Presentation by Heidi Hopkins
Cross-cutting analysis Lead, ACT Consortium
Senior Lecturer in Malaria & Diagnostics at London School of Hygiene & Tropical Medicine
Answering key questions on malaria drug delivery: 8 years of researchACT Consortium
Presentation by David Schellenberg
Director, ACT Consortium
Professor of Malaria & International Health at London School of Hygiene & Tropical Medicine
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and a...NHS Improvement
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and asthma clinic - Clare Watson
Medicines Management Pharmacist (NHS Hampshire)
Independent Prescriber (Victoria Practice, Aldershot)
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
In first of two-part series, Pamela Greenhouse explores the differences and similarities of the Patient and Family Centered Care Methodology and Practice (PFCC M/P) and leean process improvement approachs, such as Lean, Six Sigma and Toyota. She believes that the PFCC M/P can be the unifying theme for health care, incorporating both process improvement and performance improvement.
Medicines optimisation, pop up uni, 9am, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Answering key questions on malaria drug delivery: 8 years of researchACT Consortium
Presentation by David Schellenberg
Director, ACT Consortium
Professor of Malaria & International Health at London School of Hygiene & Tropical Medicine
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and a...NHS Improvement
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and asthma clinic - Clare Watson
Medicines Management Pharmacist (NHS Hampshire)
Independent Prescriber (Victoria Practice, Aldershot)
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
In first of two-part series, Pamela Greenhouse explores the differences and similarities of the Patient and Family Centered Care Methodology and Practice (PFCC M/P) and leean process improvement approachs, such as Lean, Six Sigma and Toyota. She believes that the PFCC M/P can be the unifying theme for health care, incorporating both process improvement and performance improvement.
Medicines optimisation, pop up uni, 9am, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Keith Ridge, CBE Chief Pharmaceutical Officer
Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014
Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
MicroGuide app, pop up uni, 1pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
A Dartmouth Microsystem Assessment was conducted to examine a hospital unit\\’s functionality and to highlight opportunities for improvement. To enhance the gathering of data, a statistical tool was created to measure a wider sample population. The CNL student implemented a more reliable and valid data gathering system. The nurse educator asked to use the graduate student’s tool on the unit and throughout the hospital.
We shared with you our pilot study on "The Patient Journey Evolution" at the 3-day PMRG CONNECT 2017 event.
Traditional patient journey research often falls short on actions and serves primarily as a descriptive framework used to generally understand how patients progress from symptoms to treatment. But what if we want to get more from the research?
Can patient journey research answer key business questions and ultimately, what do we hope to get out of patient journey research? Can we borrow from work we’re doing in consumer research to inform us?
Find out more https://goo.gl/JZpCUH
The purpose of this call is to learn how the Department of Family Medicine at Queen’s University was able to:
•Raise awareness about medication safety issues ‐ specifically medication reconciliation in primary care.
•Highlight the need for better communication and connectivity between hospitals, pharmacies, and primary care. (And how we can help each other.)
•Suggest that primary care take on a leadership role in medication safety ‐ we can (and should!) "own" the list.
•Stress the importance of medication reconciliation as a continuous, interdisciplinary, and collaborative activity.
The AHSN Network Polypharmacy Programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Reducing Problematic Polypharmacy in Haringey Care Homes, can be viewed here.
For more information about the polypharmacy programme, please visit https://www.ahsnnetwork.com/programmes/medicines/polypharmacy/
Keith Ridge, CBE Chief Pharmaceutical Officer
Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014
Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
MicroGuide app, pop up uni, 1pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
A Dartmouth Microsystem Assessment was conducted to examine a hospital unit\\’s functionality and to highlight opportunities for improvement. To enhance the gathering of data, a statistical tool was created to measure a wider sample population. The CNL student implemented a more reliable and valid data gathering system. The nurse educator asked to use the graduate student’s tool on the unit and throughout the hospital.
We shared with you our pilot study on "The Patient Journey Evolution" at the 3-day PMRG CONNECT 2017 event.
Traditional patient journey research often falls short on actions and serves primarily as a descriptive framework used to generally understand how patients progress from symptoms to treatment. But what if we want to get more from the research?
Can patient journey research answer key business questions and ultimately, what do we hope to get out of patient journey research? Can we borrow from work we’re doing in consumer research to inform us?
Find out more https://goo.gl/JZpCUH
The purpose of this call is to learn how the Department of Family Medicine at Queen’s University was able to:
•Raise awareness about medication safety issues ‐ specifically medication reconciliation in primary care.
•Highlight the need for better communication and connectivity between hospitals, pharmacies, and primary care. (And how we can help each other.)
•Suggest that primary care take on a leadership role in medication safety ‐ we can (and should!) "own" the list.
•Stress the importance of medication reconciliation as a continuous, interdisciplinary, and collaborative activity.
The AHSN Network Polypharmacy Programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Reducing Problematic Polypharmacy in Haringey Care Homes, can be viewed here.
For more information about the polypharmacy programme, please visit https://www.ahsnnetwork.com/programmes/medicines/polypharmacy/
Improving malaria treatment and control through enhanced diagnostic practiceACT Consortium
Professor David Schellenberg, director of the ACT Consortium, presents at the European Congress on Tropical Medicine and International Health in Basel, Switzerland on 7 September 2015.
My talk at the Scientific Research Day of Medical colleges, UQU
5 March 2019
where I presented my publication (Patient-Centered Pharmacovigilance: A review)
I am professionally pharmacist. These slides for clinical subject especially for pharmacy department students. I hope students get more benefits about it.
A study on drug utilisation evaluation of Bronchodilators using defined daily...Dr. Afreen Nasir
Conference proceeding: Nasir A. A study on drug utilisation evaluation of Bronchodilators using a defined daily dose method. Pharmacy Education Journal [Internet]. 2023 Aug;23(5):23–24. Available from: https://doi.org/10.46542/pe.2023.235.138
Evidence-based medicine is the system of practicing medicine in such a way that it results in improving outcomes and reduces the overall healthcare cost.
https://www.cognibrain.com/importance-of-evidence-based-medicine-on-research-and-practice/
Effectiveness of structured education on safe handling and disposal of chemot...SriramNagarajan16
Aim
To evaluate the effectiveness of structured education on safe handling and disposal of chemotherapeutic drugs among nursing
students
Participants and setting
A pre-experimental one group pre-test – post-test design was adopted for this study. The study was conducted in Vandhana
school of Nursing, Kodhad, telugana, India. The investigator selected 40 nursing students who fulfilled the inclusion criteria
were selected by using simple random sampling technique.
Intervention
Data was collected regarding demographic variable, knowledge and attitude of the diploma in nursing students on safe
handling and disposal of chemotherapeutic drugs.The investigator assessed the level of knowledge and attitude of the
diploma in nursing students by using structured questionnaire and modified three point Likert Scale and by using checklist
through one to one teaching by lecture, demonstration, video clippings and verbalization. Structured teaching programme was
conducted on the same day on group wise each group consists of 17members. Data collection was done in English the
questionnaire was distributed to each nursing students. At the end of the teaching the doubts were cleared. Then 10 minutes
was allotted for discussion.
Measurement and findings
The analysis finding indicates clearly that 36% of students had inadequate knowledge and 46% of them had negative attitude
regarding safe handling and disposal of chemotherapeutic drugs. A well planned structured teaching programme given to the
same group. The effectiveness of programme showed high level of significant at p<0.001 level. It showed that structured
teaching programme was an effective method to improve the knowledge and attitude.
Conclusion
The pharmacist-based interventions improved the knowledge of nursing students in cytotoxic drug handling. Further
assessment may help to confirm the sustainability of the improved practices
Pharmacist Interventions and Medication Reviews at Care Homes - Improving Med...Health Innovation Wessex
The Health Innovation Network Polypharmacy Programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Pharmacist Interventions and Medication Reviews at Care Homes - Improving Medication Safety and Patient Outcomes, can be viewed here.
For more information about the polypharmacy programme, please visit https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy/
Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral...Dr.Samsuddin Khan
Abstract
Background
Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings.
Methods
Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE.
Results
Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen.
Conclusions
AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays in the urgently needed rapid scale-up of antiretroviral therapy and second-line anti-TB treatment
Medical Conferences, Pharma Conferences, Engineering Conferences, Science Conferences, Manufacturing Conferences, Social Science Conferences, Business Conferences, Scientific Conferences Malaysia, Thailand, Singapore, Hong Kong, Dubai, Turkey 2014 2015 2016
Global Research & Development Services (GRDS) is a leading academic event organizer, publishing Open Access Journals and conducting several professionally organized international conferences all over the globe annually. GRDS aims to disseminate knowledge and innovation with the help of its International Conferences and open access publications. GRDS International conferences are world-class events which provide a meaningful platform for researchers, students, academicians, institutions, entrepreneurs, industries and practitioners to create, share and disseminate knowledge and innovation and to develop long-lasting network and collaboration.
GRDS is a blend of Open Access Publications and world-wide International Conferences and Academic events. The prime mission of GRDS is to make continuous efforts in transforming the lives of people around the world through education, application of research and innovative ideas.
Global Research & Development Services (GRDS) is also active in the field of Research Funding, Research Consultancy, Training and Workshops along with International Conferences and Open Access Publications.
International Conferences 2014 – 2015
Malaysia Conferences, Thailand Conferences, Singapore Conferences, Hong Kong Conferences, Dubai Conferences, Turkey Conferences, Conference Listing, Conference Alerts
We observed that 59% centers had staining facilities at the center. In 99% centers they had medicine
available all the time. 76% patients stated that the distance between centers and their residences is <1 kilometer. 97%
centers had accessible road to the centers. 76% providers knew consequences of treatment failure. 31% patients knew
the mode of transmission. 1% patients knew the duration of treatment. 73% patients knew consequences of treatment
failure.
Listening to your audience qualitative research in malaria interventions c ch...ACT Consortium
Presentation by Clare Chandler
Lead Society Scientist, ACT Consortium
Senior Lecturer in Medical Anthropology at London School of Hygiene & Tropical Medicine
Co-ordinated malaria research for better policy and practice: the role of res...ACT Consortium
Prof. David Schellenberg from the London School of Hygiene & Tropical Medicine presents on behalf of the ACT Consortium at the European Congress on Tropical Medicine and International Health in Basel, Switzerland, 8 September 2015
Referral from community health workers using mRDTs; evidence from two malaria...ACT Consortium
Sham Lal from the London School of Hygiene & Tropical Medicine presents on behalf of the ACT Consortium at the European Congress on Tropical Medicine and International Health in Basel, Switzerland, 7 September 2015
Health facility caseload changes during the introduction of a CHW-interventio...ACT Consortium
Sham Lal from the London School of Hygiene & Tropical Medicine presents on behalf of the ACT Consortium at the European Congress on Tropical Medicine and International Health in Basel, Switzerland on 8 September 2015.
Effects of introducing RDTs in drug shops: Findings from a randomised trial i...ACT Consortium
Sian Clarke presents at the European Congress on Tropical Medicine and International Health on behalf of the London School of Hygiene & Tropical Medicine, the Ugandan Ministry of Health and University if Copenhagen.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
2. Answering key questions on malaria drug delivery
Interventions to change providers’ practice:
A card game as interactive training
in Cameroon
Dr Heidi Hopkins on behalf of
ACT Consortium REACT study teams
LSHTM: Virginia Wiseman, Lindsay Mangham-Jefferies, Bonnie Cundill,
Clare Chandler, Neal Alexander, and Julia Langham
University of Yaoundé: Wilfred Mbacham, Olivia Achonduh, Akindeh Nji, et al.
University of Nigeria: Obinna Onwujekwe, Ogochukwu Ibe, Benjamin Uzochukwu, et al.
3. Research on Economics of ACTs
(REACT): Cameroon & Nigeria
Study objectives:
1) Understand quality of malaria case management in
different types of health facility
2) Design interventions to support the introduction of
malaria rapid diagnostic tests, with the National
Malaria Control Programmes
3) Implement interventions in selected study sites
4) Evaluate their effectiveness and cost-effectiveness
4. Study setting
Public health centres & posts
Pharmacies & drug stores
Enugu (urban)
Udi (rural)
Public & mission hospitals + health centres
Pharmacies & drug stores
Yaoundé (urban, Francophone)
Bamenda (urban & rural, Anglophone)
ENUGU STATE, NIGERIA CAMEROON
5. Policy context in Cameroon
• Malaria is endemic in Cameroon
– Antimalarials available from range of public and
private providers and medicine retailers
– ACTs became first-line treatment in 2004
• Parasitological testing is available at many
public and private facilities, but not medicine
retail outlets
• In August 2009, Cameroon government
announced intention to introduce RDTs
6. Formative research on malaria
diagnosis & treatment (2009-10)
Goal: Understand malaria case management in Yaoundé and
Bamenda
• Availability and use of parasitological testing
• Health workers’ practices when testing and treating febrile patients
• Provider & patient preferences for malaria testing and treatment
6Answering key questions on malaria drug delivery
• Chandler C et al (2012) ‘As a clinician, you are not managing lab results, you are managing the patient’:
how the enactment of malaria at health facilities in Cameroon compares with new WHO guidelines for
the use of RDTs. Social Science and Medicine 74(10):1528-35
• Mangham LJ, et al (2011) Malaria Prevalence and Treatment of Febrile Patients Attending Health
Facilities in Cameroon. Tropical Medicine and International Health 74(10):1528-35
Quantitative methods (2009):
• Patient exit survey
• Health worker survey
• Facility survey
Qualitative methods (2010):
• FGDs with health workers (public and mission)
• FGDs with community members
7. Formative research findings:
Provider practices in malaria
diagnosis & treatment
• ACT is often available
• Many providers know ACT is recommended
• Microscopy is often available, but under-utilized
• Malaria is over-diagnosed
– About one-third of febrile patients have malaria
• Treatment prescribed does not depend on the test
result
– About two-thirds of patients that did not have malaria received ACT
8. “We prescribe them drugs and to
boost their psychological
treatment we prescribe the test”
[Nurse; mission facility, Yaoundé]
How do providers perceive
malaria testing?
• Test results support treatment
decisions, but do not substitute
for clinical judgement
“Priority is always given to the
clinical (symptoms) despite the
results of the thick blood smear”
[Doctor, mission facility, Yaoundé]
• Malaria tests provide
psychological treatment
“When we do the malaria test
and it comes out negative, it does
not prevent the patient having
his malaria .... We continue with
the antimalarial treatment”
[Nurse, mission facility, Yaoundé]
8Answering key questions on malaria drug delivery
“Most of the times I will send the
patient for a malaria test just for
the psychology of the patient, just
to please the patient, ... but if I
have to decide, the lab test will not
count”
[Doctor, mission hospital, Bamenda]
9. Policy dialogue & formative research
underpinned intervention design
Formative Research:
Malaria testing is under-used
Malaria is over-diagnosed
Supporting interventions aimed to change provider behaviour:
1) Increase use of malaria testing
2) Encourage providers to treat based on test results
3) Improve provider-patient communication
Dialogue with Policy Makers:
Government plans to introduce
RDTs
9Answering key questions on malaria drug delivery
Need to address the gap between providers’ knowledge and practice
for RDT introduction to be cost-effective
10. Designing the intervention
• Literature review on supply-side interventions
• Discuss findings with stakeholders (NMCP, policy makers,
heads of public and mission facilities)
• Iterative process to design and refine intervention package
– Brainstorming workshops
– Expertise from artists
– Develop training materials: manuals, posters & card games
– Involve representatives from NMCP
– Presentations at stakeholder workshops
– Pilot 3-day training package with providers in Buea
• Finalize intervention materials
• Training of Trainers (NMCP representatives)
– on communication skills + training modules
11. Basic Training
Basic & Enhanced
Interventions
Control Basic Intervention Enhanced Intervention
* No intervention
(microscopy was
available)
* Supply RDTs
* 1-day basic training on
malaria testing &
treatment
* Peer-to-peer training
* Supply RDTs
* 1-day basic training on
malaria testing &
treatment
* 2-day enhanced training
on quality of care
* Peer-to-peer training
Enhanced Training
Case studies &
testimonials
6. Effect
Communication Picture
Scenarios
Problem
solving
Drama & role
play
4. Adapting to
change
Reflection &
Discussion3. Lecture on
malaria treatment
2. Practical on
how to use RDT
1. Lecture on
malaria diagnosis
5. Professionalism
Appropriate Tx
Card Game
11Answering key questions on malaria drug delivery
12. B C
A = Card game on
appropriate treatment
B = Card game on process
and quality of care
C= mRDT practice
A
13. Rules of the Game (3 - 5 players)
Step 1. Deal 3 cards per person, and place the remaining in a pile face down.
Step 2. The first player picks up one card from the pile and then determines if s/he
can give “appropriate treatment” using the correct combination of 3 cards.
If yes, s/he places the 3 cards on the table. If not, the turn ends.
Step 3. Play passes to the next player, and follows steps 2.
Step 4. Play continues until appropriate treatment has been given to five patients.
Appropriate Treatment Game
14. RDTs made
available at
health facility
HW knows how to do RDT
Patient
takes
medicine
as
advised
and
recovers
HW knows dosage & regimen
HW can interpret RDT
RDT available
HW has clinical guidelines
HW knows how to diagnose
malaria
Patient pays for
medicine
HW explains how to
take medicine
HW determines dose
of medicine
HW recommends
treatment
HW interprets test
correctly
HW conducts test
correctly
Patient accepts (&
pays for) test
Patient
asks for
test
Effect on Care
Provided to Patient
Intermediate effectsIntervention Expected
Output
Expected
Outcome
HW
offers
test
Medicine is
in correct
dose for
patient
Patient
knows how
to take
medicine
Patient is
satisfied with
the care
received
TREATMENT
CONSISTENT
WITH TEST
RESULT
RDTs supplied to facilities
HWs told ACT regimens
Provider
Training on
Malaria
Diagnosis &
Treatment
Intervention Process
HWs given treatment algorithm
HWs told how to interpret RDTs
HW practice using RDTs
HWs told benefits of testing
HWs told signs & symptoms
HWs attend training course
Patient receives
medicine
Data source for evaluation:
Patient Exit
Survey
Register of
Malaria Tests
Provider
Survey
Training
evaluation
Records of
RDT supply
PATIENT IS
TESTED
Provider
Training on
Improving
Quality of
Care
HWs improve communication
skills
HW recognise how their
behaviour affects care to patient
HWs reflect on professional
values
HWs understand need to change
practice
HWs attend training course
HW thinks it is important to
test and trusts test result
HW motivated to provide
quality care
HW communicates
effectively
18. Cameroon REACT study: It “worked.” Why?
Interventions → no significant increase in proportion of patients
treated according to guidelines,
but enhanced training did substantially + significantly reduce
unnecessary use of antimalarials for patients with negative test.
Suggested explanations:
• An enhanced training programme, designed to translate
knowledge into prescribing practice and improve quality of care,
can significantly reduce the unnecessary use of antimalarial drugs.
• Basic training that focuses only on how to use RDTs and the
content of malaria treatment guidelines is not likely to bring about
behaviour change needed for national roll-out of RDTs.
Mbacham W, Mangham-Jefferies L, Cundill B, Achonduh O, Chandler C., Ambebila J,
Nkwescheu A, Forsah-Achu D, Ndiforchu V, Tchekountouo O, Akindeh-Nji M, Ongolo-Zogo P,
Wiseman V. (2014) Improved treatment for uncomplicated malaria according to guidelines in
Cameroon: a cluster randomised trial of the effectiveness of provider interventions. Lancet
Global Health Volume 2, Issue 6, Pages e346 - e358.
19. 19
Behaviour change in malaria &
fever case management
Thoughtful, “enhanced” RDT training programmes for health
workers and communities, designed with formative
research and consideration of the health care context, can
significantly improve some aspects of case management.
Multiple other factors in the wider context also affect the
actual impact of behaviour change efforts.
To maximise the impact of investment in malaria control, we
must look at not just local factors – must also address
broader systems and political issues.
20. Acknowledgements
• All patients, caregivers & health
workers that participated in the
study
• Cameroon National Malaria
Control Programme, and local
stakeholders
• Funding from Bill & Melinda
Gates Foundation to ACT
Consortium
• Colleagues from University of
Yaoundé & LSHTM
20Answering key questions on malaria drug delivery
Thank you for your kind attention!
www.actconsortium.org