The document describes a study that compared the effectiveness of a DVD and web-based patient decision support tool called Health Crossroads in increasing patient knowledge about medical conditions like diabetes and prostate cancer. The study found that while more patients assigned to view the DVD completed it, those who used the web-based tool and watched the videos spent similar amounts of time and experienced comparable increases in knowledge. The results provide guidance on how to design effective online decision support tools for patients.
Detecting and managing adverse drug reactions is important for patient safety. Adverse drug reactions can range from mild to life-threatening. Common causes include dose-related toxicity, drug-drug interactions, hypersensitivity reactions, and idiosyncratic reactions. Nurses play a key role in monitoring patients, recognizing signs and symptoms of adverse reactions, reporting them immediately, and managing the situation under a physician's guidance. Timely reporting helps increase understanding of medication risks and improve safe use.
Registration procedure of drugs in european unionbdvfgbdhg
This document outlines various procedures for registering medicinal products in the European Union. It describes the centralized procedure administered by the European Medicines Agency and national procedures administered by individual member states. It also covers the mutual recognition and decentralized procedures which allow registration in multiple member states based on one member state's assessment. There are also simplified registration procedures for certain herbal medicinal products.
This ppt provides a brief overview of the regulatory evaluationprocess for New Applications under various types - Mutual recognition process, Decentralized procedure along with an overview of Grouping variations & Worksharing procedures.
Naranjo
WHO-UMC
Bayesian:
Bayesian
Expert Opinion:
CIOMS
Most commonly used:
Naranjo
WHO-UMC
Naranjo Causality Assessment Scale
Criteria Score
1. Previous conclusive reports on this reaction 0
1. Previous conclusive reports on this reaction +1
2. The adverse event appeared after the suspected drug was administered. +2
3. The adverse reaction improved when the drug was discontinued or a specific antagonist was administered. +1
4. The adverse reaction reappeared when the drug was readministered. +2
5. Alternative causes that could solely have
The aim of Safety reports is describe the safety during the lifecycle of the medicinal product. These reports are necessary during development as well as during the authorization process or renewal. In addition, several of these reports may be required by Health Authorities in case of safety concerns.
This presentation contains a full overview about periodic safety update reports and all the information related with it.
Detecting and managing adverse drug reactions is important for patient safety. Adverse drug reactions can range from mild to life-threatening. Common causes include dose-related toxicity, drug-drug interactions, hypersensitivity reactions, and idiosyncratic reactions. Nurses play a key role in monitoring patients, recognizing signs and symptoms of adverse reactions, reporting them immediately, and managing the situation under a physician's guidance. Timely reporting helps increase understanding of medication risks and improve safe use.
Registration procedure of drugs in european unionbdvfgbdhg
This document outlines various procedures for registering medicinal products in the European Union. It describes the centralized procedure administered by the European Medicines Agency and national procedures administered by individual member states. It also covers the mutual recognition and decentralized procedures which allow registration in multiple member states based on one member state's assessment. There are also simplified registration procedures for certain herbal medicinal products.
This ppt provides a brief overview of the regulatory evaluationprocess for New Applications under various types - Mutual recognition process, Decentralized procedure along with an overview of Grouping variations & Worksharing procedures.
Naranjo
WHO-UMC
Bayesian:
Bayesian
Expert Opinion:
CIOMS
Most commonly used:
Naranjo
WHO-UMC
Naranjo Causality Assessment Scale
Criteria Score
1. Previous conclusive reports on this reaction 0
1. Previous conclusive reports on this reaction +1
2. The adverse event appeared after the suspected drug was administered. +2
3. The adverse reaction improved when the drug was discontinued or a specific antagonist was administered. +1
4. The adverse reaction reappeared when the drug was readministered. +2
5. Alternative causes that could solely have
The aim of Safety reports is describe the safety during the lifecycle of the medicinal product. These reports are necessary during development as well as during the authorization process or renewal. In addition, several of these reports may be required by Health Authorities in case of safety concerns.
This presentation contains a full overview about periodic safety update reports and all the information related with it.
The document outlines procedures for identifying, recording, and reporting adverse reactions and serious adverse reactions that may occur during clinical trials. It defines key terms like adverse events, adverse reactions, serious adverse reactions, and suspected unexpected serious adverse reactions. It describes the responsibilities of investigators and sponsors in assessing adverse events, reporting serious adverse reactions to licensing authorities within 14 days, and ensuring medical care for subjects experiencing adverse reactions. Flowcharts are provided to illustrate the processes for identifying adverse reactions and determining expectedness and implications for reporting.
Ind (investigational new drug application) and ndaswati2084
The document provides an overview of the Investigational New Drug Application (IND) and New Drug Application (NDA) processes for bringing new drugs to market. It describes how an IND must be submitted to the FDA to test an experimental drug in humans, and outlines the types of INDs, content requirements, and review process. An NDA contains extensive clinical trial data and is required for FDA approval to commercially market a new drug. The lengthy and costly process from initial research to marketing approval averages 15 years and $900 million per new drug.
The document discusses regulations for clinical trials in India. It begins by explaining that an Investigational New Drug Application (IND) provides an exemption that allows investigational drugs to be transported across state lines for clinical trials. It then describes the process of submitting an IND to the FDA, including providing animal studies data, manufacturing information, clinical protocols, and investigator information. It notes that the FDA has 30 days to review submitted INDs. Finally, it summarizes that in India, an application for clinical trials should be submitted to the DCGI along with chemistry, manufacturing, animal study data and other required documents and trial protocols, and trials can only begin after approval from the DCGI and ethics committee.
This document provides an introduction to pharmacovigilance, which is the study of the safety of marketed drugs. It discusses the importance of pharmacovigilance due to past drug safety issues like the thalidomide tragedy. Key terms related to pharmacovigilance are defined, such as adverse events, adverse reactions, and signals. Methods of pharmacovigilance like passive surveillance, data mining, and active surveillance are described. Important organizations involved in pharmacovigilance include the FDA, EMEA, MHLW, and CDSCO.
This document provides definitions and classifications of adverse drug reactions (ADRs). It defines key terms like adverse event, adverse drug reaction, and adverse drug event. It then discusses various classification schemes for ADRs based on factors like onset, type of reaction, severity, and more. Different types of ADRs are explained like Type A, B, C reactions as well as side effects, drug dependence, withdrawal reactions and more, along with examples. Overall, the document provides a comprehensive overview of definitions and classifications related to ADRs.
The document discusses the history of adverse drug reactions and defines an adverse drug reaction. It describes several important incidents that increased awareness and regulation of drug safety, such as reactions to sulfanilamide in 1937 which led to the establishment of the FDA. It also discusses the thalidomide incident in the 1960s and the teratogenic effects it caused. The document estimates the incidence of adverse drug reactions for hospital inpatients and admissions. It examines various types of adverse drug reactions and factors that can influence them.
This document discusses pharmacovigilance and drug safety. It provides examples of drugs that have been withdrawn from the market in the US since 2000 due to safety issues like hepatotoxicity and cardiovascular toxicity. It also discusses key terms related to adverse drug reactions and how causality is assessed. Pharmacovigilance aims to identify safety issues with medicines through post-marketing surveillance.
The document compares the regulatory processes for drug product submissions in the US and EU. In the US, applications are submitted to the FDA's Center for Drug Evaluation and Research and can be New Drug Applications or Abbreviated New Drug Applications. In the EU, applications are submitted through national regulatory authorities or through the centralized European Medicines Agency process. The key differences between the US and EU processes include differences in application types, approval timelines, post-approval change requirements, manufacturing standards, quality testing standards, and facility inspection processes.
Do you know where the term “shared decision making” was first used…or when the first center dedicated to its research and implementation was opened? Our infographic “Shared Decision Making through the Decades” will take you on a historical journey through four decades of shared decision making to understand where it is today and what the future might hold.
25 Champions of Shared Decision Making, selected by the staff of the Informed Medical Decisions Foundation. This is not a top 25 list, merely a list of 25 individuals the staff wanted to recognize.
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Angela Coulter, Informed Medical Decisions Foundation
Dominick Frosch, Gordon and Betty Moore Foundation
Floyd J. Fowler, Informed Medical Decisions Foundation
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
John E. Wennberg, The Dartmouth Institute
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
Jeff Thompson, Washington State Health Care Authority
David Downs, Engaged Public
David Swieskowski, Mercy ACO Mercy Clinics, Inc.
Lisa Weiss, High Value Healthcare Collaborative
Kate Chenok, Pacific Business Group on Health
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Karen Sepucha, Massachusetts General Hospital
Dale Collins Vidal, The Dartmouth Institute for Health Policy & Clinical Practice
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Neil Korsen, MaineHealth
Larry Morrisey, Stillwater Medical Group
Charlie Brackett, Dartmouth-Hitchcock Medical Center
Grace Lin, Palo Alto Medical Foundation
Carmen Lewis, University of North Carolina
Leigh Simmons, Massachusetts General Hospital
This document discusses shared decision making initiatives in England. It describes 3 key programs - the Health Foundation's MAGIC program which developed decision aids and trained clinicians, the NHS Right Care program which created 38 online decision aids for conditions like cancer and joint replacements, and Bupa UK's treatment options service which engaged over 10,000 members through health coaching. It outlines successes of each program like cost savings, high patient satisfaction, and policy influence, but also challenges of sustainability, embedding in healthcare systems, and overcoming cultural barriers. The document advocates for further adoption of shared decision making in the NHS, expanding decision aid availability, and building awareness among patients.
This document summarizes a medical editors meeting about treatment options for peripheral artery disease (PAD). It discusses the development of an educational program about PAD for patients. The program aims to help patients make informed decisions about improving walking ability and reducing cardiovascular risk. Challenges in developing the program included communicating treatment benefits, comparing varied efficacy data, and addressing uninsurance coverage for supervised exercise. The document outlines strategies for addressing these challenges.
This document summarizes the results of a national survey of medical decisions. It found that 77% of Americans aged 40+ discussed at least one medical decision in the past two years. The most common decisions discussed were starting or stopping medication (52%) and discussing screening tests (59%). Knowledge about medical conditions was low, ranging from 20% to 84% correct depending on the condition. Discussion of pros and cons varied, from 6% to 84% depending on the decision. The decision process score, which measures how informed and collaborative the decision process was, ranged from 1.5 to 3.2 out of 5 depending on the decision. In the end, patients had surgery 42% of the time, took medication 79% of the
The document discusses using patient interviews to support patient decisions in medical care. It notes that patient interviews were initially used because patients should hear other patients' voices and be exposed to different choices. However, patient interviews are now being reexamined because they are relatively expensive and questions have been raised about their need as media moves to more web and mobile formats. While some argue patient interviews can be biasing, the organization finds them engaging and believes they can help patients understand options when used properly and not inherently bias decisions. More research is still needed on how different uses of interviews impact decision making.
The document summarizes the activities of the Content Development Team at the Foundation from 2012-2013, including program updates, new programs developed, and collaborations. Some of the key projects discussed include adapting decision aids for use in Australia, collaborating with outside organizations on grants and standards, and new partnerships to create medication decision aids with the American College of Cardiology.
The document outlines procedures for identifying, recording, and reporting adverse reactions and serious adverse reactions that may occur during clinical trials. It defines key terms like adverse events, adverse reactions, serious adverse reactions, and suspected unexpected serious adverse reactions. It describes the responsibilities of investigators and sponsors in assessing adverse events, reporting serious adverse reactions to licensing authorities within 14 days, and ensuring medical care for subjects experiencing adverse reactions. Flowcharts are provided to illustrate the processes for identifying adverse reactions and determining expectedness and implications for reporting.
Ind (investigational new drug application) and ndaswati2084
The document provides an overview of the Investigational New Drug Application (IND) and New Drug Application (NDA) processes for bringing new drugs to market. It describes how an IND must be submitted to the FDA to test an experimental drug in humans, and outlines the types of INDs, content requirements, and review process. An NDA contains extensive clinical trial data and is required for FDA approval to commercially market a new drug. The lengthy and costly process from initial research to marketing approval averages 15 years and $900 million per new drug.
The document discusses regulations for clinical trials in India. It begins by explaining that an Investigational New Drug Application (IND) provides an exemption that allows investigational drugs to be transported across state lines for clinical trials. It then describes the process of submitting an IND to the FDA, including providing animal studies data, manufacturing information, clinical protocols, and investigator information. It notes that the FDA has 30 days to review submitted INDs. Finally, it summarizes that in India, an application for clinical trials should be submitted to the DCGI along with chemistry, manufacturing, animal study data and other required documents and trial protocols, and trials can only begin after approval from the DCGI and ethics committee.
This document provides an introduction to pharmacovigilance, which is the study of the safety of marketed drugs. It discusses the importance of pharmacovigilance due to past drug safety issues like the thalidomide tragedy. Key terms related to pharmacovigilance are defined, such as adverse events, adverse reactions, and signals. Methods of pharmacovigilance like passive surveillance, data mining, and active surveillance are described. Important organizations involved in pharmacovigilance include the FDA, EMEA, MHLW, and CDSCO.
This document provides definitions and classifications of adverse drug reactions (ADRs). It defines key terms like adverse event, adverse drug reaction, and adverse drug event. It then discusses various classification schemes for ADRs based on factors like onset, type of reaction, severity, and more. Different types of ADRs are explained like Type A, B, C reactions as well as side effects, drug dependence, withdrawal reactions and more, along with examples. Overall, the document provides a comprehensive overview of definitions and classifications related to ADRs.
The document discusses the history of adverse drug reactions and defines an adverse drug reaction. It describes several important incidents that increased awareness and regulation of drug safety, such as reactions to sulfanilamide in 1937 which led to the establishment of the FDA. It also discusses the thalidomide incident in the 1960s and the teratogenic effects it caused. The document estimates the incidence of adverse drug reactions for hospital inpatients and admissions. It examines various types of adverse drug reactions and factors that can influence them.
This document discusses pharmacovigilance and drug safety. It provides examples of drugs that have been withdrawn from the market in the US since 2000 due to safety issues like hepatotoxicity and cardiovascular toxicity. It also discusses key terms related to adverse drug reactions and how causality is assessed. Pharmacovigilance aims to identify safety issues with medicines through post-marketing surveillance.
The document compares the regulatory processes for drug product submissions in the US and EU. In the US, applications are submitted to the FDA's Center for Drug Evaluation and Research and can be New Drug Applications or Abbreviated New Drug Applications. In the EU, applications are submitted through national regulatory authorities or through the centralized European Medicines Agency process. The key differences between the US and EU processes include differences in application types, approval timelines, post-approval change requirements, manufacturing standards, quality testing standards, and facility inspection processes.
Do you know where the term “shared decision making” was first used…or when the first center dedicated to its research and implementation was opened? Our infographic “Shared Decision Making through the Decades” will take you on a historical journey through four decades of shared decision making to understand where it is today and what the future might hold.
25 Champions of Shared Decision Making, selected by the staff of the Informed Medical Decisions Foundation. This is not a top 25 list, merely a list of 25 individuals the staff wanted to recognize.
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Angela Coulter, Informed Medical Decisions Foundation
Dominick Frosch, Gordon and Betty Moore Foundation
Floyd J. Fowler, Informed Medical Decisions Foundation
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
John E. Wennberg, The Dartmouth Institute
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
Jeff Thompson, Washington State Health Care Authority
David Downs, Engaged Public
David Swieskowski, Mercy ACO Mercy Clinics, Inc.
Lisa Weiss, High Value Healthcare Collaborative
Kate Chenok, Pacific Business Group on Health
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Karen Sepucha, Massachusetts General Hospital
Dale Collins Vidal, The Dartmouth Institute for Health Policy & Clinical Practice
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Neil Korsen, MaineHealth
Larry Morrisey, Stillwater Medical Group
Charlie Brackett, Dartmouth-Hitchcock Medical Center
Grace Lin, Palo Alto Medical Foundation
Carmen Lewis, University of North Carolina
Leigh Simmons, Massachusetts General Hospital
This document discusses shared decision making initiatives in England. It describes 3 key programs - the Health Foundation's MAGIC program which developed decision aids and trained clinicians, the NHS Right Care program which created 38 online decision aids for conditions like cancer and joint replacements, and Bupa UK's treatment options service which engaged over 10,000 members through health coaching. It outlines successes of each program like cost savings, high patient satisfaction, and policy influence, but also challenges of sustainability, embedding in healthcare systems, and overcoming cultural barriers. The document advocates for further adoption of shared decision making in the NHS, expanding decision aid availability, and building awareness among patients.
This document summarizes a medical editors meeting about treatment options for peripheral artery disease (PAD). It discusses the development of an educational program about PAD for patients. The program aims to help patients make informed decisions about improving walking ability and reducing cardiovascular risk. Challenges in developing the program included communicating treatment benefits, comparing varied efficacy data, and addressing uninsurance coverage for supervised exercise. The document outlines strategies for addressing these challenges.
This document summarizes the results of a national survey of medical decisions. It found that 77% of Americans aged 40+ discussed at least one medical decision in the past two years. The most common decisions discussed were starting or stopping medication (52%) and discussing screening tests (59%). Knowledge about medical conditions was low, ranging from 20% to 84% correct depending on the condition. Discussion of pros and cons varied, from 6% to 84% depending on the decision. The decision process score, which measures how informed and collaborative the decision process was, ranged from 1.5 to 3.2 out of 5 depending on the decision. In the end, patients had surgery 42% of the time, took medication 79% of the
The document discusses using patient interviews to support patient decisions in medical care. It notes that patient interviews were initially used because patients should hear other patients' voices and be exposed to different choices. However, patient interviews are now being reexamined because they are relatively expensive and questions have been raised about their need as media moves to more web and mobile formats. While some argue patient interviews can be biasing, the organization finds them engaging and believes they can help patients understand options when used properly and not inherently bias decisions. More research is still needed on how different uses of interviews impact decision making.
The document summarizes the activities of the Content Development Team at the Foundation from 2012-2013, including program updates, new programs developed, and collaborations. Some of the key projects discussed include adapting decision aids for use in Australia, collaborating with outside organizations on grants and standards, and new partnerships to create medication decision aids with the American College of Cardiology.
Narratives play several roles in decision aids such as engaging patients, informing them, modeling behaviors, helping patients weigh trade-offs and clarify values, but they also raise some concerns. While narratives can make information more memorable, they risk focusing on outliers and distracting from facts. The evidence on whether narratives influence decisions is mixed, though they certainly have power. The document advocates using curated patient narratives in addition to factual information to complement rather than replace facts, mitigate potential biases, and represent both common and uncommon patient viewpoints and experiences.
This study examined factors that predict whether patients with depression choose to start or continue medication treatment, or discuss non-medication treatment options with their healthcare provider. The study found that patients with worse health status or who prioritize quick relief were more likely to take medication. Patients concerned about medication side effects or costs were less likely to take them. Minority patients and those without health insurance were more likely to discuss alternative options or less likely to take medication, possibly due to stigma or lack of access. Overall, patients appeared informed about their treatment decisions.
This study surveyed U.S. adults aged 40 and older about their medical decision making regarding cancer screening tests and medications for common conditions. It found that decision processes were generally poor across age groups. While knowledge about treatments was higher for medications than screening, all groups valued potential benefits highly. The oldest group (75+) reported less discomfort with some cancer screenings and less importance on costs or side effects of medications. The study concludes there is opportunity to better educate elderly patients and their doctors about estimated benefits, competing risks when considering screenings or adding medications.
Diana Stilwell, MPH, chief production officer at the Informed Medical Decisions Foundation, walks through the role of narratives in decision aids and how the available evidence relates to the Foundation approach.
This presentation was part of a Shared Decision Making Month webinar -- The Power of Narratives: How They Shape the Way Patients Make Medical Decisions.
Jack Fowler, PhD, senior scientific advisor at the Informed Medical Decisions Foundation provides an overview of the Foundation's path to developing decision aids that included patient narratives.
This presentation was part of a Shared Decision Making Month webinar -- The Power of Narratives: How They Shape the Way Patients Make Medical Decisions.
Victoria Shaffer, PhD, describes the the pros and cons of narratives and then explains her work to develop a system of classification for narratives as part of the solution. Victoria provides an overview of the narrative taxonomies she and her colleague have developed.
This presentation was part of a Shared Decision Making Month webinar -- The Power of Narratives: How They Shape the Way Patients Make Medical Decisions.
Karen Sepucha, PhD, describes what a good decision is, how we measure decision quality and how the decision quality instrument might be used.
This presentation was part of a Shared Decision Making Month webinar -- What Makes a Good Medical Decision? Defining and Implementing Decision Quality Measures.
More from Informed Medical Decisions Foundation (20)
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Preliminary Findings from a Randomized Mixed-Methods Cross-Over Study to Compare the Performance of DVD and Web-based Patient Decision Support
1. Preliminary findings from a randomized
mixed-methods cross-over study to
compare the performance of DVD and
web-based patient decision support
Dominick L. Frosch, PhD
Associate Investigator, PAMFRI
Associate Professor of Medicine, UCLA
July 31, 2012
2. Knowledge gaps in decision support
n The internet is increasingly becoming the primary
medium for providing patients decision support.
n Few data are available to guide optimal design of
internet decision support and ensure comparable
effectiveness compared to video.
n A handful of studies have examined the efficacy
of internet decision support, but only one study
(2003) directly compared internet and video
decision support.
3. Review of Video and Internet Presentation
n 98% of participants assigned to the Video
group viewed the tape.
n 54% of those assigned to Internet viewed the
entire presentation of 47 slides. 40% never
reviewed any part of the presentation.
Frosch, Kaplan & Felitti, JGIM, 2003.
5. PSA Knowledge:
Video & Internet Completers
5
4.5
4
3.5
3
Video
2.5 I-Net Comp.
2
1.5
1
0.5
0
Pre Post
6. Research questions
n How do internet and video decision support
compare in terms of:
– Increases in patient knowledge
– User acceptability
– Decision quality
n What proportion of web-based decision support
do individuals review and how much time do they
spend with it?
7. Study design
Figure
1.
Research
design
Primary care
patients (N=90)
Complete baseline quantitative survey - 1
Review Review RA probes
DVD content
Health
selection
Crossroads
Complete quantitative survey - 2
RA probes Review Review
content Health DVD
selection
Crossroads
Complete quantitative survey - 3
8. Study measures
n Decision/disease specific knowledge
n Quantitative user ratings of decision support
n Decision quality
n Role preferences
n Click-stream (para) data on HC use
n Think-out loud while using HC
n In-depth interviews following each review of
decision support
9. Study setting and sampling
n Palo Alto Medical Foundation in Silicon Valley,
CA.
n Participants are active primary care patients at
PAMF who have/are:
– Diabetes
– Benign Prostatic Hyperplasia
– Overdue to consider colon cancer screening
n Participants are randomly selected from primary
care panels and invited by mail/phone.
10. Participant demographics
N=30
Age 64.6 (SD=12.9)
Gender 63.3% Male
Marital status 76.7% married or living with partner
Ethnicity 83.3% Caucasian
10.0% Asian
6.7% Latino
Education 80.0% College graduate or more
Household income 85.7% >$50,000
Health literacy score (range 0-8) 7.9 (SD=.35)
11. How much do patients view on the
Health Crossroads?
DVD first WWW first
70.00% 66.00%
60.00%
54.00%
50.00% 50.00% 51.00%
50.00% 46.00%
45.00%
40.00% 36.00%
30.00%
20.00%
10.00%
0.00%
All BPH CRC Diabetes
12. How much time do patients spend on
the Health Crossroads?
DVD first WWW first Video length
50.0
45
45.0
40.0
35.0 33 32.2
31
30.0
26.7 27.4
25.2 24
25.0
21.0
20.0 17.6 17.9
16.6
15.0
10.0
5.0
0.0
All BPH CRC Diabetes
13. How many videos in the Health
Crossroads do patients click on?
DVD first WWW first
6.0
5.0
5.0
4.0
3.0
2.5
2.0 1.8 1.8
1.5 1.4 1.4
1.0 0.8
0.0
All BPH (25) CRC (27) Diabetes (19)
14. Time spent watching videos in the
Health Crossroads
DVD first WWW first
3.5
3.1
3.0
2.6
2.5 2.4
2.0
2.0
1.6 1.6
1.5 1.4
1.3
1.0
0.5
0.0
All BPH CRC Diabetes
15. Reflections on using Health Crossroads
“I didn’t even look at the videos but just the presence of the videos seemed like it was
getting in my way, it was just filling up space, and you know I didn’t come looking for a
video…these days not knowing what’s going to happen when you click on a video, if you’re
going to get an advertisement, and uh, and then you know, something you know a video,
will take 10 minutes to say something that you can read in a minute.” MALE, 54, CRC
"My reaction is to take the DVD only because everybody likes to watch a DVD, but the
website is better. But see I was forced to read the website. If I had the DVD, I will actually
put the DVD in and play it. I would go to [the website]; I don't know if I would do as intensive
reading as I did here, um, um. There has to be a catch but I don't know what the catch
is...There has to be follow-up. If there's no follow up, then they might just flip through [the
website] and jot down and see a picture and read a line, but not really read the whole thing."
MALE, 61, DIABETES
16. Changes in knowledge - Combined
DVD first WWW first
90.0%
82.0%
79.0% 77.0%
80.0%
70.0%
68.0%
65.0%
60.0% 56.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Baseline First review Second review
All
17. Changes in knowledge - BPH
DVD first WWW first
80.0%
73.0%
70.0%
63.0%
60.0%
60.0%
48.0%
50.0%
43.0%
40.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Baseline First review Second review
BPH
18. Changes in knowledge – CRC Screening
DVD first WWW first
120.0%
95.0% 98.0%
100.0% 92.0%
78.0% 80.0%
80.0%
60.0% 55.0%
40.0%
20.0%
0.0%
Baseline First review Second review
CRC
19. Changes in knowledge – Diabetes
DVD first WWW first
82.0%
80.0% 80.0% 80.0%
80.0%
78.0%
78.0%
76.0%
74.0% 73.0%
72.0% 71.0%
70.0%
68.0%
66.0%
Baseline First review Second review
Diabetes
20. Understanding how patients use HC
“It wasn’t too busy, you know um, I didn’t get bored, I could easily find something you know,
some websites are too much you know, this was simple here’s all the different tests you can
take and these are all the procedures, I liked the chart you know the summary thing cause
you forget and with the summary then you don’t have to click from page to page cause you
have it all right there so that’s probably what I liked best was the summary chart.” FEMALE,
52, CRC
"I liked [the website] better because you could read something if weren't sure about it you
can go back and look at it." "In any given amount of time, you can absorb just so much
information. So the DVD is a little too fast, but that can't be helped. So the website is a very
good supplement." MALE, 85, BPH
21. Predictors of Health Crossroads
knowledge gain
Variable R2 Change Beta
Age .10 -.17
Education .21 .28
Proportion of pages .05 .18
viewed
Number of videos clicked .10 .40
Cumulative R2 = .46
22. Which medium do patients prefer?
DVD first WWW first
70.0%
64.3%
60.0%
50.0%
43.8%
40.0% 37.5%
30.0%
21.4%
18.7%
20.0%
14.3%
10.0%
0.0%
Prefer video Equal ratings Prefer Health Crossroads
23. Preferences for Health Crossroads
"Maybe I shouldn't say I would never use the DVD. If [my doctor] gave me the DVD as a
package and said view the DVD, you know, and then go to the website, you know, I would
do that. As I was watching [the DVD], I was thinking that I would never go back to this as a
tool. I would watch it once...and be done with it." MALE, 66, DIABETES
"I am not an internet person. I don't sit there and look at this stuff all day long, but I can read
it. I can go back to it. I can access it immediately with a mouse, and get what I want. [I] don't
have to watch the whole thing again to figure out where in the picture it was and I have to go
find this out. So I like that first website very much." MALE, 85, DIABETES
“The DVD you didn’t have any choice you just had to watch whatever came up but this one
you could choose what you wanted to see.” FEMALE, 64, DIABETES
"Everybody sits at a computer and it's just so easy you know, but you get a DVD in mail and
go "Oh I want to watch that" and you throw it on your desk, but you never do it. But
everyone sits at a computer and it's just "click" and we're there." FEMALE, 52, CRC
24. Conclusions
n Data appear to confirm that DVD may be the
superior option, for ensuring that patients are
exposed to all necessary information.
n Knowledge gains appear to be greater for DVD.
n More viewing of videos embedded in HC appears to
drive greater knowledge gains.
n Some suggestions that having both mediums is
valuable for patients – start with DVD, but use HC to
reinforce knowledge gains.
25. Limitations and next steps
n Findings are preliminary, based on 1/3 of ultimate
sample of 90 participants.
n Study is exploratory, not designed or powered for
null-hypothesis significance testing.
n Non-naturalistic laboratory study, but qualitative
data give us insight into how people might use
decision support at home.
n Participant recruitment is currently 85% complete.
Analysis will be complete by year-end.