Professor Saltzman introduces the basic concepts of renal physiology. Professor Saltzman first introduces the function and anatomy of the kidney. Special attention is given to the cell types and structural aspect of the nephron, the functional unit of the kidney. Filtration, secretion of toxic waste, and reabsorption of water, ions, and nutrients through the glomerulus and various segments of the nephrons is discussed in detail. Finally, Professor Saltzman describes glomerular filtration rate as a function of pressure drop, which is regulated by afferent and efferent arterioles, to control how much volume being filtered through glomerulus.
Cannulation performed following official University Hospitals of Leicester (UHL) Guidelines
Stage 1 - Consent 0:40
Stage 2 - Equipment 1:53
Stage 3 - Procedure; Treatment Room 3:25 Patient Area 8:01
Stage 4 - After Care 13:23
Flashcards for these drugs at http://helphippo.com Insulin analogues for diabetes can be classified based on duration of action. These mnemonics help remember the names. Please SUBSCRIBE - more cool stuff coming as we get more Hippo Helpers!
Our pharmacology playlist at: http://www.youtube.com/playlist?list=PLIPkjUW-piR2Ww8tUxJnhuJ8z8X-yQSuB
Professor Lord Robert Winston delivers an Enlightenment Lecture entitled "Medicine, Ethics and Society".
This lecture also forms part of this year's Our Changing World series.
Recorded on Monday 21 October at the University of Edinburgh's McEwan Hall.
The biopsychosocial model of disease existed in my notes... an excuse to get out the colouring crayons and draw a diagram, but ultimately another collection of facts that needed to be digested then regurgitated in the summer exams, something to be fitted in around learning about the important stuff - the science.
But the biopsychosocial model has come alive for me recently, now I realise what an impact the later two components, psychological and social, can have on patients. As a former medical student and now full time patient, the model really means something to me now.
In the 1977 paper in Science, George Engel introduced the biopsychosocial model:
"The dominant model of disease today is biomedical, and it leaves no room within it's framework for the social, psychological and behavioural dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching and a design for action in the real world of health care."
Following some conversations on Twitter recently and from my own experience at medical school and now as a patient, I wanted to explore my thoughts on this model.
Twitter, in the wonderful way it does, recently introduced me to the Disabled Medic blog, which among many other great posts, has also explored the biopsychosocial model, and I would recommend a read.
The biopsychosocial model shows the influence that emotions and social circumstances have on physical health, which is important. But while conversations about the model focus on the way it can be used by healthcare professionals (very important!), it needs emphasising that the model can provide a framework for patients to look at/after themselves. The model highlights the psychological and social causes of disease, but more optimistically, it can show that there are a range of treatments for disease, from the medical to the social and psychological. A diagnosis of a long-term health conditions is often simultaneous with loss of control. There are limitations to the success of medications, treatments and surgeries. And in receiving these, we are relatively passive as patients, no matter how engaged we are. The biopsychosocial model looks at our biological, psychological and social needs, and how these factors influence our overall health. Establishing that these factors affect our health is only the first step. As patients, when psychological and social factors are brought in to the equation, it becomes clear that we ourselves have some power to help ourselves. By framing our health in this more holistic way, as patients we are not as powerless as suggested by the medical model. Through self-management we can make positive changes to our own psychological and social situations, which can in turn benefit our physical biological health.
To return to the traditional ground of the model - healthcare professionals....
One strength of the model is that it places psychology side beside its (generally considered) more superior counter-part, biology. I hope that by seeing the biopsychosocial model in action, physicians can appreciate the detrimental psychological impact of a diagnosis, and the assumption of "it is all in the mind" can fall by the way side. By integrating all three elements, the model shows that neither is independent of the others, so it can't be all in the mind, because other factors, biological or social, will be involved to some degree.
For me personally, the biopsychosocial model makes me look at what a 'life' is. One of the attractions of medicine is saving lives. Without getting too deeply into philosophy or ethics, I just want to explore for a second what saving a life really means for me, as a patient. I still believe that A&E staff heroically save lives. But I have come to realise that a life is more than a swiggly line on a heart rate monitor. My counsellor has been just as heroic in saving my life, through addressing my emotions. My life is now something I can live, rather than endure. With saving lives being a key (and honourable) motivation among medical staff, it is important that we can allow them to save lives as often as possible, and in many different ways. It may not always be through emergency treatment in resuscitation, but if we embrace the biopsychosical model, they can save lives in many more ways.
When there is a limit to the effectiveness of the biological approaches to an ill person, and they can't be returned to the land of the healthy, medical science becomes unstuck. Within the biopsychosocial model, the issue of doctors not being able to do anything is slightly less. As I mentioned in my post about making the transition from medical student to patient, I went to medical school because I wanted to make people better. But I was only being taught one way to make people better - drugs and surgery. If we really embraces the biopsychosocial model, doctors could make a difference, even if their standard tools of drugs aren't available because they could turn to psychological and social support. This isn't to say that all clinicians have to be counsellors or social workers - far from it. But an awareness and appreciation of their contribution to the management of a patient is important, as well as an understanding of the basic principles and skills such as motivational interviewing.
In 2013, I don't think I can talk about social in this context without mentioning social media. It was not was Engel originally meant in 1977, but social media has become a vital social tool for patients to manage their health. Ignoring anxieties and postural problems associated with sitting at a screen seeing everyone else's photo-shopped lives, it is undeniable that social media is a big and good resource that can empower patients to take responsibility and manage their own health. To see the best examples in action, take a look at Michael Seres and his blog, Being a Patient Isn't Easy to see a whole new meaning to the social in biopsychosocial!
I am still very grateful for the biological expertise of my medical team. Don't get me wrong - it's a good place to start and I wouldn't be here writing this post today if it wasn't for the biological support. But with chronic illness, when you are past the dramatic relapses, the biological isn't enough....
The biology has allowed me to live, but its the psychological and social support I have received that has allowed me to live.
Anya de Iongh
This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates how to size and insert a Nasopharyngeal Airway.<br>It is part of a series of videos on the Initial Assessment of a Trauma Patient.
This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates how to use a nebuliser and explain correct inhaler technique to a patient. It is part of a series of videos covering Respiratory Medicine skills.
Kudos to the work of the Difficult Airway Society in UK. They are updating their intubation guidelines and have released an April 2015 draft for open comment/feedback. Check it out and help them produce a worthy publication for us all! Find it HERE My thoughts on the April Draft : cricoid pressure to be removed…
Here's the information students need to know about how drugs work and how they can affect athletic performance. Through "real life" scenarios, students gain insights into the application of pharmacology in their clinical practice—from assisting an athlete who is taking a new medication to recognizing drug-related side effects when a negative reaction is occurring to handling instances of drug abuse. Beginning with an overview of pharmacokinetics and pharmacodynamics, the text presents prescription and over-the-counter medications in relation to the injuries or health conditions athletic trainers commonly encounter. Frequently abused substances such as amphetamines, herbals, and anabolic steroids are also addressed. Legal and ethical issues of drug use are presented, such as HIPAA–mandated privacy issues, drug testing, and which drugs are deemed as acceptable or banned according to NCAA and US Olympic standard.
Controversy about the evidence, economics, ethics, lobbying, and decision making surrounding a new vaccine for serogroup B meningococcal disease should trigger change in the way we develop recommendations for new vaccines say Natasha Crowcroft and colleagues