New technology called Electromagnetic Navigation Bronchoscopy® (ENB) that uses virtual bronchoscopy and real time 3-dimensional CT images that enable me to localize these peripheral lung nodules for diagnosis and treatment. This outpatient procedure is minimally invasive and therefore has a small risk of pneumothorax (2-3%) and its published diagnostic yield rates range from 67% - 86%
New technology called Electromagnetic Navigation Bronchoscopy® (ENB) that uses virtual bronchoscopy and real time 3-dimensional CT images that enable me to localize these peripheral lung nodules for diagnosis and treatment. This outpatient procedure is minimally invasive and therefore has a small risk of pneumothorax (2-3%) and its published diagnostic yield rates range from 67% - 86%
Asthma is a chronic inflammatory condition associated with airway hyperresponsiveness (an exaggerated airway-narrowing response to specific triggers such as viruses, allergens and exercise).
Physiotherapy can provide relief from symptoms of uncontrolled asthma, including coughing, wheezing, tightness in the chest, shortness of breath and QOL.
Presentation delivered by Dr Jason Chan, Highly Specialised Clinical Psychologist at the Acute COPD Early Response Service (ACERs) at the Homerton Hospital, at the Pan London Airways Network Winter Meeting 2015
Keynote presentation delivered by Dr Irem Patel, Integrated Consultant Respiratory Physician, Kings Health Partners, at the Pan London Airways Network Summer Meeting 2016
Presentation delivered by Dr Ellie Hitchman, Speciality Doctor and Kim Barlow, Specialist Physiotherapst from St Joseph's Hospice, Hackney, at the Pan London Airways Network Winter Meeting 2016
Presentation by Sam Blamires, registered dietician and Senior Medical Affairs Advisor at Nutricia. Part of the PLAN Summer meeting 2016. A review of the latest evidence and guidelines on supporting nutrition in COPD, including the causes and consequences of malnutrition in COPD, the use of screening tools, the NICE guidelines on supplementation, and putting theory into practice.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
COVID-19 PCR tests remain a critical component of safe and responsible travel in 2024. They ensure compliance with international travel regulations, help detect and control the spread of new variants, protect vulnerable populations, and provide peace of mind. As we continue to navigate the complexities of global travel during the pandemic, PCR testing stands as a key measure to keep everyone safe and healthy. Whether you are planning a business trip, a family vacation, or an international adventure, incorporating PCR testing into your travel plans is a prudent and necessary step. Visit us at https://www.globaltravelclinics.com/
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CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
1. Vocal cord dysfunction
diagnosis and management
Douglas S Robinson
University College London
Hospital, UK
DISCLAIMER: The views and opinions expressed in this presentation are those of the authors and do not necessarily represent the views and policy of PLAN(Pan London
Airways Network).
2. Vocal cord dysfunction
2
Definition: abnormal adduction of the vocal cords during
breathing
Symptoms: breathlessness, wheeze (inspiratory), blockage in
throat, voice change
Frequently misdiagnosed as asthma, 33% also have asthma
May lead to frequent A&E visits/admissions
Prevalence: 3-15% depending on who is studied
3. Diagnosis
3
Think about it!
Symptom patterns
Inspiratory noise/wheeze
Throat/upper chest
Frequently admissions
Lack of response to asthma
treatment
Flow volume loop
Laryngoscopy (with provocation)
?imaging
?VCDQ
Exclude asthma:
full lung function
PC20
FeNO
10. 10
Management
MDT
Respiratory physician: often diagnosis,
treating/assessing co-existing asthma,
or preventing treatment for asthma
Laryngologist (specialist ENT): assessment at rest
and with exercise/provocation
Speech therapy: throat relaxation and cough suppression
Physiotherapy: breathing control
Where: London: Royal Brompton ? Any others
13. 13
Asthma since childhood
Multiple hospital admissions
Atopy nut anaphylaxis
Paramedic
Blood eos not raised, FeNO 16ppb, IgE 22, spIgE all negative, PC20 negative
14. 14
Management
Wean off oral steroids
Physiotherapy and CNS for breathing control
Psychology input
Still intermittent admissions
ACQ 3.0
15. 15
VCD Summary
• Probably much commoner than is appreciated
• May co-exist with asthma
• Diagnosis difficult
• Symptoms: inspiratory wheeze, upper airway
• Lung function (FLC)
• Laryngoscopy (with challenge)
• ?VCDQ
• MDT management: speech therapy, physiotherapy
• psychology
16. What is severe asthma?
• The term severe asthma should be reserved for patients
with asthma in whom alternative diagnoses have been
excluded; co morbidities have been treated; trigger
factors have been removed (if possible); and adherence
with treatment, including inhaler technique has been
checked, but still have poor symptom control (Asthma
Control Questionnaire > 1.5 or Asthma Control Test <
20), or frequent severe exacerbations (2 or more bursts
of systemic corticosteroids in the previous year), or
serious exacerbations (at least one hospitalisation, ICU
stay or mechanical ventilation in the previous year)
despite the prescription of high- intensity treatment (step
IV/V of the asthma guidelines), or those patients with
controlled asthma that worsens on tapering of high
doses of inhaled or systemic corticosteroids.
Chung KF, et al. Eur Respir J 2014; 43: 343-73.
17. CONSIDER
patients at step 3 or 4 not responding to therapy
recent A&E visits or hospitalisation (2 or more)
recent exacerbations requiring oral prednisolone (2 or more)
diagnostic doubt
questions about biologics
Who to refer
(NHSE)
• Symptoms of asthma are not responding to high dose inhaled corticosteroids
together with additional controller (LABA, theophylline or LTRA), or require long
term oral corticosteroids for control
•AND
–Hospital admission for asthma (especially ITU), or two A and E attendances in
the last year
–Frequent oral corticosteroids use within a year or daily oral corticosteroid
dependence
–Asthma with persistent airflow obstruction (FEV1<70% predicted)
18. Is it asthma ?
Lung function/reversibility/PC20/CT scan
Adherence
Prescription records, FeNO suppression
Physiotherapy: breathing pattern, sputum clearance,
exercise
Psychology
Objective measures of severity
ACQ
mAQLQ
FeNO
Blood eos
Spirometry/PEF
Access to biologics
Research