No matter how fast we construct buildings the time it takes from planning to use, means that the building is dated at the time it is handed over.
This time frame will vary according to the nature and circumstances of the contract and or construction.
In private healthcare it will average 24 months (2 years)
In public healthcare its longer 36 months – 60 months (5 years)
There is no value judgement simply a comment of the process, and regardless of cause or the actual time frame it is simply out of date by the time of handover.
This paper explores explores the notion that out of date hospitals ( crocodiles) are better than hospitals that are extinct (dodo).
Advances in Interior Design Technology
in Healthcare Facilities
In the last two decades, evidence-based design-features that
Improve patient healing, mood, and well-being,
Staff efficiency and safety
Through thoughtful and research-based design initiatives-has fundamentally changed how we design hospital interiors.
For healthier indoor environments.
low-VOC paint, recycled paint, less toxic adhesives that generate less off-gassing, and carpets and ceiling tiles that include post-consumer waste and/or can be recycled.
Advances in Interior Design Technology
in Healthcare Facilities
In the last two decades, evidence-based design-features that
Improve patient healing, mood, and well-being,
Staff efficiency and safety
Through thoughtful and research-based design initiatives-has fundamentally changed how we design hospital interiors.
For healthier indoor environments.
low-VOC paint, recycled paint, less toxic adhesives that generate less off-gassing, and carpets and ceiling tiles that include post-consumer waste and/or can be recycled.
For long time there is a human obsession to overcome death. In the past, man sought to overcome death through the religions. In the contemporary era, we started to believe that it would be possible to overcome death with the use of science and technology. The belief that, if it´s not possible to overcome death, but that it would be possible to extend the life is based on the fact that the life expectancy of men increased from 30 years in 1500, 37 years in 1800, 45 years in 1900, 46.5 years in 1950 and 80 years in 2012. The Superinteressante magazine (<http: />) published an article under the title Quem quer viver 1 000 anos? (Who wants to live 1000 years?), which states that the achievement of a longer existence in the 20th century resulted from the improvement of sanitary conditions in the cities and the creation of public health services. In addition, science discovered vaccines and antibiotics that made possible the disease prevention and control of epidemics. The increase in educational level and income also contributed to improving the quality of life and increase the longevity even more in the third or -. perhaps we can say - fourth age.
Linking Long-Term Care and Healthcare Facilities: Examining Typologies, Cultu...Erin K. Peavey
Texas A&M University. 2006. Independent Study in Healthcare Design with Dr. Susan Rodiek.
The goal of this project is to explain the way in which healthcare (HC) and longterm care (LTC) facilities share significant attributes and are evolving on parallel paths. A review of the literature reveals a lack of documentation recognizing the commonalities of HC and LTC facilities. This paper will call attention to the similarity between HC and LTC facilities by reviewing facility types and examining design features common to both. Additionally, it reviews the major factors that tend to influence how the culture of these facilities is hanging. This paper is limited to what appear to be the most important and diverse aspects that link the HC and
LTC facility design fields.
Essay On Marxism. Marxist theory essay - presentationbackgrounds.web.fc2.comMaria Watson
AQA A Level Sociology 20 mark essay Marxism families | Teaching Resources. Marxism & Literature - University Media Studies - Marked by Teachers.com. A Marxist Criticism Free Essay Example. Essay plan: Assess the contribution of Marxism to our understanding. Marxism critical essays - educationcoursework.x.fc2.com.
During those disasters unmanned aircraft surveyed wrecked roads, bridges and rail lines. They spotted oil and gas leaks. They inspected damaged cell towers that had left thousands unable to call for help. "Drones became a literal lifeline," former Federal Aviation Administration chief Michael Huerta told the agency's drone advisory committee in November.
The drones used needed a special exemption from a set of FAA rules, known as Part 107, that normally require small drones to fly below 400 feet, stay within the operator's visual line of sight and avoid populated areas.
Sample essay on influences of conformity and obedience. Describe and evaluate the explanations of conformity. (12 marks) - A .... The Concepts Of Conformity And Obedience - A-Level Psychology - Marked .... Conformity. Conformity discussion. - A-Level Psychology - Marked by Teachers.com. Confronting the Issue of Conformity - Free Essay Example | PapersOwl.com. Stupendous Conformity Essay ~ Thatsnotus. What is conformity - A-Level Psychology - Marked by Teachers.com. Outline and Evaluate Explanations of Conformity - A-Level Psychology .... Conformity essay psychology - copywritingname.web.fc2.com. Social psychology conformity essay - essayfor.x.fc2.com. Social psychology paper conformity theory essay. Antigone: conformity and nonconformity assignment - Essay Example for .... Asch - Conformity - A-Level Psychology - Marked by Teachers.com. Essay On Conformity. What is Conformity?. Conformity in the 1950s essay. Essay Question Evaluate Research On Conformity To Group Norms .... ⇉Not All Conformity Is Bad, However, Harmful Conformity Can Become a .... conformity essay p3.docx - Conformity Makes Us What is the true .... ᐅ Essays On Conformity and Obedience
A Good Teacher Essay | PDF | Teachers | Learning. essay on my favourite teacher in english. Essay About Teacher - My Favorite Teacher. Essay- Becoming an excellent teacher. Teachers Essay. Essay Of Teacher – Telegraph. Essay On Teachers Day. 310 best images about teacher stuff on Pinterest | Teaching, Earth day .... What Is A Teacher Essay Example | Sitedoct.org. "I Am a Teacher" 2011 Texas Teacher of the Year essay by ATPE member .... Essay on Teachers Day in English for Students 500 Words. Essay on Teachers Day/Ten lines about Teachers day/Essay writing/Best .... [Essay] Good and Bad Teachers | Teachers | Emotions. ️ Becoming a teacher essay. Becoming A Teacher Essay. 2019-01-31. Teacher’s Passionate Essay Brings Year’s Worth of School Supplies to .... Essay on Teachers Day (2023) in English [Short, Simple & Best]. Short essay about a teacher. Essay on Teacher | Teachers | Classroom. My teacher essay - Purchase Custom Written Essays.. 006 Essay Example Why I Want To Teacher ~ Thatsnotus. Being A Teacher Essay – Telegraph. Essay on Teacher in English for Kids and Students | 500 Words Essay on .... Essay on my teacher is the best in 2021 | Essay, College application .... My Teacher Essay | Essay on My Teacher for Students and Children - A .... Essay about teachers - College Homework Help and Online Tutoring.. essays on teachers | Teacher favorite things, Essay help, Writing .... Short Essay on Teachers' Day [100, 200, 400 Words] With PDF - English .... ESSAY - Qualities of a Good Teacher | Teachers | Action (Philosophy ....
≫ Going Green Energy Free Essay Sample on Samploon.com. [Best] Essay On One Step Towards Green And Clean Energy - Intellectual .... Analytical Essay: Green energy essay. ≫ My Interest to Renewable Energy Free Essay Sample on Samploon.com. Energy Assignment Essay.docx | Wind Power | Renewable Energy. Conservation of energy essay writing - writinghtml.web.fc2.com. Saving energy essay writing. Essay On Renewable Energy | Renewable Energy Essay for Students and .... Renewable Energy - A-Level Science - Marked by Teachers.com. Green Energy. solar energy essay thesis paper on renewable energy how arguments on .... Green Revolution Essay | Essay on Green Revolution for Students and .... (PDF) GREEN ENERGY: The NEED of the WORLD. What is Renewable Energy? - A-Level Science - Marked by Teachers.com. (PDF) Three Essays on Renewable Energy. Free «Use Green Energy» Essay Paper in the «Research» Category .... Modern Marvels - Renewable Energy Essay Example | Topics and Well ....
Professional Essay Writing. How To Write an Essay - Essay Tips: 7 Tips on Wri...Caroline Barnett
College Essay Format: Simple Steps to Be Followed. Business paper: Sample essay paper. Professional Essay Samples from Top Writers. How to Write In College Essay Format | OCC NJ. Impressive Academic Essay Format ~ Thatsnotus. Write essay paper from a professional academic writing service. Writing a professional essay - College Homework Help and Online Tutoring.. 10 easy steps to writing a professional essay. 10+ Formal Writing Examples - PDF | Examples. 001 Essay Example Professional ~ Thatsnotus. How to Find the Best Essay Writers Online - The Katy News. Professional essay writing help quick essay writers — www.quickessayw…. 50 Best Reflective Essay Examples (+Topic Samples) ᐅ TemplateLab. Essay Writing Service - Many professionals find that it is quite .... Professional essay writing help | Custom Writing Service for College .... Formal Essays - 9+ Examples, Format, Sample | Examples. How To Write an Essay - Essay Tips: 7 Tips on Writing an Effective .... 023 Essay Example Professional ~ Thatsnotus. Professional Essay Writing Service In Australia | Quick Market. 013 Essay Example Professional ~ Thatsnotus. Academic Essay Structure Tips [Writing Guide] | Pro Essay Help. Academic Essay Examples - 15+ in PDF | Examples. 11 Reasons Why Essay Writing Is Important In One’s Professional Life. Professional Essay Writers$ 10 For Page - Professional Custom Essay .... College Essay: Professional essays. Professional essays. Main Characteristics Of A Pro Essay Writer. Professional Essay Writers. professional essay writing service by cecilfugate38 - Issuu. 006 Essay Example Professional Writers Page 1fit11562c1496ssl1 ~ Thatsnotus Professional Essay Writing Professional Essay Writing. How To Write an Essay - Essay Tips: 7 Tips on Writing an Effective ...
Healthcare Associated Infections (HAIs): Research NewsletterErin K. Peavey
In the US “One in 25 patients have a hospital-acquired
infection...Each day, over 205 deaths occur from HAIs...”
— Centers for Disease Control, 2011
An overview of this month’s article follows with bullet-points of the advantages and disadvantages of various environmental interventions in the prevention of Healthcare-Associated Infections (HAIs), often referred to as hospital-acquired infections. Paragraph summaries of Cleaning Strategies, Materials, Room Design and Hand-Hygiene are listed below. These provide broad themes and findings from the article. Reading the full article is always of benefit for a fuller understanding and is recommended. Click here to access the full article on the HERD Journal website.
[PDF Notes] Write an Essay on Energy Conservation 2023. Write a short essay on Energy Conservation | Essay Writing | English .... Paragraph On Energy Conservation 100, 150, 200, 250 to 300 Words For ....
[PDF Notes] Write an Essay on Energy Conservation 2023. Write a short essay on Energy Conservation | Essay Writing | English .... Paragraph On Energy Conservation 100, 150, 200, 250 to 300 Words For ....
A Website That Writes Essays For You Has To Be Reliable penessays.com. 5 Best Websites That Write Essays For You In USA - The European .... Essay Writer Website Template. Websites That Write Essays for You: Top 10 Services. Essay Writing Website Template 59201 - TemplateMonster. 003 How To Cite Website In An Essay Mla Thatsnotus. Best websites for custom essays writing. 012 Website That Writes Essays For You Free Essay Editing Checklist .... 015 Essay Example Cite An Step Version How To Website Thatsnotus. Websites for essay writing - 24/7 Homework Help.. 021 Best Essay Writing Website Websites For Essays 10004 Uk 1048x1620 .... Write my essay website - Purchase Custom Written Essays.. How To Write Websites In A Paper Allison Writing. Good Essay Help Website - Best Essay Writers Here Order Your Own .... 014 How To Cite Website In An Essay Example Aite
For long time there is a human obsession to overcome death. In the past, man sought to overcome death through the religions. In the contemporary era, we started to believe that it would be possible to overcome death with the use of science and technology. The belief that, if it´s not possible to overcome death, but that it would be possible to extend the life is based on the fact that the life expectancy of men increased from 30 years in 1500, 37 years in 1800, 45 years in 1900, 46.5 years in 1950 and 80 years in 2012. The Superinteressante magazine (<http: />) published an article under the title Quem quer viver 1 000 anos? (Who wants to live 1000 years?), which states that the achievement of a longer existence in the 20th century resulted from the improvement of sanitary conditions in the cities and the creation of public health services. In addition, science discovered vaccines and antibiotics that made possible the disease prevention and control of epidemics. The increase in educational level and income also contributed to improving the quality of life and increase the longevity even more in the third or -. perhaps we can say - fourth age.
Linking Long-Term Care and Healthcare Facilities: Examining Typologies, Cultu...Erin K. Peavey
Texas A&M University. 2006. Independent Study in Healthcare Design with Dr. Susan Rodiek.
The goal of this project is to explain the way in which healthcare (HC) and longterm care (LTC) facilities share significant attributes and are evolving on parallel paths. A review of the literature reveals a lack of documentation recognizing the commonalities of HC and LTC facilities. This paper will call attention to the similarity between HC and LTC facilities by reviewing facility types and examining design features common to both. Additionally, it reviews the major factors that tend to influence how the culture of these facilities is hanging. This paper is limited to what appear to be the most important and diverse aspects that link the HC and
LTC facility design fields.
Essay On Marxism. Marxist theory essay - presentationbackgrounds.web.fc2.comMaria Watson
AQA A Level Sociology 20 mark essay Marxism families | Teaching Resources. Marxism & Literature - University Media Studies - Marked by Teachers.com. A Marxist Criticism Free Essay Example. Essay plan: Assess the contribution of Marxism to our understanding. Marxism critical essays - educationcoursework.x.fc2.com.
During those disasters unmanned aircraft surveyed wrecked roads, bridges and rail lines. They spotted oil and gas leaks. They inspected damaged cell towers that had left thousands unable to call for help. "Drones became a literal lifeline," former Federal Aviation Administration chief Michael Huerta told the agency's drone advisory committee in November.
The drones used needed a special exemption from a set of FAA rules, known as Part 107, that normally require small drones to fly below 400 feet, stay within the operator's visual line of sight and avoid populated areas.
Sample essay on influences of conformity and obedience. Describe and evaluate the explanations of conformity. (12 marks) - A .... The Concepts Of Conformity And Obedience - A-Level Psychology - Marked .... Conformity. Conformity discussion. - A-Level Psychology - Marked by Teachers.com. Confronting the Issue of Conformity - Free Essay Example | PapersOwl.com. Stupendous Conformity Essay ~ Thatsnotus. What is conformity - A-Level Psychology - Marked by Teachers.com. Outline and Evaluate Explanations of Conformity - A-Level Psychology .... Conformity essay psychology - copywritingname.web.fc2.com. Social psychology conformity essay - essayfor.x.fc2.com. Social psychology paper conformity theory essay. Antigone: conformity and nonconformity assignment - Essay Example for .... Asch - Conformity - A-Level Psychology - Marked by Teachers.com. Essay On Conformity. What is Conformity?. Conformity in the 1950s essay. Essay Question Evaluate Research On Conformity To Group Norms .... ⇉Not All Conformity Is Bad, However, Harmful Conformity Can Become a .... conformity essay p3.docx - Conformity Makes Us What is the true .... ᐅ Essays On Conformity and Obedience
A Good Teacher Essay | PDF | Teachers | Learning. essay on my favourite teacher in english. Essay About Teacher - My Favorite Teacher. Essay- Becoming an excellent teacher. Teachers Essay. Essay Of Teacher – Telegraph. Essay On Teachers Day. 310 best images about teacher stuff on Pinterest | Teaching, Earth day .... What Is A Teacher Essay Example | Sitedoct.org. "I Am a Teacher" 2011 Texas Teacher of the Year essay by ATPE member .... Essay on Teachers Day in English for Students 500 Words. Essay on Teachers Day/Ten lines about Teachers day/Essay writing/Best .... [Essay] Good and Bad Teachers | Teachers | Emotions. ️ Becoming a teacher essay. Becoming A Teacher Essay. 2019-01-31. Teacher’s Passionate Essay Brings Year’s Worth of School Supplies to .... Essay on Teachers Day (2023) in English [Short, Simple & Best]. Short essay about a teacher. Essay on Teacher | Teachers | Classroom. My teacher essay - Purchase Custom Written Essays.. 006 Essay Example Why I Want To Teacher ~ Thatsnotus. Being A Teacher Essay – Telegraph. Essay on Teacher in English for Kids and Students | 500 Words Essay on .... Essay on my teacher is the best in 2021 | Essay, College application .... My Teacher Essay | Essay on My Teacher for Students and Children - A .... Essay about teachers - College Homework Help and Online Tutoring.. essays on teachers | Teacher favorite things, Essay help, Writing .... Short Essay on Teachers' Day [100, 200, 400 Words] With PDF - English .... ESSAY - Qualities of a Good Teacher | Teachers | Action (Philosophy ....
≫ Going Green Energy Free Essay Sample on Samploon.com. [Best] Essay On One Step Towards Green And Clean Energy - Intellectual .... Analytical Essay: Green energy essay. ≫ My Interest to Renewable Energy Free Essay Sample on Samploon.com. Energy Assignment Essay.docx | Wind Power | Renewable Energy. Conservation of energy essay writing - writinghtml.web.fc2.com. Saving energy essay writing. Essay On Renewable Energy | Renewable Energy Essay for Students and .... Renewable Energy - A-Level Science - Marked by Teachers.com. Green Energy. solar energy essay thesis paper on renewable energy how arguments on .... Green Revolution Essay | Essay on Green Revolution for Students and .... (PDF) GREEN ENERGY: The NEED of the WORLD. What is Renewable Energy? - A-Level Science - Marked by Teachers.com. (PDF) Three Essays on Renewable Energy. Free «Use Green Energy» Essay Paper in the «Research» Category .... Modern Marvels - Renewable Energy Essay Example | Topics and Well ....
Professional Essay Writing. How To Write an Essay - Essay Tips: 7 Tips on Wri...Caroline Barnett
College Essay Format: Simple Steps to Be Followed. Business paper: Sample essay paper. Professional Essay Samples from Top Writers. How to Write In College Essay Format | OCC NJ. Impressive Academic Essay Format ~ Thatsnotus. Write essay paper from a professional academic writing service. Writing a professional essay - College Homework Help and Online Tutoring.. 10 easy steps to writing a professional essay. 10+ Formal Writing Examples - PDF | Examples. 001 Essay Example Professional ~ Thatsnotus. How to Find the Best Essay Writers Online - The Katy News. Professional essay writing help quick essay writers — www.quickessayw…. 50 Best Reflective Essay Examples (+Topic Samples) ᐅ TemplateLab. Essay Writing Service - Many professionals find that it is quite .... Professional essay writing help | Custom Writing Service for College .... Formal Essays - 9+ Examples, Format, Sample | Examples. How To Write an Essay - Essay Tips: 7 Tips on Writing an Effective .... 023 Essay Example Professional ~ Thatsnotus. Professional Essay Writing Service In Australia | Quick Market. 013 Essay Example Professional ~ Thatsnotus. Academic Essay Structure Tips [Writing Guide] | Pro Essay Help. Academic Essay Examples - 15+ in PDF | Examples. 11 Reasons Why Essay Writing Is Important In One’s Professional Life. Professional Essay Writers$ 10 For Page - Professional Custom Essay .... College Essay: Professional essays. Professional essays. Main Characteristics Of A Pro Essay Writer. Professional Essay Writers. professional essay writing service by cecilfugate38 - Issuu. 006 Essay Example Professional Writers Page 1fit11562c1496ssl1 ~ Thatsnotus Professional Essay Writing Professional Essay Writing. How To Write an Essay - Essay Tips: 7 Tips on Writing an Effective ...
Healthcare Associated Infections (HAIs): Research NewsletterErin K. Peavey
In the US “One in 25 patients have a hospital-acquired
infection...Each day, over 205 deaths occur from HAIs...”
— Centers for Disease Control, 2011
An overview of this month’s article follows with bullet-points of the advantages and disadvantages of various environmental interventions in the prevention of Healthcare-Associated Infections (HAIs), often referred to as hospital-acquired infections. Paragraph summaries of Cleaning Strategies, Materials, Room Design and Hand-Hygiene are listed below. These provide broad themes and findings from the article. Reading the full article is always of benefit for a fuller understanding and is recommended. Click here to access the full article on the HERD Journal website.
[PDF Notes] Write an Essay on Energy Conservation 2023. Write a short essay on Energy Conservation | Essay Writing | English .... Paragraph On Energy Conservation 100, 150, 200, 250 to 300 Words For ....
[PDF Notes] Write an Essay on Energy Conservation 2023. Write a short essay on Energy Conservation | Essay Writing | English .... Paragraph On Energy Conservation 100, 150, 200, 250 to 300 Words For ....
A Website That Writes Essays For You Has To Be Reliable penessays.com. 5 Best Websites That Write Essays For You In USA - The European .... Essay Writer Website Template. Websites That Write Essays for You: Top 10 Services. Essay Writing Website Template 59201 - TemplateMonster. 003 How To Cite Website In An Essay Mla Thatsnotus. Best websites for custom essays writing. 012 Website That Writes Essays For You Free Essay Editing Checklist .... 015 Essay Example Cite An Step Version How To Website Thatsnotus. Websites for essay writing - 24/7 Homework Help.. 021 Best Essay Writing Website Websites For Essays 10004 Uk 1048x1620 .... Write my essay website - Purchase Custom Written Essays.. How To Write Websites In A Paper Allison Writing. Good Essay Help Website - Best Essay Writers Here Order Your Own .... 014 How To Cite Website In An Essay Example Aite
Similar to SAFHE/CEASA2011 - Hospital Design in Southern Africa (20)
Health facility design for infection controlSA FHE
The South African Federation of Hospital Engineers was invited to make a presentation at the Green Building Design for Health Facilities Conference held in Cape Town on 23 August 2013.
SAFHE/CEASA 2011 - Open Building for Healthcare Facilities: Lessons from the ...SA FHE
Amira Osman presents lessons learned from the construction of the INO Hospital in Bern, Switzerland using "open building" practices. Presented at the SAFHE/CEASA 2011 conference in Johannesburg, South Africa.
SAFHE/CEASA 2011 - DR. A.G. JEETOO HOSPITAL UPGRADESA FHE
A presentation from the SAFHE/CEASA 2011 Conference by Colin du Toit. He covers the process and details of upgrading the Dr A G Jeetoo Hospital in Mauritius.
This paper proposes a methodology to provide a new system of area standards, driven by clinical needs, in order to give guidance to health planners, give a baseline for cost comparisons and a method of judging value for money in a given health facility design.
“More clarity for less costly confusion”
This is a presentation on airborne disinfection methods as presented by Peta de Jager at the bi-annual SAFHE/CEASA Conference 2011.
The conference theme was "More for less".
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
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.
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
- 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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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ASA GUIDELINE
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3. Dodo
D d
From Wikipedia, the free encyclopaedia
Dodo
The dodo (Raphus cucullatus) was a flightless bird endemic to the Indian Ocean island of Mauritius. Related to pigeons and doves, it stood about a meter (3.3 feet)
tall, weighing about 20 kilograms (44 lb), living on fruit, and nesting on the ground.
The dodo has been extinct since the mid‐to‐late 17th century.[2] It is commonly used as the archetype of an extinct species because its extinction occurred during
recorded human history and was directly attributable to human activity.
The dodo had a flawed design (it couldn‘t, that over time meant it didn't adapt to
the threat in its environment and thence disappeared due to its inability to avoid
predators, humans.
4. Crocodile
From Wikipedia, the free encyclopaedia
A crocodile is any species belonging to the family Crocodylidae (sometimes classified instead as the subfamily Crocodylinae). The term can also be used more
loosely to include all extant members of the order Crocodilia: i.e. the true crocodiles, the alligators and caimans (family Alligatoridae) and the gharials (family
loosely to include all extant members of the order Crocodilia: i.e. the true crocodiles, the alligators and caimans (family Alligatoridae) and the gharials (family
Gavialidae), as well as the Crocodylomorpha which includes prehistoric crocodile relatives and ancestors.
Member species of the family Crocodylidae are large aquatic reptiles that live throughout the tropics in Africa, Asia, the Americas and Australia. Crocodiles tend to
congregate in freshwater habitats like rivers, lakes, wetlands and sometimes in brackish water. They feed mostly on vertebrates like fish, reptiles, and mammals,
sometimes on invertebrates like molluscs and crustaceans, depending on species. They are an ancient lineage, and are believed to have changed little since the time
of the dinosaurs. They are believed to be 200 million years old whereas dinosaurs became extinct 65 million years ago; crocodiles survived great extinction events.[1]
The crocodile has a tried and tested design that is quite stable and adapted over
g q p
time to conditions in its environment relevant to its continued survival.
8. • contract period – project timeframe
The form of contract will determine the period of the construction and thus influence the perception of the
relevance of any particular building.
l f ti l b ildi
Fast track contracts will deliver a lot quicker and in a sense the client will feel that the building at completion is
relevant to the ideas they had at the planning stages.
Conversely a slower contract will leave a client feeling that the trends in the medical field have supplanted their
building and that they will need to change or update the facility to stay current with the trends in their field.
This will not necessarily result in extinction but the perception of the client will be closer to wanting some form of
evolution rather than the feeling that the facility is functional and doesn t need to adapt just yet.
evolution rather than the feeling that the facility is functional and doesn't need to adapt just yet.
10. • Changing disease profiles
Over time disease profiles change.
In the 1500’s the leading cause of death was infection, poor hygiene, poor diet and poverty.
In the 1700’s the leading cause of death was consumption (TB), ague and smallpox
In the 1900 the leading cause of death was the flu, TB and diarrhoea.
In the 1960’s the leading cause of death was heart disease, cancer and degenerative diseases.
In the 2000 the leading cause of death is lower respiratory infections, heart disease, diarrhoea, HIV
Currently we have seen viral infection from various strains of influenza and closer to home the emergence of
multiple drug resistant TB.
Statistics from the WHO
14. Thus the buildings design and layout adapts to the people and their diseases at that point in time.
Specialised treatments differentiate the design process between high care, maternity, paediatrics, cardiac, medical
and surgical ward configurations.
d i l d fi ti
ICU / high care has wider bed spacing to allow for more intense monitoring with machines and or ventilators.
Surgical wards will have a larger store to accommodate specialised equipment, they tend to have a more
comprehensive treatment room to wash and treat wounds following surgery.
Medical wards have patients with less invasive treatments and therefore will adapt according to the medical profile
of the illness. TB, cancer and HIV although not invasive will have design input that is different to a wider range of
medical illnesses.
At any given time, hospitals need to be responsive to the communities they are situated in, hence when the
communities are young, there is a focus on paediatrics and maternity, over time (10‐20 years) when the community
has aged the medical profile changes and the hospital needs to accommodate a different set of patient needs.
In societies that have an aging population profile, the design input with regards medical care will be integrated into
the residential unit at varying levels and has become a sub speciality all of its own with people living longer and a
decline of staff moving into the nursing profession. This is relevant in both developed and developing societies the
reasons and cost centres vary.
16. • Information technology
This is a relatively new phenomenon but one that changes exponentially faster than the rest due to the rapid
changes in the technology itself.
h i th t h l it lf
Information technology allows an interconnectedness that wasn't part of facilities previously, now designers have
server rooms and control centres where a host of electronic data interfaces with the patients, staff and building
management systems. This connectivity adds a whole other layer of servicing, specialised spaces and support infra
structure.
17. • Information technology
These systems are moving towards a paperless hospital reducing large stores for patient files but increasing other
aspects like the electrical loading and back up systems to keep the electronic systems operational.
t lik th l t i l l di db k t t k th l t i t ti l
These systems envision a total integration into a singular operating and or management system, items like:
security monitoring
access for staff
patient data and various levels of access
staff data and time management
reporting via diagnostics, x‐ray and pathology
electronic load monitoring on electrical supply
building management systems that control the building environment
building management systems that control the building environment
integrated stock control and remote ordering
statistical reporting on patient profiles and occupancies
pharmacy control via integrated networks that monitor patients
(it might be a point to ponder if an emerging society needs more information technology or tried and tested systems
that can be upgraded at a later date if there is sufficient understanding that record stores will eventually become
server rooms for building management systems and control rooms for the information technology.)
If your facility cant adopt or embrace this technology then its more likely to go the way of the dodo ....
18. Staff /
Patient
access
Building management
system security
Patient data + records
Electrical load
Electrical load
management
Statistical reporting
Statistical reporting stock management
stock management Diagnostic data
Diagnostic data
19. • Equipment
Along with information technology the support equipment is changing as well.
Beds are increasing in length and width to accommodate the extra electronic monitoring as well as more functions
that make the bed more adaptable to a variety of medical functions within a singular facility as well as easier for staff
to manage patient comfort.
This impacts on the norms and standards that surround minimum spacing at the attending and non attending sides
as well as openings, lifts and the various corridors sizing in a facility.
Bed sizing 1000 x 2100mm Bed sizing 1100 x 2200mm
20. • Over simplified two
bed sample
Taking a 2 bed ward sample and
Taking a 2 bed ward sample and
applying the R158 norms we would
arrive at a minimum room sizing of
15.02m²
Applying a newer model bed sizing
to the same R158 norm example we Bed sizing in the 1995
end up with a minimum room size of
16.15m²
This is a 6% increase on the room
size, take a 210 bed hospital with a
foot print area of 19 250m² (one of
our recently completed projects)
and add a 6% extra to the area,
and add a 6% extra to the area
simply as a rule of thumb.
That's an additional 1155m² for a
facility just because the bed has
increased marginally in size.
R 20 000.00/m² = R 23.1 million Bed sizing in the 2010
21. • Example, paediatric hospital
In one of our early projects, originally a dedicated stand alone paediatric hospital was bought by a hospital
group and they wanted to convert portions of the facility into adult beds(patient profile had changed) that
d th t dt t ti f th f ilit i t d lt b d ( ti t fil h d h d) th t
had a better return on income.
The problem in most of the ward configurations was that the wards where designed for children's hospital
cots, which were in the order of 1600x800mm. The beds had the correct distances between each other and
the attending and non attending sides but when we tried a standard hospital bed we either had too little
space for bed to bed layouts or too much space for one bed layouts.
In most cases the concrete structure was designed around the original ward sizes (children's cots)and thus
limited the flexibility and adaptability of the facility to an efficient adult configuration. This meant that we
limited the flexibility and adaptability of the facility to an efficient adult configuration. This meant that we
lost beds in the new ward layouts in terms of the original bed count.
Subsequently we design paediatric wards for standard hospital beds and that way the ward
can adapt in 5‐10 years time as the hospitals demographics change.
The additional area in this case is always used by concerned parents and means that later
the ward adapts more easily into a different types of wards , avoiding an extinct facility.
22. • Equipment
Items in diagnostics like x‐ray machines and the support equipment is getting smaller and accommodated in smaller
spaces with more electronics. Large expense pieces of equipment are reducing in price which means that it becomes
ith l t i L i f i t d i i i hi h th t it b
obsolete sooner (term of financing)and more likely to be replaced and the space adapted accordingly.
Items that lasted 10 years now turn over in 6 years, this impacts on the spaces and their re‐use.
The increase in monitors for patients means that there needs to be more or larger equipment stores built into a ward
to accommodate the equipment when not in use or when charging the rechargeable batteries.
This has also lead to the addition of clinical stores and workshops where this specialised electronic equipment is
serviced or repaired on site.
More and more the inclusion of these items is to reduce staff work loads but also requires specialised training rooms
More and more the inclusion of these items is to reduce staff work loads but also requires specialised training rooms
where the staff are updated on the equipment, their use and problem solving or reporting.
The specialised equipment also needs extra electrical loading and often extra mechanical ventilation to cool the
electronics.
23. • Electrical usage and short supply
There seems to be cut backs on everything and given the recent ESKOM outages this effects essential services like
hospitals most acutely.
h it l t t l
On the one hand we have shortage of supply as a resource issue and on the other hand we have an increase in need
determined by the additional electronic monitoring and sophisticated electrics to supply this specialised equipment
often as a result of staff shortages.
A solution is the integrated building management systems that cut down on unnecessary electric usage and manages
the power consumption via various management strategies. Heat pumps, solar heating and solar control to reduce
heat loading.
24. • Electrical usage and short supply
All of these items require a more detailed knowledge of what is available and where to house these extra items that
do effect the planning and service area allowances.
d ff t th l i d i ll
UPS and back up generators become integral to the electrical solution within a facility and the electrical
requirements. This has changed over the last few years world wide with a stronger emphasis on the backup systems.
On the other hand the increase in the cost of electricity has also developed a heightened awareness that has
facilitated efficiency in other areas. Lights are moving towards LED technology which increase life span and reduces
electrical loads and thus heat loads requiring less mechanical input. Heat pumps and solar heating also reduce the
reliance on electrically generated heat and more on efficient heating with the systems that are in place.
25. • Skilled staff shortages
This is a world wide phenomena and unfortunately the developed countries do attract skills away from developing
countries on an economic bias, thus we are forced to plan with this in mind.
ti i bi th f dt l ith thi i i d
In developing countries planning makes the difference between extinction and adaptation.
Designing to allow shorter travel distances for less staff means that your staff as a resource is looked after.
Electronic monitoring also allows for less staff to deal with more patients but the reliance on electronic monitoring is
feasible in private facilities and developed counties but not so in a developing country, this paradox is particular to
SA which straddles both first and third world in one society.
26. Efficiently planned facilities allow staff to circulate over less distance between various zones and careful planning
linking symbiotic functions together is also a good planning tool to assist staff, the 30/60 rule for duty station
placement in a general ward layout.
Overflow portion Bulk of staff travel
The area that is
filled last
filled last
4 bed configuration
Patient assisted Travel distance travel distance
nursing
Duty station
Staff zone
Image courtesy of A3 Architects,
Moses Kotane Hospital, surgical ward
27. • Global trends versus local solutions
In developed counties the trend is towards a hotel like environment and with patients having single rooms and more
privacy. This leads to a higher staff complement to service the one bed units or electronic monitoring, both are
i Thi l d t hi h t ff l tt i th b d it l t i it i b th
expensive options that are affordable in developed economies.
In developing economies we see more 2, 3, 4 and even 6 bed ward options. These require less staff to see the same
amount of people and as a spin off the patients become part of the nursing staff through their communal concern.
Locally we have a society that has a strong social basis and that 2‐4 bed ward configurations are more appropriate
for SA . Social awareness for fellow patients means that your fellow patient is as likely to assist in the monitoring of
patients as nursing staff, this reduces the load on staff and works within the social norms of our society.
The 4‐6 bed ward options use less space per patient to their 1 or 2 bed layouts and that translates to savings in
capital cost amounts as well as reducing staff and staff circulation distances.
Global trends have vertically stacked hospitals because of the cost of land, locally we can still afford to have well
designed horizontally spread hospitals with less reliance on mechanical circulation and servicing, only in dense urban
designed hori ontally spread hospitals with less reliance on mechanical circulation and servicing only in dense urban
environments should we be looking at vertically stacked solutions.
It is easy to copy inappropriate solutions to give the idea that we are delivering sophisticated healthcare in a
resource constrained environment but this will eventually lead to extinction due to an inability to afford and maintain
these systems.
Appropriate and affordable solutions are home grown and not copied from first world healthcare.
29. • Architectural style
In private healthcare there used to be a rule of thumb that you would do a facelift on a facility approximately every 7
years and a refit every 14 years, reinventing a facility within a style matrix for a fluid and style orientated market.
d fit 14 i ti f ilit ithi t l ti f fl id d t l i t t d k t
In public healthcare i would argue that we need to resolve primary need first and concern ourselves with style only
after we have a fully operational healthcare network.
Maintaining this network is more of a challenge than just re‐inventing.
In Abu Dhabi we where exposed to a facility that is 30 years old and very well maintained, it is stylistically out of date
In Abu Dhabi we where exposed to a facility that is 30 years old and very well maintained, it is stylistically out of date
but functionally providing a healthcare service to the community.
31. Tawam hospital, Abu Dhabi UAE ‐ 2001
• Rates of change as presented by Jane Carthey
g p y y
• Site 50‐500 years
• Structure 30 – 50 years
• Skin 20 – 30 years
• Services 10 – 20 years
• Space plan 5 – 20 years
• Stuff 0 – 1 year
Carthey, J. Health asset and facility management. Slide 41, www.chaa.net.au
C h J H lh d f ili Slid 41 h (accessed 2011‐03‐11)
( d 2011 03 11)
32. University of Iowa hospital ‐ 1900
U i it f I h it l Wharmcliffe hospital, Sheffield ‐ 1900
h l ff h l h ff ld
1900
Changing a dressing in 1900
Bloemfontein hospital ‐
Bloemfontein hospital 1900
34. St. Clara’s hospital ‐
St Cl ’ h it l 1960 Concordia Hospital, Canada ‐
Concordia Hospital Canada 1960
1960
Patient in traction ‐ 1960
Chris Hani Baragwaneth Hospital ‐ 1960
35. First Peoples Hospital, Shanghai ‐ 1990
Fi t P l H it l Sh h i Tan Tock Seng Hospital, Singapore ‐ 1990
k l
1990
Theatre ‐ 1990
Inkosi Albert Luthuli Hospital ‐
I k i Alb L h li H i l 1990
37. • Building evolution
The most basic evolution is simply that a facility will grow and expand beyond the borders and boundaries of the
original envelope. Careful planning will not always cover these eventualities but flexible design strategies will
i i l l C f l l i ill t l th t liti b t fl ibl d i t t i ill
accommodate future extensions.
In 1994 we did a major addition to the existing hospital, over the next 17 years an additional 4 major phases were
added to the facility as it out grew its original shell and then added additional beds and support services.
43. • More for less
There is an inherent paradox in a hospital in as much as a hospital is a purpose
p p p p p
made building were form is often determined by medical function and efficiency
and not necessarily its ability for flexibility and adaptation.
If the building is too purpose built this will effect future adaptation and result in a
Dodo that will be extinct/demolished sooner than a building that is purpose built
with enough flexibility to adapt and morph into a crocodile.
A new generation of hospitals, INO Hospital in Bern, Switzerland, are looking at
flexible construction solutions that will allow cost effective permutations and
flexibility over the life cycle of the hospital.
fl ibili h lif l f h h i l
In hospital terms, the client that gets a crocodile, will eventually get more for less.