More presentations from the NCVO Annual conference: http://www.ncvo-vol.org.uk/networking-discussions/blogs/20591 will help you innovate in your work.
Fiona Sheil, Public Service Delivery Officer, NCVO
This expert-led workshop explores the future of contract design, what it means for funding public services and th e legal and cultural implications for organisations like yours. Public service contracting is becoming more diverse in both size and structure. With large contracts being broken up and work being passed down supply chains in sub-contracts, you see a number of challenges arising.
If you are involved in contracting , our panel of senior national charity finance directors and civil servants will help you navigate some of the key difficulties, including modelling cash-flows in supply chains and managing the sharing of risk between providers.
The presentation was a workshop at Evolve 2014: the annual event for the voluntary sector in London on Monday 16 June 2014.
The presentation was chaired by Anna Bloch from Charity Finance Group and shares highlights of how charities have adapted and are continuing to adapt to the climate, covering reductions in statutory funding and new fundraising strategies.
Find out more about the Evolve Conference from NCVO: http://www.ncvo.org.uk/training-and-events/evolve-conference
Find out more about the work NCVO does around funding: http://www.ncvo.org.uk/practical-support/funding
This presentation was given by Thomas Leftwich - Senior Policy Advisor, Sector Sustainability Programmes.
For more resources on public service delivery visit http://www.ncvo.org.uk/practical-support/public-services
Developments in Personalised Support and ISFsCitizen Network
Simon Duffy gave this overview of where ISFs came from, some of the different approaches going on internationally and how commissioners could encourage them locally.
The presentation was a workshop at Evolve 2014: the annual event for the voluntary sector in London on Monday 16 June 2014.
The presentation was chaired by Anna Bloch from Charity Finance Group and shares highlights of how charities have adapted and are continuing to adapt to the climate, covering reductions in statutory funding and new fundraising strategies.
Find out more about the Evolve Conference from NCVO: http://www.ncvo.org.uk/training-and-events/evolve-conference
Find out more about the work NCVO does around funding: http://www.ncvo.org.uk/practical-support/funding
This presentation was given by Thomas Leftwich - Senior Policy Advisor, Sector Sustainability Programmes.
For more resources on public service delivery visit http://www.ncvo.org.uk/practical-support/public-services
Developments in Personalised Support and ISFsCitizen Network
Simon Duffy gave this overview of where ISFs came from, some of the different approaches going on internationally and how commissioners could encourage them locally.
The Investment Case For Financial InclusionElena Thomas
As part of the World Bank MOOC on Development Finance - this document makes the case for development financing to enhance social microfinance and bridge the gap from social to commercial financial services as a way to reduce poverty and build local economies.
Presentation will cover: Introduction to AFI and AFI Network’s experience of Financial Inclusion Strategies; What are the global trends in Financial Inclusion Strategy Formulation & Implementation?; What lessons and conclusions can we draw from the current practices?
Thinking About CSR in Practice: learnings from decades in the trenchesWayne Dunn
Lecture delivered to the McGill Institute for the Study of International Development’s Executive Program on Corporate Social Responsibility Strategy and Management, Accra, Ghana, Nov 6, 2013
Roadmap to employment, career and day services trudygrable
Along with the several factors involved when making decisions about day and employment services, the health and safety of the individual remain the most important and no service can be arranged or provided with out these considerations taken into account.
This roadmap is not to replace the importance of a discussing day and employment service options with the regional center service coordinator, the Department of Rehabilitation, and other funding sources and service providers.
The roadmap does not address employment trends or describe provider organizations or availability.
The definitions for the services described in this roadmap are primarily from the Department of Developmental Services for the State of California.
As the charity sector continues to manage the impact of the pandemic, many charities are facing financial uncertainty. In this context many senior leaders, to ensure their charity’s sustainability, will be considering collaboration and merger. In this webinar, in association with Bates Wells, we aim to answer questions such as: When should a charity in crisis consider merging? What are the alternatives? How can you make the best decision for your organisation? You will also hear about a new online decision-making tool which will help organisations chart the options open to them in a tight financial spot.
The Investment Case For Financial InclusionElena Thomas
As part of the World Bank MOOC on Development Finance - this document makes the case for development financing to enhance social microfinance and bridge the gap from social to commercial financial services as a way to reduce poverty and build local economies.
Presentation will cover: Introduction to AFI and AFI Network’s experience of Financial Inclusion Strategies; What are the global trends in Financial Inclusion Strategy Formulation & Implementation?; What lessons and conclusions can we draw from the current practices?
Thinking About CSR in Practice: learnings from decades in the trenchesWayne Dunn
Lecture delivered to the McGill Institute for the Study of International Development’s Executive Program on Corporate Social Responsibility Strategy and Management, Accra, Ghana, Nov 6, 2013
Roadmap to employment, career and day services trudygrable
Along with the several factors involved when making decisions about day and employment services, the health and safety of the individual remain the most important and no service can be arranged or provided with out these considerations taken into account.
This roadmap is not to replace the importance of a discussing day and employment service options with the regional center service coordinator, the Department of Rehabilitation, and other funding sources and service providers.
The roadmap does not address employment trends or describe provider organizations or availability.
The definitions for the services described in this roadmap are primarily from the Department of Developmental Services for the State of California.
As the charity sector continues to manage the impact of the pandemic, many charities are facing financial uncertainty. In this context many senior leaders, to ensure their charity’s sustainability, will be considering collaboration and merger. In this webinar, in association with Bates Wells, we aim to answer questions such as: When should a charity in crisis consider merging? What are the alternatives? How can you make the best decision for your organisation? You will also hear about a new online decision-making tool which will help organisations chart the options open to them in a tight financial spot.
More presentations from the NCVO Annual conference:
http://www.ncvo-vol.org.uk/networking-discussions/blogs/20591
Carrie Deacon, Improvement and Innovation Consultant, NCVO
Alice Casey, Neighbourhood Challenge Programme Manager, NESTA
How can your organisation lead meaningful change in your neighbourhood? In this interactive workshop you will go beyond the theory. Hear practical examples from community organisations that have successfully unlocked potential in their communities to solve their own challenges.
Share which approaches to supporting community led action would work best in your area and how we can make local changes to achieve impact and then build on the existing strengths of our communities. You will come away with simple methods and ideas that will help you innovate in your work.
On 4th December 2015 the Big Lottery Fund and CBO evaluation team ran a peer learning event for people developing SIBs related to employment, housing and crime. These slides are from the afternoon workshop on working with investors.
On 11th February 2016 the Big Lottery Fund and CBO evaluation team ran a peer learning event for people developing SIBs related to health. These slides are from the workshop on working with investors.
Commissioning to Facilitate Community Building & DevelopmentOlivia Wilson
Asset-based commissioning is an approach that enables communities and people, along with organisations, to become equal co-producers and co-commissioners while making best complimentary use of all assets, via self-help, to enhance whole life as well as community outcomes. Find here approaches to commissioning that facilitate community building and community development. For more information, visit this link: https://www.global-cxm.com/commissioning/
Digital By Default Local Government Event - Southwark CathedralAndrew Bennett
Featured slides from the Gandlake, Southwark Council and IRRV event held at Southwark Cathedral on 12th November 2015.
Presenters:
Dominic Cain, Assistant Director (Revenues, Benefits & Financial Transaction shared services), Southwark Council
David Ashmore, Director of Business and Customer Service, Lambeth Council
Stephen Hughes, Freelance Financial Adviser (former LGA Executive Director and CEO of Birmingham City Council)
Dave Briggs, Head of Digital & Design, Adur and Worthing Councils
Karen Michael, Service Development Team Leader, London Borough of Southwark
Vivian Davies, Head of Collections and Credit Control, Family Mosaic
Liz Bruce: Manchester health and wellbeing boardThe King's Fund
Liz Bruce talks through how Manchester health and wellbeing board promotes partnership across local government, public health, the local NHS and third sector.
Webinar: How to Future Proof Your CTRS scheme for Universal CreditPolicy in Practice
Despite greater flexibility to raise income, councils still have to make savings and ensure their budgets are spent as efficiently as possible.
In many councils the spotlight is on Council Tax to raise income and the Council Tax Reduction Scheme (CTRS) to make savings.
Council Tax Schemes have been locally designed since April 2013. While many still reflect the nationally administered Council Tax Benefit, we're starting to see greater innovation locally.
The driver of this innovation is the backdrop of the cumulative impact of past and future welfare reforms, the introduction of Universal Credit and ever tighter budgets.
CTRS schemes are intended to keep the most vulnerable citizens safe from poverty. Knowing who those people are is a huge challenge.
We've modelled options for future CTRS schemes in detail for various councils. The impact assessments are used to make informed policy decisions by officers and members.
View this webinar to learn how:
1. We accurately model the cost of CTRS schemes today
2. We accurately model the cost of CTRS schemes in the future, including under Universal Credit
3. We accurately model, compare and evaluate CTRS options under consideration
4. We provide evidenced based recommendations on which CTRS scheme best supports the strategy e. g. best fit for anti-poverty strategy while operating within financial constraints
5. What CTRS schemes we have created for North Hertfordshire, Leeds City and Newcastle City Councils
A panel discussion considering what the future hold for charities and their governance, and how trustees can support their charities to survive and thrive.
Here we share our progress on updating the Charity Governance Code. Hear from the Code steering group about changes that are being made to the Diversity and Integrity principles following its refresh.
The panel will share some of the proposed changes to the Integrity principle, offering a preview of the updates. They will also reflect on findings from engagement and the extended consultation on enhancements to the Diversity principle. This will be an opportunity for the steering group to share their learning, having listened to a range of experiences. It is also an opportunity to discuss best practice which has been identified through the revision work. Finally, the group will offer an update on next steps on the Code's revision.
We’ve put together this video guide to using the governance wheel to carry out a board effectiveness review. It will be most useful for trustees or staff who are undertaking a board review for their own charity and want to know how best to use the governance wheel to support them in this.
Normal working practices have changed dramatically in a very short period. Most staff are still working remotely, and many organisations have made use of the furlough scheme. This has meant organisations are having to manage and support staff remotely; review some existing policies to ensure they are still fit for purpose; and manage with a reduced and rotating staff capacity. In partnership with our Trusted Supplier Croner, in this webinar we will be sharing good practice on managing and supporting staff in this new environment. We will be joined by Vicky Scott, Operations and HR Manager at Hackney CVS who will share the experiences and learnings of Hackney CVS in this new context.
The economic impact of coronavirus means that many voluntary sector organisations will be going through a period of significant change over the coming months. For many of the hardest hit charities, the process of restructuring and making redundancies will sadly be inevitable. In this webinar we help organisations prepare for this context.
Entering a new phase of the Covid-19 pandemic, with the option of returning to your workplace, has legal and practical implications for all charities. Employers need to be clear about what they are required to do to ensure the health and safety of their staff and volunteers. Employers are having to consider questions such as: what reasonable adjustments should employers make for their workforce in returning to a ‘new normal?’ How can we prepare for what lies ahead? In partnership with TrustLaw, in this webinar we aim to answer these questions. We will be joined by Sarah Valentine, Senior Associate at Eversheds Sutherland and Andrew New, Head of Education at St John Ambulance.
Slides from a webinar broadcast on 15 July 2020, sharing what volunteering organisations have learned since the lockdown in March.
Watch the full recording here: https://www.youtube.com/watch?v=HyFbDAtHHQo
Slides of NCVO webinar that took place on 24 June 2020 covering:
the general health and safety obligations to staff and volunteers, the key legal and practical issues employers need to consider and where to go for further support and guidance.
Watch the webinar: https://www.youtube.com/watch?v=RDBvyTIFTIc
Slides of the NCVO webinar that took place in June 2020 covering:
1) the role of the chair and the board in supporting organisations in the next phase
2) challenges and opportunities which the easing of lockdown presents for trustees
3) tips and resources to help boards plan in a period of significant change
Watch the webinar: https://www.youtube.com/watch?v=HaPktkiCRgo
In partnership with Zurich, NCVO is pleased to bring you a webinar discussing the importance of risk assessments and how effective risk assessments can demonstrate that appropriate health and safety measures are being adopted during the COVID 19 pandemic.
More from NCVO - National Council for Voluntary Organisations (20)
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
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
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.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
- 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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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.
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
3. A little bit of background
• Certitude is a social care group with a turnover of
circa £25M
• 630 staff delivering a range of support options for
people with mental health needs and learning
disabilities.
• Support individuals with complex needs and
profound and multiple disabilities
• Currently operate mainly in Greater London with
provider status in 14 local authority areas
A dynamic force in social care!
4. • Income sources:
90% income
from contracts
So what's personal about that?
A dynamic force in social care!
5. Our Guiding Principles:
• Choice and control on all aspects of one’s life
is the right of everyone we support now or in
the future
• Coproduction leads to better outcomes
• Deliver value for money; will include
restructuring services and delivery methods
A dynamic force in social care!
6. What do we mean by Co-production?
• Recognising people as assets
• Building on people's capabilities
• Promoting mutuality and reciprocity
• Developing peer support networks
• Breaking down barriers between
professionals and users
• Facilitating rather than delivering
NEF and NESTA
A dynamic force in social care!
7. Current Landscape – our perspective
• Contracts are not outcome focussed
• Spot contracts do not achieve personalisation
• Financial necessity requires us to think and act differently -
cost cutting is increasingly the driver for change
• We are well placed to offer solutions - commissioners need
and welcome ideas
• Radical new approaches are needed by all parts of the system
• If we can get it right for those with the most complex needs
then everything is possible
A dynamic force in social care!
8. Why Current Commissioning and contracting doesn’t
deliver on outcomes?
•An over focus on needs
Joint needs assessments often focus purely on the need of a cohort often failing
to identify their inherent or potential capacity and asset base
•Lack of useful, reliable and up-to-date local intelligence
This leads to localised services being designed and evidenced using national
data which often fails to identify with local needs and aspirations
•Risk averse commissioning reduces opportunities for real innovation
Often due to a lack of useful dialogue between providers and commissioners
about risk and unexamined anxieties
•Commissioning and procurement as a reductive process
This leads to localised services being designed and evidenced using national
data which often fails
A dynamic force in social care!
9. Why Current Commissioning and contracting doesn’t
deliver on outcomes?
•Short-term and static specifications and contracting
Limited opportunities for services to change in order to meet shifting needs
of cohorts and limited maintained dialogue between commissioners and providers
•Collaboration is weak
This leads to a lack of effective working between commissioners and
providers and between providers and providers
•Orthodoxy to create economies of scale produces static markets
This leads to commissioning not shaping supply chains or creating overly
dominant prime providers
• “We already do co-production”
Misunderstanding of translation of the core principles of co-production often
leads to a lack of meaningful engagement with people who use services, their carers
and families A dynamic force in social care!
10. What commissioning approach is needed?
• Assess needs, aspirations and assets
Engages with people in meaningful ways in order to gather localised intelligence of
needs, aspirations and assets
• Outcomes and impacts are assessed dynamically, using diverse methods
Measurements of the success of services is continually made using a range of
touchpoints and feedback options to ensure that measurement is informed by
individuals that include: people who use services, families, carers and front-line
staff.
• Accountability panels to challenge and spread co-production
Accountability for upholding a co-production and collaborative led approach to
commissioning will be distributed across panels made up to include: community
members, people who use services, staff, service providers and commissioners.
A dynamic force in social care!
11. What commissioning approach is needed?
• Specifications are iterative and change over time to best meet the needs and
assets
By ensuring better community intelligence, better processes of design and smarter
governance, commissioning will drive the options for supply
• Co production principles define and assess all interactions
All planning of processes and interactions are led by the 6 principles of co-
production and success is assessed against these too.
• Actively shapes markets
By ensuring better community intelligence, better processes of design and smarter
governance, commissioning drives the options for supply.
A dynamic force in social care!
12. What are we trying?
• Renegotiating Relationships
• Piloting Individual Service Funds
A dynamic force in social care!
13. Renegotiating Relationships - Contracts
• Offering pathway solutions
• Collaboration – alliance contracts
• Specifications based on recovery outcomes
• Agency to Agency time bank
• Working Together for change – coproduction
A dynamic force in social care!
14. Piloting Individual Service Funds
• Tailoring support to people, including the money available;
• Can be achieved within a range of contracting options
including block arrangements
• Offering the greatest possible choice and control to people in
existing services;
• Changing the relationship between budget recipient and
service provider;
• Better outcomes for people that take managed budgets.
A dynamic force in social care!
15. Key features of an ISF (DH, 2011)
• All or part of a personal budget held by a provider on an
individual's behalf where the money is restricted for use on
that person’s support and accounted for accordingly;
• No specific tasks predetermined so that the personal budget
holder is empowered to plan with the provider the
who, how, where, when and what of any support provided;
• Flexibility to roll money/support over into future weeks or
months and to bank support for particular purposes;
• Accompanied by written information that clearly explains the
arrangement and confirms any management costs to come
from the personal budget;
• Portability so that the personal budget holder can choose to
use the money in a different way or with a different provider.
A dynamic force in social care!
16. Contractual implications
• An ISF is not a contract – accountability and liability remains
between the council and the provider unless it is a direct
payment;
• ISFs do not necessarily require different forms of
contract, though there may be a need for contractual
variations;
• Variations relate to issues around subcontracting, banking of
hours and “cash conversion”;
• Spot contracts: the contract sum becomes the ISF;
• Block contracts: the block is disaggregated on the basis of
people’s respective needs into ISFs for each person;
• Direct payments and personal budgets: the allocated sum
becomes the ISF
A dynamic force in social care!
17. What have we learned?
• Working in partnership with supportive and innovative
commissioners and other partners is key
• Start from a clear view of what success looks like
• Concentrate as much on the practice as the money
• Be Risk aware not impotent
• Share stories of success especially with staff
• Do business differently – breakfast meetings work!
A dynamic force in social care!
19. Two Innovations for social
Change
Chris Sherwood, Director of
Innovation & Development
NCVO Annual Conference – 5th
March 2012
20.
21. Needs and drivers for change
• External factors including cuts, localism, improved
outcomes and public service reform are spurring us to
action.
• We are part of the sector wide Think Local, Act Personal
initiative to promote personalisation.
• Although our internal drivers are also strong. We have
refocused ourselves as an organisation that is about
social change.
• We want to transform to meet the aspirations of our
customers.
• We see this as the innovation imperative.
22. Our services are undergoing significant
transformation
Support
Information Education
Care
23. Disability Works UK
• Scope is a founding member of DWUK. We are one of 8
different specialist disability employment organisations
who are working together including Leonard Cheshire
Disability and MIND.
• DWUK is a is a 2nd tier sub-contracting consortium
Welfare to Work contracts.
• DWUK delivers 11 Work Programme contracts across the
UK.
• Scope is the lead partner for a Work Programme contract
in Sussex, Surrey and Kent working with Avanta.
24. Why does Scope need to collaborate?
• Provides access to markets that we might not otherwise
be able to compete in.
• Maximises our power in those markets by working with
like minded organisations.
• National reach combined with local delivery.
• Allows us to share risk through coordinated approach
and shared resources.
• Achieve economies of scale by maximising the
resources and capacity within the consortium.
• Share learning and insight to improve practice.
25. Why does Scope need social investment?
Investing in campaigns, advocacy and support services
• Whilst its impact on the lives of disabled people and their
families is significant, our crucial support and advocacy work
does not generate a direct revenue, so requires 100% grant
funding.
Investing in new direct services
• Those services that need pump priming but can be sustainable
in the long term. Could use a combination of donations, soft
loans and commercial loans.
Investing in income generation and profile raising
• We need loans to fund areas of our work that can afford to pay
a small return e.g. new retail outlets or donor acquisition.
• This an area where we think bonds will be most applicable.
26. The Scope Bond Programme
• A scalable, re-usable way of generating large amounts of
social investment at varying yields and terms.
• £20M program (in practice limited to £10M outstanding debt).
• Listed on EURO (MTF) stock exchange.
• Unsecured.
• Investment decision based on ‘Scope as investible
proposition’ e.g.
• £29M fixed assets;
• £9M reserves;
• £4M surplus on £100M p.a turnover for last two years.
27. The First Tranche
• £2M
• 3 year maturity
• 2% yield
• Invested in income generating activities
• Subsequent tranches invested in direct service
delivery e.g. our parent befriending service Face 2
Face and paying higher yield
30. Jim Clifford
jim.clifford@bakertilly.co.uk
+44 7860 386 081
Social Impact Bonds in Public Commissioned Services
Presentation to NCVO Conference 2012
(…with thanks to CVAA and PACT…..)
31. Social Impact Bonds in Public Commissioned
Services
• Payment by results models
• Social Finance and the emerging SIB
• Collaboration and Risk sharing
• Funder markets
32
32. Payment by Results
• Why PBR ?
• Economic trade
• Meaningful measures
• “Informed” Output
Inputs to Activities to Outputs to Outcomes to Impacts
33. Social Finance and the emerging SIB
•Issuer defines terms
•Multi-party funding; same
terms
•Application for specified
social purposes
•Investor reward balance
34. 3-DTypology of SIB-style funding....
Bridging
to PBR Regular or
With deferred
profits
Capital No
interest
Variable
Special interest
Fixed
donors interest
Repayable
Equity Permanent Listed
(regular or
risk capital
bullet)
36. Funder markets
Match the project to
the funder market:
• Public funds
• Third Sector
• Corporates
• Individuals THINK......
• Family offices • Project
• Provider
• Purpose
• Presentation
Everything we do at Scope is about inspiring belief in the possible. And the thing we absolutely believe is possible is that by working together our society can change for the better. So that disabled people have the same opportunities as everyone else. That’s why we share stories of inspiring real life experiences, aspirations and ambitions of disabled people and their families or friends. The things they tell us they’d like to do in the future – the things we support them to achieve. Every day. It’s the reason were here.We see the person and we set no limit on potential. We believe in independence, inclusion and freedom to choose. Everyday life equality. No more. No less.Together we can create a better society