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Showing posts with label innovative. Show all posts
Showing posts with label innovative. Show all posts

Tuesday, 29 January 2019

Inhalers and inhaled therapy

I have worked in the speciality of respiratory disease management for decades.

I have been responsible for designing services to aid the delivery of care for patients with asthma, COPD and other diseases.

I am also asthmatic and have been for decades.
I have not needed regular treatment with inhalers until last year. Now, I have to take 2 puffs of symbicort 200/ 6 twice daily.
It takes a few seconds a day, yet I have a problem remaining compliant..!
I know right?
Tablets wise, I use a dosset box and I can see when I need to take my meds, when I have forgotten them, in time to correct this.
I am extremely compliant with my tablets.
So why such a difference in adherence?

One of the key areas we have always tried to focus on is concordance and compliance with inhaled therapy.
Unlike pills, we cannot put inhalers into dosset boxes so concordance can sometimes be very poor.
Inhalation therapy is recommended at all stages of the disease and allows the delivery of active molecules directly to the target site of action, whilst minimising adverse side-effects. Inhalers therefore play a crucial role in the effective management of patients with COPD and asthma. Many patients choose not to take their medication because they perceive it to be unnecessary or because they are concerned about potential adverse effects.

Rate of adherence is usually reported as the percentage of the prescribed doses of the medication actually taken by the patient over a specified period. The extent of non-adherence varies widely, and in different studies it has been recorded as low as 10% and as high as 92%.
Extensive review of the literature reveal that in developed countries adherence to therapies averages 50%.
Approximately half of this non-adherence is intentional, whilst the remainder occurs because patients are either unaware that they are not taking medications as prescribed or the regimen is just too complex. Adherence rates are typically higher among patients with acute conditions, as compared against those with chronic conditions.
Studies reveal that patients with chronic illnesses take only ~50% of medications prescribed for those conditions.

So can we make this easier?

Yes and this is something I am working on to develop a new strategy around this through an innovative approach that I will disclose once it is complete... So watch this space.

Useful link

Concordance

Thursday, 25 August 2016

Continuity of a great story... MENTAL DENTAL MBP II

Thank you to all the readers who are actively reading my books.
The activity on the kindle editions seems very healthy and encouraging.

With that in mind, I am excited at the progress of my new novel, the follow up to Mental Dental (Murder by Proxy)

My hope,  should I say target, is to have it ready by Christmas.

It's really a great relief and exciting seeing the stories develop. The aim is to provide a great tale to continue the original story line as it "has legs" ... And it will run!!

This time,  I will have a pre release date and a chance to pre-order for Christmas on paperback and Kindle. Trying something different for this whopper of a story

So in preparation for the new release, this may be an appropriate time to make an appointment with the dentists and read the precursor to it...  REMEMBER... Mental Dental (MBP) is on Amazon.

Gotta work on the title and cover...  Any suggestions are welcome.

Monday, 8 August 2016

Daring and innovative

Mental Dental (Murder by Proxy)
A book I wrote that has surpassed expectations.
Despite self publishing, it is fast becoming my best seller in paperback and doing okay in Kindle format.
Why?
Well it has been extremely well received by readers, been described as ingenious and entertaining.
It is Different and Original.
My plea to you... Try it and you will not be disappointed.

Like the book on the history of glue,  you won't be able to put it down.

It's a roller coaster ride of a tale, a killer thriller.
Dentistry gone Really Bad!

Murderous psychopaths create havoc and mayhem before the very eyes of all at large.

I only hope this never becomes a reality...

To read it click here

Friday, 27 May 2016

Bite sized snippet of Mental Dental (MBP)

My best selling novel, Mental Dental (Murder By Proxy) is a thrilling ride into a criminal world of psychopathic Health Care professionals.
This book is a meeting between "The Usual Suspects" with Kevin Spacey et al and Serial Killers you would never suspect.
It is a work of fiction but could it really happen?
No this is not a crime solving manual but it is innovative, inspirational and entertaining, what a good book should be!
here is the first chapter to entice you - the first of sixteen gripping chapters


Chapter 1
The Dreaded Dentist's Waiting Room

His thumping heart raced at a rate of knots, as if trying to escape from his chest wall. A copious amount of sweat was pouring from every pore of John Massey‟s body, stinging his eyes as it trickled down his face. His cold and clammy hands, clasped in despair as the point of no return fast approached with each passing second. His mouth felt as dry as a bone and he didn't want to be where he was.
The day he had dreaded for so many weeks had finally arrived, and the hour of potential torture and pain was now unequivocally unavoidable.
He sat in the cold, clinical waiting room, a bundle of nervous fear stuck on an uncomfortable and well-worn chair, firmly between the white walls scattered with posters of people with perfect, gleaming smiles. Trying to remain composed and focused, he attempted to divert his worries and think positively. He watched the public interact with the friendly receptionist as she tapped their details on her computer and smiled at the grateful punters as they smiled back and made follow up appointments.
'Why can't I be like that?' he thought to himself.
John was in his thirties and an accountant by profession who was no stranger to stress. However, he quizzed himself on why he was being so scared and negative at coming to the dentists and why he would react in this way, every time he had to be there. He knew the inevitability of this all was worthwhile in the end and after all, what was the worst that could happen?
This was his local dentistry centre, a seven partner practice that he had been coming to since he moved to this small town in the south east of England with his parents as a young child. His mum used to bring him here and no matter how good the dental practitioner was, he would still get frightened and dread the whole experience. His parents were dead and he was unmarried so there was no one around to hold his hand and reduce his apprehension and anxiety.
He was resolute in getting through the torment and John always tried to be brave and face this ordeal but for some unapparent reason, he caved in to the feelings of fear and helplessness, transforming into this quivering wreck. Visiting the dentist was not on his list of great days out or wonderful things to do in life…
The small aquarium buzzed with life as the innocent and colourful fish swam aimlessly between the bubbles of air being pumped out from a plastic sunken ship that lay on the colourful blue gravel base. The purpose of this display of nature was supposed to sooth nerves and relax potential victims of the tyrannical Torquemada trained dental health professional he would be facing but it did not seem to do much for him.
John tried to think of other things and reassure himself that this trip to the dentist was necessary and that it may not be as horrific as he was making it out to be. However, this was not happening, the more he tried to think about something else, the more images of a large handed, drill wielding monster came to mind.
'Mr Massey' John heard, being called out by a young lady dressed in a gleaming and clean white gown and a face mask resting under her chin, exposing a kind smile of reassurance.
No blood or mangled body parts to be seen, this was a good sign.
'Oh, that's me' he said as he clambered clumsily and timidly off his seat, knocking a fellow patient‟s magazine off his hand and onto the floor.
He apologised, recovered it and made his way to the young lady who waited at the door to the corridor of fear, the corridor that led to the rooms that were set off from it and into the torture chambers full of drills, hammers, needles and other menacing tools of pain.
'Please don't be nervous Mr. Massey, everything will be just fine' the young lady said reassuringly.
'My name is Dr. Jessie Stack; I will be your dentist today'.
John felt better but a little awkward as he had been expecting a male dentist equipped with big hairy arms and strong forearms that were used to pulling heavily against gravity and extracting the most cumbersome of molars.
'I am ever so sorry, I am a little anxious at being here at the dentist' John uttered.
'Please don't worry, we get many nervous people here and let me assure you my colleague Wendy, the dental nurse and I will look after you'.

She continued by pointing at the bucking bronco like chair in the middle of the room and said 'please take a seat here, and mind your head on the lamp'.
John obliged by following these instructions, sitting on the examination chair and clasping his hands tightly on his chest as he did so. He had managed to avoid an extra bump on his head and then Wendy, the dental nurse, proceeded to place a waterproof bib on his chest, this covered his nervous, sweaty palms that were now clamped shut like a vice on each other.
Jessie then asked 'what can we do for you today?' to which John explained in a weak voice that he had been experiencing some discomfort to his back teeth and he had noticed some blood on occasions when he had brushed his teeth.
Jessie then politely said, 'Let us have a look then, can you please open your mouth up as wide as you can, thank you' as she popped the mask over her mouth and nose.
She then proceeded to place the light above the chair over his cavernous mouth, then put some disposable gloves on and switched the light on placing the dentist mirror in his mouth. She then started to call out some numbers as she prodded the dental probe into his gums.
John was getting more nervous, curious as to what she might find, what would be involved in rectifying the damage, how much would it cost and more importantly, how much would it hurt?
As the numbers flew out of Jessie's mouth she then paused and said 'ah yes, we have the culprit here, a cavity on your right lower molar with associated abscess, we will need to do something with that right away'. What then followed was what John had dreaded, Jessie explained the treatment and then she uttered those words 'you need a root canal on that…'
He had previously required this intervention and he recalled it was painful, very painful. He started to perspire more and his pulse rate seemed to double with the adrenaline surge that had ensued following these words.
The anticipatory fear was evident as both the dentist and the nurse said 'are you okay Mr. Massey, you have gone a little pale?'
He was obviously far from comfortable with this but he nodded and they proceeded to inject his gums with some anaesthetic. There were two jabs to the site and it was done, well this bit anyway. Wendy asked him to sit out in the waiting room again for a few minutes for the anaesthetic to take full effect and they would start on the job in hand once the gum was numb.
John obeyed clambered off the chair and went out clumsily into the crowded waiting room. He sat on a chair, quietly anticipating the drilling, re-drilling and pulling of things from his oral cavity. He watched as a child was being called in by his dentist and tried to remain brave. He felt numbness to his right side of his face and thought 'good, the anaesthetic is working'.
Suddenly the strangest feeling occurred, the numbness was no longer contained to the lower jaw, he could feel a rush of warmth across his face that was increasingly widening, he now seemed to no longer be able to move his head or mouth, he found he was then not able to move any of his limbs, he was pinned to his chair and unable to anything about this, he had no control over these bizarre effects.
'This is very strange' he thought but could not address this as he was now fixed to the seat.
The busy waiting room bustled with life as Handel's water music was being piped out to the reception room as a soothing background. It was too loud for anyone to hear his mumbled call for help… he then felt his chest become heavy and felt breathless. Was he having some kind of untoward reaction to the injected drug?
Quite quickly, he felt he was becoming sleepy and his eyes shut and his hearing seemed to change frequency, echoes now that were fast becoming distant and then they came to an end, the noises had stopped.
It was approximately twenty minutes from when he sat out that the young girl that had gone in with her mum to see the dentist had come out of the clinic room and was back in the waiting room.
Wendy addressed the waiting room from the corridor and called John back by saying 'Mr. Massey, do you want to come back in?'
There was no reply, no movement and no attempt from John to return to the surgery room, he remained sat on his chair, eyes closed and peaceful.
'Mr Massey, the dentist is waiting for you, please come through' Wendy exclaimed again, but with equal abandonment of reactions from the patient.
Other patients were now taking an interest in this waiting room drama that was developing; a patient was ignoring a staff member and what was going to happen now?

At this point Wendy approached him and nudged his left shoulder slightly. There was no response and although it was the deftest of touches, this nudge was enough to send John propelling slowly sideways and falling towards the patient next to him.
The lady screamed out as John's limp body slumped against her 'oh my god is he dead?'
Wendy was alarmed to say the least and desperately called for help when the truth became apparent to her and the waiting room full of patients. They were horrified by the fact that John Massey was indeed dead.
Children screamed, mothers clasped their offspring to their protective bosoms and hurtled out of the building, screaming. The staff now surrounded the patient, threw him to the floor and commenced basic life support and CPR whilst the young receptionist had now abandoned her computer and was calling the paramedics. Chaos had ensued in an otherwise mundane world of community dentistry. What could have gone so dreadfully wrong?

The public were kept out by the clinic staff and as the paramedics arrived, within minutes of the desperate call for help, they were directed to the mortally wounded soul that lay on the floor, ashen and lifeless.
They took over from the staff and like a green clad cavalry, worked on John, thumping his chest, inserting cannulae into veins, injecting drugs, giving oxygen and intubating his airway. They even considered an attempt to shock his heart but due to the absence of any electrical activity, this consideration was soon abandoned.
They continued to try and resuscitate him but after forty minutes, they declared him deceased.
John Massey now lay alone on the previously clean floor, chest exposed, tubes protruding from his lifeless body.
'This is a mess, a complete mess' Wendy exclaimed to one of her colleagues.
'I have never seen this happen before in over fifteen years of working as a dental nurse, what could have gone so wrong'?

This was indeed not a common sight in a dental surgery, what made it worse was that the victim was someone that was young and apart from being a little nervous and anxious he was otherwise fit and well…
There were going to be questions that needed answering urgently, people did not die in dental surgeries, not like this anyway.
The practice manager telephoned the police at the request of the paramedics. She then addressed her colleagues and asked that everyone please not touch anything and sits in the staff room, they all comforted each other and did as they were instructed.
John Massey's body was covered up with a blanket to restore some dignity to the unfortunate soul and the doors were firmly closed to the public. The reception staff started to call the rest of the patients who were booked for the day and cancel their appointments. None could continue to work, not after this incident.
Dr. Jessie Stack was crying as were others, aghast at what had transpired as this was far from “a normal day at the office”.
The dentists, nurses and administrative staff sat quietly for a few minutes, the distant sirens of the approaching police cars were getting closer. They then heard the screech of brakes outside the building and the Practice manager, Julie, let the police officers in.
Initially there were two officers but soon they seemed to multiply as more officers came.
After hours of questions and statements, the police and Scenes of Crimes Officers had gathered all the evidence, especially the syringes and vials that had been used on the day, the clinic room, reception area and the body had been photographed, evidence catalogued and John Massey was released to the coroner.
His body was taken away in a black body-bag which was zipped to the top and made this already sinister scene more morbid.
There was no next of kin to be informed. There was still, the big question of why this had happened and what could have caused this?
Dr. Stack was distraught, inconsolable and as she saw it, the prime suspect. She had done everything by the book. She was a young but experienced dentist whose practice was unflawed, so what had gone wrong? She had never even had a complaint in the six years she had been a dentist and now as the newest partner in this thriving practice, it was the last thing she needed.
She asked herself: 'Was it something in the vial of anaesthetic?'
'Was he allergic to anaesthetic, even though he had received this product in the past as his documented records clearly stated?'
'Was there foul play?'
'God forbid … was this a murder?'
'If it was, what were the motives if any and who had done it?'

Questions and more questions but no answers… these were up to the police investigation to reveal and they needed to come up with some very definite answers.

At this point, the reporters were gathering outside the surgery, like a pack of hyenas stalking their prey, eager to get a story to fill their pages with, especially one as tragic and as unusual as this one. There was also a small mob of worried and equally inquisitive members of the public, many who were patient‟s at that same dental practice and obviously keen to establish a cause and avoid a recurrence if one was found. Already they had started to make stories up, blaming this dentist or that dentist as they may have been less courteous to them in the past or inflicted more pain than tolerated during a filling. One member even speculated at the victim being 'bumped off by the secret service' even though they did not know the victim, but if it makes life interesting…?
A week had passed and this otherwise thriving and busy practice was everything but busy, patients either took their business elsewhere or they lived with their dental pain. It had wrecked their business. It had wrecked patient confidence in them. It was dreadful.
A week had passed and after toxicology and post mortem examinations were concluded, the cause of death was recorded as accidental death, possibly due to anaphylaxis. The toxicology results were inaccurate as some of the drugs that had been injected by the paramedics into Mr. Massey in an attempt to save his life may have caused the results to be inaccurate.
A sad end to a life but no misadventure or wrong doing, was this right or was something more sinister occurring?
Was there still something that was left untapped?

Intrigued? 
Want to know what happened?

I know you are so: download your own copy of Mental Dental (MBP) via this Amazon link

If it's a paperback version you want, this is also available...

Enjoy the ride!!



Monday, 21 March 2016

Time on your hands? Read a good book

Have you got some time on your hands? Between meetings, at lunch, chilling or before bed time... Why not read a good book.
RPG Books will fill your time. There's a few different, innovative and exciting reads by clicking the link.

Catch a glimpse and fill those moments with imagination and entertainment.

Wednesday, 24 February 2016

Growing library

Here's my eight books...
Increasing number of choices and stories to entertain.
Ghost stories, murder mystery, sci-fi, humour, hopes, dreams and millionaires...
Fiction aficionado... Look no further.

'They ain't heavy"
Not into long winded books? Something light that will keep you engaged?

These Red here, waiting and they won't break the bank.

Monday, 22 February 2016

Visit to the dentist

It's been a bit of a day, having started by visiting the Dental surgery for a checkup.
All I thought of was,  keep calm...  But how can I after writing Mental Dental (Murder by Proxy).
Thankfully, the dentist was far removed from the killer dentists I wrote about.. Phew!!

Still,  a great reminder to prompt others to read my creation. 

Support independent publishing: Buy this book on Lulu.

Thursday, 19 November 2015

The day job rewarded

Yesterday evening, one of the teams I manage and created was rewarded for our innovative approach to patient care.
We received a commendation for our YouTube video we produced for increasing Pulmonary Rehabilitation attendance.
Our CEO presented the prize at the awards ceremony in a great evening celebrating the best of the local NHS services.
Nice to be acknowledged especially in these times of austerity.
Motivation and inspiring

Thursday, 30 July 2015

Home of the killer dentists

Mental Dental at the publishing house
click on the link below to access the paperback edition from the publisher.
 Murderous and ingenious

Sunday, 10 May 2015

Book of ghostly

Dare to visit the haunted hospital?
Phantasms in the Infirmary... Good old fashioned ghostly stories and macabre goings on....

A Great collection of short stories by Ram and Julie Gulrajani.

Paperback

Thursday, 7 May 2015

Writing Horror fiction

As a wacky experiment, it would be really cool if we could all write a short story to feature in Phantasms in the infirmary Vol II?
The theme is Hospital Horror.
I'd like to start this off and then add in as and when, but if the result works, could we include it in as a short story written on a Blog?
Has this ever been done before?
It certainly is Blue sky thinking / innovation so here goes...

'Another day, another dollar' was the greeting from Tom at reception as Julie walked briskly in for yet another shift on the Orthopaedic ward.
She smiled as she rushed past, eager to get into the ward in time for the handover from the evening shift.  
The prospect of her fourth night shift with a grueling twelve hours ahead of her was making her feel quite resistant but she had a job to do.
The preceding three nights had been so busy and these had been punctuated by very little sleep as her youngest daughter, Natalie, had not been well and was off school. Her nursing role had blended in with Motherhood somehow. She felt like she had been on call for 24 hours, with every effort zapping more of her precious energy out of her.

Although she had been on this ward before, the last three shifts had certainly made a big impact on her confidence, she had mastered new procedures and as the nurse in charge, was enjoying the responsibility. Everything had run smoothly and to plan.
Well almost everything...

I would now like to open the floor to you to add a paragraph or two to this multi-layered / multi-authored story..

Shall we set a deadline for a month and see what happens?
Its a bit of fun and the chance to have part of your invaluable contribution published with the rest of the book of short stories.

Monday, 20 April 2015

Criminal minds on overdrive

Dentists get away with murder...
This was a statement made today in a meeting I attended regarding health services.
What the individual meant was not what I heard.
I heard connotations of Mental Dental (Murder by Proxy)

My third book, was about crime undertaken by Dentists.  The most severe of the ten commandments being broken... Though shall not kill!

It's an original story of multiple murders that go relatively undetected.
Psychopathic and criminal minds on overdrive...

Here's the link killer thriller

Monday, 30 March 2015

Every dentists nightmare

Mental Dental (MBP)
A nail biting thriller full of twists and turns, one you need to get your teeth into to find out who is killing dental patients and why they are being slaughtered.
Join Dr Jessie Stack as she tries to prove her innocence following accusations of murder. The murder she is involved in is not the only one uncovered and committed by others.
A spine chilling thriller that is different in every way. Its bark is not worse than its bite.
I dare you read it.

Lulu

Wednesday, 4 March 2015

Powerful publishing

Mental Dental (MBP)
Read it!
Why?

Simply because you have never read anything like this, ever.

It's a blend of murder, mystery, good and evil. Intrigue and fear, twists and turns galore.
People are dying and innocent people are being blamed.

One person dies and another destroyed.. Two for the price of one.
The recognition of a pattern is overlooked by law enforcement agencies until one of the accused stumbles on the truth.
Join Dr Jessie Stack in her quest for truth.  Her life and those of others depend on it.

This stylish killer thriller is a must read... Link

Find it on Amazon Kindle, paperback or on the Lulu.Com website.... You will be thankful for the recommendation.
😉

Thursday, 15 January 2015

Fiction Author with a different outlook

Having written four books, I am enjoying the prospect of completing another work of fiction.
I've tried to be different, innovative and exciting in my writing.
All the books are original and make a great read without padding out the stories.
So give them a try,  read them and share your experiences.
Legally Lucky,  Phobic Wars, Mental Dental (MBP) and Phantasms in the Infirmary are out there...  Discovery awaits.

Sunday, 7 December 2014

Driving inspired writing

Writing stories is something I enjoy.  Development of the book and it's characters is a massive undertaking and can be arduous.
One has to be systematic and organised,  which is hard to do when you have a day job and family etc...  Life gets in the way!

Creativity is like a drug,  a mystical driving force that pushes one on to remain original and innovative.

All four books I've written have been projects of love.
There are no forced deadlines or contractual commitments other than those set by myself. Even so,  I hope that they are read by many for the right reasons.  Enjoyment, originality and familiarity with my work.

Please read any or all...  Please tell others about them and leave your reviews.