Edwina Rogers, executive director of Patient-Centered Primary Care Collaborative, began her presentation by highlighting the movement to advance medical homes.
With the U.S. being the number one in the world for the cost of healthcare and ranked number 37 in the quality category, something needs to change. Rogers discussed the broad stakeholder support and participation for the movement, as well as the incredible volunteer involvement. The four ‘centers’ include: the Center to Promote Public-Payer Implementation, the Center for Multi-Stakeholder Demonstration, the Center for eHealth Information Adoption and Exchange and the Center for Health Benefit Redesign and Implementation. Medical Homes will provide superb access to care, patient engagament in care, clinical information systems, care coordination, team care, patient feedback and publically available information.
Edwards explained that the Obama administration believes the medical homes concept is the best way to approach healthcare reform. The U.S. House of Representatives has showed great support for the movement and is helping develop and allocate funds for a five-year pilot program. She expressed her enthusiasm for the movement and her prediction that the medical home model is certainly the future of health care.
A complete version of Rogers’ presentation on the Patient-Centered Primary Care Collaborative is available online.
This presentation explains the concept of the patient-centered medical home (PCMH), its function and its intended effects. A brief overview of the history of PCMH is also provided, as well as a discussion of its operational characteristics, its principles and outcomes, and what is expected in the future for the PCMH model.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
The Indonesia HiT reports the significant improvement in the health status of the population over the last 25 years through transitional period in all fields. However, the country faces remaining and foreseeing challenges in communicable diseases and emerging NCDs. The HiT concludes with the future challenges of expanding coverage of National health insurance scheme (JKN), reducing regional disparities in health-care services, managing resources and engaging private sector.
This presentation explains the concept of the patient-centered medical home (PCMH), its function and its intended effects. A brief overview of the history of PCMH is also provided, as well as a discussion of its operational characteristics, its principles and outcomes, and what is expected in the future for the PCMH model.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
The Indonesia HiT reports the significant improvement in the health status of the population over the last 25 years through transitional period in all fields. However, the country faces remaining and foreseeing challenges in communicable diseases and emerging NCDs. The HiT concludes with the future challenges of expanding coverage of National health insurance scheme (JKN), reducing regional disparities in health-care services, managing resources and engaging private sector.
Advanced practice nursing; an expanded nursing role on an international level Hanze University Groningen
Eduprof Expertmeeting 14-15 April 2011 Groningen.
Workshop Nursing
presentation on Advanced practice nursing; an expanded nursing role on an international level by Mrs. P. Roodbol, Hanze University of Applied Sciences Groningen. The Netherlands
Review of the Saudi Guidelines for informed consent in Surgery as well as the international best practice guidelines for a better approach to Informed Consent in the Kingdom of Saudi Arabia.
What is Health Informatics?
HI Goals
HI stakeholders
HI subfields / subspecialties
Healthcare trends & HI
HI professional environments
HI education / training opportunities & degrees
HI organizations / journals / meetings / events
HI professional certificates
HI books
To innovate is to put new ideas into practice or existing ideas into practice in new ways. Every nurse is an agent of change and an innovator. Every day, nurses work together to solve difficult challenges in the workplace and for their patients.
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
Shared By The Many: Advances in technology are allowing for the provision of affordable, decentralized healthcare for the masses and are lowering the barriers to entry in less developed markets.
The analysis in PSFK’s Future of Health Report has yielded a number of insights, the most evident of which is mobile technology as a catalyst for change. The mobile phone and connected tablet computer are allowing for the distribution of a broad range of medical and support services. This is especially important in countries with little or no healthcare infrastructure and areas in which there are few trained healthcare professionals. These technologies also allow trained professionals to perform quality control remotely.
Amongst the many significant developments is a shift towards one-on-one, in- field diagnostics and monitoring. Services that were once only available at a doctor’s office or hospital are now available on-demand through low-tech, affordable solutions. Personal systems allow for ‘good enough’ diagnostics that would have been difficult, expensive and timely to attain previously.
Using a basic phone with adapted software, a health worker can test for myriad symptoms - even cancer. This information can be relayed to a central medical care center where doctors and trained professionals can react to the data, provide prompt diagnosis and suggest treatment options. The ability to capture this data and get quick responses remotely means better healthcare, fewer trips to the hospital (which, for many means days away from home and family), and less time away from work.
A change is also occurring that is seeing increased access to and sharing of health information. This is made possible by the proliferation of systems designed to overcome infrastructure insufficiencies. these systems are enabling the broadcast of information and receipt of subsequent feedback in virtually any setting. From ‘town crier’ systems to ‘internet by text’, the collective knowledge found on the web is being made available to populations around the world who previously lacked access. The connectivity that is enabling the sharing of health information is also powering the growth of social networks focused on health and medical care. These networks are allowing professionals, health workers and individuals to connect and share knowledge quickly.
PSFK’s Future of Health Report details 15 trends that will impact health and wellness around the world. Simple advances such as off-the-grid energy and the introduction of gaming into healthcare service offerings sit alongside more future-forward developments such as bio-medical printing. It is our hope that this report will inspire your thinking and lead to services, applications and technologies which will allow for more available, quality healthcare.
For a download of this report - visit: http://www.psfk.com/future-of-health
Advanced practice nursing; an expanded nursing role on an international level Hanze University Groningen
Eduprof Expertmeeting 14-15 April 2011 Groningen.
Workshop Nursing
presentation on Advanced practice nursing; an expanded nursing role on an international level by Mrs. P. Roodbol, Hanze University of Applied Sciences Groningen. The Netherlands
Review of the Saudi Guidelines for informed consent in Surgery as well as the international best practice guidelines for a better approach to Informed Consent in the Kingdom of Saudi Arabia.
What is Health Informatics?
HI Goals
HI stakeholders
HI subfields / subspecialties
Healthcare trends & HI
HI professional environments
HI education / training opportunities & degrees
HI organizations / journals / meetings / events
HI professional certificates
HI books
To innovate is to put new ideas into practice or existing ideas into practice in new ways. Every nurse is an agent of change and an innovator. Every day, nurses work together to solve difficult challenges in the workplace and for their patients.
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
Shared By The Many: Advances in technology are allowing for the provision of affordable, decentralized healthcare for the masses and are lowering the barriers to entry in less developed markets.
The analysis in PSFK’s Future of Health Report has yielded a number of insights, the most evident of which is mobile technology as a catalyst for change. The mobile phone and connected tablet computer are allowing for the distribution of a broad range of medical and support services. This is especially important in countries with little or no healthcare infrastructure and areas in which there are few trained healthcare professionals. These technologies also allow trained professionals to perform quality control remotely.
Amongst the many significant developments is a shift towards one-on-one, in- field diagnostics and monitoring. Services that were once only available at a doctor’s office or hospital are now available on-demand through low-tech, affordable solutions. Personal systems allow for ‘good enough’ diagnostics that would have been difficult, expensive and timely to attain previously.
Using a basic phone with adapted software, a health worker can test for myriad symptoms - even cancer. This information can be relayed to a central medical care center where doctors and trained professionals can react to the data, provide prompt diagnosis and suggest treatment options. The ability to capture this data and get quick responses remotely means better healthcare, fewer trips to the hospital (which, for many means days away from home and family), and less time away from work.
A change is also occurring that is seeing increased access to and sharing of health information. This is made possible by the proliferation of systems designed to overcome infrastructure insufficiencies. these systems are enabling the broadcast of information and receipt of subsequent feedback in virtually any setting. From ‘town crier’ systems to ‘internet by text’, the collective knowledge found on the web is being made available to populations around the world who previously lacked access. The connectivity that is enabling the sharing of health information is also powering the growth of social networks focused on health and medical care. These networks are allowing professionals, health workers and individuals to connect and share knowledge quickly.
PSFK’s Future of Health Report details 15 trends that will impact health and wellness around the world. Simple advances such as off-the-grid energy and the introduction of gaming into healthcare service offerings sit alongside more future-forward developments such as bio-medical printing. It is our hope that this report will inspire your thinking and lead to services, applications and technologies which will allow for more available, quality healthcare.
For a download of this report - visit: http://www.psfk.com/future-of-health
Opening presentation by Matthew Holt and Indu Subaiya, Health 2.0 at the Health 2.0 Conference, October 7, 2010 at the Hilton Union Square in San Francisco, CA.
Medicine of the Future—The Transformation from Reactive to Proactive (P4) Med...Ryan Squire
Medicine of the Future—The Transformation from Reactive to Proactive (P4) Medicine as presented at the Ohio State University Medical Center Personalized Health Care National Conference.
Leroy Hood, MD, PhD, is the president and founder of the Institute of Systems Biology. Dr. Hood is a member of the National Academy of Sciences, the American Philosophical Society, the American Academy of Arts and Sciences, the Institute of Medicine and the National Academy of Engineering. His professional career began at Caltech where he and his colleagues pioneered four instruments — the DNA gene sequencer and synthesizer and the protein synthesizer and sequencer — which comprise the technological foundation for contemporary molecular biology. In particular, the DNA sequencer played a crucial role in contributing to the successful mapping of the human genome during the 1990s.
http://www.systemsbiology.org/Scientists_and_Research
Dr. Leroy Hood lectured to a group of Ohio State University College of Medicine students and faculty on May 13, 2010 in advance of an announcement of a partnership between the Ohio State University Medical Center and the Institute for Systems Biology. The partnership will be known as
The Patient Centered Primary Care Collaborative has been working for years to build evidence and knowledge about how to improve healthcare by providing a medical "home" for each of us - a place where all our records reside, where the staff know us, etc. This April 2010 by Executive Director Edwina Rogers shows the phenomenal range of results they've produced.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Michigan Hospital Association Governance meetingMary Beth Bolton
Patient centered medical home activities in MI and Nationally and the opportunity to improve quality outcomes by increased access to primary care doctors who outreach members who are missing preventive and chronic care services.
Ohio State Medical Center Social Media April 2011Ryan Squire
Presentation to Ohio State University Medical Center Senior Leaders about social media and the change that we are driving. The event is #MCSLR or the Medical Center senior leader retreat that focused on change.
Presentation to Ignite Columbus 4 about how social technologies can affect the transformation of health care from reactive medicine to medicine that is predictive, preventative, participatory, and personalized.
Using the New Social Media to Communicate with Policymakers
Facebook, Twitter, and other social networking strategies are rapidly becoming a part of the Washington scene. But are they an effective way to get your message to members of Congress and other policymakers? Experts in social media will explain how they work, and how members of Congress, the administration, the press, and others use these communications tools to disseminate and gather information and to drive their policy agendas.
How To Handle The Responsibilities Of Hipaa, Identity Theft, And Privacy Conc...Ryan Squire
How To Handle The Responsibilities Of Hipaa, Identity Theft, And Privacy Concerns While Introducing New Social Media Technologies as presented by Ryan Squire at the ALI conference on health care in social media 10/5-8/09.
Direct To Consumer Genomics and the Future of HealthcareRyan Squire
Richard Sharp, Ph.D., Director of Bioethics Research at the Cleveland Clinic presents on direct-to-consumer genomics and the future of health care.
Dr. Sharp received his training in philosophy and medical ethics at Michigan State University.
Prior to joining the Cleveland Clinic in 2007, Dr. Sharp taught bioethics at Baylor College of Medicine and the National Institute of Environmental Health Sciences, one of the National Institutes of Health (NIH), where he directed the Program in Environmental Health Policy and Ethics.
His research examines the promotion of informed patient decision-making in clinical research, particularly research that involves genetic analyses.
Pharmacogenomics in Clinical Medicine: What Is FDA Doing to Facilitate the M...Ryan Squire
Larry Lesko, director of the Office of Clinical Pharmacology at the Center for Drug Evaluation and Research with the Federal Drug Administration, begins his talk by making the FDA’s commitment to personalized medicine as a public health agency. He touched on the future focus of improving drug safety and its role in future healthcare policy, citing the FDA Amendments Act of 2007.
Lesko explained that the dual mission at hand is to foster innovation and promote new initiatives under a critical path while developing and clearly articulating the standards for drugs and diagnostics. The organization takes a lifecycle approach to evidence to inform and support decisions—this goes for previous drugs and new drug development.
Moving forward, what else needs to be done? Lesko explained that ways to consensus on evidence are needed to support new drug approvals and relabeling of older drugs. He also believes that the FDA needs to develop more unambiguous drug product labels to enable actionable medical decisions and improve communication between CDER and CDRH on co-development and companion diagnostics.
Tamoxifen And CYP2D6: Using Pharmacogenetics to discover a new drugRyan Squire
Dr. Matthew Goetz, assistant professor of oncology and pharmacology at the Mayo Clinic, shared his pharmacogenomic research findings related to risks and occurrence of breast cancer. He explained that in order to truly personalize medicine, you must account for all possible theories and variables. Goetz continued to say that although many believe pharmacology to be boring, it is a key component of the future model of care. Some may say, so this drug doesn’t work–why not just try another drug? It’s much more complicated than that.
Dr. Goetz touched on the variety of cases in his study in breast cancer patients, some with strange and perplexing results. When giving the same drug to multiple patients, each yielded a variety of different results. Some patients had successful reduction in tumor size, while others resulted in no change and some even experienced tumor growth as a result of the drug. Personalized health care is the answer to this, for lack of a better term, ’shot-in-the-dark’ type of therapy. If physicians can understand each patient’s biology and genetic makeup individually, they can better apply treatments and medications. This would therefore reduce health care costs and enable patients to receive much more efficient treatments.
Transforming Medicine Through Personalized Health Care at Ohio State Universi...Ryan Squire
Dr. Clay Marsh presented "Transforming Medicine Through Personalized Health Care at Ohio State University Medical Center" at the 2009 Personalized Health Care National Conference.
Dr. Marsh is leading the Ohio State University Center for Personalized Health Care to create the future of medicine to improve people’s lives through personalized health care.
Kathryn Phillips, PhD presents "Value of Personalized Health Care: What is it? How to measure it? Why Care" at the 2009 Personalized Health Care National Conference at Ohio State University.
Dr. Phillips is Professor of Health Economics and Health Services Research and director/founder of the Center for Translational and Policy Research on Personalized Medicine at the University of California San Francisco.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- 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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
1. Edwina Rogers Executive Director Patient Centered Primary Care Collaborative 601 Thirteenth St., NW, Suite 400 North Washington, D.C. 20005 Direct: 202.724.3331 Mobile: 202.674.7800 [email_address] Patient Centered Medical Home
2.
3. Pilots in planning phase for 2009 implementation Multi-Stakeholder demonstration Pilot activity in early stages of development Pilots in progress Blue Cross Blue Shield Plan Pilots (as of January 2009)
4.
5. State Initiatives to Advance Medical Homes in Medicaid/SCHIP = Identified to have a medical home initiative Source: National Academy for State Health Policy State Scan, November 2008
6. Patient-Centered Medical Home 2009 Overview of Pilot Activity and Planning Discussions RI Multi-Payer pilot discussions/activity Identified pilot activity No identified pilot activity – 6 States
7.
8. PCPCC: 2008-2009 4 Key Organizations Joining PCPCC Since April 28 th Stakeholder Meeting
9. How do you start to fix the foundational issue around why our healthcare system is so expensive and yet so broken? Average health spend per capita ($US PPP)
10. The World Health Organizations ranks the U.S. as the 37 th best overall healthcare system in the world
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12. Collaborative Principles The Patient Centered Primary Care Collaborative is a coalition of major employers, consumer groups, patient quality organizations, health plans, labor unions, hospitals, clinicians and many others who have joined together to develop and advance the patient centered medical home. The Collaborative believes that, if implemented, the patient centered medical home will improve the health of patients and the viability of the health care delivery system. In order to accomplish our goal, employers, consumers, patients, clinicians and payers have agreed that it is essential to support a better model of compensating clinicians. Compensation under the Patient-Centered Medical Home model would incorporate enhanced access and communication, improve coordination of care, rewards for higher value, expand administrative and quality innovations and promote active patient and family involvement. The Patient-Centered Medical Home model will also engage patients and their families in positive ongoing relationships with their clinicians. Further, the Patient-Centered Medical Home will improve the quality of care delivered and help control the unsustainable rising costs of healthcare for both individuals and plan-sponsors. If you agree, please visit us at www.pcpcc.net and join today!
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18. PCPCC Payment Model May 2007 Key physician and practice accountabilities/ value added services and tools Proactively work to keep patients healthy and manage existing illness or conditions Coordinate patient care among an organized team of health care professionals Utilize systems at the practice level to achieve higher quality of care and better outcomes Focus on whole person care for their patients Performance Standards Incentives Incentives Incentives 16
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21. NC Savings (FY04) Simple Cost Avoidance Category of Service Estimated Savings from Benchmark Inpatient $142,085,680 Outpatient $51,865,028 Emergency Room $25,944,553 Primary Care, Specialist $45,498,709 Pharmacy $(15,526,996) Other $(5,065,238) Totals $244,801,735
22. North Carolina Pilot Project Details AccessCare Network Counties Access II Care of Western NC Access III of Lower Cape Fear Central Care Health Network Community Care of Wake and Johnston Counties AccessCare Network Sites Community Care Plan of Eastern NC Community Health Partners Northern Piedmont Community Care Partnership for Health Management Sandhills Community Care Network Carolina Collaborative Comm. Care Carolina Community Health Partnership Comm. Care Partners of Gtr. Mecklenburg Northwest Community Care Network Southern Piedmont Community Care Plan
23. Pilot: Geisinger Health System Lewisburg Pennsylvania Pre-Test period Jan - Oct 2006 First pilot year Jan – Oct 2007 Percent reduction Hospital Admission 365/1000 291/1000 - 20% Hospital readmissions 15.2% 7.9% - 48% Cost 7% less
24. At least 14 Independent Evaluations in 11 States . . . And Growing RI CMS will select 8 states for the Medicare Medical Home Demonstration
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27. **Must Pass Elements NCQA PPC-PCMH Content and Scoring Standard 1: Access and Communication A. Has written standards for patient access and patient communication** B. Uses data to show it meets its standards for patient access and communication** Pts 4 5 9 Standard 2: Patient Tracking and Registry Functions A. Uses data system for basic patient information (mostly non-clinical data) B. Has clinical data system with clinical data in searchable data fields C. Uses the clinical data system D. Uses paper or electronic-based charting tools to organize clinical information** E. Uses data to identify important diagnoses and conditions in practice** F. Generates lists of patients and reminds patients and clinicians of services needed (population management) Pts 2 3 3 6 4 3 21 Standard 3: Care Management A. Adopts and implements evidence-based guidelines for three conditions ** B. Generates reminders about preventive services for clinicians C. Uses non-physician staff to manage patient care D. Conducts care management, including care plans, assessing progress, addressing barriers E. Coordinates care//follow-up for patients who receive care in inpatient and outpatient facilities Pts 3 4 3 5 5 20 Standard 4: Patient Self-Management Support A. Assesses language preference and other communication barriers B. Actively supports patient self-management** Pts 2 4 6 Standard 5: Electronic Prescribing A. Uses electronic system to write prescriptions B. Has electronic prescription writer with safety checks C. Has electronic prescription writer with cost checks Pts 3 3 2 8 Standard 6: Test Tracking A. Tracks tests and identifies abnormal results systematically** B. Uses electronic systems to order and retrieve tests and flag duplicate tests Standard 7: Referral Tracking A. Tracks referrals using paper-based or electronic system** Pts 7 6 13 Pts 4 4 Standard 8: Performance Reporting and Improvement A. Measures clinical and/or service performance by physician or across the practice** B. Survey of patients’ care experience C. Reports performance across the practice or by physician ** D. Sets goals and takes action to improve performance E. Produces reports using standardized measures F. Transmits reports with standardized measures electronically to external entities Pts 3 3 3 3 2 1 15 Standard 9: Advanced Electronic Communications A. Availability of Interactive Website B. Electronic Patient Identification C. Electronic Care Management Support Pts 1 2 1 4
28. NCQA PPC-PCMH Scoring Levels: If there is a difference in Level achieved between the number of points and “Must Pass”, the practice will be awarded the lesser level; for example, if a practice has 65 points but passes only 7 “Must Pass” Elements, the practice will achieve at Level 1. Practices with a numeric score of 0 to 24 points or less than 5 “Must Pass” Elements are not Recognized. Level of Qualifying Points Must Pass Elements at 50% Performance Level Level 3 75-100 10 of 10 Level 2 50-74 10 of 10 Level 1 25-49 5 of 10 Not recognized 0-24 <5
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33. TODAY’S CARE MEDICAL HOME CARE My patients are those who make appointments to see me Our patients are those who are registered in our medical home Patients’ chief complaints or reasons for visit determines care We systematically assess all our patients’ health needs to plan care Care is determined by today’s problem and time available today Care is determined by a proactive plan to meet patient needs without visits Care varies by scheduled time and memory or skill of the doctor Care is standardized according to evidence-based guidelines Patients are responsible for coordinating their own care A prepared team of professionals coordinates all patients’ care I know I deliver high quality care because I’m well trained We measure our quality and make rapid changes to improve it It’s up to the patient to tell us what happened to them We track tests & consultations, and follow-up after ED & hospital Clinic operations center on meeting the doctor’s needs A multidisciplinary team works at the top of our licenses to serve patients Acute care is delivered in the next available appointment and walk-ins Acute care is delivered by open access and non-visit contacts Slide from Daniel Duffy MD School of Community Medicine Tulsa Oklahoma
34. Information Flow- Consumer Materials What consumers can expect- PCMH consumer principles (brochure) Guidance to create your own practice brochure in support of PCMH model (paper) Four minute video for waiting room viewing; deep-dive on PCMH (Flash) Promotes Primary Care (brochure) Deep-dive focus on PCMH (brochure)
35. Inclusion of the Medical Home Concept in Health Reform Efforts Employer Trade Associations Think Tanks Executive Branch Plans developed by Congressional Representatives The Patient-Centered Medical Home
36. Statement on the PCMH: President Obama “ I support the concept of a patient-centered medical home, and as part of my health care plan, I will encourage and provide appropriate payment for providers who implement the medical home model, including physician-directed, interdisciplinary teams, care management and care coordination programs, quality assurance mechanisms, and health IT systems which collectively will help to improve care.” President Barack Obama
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39. UPCOMING COLLABORATIVE EVENTS Thursday October 22, 2009 - Washington D.C., Annual Summit - Washington Convention Center Tuesday, March 30, 2010 - Washington D.C., Stakeholder Meeting - Ronald Reagan Building and International Trade Center Thursday, July 22, 2010 - Washington D.C., Stakeholder Meeting - Ronald Reagan Building and International Trade Center Thursday, October 21, 2010 - Washington D.C., Annual Summit - Ronald Reagan Building and International Trade Center
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41. CONTACT INFORMATION Visit our website – http://www.pcpcc.net To request any additional information on the PCMH or the Patient Centered Primary Care Collaborative please contact: Edwina Rogers Patient Centered Primary Care Collaborative Executive Director 202.724.3331 202.674.7800 (cell) erogers@pcpcc.net, 601 Thirteenth St., NW, Suite 400 North Washington, DC 20005
Editor's Notes
Many of the Blue Plans are committed to develop PCMH pilot demonstrations to test the model. (28 TOTAL) Pilots already in progress include (Blue House): Regence BlueCross BlueShield of Oregon Regence BlueShield (Washington) BlueCross BlueShield of North Dakota Wellmark Blue Cross and Blue Shield Blue Cross Blue Shield of Michigan Horizon Blue Cross and Blue Shield of New Jersey Independence Blue Cross * Empire Blue Cross and Blue Shield * Blue Cross & Blue Shield of Rhode Island * Blue Cross and Blue Shield of Vermont * Pilots in planning phase for 2009 implementation include (Purple House): Blue Cross of Idaho Anthem Blue Cross and Blue Shield – Colorado * Blue Cross and Blue Shield of Kansas City Blue Cross and Blue Shield of Minnesota Anthem Blue Cross and Blue Shield – Ohio * BlueCross and BlueShield of Tennessee * Anthem Blue Cross and Blue Shield – Georgia Blue Cross and Blue Shield of Florida Blue Cross and Blue Shield of North Carolina CareFirst BlueCross BlueShield Highmark Blue Cross Blue Shield BlueCross Blue Shield of Western New York Excellus BlueCross BlueShield Blue Cross and Blue Shield of Massachusetts Blue Cross and Blue Shield of South Carolina Anthem Blue Cross and Blue Shield – New Hampshire * Anthem Blue Cross and Blue Shield – Maine * Pilot activity in early stages of development include (Yellow House): Blue Shield of California Blue Cross and Blue Shield of Hawaii Blue Cross and Blue Shield of Texas Blue Cross and Blue Shield of Louisiana Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Alabama Triple-S (Puerto Rico) Capital Blue Cross Who is NOT involved: BCBS Arizona BCBS Nebraska Arkansas BCBS BC of NEPA BCBS Delaware Premera BC BCBS Kansas BCBS Wyoming BCBS Mississippi BCBS Montana * = Multi-Payer Demo (Red House)
This map showing the Medicaid/SCHIP was developed by NASHP—the National Academy for State Health Policy
This map showing the Medicaid/SCHIP was developed by NASHP—the National Academy for State Health Policy
These next few slides speak to the spread of medical home activities and pilots nationally: private payer pilots, Medicaid/SCHIP, and legislation. This first one shows the activity from multipayer pilots as of April 2008. Unfortunately, most of these pilots are dealing with the adult population.