Alice Ferguson is the director of Playing Out, which advocates increasing children's freedom to play outside. Only 21% of boys and 16% of girls meet the minimum daily physical activity recommendations. A study in Bristol found that when given the opportunity to play outside through a "playing out" session, children spent 70% of the time outdoors and 30% of that time was moderate physical activity, much higher than on normal days. Playing Out provides resources to help communities organize temporary street closures to allow children to play outside safely.
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
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
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
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.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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.
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.
10. Only 21% of boys and 16% of girls
are getting the minimum
recommended daily amount
of physical activity. (1)
(1) British Heart Foundation, 2015
11.
12. “Our street is only quite short but I
know a number of families (myself
included) are reluctant to let our 'active'
6 yr olds out as there are
fast vans that drive along it”.
(Antonia, Cardiff)
21. Bristol City Council
Application for Temporary Play Street Order
(Town & Police Clauses Act 1847)
Important –please read carefully!
1. Please use this form only if you wish to apply for a temporary Play Street road closure
Order. This Order will permit you to close a road for the purpose of childrens play at
no more than weekly intervals and for a 12 month period from the Order start date. If
you are not sure that these are the correct forms for your event please contact
Highway Network Management on (0117) 9036857. (This application process is
currently a trial running from Sep 2011 until Sep 2012.)
2. We must receive your application at least 6 weeks before the date of the first event
otherwise we will not be able to process it. To avoid disappointment please hand
deliver or send your application by recorded delivery as lost or late applications are
your responsibility and will not be processed.
3. Please make sure you give all the information requested on the form. To prevent
delay you must enclose the following with your application:
i) a street plan of your event (see section 2)
ii) a copy of your resident consultation letter (see section 4)
4. Bristol City Council cannot guarantee that an Order will be made, and any Order
made under this application will be revoked if any of these conditions are not met:
i) you must pay to the council the full costs of any damage to the highway or
street furniture or other loss or damage suffered by it and of any claims made
22.
23.
24. University of Bristol pilot study
2012
66 children (2-13yrs) wore GPS and accelerometers at ‘playing out’
sessions on 2 Bristol streets.
• Children were outdoors 70% of the time (compared to 20% on ‘normal’ day
after school)
• On average 30% of time outdoors was ‘moderate intensity physical activity’
(compared to 5% of indoor time at this time of day)
• Equal participation by boys and girls (unusual!)
Playing Out is an idea that began on one street in Bristol 7 years ago. It has now become a not for profit organisation and a national grassroots movement aimed at giving children back the freedom to play outside their own front door. This is our story.
The story of Playing Out began 8 years ago, when my children were 8 and 4. I was living in a nice residential area near Bristol city centre, with lots of families around and a couple of parks fairly nearby – yet feeling that my children’s lives were not as they should be. They were stuck indoors too much and this was largely due to the fact that they didn’t have the freedom to just go out and play, as I did as a child.
I also grew up in Bristol and ‘playing out’ was a normal part of life – a big part of our lives in fact. From a very young age, we would be out playing with other kids on our own the street. By about 8/9 we were out and about around our whole neighbourhood – calling on friends; going to the shops; raising money for the latest cause; roller-skating under the flyover - often without adult supervision.
We just took it for granted and didn’t think about all the benefits it gave us – and I don’t think our parents did either. Now, looking back, I realised how lucky we were.
By contrast, what I realised on becoming a parent was that ‘playing out’ was no longer normal or socially acceptable. Even calling on friends down the street just didn’t seem to happen any more. Play had become something to be organised in advance!
And, instead of being free to play across the whole neighbourhood, children are now expected to play within limited, designated spaces – sometimes literally contained within a fenced-in area.
Which wouldn’t be so bad if they could get to these places by themselves! But children’s freedom to roam independently has become massively restricted. Fifty years ago it would have been fairly normal for an 8-year old to walk or cycle a couple of miles on their own. Now it is quite unusual for an 8-year old to even be allowed to play out on their own street, let alone walk to the park.
The new norm – at least where I live - is for parents to escort and supervise children everywhere up to the age of at least 10 or 11.
Which might sound fine but in fact they are missing out on a whole lot of stuff that you only really get from playing out independently. Notes from workshop with parents.
And on top of all this is the hard fact that despite all the millions of pounds thrown at sports activities, they are not even getting the basic minimum of daily physical activity. So, in terms of tackling obesity, children’s lack of freedom to play out needs to be taken very seriously.
So….WHY?? Many reasons – complex and interrelated. However, the number one reason that keeps coming up in surveys is parental concern about traffic.
This is not what the media like to call “parent paranoia”. Reality is that despite the statistics showing child pedestrian deaths have fallen over the past few decades, roads are not safer – children are just outside less.
But enough doom and gloom! There is hope.
The Playing Out story is one of optimism that things can change and people want things to change. It’s an attempt to give children back the 3 key ingredients they need to play: time, space and permission.
This is the street in Bristol where it all began. In 2009 , 2 neighbours (A&A) were discussing this whole issue of children’s lack of freedom to play out and decided best place to start was to transform their own street into a safe, playable space. Realised it would be massively difficult to do this permanently so decided to try just closing to cars for a few hours using council street party process - and see what happened.
Symbolic as well as practical – reclaiming the space, make children and their need for play/freedom more visible and get people thinking/talking about what needs to happen. Decided not to provide anything, just a safe space. Got permission and organised rota of stewards. Would children come out, would they know what to do??
What happened? Children came out and filled the space!
Noticed children MORE active than if we took them to the park.
Wasn;t intended as a PH intervention – we just wanted to change the world! – but PH people saw the potential and gave us funding.
2010 – Supported 5 other local streets to do it and saw that it worked.
Refined Model, provided guidance. Consultation w neighbours; Legal RC order from council; RC signs; stewards.
Decided too good an idea not to share. Set up website – free resource for residents anywhere.
Since 2012 we have supported the movement and it has grown across the UK…. through media, direct support, involvement in a government-funded project, and finding local activators who work in their own areas. Now around 500 street communities we know have done PO - .15,000 children?
2011 - Bristol City Council saw potential and brought in TPSO to enable people to do it more often – pioneering.
Outcomes: Physical activity, Children feel belonging to community (place and people). Not just public space – it is their own public space and an extension of home.
Also “soft” outcomes: sense of community/belonging; ‘citizenship in action’.
Not just parents and children – other residents benefit too. Addressing isolation. Adults feel more positive about where they live.
The key thing about this model is that people want to do it – just need the tools and support – very low-cost and sustainable. Can talk about how councils / local orgs can support it and what PO can offer. Finish with direct words of residents in Bristol who have been organising this on their own streets.
