Davin Lundquist, MD
CMIO
Dignity Health Medical Foundation
Case Study: "Leveraging technology to build an organizational strategy fostering staff competency & physician satisfaction"
Health IT systems will never please all users however providers are employing strategies that can significantly improve user satisfaction. Staff re-education and continually measuring the effectiveness of initiatives can make a positive impact on an organization’s ability to realize gains with IT. This presentation will explore Dignity Health’s lessons learned and organizational strategy to ensure staff competency levels and physician satisfaction.
Dignity Health is a family of more than 60,000 caregivers and staff delivering excellent care to diverse communities across 17 states. Founded in 1986 and headquartered in San Francisco Dignity Health is the fifth largest hospital provider in the nation and the largest hospital system in California.
Gender and Essential Packages of Health Services: Exploring the Evidence BaseReBUILD for Resilience
Presented by Val Percival of Norman Paterson School of International Affairs, Carleton University, Canada.
Part of a session - 'Context, gender, and sustainability in introducing and scaling-up essential health care packages in fragile and crisis-affected countries' - at the Fifth Global Symposium for Health Systems Research in October 2018. The essential package of health services is a mechanism for expanding equitable coverage of primary health care and essential hospital services in countries recovering from conflict. The session explores the evidence-base on such healthcare packages in different contexts and prioritizes areas for strengthening research.
Davin Lundquist, MD
CMIO
Dignity Health Medical Foundation
Case Study: "Leveraging technology to build an organizational strategy fostering staff competency & physician satisfaction"
Health IT systems will never please all users however providers are employing strategies that can significantly improve user satisfaction. Staff re-education and continually measuring the effectiveness of initiatives can make a positive impact on an organization’s ability to realize gains with IT. This presentation will explore Dignity Health’s lessons learned and organizational strategy to ensure staff competency levels and physician satisfaction.
Dignity Health is a family of more than 60,000 caregivers and staff delivering excellent care to diverse communities across 17 states. Founded in 1986 and headquartered in San Francisco Dignity Health is the fifth largest hospital provider in the nation and the largest hospital system in California.
Gender and Essential Packages of Health Services: Exploring the Evidence BaseReBUILD for Resilience
Presented by Val Percival of Norman Paterson School of International Affairs, Carleton University, Canada.
Part of a session - 'Context, gender, and sustainability in introducing and scaling-up essential health care packages in fragile and crisis-affected countries' - at the Fifth Global Symposium for Health Systems Research in October 2018. The essential package of health services is a mechanism for expanding equitable coverage of primary health care and essential hospital services in countries recovering from conflict. The session explores the evidence-base on such healthcare packages in different contexts and prioritizes areas for strengthening research.
Health system strengthening – what is it, how should we assess it, and does i...ReBUILD for Resilience
This presentation was given to the UK's Department for International Development on 30th July 2019.
Comprehensive reviews of health system strengthening interventions are rare, partly because of lack of clarity on definitions of the term but also the potentially huge scale of the evidence. In our talk, we will reflect on the process of undertaking such an evidence review for DFID recently (attached again), drawing out suggestions on definitions of HSS and approaches to assessment, as well as summarising some key conclusions from the current evidence base. Most HSS interventions have theories of change relating to specific system blocks, but more work is needed on capturing their spill-over effects and their contribution to meeting over-arching health system process goals. We will make some initial suggestions about such goals, to reflect the features that characterise a ‘strong health system’. We will highlight current findings on ‘what works’ but also that these are just indicative, given the limitations and biases in what has been studied and how, and argue that there is need to re-think evaluation methods for HSS beyond finite interventions and narrow outcomes. Clearer concepts, frameworks and methods can support more coherent HSS investment.
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an ...cheweb1
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an Urban Regeneration context using economic evaluation techniques. Economic evaluation seminar presented by Camilla Baba, PhD candidate, University of Glasgow 12 May 2016
Health system strengthening evidence review – A summary of the 2021 updateReBUILD for Resilience
A presentation given by Professor Sophie Witter to the UK government's Foreign, Commonwealth & Development Office. This summarises a 2021 review of a health systems strengthening evidence review originally undertaken for the office in 2019.
Rick MacCornack, PhD
Chief Systems Integration Officer
Northwest Physicians Network
CEO
Rainier Health Network
Closing Presentation "ACOs and Health IT: True Delivery System Reform or Another Round of Unintended Consequences?"
A fundamental component of the Affordable Care Act is support for the creation of so-called Accountable Care Organizations. Health care information technology will play a critical role in the reform process, perhaps in ways which are not yet well understood. Using the framework and early experience of a local CMS appointed ACO, this session is intended to ask questions and provide examples for how IT efforts might contribute to healthy, disruptive change in improving medical care delivery.
Learning Objectives:
∙ Consider the unintended consequences of the current IT trajectory in supporting medical care delivery in relation to the mandates of the
Affordable Care Act. Consider some opportunities for future IT contributions and what will need to occur for these opportunities to be tapped.
∙ Reflect on the historical contributions of IT in health and how there will necessarily be a shift in IT development in the future in support of
medical care delivery reform.
Personalized Health and Care: IT-enabled Personalized HealthcareIBM HealthCare
Healthcare reform currently focuses on changing the structure and incentives of the U.S. healthcare system. Healthcare transformation requires a more open, robust health information technology (HIT) environment to go beyond removing waste and inefficiencies to discover the science of health and care. Learn how IBM can make this possible.
AIDSTAR-One Assessment of the Integration of PMTCT within MNCH Services at He...AIDSTAROne
In guidelines released in 2010, the World Health Organization recommends that health facilities integrate prevention of mother-to-child transmission (PMTCT) with maternal, newborn, and child health (MNCH) services to improve patient follow-up and adherence. This report describes the results of an assessment conducted across 70 randomly sampled PMTCT facilities in 14 regions of Tanzania, and the effect of integration on health quality.
www.aidstar-one.com/focus_areas/pmtct/resources/report/assessment_integration_pmtct_within_mnch_services_health_facilities_tanzania
Evaluation of IC initiatives - challenges, approaches and evaluation of Engla...Sax Institute
This presentation from Nicholas Mays, Professor of Health Policy, Director, Policy Innovation Research Unit, Department of Health Services Research & Policy focuses on the challenges, approaches and evaluation of England's Pioneers.
Presentation is about the uniqueness of Implementation Research and Role of the Government, specially in Indian context of health programme implementation.
The revised OECD Health Systems Performance Framework: methodological issues ...Sax Institute
The OECD is a leading organization in the international measurement of health system performance. The OECD Expert Group on Health Care Quality Indicators (HCQI) has recently revised its performance framework, identifying core indicators and highlighting new directions. Although improving, the capacity of countries to deliver more accurate standardized indicators still needs to be fostered. A particular aspect that deserves attention is the design, planning and implementation of public performance reporting. Such activity, strictly interrelated to the capacity of the information infrastructure, also depends from cultural, organizational and political conditions that can be differently present at the international level. The applicability of standardized principles and the evidence of improved outcomes due to public reporting systems is still questioned to a large extent. A first international conference on the topic of hospital performance reporting has been organized in Rome, Italy in 2014, followed by a second event held in Seoul, South Korea, in 2015. In his talk, Fabrizio Carinci will present recent developments of OECD projects, including:
• state of the art in the definition of OECD performance indicators
• challenges emerging from OECD R&D studies
• transferability and use of definitions at sub-national and provider level
• applicability for hospital performance benchmarking and geographical variation
• limitations imposed by the legislation on privacy and data protection
• an overarching vision of “essential levels of health information”
Through practical examples drawn from his direct experience as Member of the Bureau of the HCQI and other relevant Boards, Prof. Fabrizio Carinci will discuss the state of the art, the role played by national governments (including Australia), and potential avenues for mutual collaboration.
Policy Implications of Healthcare Associated InfectionsAlbert Domingo
On February 19, 2014 at the Ateneo School of Medicine and Public Health in Pasig City, Dr. Albert Domingo presented an introduction to the economic impact of healthcare associated infections (HAIs) as well as related concepts in health policy and management. The speaker discussed common approaches taken to ascertain the economic impact of HAIs, followed by factors/considerations in Philippine health policy and management that must be understood and adjusted in order to minimize HAIs.
Getting evidence from economic evaluation into healthcare practicecheweb1
Seminar:Understanding the underutilisation of evidence from economic evaluations in healthcare: a mixed methods design. Speaker: Gregory Merlo, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology, Brisbane, Australia.
Health system strengthening – what is it, how should we assess it, and does i...ReBUILD for Resilience
This presentation was given to the UK's Department for International Development on 30th July 2019.
Comprehensive reviews of health system strengthening interventions are rare, partly because of lack of clarity on definitions of the term but also the potentially huge scale of the evidence. In our talk, we will reflect on the process of undertaking such an evidence review for DFID recently (attached again), drawing out suggestions on definitions of HSS and approaches to assessment, as well as summarising some key conclusions from the current evidence base. Most HSS interventions have theories of change relating to specific system blocks, but more work is needed on capturing their spill-over effects and their contribution to meeting over-arching health system process goals. We will make some initial suggestions about such goals, to reflect the features that characterise a ‘strong health system’. We will highlight current findings on ‘what works’ but also that these are just indicative, given the limitations and biases in what has been studied and how, and argue that there is need to re-think evaluation methods for HSS beyond finite interventions and narrow outcomes. Clearer concepts, frameworks and methods can support more coherent HSS investment.
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an ...cheweb1
Valuing the health and wellbeing aspects of Community Empowerment (CE) in an Urban Regeneration context using economic evaluation techniques. Economic evaluation seminar presented by Camilla Baba, PhD candidate, University of Glasgow 12 May 2016
Health system strengthening evidence review – A summary of the 2021 updateReBUILD for Resilience
A presentation given by Professor Sophie Witter to the UK government's Foreign, Commonwealth & Development Office. This summarises a 2021 review of a health systems strengthening evidence review originally undertaken for the office in 2019.
Rick MacCornack, PhD
Chief Systems Integration Officer
Northwest Physicians Network
CEO
Rainier Health Network
Closing Presentation "ACOs and Health IT: True Delivery System Reform or Another Round of Unintended Consequences?"
A fundamental component of the Affordable Care Act is support for the creation of so-called Accountable Care Organizations. Health care information technology will play a critical role in the reform process, perhaps in ways which are not yet well understood. Using the framework and early experience of a local CMS appointed ACO, this session is intended to ask questions and provide examples for how IT efforts might contribute to healthy, disruptive change in improving medical care delivery.
Learning Objectives:
∙ Consider the unintended consequences of the current IT trajectory in supporting medical care delivery in relation to the mandates of the
Affordable Care Act. Consider some opportunities for future IT contributions and what will need to occur for these opportunities to be tapped.
∙ Reflect on the historical contributions of IT in health and how there will necessarily be a shift in IT development in the future in support of
medical care delivery reform.
Personalized Health and Care: IT-enabled Personalized HealthcareIBM HealthCare
Healthcare reform currently focuses on changing the structure and incentives of the U.S. healthcare system. Healthcare transformation requires a more open, robust health information technology (HIT) environment to go beyond removing waste and inefficiencies to discover the science of health and care. Learn how IBM can make this possible.
AIDSTAR-One Assessment of the Integration of PMTCT within MNCH Services at He...AIDSTAROne
In guidelines released in 2010, the World Health Organization recommends that health facilities integrate prevention of mother-to-child transmission (PMTCT) with maternal, newborn, and child health (MNCH) services to improve patient follow-up and adherence. This report describes the results of an assessment conducted across 70 randomly sampled PMTCT facilities in 14 regions of Tanzania, and the effect of integration on health quality.
www.aidstar-one.com/focus_areas/pmtct/resources/report/assessment_integration_pmtct_within_mnch_services_health_facilities_tanzania
Evaluation of IC initiatives - challenges, approaches and evaluation of Engla...Sax Institute
This presentation from Nicholas Mays, Professor of Health Policy, Director, Policy Innovation Research Unit, Department of Health Services Research & Policy focuses on the challenges, approaches and evaluation of England's Pioneers.
Presentation is about the uniqueness of Implementation Research and Role of the Government, specially in Indian context of health programme implementation.
The revised OECD Health Systems Performance Framework: methodological issues ...Sax Institute
The OECD is a leading organization in the international measurement of health system performance. The OECD Expert Group on Health Care Quality Indicators (HCQI) has recently revised its performance framework, identifying core indicators and highlighting new directions. Although improving, the capacity of countries to deliver more accurate standardized indicators still needs to be fostered. A particular aspect that deserves attention is the design, planning and implementation of public performance reporting. Such activity, strictly interrelated to the capacity of the information infrastructure, also depends from cultural, organizational and political conditions that can be differently present at the international level. The applicability of standardized principles and the evidence of improved outcomes due to public reporting systems is still questioned to a large extent. A first international conference on the topic of hospital performance reporting has been organized in Rome, Italy in 2014, followed by a second event held in Seoul, South Korea, in 2015. In his talk, Fabrizio Carinci will present recent developments of OECD projects, including:
• state of the art in the definition of OECD performance indicators
• challenges emerging from OECD R&D studies
• transferability and use of definitions at sub-national and provider level
• applicability for hospital performance benchmarking and geographical variation
• limitations imposed by the legislation on privacy and data protection
• an overarching vision of “essential levels of health information”
Through practical examples drawn from his direct experience as Member of the Bureau of the HCQI and other relevant Boards, Prof. Fabrizio Carinci will discuss the state of the art, the role played by national governments (including Australia), and potential avenues for mutual collaboration.
Policy Implications of Healthcare Associated InfectionsAlbert Domingo
On February 19, 2014 at the Ateneo School of Medicine and Public Health in Pasig City, Dr. Albert Domingo presented an introduction to the economic impact of healthcare associated infections (HAIs) as well as related concepts in health policy and management. The speaker discussed common approaches taken to ascertain the economic impact of HAIs, followed by factors/considerations in Philippine health policy and management that must be understood and adjusted in order to minimize HAIs.
Getting evidence from economic evaluation into healthcare practicecheweb1
Seminar:Understanding the underutilisation of evidence from economic evaluations in healthcare: a mixed methods design. Speaker: Gregory Merlo, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology, Brisbane, Australia.
Public private partnerships in healthcare. Evaluation of 10 years´ experience...Antonio Clemente Collado
Doctoral Thesis based in a performance model to compare the outcome of PPPs hospitals vs public managed ones. This study integrates the cost and also quality variable to point the strengths and weaknesses of both management models.
Measuring and Evaluating Reproductive Health Initiatives MEASURE Evaluation
This presentation provides an overview of the process of updating the Compendium of Indicators for Evaluating Reproductive Health Programs and what the final product will include.
Jack Hazerjian's presentation from the Measuring Success Toolkit webinar in September 2012. This PowerPoint is available for download, and the explanatory notes are visible below.
Performance of Routine Information System Management Framework (PRISM) led by Natasha Kanagat
The PRISM framework consists of four tools to assess Routine Health Information System (RHIS) performance, identify technical, behavioral and organizational factors that affect RHIS, aid in designing priority interventions to improve performance and improve quality and use of routine health data.
Recording: http://universityofnc.adobeconnect.com/p1edhgz9zs7/
PRISM Tool: https://www.cpc.unc.edu/measure/publications/ms-11-46-d
The 7 Steps to Improve HIV/AIDS Programs Guide presents concrete steps and illustrative examples that can be used to facilitate the use of information as a part of the decision-making processes guiding program design, management and service provision in the health sector. Download 7 Steps to Improve HIV/AIDS Programs Guide.
Tool: http://www.cpc.unc.edu/measure/publications/ms-11-46-b
Webinar Recording: http://universityofnc.adobeconnect.com/p5msoue5e67/
Primary Health Care Strategy:
Key Directions for the Information Environment. Case study report and composite success model.
Steve Creed & Philip Gander
Health Services Integration-A Vision For 2015: Strategic Direction and Action...Fairfax County
Health Services Integration-A Vision For 2015: Strategic Direction and Action Plan
Presentation to the Fairfax County Board of Supervisors
October 9, 2012
Similar to A Systematic Approach to Monitoring and Evaluating Integrated Health Interventions in the Era of the Global Health Initiative (20)
Managing missing values in routinely reported data: One approach from the Dem...MEASURE Evaluation
This Data for Impact webinar was held in December 2020. Access the recording and learn more at https://www.data4impactproject.org/resources/webinars/managing-missing-values-in-routinely-reported-data-one-approach-from-the-democratic-republic-of-the-congo/
This Data for Impact webinar took place October 29, 2020. Learn more at https://www.data4impactproject.org/resources/webinars/use-of-routine-data-for-economic-evaluations/
Data for Impact hosted a one-hour webinar sharing guidance for using routine data in evaluations. More: https://www.data4impactproject.org/resources/webinars/routine-data-use-in-evaluation-practical-guidance/
Lessons learned in using process tracing for evaluationMEASURE Evaluation
Access the recording for this Data for Impact (D4I) webinar at https://www.data4impactproject.org/lessons-learned-in-using-process-tracing-for-evaluation/
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.
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
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- 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
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
A Systematic Approach to Monitoring and Evaluating Integrated Health Interventions in the Era of the Global Health Initiative
1. A Systematic Approach to Monitoring and
Evaluating Integrated Health Interventions in
the Era of the Global Health Initiative
Heidi Reynolds, MPH, Ph.D. and
Elizabeth Sutherland, Ph.D.
3. Definition of integration
Linkages
Primary
Comprehensive care One stop shop
Coordination
Holistic Interoperable
Not vertical Synergies
Case management
4. Defining Integration
The effort, within any building block of the health
system, to improve the continuum of care for
clients over the life course.
• Integration is from the
client’s perspective
Client
• Goal is to improve health
outcomes
5. Health System Building Blocks
and Integration
Health financing
Direct funding by external donors -> General health care
budget
Leadership and governance
Disease policies -> integrated health policies
Decisions made without -> with consideration of general
health care activities
Health services
Single purpose ->multi-purpose service
Atun et al 2009;
Mitchell et al 2004
6. Health System Building Blocks
and Integration (con’t)
Work-force
Providers and supervisors with specialized -> generalized
knowledge
Medical products, vaccines and technologies
Vertical -> general systems
Health information systems
Single purpose reporting ->patient centered system
Atun et al 2009; Mitchell 2004
7. Health Systems and Integration
Health systems do not need to be integrated to
result in integrated care
Health systems do need to be strong
Whether and how health systems will be
integrated is context specific
8. So now what?
How do we operationalize integration in a
systematic fashion?
How do we monitor and evaluate integrated
interventions?
How do we use the data to adapt program
response and inform the global evidence base
for integration?
10. Existing M&E Best Practices
Apply
Are we doing 8. Are collective efforts
them on a large impacting the epidemic?
enough scale?
7. Are Interventions making a
difference?
6. Are we implementing the program as
Are we doing
planned?
them right?
5. What are we doing? Are we doing it correctly?
4. What interventions and resources are needed?
Are we doing
the right things?
3. What interventions can work (efficacy & effectiveness)?
2. What are the contributing factors?
1. What is the problem?
Adapted from: Organizing a framework for a functional national HIV
monitoring and evaluation system. A report. UNAIDS. April, 2008.
11. Key M&E Steps for Integration
1. Begin with end in mind
2. Define essential packages of services
3. Develop logic model
4. Improve health information systems
5. Use the data
12. 1. Begin with the end in mind
Key health outcomes and impacts
MDGs 4, 5, and 6
National priorities and targets
Proximate health outcome indicators where
appropriate
E.g. delivery with skilled birth attendants
13. 2. Define essential packages of
services
Built around specific health care entry points
ANC/maternity
HIV testing and treatment
Curative or ambulatory services
Child wellness
14. 2. Essential packages of services
(con’t)
Precedent setting examples of such
packages exist
ANC
Women presenting in pregnancy
WHO package includes range of services
HIV testing and screening for other STIs
Blood pressure and anemia screens
Tetanus toxoid injection and malaria prophylaxis
15. 2. Essential packages of services
(con’t)
Need international guidance on service
packages
Choice of package determined by health
needs
Tailored for country-specific priorities and
epidemiology
Service delivery guidelines for different
service delivery levels
16. 3. Develop logic models
Defines how and where integration occurs at each
level of intervention
Inputs, processes, outcomes, impacts
National, district hospital, health facility, community
Health system building blocks
Promotes stakeholder buy in at national-level
17. IHP+ Common M&E Framework
Inputs and Processes Outputs Outcomes Impacts
• Service
• Improved
Governance
• Infrastructure Readiness • Coverage
Financing
Health
• Workforce
Outcomes
• Commodities • Access • Prevalence
• Information of risk
• Efficiency
Systems • Quality of factors
Care
Adapted from: Monitoring the building blocks of the
health system. WHO Report. October 2010.
18. 4. Improve health information
systems
Support provider access to client health
information
Electronic medical records
3 interlinked patient monitoring systems
ANC client cards
Strong linked/interoperable routine health
information systems still needed
Track progress in service delivery
19. 4. Health information systems (con’t)
Indicators
Derived from logic model
Access, readiness, coverage, health outcomes
New indicators are needed
Quality
Met needs and prevention
Referral
20. 4. Health information systems (con’t)
Consistent with efforts to strengthen the
broader M&E system
IHP+, CHeSS, evaluation platform, etc.
Map data needs (from indicators in logic model)
to existing survey data, surveillance, RHIS, etc.
Determine what new data collection efforts are
necessary
21. 5. Use the data
Inform program decision making
Refine logic model inputs, processes, indicators
Strengthen the evidence base of what works
23. Current state of the evidence
Some improved client-level outcomes noted
increased uptake of services
increased client satisfaction
Pilot tests
Little info on how to implement/effectiveness at
scale
Value added
Little/no info on relative value of integration
24. Research agenda
Conduct outcome and impact evaluations
At scale/going to scale
Across several models and countries
Evaluate essential packages of services
What should they contain?
What is the effectiveness of package in improving key health
outcomes?
Evaluate effectiveness of improved patient monitoring tools on
Continuum of care
Provider access to client health info
25. Research agenda
Evaluate effective capacity building approaches to
intervention
For building human resources to provide
integration
Evaluate effectiveness of referral mechanisms
Conduct case studies of integrated interventions to
inform impact evaluations
26. Conclusions
Integration is fundamentally client-centered
Interventions should improve continuum of care
Approach assumes integration will be country led
Context specific and tailored to epidemiology
Experience needed to understand how to adapt
approach to reality of country setting
Role for international community to guide and
help build evidence base
27. Conclusions
Health system needs to be strong but not
necessarily integrated
Integrated interventions take place within health
system building blocks
Intersects with innovative National Evaluation
Platform design, IHP+ initiative, HSS questions,
and the CHeSS initiative
Leadership is needed from GHI on expectations
for implementing the integration principle
28. MEASURE Evaluation is a MEASURE project funded by the
U.S. Agency for International Development and implemented by
the Carolina Population Center at the University of North Carolina
at Chapel Hill in partnership with Futures Group International,
ICF Macro, John Snow, Inc., Management Sciences for Health,
and Tulane University. Views expressed in this presentation do not
necessarily reflect the views of USAID or the U.S. Government.
MEASURE Evaluation is the USAID Global Health Bureau's
primary vehicle for supporting improvements in monitoring and
evaluation in population, health and nutrition worldwide.
Editor's Notes
The definition of integration, what we mean by integration, bogs down the dialogueIt is really an umbrella term for many concepts and operationalizations
Many definitionsDefinition must supersede specific disease areas or health outcomesClient at center as opposed to program or donor prioritiesClient has easy access, perceives seamless care, her/his needs are met
Interventions to improve the continuum of care take place within the health system building blocks, but the health system building blocks do not themselves have to be integrated to improve the continuum of care for the client(Building blocks from WHO, definitions of integration within building blocks mixed from Atun and Mitchell, and this may not be exhaustive and certainly is not definitive)
We propose a systematic approach that will inform operationalization, M&E, and data for decision making.
Many frameworks exist, this is one (MDG 6)and there are others (e.g. Bryce MCH approach to evaluate the scale up for MDGs 4 and 5) These present a series of important questions to be asked when addressing M&E. Namely, we must id the problem, plan the response to the problem, monitor implementation of the response, collect and analyze data that will allow us to revise the response as needed and assess the effectiveness of the response.This is a dynamic process and not just a matter of reporting on indicators and putting together a report.
How would we approach this process for integration? There are several key principles for applying these types of frameworks/processes to integration. This outlines some practical steps that must be taken to appropriately operationalize M&E for integration. Highlight three principles to discuss in greater depth.
Roles of international and national public health community in each of these.
Some useful packages already created (e.g. ANC and to some extent HIV) but others still needed. Not all packages can be implemented in all countries immediately. Priorities determined by country level health needs as evidenced by national plans and targets.
Lack evidence for some may have to rely on expert opinion while evidence is generated for specific packages
Logic model provides a template for integration and coordination. This is a planning document that allows for each stage of implementation (inputs and processes to be planned in terms of coordination/integration roles and responsibilities). This is where the integrated interventions are planned for, with the aim of improving the continuum of care for clientsLogic models describe plausible pathways for causal effects. They are informed by theory and evidence. They lay out a logical expected pathway for activities to influence intermediate outcomes and collectively work toward expected impact.
Common framework adapted to show how the logic model can show the elements of the health care system working together to influence service delivery/care and ultimate health impacts.
Information that allows providers to follow clients health information over time will be important in the case of screening and referrals.
Outcome/impact evaluateions are needed to generate evidence for decision making for program management and scaleup and also for global adaptation and adoption. To understand the benefit of investment in integration must also understand cost effectiveness and Must also understand the ideal interventions within each health building block to maximize the benefits of integration interventions for health
(Re: last bullet: Case studies of on-going integration efforts can help understand what changes have been made to the health system building blocks, uncover other’s ideas about plausible pathways for effects of integrated interventions on client outcomes, build the “integration theory”, tap into the measures they are testing. This information can broadly inform interventions and determine impact evaluation priorities and designs)