The West Midlands Research Collaborative (WMRC) was formed by surgical trainees to conduct multicenter clinical research trials. The WMRC aims to enhance members' research skills and career development while improving the quality and recruitment for surgical trials. It operates through regular meetings, a management committee, and communication platforms. Current WMRC research includes randomized controlled trials on surgical site infection prevention and postoperative nausea/vomiting reduction. The WMRC provides guidance on setting up collaborative networks and has helped spread trainee-led research to other regions in the UK.
Strand SmartLab - Enabling Precision Medicine at community HospitalsHarsha Rajasimha
Strand SmartLab is a complete soup to nuts solution that enables a community hospital to establish precision medicine testing services in-house. This enables the retention of revenues internally rather than loosing them to external third party laboratories. Genomics driven precision medicine for Cancer and other diseases require highly skilled people, lab equipment, processes, regulatory experts, bigdata software, databases and curation, medical geneticists to interpret the results in clinical settings and genetic counselors. Strand SmartLab brings all these to your institution in a pre-packaged solution.
By introducing eye care at your doorstep service, we ensure that a daycare cataract surgery for your loved ones at home need not wait until your next vacation
Outlining the proces and lessons learned in organising the technological infrastructure at the Radboud university medical center, to shape the Radboudumc Technology Centers, supporting our mission in enabling personalized healthcare.
Strand SmartLab - Enabling Precision Medicine at community HospitalsHarsha Rajasimha
Strand SmartLab is a complete soup to nuts solution that enables a community hospital to establish precision medicine testing services in-house. This enables the retention of revenues internally rather than loosing them to external third party laboratories. Genomics driven precision medicine for Cancer and other diseases require highly skilled people, lab equipment, processes, regulatory experts, bigdata software, databases and curation, medical geneticists to interpret the results in clinical settings and genetic counselors. Strand SmartLab brings all these to your institution in a pre-packaged solution.
By introducing eye care at your doorstep service, we ensure that a daycare cataract surgery for your loved ones at home need not wait until your next vacation
Outlining the proces and lessons learned in organising the technological infrastructure at the Radboud university medical center, to shape the Radboudumc Technology Centers, supporting our mission in enabling personalized healthcare.
Overcoming the challenges of delivering 7DS for Echocardiogram and Ultrasound...NHS England
This webinar recording will provide you with a practical example of delivering echocardiography services from East Sussex Healthcare, a model for delivering ultrasound service from Salisbury NHS Foundation Trust and a national update on the strategy for delivering sustainable echocardiography services from Giancarlo Laura, Programme Manager, 7 Day Hospital Services, NHS England
V Rolfe STEM 2012 Employer Engagement in OER 12April2012Vivien Rolfe
Talk given by Viv to the annual UK STEM conference, Imperial College on working with external collaborators to produce OER. Part of the UKOER Phase 3 project at De Montfort University, http://www.biologycourses.co.uk
Invited talk at the 'New Fellows' conference organised by the Royal College of Surgeons of England, Bristol, June 2016. Mr Vasdev shares his fellowship experience being the first accredited Post CCT Fellow in the UK in Robotic Urology by the Royal College of Surgeons of England and British Association of Urological Surgeons
Service Improvement for Radiologists
a signposting document summarising service improvement methodology and benefits
Success factors - general
Success factors - computerised tomography
Complications in Surgery- Mr G Williamsjimmystrein
Presentation given by Mr Graham Williams, Royal Wolverhampton Hospitals, at the Dukes' Club AGM 2012. Why do complications occur, identification and management of complications, management of the situation.
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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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.
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
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
3. Project
Methodology
& design Data
Collection
Team leading
& analysis
& working
Write papers
Patients
Enhance CV
Trainee
Publications
Multicentre
& Presentations Benefits of Trials
Research
Transferable Collaborative
skills Quality of
Research
More clinical
Region Better surgical trials
recruitment
4. Getting it off the Ground
• Enthusiastic Trainees
• Senior Support and guidance
• Consultant trainer support
• Trials Unit(s)
• National Support
5. Running the WMRC
• Regular meetings as a group
• Formation of a management committee
• Communication
• www.wmresearch.co.uk
• Forums
• E-mail
6. How to set up a collaborative
Formation of a committee
Network Development
Trial Development
Overall organisation
Committee members:
Chairperson
Secretary
Webmaster
A junior surgical liaison
Treasurer
New study manager
Chief Investigator of each study
7. Committee
Trial 1 Trial 2 Trial 3
Chief Investigator Chief Investigator Chief Investigator
Working Working Working
group group group
Local Local Local
investigators investigators investigators
8. How to set up a collaborative
Monthly group meeting
Discuss existing trials
New project presentations and discussions
Educational talks
Cancer Intelligence Unit
Trials Unit
Clinical
Journal club
Individual trials meetings
9. Current Research Portfolio
3 RCTs Cohort studies
ROSSINI CANOES
CHARMS
DREAMS
ABPI
PHAROES
Multicentre Audit
Pancreatitis Study
Qualitative research
10. Current Progress
• Around 45 trainees have GCP accreditation and are
randomising to ROSSINI
• Many more (junior) trainees are involved in our trials
• £232,000 NIHR RfPB grant for ROSSINI
• £131,000 BDRF grant for DREAMS
• £150,000 company sponsorship for PHAROES
• Presentations/Papers
• National Meetings
11. ROSSINI Trial
Reduction Of Surgical Site Infection
using a Novel Intervention
A multicentre, prospective randomised controlled trial of a
wound-edge protection device to reduce surgical site infection
12. ROSSINI Trial
• Primary Hypothesis:
Use of a wound-edge protection device in
adults undergoing laparotomy will result in a
reduced rate of surgical site infection (SSI) at
30 days.
13. Inclusion/Exclusion Criteria
• Inclusion criteria
– Any laparotomy
– Any Incision (eg midline, transverse, Kocher’s etc)
– Emergency or Elective
• Exclusion criteria
– Unable to consent
– Laparoscopic assisted cases
– Previous laparotomy within last 3 months
14. ROSSINI – Process
PATIENT CONSENT OPERATION FOLLOW UP A FOLLOW UP B
LISTED
Consent form Randomised in Day 5-7 wound Day 30-33 wound
Patient completed theatre (50:50) review review
Information
Sheet given CRF 1 CRF 2 CRF 3 CRF 4+5
EUROQOL EQ-5D
RESOURCE USE
Completed at end
CRF 6
15. ROSSINI sites (West Mids)
• University Hospital • University Hospital Coventry
Birmingham and Warwickshire
• Russells Hall Hospital • Royal Shrewsbury Hospital
• Walsall Manor Hospital • Princess Royal Hospital Telford
• City and Sandwell Hospitals • Hereford County Hospital
• Heartlands and Good Hope • Worcester Royal Hospital
Hospitals • George Elliot Hospital,
• Warwick Hospital Nuneaton
• University Hospital North
Staffordshire
• New Cross Hospital
Wolverhampton
16. ROSSINI sites (National)
• Royal Derby Hospital • St Marks, London
• Wrightington,Wigan and • Stepping Hill, Stockport
Leigh • Bolton
• Derriford Hospital, • The Christie, Manchester
Plymouth
• Wrexham
• Hope Hospital, Salford
• Glan Clwyd
• Royal Devon and Exeter
Hospital • Manchester Royal Infirmary
• Medway • Yeovil
• Maidstone + Tunbridge
Wells
• The Homerton, London
19. Spreading the word
• RCS support
• SARS / ASGBI support
• Presentations at ASIT, ASGBI, SARS, ACPGBI
• Networking with other groups of trainees
• London / Trent / Southampton / Bristol / Leeds