Czy pacjent może być ekspertem od leków? - przykłady działań organizacji pacj...Fundacja MY PACJENCI
Wykład w ramach projektu Pacjenci Decydują (II edycja) realizowanego przez Fundację MY Pacjenci w partnerstwie z Fundacją Urszuli Jaworskiej, Fundacją Aktywnych Pacjentów ARGUS, Innopharm Centrum Informacji o Leku oraz Fabryką Komunikacji Społecznej
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
Czy pacjent może być ekspertem od leków? - przykłady działań organizacji pacj...Fundacja MY PACJENCI
Wykład w ramach projektu Pacjenci Decydują (II edycja) realizowanego przez Fundację MY Pacjenci w partnerstwie z Fundacją Urszuli Jaworskiej, Fundacją Aktywnych Pacjentów ARGUS, Innopharm Centrum Informacji o Leku oraz Fabryką Komunikacji Społecznej
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Applitools
During this webinar, Anand Bagmar demonstrates how AI tools such as ChatGPT can be applied to various stages of the software development life cycle (SDLC) using an eCommerce application case study. Find the on-demand recording and more info at https://applitools.info/b59
Key takeaways:
• Learn how to use ChatGPT to add AI power to your testing and test automation
• Understand the limitations of the technology and where human expertise is crucial
• Gain insight into different AI-based tools
• Adopt AI-based tools to stay relevant and optimize work for developers and testers
* ChatGPT and OpenAI belong to OpenAI, L.L.C.
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Applitools
During this webinar, Anand Bagmar demonstrates how AI tools such as ChatGPT can be applied to various stages of the software development life cycle (SDLC) using an eCommerce application case study. Find the on-demand recording and more info at https://applitools.info/b59
Key takeaways:
• Learn how to use ChatGPT to add AI power to your testing and test automation
• Understand the limitations of the technology and where human expertise is crucial
• Gain insight into different AI-based tools
• Adopt AI-based tools to stay relevant and optimize work for developers and testers
* ChatGPT and OpenAI belong to OpenAI, L.L.C.
2. • Despite the lack of randomised trials on energy drinks
consumption, few case reports on atrial and ventricular
arrhythmias as well as on myocardial ischaemia inducted by
energy drinks have raised concerns on the safety of these
beverages.
• Energy drinks are beverages which contain a variable amount
of caffeine, taurine, sweeteners and vitamins. They may also
contain other stimulants such as guarana or ginseng.
3. • The amount of caffeine can vary greatly between different
brands of energy drinks. On average, caffeine content per
energy drink is modest and comparable to an espresso coffee
cup (80mg).
• Taurine is thought to be a stimulant to a greater extent than
caffeine.
• Conversely, taurine is an organic acid normally present in meat
and fish, with a number of fundamental biological roles.
4. • Energy drinks have been an active subset in the soft drinks
industry for a long time. Pepsi and Coca-Cola, for instance,
were originally marketed as energy boosters.
• Nevertheless, it was in the late 90’s that energy drinks
consumption grew at a faster pace.
5. • In 2011, the European Food Safety Authority commissioned a
study to gather consumption data for energy drinks in 16
countries of the European Union.
• They found that 68% of adolescents (aged 10–18 years old),
30% of adults, and 18% of children (<10 years old) consumed
energy drinks.
6. • An analysis of US National Poison Data System2 reported 4,854 (0,2%)
phone calls for energy drink exposure, between 1 October 2010 and 30
September 2011. Of 1,480 non-alcoholic energy drink cases, 50.7% were
children <6 years old, 76.7% were unintentional and 60.8% were males.
Major adverse effects consisted of three cases of seizure, two of non-
ventricular dysrhythmia, one ventricular dysrhythmia, and one
tachypnoea.
•
Ventricular arrhythmias and sudden death related to energy drink
consumption have been reported.
• A 28-year-old-man was admitted to an emergency department with
ventricular tachycardia. The patient had drunk three cans of 250-mL
energy drink five hours before a basketball match.
• Another case was a 45-year-old man who underwent repair of tetralogy of
Fallot at the age of five years. He reported to his cardiologist because of his
first ICD shock. He awoke tired for an early workday and consumed three
Red Bull energy drinks over three to four hours. The ICD shock occurred
within 30 minutes after he finished the third drink.
7. • Moreover, three recent reports suggest that energy drinks can
not only trigger cardiac events—but much like an exercise test
or an adrenaline or flecainide‐challenge—can unmask an
underlying primary pathogenic disorder, such as Long QT
(LQTS) or Brugada syndrome.
•
Atrial arrhythmias may be triggered as well by energy drinks.
The cases of two young boys with no structural heart disease
and atrial fibrillation after energy drink consumption have
been reported.
8. • Energy drinks may also play a role in myocardial ischaemia:
detrimental effects of energy drink consumption on platelet
and endothelial function was tested on 50 healthy volunteers.
Platelet aggregation and endothelial function were tested
before, and one hour after, the consumption of 250 mL (one
can) of a sugar-free energy drink.
• Compared with baseline values, there was a significant
increase in platelet aggregation and decrease in endothelial
function following energy drink consumption.
9. • There are some reports of acute coronary syndrome and even
ST segment elevation myocardial infarction (STEMI) after
energy drink overconsumption: a case of a 26 year-old male
with chest pain admitted to an emergency department after
drinking his usual quantity (about 4L) of energy drinks.
• The patient had inferior STEMI and underwent cardiac
catheterisation and primary percutaneous coronary
intervention on occluded circumflex coronary artery.
10. Energy drinks are used worldwide, but are they
dangerous to some extent?
• The main reasons why energy drinks may have deleterious
effects lie in the way how they are consumed, since they are
frequently mixed with alcohol and stimulant drugs.
• Moreover, energy drinks overconsumption is not rare and it
may lead to caffeine intoxication.
• When children are exposed to energy drinks they have a
higher probability of adverse events.
• Additionally, energy drinks toxicity may be enhanced in the
presence of underlying cardiac disease.
• For these reasons, details on the possible cardiac health issues
should be informed and main health associations should also
discuss and point out the possible limitations to consumption
of these popular beverages.
11. • References
•
• 1. Shao A, Hathcock JN Risk assessment for the amino acids taurine, L-
glutamine and L-arginine. Regul Toxicol Pharmacol. 2008
• 2. SeifertSM et al, Clin Toxicol 2013;51(7):566‒74
• 3. Avci S et al, Am J Emerg Med 2013;31(11):1624.e3‒4. doi:
10.1016/j.ajem.2013.06.031. Epub 2013 Jul 27
• 4. Ward AE et al, Am J Cardiol 2014;114(7):1124‒5
• 5. Gray B et al, Int J Cardiol 2012;159(1):77‒8. doi:
10.1016/j.ijcard.2012.05.121. Epub 2012 Jun 15
• 6. Izquierdo Fos I et al, An Pediatr 2012;77(6):417‒9
• 7. Worthley MI et al, Am J Med 2010;123(2):184‒7
• 8. Lippi G et al, Energy Drinks and Myocardial Ischemia: A Review of Case
Reports. Cardiovasc Toxicol. 2015 Aug 30
• - See more at: http://www.cxvascular.com/crn-highlights/cardiac-rhythm-
news---highlights/are-energy-drinks-safe-enough-for-the-
heart#sthash.W4JWgJaM.dpuf
12. jest wydarzeniem,
nie procesem
To określenie często oznacza
przekazanie.
celowy, zaplanowany proces
uwzględniający potrzeby
medyczne, psychospołeczne
i edukacyjne/zawodowe
nastolatków i młodych dorosłych
z przewlekłymi schorzeniami
w okresie przechodzenia spod
opieki zdrowotnej dla dzieci
do systemu opieki zdrowotnej
dla dorosłych.
Przejście czy przeniesienie?
Przeniesienie
(transfer)
Przejście
(transition)
13. Psychologiczne procesy dorastania u młodzieży
przewlekle chorej
Podróż do dorosłego życia jest
czasem głębokich przemian
psychologicznych i społecznych
dla wszystkich młodych ludzi
i ich rodzin (Eiser 1993)
Ale dla młodych ludzi z przewlekłymi
chorobami, to przejście często
dodatkowo komplikują zarówno
zmiany w ich potrzebach
zdrowotnych jak i zmiany
w dostępie do usług medycznych
(While 2004)
14. Komunikacja
Jeśli przeskakujesz co chwilę do kogoś
innego- tak jak ja- badało mnie sześciu lekarzy
w ciągu roku- wtedy po prostu
nie chciało mi się z nimi rozmawiać.
Ale jeśli pozostaniesz u tego samego lekarza
dłużej, to trochę łatwiej jest się otworzyć
Bartosz, lat 19
15. Zalety i wady opieki pediatrycznej
z punktu widzenia młodych pacjentów i ich rodziców
Zalety i wady opieki pediatrycznej
Zalety Wady
Staa A.L., Jedeloo S., Meeteren J. van: Crossing the transition chasm: experience and recommendations for
improving transitional care of young adults, parents and providers. Child: care, health and development.
2011, 6, 821-832.
16. Korzyści związane z opieką pediatryczną
• Znana
• Komfortowa i luźna atmosfera
• Przyjazna dla dzieci
• Zaangażowanie rodziców
• Szacunek dla doświadczenia pacjenta
i rodzica
• Godne zaufania doświadczenie
pracowników służby zdrowia
• Dobra współpraca między
pracownikami służby zdrowia
• Multidyscyplinarny zespół
• Podejście holistyczne
• Doskonałe warunki do leczenia
pacjenta w szpitalu
• Wszystko jest zaplanowane
17. Wady związane z opieką pediatryczną
• Dziecięca, nie jest dostosowana do wieku
• Kontakt z małymi dziećmi
• Mniej zachęty związanej z niezależnością
i samokontrolą leczenia
• Nastolatek jest mniej zaangażowany
w proces decyzyjny; obecność rodziców
ogranicza swobodę wypowiedzi/udział
młodzieży
• „Ustalone” związki
• Brak informacji o kwestiach dotyczących dorosłych
• Lekarze są niechętni, aby stosować agresywne leczenie
i wypróbowywać nowe opcje
18. Zalety i wady opieki nad dorosłymi
z punktu widzenia młodych pacjentów i ich rodziców
Zalety i wady opieki nad dorosłymi
Zalety Wady
19. Wady związane z opieką nad dorosłymi
Nieznana
Formalna,
zdystansowana,
szorstka
Nie skupia się na
młodych ludziach
Rodzice nie są tak
mile widziani
Brak szacunku dla
doświadczenia
pacjenta i rodzica
Doświadczenie nie
zawsze godne
zaufania
Słaba koordynacja
z pediatrami
/innymi
specjalistami
Podejście
zespołowe nie jest
oczywiste
Mniejsze skupianie
się na aspektach
psychologiczno-
społecznych
Słabsze warunki do
leczenia pacjenta w
szpitalu
Konfrontacja ze
starszymi
pacjentami
Inne metody i
procedury lecznicze
niż w opiece
pediatrycznej
Trzeba samemu
wszystko
zorganizować
20. Korzyści związane z opieką nad dorosłymi
Dostosowana do
wieku (dorosłych)
Atmosfera rzeczowa,
niemal jak w
przedsiębiorstwie
Większe skupienie się
na odpowiedzialności
i samokontroli
leczenia
Młodociany pacjent
jest bardziej
zaangażowany w
podejmowanie decyzji
Z chęcią buduje nowe
związki, rozpoczęcie
wszystkiego od
początku
Informacje odnoszące
się do kwestii
dotyczących dorosłych
Możliwość wybrania
szpitala położonego
bliżej miejsca
zamieszkania
Możliwe jest
skorzystanie z nowych
możliwości leczenia
21. Niezbędne elementy programu przekazania
Przed przekazaniem:
• Ocenić rozwój poznawczy
i psychospołeczny
nastoletniego pacjenta
• Ocenić pacjenta i opiekuna
pod kątem depresji,
zaburzeń lękowych
Przekazanie
Sable C., Foster E., Uzark K. i wsp.: Best practices in managing transition to adulthood for adolescents with
congenital heart disease: the transition process and medical and psychosocial issues: a scientific statement
from the American Heart Association. Circulation, 2011; 123: 1454-1485
22. Rozpoczęcie przekazania
• Omówić ideę przekazania opieki z pacjentem oraz
rodzicami
• Jasno zdefiniować role i oczekiwania związane z rolą
dla pacjenta, rodziców i pracownika opieki pediatrycznej
• Szkolić rodziców, aby pomóc im bezpiecznie przebrnąć
przez proces przekazania
• Opracowywać cele i oś czasową dotyczącą przekazania
z pacjentem i rodzicami
• Zapewnić materiały szkoleniowe
• Dokonać oceny okresowej oraz kontroli oczekiwań
i celów odpowiednich dla danego wieku oraz etapu
rozwoju
pacjent
rodzice
Przekazanie
23. Cele i oczekiwania,
które pacjent powinien spełnić przed przekazaniem
• Zrozumienie diagnozy i historii choroby
• Znajomość terapii medycznych
(leków – dawek, częstotliwości oraz przyczyny
ich przyjmowania)
• Dodatkowa wiedza medyczna:
• Konieczność określonego monitorowania i opieki anestezjologicznej
• Profilaktyka zapalenia wsierdzia, jeśli dotyczy
• Ryzyko ciąży i antykoncepcja
• Nadużywanie narkotyków i alkoholu
• Samokontrola w zakresie opieki
• Samodzielne przyjmowanie leków doustnych
• Samodzielne podawanie leków dożylnych/podskórnych
• Dbanie o centralny cewnik dożylny
• Wiedza na temat celu i przestrzegania badań diagnostycznych,
• Obowiązki szkolne – dostosowanie szkoły lub do choroby i leczenia
Przekazanie
24. Tuż przed przekazaniem
• Zaaranżować wspólną wizytę pacjenta, opiekuna, zespołu opieki pediatrycznej i dla dorosłych
w ośrodku pediatrycznym
• Podczas wspólnej wizyty należy dokonać przeglądu
historii choroby
• Przedstawić pacjentowi oraz zespołowi
ds. leczenia dorosłych pacjentów oficjalne
pismo podsumowujące
• Omówić datę pierwszej wizyty w ośrodku leczenia
dorosłych, a także częstotliwość wizyt
• Ocenić potrzebę dalszych badań kontrolnych
u innych specjalistów, jeśli konieczne
• Zapewnić pisemne materiały oraz ustny przegląd
organizacji placówki dla dorosłych
• Oprowadzić po placówce dla dorosłych
• Przedstawić członków zespołu opieki nad dorosłymi pacjentami,
podać dane kontaktowe (wskazanych osób kontaktowych)
Przekazanie
Podsumowanie powinno
obejmować (choć przegląd
nie musi być dokonany
podczas wizyty):
rozwój psychologiczny,
zdrowie psychiczne,
zaangażowanie rodziny,
przestrzeganie zaleceń,
kwestie terminalne.
25. Po zmianie ośrodka
• Zaaranżować wizytę „na zakładkę”
– pracownik opieki pediatrycznej
uczestniczy w pierwszej wizycie
w ośrodku dla dorosłych
• Ponownie zdefiniować
role i oczekiwania
wobec roli dla pacjenta, rodzica oraz
pracowników placówki opieki
zdrowotnej
Przekazanie
26. Co zawiera dobry model?
Te elementy nie zawierają
wszystkiego, co jest potrzebne,
ale wskazują na mnogość
i rozległość wymagań
Model
Docenienie wagi
procesu
Elastyczność
planowania w
czasie
Okres
przygotowania
młodego
człowieka i jego
rodziny
Informacja o
przeniesieniu
Monitoring
dopóki młoda
osoba nie
zakorzeni się w
ośrodku dla
dorosłych
Praca
wielodyscyplinar
na
Rozwijania
wiedzy i
umiejętności
pracy z młodymi
ludźmi dla
profesjonalistów
27. Zalecenia ekspertów AHA
Wiedza młodocianych chorych na temat
własnej choroby i wynikających z niej
ograniczeń, w tym możliwości założenia
rodziny i oczekiwanej długości życia, jest
warunkiem prawidłowego procesu
przejścia pod opiekę systemu kardiologii
dorosłych.
Drugim strategicznym punktem jest
współpraca pomiędzy kardiologiem
dziecięcym, kardiologiem dorosłych oraz
- co bardzo ważne - lekarzem rodzinnym,
który powinien aktywnie uczestniczyć
w opiece nad chorym z CHD.
Sable C., Foster E., Uzark K. i wsp.: Best practices in managing transition to adulthood for adolescents with
congenital heart disease: the transition process and medical and psychosocial issues: a scientific statement
from the American Heart Association. Circulation, 2011; 123: 1454-1485
współpraca
Kardiolog
dziecięcy
Lekarz
rodzinny
Kardiolog
dorosłych
30. Rodzice pod drzwiami gabinetu
Rodzice
• tendencja do większego zdenerwowania oraz trudności z pogodzeniem się ze
zmianą w zakresie opieki, w przeciwieństwie do swoich dzieci
• uważają specjalistów pediatrii, kardiologów i kardiochirurgów dziecięcych za
osoby, które uratowały życie ich dzieci.
• mają prawo niepokoić się na myśl o zmianie długoletniego przywiązania do
dziecięcego centrum leczenia i przejścia do nowego ośrodka.
• Obawiają się, że pracownicy nowej placówki mogą nie posiadać wystarczającej
wiedzy na temat stanu ich dziecka,
mogą mieć wyższe oczekiwania jeśli
chodzi o samodzielność ich dziecka,
oraz mogą nie wtajemniczać opiekunów
w plan leczenia.
Sable C., Foster E., Uzark K. i wsp.: Best practices in managing transition to
adulthood for adolescents with congenital heart disease: the transition
process and medical and psychosocial issues: a scientific statement from the
American Heart Association. Circulation, 2011; 123: 1454-1485
31. Doświadczenia ośrodków belgijskich:
• młodzi pacjenci z PAH i ich rodzice po
pierwszej wizycie u kardiologa opiekującego
się dorosłymi pacjentami, mieli wrażenie, że
lekarz nie wie nic na temat ich choroby,
ponieważ objętość dokumentacji medycznej,
którą dysponował, była niewielka w
porównaniu z dokumentacją z ośrodka
pediatrycznego.
• Jednym z elementów udanego przejścia
pacjenta z PH do lekarzy opiekujących się
dorosłymi musi być przygotowanie
streszczenia dotychczasowej historii choroby,
w czym powinien uczestniczy sam pacjent,
ale także jego rodzina.
Jak zmieścić historię 18 lat leczenia
na jednej kartce?
32. Przekazywanie pacjentów jest jak most,
który łączy dwa brzegi.
Są mosty długie i monumentalne,
są mosty krótkie i lekkie w konstrukcji...
Wspólnym zadaniem kardiologów
dziecięcych i kardiologów dorosłych jest
budowanie dla naszych pacjentów
najlepszych mostów
i wytyczanie jak najdłuższych szlaków.
zdjęcie ze slajdu 2a, lub z innym nastolatkiem, ale nie z dredami:)
Dodatkowa wiedza medyczna:
Konieczność określonego monitorowania i opieki anestezjologicznej,
Profilaktyka zapalenia wsierdzia, jeśli dotyczy
Ryzyko ciąży i antykoncepcja , czy rozumieją zmiany w swoim ciele, sprawy płciowości, środków zapobiegania ciąży (jak i gdzie je pozyskać?), chorób przenoszonych droga płciową
Nadużywanie narkotyków i alkoholu
Samokontrola w zakresie opieki
Samodzielne przyjmowanie leków doustnych
Samodzielne podawanie leków dożylnych/podskórnych (kroki do osiągnięcia perfekcji – obserwacja przygotowań opiekuna, wykonanie pod okiem opiekuna, indywidualne przygotowanie)
Rozwijania wiedzy i umiejętności pracy z młodymi ludźmi dla profesjonalistów (psychologia młodocianych, komunikacja)