Perspectives from northern ireland – development of bereavement care standard...Irish Hospice Foundation
Presentation delivered at the Hospice Friendly Hospitals Acute Hospital Network meeting on November 15 by the HSC Bereavement Network (HSCBN) Northern Ireland.
Our vision for using patient insight and feedback in the nhs, 12.00, pop up u...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
Improving Sustainability of BC's Home and Community Care SystemBCCPA
In the face of unprecedented growth in the seniors population, health systems across Canada are challenged to ensure sustainability while addressing consumer expectations and respecting the wishes of individuals to remain independent as long as possible. Waitlists for access to continuing care services, and the high numbers of seniors that remain in hospital while no longer requiring acute care, demonstrate potential mismatches between supply and demand. As the population of seniors continues to grow, this disparity will continue to increase, unless practices within health systems change. Island Health will share its experiences supporting seniors to live independently.
Perspectives from northern ireland – development of bereavement care standard...Irish Hospice Foundation
Presentation delivered at the Hospice Friendly Hospitals Acute Hospital Network meeting on November 15 by the HSC Bereavement Network (HSCBN) Northern Ireland.
Our vision for using patient insight and feedback in the nhs, 12.00, pop up u...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
Improving Sustainability of BC's Home and Community Care SystemBCCPA
In the face of unprecedented growth in the seniors population, health systems across Canada are challenged to ensure sustainability while addressing consumer expectations and respecting the wishes of individuals to remain independent as long as possible. Waitlists for access to continuing care services, and the high numbers of seniors that remain in hospital while no longer requiring acute care, demonstrate potential mismatches between supply and demand. As the population of seniors continues to grow, this disparity will continue to increase, unless practices within health systems change. Island Health will share its experiences supporting seniors to live independently.
An overview of the work carried out by NHS England and NHS Improving Quality's Long Term Conditions Sustainable Improvement Team. It puts the case for why person-centred care has to be at the heart of healthcare.
Innovation in commissioning and provisioning of community healthcare - Counti...Clever Together
Benedict Hefford is Director of Primary and Community Services at Counties Manukau Health, where he is also the executive lead for integrated care:
http://www.countiesmanukau.health.nz/AchievingBalance/System-Integration/system-integration-home.htm. As Director, Benedict is responsible for both operational delivery and commissioning of health and social care services in South Auckland – a culturally diverse and economically deprived area of New Zealand with over 500,000 residents.
Benedict has 20 years healthcare experience encompassing senior management, commissioning, and strategic roles in both New Zealand and the UK. Prior to joining CM Health, he was Director of Commissioning (Social Care and Health) in central London. Benedict’s previous experience also includes re-designing community care services at Hammersmith and Fulham PCT and Capital Coast Health, as well as developing national health strategies as a Senior Policy Analyst with the NZ Ministry of Health. Benedict holds an MSc in Public Services Policy & Management from King’s College London; a Postgraduate Diploma in Health Services Management; and a BSW (Hons).
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
The concept of advance care planning outlined. The Assisted Decision Making (Capacity) Act 2015. Using Think Ahead as a tool to engage with advance care planning and with advance healthcare directives
"putting patients at the heart": the workforce implicationsJeremy Taylor
Slides I presented at the NHS Employers autumn workforce summit on 13 October 2015. They set out National Voices' perspective on what good person centred, community-focussed care looks like, and the implications for the healthcare workforce of making it real.
Working together for Better Care in Richmond HW_Richmond
Presentation from Richmond CCG, Healthwatch Richmond, Hounslow and Richmond Community Healthcare, Kingston Hospital, West Middlesex University Hospital and the Richmond GP Alliance on the changes happening to community services in Richmond.
Raising Awareness of Dementia, prepared by the Thames Valley Knowledge Team. This document will be of interest to those wishing the raise the awareness of dementia amongst non-specialist health and social care staff. The document describes projects taking place across the South of England and provides links to existing on-line resources that may be of use.
Guidance for commissioners of acute care – inpatient and crisis home treatmentJCP MH
This guide is about commissioning services for people with acute mental health needs. It explains the purpose, characteristics and components of acute care so that commissioners can commission good quality services that are therapeutic, safe and support recovery.
Dr Leon Le Roux - Introducing the framework for community mental health suppo...Innovation Agency
Presentation by Dr Leon Le Roux, Clinical Director/ Consultant Psychiatrist, Lancashire Care NHS Foundation Trust: Introducing the framework for community mental health support, care & treatment on Wednesday 13 March at Haydock Park Racecourse.
How to make care and support planning a two-way dynamic - presentation from webinar held on 1 October 2014
This relates to the first NHS IQ Long Term Conditions Improvement Programmes Wednesday Lunch & Learn Webinar Series. How to make care and support planning a 2 way dynamic hosted by Dr Alan Nye & Brook Howells from AQuA. This webinar discussed how to encourage patients, carers and the public to work alongside (in equal partnership) with clinicians and managers
Transforming End of Life Care in Acute Hospitals PM Workshop 5: How to use th...NHS Improving Quality
Transforming End of Life Care in Acute Hospitals PM Workshop 5: How to use the revised and updated ‘Transform How to Guide’ presented by Maggie Morgan Cooke, Wendy Gray, NHS England
An overview of the work carried out by NHS England and NHS Improving Quality's Long Term Conditions Sustainable Improvement Team. It puts the case for why person-centred care has to be at the heart of healthcare.
Innovation in commissioning and provisioning of community healthcare - Counti...Clever Together
Benedict Hefford is Director of Primary and Community Services at Counties Manukau Health, where he is also the executive lead for integrated care:
http://www.countiesmanukau.health.nz/AchievingBalance/System-Integration/system-integration-home.htm. As Director, Benedict is responsible for both operational delivery and commissioning of health and social care services in South Auckland – a culturally diverse and economically deprived area of New Zealand with over 500,000 residents.
Benedict has 20 years healthcare experience encompassing senior management, commissioning, and strategic roles in both New Zealand and the UK. Prior to joining CM Health, he was Director of Commissioning (Social Care and Health) in central London. Benedict’s previous experience also includes re-designing community care services at Hammersmith and Fulham PCT and Capital Coast Health, as well as developing national health strategies as a Senior Policy Analyst with the NZ Ministry of Health. Benedict holds an MSc in Public Services Policy & Management from King’s College London; a Postgraduate Diploma in Health Services Management; and a BSW (Hons).
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
The concept of advance care planning outlined. The Assisted Decision Making (Capacity) Act 2015. Using Think Ahead as a tool to engage with advance care planning and with advance healthcare directives
"putting patients at the heart": the workforce implicationsJeremy Taylor
Slides I presented at the NHS Employers autumn workforce summit on 13 October 2015. They set out National Voices' perspective on what good person centred, community-focussed care looks like, and the implications for the healthcare workforce of making it real.
Working together for Better Care in Richmond HW_Richmond
Presentation from Richmond CCG, Healthwatch Richmond, Hounslow and Richmond Community Healthcare, Kingston Hospital, West Middlesex University Hospital and the Richmond GP Alliance on the changes happening to community services in Richmond.
Raising Awareness of Dementia, prepared by the Thames Valley Knowledge Team. This document will be of interest to those wishing the raise the awareness of dementia amongst non-specialist health and social care staff. The document describes projects taking place across the South of England and provides links to existing on-line resources that may be of use.
Guidance for commissioners of acute care – inpatient and crisis home treatmentJCP MH
This guide is about commissioning services for people with acute mental health needs. It explains the purpose, characteristics and components of acute care so that commissioners can commission good quality services that are therapeutic, safe and support recovery.
Dr Leon Le Roux - Introducing the framework for community mental health suppo...Innovation Agency
Presentation by Dr Leon Le Roux, Clinical Director/ Consultant Psychiatrist, Lancashire Care NHS Foundation Trust: Introducing the framework for community mental health support, care & treatment on Wednesday 13 March at Haydock Park Racecourse.
How to make care and support planning a two-way dynamic - presentation from webinar held on 1 October 2014
This relates to the first NHS IQ Long Term Conditions Improvement Programmes Wednesday Lunch & Learn Webinar Series. How to make care and support planning a 2 way dynamic hosted by Dr Alan Nye & Brook Howells from AQuA. This webinar discussed how to encourage patients, carers and the public to work alongside (in equal partnership) with clinicians and managers
Transforming End of Life Care in Acute Hospitals PM Workshop 5: How to use th...NHS Improving Quality
Transforming End of Life Care in Acute Hospitals PM Workshop 5: How to use the revised and updated ‘Transform How to Guide’ presented by Maggie Morgan Cooke, Wendy Gray, NHS England
Transforming the relationship with patients and communities (are we getting t...Jeremy Taylor
Slides to accompany a presentation at Member Engagement Services Challenge 2020 event on 6 July 2016. Is engagement getting better? An overview of policy, practice and lived experience, and what needs to happen next
As new payment models emerge that emphasize value over volume, providers are being compelled to look more closely at how to motivate patients—especially those with multiple chronic conditions—to actively manage their care, make better decisions and change behaviors. This editorial webinar will explore the relationships between engagement and improved health outcomes, greater patient satisfaction and better resource utilization. Our panel of experts will share proven strategies for building patients' confidence, disseminating self-management tools and making the best use of your care team.
Six principles for engaging people and communitiesJeremy Taylor
Slides presented at King's Fund on 1 November 2016. How to make real the vision in the Five Year Forward View of "a new relationship with patients and communities"? We know a lot about the "what" and the "who" of implementation. But the "how" is still a mess. What high impact actions would make a difference to driving this agenda? I offer some thoughts. These slides are not entirely self-explanatory without the accompanying talk. Please feel free to get in touch to explore further!
This workshop brought together, for the first time, the pioneers and the partner organisations of the Integrated Care and Support programme. It focused on building a learning community that will help develop, share and spread knowledge and solutions at scale and pace across the country.
More information: http://www.nhsiq.nhs.uk/news-events/events/integrated-care-and-support-pioneers-inaugural-workshop.aspx
More about the integrated care and support pioneers programme: http://www.nhsiq.nhs.uk/7862.aspx
NHS Quality conference - Jonathan BostockAlexis May
“It’s your NHS – a community of influence”
Jonathan will announce the imminent arrival of healthcare’s largest community of influence targeted at engaging over 100,000 people passionate about the future of healthcare in the UK. It’syourNHS.NET will provide the space for providers and commissioners to engage and work collaboratively with service users in a true co-produced environment.
Sussex Partnership NHS Foundation Trust - one of the partners working with NHS Improving Quality on the Winterbourne Medicines Programme
Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014
Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge
BILD Event – 21 March 2018 : Transforming care - Sharing solutions that make ...NHS England
Stream E – Clinical leadership: using dynamic risk registers to prevent admissions and Care and Treatment Reviews to facilitate discharge
Dr Roger Banks and Dr Salim Razak discuss clinical leadership and clinical culture and the dynamic process for risk stratification before describing C(E)TRs, their outcomes so far and their role in achieving successful discharge into the community.
Case Study Three: Dementia Reablement Service for Cheshire East
An example of a how integrated care is working across Eastern Cheshire.
Presented at the Caring Together stakeholder event at Poynton Civic Centre 20July 2015
www.caringtogether.info
News from the Coal Face: There’s light at the end of the tunnel. Presented by Dr Andrew Miller, General Practitioner, at HINZ 2014, 11 November 2014, 4.30pm, Marlborough Room
Krames Patient Education is the only choice for enterprise-wide patient education. In this presentation, practices will learn who Krames Patient Education is and What we can do for you.
We will review Patient-Centered Care and Patient Education; The Case for a Patient Education Investment, The Krames Differencet; Return on Investment; and Krames Solutions.
Similar to Professor Aine Carroll - IPPOSI Patient Reported Outcomes Measures conference Oct 2018 (20)
Derick Mitchell_Biobanking from the patient perspective.pdfipposi
IPPOSI CEO Derick Mitchell presented the patient perspective on biobanking at the 2023 WECAN Academy for Cancer Patient Advocates on July 2nd, 2023 in Frankfurt, Germany.
Mental Health - Leading the data sharing charge with a rights-based approachipposi
Frankie Prendergast's (Digital Health Applications Programme Manager in St Patrick's Mental Health Services) presentation on health information at the 2023 IPPOSI Conference.
Muiris O'Connor, Assistant Secretary of the Department of Health, presented key government updates on health information at the 2023 IPPOSI Conference Building a Data Sharing Health Sector in Ireland.
Clinical Workflow for Capture of Patient Registry Dataipposi
Clare Harney, Managing Director of HD Health, gave a lightning presentation on managing data for patient registries at the 2023 IPPOSI Conference on Building a Data Sharing Health Sector in Ireland.
EU Clinical Trials Regulation - IPPOSI perspectiveipposi
IPPOSI CEO, Dr Derick Mitchell delivered a presentation on the EU Clinical Trials Regulation from the patients' perspective at the 20th International Conference on Pharmaceutical Medicine, Athens, Greece.
Patient Centricity in Value-based healthcare, Sept 2022ipposi
IPPOSI CEO Derick Mitchell delivered a presentation as part of the RCSI Value Based Healthcare Webinar on Patient Centricity on Sept 18th, 2022.
The Future of Value Based Healthcare in Ireland webinar series is run by The RCSI Healthcare Outcomes Research Centre, Janssen Sciences Ireland UC and Novartis Ireland.
2022 World Day Brain Event - IPPOSI Presentationipposi
Laura Kavanagh, Research and Advocacy Manager in IPPOSI, gave a presentation on World Brain Day 2022 at an event hosted by the Neurological Alliance of Ireland.
In October 2020, IPPOSI published a membership engagement survey on its draft 4-year strategy. This slide deck captures the summary results of the survey.
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.
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
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!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
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
22. Definition of Person-Centred
Coordinated Care in Ireland
“Person centred co-ordinated care provides me with
access to and continuity in the services I need when
and where I need them. It is underpinned by a
comprehensive assessment of my life and my world
together with the information and support I need. It
demonstrates respect for my preferences, building
care around me and those involved in my care”.
23. Patient Narrative Project
HSE Corporate
Plan 2015-017
“…we will deliver care around the
individual patient and service user
and put the patient at the heart of
what we do. We will do this by
developing a modern model of
integrated care across our hospital
and community services …” (HSE
Corporate Plan , 2015 – 2017)S services
Definition of Quality within
the Irish Healthcare System
“Person centred; care that is
respectful & responsive to
individuals’ needs and values
and partners with them in
designing and delivering that
care” (HSE Framework for
Improving Quality in our Health
Service , 2016)
Origins
Quality Goals
Patient /
Service
User
Voice in
Health
The Patient/Service
User Voice
The Patient
Narrative Project
• Clear description of
the expectations of
Irish service users
/patients and carers
as they journey
through health
services
• Single shared
definition of Person-
centred Coordinated
Care
• Framework to hear
patient/service user
experiences and use
these to aid
partnership driven
local & national
integrated care
Patient Representative Organisations
Patients / Families / Service Users /
Carers
HSE / Dept. of Health
HSE Programme Managers / Service
Providers
Quality, Safety & Service
Improvement in CHO & HG
Community Interests etc.
Hearing Service Users’ experiences and
expectations of health services
“…there is a need for a clear articulation
of the benefits to patients, service users
and carers, backed up by regular and
detailed assessment of their experience…”
Goodwin et al., 2011
Project Goals
24. A Framework to Enable Co-Design and Co-
Production in the Design and Delivery of
Integrated Care
25. Your Voice Matters: Process Overview
Jan –
May
2017
June –
July
2017
Sept –
Nov 6th
2017
Nov 13th
2017
Jan 2018
onwards
26.
27. Your Voice Matters: Listen
Survey Available:
• Hard Copy
• Online
• App on Smart
Phone
28. Your Voice Matters: Listen
-Focus on people who do or
may use the ICP-OP & ICP-CD
-Engaged with HSE and non-
HSE patient groups and
through community and
hospital services for older
people and people with
chronic conditions
-Engagement at three levels;
broad to specific supported
engagement
29. Your Voice Matters: Listen
584 respondents
Patient/ Service
User, Carer, family
52% respondents patients/service users
45% respondents carers, family or friend
3 & ‘other’
Ethnicity 84% respondents Irish, 4.1% Irish Traveller Community, 6.3% another white background, 4.1% other
backgrounds
Gender 63.8% Female and 32.7% male. 4.4% preferred not to say and no transgender respondents
Age 82% respondents between 26 and 84 years old, 20.3% between 46 and 55 years
Health Condition Respondents had a range of health conditions with respondents selecting between 1 and 13 conditions;
2 health conditions selected most
Cultural Needs 27% respondents reported cultural needs met, 60% reported ‘not an issue’, 13% reported ‘to some
extent’ and 2 respondents reported ‘not met’
Healthcare Setting Many respondents selected more than one setting
Hospital settings were selected most (ED 299, hospital ward 240, hospital clinic 150).
Of community settings, GP was selected 209 times, own home 88 times, day care centre 54 times,
health centre 45 times, nursing home/residential home 20 times and hospice (1)
Healthcare Staff Many respondents selected more than one member of healthcare staff.
Hospital nurse, hospital doctor and consultant were selected most by respondents, 335, 313 and 282
respectively
In the community, GP was selected most times (215), Public Health Nurse (67) and Community Nurse
(47)
CHO Area CHO 1: 59 CHO 2: 70 CHO 3: 67 CHO 4: 91 CHO 5: 139 CHO 6: 50
CHO 7: 117 CHO 8: 51 CHO 9: 83
30. What does it mean?
•Many survey respondents are not experiencing
person-centred care
•Many staff are not successfully conveying empathy,
dignity and respect to patients
•Conversations between health staff and patients focus
mostly on the medical condition and not the impact of
this on the person and his or her life
•Decisions about treatment are based most on health
staff knowledge and health service resources, with
limited input from what the patient wants
31. What does it mean?
• Many people are not experiencing co-ordinated
care during their health and social care experiences
• 2 out of 3 people have experienced disruption
when trying to have their health and social care
needs met
• 2 out of 3 people do not experience team decision
making
• ¼ of people do not know who made decisions about
their treatment and ¼ don’t know what’s happening
after the experience was over
• For more than half of people follow-up is happening
• Not knowing what is happening is disempowering
for people
32. What does it mean?
• The largest cluster of experiences are indexed towards accessing services
after an uncomfortable delay. Keeping patients informed during the waiting
period is essential as well as increasing access to services
• Keep the patient perspective at the centre when measuring the impacts of
services
• It is positive that over 50% of people got information that was practical
and/or easy to understand
• Over a quarter of people got information from healthcare staff that was
conflicting
• Highlights the importance of understandable, practical information to being
in control of one’s health
35. Your Voice Matters: Influence
Story Migration
What needs to change
so that there are more
stories in the centre of
this triangle?
• Co-ordination
• Care-planning
• Communication
• Partnership
36. Your Voice Matters: Co-design & Co-production
National
• Design and development of Integrated Care Programmes (Older Persons, Prevention
& Management of Chronic Conditions, Children, Patient Flow)
• Baseline of how people experience services
• National programmes and frameworks
• Evidence-informed ‘Urgent and Emergency Care: snapshot in the Irish context’
which supports the HSE Transformation of Urgent and Emergency Care Project
Local
• Local implementation of national frameworks; local evidence informed prioritisation
of actions plans for national strategy
• Local identification an planning of service improvements; local data & local
workshops
• ICP-OP Pilot site Service Improvement Workshops and plans
• Contribute to the service user representative voice and progress co-design and co-
production philosophy (e.g., QID patient advocacy, National Patient Forum)
37. Your Voice Matters: Influence and Co-produce
ICP – Older Persons Service
Improvement
The cycle as to how the voice of
older people collated through
Your Voice Matters will be used
to improve local services for
older persons.
Local ICP-OP steering groups,
Age Friendly Ireland and Older
Persons Council provide an
integrated network through
which improvements can be
driven.
38. • Your Voice Matters provides a framework to enable co-production and
co-design in the delivery of integrated care
• The data from Your Voice Matters pilot provides that first check of how
the journey is going from the perspective of the people who use
services.
• It has the ability to provide real-time qualitative and quantitative data
about the experiences of people and allow us to see the person
behind the statistics
“What matters is what gets measured … “ (National Voices, 2017)
…..what gets measured is what matters??
Your Voice Matters Pilot: Conclusions
Editor's Notes
The context, the origins and the deliverables for the project.
The Patient Narrative Project was initiated in 2016 through the Clinical Strategy and Programmes Division, HSE to position the voice of patients and service users centrally in the design and implementation of Integrated Care through the four Integrated Care Programmes (ICPs). As a result it supports progress of key objectives from the HSE Corporate Plan (2015 –17), Framework for Improving Quality (2016) , National Strategy for Service User Involvement (2008 – 2013)and addresses the importance of understanding and responding to the experiences of service users as one component in the development of sustainable quality health services alongside and equal to clinical effectiveness, clinical safety and staff experience.
For integrated care in particular the service user is seen as ‘the organising principle’; looking at integration from the perspective of the service user rather than from the perspective of service processes
The Patient Narrative Project provides one means by which the patient voice is sought and heard within the HSE to support the design and development of services. It complements other methods for capturing feedback from patients such as The National Patient Experience Survey, Listening Groups and Your Service Your Say.
the HSE, IPPOSI (Irish Platform for Patient Organisations, Science and Industry) and the School of Nursing, Midwifery & Health Systems in University College Dublin worked with patients, service users, caregivers and caregiver representative organisations to identify what people want from health services particularly when they need care over time from multiple healthcare staff or in multiple settings. During this work the voices of service users, individuals who support service users and patient representative groups were heard within an ethos of researching with, rather than researching on people. Analysis of the experiences heard resulted in three overarching domains containing a total of nineteen statements which represent what people want to experience within person centred co-ordinated care in Ireland. The findings also led to a definition of person centred co-ordinated care:
“Person-centred coordinated care gives me the services I need, when and where I need them. It is based on a full understanding of my life and my world, combined with the information and support I need. It respects my choices, building care around me and those involved in my care”
The domains, statements, and definition provide an opportunity to enhance the quality of the healthcare experience by identifying objectives for staff and expectations for service users within person centred co-ordinated care. They form the basis of the Your Voice Matters survey that allows service users the opportunity to tell us how we are doing on the journey to person-centred : Phelan A., Rohde D., Casey M., Fealy G., Felle P., Lloyd H. & O’Kelly G. (2017) Patient Narrative Project for Person-centred Co-ordinated Care. UCD, IPPOSI & HSE, Dublin.
this framework will provide continuous feedback to the health service on how its services are experienced by its users in the form of both qualitative and quantitative data. The framework asks patients to tell about their experience of health services in their own words. It then asks them to think about this health experience in relation to the necessary elements of healthcare that treats them as individual people, meets their needs, is flexible enough to enable timely access and provides responsive care in the right place. That is, to consider how the experience was in relation to the person-centred coordinated care that patients want to experience and we the health and social care services want to deliver. The experiences can be analysed to identify the themes and issues that need to be factored into the design of service provisions and professional training and development.
In essence Your Voice Matters looks to progress and instil the guiding philosophy of ‘patients as partners’ in health; to support progress in the empowerment and engagement of people, one of five interdependent strategic goals proposed by the WHO (2015) to progress integrated people-centred health services. Integral in the Your Voice Matters framework for engagement with patients has been the involvement of patients / service users and carers throughout, with the constructs of co-design and co-production kept to the fore.
The Your Voice Matters framework consists of:
An online survey that utilizes the SenseMaker® software programme and is grounded in the voice of patients from phase 1 of the Patient Narrative Project
Engagement plan to maximize service user participation, knowledge and empowerment
Analysis of data by staff and service users together
Identification of key themes and actions to influence the design and delivery of services
This is how the framework was implemented – what it looks like to run it.
YVM utilises the SenseMaker® software tool and is underpinned by a partnership approach between those who use health and social care services and those who provide them.
The Your Voice Matters framework consists of:
An online survey that utilizes the SenseMaker® software programme
Engagement plan to maximize service user participation, knowledge and empowerment
Analysis of data by staff and service users together
Identification of key themes and actions to influence the design and delivery of services
Your Voice Matters is a mechanism or vehicle to allow voices from people in all sectors of society to be heard. It allows for those who can complete it in their own homes online to do so but also allows for 1:1 support to complete, group completion (in a day care centre for example) or peer support (e.g., in the Traveller Co
community where members of the community gathered the stories from their peers). It takes time.
Engagement with local groups included attendance at meetings and promotion of the survey through COPD Ireland support groups, Diabetes Ireland Education groups, National Age Friendly Network and local Older Persons Councils.
In order to hear the voices of people in more vulnerable sectors of our community specific engagement was also carried out with a defined number of Traveller Communities in Dublin, Galway and Kerry, with Dublin Simon Community, with the Deaf community in Kerry and contacts were made with the HSE Social Inclusion Division and a variety of local ethnic minority groups. Within more vulnerable communities a peer education approach was taken whereby members of the communities were supported to be ‘story gatherers’ within their own communities. ‘Narrative circles’ were used in some day care facilities as a means of supporting older people to complete the survey in small facilitated groups and one to one support was given in longer stay facilities.
A number of regions in the country undertook specific promotion of the survey with staff and patients including, Donegal Long Term Conditions Team and Kerry Community Development Team. The health services in the South East (CHO5) as the lead CHO pilot area worked with South Tipperary Integrated Care Programme, the South East Recovery College (MHS), Integrated Care Chronic Disease Management and Social Inclusion Services.
An engagement strategy for the pilot focused at three levels for the populations relevant to the Integrated Care Programme for Older Persons and the Integrated Care Programme for People with Chronic Conditions:
National level patient organisations groups and citizen groups both HSE and Non-HSE
Local HSE services and pilot/demonstrator sites for the targeted populations
Pilot and demonstrator sites for the integrated care programmes for Older Persons and Prevention and Management of Chronic Conditions (see figure 1)
Now 657 respondents. This gives an overview of the demographics of those who participated. 32% of stories currently in the system are from people aged 65 and over
On the left hand side are the domains of the person-centred coordinated care from IPPOSI, HSE and UCD work of service user perspective. The middle column outlines key principles of IC related to patients and staff and on the right hand side is the current reality as described by patients and service users.
Patients are asked to identify acts of kindness and idea for improvement - There is a strong correlation between what people valued and what they would like to see more of. The human factors of communication, empathy, kindness rate highly in both.
How can this types of data collection, which gives us qualitative and quantitative data in real-time on an on-going basis, change the experiences of patients and service users?
Specific use of the Your Voice Matters framework within integrated care programmes, CHO pilot site
The Model of ICP-OP demonstrates the use of YVM for co-production