This document provides information on assessing mental capacity when working with homeless individuals under the Mental Capacity Act. It outlines the background and principles of the MCA, including the functional test of capacity. It then walks through a case study of a homeless man, "Darren", who needs to decide whether to accept shelter but appears to lack capacity. By working through a screening tool, it is determined that while Darren can understand and retain information, he cannot weigh the information to make a decision due to a likely mental impairment. It is assessed to be in his best interests to have a formal mental health assessment and potential admission to hospital.
Support Sheet 12: Mental Capacity Act (2005)
This support sheet outlines the main provisions of the Mental Capacity Act the four tests essential for assessing capacity
Support Sheet 12: Mental Capacity Act (2005)
This support sheet outlines the main provisions of the Mental Capacity Act the four tests essential for assessing capacity
Aim
To provide a practical understanding of the central concepts of the Mental Capacity Act using a real case
Objectives
• Understand concept of Mental Capacity
• Know how to assess capacity and apply it practically • Understand the concept of best interests
• Be able to describe a best interests assessment
Social care information packs
This is a series of short information sheets and matching slide sets about how social care staff can support people with learning disabilities to have better access to health services. They provide an introduction to each area and links to where further information and useful resources can be found.
This presentation addresses the links between self-neglect, including hoarding and trauma. The safeguarding process is identified, as well as the need for co-ordinated multi-agency responses.
Emotional Intelligence in Consulting DecisionNazrul Islam
The critical factor for building consensus, finding common ground and taking decisions – even with complex partnership dynamics – is emotional intelligence. Developing 'social capital' is essential for individuals who want to progress in a consulting firm.
Aim
To provide a practical understanding of the central concepts of the Mental Capacity Act using a real case
Objectives
• Understand concept of Mental Capacity
• Know how to assess capacity and apply it practically • Understand the concept of best interests
• Be able to describe a best interests assessment
Social care information packs
This is a series of short information sheets and matching slide sets about how social care staff can support people with learning disabilities to have better access to health services. They provide an introduction to each area and links to where further information and useful resources can be found.
This presentation addresses the links between self-neglect, including hoarding and trauma. The safeguarding process is identified, as well as the need for co-ordinated multi-agency responses.
Emotional Intelligence in Consulting DecisionNazrul Islam
The critical factor for building consensus, finding common ground and taking decisions – even with complex partnership dynamics – is emotional intelligence. Developing 'social capital' is essential for individuals who want to progress in a consulting firm.
Similar to Mental Health Interventions and Rough Sleepers "Saving Lives" (20)
Midwifery 101 by Corrine Clarkson and Morag Forbes lnnmhomeless
What to worry about and how to help when presented with complex pregnant women in your practice. A presentation to the London Network of Nurses and Midwives Conference 2016
Topic The Care Act: Implications for Homeless Health Care
Presenter Karl Mason
Social Work Lead - Trauma, Emergency and Acute Medicine Kings Lead KHP Homeless Pathway Team Kings
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
3. Objectives
“A practical examination of how the legislation and guidance
available can support better decision making for those involved
in working with homeless people.”
To do this with a focus on the Mental Capacity Act screening
tool – and an interactive discussion of a case study followed by
a discussion around other situations involving people who may
lack capacity.
The goal is for people to leave with increased knowledge and
understanding and with access to a tool that they can use.
Not a comprehensive guide to all elements of the MCA
4. Background to Mental Capacity Act (MCA)
‘The existing law relating to decision-making on behalf
of mentally incapacitated adults is fragmented,
complex and in many respects is out of date. There is
no coherent concept of their status, and there are
many gaps where the law provides no effective
mechanism for resolving problems’
(Law Commission 1991)
5. MCA - Overview
A functional test of capacity
“Best Interest” approach to decision making
Powers of Attorneys / Advance decisions
Deprivation of Liberty Safeguards
Court of Protection
Independent Mental Capacity Advocates
6. MCA - The Principles 1
•A person must be assumed to have capacity unless it is
established that he lacks capacity.
•A person is not to be treated as unable to make a
decision unless all practicable steps to help him to do
so have been taken without success.
•A person is not to be treated as unable to make a
decision merely because he makes an unwise decision.
7. MCA –The Principles 2
An act done, or decision made, under this Act for or on
behalf of a person who lacks capacity must be done, or
made, in his best interests.
Before the act is done, or the decision is made, regard
must be had to whether the purpose for which it is
needed can be as effectively achieved in a way that is
less restrictive of the person's rights and freedom of
action.
8. What is capacity?
‘….legal capacity depends upon understanding
rather than wisdom: the quality of the decision is
irrelevant as long as the person understands what
he is deciding’
(Law Commission 1991)
15. Case study
Split into groups
Read through case study as individuals
Discuss the case within your group with a focus on the particular question you are
directed to
Come back together and work through the screening tool
16. 1
What is the decision the person you are
concerned about needs to make, and why do
they need to make this decision now?
THE MENTAL CAPACITY ACT SCREENING TOOL
THE MENTAL CAPACITYACT SCREENING TOOL
17. Decision he needs to make
• Whether to accept shelter
Why now
• placing himself at immediate risk through sleeping
rough with insufficient bedding … temperature is due
to remain below freezing over coming days
• appears to have significant physical health problems
that he is not addressing … may be a hernia
THE MENTAL CAPACITYACT SCREENING TOOL
18. 2
Is there reason to believe that the person may lack
mental capacity to make the decision due to a
known/suspected mental health problem, learning
disability, brain injury, dementia or intoxication?
THE MENTAL CAPACITYACT SCREENING TOOL
19. Yes, on balance of probability
Specifically when asked about his welfare, he is unable to
maintain eye contact and his speech becomes broken
In relation to other issues he has made odd statements that
suggest paranoia – for example he has said that a local café (in
an area he is new to) had poisoned his sister
THE MENTAL CAPACITYACT SCREENING TOOL
20. He is drinking alcohol heavily in a way that suggests
dependence (although concerning statements above have
been made at times when not acutely intoxicated)
He has had past psychiatric assessment which whilst not
conclusive found him to be guarded
THE MENTAL CAPACITYACT SCREENING TOOL
21. 3
Has sufficient information been given to the
person to help them understand the decision?
THE MENTAL CAPACITYACT SCREENING TOOL
22. Yes – he has been offered more than one form of
shelter, with details about their location.
He has also had the risks of remaining sleeping
outside explained to him at length.
THE MENTAL CAPACITYACT SCREENING TOOL
23. 4
Have all practicable steps been taken to
support the person to make the decision?
THE MENTAL CAPACITYACT SCREENING TOOL
24. Yes, given the urgent time-frame. Outreach team has
been visiting him at different times of day, on a daily basis
over past two weeks. It has been possible to establish
some rapport, more with some workers than others. He
has been offered transport and accompaniment to
shelters.
We have left him written information too.
THE MENTAL CAPACITYACT SCREENING TOOL
25. 5
Is it felt that the person is free from external
pressures to make their decision?
THE MENTAL CAPACITYACT SCREENING TOOL
26. To the best of our knowledge.
He appears to be on his own almost all the time, those
people who do interact with him appear to be
expressing concern for his welfare.
It is not clear that anyone else would benefit whether
or not he accepts shelter
THE MENTAL CAPACITYACT SCREENING TOOL
27. 6
Can the person understand in simple
language the information involved in making
the decision?
THE MENTAL CAPACITYACT SCREENING TOOL
28. English is Darren’s first language – he appears to
understand the information given to him but this is
difficult to be certain about this as he struggles to give
answers.
In relation to other matters, of less immediate concern,
he is entirely fluent.
THE MENTAL CAPACITYACT SCREENING TOOL
29. 7
Can they retain the information long enough
to make the decision?
THE MENTAL CAPACITYACT SCREENING TOOL
30. There is nothing to suggest or indicate that he has
difficulties retaining the information necessary.
He recognizes different workers and refers back to past
conversations.
THE MENTAL CAPACITYACT SCREENING TOOL
31. 8
Can they use or weigh up the information to
make the decision?
THE MENTAL CAPACITYACT SCREENING TOOL
32. No. He does not appear able to weigh up the
information necessary to make the decision.
He does appear to understand and acknowledge the
concerns which we have expressed about his
immediate situation, but there appears to be
something (possibly paranoid ideas?) that is stopping
him from being able to accept this help.
THE MENTAL CAPACITYACT SCREENING TOOL
33. 9
Can they communicate their decision
(whether by talking, using sign language or
any other means)?
THE MENTAL CAPACITYACT SCREENING TOOL
34. Probably. He does appear able to indicate that he does
not want to go to, or visit even, shelter – albeit that he
cannot express his reasons for this.
THE MENTAL CAPACITYACT SCREENING TOOL
35. 10
The decision: does the person on the balance
of probabilities have the capacity to make the
specific decision at this particular time?
THE MENTAL CAPACITYACT SCREENING TOOL
36. No. We feel that some form of mental impairment –
likely to be paranoid beliefs – is stopping him from being
able to weigh up the information needed to make a
decision about accepting accommodation.
THE MENTAL CAPACITYACT SCREENING TOOL
37. 11
How did you decide what was in the person’s
best interests?
THE MENTAL CAPACITYACT SCREENING TOOL
38. We believe that the immediate risks to his well-being,
life even, of remaining in his current situation makes it
in his best interest to be
a) inside
b) have his mental health more fully assessed.
THE MENTAL CAPACITYACT SCREENING TOOL
39. We believe that the immediate risks to his well-being,
life even, of remaining in his current situation makes it
in his best interest to be
a) inside
b) have his mental health more fully assessed.
We have considered other elements of the best interest
checklist as far as possibleTHE MENTAL CAPACITYACT SCREENING TOOL
40. 12
What action should be taken in the person’s
best interests?
THE MENTAL CAPACITYACT SCREENING TOOL
41. We would request that mental health professionals
formally assess Darren and consider whether the
grounds are met for him to be subject to admission
to hospital (either under the Mental Health Act 1983
or the Mental Capacity Act 2005).
THE MENTAL CAPACITYACT SCREENING TOOL
42. Best interest checklist – 1
1.Encourage the person to take part as much as possible
2.Identify all relevant circumstances
3.Find out the person's past and present wishes, feelings, beliefs, values and
any other factors they would be likely to consider if they had capacity,
including any advanced statements
4.Do not make assumptions based on the person's age, appearance,
condition or behaviour
5.Assess whether the person might regain capacity
43. Best interest checklist – 2
6. If the decision concerns life-sustaining treatment then the best interests decision
should not be motivated by the desire to bring about the person's death
7. Consult with others where it is practical and appropriate to do so. This includes
anyone previously named as someone to be consulted; anyone engaged in caring for
the person; close friends, relatives or others with an interest in the person's welfare;
any attorney and any Deputy appointed by the Court.
8. Avoid restricting the person's rights by using the least restrictive option
9. Abide by any valid advanced decision
44. Other relevant topics…
Help line 020 3291 4184
http://www.pathway.org.uk/services/mental-
health-guidance-advice/
Editor's Notes
Just serves as a rationale as to why the MCA was developed. To provide a more objective framework to assess Mental capacity
Brief overview of MCA. The tool is only concerned really with the functional test, and to some extent the BI approach.
Functional test ‘the approach of defining a person as incapacitated only in relation to a particular decision at a particular time’
1)But on the first principle highlight that if there is reason to believe someone may lack capacity their capacity should then be tested
2) Highlight that the assessment tool asks the outreach worker to evidence all the steps that they have taken.
3) although an unwise decision may provide some of the rationale for thinking someone may lack capacity which may then trigger an assessment of capacity.
All pretty much common sense and similar to the MHA
I always use the smoking example here.
Here highlight that as the MCA tool isn’t being used to actually take action in the person’s best interest the time specific part isn’t relevant although the assessment would need to be up to date as to their current presentation.
The MCA suggests time should be given where possible to allow someone to regain capacity before making the decision. If someone is intoxicated with drugs and alcohol the outreach worker will need to say why it is not appropriate to wait for them to sober up.
Only in the balance of probabilities and if you have reason to believe than you should go forward and test capacity.
Again each of these is in the balance of probabilities.
If someone is unable to demonstrate that they understand it is unlikely that they will be able to retain or use and weigh up so there will be some repetition.
Use and weigh up.
This is where the person can’t show they understand the pro’s and cons of their decision.
It might be that there is a discrepancy between what they say they want and what is actually happening.
Where their reasoning doesn’t ring true it should be explored further.
Again each of these is in the balance of probabilities.
If someone is unable to demonstrate that they understand it is unlikely that they will be able to retain or use and weigh up so there will be some repetition.
Use and weigh up.
This is where the person can’t show they understand the pro’s and cons of their decision.
It might be that there is a discrepancy between what they say they want and what is actually happening.
Where their reasoning doesn’t ring true it should be explored further.
Again each of these is in the balance of probabilities.
If someone is unable to demonstrate that they understand it is unlikely that they will be able to retain or use and weigh up so there will be some repetition.
Use and weigh up.
This is where the person can’t show they understand the pro’s and cons of their decision.
It might be that there is a discrepancy between what they say they want and what is actually happening.
Where their reasoning doesn’t ring true it should be explored further.
Again each of these is in the balance of probabilities.
If someone is unable to demonstrate that they understand it is unlikely that they will be able to retain or use and weigh up so there will be some repetition.
Use and weigh up.
This is where the person can’t show they understand the pro’s and cons of their decision.
It might be that there is a discrepancy between what they say they want and what is actually happening.
Where their reasoning doesn’t ring true it should be explored further.