands? What kind of interaction do they expect?
How different are the female expectations when it comes to mobile marketing?
On May 7th 2009, as part of its Dynamic Insourcing programme, Cleverwood invited the major actors in the mobile market to talk about the growing importance of mobile media for women to help understand : What women want... in Mobile.
Check http://www.cleverwood.be/blog
frogs from around the world predict the 15 most significant technology trends you will see in 2014. Check out the list and cast your votes on what you think is Likely or Not Likely: http://fro.gd/1ksg2iS
A brief overview of digital trends and developments for 2012...its not meant to be massively comprehensive, nor overly detailed, its just my view on some interesting things that are going on in the digital world currently
A presentation on how we are preparing to step through 'boxed media' into the world of Life Media Covergence.
1. Boxed Media
2. The Mobile Medium
3. Future of Media
Zeno India 2013 Trends: Convergence Compassjohnkerrnz
Timed to celebrate the advent of the Year of the Snake and for the fourth year in a row, welcome to 'Zenology 2013: The Convergence Compass.' Launched with a two-day roadshow in India (Delhi and Mumbai), this deck steps out:
- Key Consumer Trend affecting marketing and engagement
- Implication for communications and marketing professionals
- Best Practice Approach and goes deeper into a local market example
The Five Key Consumer Insights Are:
1. Simpler Lives
2. National and Cultural Pride
3. All About Me
4. Karmic Brands
5. e2Commerce
If you'd like more information, or are interested in a point-of-view for your specific country, please do not hesitate to contact john.kerr@zenogroup.com.
Social Intelligence will be a part of all consumer and commercial interactions. This presentation looks at the evolution of the Swipp social intelligence platform, shows how social intelligence will be included in industries going forward and provides a checklist of what brands can do to begin tapping into social intelligence today.
Resource Labs: Digital Trends Innovation CAMP 2013Fisher AMP
Dan Shust (VP of ResourceLab @ Resource: Building Open Brands) shares his thoughts on the future digital trends facing marketers at Innovation CAMP 2013.
Principles of Christian ministry and social action (mangneo)Oasis India
This PPT was specially designed for use in the "Christian ministry and social action" session of a training for the pastors and mission workers at Guwahati.
Türkiye'de gönüllülük ve hayırseverlik davranışı, gönüllülük kavranımın gençler arasında algılanışı, TEGV gönüllülerinin ve gençlerin değer ve tutumlarındaki farklılıklar üzerine bir araştırma raporu
Everyday, brands are exploring new ways of engaging conversations with their consumers. And Mobile, the fastest growing media, is one of them.
Is Mobile really all about males? What about women? What do they want to hear from brands? What kind of interaction do they expect?
How different are the female expectations when it comes to mobile marketing?
On May 7th 2009, as part of its Dynamic Insourcing programme, Cleverwood invited the major actors in the mobile market to talk about the growing importance of mobile media for women to help understand : What women want... in Mobile.
Check http://www.cleverwood.be/blog
frogs from around the world predict the 15 most significant technology trends you will see in 2014. Check out the list and cast your votes on what you think is Likely or Not Likely: http://fro.gd/1ksg2iS
A brief overview of digital trends and developments for 2012...its not meant to be massively comprehensive, nor overly detailed, its just my view on some interesting things that are going on in the digital world currently
A presentation on how we are preparing to step through 'boxed media' into the world of Life Media Covergence.
1. Boxed Media
2. The Mobile Medium
3. Future of Media
Zeno India 2013 Trends: Convergence Compassjohnkerrnz
Timed to celebrate the advent of the Year of the Snake and for the fourth year in a row, welcome to 'Zenology 2013: The Convergence Compass.' Launched with a two-day roadshow in India (Delhi and Mumbai), this deck steps out:
- Key Consumer Trend affecting marketing and engagement
- Implication for communications and marketing professionals
- Best Practice Approach and goes deeper into a local market example
The Five Key Consumer Insights Are:
1. Simpler Lives
2. National and Cultural Pride
3. All About Me
4. Karmic Brands
5. e2Commerce
If you'd like more information, or are interested in a point-of-view for your specific country, please do not hesitate to contact john.kerr@zenogroup.com.
Social Intelligence will be a part of all consumer and commercial interactions. This presentation looks at the evolution of the Swipp social intelligence platform, shows how social intelligence will be included in industries going forward and provides a checklist of what brands can do to begin tapping into social intelligence today.
Resource Labs: Digital Trends Innovation CAMP 2013Fisher AMP
Dan Shust (VP of ResourceLab @ Resource: Building Open Brands) shares his thoughts on the future digital trends facing marketers at Innovation CAMP 2013.
Principles of Christian ministry and social action (mangneo)Oasis India
This PPT was specially designed for use in the "Christian ministry and social action" session of a training for the pastors and mission workers at Guwahati.
Türkiye'de gönüllülük ve hayırseverlik davranışı, gönüllülük kavranımın gençler arasında algılanışı, TEGV gönüllülerinin ve gençlerin değer ve tutumlarındaki farklılıklar üzerine bir araştırma raporu
Fraud specialist and published author Pamela Mantone presented "Fraud - Real Life Horror Stories" at the 2013 Decosimo Accounting Forum hosted by the University of North Alabama on July 19.
Cyber Security - The New Threats to Internal ControlsDecosimoCPAs
Fraud specialist and published author Pamela Mantone presented "Cyber Security - The New Threats to Internal Controls" at the 2013 Decosimo Accounting Forum hosted by the University of North Alabama on July 19.
Social in Seattle: How Children's Hospital Boston uses social media to commun...Matt Cyr
In this presentation, given at the Ragan Communications Conference in Seattle from April13-15, Matt Cyr talks about how Children's Hospital Boston uses Facebook, blogs, Twitter and YouTube to connect with its patients, families and physicians.
Mobile market research: a new drink or old wine in a new bottle?Merlien Institute
Mobile market research: a new drink or old wine in a new bottle?
Palanivel Kuppusamy - Founder & Chief Executive Officer - iPinion Surveys
Understanding the biggest value of mobile market research. Appreciating the possibilities of engaging with customers through various channels. Understanding why mobile market research is becoming a major tool in the research tool kit. Discussing how mobile market research is shaping the future of research.
Social media and mobile devices have combined to help create the always-with-us, always-on, always-connected campus. Not just student-to-student but, importantly, institution/faculty/staff-to-student as well as staff-to-staff. We need to look beyond the silo-ed, one-way web sites of the past towards more personal, two-way applications that take advantage of this sea change on campus. The ways in which our users will want to interact with us, the types of tasks they’ll want to complete, and the types of devices we’ll want to deliver to will just continue to proliferate.
Now is the time to reevaluate.
Using lessons learned at a large land-grant institution we’ll look at what the future friendly campus might look like, ways to plant the seed of that change and tips on how to accomplish it.
This presentation was given at the 2012 .eduGuru Summit on April 11, 2012.
Février 2011 - What changed in the way people consume media (french market) and how brands can engage with them playing the rules set up by those major tendencies.
MoDev Tablet 2012 - Now thats engaging!Erin Daniels
So you have a great idea for an app or site but you want to make sure it resonates with users and makes them want to come back again and again? This session is a brief introduction to ways to make your tablet app or site more engaging for users while staying true to the main goal or purpose of your product. We will explore various approaches including storytelling, gamification, augmented reality, and user-generated content that will help get your audience hooked and strengthen your product’s value proposition. Showcased here is a collection of remarkable implementations of the approaches discussed.
Tutorial from JBoye Aarhus 2012.
Covers:
Introduction to mobile & touch
Identifying mobile-friendly tasks
A look at smartphones and UI/UX
Mobile wire-framing exercise
Tablets as a "form factor"
Tablet debate exercise
A second view on content, media and advertising for iPad and tablet devices in general. What is it all about and how can it affect our way of looking at media consumption.
Presented at the Digital Marketing seminar for the Marketing Foundation in Belgium.
The Mobility Revolution and the Power of Social Media (Gerd Leonhard at ACTE0...Gerd Leonhard
A presentation on how mobile and social media trends impact business, in general, and the corporate travel industry, in particular. The social media and mobile Internet explosion is resulting in unprecedented changes in communications and commerce. The need to reduce CONTROL to get more SHARE is evident... but how can this be done within large organizations? How can social media add value, and what are the risks? Find out more at http://www.mediafuturist.com and http://www.gerdtube.net (videos)
The Youth Mental Health Network (YMHN) is driven and made up of a range of individuals and groups that are passionate about improving the mental health of young people, regardless of their background.
The Youth Mental Health Network's vision is to improve the provision of youth mental health services by harnessing and fostering commitment to evidence based youth mental health services, in their various forms.
The Youth Mental Health Network (YMHN) is driven and made up of a range of individuals and groups that are passionate about improving the mental health of young people, regardless of their background.
The Youth Mental Health Network's vision is to improve the provision of youth mental health services by harnessing and fostering commitment to evidence based youth mental health services, in their various forms.
The Youth Mental Health Network (YMHN) is driven and made up of a range of individuals and groups that are passionate about improving the mental health of young people, regardless of their background.
The Youth Mental Health Network's vision is to improve the provision of youth mental health services by harnessing and fostering commitment to evidence based youth mental health services, in their various forms.
The Youth Mental Health Network (YMHN) is driven and made up of a range of individuals and groups that are passionate about improving the mental health of young people, regardless of their background.
The Youth Mental Health Network's vision is to improve the provision of youth mental health services by harnessing and fostering commitment to evidence based youth mental health services, in their various forms.
The Youth Mental Health Network showcased its work to senior NHS and Social Care Leaders at the launch of the South East Strategic Clinical Network on 1st may 2013.
The Mental Health Network represents providers from across the statutory and non-statutory sectors.
The network works with government, regulators, opinion formers, media and the wider NHS to promote excellence in mental health services, and the importance of good mental health.
You can find out more about the NHS Confederation Mental Health Network at www.nhsconfed.org/mhn
Buddy is a digital tool to support therapy services. Clients use text messaging to keep a daily diary of what they are doing and how they are feeling, helping to spot and reinforce positive behaviours. Find out more at www.buddyapp.co.uk
Getting stressed by work, family or friends? Dealing with big issues? Share what's troubling you anonymously - join the Big White Wall network at www.bigwhitewall.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
- 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
4. Time Speaker & Topic
10:00 Chair
Welcome
10:20 Ali Mousa
Why Use Digital Technology in Mental Health?
10:40 Paul Irwin – Director, TryLife
The Role of Technology in Youth Services
11:00 Jenny Hyatt – CEO, The Big White Wall
Delivering Best Practice in E-Mental Health
11:30 Refreshments and e-Mental Health Exhibition
11:50 Rebecca Cotton -Deputy Director, Mental Health Network, NHS
Confederation
The Policy Context & Future of E-Mental Health
12:10 James Seward – Managing Director, Buddy App
Psychological therapies in the Digital World: The Buddy App
12:30 Buffet Lunch in Main Foyer
5. Time
13:00 E-Mental Health Exhibition, Live Computer-based Demonstrations
Opportunity to View & Create Your E-Mental Health Videos
13:45 Interactive Workshop Session (6 Questions on 6 Tables)
15:00 Feedback & Postcard Pledges
15:15 Question Time Debate with:
Ali Mousa
James Seward
Paul Irwin
Jenny Hyatt
Rebecca Cotton
16:00 Sarah Amani & Katrina Lake
Closing Comments
16:15 Closing
8. “Following a wide eyed collective gasp of realization, we
were quickly swept up in a heady conversation about
how useful it would be to have a designated EIIP mobile
app that could help people manage their mental health
through reminders and trackers.”
Sarah Amani
DH Maps & Apps Competition – 7th out of 500
ideas submitted for health apps
9. 77%
of people have a mobile device
or 5.3 billion at the end of 2010 – U.N. Telecommunications Agency, http://www.itu.int
10. This was ‘portable’...
<10 years...
Released: 1998 Released: 2007
CPU: 233 MHz CPU: 412 MHz
RAM: 32 MB (512 MB max) RAM: 128 MB
Storage: 4 GB (+ optical drive) Storage: 4 GB (8 GB max)
Display: 38.1 cm Millions of colours Display: 8.9 cm Millions of colours
Dimensions: 40.1 x 38.6 x 44.7 cm Dimensions: 11.4 x 6.1 x 1.2 cm
Weight: 17.3 kgs Weight: 135 g
11. Your mobile phone has
more computing power than
all of NASA in 1969.
http://www.flickr.com/photos/43533334@N07/5153726732
12. “For kids like my 13 year-old, the
boundaries between the internet
and life are so porous as to be
meaningless.“
Comment on the Guardian web site
most will grow up connected
http://www.flickr.com/photos/tocaboca/5523598823
14. Public space
distractions
limited attention
mobile usage can be this...
glanceable?
onehand simple?
tedious input
personal
http://www.flickr.com/photos/oimax/3800475934
15. 1hr train ride Focused user privacy
reliable
network? comfy
Unlimited wifi?
chair
two
hands
Reliable power source?
or this...
16. comfy
chair privacy
One hand prone to
Reliable power interruptions
source
gravity
...or this?
http://www.flickr.com/photos/joeshlabotnik/2359224681
17. “ The most profound technologies are those
that disappear. They weave themselves
into the fabric of everyday life until they are
indistinguishable from it…. Mark Weiser
http://www.flickr.com/photos/armaggeusa/3176297283
19. Mobile Opportunities
touch
screen
tiny hybrid
screen +
keypad large
input touch
navipad
screen
many of these are now <£50
yesterday today
20. A big screen...
web browser
+
application is now a highly customisable
layer always on, always connected
+ blank canvas...
APIs
With a button or two!
21. camera
a big screen...
work communication
play
sharing
web browser
learning
+
enabling users to choose
application
layer music their own experience
+
chat
APIs navigation
With a button or two!
discovery
Health
creativity
video
22. Mobile App Costs, Benefits, Build vs. Buy
Gauge the Opportunity Business Drivers
Examples ROI Decision
Compare Mobile Platforms Mobile Market Overview Platform Analysis and Selection
Focus Business Application
Goals and Objectives Security and Privacy
Requirements Requirements
Development and
Develop the Application Keys to Success Required Resources
Testing
Launch, Measure,
Launch and Promotion Feedback and Metrics Future Releases
Iterate
26. My Journey
times have
changed
Person
motivation
Ce n’est pas unIntuitive
al phone Usabl
Responsi al
Customiz eHelpf
ve
able ul
27.
28.
29. • 47 Adolescents & 6 clinicians
• Outpatient Clinic
• Self Reported Mental Health Outcomes for 4 weeks
• First week - 91% entries completed
• 88% said data reflected actual experiences
• 92% adolescents found app ‘helpful’ in understanding
their condition + collaborating with clinician in
managing their health
1. Reid et al (2011) A mobile phone application for the assessment and management of youth
mental health problems in primary care: a randomised controlled trial.
2. Reid et al (2012) Using a Mobile Application in Youth Mental Healh
Journal of Australian Family Physician http://www.ncbi.nlm.nih.gov/pubmed/22962650
30. http://speirs.org/blog/2011/4/1/stop-lying.html
This is the world we are living in and we can either
lie to ourselves about it or we can dive headlong
into the new forms and effects that it produces.
– James Bridle
http://www.flickr.com/photos/tijanav/4885088185
39. There’s a lot of choice….
Text and listening services
Moodtrackers and buddy systems
Social networks
Self management programmes
(often CBT)
Online therapy
Integrated systems
53. Safety
Privacy PEOPLE Evidence
Professional
re-
imagined
54. The Policy Context and Future of E-Mental Health
Rebecca Cotton
Acting Deputy Director, Mental Health Network
55. Today’s session
• About the Mental Health Network.
• Outline our work on e-mental health.
• Outline some of the policy and strategic drivers that
may help drive spread innovation in e-mental health.
• Opportunity to get involved in future work.
• Q&A
56. About the Mental Health Network
• Part of the NHS Confederation – the membership
body for all organisations that commission and
provide NHS services.
• We represent 70 providers of mental health services
in England – including NHS Trusts, Foundation
Trusts, voluntary sector and independent sector
providers.
• Governed by a board of members – including Chief
Executives, Chairs, Clinicians and service user and
carer representatives.
57. What we do
• We help shape and challenge
national policy and legislation
affecting our members.
• We provide members with up to
date news and analysis,
through briefings and events.
• We also work to identify and
spread good practice and
innovation in the mental health
sector, plus carry out original
research.
58. Work over the last 12 months
• Social media
• Payment by Results in mental health
• Measuring outcomes in mental health
• Suicide prevention
• Housing and mental health
• Mental health and homelessness
• Effectiveness of psychological
interventions for patients with long-term
conditions and MUS
• Race equality in mental health
59. E-mental health – what’s all the fuss about?
• Discussion paper launched 30th
January
• Asks how can the mental health
sector make the most of
opportunities offered by e-mental
health to not only improve
efficiency, but also to transform the
nature of mental healthcare itself?
• Asserts a national framework for e-
mental health should be developed
to provide a platform for change.
60.
61.
62.
63.
64. Policy context
No Health Without Mental Health
• Number of objectives are relevant
to e-mental health, inc improving
access, recovery rates and
experience of using services.
• Implementation framework highlights e-mental health.
Information strategy
• Published May 2012. Sets a ten-year framework for
transforming information for the NHS, public health and
social care.
65. Policy context
Innovation, health and wealth
• Published December 2011. Sets out eight principles
that could help frame a strategy for e-mental health.
Choice, personalisation and Any Qualified Provider
• Making choice work – in terms of choice of provider
and choice of treatment – will depend on access to
high-quality, comparable information.
NHS Mandate
• Sets an objective around increasing in the use of
technology to help people manage their health and
care.
66.
67. Where do we go from here?
1. How can we build momentum and support real
change, in partnership with service users?
2. How can providers make sense of what is a rapidly
evolving marketplace and make informed choices
about which programmes and applications to use?
3. How do we determine what „quality‟ looks like?
4. How can we ensure that innovations in this field are
developed within appropriate governance
frameworks?
5. At a national level, how can we help spread
knowledge and good practice about what works?
68. A national framework for e-mental health
• In our view, a two-stage process is needed,
culminating in the development of a national
framework for e-mental health.
Stage one: Comprehensive mapping exercise.
• What are people already doing with technology –
including service users, carers, members of the
public, professionals (including clinicians, managers
and informatics specialists), providers and
commissioners?
69. A national framework for e-mental health
Stage two: Designing the framework
• Building on the mapping exercise, this would lead to
a shared vision for what people would like to be able
to do with technology, and set out clear actions for
different parts of the system to enable that change to
be brought about.
• Broad engagement process – involving service
users, carers, members of the public, professionals,
providers and commissioners.
70. What happens next?
• We have secured funding from the SHA mental
health leads group to undertake the first stage of
work – the mapping exercise.
• Scoping work on this is currently underway – we
would very much welcome input and involvement
from MHN members, including any examples of
current work in this area.
• We will continue discussions with DH, NHSCB and
others about future development of a framework for
e-mental health.
75. BUDDY APP: SIMPLE PROPOSITION
To use ubiquitous text-messaging
to give users a tool for taking
more control of their recovery and
as a resource for collaborating
with professionals to achieve their
goals
76. BUDDY APP PROVIDES
Buddy is a digital tool to support therapy services.
It enables clients to:
– Keep a daily diary via SMS
– Spot patterns via a website
– Be reminded about session appointments via SMS
– Create their own session plans in advance
– Set and receive behavioural activation goals via SMS
79. BENEFITS
SERVICE USERS PROFESSIONALS MANAGERS
Spot Patterns Rich Insight Improved DNA rate
Improved Communication Make Time in Therapy Caseload management
Create Control Focus on Goals
Appointment reminders
Happier users, enabled clinicians, and more
efficient services
80. SLaM Service
SERVICE USERS PROFESSIONALS MANAGERS
Improved quality of life in 63% Compliance 7% DNA decrease
87.5% of users
(from previous trial)
57.1% of users reported 71% users felt it allowed
decrease in CORE-10 for more open and
honest discussion
100% of users said
they would use again
* Published data from the SLaM EIS 100 week trial
81. USER FEEDBACK
“Buddy helped me communicate
better with my therapist, and it
helped me to spot patterns and see
what I was doing or not doing.
Buddy really felt like a friend
checking up on me at the end of
the day. Sometimes it was the only
contact I would have throughout
the day. It's something that helped
point me in the direction of
change, and which I then felt better
able to act on."
Helena, Service user
82. CLINICIAN FEEDBACK
Eric Morris, Clinical Director, EIS, SLaM
"The idea of Buddy is to put the person's goals at the centre of their treatment. I've
noticed that the ones who are using it have become more focused in what they want
to get out of our meetings. Early intervention service users usually have problems
with depression and anxiety and Buddy gives them support during the week when
they're not seeing a therapist."
83. Stockport IAPT, Self Help Services
SERVICE USERS PROFESSIONALS MANAGERS
100% of users satisfied 100% clinicians would
use again in the future 4.5% DNA decrease
with care received
63.8% reported 83% felt it allowed 4% canc. decrease
decrease in PHQ9 and for more open and
GAD7 scores honest discussion
500 additional clinical hours
Improved quality of life
in 89.2% of users
£25k additional income (PbR)
* Published data from the SHS Buddy Trial Outcome report
* All data over historic baseline
84. CEO FEEDBACK
Nicky Lidbetter, Chief Officer, Self Help Services
“With the increasing demand for providers of mental health services to
deliver more for less, Buddy contributes to system efficiency and enhances
patient experience by promoting the collaborative nature of therapy sessions.
This enables patients to feel more in control of their interaction with the
service. ”
85. RETURN ON INVESTMENT
• For service providers moving towards PbR, Buddy
offers increased:
– Throughput
– Efficiency
– Outcomes
86. CLINICAL FEEDBACK
“Buddy is being used in a variety of
ways in addition to routine activity
and mood monitoring. These
include: pain diary, alcohol
diary, monitoring
flashbacks, monitoring for
dissociation, promoting grounding
techniques and mindfulness such
as 'remember to notice where you
are‟ and „what you are doing right
now?” Regarding impact on DNA
and CNA rates, it‟s also having a
positive effect of reducing DNA's”
Dr Alan Barrett, Clinical Lead
87. SUMMARY
• Buddy has been designed to specifically support mental health
pathways
• Built to improve user engagement
• Designed around everyday lives, and everyday technology
• Improves the relationship between professional and service user
• Empowering and non-stigmatising
88. ABOUT US
• Incubated by Sidekick Studios, Buddy Enterprises Ltd brings together
business, design, digital and mental health professionals
• Developed in collaboration with SLaM‟s CMHTs & Early Intervention in
Psychosis service & Rethink‟s NE Essex Health in Mind IAPT service
• Current clients:
– NW Regional IAPT for Military Veterans service (Pennine Healthcare
NHS Trust)
– Nottingham Healthcare NHS Trust
– Self Help Services Stockport
– Kent & Medway NHS Trust
– West London Mental Health Trust
– Sheffield Health and Social Care NHS Trust
– Derbyshire Healthcare NHS Trust
– Mental Health Matters
89. Awards / Recognition
Gold Award Winner 2012 Finalist 2012
Community & Social Mobile App Innovation in Mental Health
www.lovieawards.eu
91. Thank You
E-Mental Health:
Harnessing the Power of Digital for
Better Mental Health
NHS South of England (East)
Monday 18th March 2013
Editor's Notes
Thanks for intro. Thanks for having me here today to talk to you all. I’ve been asked to take the next 20 mins or so to talk about the broader policy environment, and how this may well help to drive further adoption and spread of the sorts of innovations we’re talking here today about.
In that time, I want to do a number of things. First of all, some of you will be aware of the organisation I work for – some of you won’t! For those of you who aren’t familiar with us, I want to briefly outline who we are and what we do – including some of the work I’ve been doing recently with Sarah, Jen – who spoke just now – and some other enthusiasts for e-mental health. Then I’m going to talk about the policy and wider strategic environment, and how this might drive further adoption and spread. I’m going to wrap up by talking about some future work I’m involved in that people in the room might want to get involved in. And, of course, we’ll have time for some questions and answers.
So, just to kick off, let me tell you about the organisation I work for. The Mental health Network is part of the NHS Confederation. The Confed is essentially *the* membership bodyfor all organisations that commission and provide NHS services. Around 90 / 95% of all NHS organisations – Trusts, Foundation Trusts, PCTs, SHAs – are in membership. We’re also, with the NHS Alliance and NAPC, have a membership body for CCGs. The MHN is the part of the Confed that represents providers of mental health services. We represent 70 providers of mental health services in England – including NHS Trusts, Foundation Trusts, voluntary sector and independent sector providers. Governed by a board of members – including Chief Executives, Chairs, Clinicians and service user and carer representatives.
This slide explains a little more about what we do. Firstly, like any other membership organisation, we lobby and influence national policy on behalf of our members. We keep people up to date on news affecting the sector, plus we have a busy events and publications programme throughout the year. We also run a number of development programmes in conjunction with other organisations. One example of that is the IMROC programme we run with the Centre for Mental Health, to help services focus on recovery. We also carry out pieces of original research, which are often pieces commissioned by government.
This slide just gives a flavour of some of the topics we’ve worked on over the past year and the publications we’ve put out – on housing, use of social media, outcomes and pbr. We’ve also done a lot of work with government on developing an implementation framework in support of the mental health strategy and on the NHS mandate. That’s been a particularly big focus for me over the past 12 months, and as people are starting to be appointed to the NHS commissioning board we’re beginning to have conversations there about the sorts of early priorities from the Board should be.
In terms of our work on e-mental health, some of you may have seen this paper that we published in January of this year. That was written by three people – myself, Jen Hyatt – who you heard form earlier – and Matthew Patrick, who’s Chief Exec of the Tavistock and Portman in London. That was the result of conversations we starting having last summer. Jen and Matthew have done so much in this area and are so knowledgeable – it wasn’t an area I could profess to having anything like the area of expertise that they do. But it had struck me for quite a long time that public services in general are – with some very notable and excellent exceptions – very much behind the curve when it comes to making use of technology in terms of the way services are delivered. What also struck me, when I started talking to our members about it and what their organisations were doing, was that there was actually a lot of interest in working out how they can exploit these opportunities – but most people had no idea where to start. The same sorts of questions kept coming up again and again – essentially they came down to wanting to figure out what service users actually want, and how they could make informed choices about what sorts of products and services can meet that need. There was also a big interest in hearing about where else in the NHS, and abroad, there was good practice that might be helpful to learn from. So all those things led to this paper. If you haven’t read it already, then it’s on our website – I hope you give it a look.
In it, we argue that there’s a powerful case for change. Firstly, in simple terms, this is the reality of the world we’re living in. We’re living in a totally different world, in terms of technology, to where we were 10 – 20 years ago. 74 % of households are online.
91 % of adults use a mobile phone. For young people, the rates of smartphone ownership are high, and increasing.It’s this reality, rather than any policy document or anything else, that is going to drive this change. The expectations of the public are changing, and through technology we have more opportunities than ever before to be more active, informed consumers of healthcare. It’s commonplace now for GPs to find their patients coming into surgeries readily armed with information about treatment options and NICE guidance they’ve gleaned from NHS Choices and other websites. People with long term conditions are also making the most of the opportunities presented by social media to get information, support and advice from other people going through the same thing – Big White Wall is one example of that, and there are others cited in the paper.
There’s a huge cultural transformation going on. People aren’t passive recipients of healthcare any more – and that applies to mental healthcare as much, if not more so, than any other sector. If the recovery movement is about empowering people and supporting them to recover on their own terms, then services have got to embrace the way people want to make use of technology. That can help support a more collaborative approach between professionals and service users.
But it’s also about the reality of the economic environment we’re in too. The rates of common mental health problems are increasing. And we know that only a relatively small proportion of people with anxiety and depression are in treatment. Stigma is probably a big factor in people not coming forward when they need help – and we know that attitudes are changing, albeit slowly. So, in the future, we’re only going to see the numbers go up. But we’re in a very tough economic climate. Whilst the NHS budget is flat, the proportion of that that’s spent on mental health services went down by 1% last year. And whilst none of us have a crystal ball, it’s unlikely you’re going to see big injections of cash into the health service for the foreseeable future. So, we all have to do a lot more with what we’ve got. Making the most of the opportunities presented by e-mental health might be able to go some way in addressing this resource challenge. In the paper, we talk about products and services can enable existing tasks and practices to be conducted in a more efficient way. That can include applications and programmes to monitor mood or medication compliance. Delivering interventions online is another examples – there’s certainly a growing interest in delivering CBT online and things like that.
So what of the policy context...... There’s a number of documents that have come out over the past two years that are certainly supportive of this direction.The mental health strategy came out 2 years ago – that has a number of objectives that are relevant to use of technology. Last year, the DH published an implementation framework for the strategy. I must confess an interest in that – I helped write it, along with colleagues at the DH and organisations like Mind, Rethink and Turning Point. That sets out a number of priorities for all sorts of public services, not just the NHS, but schools and social services too. The framework cites how mental health services should consider how technology can support self care and peer support. The information strategy came out last year from the Department of Health – again, that document supported this idea of using technology to support cultural transformation.
In December 2011 the DH published the innovation review led by Sir Ian Carruthers. That looked at how barriers to the adoption of innovations can be overcome – the contents of that and the actions taken as a result are all very relevant to the issue we’re talking about today. This idea of supporting choice is a really important one – before Christmas the Government announced that service users will have the same rights in terms of choice of provider by April 2014. That could be a really important driver in terms of changing the way services are delivered, and how responsive they are to the wants of the people who use them – in future, if they’re not happy, the may just simply choose to go elsewhere!Lastly, the NHS Mandate will be particularly key in terms of setting the priorities of the Commissioning Board as it becomes established. The Mandate does talk explicitly about increasing the use of technology to help people with long term conditions manage their health better.
So, what does all this mean for the future?In technology we have something that has the potential to help us support the cultural transformation we need, and also address the massive challenge around resources we have. We have a mental health strategy that supports that. As does the NHS Mandate. In them, we’ve got two documents by which the Commissioning Board are going to be held to account for delivering the kinds of change we all want to see. But that’s not going to be enough.
Back when I started I talked a bit about the conversations I was having with our members about this issue, and what they thought might be needed. The same questions remain - How can we build momentum and support real change, in partnership with service users?How can providers make sense of what is a rapidly evolving marketplace and make informed choices about which programmes and applications to use? How do we determine what ‘quality’ looks like? How can we ensure that innovations in this field are developed within appropriate governance frameworks? At a national level, how can we help spread knowledge and good practice about what works?
In the paper, we argue that there needs to be a national framework for e-mental health.That would take the form of two distinct phases. In the first phase, we’d want to map what people are already doing – do build a better picture about how technology is being used, what lessons we can learn from other sectors and countries, and also to discover what examples of good practice there are out there.
As a second phase, we want to design the actual framework. That would articulate a shared vision, from service users, professionals and managers, about where we want to get to and what actions different parts of the system need to take to enable us to get there. Whilst that might not be a process led by the Commissioning Board, I think it would certainly need the endorsement and support of the Board.
And that’s it from me. Thank you for listening, I hope that was a helpful canter through the policy context for this work, and also about what the MHN is doing in this area. I’d be really happy to take any questions anyone has at this point.
We live in a digital world that has transformed society to put consumers in control, but Public services (the NHS and mental health) have embraced technology for interventions, data management and medication BUT remain analogue in harnessing technology to empower consumers. In mental health, we have:Users who are often passive, not in control, not engaged with treatmentCulture of professionally-led carePaper-based user tools (mood diaries, help books, leaflets)