Miscellaneous

2021 ◽  
pp. 272-290
Author(s):  
Thomas Marjot
Keyword(s):  
Performance Measures ◽  
Best Practice ◽  
Intraepithelial Neoplasia ◽  
Curriculum Material ◽  
Breath Tests ◽  
Anorectal Disorders ◽  
Caustic Injury ◽  
Gastrointestinal Conditions ◽  
Procedural Complications ◽  
Curriculum Topics

This chapter includes a range of miscellaneous curriculum topics including endoscopy, anorectal disorders and gastrointestinal (GI) investigations. Questions discussing the role and indications for antibiotic prophylaxis in endoscopy, sedation, performance measures and consent will provide education on best practice in endoscopy. Coverage is also given to the management of anticoagulation pre- and post-endoscopy together with commonly encountered procedural complications: post-polypectomy syndrome, post-endoscopic retrograde cholangiopancreatography pancreatitis and caustic injury. The presentation and management of key anorectal disorders (haemorrhoids, anal fissures, anal intraepithelial neoplasia, infectious proctitis) are also presented here. Finally, principles of salient GI investigations including anorectal manometry and breath tests are well described. Additional curriculum material regarding miscellaneous gastrointestinal conditions and investigations will be covered in the mock examination chapter.

Oesophageal disorders

2021 ◽  
pp. 16-38
Author(s):  
Thomas Marjot
Keyword(s):  
Chest Pain ◽  
Foreign Body ◽  
Reflux Disease ◽  
Therapeutic Approach ◽  
Core Curriculum ◽  
Curriculum Material ◽  
Eosinophilic Oesophagitis ◽  
Diagnostic Features ◽  
Curriculum Topics

This chapter covers core curriculum topics relating to disorders of the oesophagus. A diagnostic and therapeutic approach to symptoms of gastro-oesophageal reflux disease is covered including physiology testing and the role of anti-reflux surgery. Other benign conditions causing dysphagia and chest pain are presented incorporating disorders of motility, infections, and the management of eosinophilic oesophagitis and oesophageal stricturing. Coverage is given to the investigation and management of patients with foreign body or caustic substance ingestions. There is particular focus on the investigation and management of oesophageal malignancy including in palliative stages, along with the various stages of Barret’s oesophagus. This includes diagnostic features, surveillance intervals and management of dysplasia associated with Barrett’s. Additional curriculum material regarding disorders of the oesophagus will also be covered in the mock examination chapter.

Best practice in the health sector

1996 ◽  
Vol 19 (4) ◽  
pp. 73 ◽  
Author(s):  
Andrew Podger
Keyword(s):  
Public Health ◽  
Service Delivery ◽  
Health Outcomes ◽  
Continuous Improvement ◽  
Performance Measures ◽  
Best Practice ◽  
Health Sector ◽  
Pivotal Role ◽  
Commonwealth Government

The Commonwealth Government is increasing its emphasis on public health andquality of care, which will require a capacity to measure health outcomes and developstrategies for continuous improvement. The reforms being considered by the Councilof Australian Governments (COAG) are designed to improve the quality of healthservices by allowing the Commonwealth to concentrate on broader strategic analysisand performance measures. The health industry will need to take a pivotal role inimproving service delivery through collaboration with industry leaders and aimingfor best practice.

scholarly journals Multidisciplinary Approach to the Management and Treatment of Anal Dysplasia

2018 ◽  
Vol 31 (06) ◽  
pp. 361-367 ◽  
Author(s):  
Jeffrey Douaiher ◽  
Sean Langenfeld
Keyword(s):  
Best Practice ◽  
Multidisciplinary Approach ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Intraepithelial Neoplasia ◽  
Anal Dysplasia ◽  
Hiv Coinfection ◽  
Related Risk ◽  
Immunocompromised State ◽  
Sex With Men

AbstractThe incidence of anal intraepithelial neoplasia (AIN) has been increasing over the years. AIN acts as a precursor lesion for anal squamous cell cancer. Factors leading to progression of AIN into malignancy are complex and involve grade of the lesion, human papillomavirus and HIV coinfection, as well as patient-related risk factors such as immunocompromised state and men who have sex with men. The multifaced aspects of this disease make its management challenging, as it involves several disciplines including pathology, primary care, infectious disease, and colorectal specialties. Each of these fields brings its own expertize to the management of AIN, and their collaborative, coordinated work culminates into best practice and optimized outcomes in the care of the AIN patient.

scholarly journals Triage system performance: consistency and accuracy in the emergency centre

2020 ◽  
Vol 12 (3) ◽  
pp. 94-99
Author(s):  
Enrico Dippenaar
Keyword(s):  
Decision Making ◽  
Performance Measures ◽  
Resource Availability ◽  
System Performance ◽  
Best Practice ◽  
Decision Makers ◽  
Triage System ◽  
Perfect System ◽  
Conscious Decision ◽  
Made In

Triage systems have evolved over recent times with the use of tiered acuity to achieve a balance between patient need and resource availability. Triage is a way to sort patients based on acuity, irrespective of the setting, and whether by telephone, in the prehospital environment or in hospital. The growth of the paramedic profession means that paramedics are now working in emergency centres and having to contend with the concept of triage in this setting. The nature of emergency centres and the variety of patient presentations makes it nearly impossible to have a perfect system that is both consistent and accurate. Paramedics, as decision makers, should understand the underlying concepts of what makes a triage system perform well so best practice can be adopted with specific goals in mind. There is a patient-centred focus to do the most for the most at any given time and to ensure that resources are aligned with the needs of patients. It is vital to monitor a triage system's performance so that improvements or adjustments can be made in response to patient population needs over time. This commentary focuses on the main principles of triage system performance measures and what factors should be taken into consideration during clinical practice. Highlighting the concepts of triage reliability, validity and decision-making should help paramedics to understand the importance of conscious decision-making practice.

A combined ultrastructural and gene molecular research for the relationship between human uterine cervical carcinoma and human papillomavirus

1990 ◽  
Vol 48 (3) ◽  
pp. 204-205
Author(s):  
Kun Lee ◽  
Jingyi Si ◽  
Ricai Han ◽  
Wei Zhang ◽  
Bingbing Tan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Dot Blot ◽  
Homologous Sequences ◽  
Normal Cervical Epithelium ◽  
The Relationship ◽  
Chronic Cervicitis

There are more supports for the view that human papillomavirus (HPV) infection might be an etiological factor in the development of cervical cancer when the association of persistent condylomata is considered. Biopsies from 318 cases with squamous cell carcinoma of uterine cervix, 48 with cervical and vulvar condylomata, 14 with cervical intraepithelial neoplasia (CIN), 34 with chronic cervicitis and 24 normal cervical epithelium were collected from 5 geographic regions of China with different cervical cancer mortalities. All specimens were prepared for Dot blot, Southern blot and in situ DNA-DNA hybridizations by using HPV-11, 16, 18 DNA labelled with 32P and 3H as probes to detect viral homologous sequences in samples. Among them, 32 cases with cervical cancer, 27 with condyloma and 10 normal cervical epitheliums were randomly chosen for comparative EM observation. The results showed that: 1), 192 out of 318 (60.4%) cases of cervical cancer were positive for HPV-16 DNA probe (Table I)

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

A Guide to Coding and Billing for the Audiological Management of Patients Receiving Ototoxic Medical Treatments

2019 ◽  
Vol 4 (5) ◽  
pp. 936-946
Author(s):  
Dawn Konrad-Martin ◽  
Neela Swanson ◽  
Angela Garinis
Keyword(s):  
Otoacoustic Emissions ◽  
Best Practice ◽  
Private Insurance ◽  
Monitoring Program ◽  
Current Method ◽  
International Classification Of Diseases ◽  
Ethical Practice ◽  
Party Payer ◽  
High Frequency Audiometry ◽  
Icd 10

Purpose Improved medical care leading to increased survivorship among patients with cancer and infectious diseases has created a need for ototoxicity monitoring programs nationwide. The goal of this report is to promote effective and standardized coding and 3rd-party payer billing practices for the audiological management of symptomatic ototoxicity. Method The approach was to compile the relevant International Classification of Diseases, 10th Revision (ICD-10-CM) codes and Current Procedural Terminology (CPT; American Medical Association) codes and explain their use for obtaining reimbursement from Medicare, Medicaid, and private insurance. Results Each claim submitted to a payer for reimbursement of ototoxicity monitoring must include both ICD-10-CM codes to report the patient's diagnosis and CPT codes to report the services provided by the audiologist. Results address the general 3rd-party payer guidelines for ototoxicity monitoring and ICD-10-CM and CPT coding principles and provide illustrative examples. There is no “stand-alone” CPT code for high-frequency audiometry, an important test for ototoxicity monitoring. The current method of adding a –22 modifier to a standard audiometry code and then submitting a letter rationalizing why the test was done has inconsistent outcomes and is time intensive for the clinician. Similarly, some clinicians report difficulty getting reimbursed for detailed otoacoustic emissions testing in the context of ototoxicity monitoring. Conclusions Ethical practice, not reimbursement, must guide clinical practice. However, appropriate billing and coding resulting in 3rd-party reimbursement for audiology services rendered is critical for maintaining an effective ototoxicity monitoring program. Many 3rd-party payers reimburse for these services. For any CPT code, payment patterns vary widely within and across 3rd-party payers. Standardizing coding and billing practices as well as advocacy including letters from audiology national organizations may be necessary to help resolve these issues of coding and coverage in order to support best practice recommendations for ototoxicity monitoring.

Business: The Electronic Health Record: Front Line Experience

2011 ◽  
Vol 21 (1) ◽  
pp. 18-22
Author(s):  
Rosemary Griffin
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Electronic Health Record ◽  
Financial Incentives ◽  
Best Practice ◽  
Health Care Systems ◽  
The United States ◽  
Health Record ◽  
Health Trends ◽  
Electronic Health

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

Reliability of the Conversational Interaction Coding Form When Applied to Natural Conversation of Individuals With Aphasia

2010 ◽  
Vol 20 (4) ◽  
pp. 125-135 ◽  
Author(s):  
Ashley Pozzolo Coote ◽  
Jane Pimentel
Keyword(s):  
Best Practice ◽  
Interobserver Reliability ◽  
Training Session ◽  
Clinical Tool ◽  
Group Setting ◽  
Conversational Interaction ◽  
Video Recordings ◽  
Aphasia Therapy ◽  
Natural Conversation ◽  
Point To Point

Purpose: Development of valid and reliable outcome tools to document social approaches to aphasia therapy and to determine best practice is imperative. The aim of this study is to determine whether the Conversational Interaction Coding Form (CICF; Pimentel & Algeo, 2009) can be applied reliably to the natural conversation of individuals with aphasia in a group setting. Method: Eleven graduate students participated in this study. During a 90-minute training session, participants reviewed and practiced coding with the CICF. Then participants independently completed the CICF using video recordings of individuals with non-fluent and fluent aphasia participating in an aphasia group. Interobserver reliability was computed using matrices representative of the point-to-point agreement or disagreement between each participant's coding and the authors' coding for each measure. Interobserver reliability was defined as 80% or better agreement for each measure. Results: On the whole, the CICF was not applied reliably to the natural conversation of individuals with aphasia in a group setting. Conclusion: In an extensive review of the turns that had high disagreement across participants, the poor reliability was attributed to inadequate rules and definitions and inexperienced coders. Further research is needed to improve the reliability of this potentially useful clinical tool.

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