Humanity's responses to the Covid-19 pandemic has been variable and often chaotic. This presentation attempts to use 'Sense of coherence' and 'Ikigai' as 2 lenses to gain a holistic perspective of the varied human responses to the pandemic crisis of 2020.
Comprehension or understanding, Manageability or coping-behavior, and Meaningfulness are the three components of Sense of Coherence (SOC), first proposed by Antonovsky. Ikigai is a Japanese concept of one's 'Purpose of Life', which has been modified by a life-coach from the West. Using SOC and Ikigai, we can try to get a holistic understanding of the varied responses of humanity across the globe.
Since the publication of the eye-opening revelations "To Err is Human" and "Quality Chasm" Patient Centered Care (PCC) has been promoted as an important concept which every medical student in 21st century ought to learn and internalize.
This slide set is based on recent articles published on PCC and how to effectively teach and learn in health sciences curricula. A recent doctoral research conducted by the author and his team, which has revealed robust evidence of 8-fold improvement in patient satisfaction after the postgraduates underwent intensive training of skills for effective PCC.
Creating an optimal healing environment through salutogenesis for yoga therapyK Raman Sethuraman
Optimal Healing Environment (OHE) is a post modern concept that aims to promote healing through positively influencing and supporting the four domains of OHE, viz, Personal, Interpersonal, Behavioral and External domains. Sense of coherence approach to wellbeing (Salutogenesis) fits in well with interpersonal and behavioral domains of OHE. Yoga therapy uses holistic approach to mind-body healing and can focus on promoting optimal healing as a complementary healthcare service to Evidence-based modern medicine in an integrative practice of holistic care.
In view of advances in artificial intelligence and global connectivity, tomorrow's doctors need to develop skills set that would help them to outperform the AI-gadgets and stay relevant in the 21st Century. Critical thinking, Creative Problem solving, Communication skills and Collaborative team-work are among the top skills needed for healthcare professionals of the future.
CRIS LUTHER'S TRENDS AND ISSUES IN PSYCHIATRIC MENTAL HEALTH NURSINGcrisluther
TRENDS AND ISSUES IN PSYCHIATRIC MENTAL HEALTH NURSING, perhaps the greatest challenge to nursing lies in the future, as we identify and develop clinical provider performance measures that are relevant to the care and the people we nurses serve!
Since the publication of the eye-opening revelations "To Err is Human" and "Quality Chasm" Patient Centered Care (PCC) has been promoted as an important concept which every medical student in 21st century ought to learn and internalize.
This slide set is based on recent articles published on PCC and how to effectively teach and learn in health sciences curricula. A recent doctoral research conducted by the author and his team, which has revealed robust evidence of 8-fold improvement in patient satisfaction after the postgraduates underwent intensive training of skills for effective PCC.
Creating an optimal healing environment through salutogenesis for yoga therapyK Raman Sethuraman
Optimal Healing Environment (OHE) is a post modern concept that aims to promote healing through positively influencing and supporting the four domains of OHE, viz, Personal, Interpersonal, Behavioral and External domains. Sense of coherence approach to wellbeing (Salutogenesis) fits in well with interpersonal and behavioral domains of OHE. Yoga therapy uses holistic approach to mind-body healing and can focus on promoting optimal healing as a complementary healthcare service to Evidence-based modern medicine in an integrative practice of holistic care.
In view of advances in artificial intelligence and global connectivity, tomorrow's doctors need to develop skills set that would help them to outperform the AI-gadgets and stay relevant in the 21st Century. Critical thinking, Creative Problem solving, Communication skills and Collaborative team-work are among the top skills needed for healthcare professionals of the future.
CRIS LUTHER'S TRENDS AND ISSUES IN PSYCHIATRIC MENTAL HEALTH NURSINGcrisluther
TRENDS AND ISSUES IN PSYCHIATRIC MENTAL HEALTH NURSING, perhaps the greatest challenge to nursing lies in the future, as we identify and develop clinical provider performance measures that are relevant to the care and the people we nurses serve!
CRIS LUTHER's ADVANCED HEALTH ASSESSMENT IN PSYCHIATRIC MENTAL HEALTH NURSINGcrisluther
The course title is: Advanced Health Assessment in Psychiatric & Mental Health Nursing. Nurses in all specialties practice assessment as the first step in the universal approach of problem-solving in nursing, the nursing process. The application of which in Psychiatric Mental Health Nursing has the same goal as it has in other areas of nursing.
Though, the goal of the nursing process in this specialty field is not different as mentioned, the process of assessment is composed of complex concepts the psychiatric mental health nurse must familiarize- theoretically and clinically. This posted a main challenge in the completion of this material.
The student performed repeated accession and elimination of concepts to finalize the contents which are deemed significant and consistent with the course title: Advanced Health Assessment in Psychiatric & Mental Health Nursing.
________________________________________
The text is organized in four parts presenting various approaches in psychiatric assessment. The focus remained on the basic principles of nursing assessment:
Part 1: Assessment of Psychiatric Mental Health Clients, discusses the basic principles of nursing assessment; the topic progresses to assessment procedures specific to the specialty field (M.S.E.), an example was presented to clearly understand its congruence to practice. Related terminologies and discussion of comorbid problems are important tools in identifying actual and potential health problems during client assessment.
Part 2: The DSM-IV-TR, An Essential Tool for Assessment and Diagnosis of Psychiatric-Mental Health Clients, presents vital components of this universal tool in diagnosing mental illnesses.
Part 3: Assessment Factors in Dual Diagnosis, addresses the need to thoroughly assess other equally significant problems that co-exist with the diagnosed primary mental illness. The co-existence of substance abuse is the commonest in dual diagnosis.
Part 4: Formulation of Assessment-based Care Plan. The nursing process has been referred to as an ongoing systematic series of actions, interactions and transactions. Hence, the inclusion of the entire process is a must to fully appreciate the essentiality of an assessment that is done in congruence with standards.
Ethics Grand Rounds presented at Providence Health Care on 9/29/15 regarding questions and dilemmas in psychiatric care, particularly in the hospitalized medical patient
Crisis InterventionAdaptation and coping are a natural part ofCruzIbarra161
Crisis Intervention
Adaptation and coping are a natural part of life. If children are protected from experiencing negative events and developing coping skills, they may be unable to cope and adapt to crisis situations in later life. Crisis occurs when there is a perceived challenge or threat that overwhelms the capacity of the individual to cope effectively with the event. A crisis disrupts the life of the individual experiencing the event.
In a crisis, the person’s habits and coping patterns are suspended. Often, unexpected emotional (e.g., depression) and biologic (e.g., nausea, vomiting, diarrhea, headaches) responses occur. Although a person may become extremely anxious, depressed, or elated, feeling states do not determine whether a person is in a crisis. If functioning is severely impaired, a crisis is occurring (Yeager & Roberts, 2003).
Crisis
A crisis is generally regarded as time limited, lasting no more than 4 to 6 weeks. At the end of that time, the person in crisis should have begun to come to grips with the event and to harness resources to cope with its long-term consequences. By definition, there is no such thing as a chronic crisis. People who live in constant turmoil are not in crisis but in chaos. A crisis can also represent a turning point in a person’s life, with either positive or negative outcomes. It can be an opportunity for growth and change because new ways of coping are learned.
Either internal or external demands that are perceived as threats to a person’s physical or emotional functioning can initiate a crisis. The precipitating event is not only stressful, but unusual or rare. Many life events can evoke a crisis, such as pandemics, natural disasters (e.g., floods, tornadoes, earthquakes) and manmade disasters (e.g., wars, bombings, airplane crashes) as well as traumatic experiences (e.g., rape, sexual abuse, assault). In addition, interpersonal events (divorce, marriage, birth of a child) may create a crisis event in the life of any person.
A crisis is not the same as a psychiatric emergency that requires immediate intervention. A person in crisis may not need an immediate intervention and should not be viewed as having a mental disorder (Roberts, 2005). However, if the person is significantly distressed or social functioning impaired, an Axis I diagnosis of acute stress disorder should be considered (American Psychiatric Association [APA], 2000). The person with an acute stress disorder has dissociative symptoms and persistently re-experiences the event (APA).
A. Historical Perspectives of Crisis
The basis of our understanding of the biopsychosocial implications of a crisis began in the 1940s when Eric Lindemann (l944) studied bereavement reactions among the friends and relatives of the victims of the Coconut Grove nightclub fire in Boston in 1942. That fire, in which 493 people died, was the worst single building fire in the country’s history at that time. Lindemann’s goal was to develop prevention approa ...
CRIS LUTHER's ADVANCED HEALTH ASSESSMENT IN PSYCHIATRIC MENTAL HEALTH NURSINGcrisluther
The course title is: Advanced Health Assessment in Psychiatric & Mental Health Nursing. Nurses in all specialties practice assessment as the first step in the universal approach of problem-solving in nursing, the nursing process. The application of which in Psychiatric Mental Health Nursing has the same goal as it has in other areas of nursing.
Though, the goal of the nursing process in this specialty field is not different as mentioned, the process of assessment is composed of complex concepts the psychiatric mental health nurse must familiarize- theoretically and clinically. This posted a main challenge in the completion of this material.
The student performed repeated accession and elimination of concepts to finalize the contents which are deemed significant and consistent with the course title: Advanced Health Assessment in Psychiatric & Mental Health Nursing.
________________________________________
The text is organized in four parts presenting various approaches in psychiatric assessment. The focus remained on the basic principles of nursing assessment:
Part 1: Assessment of Psychiatric Mental Health Clients, discusses the basic principles of nursing assessment; the topic progresses to assessment procedures specific to the specialty field (M.S.E.), an example was presented to clearly understand its congruence to practice. Related terminologies and discussion of comorbid problems are important tools in identifying actual and potential health problems during client assessment.
Part 2: The DSM-IV-TR, An Essential Tool for Assessment and Diagnosis of Psychiatric-Mental Health Clients, presents vital components of this universal tool in diagnosing mental illnesses.
Part 3: Assessment Factors in Dual Diagnosis, addresses the need to thoroughly assess other equally significant problems that co-exist with the diagnosed primary mental illness. The co-existence of substance abuse is the commonest in dual diagnosis.
Part 4: Formulation of Assessment-based Care Plan. The nursing process has been referred to as an ongoing systematic series of actions, interactions and transactions. Hence, the inclusion of the entire process is a must to fully appreciate the essentiality of an assessment that is done in congruence with standards.
Ethics Grand Rounds presented at Providence Health Care on 9/29/15 regarding questions and dilemmas in psychiatric care, particularly in the hospitalized medical patient
Crisis InterventionAdaptation and coping are a natural part ofCruzIbarra161
Crisis Intervention
Adaptation and coping are a natural part of life. If children are protected from experiencing negative events and developing coping skills, they may be unable to cope and adapt to crisis situations in later life. Crisis occurs when there is a perceived challenge or threat that overwhelms the capacity of the individual to cope effectively with the event. A crisis disrupts the life of the individual experiencing the event.
In a crisis, the person’s habits and coping patterns are suspended. Often, unexpected emotional (e.g., depression) and biologic (e.g., nausea, vomiting, diarrhea, headaches) responses occur. Although a person may become extremely anxious, depressed, or elated, feeling states do not determine whether a person is in a crisis. If functioning is severely impaired, a crisis is occurring (Yeager & Roberts, 2003).
Crisis
A crisis is generally regarded as time limited, lasting no more than 4 to 6 weeks. At the end of that time, the person in crisis should have begun to come to grips with the event and to harness resources to cope with its long-term consequences. By definition, there is no such thing as a chronic crisis. People who live in constant turmoil are not in crisis but in chaos. A crisis can also represent a turning point in a person’s life, with either positive or negative outcomes. It can be an opportunity for growth and change because new ways of coping are learned.
Either internal or external demands that are perceived as threats to a person’s physical or emotional functioning can initiate a crisis. The precipitating event is not only stressful, but unusual or rare. Many life events can evoke a crisis, such as pandemics, natural disasters (e.g., floods, tornadoes, earthquakes) and manmade disasters (e.g., wars, bombings, airplane crashes) as well as traumatic experiences (e.g., rape, sexual abuse, assault). In addition, interpersonal events (divorce, marriage, birth of a child) may create a crisis event in the life of any person.
A crisis is not the same as a psychiatric emergency that requires immediate intervention. A person in crisis may not need an immediate intervention and should not be viewed as having a mental disorder (Roberts, 2005). However, if the person is significantly distressed or social functioning impaired, an Axis I diagnosis of acute stress disorder should be considered (American Psychiatric Association [APA], 2000). The person with an acute stress disorder has dissociative symptoms and persistently re-experiences the event (APA).
A. Historical Perspectives of Crisis
The basis of our understanding of the biopsychosocial implications of a crisis began in the 1940s when Eric Lindemann (l944) studied bereavement reactions among the friends and relatives of the victims of the Coconut Grove nightclub fire in Boston in 1942. That fire, in which 493 people died, was the worst single building fire in the country’s history at that time. Lindemann’s goal was to develop prevention approa ...
At the 2016 CCIH Annual Conference, Dr. Jonathan Quick of Management Sciences for Health discusses recent pandemics and explores the keys to preventing future outbreaks.
Community Resilience for the Environmental Health officerDavid Eisenman
Why is community resilience important to environmental health officers in public health? What are some challenges to incorporating this approach in EH?
A briefing for Public Health teams on a public mental health approach resilience, trauma and coping beyond the pandemic, and addressing the needs of communities and workplaces
Here's a collection of some of my LinkedIn Posts on the Coronavirus Pandemic.
I don't claim to be an expert - but do try to think logically as a doctor, and use my common sense to reason !
Social Psychiatry Perspectives - Di Nicola & Marussi - CPA Toronto - 29.10.2...Université de Montréal
CASP Workshop on Social Psychiatry
Canadian Psychiatric Association 72nd Annual Conference
Toronto, Ontario
October 27 – 29, 2022
Title:
Social Psychiatry Perspectives on the Health of Canadians:
A Social Psychiatry Manifesto & Intimate Partner Violence
Symposium Panel:
1. Vincenzo Di Nicola (Chair & Presenter, Montreal, QC)
2. Daphne Marussi (Presenter, Sherbrooke, QC)
Abstract:
This workshop sponsored by the Canadian Association of Social Psychiatry (CASP) reviews two contemporary Canadian psychiatric issues from a social psychiatry perspective:
1. Vincenzo Di Nicola (Montreal, QC) presents a social psychiatry manifesto with an overview of Social Psychiatry in the 21st century by surveying three main branches of Social Psychiatry: (1) psychiatric epidemiological studies and public health; (2) community psychiatry; and (3) relational and social therapies such as couple, family and community therapies. Implications for research, practice, and teaching in social psychiatry will be outlined.
2. Daphne Marussi (Sherbrooke, QC) explores Intimate Partner Violence (IPV) which describes an alarming aspect of relational violence with major social psychiatric consequences: the physical, sexual, or psychological harm by a current/former partner that is associated with many mental disorders from anxiety and depression to eating and substance abuse disorders. This presentation discusses different forms of psychological abuse and coercive control in IPV, the abused/abuser bond and their impacts and consequences.
References:
1. Di Nicola, V. Review article—“A person is a person through other persons”: A Social Psychiatry manifesto for the 21st century. World Social Psychiatry, 2019, 1(1): 8-21.
2. Snyder, R.L. No Visible Bruises - What We Don’t Know About Domestic Violence Can Kill Us. New York, NY, Bloomsbury Publishing, 2019.
Learning Objectives:
1. Redefine Social Psychiatry, name and describe its main branches: psychiatric epidemiology, community psychiatry, and relational therapies.
2. Describe Intimate Partner Violence (IPV) mainly against women, with examples of its mental health impacts, and its importance in Canadian society.
DOI: 10.13140/RG.2.2.32952.62728
This is a presentation to the Emergency Medicine Teaching Programme in the Faculty of Medicine at McGill University, Montreal, Quebec, Canada
Educational Objectives:
After this presentation, the audience should be able to define, clarify and better appreciate the following topics:
* The Burden of Care (epidemiology)
* Principles of Crisis Intervention
* The Emergency Physician’s Task
DOI 10.13140/RG.2.2.20724.30080
Covid 19 pandemic - an outbreak of a respiratory or psychosomatic disease?Janis Klumel
An active proponent of vaccination will see it as a conspiracy, a fact-checker – as a false or partially false statement, a scientist – as a hypothesis, an antivaxxer – as a truth. The assumption is that general vaccination of the population against COVID-19 with currently available vaccines will only lead to SARS-CoV-2 becoming more infectious and able to attach to cells more quickly with a much shorter time spent in an extracellular domain, leading to a return of the population to the situation faced in the beginning of the pandemic in 2020, however, with a much more contagious virus that will affect more broader public, not just seniors and people with co-morbidities, then the vaccination is not used to prevent against the viral disease, but to gain a sense of security and reduce free-floating anxiety; to end social isolation and establish social bonds with other vaccinees; to rely on at least one solution for the fight against the virus, while the physician are prevented from recommending effective immunotherapies against SARS-CoV-2. It is then in medial reasoning obvious that the purpose of the vaccination is to address psychosomatic problems caused by epidemiological restriction, not immunological issues.
Effect Essay Outline. . 8 Cause And Effect Essay Template - Template GuruAmanda Harris
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“The Experimental Child”: Child, Family & Community Impacts of the Coronaviru...Université de Montréal
Abstract
Not only is the coronavirus crisis a natural laboratory of stress offering health and social care services a unique historical opportunity to observe its impact on entire populations around the world, but the responses to the crisis by international health authorities, such as the WHO, along with national and local educational institutions and health care and social services, are creating an unprecedented and unpredictable environment for children and youth. This hostile new environment for growth and development is marked by the sudden and unpredictable imposition of confinement and social isolation, cutting off or limiting opportunities for the development of cognitive abilities, peer relationships, and social skills, while exposing vulnerable children and youth to depriving, negligent, or even abusive home environments.
For this reason, this crisis has been renamed a syndemic, encompassing two different categories of disease—an infectious disease (SARS-CoV-2) and an array of non-communicable diseases (NCDs). Together, these conditions cluster within specific populations following deeply-embedded patterns of inequality and vulnerability (Horton, 2020). These pre-existing fault lines of inequity, poverty, mental illness, racism, ableism, ageism create stigma and discrimination and amplify the impacts of this syndemic. And children are the most vulnerable population around the world. The impact on children is part of a cascade of consequences affecting societies at large, smaller communities, and the multigenerational family, all of which impinge on children and youth as the lowest common denominator (Di Nicola & Daly, 2020).
This exceptional set of circumstances—in response not only to the biomedical and populational health aspects but also in constructing policies for entire societies—is creating an “experimental childhood” for billions of children and youth around the world. With its commitment to the social determinants of health and mental health, notably in light of the monumental Adverse Childhood Events (ACE) studies (Felitti & Anda, 2010), social psychiatry and global mental health in partner with child and family psychiatry and allied professions must now consider their roles for the future of these “experimental children” around the world. The parameters for observing the conditions of this coronavirus-induced syndemic in the family and in society, along with recommendations for social psychiatric interventions, and prospective paediatric, psychological, and social studies will be outlined.
Keywords: Children & families, COVID-19, syndemic, ACE Study, confinement, social isolation
In 21st Century, when medical information is freely available to everyone, soft skill-set combined with technical competence is the key to professional success as a clinical care provider. The various components of soft-skills viz, Professionalism Humanism, Communication skills are discussed. Research findings on how to enhance patient satisfaction 8-fold by improving communication skills is highlighted.
Ikigai (reason for being) versus Maslow's Hierarchy of Needs K Raman Sethuraman
Ikigai is a Japanese word that signifies "sense of Purpose" in one's life. Ikigai fulfillment promotes wellness. Maslow's needs are hierarchically arranged from Basic needs to Psychological and Self-actualization needs. According to Maslow's theory, fulfillment of the "lower deficiency needs' can curb one's motivation, while fulfillment of "growth needs" would further increase the motivation to excel.
While E-health is based on networked I-C-T devices of the humans, operated by the humans for human healthcare and wellness, IOMT is a network of the ‘smart-devices’, operated by the devices for human healthcare and wellness. An estimated 160 million smart medical devices are expected to be connected in 2020. This number will increase exponentially. We need to be prepared for the disruptive influence of IOMT on the present-day healthcare paradigm. A major concern is the sheer magnitude of digital healthcare data generated by IOMT. Are we creating a "Digital Black hole" is a question for deep introspection.
The estimated delay of 17 years for scientific discovery to reach clinical practice is a matter of great concern. The current flow-charts do not even acknowledge the important role of Effective Teaching of Basic sciences that is oriented to real-life clinical practice. This brief PPT set addresses this issue.
Salutogenic approach is based in promoting sense of coherence by making the person i) comprehend the situation or the challenge ii) find ways to manage it, using general and specific resistance resources and iii) find it meaningful to cope with the challenge and accept the outcome. Using real-life case narratives, this slide set explains how to practice salutogenic approach in patients with diabetes and its complications.
The essence of authentic assessment is to focus on real-life tasks and competencies relevant to later day professional practice. Since 2018, there is a national move in India to adopt Competency-based medical curriculum to produce IMG (Indian Medical Graduate) who would possess the competencies to be a competent clinician, an effective Communicator, a team-leader, an ethical Professional and a life-long learner. This slide-set looks at an authentic curriculum and how to develop an authentic assessment 'for', 'as' and 'of' learning.
Attitude, Ethics and Communication-skills for the Teacher and the TaughtK Raman Sethuraman
Imparting education to inculcate ethical values, professional attitude and effective inter-personal communication is much stressed in current curricula for Medical and other Health-professions. This talk stresses the need for the teachers to evolve themselves as positive role models if they wish to be effective in their mission to empower their students with values and professional identity.
Concepts and principles of bioethics for the students of health professionsK Raman Sethuraman
Students and many educators have difficulty in differentiating among Legal, Ethical and Moral viewpoints. After explaining these terms, the concept of biomedical ethics, a brief history of its origin in the post-War period and the components of ethics are explained. The final part is on Nursing ethics, attributes of an ethical nurse and ethical challenges faced by the nursing profession.
Novice medico to graduate doctor climbing the competency ladder K Raman Sethuraman
From the time of entry in to a medical college, over 4 to 6 years time, a novice medico is expected to acquire several competencies that go to make a competent doctor. The medical teachers need to construct the learning ladder as a progressive path to acquiring these competencies. This slide set explains the various "ladders" viz., Miller's Pyramid, Dreyfus competency stages and RIME framework and also Dunning-Kruger effect that explains why many novices do not acquire the competencies.
Authentic assessment of affective domain in medical educationK Raman Sethuraman
To be effective, Medical education needs to set up authentic methods for assessing and evaluating the affective domain, based on Bloom's taxonomy. This domain is the most difficult to assess. Checklists, Rating scales and Rubrics are useful tools, as explained in this slide-set.
Optimum assessment of cognitive domain in medical educationK Raman Sethuraman
To be effective, Medical education needs to set up authentic methods for assessing and evaluating all the domains of learning, based on Bloom's taxonomy. This slide-set is on cognitive domain.
This talk, delivered in the 4th international meet on Music Therapy at Sri Balaji Vidyapeeth, discusses the concept of Salutogenesis and highlights how a music therapist could help create an Optimal Healing Environment. Curing is not the same as Healing but they are complementary and both are perhaps essential for holistic wellness.
Innovations in Medical Education are needed to align it with 21st Century needs and aspirations. Globally efforts are under way since the release of Lancet Commission report in Dec-2010 on Transforming Health Professions in the 21st Century
Integrated teaching for effective learning in health professionsK Raman Sethuraman
Health professions education, being complex is ideally suited for integrated teaching-learning. This is a slide-set that will help you to conduct a 100-minute session set in a workshop mode. Suitable for Educators of Medicine, Dentistry, Nursing and allied health professions.
Clinical Skills Training, to be effective, has to be based on the science of Simulation Pedagogy. This slide-set is a part of a presented in the International conference on Simulation in Medical Education held in AIMST University, Malaysia.
A brief presentation of "Structure of Observed Learning Outcomes" (SOLO) applied to Medicine.
A worked out medical example with all the 5-levels of SOLO taxonomy is presented.
This should make it easy for Medical educators to adopt and use this innovative way of assessing written answers.
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
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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
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.
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Using Sense of Coherence and 'ikigai' for holistic view of Humanity's response to the Pandemic-2020
1. Using Two Lenses
(Sense of Coherence & Ikigai)
for Holistic Understanding of
Humanity’s Responses to the
Pandemic
Dr KR Sethuraman.
Senior Professor and Medical Dean,
AIMST University, Malaysia
2. “Nothing Is As It Seems, Nor Is It
Otherwise.” – A Zen Saying.
• The truth we perceive may not represent the Real truth.
• We perceive our version of truth within the brittle framework
of language*, logic, symbolic thought and personal beliefs &
values.
* Mokusatsu, a Japanese word could be translated as “no comment”
or “withholding comments” was translated as “let’s ignore the final
warning” as response to the call for Japanese surrender in W-War-2
– The first atomic bomb was dropped on Hiroshima 10 days later.
– A translation error that killed >70,000 people instantaneously and
>100,000 as a result of the destruction and radiation.
Indeed, Nothing Is As It Seems, Nor Is It Otherwise!!!
• Please have an open and receptive mind for this presentation
* Ref: https://www.pangeanic.com/knowledge_center/the-worst-translation-mistake-in-history/#
3. Today’s Agenda
• Introduce concepts of Sense of Coherence (SOC) and Ikigai
(Japanese word for ‘reason to live’)
• Consider the varied and often contradictory responses of Humanity
to the Pandemic-2020
• Use SOC and Ikigai as two Lenses, try to understand the basis for
such human behaviours
• Consider the proactive action by Doctors, Public Health
campaigners and the rulers to provide effective relief to the
affected
– My article of June-2020 related to this topic for free download:
https://www.ajmhsrcmp.org/images/journal/Vol3_Issue1/SethuramanKR_AJMHS_2020
_Vol3_Issue1_ReviewArticle_COVID19.pdf (Asian Journal of Medicine & Health Sciences)
4. What is a Crisis Scenario?
• “The meaning of a crisis lies not in the situation but in the
interaction between the situation and the ability of the person to
successfully cope with it”. – WI Thomas (1863-1947)
• Like most crises, the Pandemic-2020 too has five components
(Roberts et al, 2005)
– a hazardous event viz., the emergence of a mutant corona virus SARS-
CoV-2 or Covid-19
– a vulnerable state of Human beings, viz., the absence of protective
antibodies to combat the virus
– a precipitating factor, which is uncertain and is still being debated
– an active crisis situation, which is based on people’s perception of
danger
– the resolution of the crisis, which in the case of CVP-2020 may take
several months more to achieve.
5. Sense of Coherence
– Aaron Antonovsky
• Based on study of the survivors of Nazi atrocities, Antonovsky
proposed Sense of Coherence (SoC) as the basis of ‘wellness’
• A strong SoC helped that individual to cope better with
stressors (such as the CV-Pandemic-2020)
• He enunciated that SoC had three components:
i) Comprehensibility: “do I truly understand my situation and
the reasons for my stress?”
ii) Manageability: “do I have the resources to cope with it?”
iii) Meaningfulness: “do I feel it is worth my time and effort to
manage it?”
6. Sense of
Sense of Coherence: 3 components…
“My world is
understandable”
“My world is
manageable”
“My world has
meaning”
Coping
24/06/2020 6Salutogenesis in Family Medicine
7. I – Comprehension or Understanding
• Emotional or ‘visceral’ reactions of people to a crisis greatly
influence their ‘cerebral’ understanding of the crisis and a
rational approach to cope with the challenges
• In relation to the global crisis of CVP, it has been a "gut"
versus "brain" battle (right from Nov-2019 in Wuhan, China)
• Public health experts predict very challenging times ahead &
at least a few years of living with the "New Normal"
• If we think in rational and cerebral way, we would accept this
and adopt the new-normal behaviour to be safe
• However, wishful thinking, resistance or denial make people
ignore these instructions and put themselves at risk
8. Misunderstanding is
Common!
In DLE,
Only
5% SLE
In SLE,
DLE in
20%
A Textbook of Medicine:
1- Skin diseases: Only 5 % of
Discoid Lupus goes on to Systemic
Lupus; REASSURE the patients of
DLE
2- Auto-immune diseases: 20% of
SLE start with DLE; therefore,
WARN all the DLE cases to watch
for Systemic Lupus
A medical example from 2004
9. II – Manageability
• Antonovsky said that the sense of coherence enabled one to
focus on adapting to the crisis and remain well even in a
stressful milieu; in contrast, lack of coherence lead to
Maladaptive coping behaviour that put them at risk
• He proposed that to manage the challenge effectively, one
required General resistance resources (GRRs) and Specific
resistance resources (SRRs)
• Therefore, to face the pandemic and remain well, adequate
and effective resources are available to the people to meet
the challenges of CVP-2020;
if not, the people will choose other means of coping with the
crisis
10. General Resistance Resources (GRR)
to cope with the challenges
• GRR includes material & non-material resources
• Antonovsky classified GRR into 3 types:
(1) Adaptability at a personal level, viz., biochemical, physical,
psychological and socio-cultural aspects of the individual
(elderly & those with comorbidity are vulnerable to CVP)
(2) Deep & Meaningful bonding with others, such as family
members and friends
(frontline workers in CVP need Love and Support; Not HATE)
(3) Committed support system and effective links between
the person, his/her community and the supporting agencies
(If only our migrant labour force had been looked after well…)
11. Specific Resistance Resources (SRR)
• Antonovsky stressed on the importance of SRR
• SRRs are effective in specific circumstances causing the crisis,
e.g, in case of the CVP-2020, the SRR would be:
i. a vaccine, PPE etc, to prevent the Covid-19 infection
ii. specific medications to mitigate/treat the disease
iii. critical care facility to manage severe cases
iv. monetary and other support like transport etc.
• Availability of and accepting the use of GRRs and SRRs enable
the people to actively face the crisis and to remain well even
under the stressful situation
13. III – Meaningfulness
• An acceptance that the additional demands created by the
challenge are worth my money, time and effort to resist it;
also embracing curiosity and a sense of adventure
– “it is an once in a life time crisis that will stay in our minds for
decades”
• Meaningfulness is highly personalized as every individual has
a unique set of personal beliefs and values.
• Every one perceives all that happens around him/her through
these filters.
• Biases may promote adaptive (eg, “constructive paranoia” or
“prepare for the worst & hope for the best”) or maladaptive
(eg, avoidance, denial, fatalistic negativism etc) behaviour
14. Some of the Coping Strategies in the context of
CVP-2020: Adaptive & Maladaptive
• Anticipatory problem solving: the individual is proactive to prepare for
all eventualities in a rational “cerebral” way
• Accepting Responsibility: the individual takes responsibility in boldly
facing up to the challenges – e.g., cycling home long distances
• Dependence on social support: such people depend on relief-providers
• Confrontation: one meets the crisis head-on and persists until achieving
the goal in a constructive way or a destructive way
• Denial: a false belief that nothing has really happened and that people
always exaggerate – (VIPs ignoring all the safety precautions)
• Escape or Avoidance: belief that they do not have to follow any advice
as the crisis will vanish soon (misplaced faith in superstitions)
• Lack of Self-control: Those, who exhibit their anxieties through social
media and contribute to the infodemic & panic
(https://www.verywellmind.com/social-network-use-and-social-anxiety-disorder-4117143)
15. Humour as a Coping : When life gives you a
pandemic, it is okay to laugh about it
God gets a police-ticket for
‘touching Adam’ !
NEW NORM: Security
staff Checks the
Temperature of
Doctor and Nurse !
16. How Personal Biases affect Human Responses to
CVP-2020 – some examples
• Depending on the individual beliefs, people may ascribe the
CVP crisis to
– astrology (malevolent planetary positioning),
– astronomy (the recent sighting of a comet coming towards the Earth),
– karma theory (Mother Nature responding to the avaricious
exploitation of the natural resources) etc.
• Their personal belief system makes them suggest cause-and-
effect relationship to mere coincidental occurrences listed
above.
– More on Self-fulfilling prophecy at
https://en.wikipedia.org/wiki/Self-fulfilling_prophecy
17. Media Hype Promotes Myths and “Infodemics”
• Because Guru is leaving Ketu’s alliance and entering Capricorn
on March 30, we will all be free from the effects of the Covid-
19 from 30th March, said Ashish Mehta, an astrologer.
• Acharya Sandeep Bhargava, predicted that the pandemic will
end this year globally by May 11.
• Upendra Shastri claimed that things will have a positive turn
from May onwards.
– Read more at: https://www.deccanherald.com/national/when-will-coronavirus-
end-in-india-and-across-globe-astrologers-prediction-815370.html
• Reality Check in mid- June!!!
18. Use of Unproven Remedies as ‘Cures’ – A
Maladaptive Behaviour
• Numerous unproven strategies and downright irrational
methods, which people are using in various parts of the globe
for prevention, diagnosis, treatment of COVID-19 are listed in
Wikipedia (https://en.wikipedia.org/wiki/List_of_unproven_methods_against_COVID-19)
• Some examples from 130+ references from all over the Globe:
• Drinking camel urine - advocated in the Middle East
• Drinking cow urine & applying cow dung on the body in India
• Sri Lankan herbal drink as a viral-cure remedy
• An "anti-coronavirus mattress” was advertised in India
• People who find any of these as being meaningful, fall prey to
the charlatans and fly-by-night operators
19. Another
Covid-19
Anxiety!
Doctor, Now I use the following 21 things to prevent a
Covid-19 attack:
Yoga + Walk + Lemon Water + Turmeric powder +
chayvanprash + Kachha Garlic + Kachha Ginger +
Almond + Anzeer + Khurmani + Kali mirch + Laung +
Gargles of hot saline + Drinking hot water + Tulsi Batti +
Giloi batti + Neem Batti + Arsenic Albs Homeopethic
Medicine + Allopathic drugs NAC + HCQ + Ivermectine.
Doctor. Any latest thing that I need to add to this?
KRS
20. Domestic Violence/Child abuse as Maladaptive
and Abhorrent Coping Behaviour
Globally, there has been an increase in domestic violence and
child abuse.
• Social tensions, which predispose to violent behaviour, seem
to arise from
– dominant and vulnerable members confined at home 24/7
– reduced access to resources (GRR and SRR),
– disruption of normal lifestyle,
– stress of losing job,
– financial insecurity and
– being physically isolated from various support systems
Ashley Abramson. How COVID-19 may increase domestic violence and child abuse.
URL: https://www.apa.org/topics/covid-19/domestic-violence-child-abuse
21. Coping by the Poor without Basic Needs for Life
• The lockdown in India to delay the spread of the virus resulted in the poor and the
marginalised without access to basic needs
• Some of them dug the city dumps for
– discarded food that they could eat and
– other discarded items of value (including used face masks and gloves) that they could sell in a
flea market
– Not covered in Indian media but shown on Germany’s DW TV
• Angry reactions from many Indians at the “foreign TV” for this expose’ and blaming
the poor for recycling used masks;
no one tracked the vendors who were reselling used stuff at jacked up prices in black-
market!
22. GRR = steps 1 & 2 of Maslow’s Hierarchy of Needs
= GRR
23. Components of Meaningfulness to an Individual
• Purpose (why should I)
– Goals
– Future fulfillment
• Values (is it worth it?)
– Justify course of action
– Moral decision making
• Efficacy (is it of use?)
– It will make a
difference
• Self worth (can I/we?)
– Skills
– Belonging to groups
you value
People found it more meaningful to accept the restrictions if they were
for self-protection rather than to protect others (Selfishness > Altruism)
Zettler et al (2020). Individual differences in accepting personal restrictions to fight the COVID-19 pandemic: Results from a
Danish adult sample. DOI: 10.31234/osf.io/pkm2a
24. To understand such “abnormal” and
often hazardous responses, we need to look at
the concept of ikigai …
25. Ikigai, a Japanese Concept
Reason for Living (or Purpose of Life)
is the Basis of Feeling Well
• The Japanese word derives from iki, meaning life and
gai, meaning value.
• Ikigai signifies “a reason for being, encompassing a sense of
purpose, a life of meaning & joy and a feeling of well-being.
26. Ikigai, a Japanese Concept – Modified by a Life-Coach*
* Winn, Marc. Ikigai Venn Diagram. What’s Your Ikigai?, The View Inside Me, May
14, 2014, http://theviewinside.me/what-is-your-ikigai/.
The sudden Loss of
Jobs and Livelihood
has rendered Millions
of workers with a Loss
of Sense of Coherence
and wellbeing.
Sociologists were
missing in most of the
“crisis teams” leading
to several unexpected
outcomes…
27. Ikigai Explains Life vs Livelihood Dilemma
• Lakhs of migrant workers, who have lost their livelihood were
stranded without any mode of transport to return home.
• Perceiving starvation to be a far greater threat than the
pandemic, they marched in thousands to their native villages;
quite a few have lost their lives on the way...
• Later, the Govt yielded to organise special trains and buses
• No doubt, several of them might carry the killer virus to the
villages all across India.
• Time will show its impact in terms of mortality and morbidity
in villages (WHO – April 2020)
India_ Migrant workers' plight prompts UN call for ‘domestic solidarity’ in coronavirus
battle. UN News 2020. URL: https://news.un.org/en/story/2020/04/1060922
28. What can Medical Professionals do to help their
worried patients?
• Adopt Roberts' Seven-Stage Crisis Intervention Model to
COVID-19 Pandemic:
• Step 1 – Rapidly Establish Rapport
• Step 2 – Assess Psychosocial & health risks
• Step 3 – Identify Major Problems or Crisis Precipitants
• Step 4 – Deal with Feelings & Emotions appropriately
• Step 5 – Generate and Explore Alternative solutions
• Step 6 – Suggest an Action Plan that the patient can
understand and find it meaningful & manageable to follow
• Step 7 - Follow-Up: being ‘always there for the patient’ helps
assuage fear and panic
29. Public Health Campaigns Need to Balance
Cognition and Emotion
i) The campaign leaders must acknowledge the ambivalence of the people: they
are extremely anxious and yet, many of them resist rational advice.
ii) Early in the crisis, the public may feel that the officials are overreacting; later,
when the crisis is full blown, the same public may feel that the officials
showed apathy. The campaign must repeatedly and emphatically inform the
people.
iii) The campaign must be proactive and get the people prepared for the
subsequent actions, such as personal hygiene, social distancing, wearing of
protective gear, volunteering to donate convalescent plasma, etc.
iv) The leaders must acknowledge the public fear and other reactions such as
denial, stigma, embarrassment, depression etc., to make it easier for the
people change their mind set without feeling undue guilt or remorse.
v) The campaign should be careful in wording the messages. It should not be
guilt inducing or intrusive. Such a direct approach can trigger defensive denial
instead of determination and action.
vi) The messages should avoid false optimism and instead promote solidarity,
resilience and adaptability to cope with the New-Normal.
Ref: Sandman PM, Lanard J. Strange COVID-19 bedfellows: gnawing anxiety and under-reaction.
https://www.cidrap.umn.edu/news-perspective/2020/03/commentary-strange-covid-19-bedfellows-gnawing-anxiety-and-under-reaction
30. What Rulers can Do to Proactively Mitigate the
Sufferings in Pandemic
• Preamble: in 2040, historian may record this: Absence of
sociologists and invisible/inactive social welfare agencies
affected proactive planning of relief for the poor and
vulnerable; the migrant labourers, without basic needs like
food & shelter, had to make drastic life & death decisions
• Public Health views are very important for reducing morbidity
and mortality; saving Lives Matter
• However, saving Livelihood is equally important
• It is possible to be proactive in taking care of both if all the
key players and stake-holders take a holistic view of the crisis
• Who ever can contribute to the people’s understanding and
acceptance of the New Norms should be included in the Team
for planning crisis management and mitigation efforts