Trends in the Private Sector

Trends in the Private Sector

Money from us (from our taxes) is passed to the government, which is passed down to the NHS to fund it. But how does the NHS department should get which money? And which departments should exist and get funded by the NHS at all?  How are private companies involved if the NHS is a public organisation?  The system set up to decide how the NHS’ money is spent is complicated, and it’s easiest if you just watch this video to understand:

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Trends and Contexts in Occupational Therapy

Trends and Contexts in Occupational Therapy

trendy-otter-meme-mug
#trendy

Trends are a something (like a style of therapeutic practice) that is popular at the moment. Example:

  • mindfulness
  • adult colouring books
  • active ageing
  • life stories
  • use of Sensory Integration in settings other than paediatrics
  • paternalism being challenged
  • holistic approach to health
  • in society, being in debt is acceptable whereas in the past it wasn’t

Contexts are the circumstances that influence or affect something (like a trend):

  • Politics and the resulting government policies on access to services and funding
  • the culture
  • the attitudes of individual therapists

 

Contexts in healthcare are often influenced by political and legislation, because in the UK healthcare is funded by the government because we have the NHS. In other countries where healthcare is paid for by insurance or individuals consumers, it may be be more heavily influenced by these other factors?  Anyway, in the UK the Care Act (2014) is a recent policy that supersedes the previous health-related acts such as NHS act (2006). Because of what the Care Act (2014) states, some expected trends to happen in healthcare will be

  • integration of services:
    • health and social care working more closely
    • between hospitals and GPS (primary & secondary care)
    • between mental and physical care
Stroke Terminology

Stroke Terminology

There are a lot of medical latin-sounding words used to describe the different stroke symptoms. Below is a list together with the way that I remember them.

In brackets is (Ph) or (M) to indicate whether the symptom is physical or mental. Physical could be movement or sensation; and Mental means cognitive processes such as perception or attention.

Vision

Around 40% of the brain is actually involved with vision, since it includes ocular motor movement, planning of these movements, receipt of the visual information, processing of it and then decisions made on the visual information – these decisions could be visuospatial, emotional etc.

Hemianopia (Ph) (hemi=half;   plegia=paralysis)

Loss of vision in either L or R half of both eyes. So not loss of vision in left eye, but loss of left visual field in both eyes. The information from one side is not transmitted to the brain.

Neglect (M)

The information from eyes is being transmitted to the brain, but information for one side is ‘ignored’ or not processed by the brain.

Diplopia (Ph) (diplo=double; op=eye)

Double vision.

Nystagmus (Ph)

Continuous uncontrolled eye movements, seen with involuntary flickering movements of the eyes either L-R or up-down.

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Background information on Acute Stroke

Background information on Acute Stroke

What is a stroke?

A stroke is similar to how a heart attack stops the blood going to the heart -but for the brain. So like a ‘brain attack’ or a sudden ‘strike’ to the brain. Depending where the blood is stopped from getting to in the brain, depends on what effect it’ll have on the person. Once deprived of blood and therefore oxygen, parts of the brain begin to die after only a few minutes and so a stroke  is classed as a medical emergency.

Otter hospital

Causes of stroke

Ischaemic– blood vessel blocked by clot, stopping flow. Most common 85% cases. Clot could be due to narrow arteries, clot in artery, or clot travelling from somewhere else to the brain. Brain area that dies is called an infarct‘the naughty clot “schemes” to injure the brain’

OR

Haemorrhagic-blood vessel ruptures and blood leaks out. 15% cases. The leaking blood building up also causes extra pressure inside the skull. Leak could be due to high blood pressure or a weakened/bulging blood vessel wall (‘aneurysm’)…‘haemorrhage of blood’

 

Brain anatomy

Where the brain dies dictates which abilities will be lost. The right side of the brain controls the left side of the body, and vice versa.This means an injury to the left side will affect movement in the right side of the body.

Areas of the brain

The different areas of the brain control different tasks:

Frontal lobe (front)

  • planning
  • initiation and motivation
  • problem-solving
  • voluntary movement
  • appropriate socialising & interactions with others
  • personality/emotions/behaviour
  • Broca’s area -produce spoken language

Parietal lobe (top middle strip: like saddle on a horse on the prairies, you experience a lot of unusual sensations as you ride through the desert like heat, smells, sore bum etc!)

  • perception: processing sensation from touch/pressure/temp/pain
  • Wernicke’s area-understand received language: spoken & written

Occipital lobe (back: why a blow to back of the head often affects vision)

  • processing visual input from eyes

Temporal lobes (front either side:where your temples are located, a lot of old artefacts are stored (memory) and labelled (different things identified) in an old temple)

  • distinguishing different smells & sounds apart
  • visual & verbal memory (for words & names)
  • attention

Cerebellum (bottom underneath, Latin for ‘little brain’)

  • controls smooth (involuntary) muscles like gut or maintaining balance

Brain stem (stick at bottom, joining onto spinal cord)

  • basic life support functions eg breathing, heart

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OT and Pain Management Clinics- how Occupational Therapy can help people with chronic pain

OT and Pain Management Clinics- how Occupational Therapy can help people with chronic pain

The gate control theory of pain  (Melzack & Wall 1965) proposes that non-painful input closes the “gates” to painful input, which prevents pain sensation from travelling to the central nervous system.  Activation of nerves which do not transmit pain signals but transmit information about touch, pressure & vibration (called non-nociceptive fibres; nociception [no-see-sep-shun] is the perception of pain by beings) can interfere with signals from pain fibres, thereby inhibiting pain. Therefore, stimulation by non-harmful input is able to suppress pain.

fustrated otter

The team in a pain clinic will typically be up of a clinical psychologist, nurse, occupational therapist, physiotherapist, an advising pharmacist, CBT therapist and counsellor. The International Association for the Study of Pain recommends the use of OTs for assessments an treatment of chronic pain (Loesler 1991). A pain clinic can be hospital (inpatient) or community (outpatient) based.
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Sensory Integration theory

Sensory Integration theory

The theory of Sensory Integration (SI) proposed by Jean Ayres explains that how the senses are processed will affect other aspects of child development, such as social, emotional, physiological & neurological development. She hypothesised that motor learning was based on sequential developmental stages and could only be achieved if the necessary incoming sensations were received by the body.

piano playing otter
Auditory sensations: incoming

There are two main sensory processing pathways in the body, the Dorsal Column Medial Lemniscal pathway (DCML) and the Anterolateral system (AL). [AL is sometimes called the Spinothalmic pathway.] These transmit the  information received by the sensory systems from the body to the brain and vice versa. Read more