Learning from Practitioners: Making adolescent-focused RCTs work (better) in ...StephanieHall57
Helped in developing and presenting a group presentation at the 2017 AEA Conference in Washington D.C. The presentation focused on several adolescent-focused Randomized Controlled Trials that my company was implementing and strategies we found to improve implementation in the various settings. The area that I presented was the Lessons Learned from Implementing an Adolescent-focused RCT in Mental Health Settings.
Utah Diabetes Telehealth Program --
Wednesday, August 19, 2009
12:00 p.m. - 1:00 p.m. (MDT)
To participate visit http://health.utah.gov/diabetes/telehealth/telehealth.html
Carol Rasmussen, MSN, NP-C, CDE is a nurse practitioner with many years of experience treating patients with diabetes. Currently Ms. Rasmussen practices at the Exodus Healthcare Network in Magna, Utah and also serves on the AADE Editorial Advisory Board for The Diabetes Educator publication. Moreover, Ms. Rasmussen received the Legislative Leadership Award from the American Association of Diabetes Educators at their 2009 Conference in Atlanta.
Her presentation will cover the challenges of increasing access to diabetes education and strategies for overcoming such obstacles, as well as various tools/resources/programs from AADE.
Eshlsg medical-education-survey-results-june2013Market iT
In July 2013 at the BMJ/ABPI Conference on medical education the ESHLSG made public the results of its survey on attitudes to industry support of medical education.
Learning from Practitioners: Making adolescent-focused RCTs work (better) in ...StephanieHall57
Helped in developing and presenting a group presentation at the 2017 AEA Conference in Washington D.C. The presentation focused on several adolescent-focused Randomized Controlled Trials that my company was implementing and strategies we found to improve implementation in the various settings. The area that I presented was the Lessons Learned from Implementing an Adolescent-focused RCT in Mental Health Settings.
Utah Diabetes Telehealth Program --
Wednesday, August 19, 2009
12:00 p.m. - 1:00 p.m. (MDT)
To participate visit http://health.utah.gov/diabetes/telehealth/telehealth.html
Carol Rasmussen, MSN, NP-C, CDE is a nurse practitioner with many years of experience treating patients with diabetes. Currently Ms. Rasmussen practices at the Exodus Healthcare Network in Magna, Utah and also serves on the AADE Editorial Advisory Board for The Diabetes Educator publication. Moreover, Ms. Rasmussen received the Legislative Leadership Award from the American Association of Diabetes Educators at their 2009 Conference in Atlanta.
Her presentation will cover the challenges of increasing access to diabetes education and strategies for overcoming such obstacles, as well as various tools/resources/programs from AADE.
Eshlsg medical-education-survey-results-june2013Market iT
In July 2013 at the BMJ/ABPI Conference on medical education the ESHLSG made public the results of its survey on attitudes to industry support of medical education.
We share the key insights from a nation wide 2014 quantitative research study to separate the "nice to haves" from the "must haves" when it comes to health cover
HSA 525 RANK Education Your Life / hsa525rank.comkopiko6
FOR MORE CLASSES VISIT
www.hsa525rank.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
FOR MORE CLASSES VISIT
www.hsa525rank.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
For more course tutorials visit
www.newtonhelp.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
Question 2This committee develops blood usage policies and procedures. It is responsible for monitoring transfusion services and reviewing indications for transfusions, blood ordering practices, each transfusion episode, and transfusion reactions. The committee reports its findings and recommendations to the medical staff executive committee.
For more course tutorials visit
www.tutorialrank.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
Question 2This committee develops blood usage policies and procedures. It is responsible for monitoring transfusion services and reviewing indications for transfusions, blood ordering practices, each transfusion episode, and transfusion reactions. The committee reports its findings and recommendations to the medical staff executive committee.
We share the key insights from a nation wide 2014 quantitative research study to separate the "nice to haves" from the "must haves" when it comes to health cover
HSA 525 RANK Education Your Life / hsa525rank.comkopiko6
FOR MORE CLASSES VISIT
www.hsa525rank.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
FOR MORE CLASSES VISIT
www.hsa525rank.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
For more course tutorials visit
www.newtonhelp.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
Question 2This committee develops blood usage policies and procedures. It is responsible for monitoring transfusion services and reviewing indications for transfusions, blood ordering practices, each transfusion episode, and transfusion reactions. The committee reports its findings and recommendations to the medical staff executive committee.
For more course tutorials visit
www.tutorialrank.com
Question 1 The committee responsible for developing and/or approving policies relating to the handling and administration of drugs
Question 2This committee develops blood usage policies and procedures. It is responsible for monitoring transfusion services and reviewing indications for transfusions, blood ordering practices, each transfusion episode, and transfusion reactions. The committee reports its findings and recommendations to the medical staff executive committee.
Depression and Inclusion in Secondary and Middle Schooljordanswain
Suicide is the third leading cause of death for young people ages 15 to 24. For every adolescent who is affected by depression, there are friends, family, and educators who can help. Helping is not always easy. Spotting the red flags are only the first step. Once we get help for students who need it, what is the best way to include them in our classrooms? Here are a few ideas.
Here are some resources that might be helpful to teachers and students:
www.nami.org: National Alliance on Mental Illness, a great place to start when looking for information, help, and support.
www.nimh.nih.gov: National Institute of Mental Health, a wonderful source for current research and studies surrounding mental disorders. This site aims to “transform the understanding and treatment of mental illness through research”.
www.healthyplace.com: Information on psychological disorders and psychiatric medications from both a consumer and expert point of view. They have an "active mental health social network for support, online psychological tests, breaking mental health news, mental health videos, documentary films, a live mental health tv show, unique tools like their "mediminder" and more."
http://www.lineajohnson.blogspot.com/ A blog my a young woman who has been through it all, and has lived to tell. Articulate and intelligent, Linea represents young people with bipolar disorder. She has an agent and a book may be coming soon... full disclosure, this is my little sister.
http://www.bringchange2mind.org/ An organization dedicated the ending the stigma of mental illness. This is spearheaded by Glenn Close and her sister, Jessie.
Please help to end the negative stigma attached to mental illness. Educate your students and remember that everyone is somebody’s beloved baby.
Designing and Building Culture at a Startup: Three Key Elements to Keep in MindRishi Dean
These slides were used for a talk I gave to MBA students at the Carroll School of Management at Boston College, in the "Managing People in Organizations" class. The lecture was on culture, and my task was to provide them with the perspective of creating a culture at a startup, and the unique challenges that come with that along the way. I gave them a little framework, called the "Three Ps", to help the think about the key issues in culture creation. The bottom line here is that culture matters, and at a startup its especially hard to create and maintain.
Respond to the post bellow by comparing your assessment tool .docxcwilliam4
Respond to the post bellow
by comparing your assessment tool to theirs.
NOTE: my assessment tool: The patient Health Questionnaire (PHQ-9
Main Post
According to the American Academy of Child and Adolescent Psychiatry (1995), children and adolescents are evaluated due to psychiatric disorders that impair emotional, cognitive, physical, and/or behavioral functioning. The child or adolescent is evaluated in the context of the family, school, community, and culture. The purpose and aims of the clinical diagnostic assessment are to determine whether psychopathology is present and, if so, to establish a differential diagnosis and tentative diagnostic formulation, to develop a treatment recommendation and plan, or to communicate the above findings in an appropriate fashion to the parents and child. In addition, the aims of the assessment process are to identify the stated reasons and factors leading to the referral, to assess the nature and severity of the child's behavioral difficulties, functional impairments, subjective distress, and to identify individual, family, or environmental factors that may potentially account for, influence, or ameliorate these difficulties. When assessing children, parents’ interviews and school functioning reports are necessary.
The assessment tool I will discuss in this post is the Screen for Child Anxiety Related Emotional Disorders (SCARED). Per the University of Pittsburg (2019), SCARED is a child and parent self-report instrument used to screen for childhood anxiety disorders including general anxiety disorder, separation anxiety disorder, panic disorder, and social phobia. In addition, it assesses symptoms related to school phobia. The SCARED consists of 41 items and 5 factors that parallel the DSM-IV classification of anxiety disorders. The child and parent versions of the SCARED have moderate parent-child agreement and good internal consistency, test-retest reliability, and discriminant validity, and it is sensitive to treatment response
Target population
:
Children ages 8-18 years
Intended users
:
Clinicians and Psychiatrists
Time to Administer
:
10 minutes
Completed by
:
Children and Parents
How to Use SCARED
: SCARED is a questionnaire with scales that describes how people feel. Clients read each phrase and decide if it is “Not True or Hardly Ever True” or “Somewhat True or Sometimes True” or “Very True or Often True”. Then, for each sentence, they fill in one circle that corresponds to the response that seems to describe them for the last 3 months. After each phrase and circles, there are abbreviations of the various disorders. Therefore,
a total score of >25 may indicate the presence of an
Anxiety Disorder
. Scores higher than 40 are more specific.
A score of 7 for items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38 may indicate
Panic Disorder or Significant Somatic Symptoms (PN).
A score of 9 for items 5, 7, 14, 21, 23, 28, 33, 35, 37 may.
Developmental delay Identification and managementOlaAlkhars
Objectives
•Definitions
•Benefits and Possible harms of developmental surveillance and screening
•Combining Screening and Surveillance Practice Algorithm
Before moving through diagnostic decision making, a social worke.docxtaitcandie
Before moving through diagnostic decision making, a social worker needs to conduct an interview that builds on a biopsychosocial assessment. New parts are added that clarify the timing, nature, and sequence of symptoms in the diagnostic interview. The Mental Status Exam (MSE) is a part of that process.
The MSE is designed to systematically help diagnosticians recognize patterns or syndromes of a person’s cognitive functioning. It includes very particular, direct observations about affect and other signs of which the client might not be directly aware.
When the diagnostic interview is complete, the diagnostician has far more detail about the fluctuations and history of symptoms the patient self-reports, along with the direct observations of the MSE. This combination greatly improves the chances of accurate diagnosis. Conducting the MSE and other special diagnostic elements in a structured but client-sensitive manner supports that goal. In this Assignment, you take on the role of a social worker conducting an MSE.
To prepare:
Watch the video describing an MSE. Then watch the Sommers-Flanagan (2014) “Mental Status Exam” video clip. Make sure to take notes on the nine domains of the interview.
Review the Morrison (2014) reading on the elements of a diagnostic interview.
Review the 9 Areas to evaluate for a Mental Status Exam and example diagnostic summary write-up provided in this Week’s resources.
Review the case example of a diagnostic summary write-up provided in this Week’s resources.
Write up a Diagnostic Summary including the Mental Status Exam for Carl based upon his interview with Dr. Sommers-Flanagan.
By Day 7
Submit
a 2- to 3-page case presentation paper in which you complete both parts outlined below:
Part I: Diagnostic Summary and MSE
Provide a diagnostic summary of the client, Carl. Within this summary include:
Identifying Data/Client demographics
Chief complaint/Presenting Problem
Present illness
Past psychiatric illness
Substance use history
Past medical history
Family history
Mental Status Exam (Be professional and concise for all nine areas)
Appearance
Behavior or psychomotor activity
Attitudes toward the interviewer or examiner
Affect and mood
Speech and thought
Perceptual disturbances
Orientation and consciousness
Memory and intelligence
Reliability, judgment, and insight
Part II: Analysis of MSE
After completing Part I of the Assignment, provide an analysis and demonstrate critical thought (supported by references) in your response to the following:
Identify any areas in your MSE that require follow-up data collection.
Explain how using the cross-cutting measure would add to the information gathered.
Do Carl’s answers add to your ability to diagnose him in any specific way? Why or why not?
Would you discuss a possible diagnosis with Carl at time point in time? Why?
Support Part II with citations/references. The DSM 5 and case study
do not
need to be cited. Utilize the o.
Reflective practice is the innovative way of learning through your own actions. This enhance the critical thinking abilities through forming strategies to overcome and prevent the same mistake happening again.
Neurodevelopmental Treatment and Cerebral Palsy- Researchda5884
An alternative description of my Critically Appraised Topic on Neurodevelopmental treatment when used on children with cerebral palsy. This presentation focuses more on the process of the research.
ITS 835 enterprise risk managementChapter 15Embedding ERM in.docxjesssueann
ITS 835 enterprise risk management
Chapter 15
Embedding ERM into Strategic Planning at the City of Edmonton
University of Cumberlands
1
introduction
Edmonton –Past and present ERM
Links to strategic plan and to other strategic tools
Selecting and testing tools and framework
Recommended strategic ERM approach
Lessons learned
2
University of Cumberlands
Edmonton past and present erm
Edmonton –Capital of Alberta, Canada
Over 800,00 population
ERM piloted in 2005
CORPORATE Business Risk Planning (CBRP) model
Not fully implemented
Based on COSO
Adopted strategic plan
The Way Ahead
Strategic ERM
3
University of Cumberlands
Links to strategic plan
University of Cumberlands
4
Selecting and testing tools and framework
5
University of Cumberlands
Selecting and testing tools and frameworks
University of Cumberlands
6
Strategic goals and objectives
University of Cumberlands
7
Risks and strategic objectives
University of Cumberlands
8
Iso 31000 risk management
University of Cumberlands
9
Pm2 versus iso 31000
University of Cumberlands
10
Proposed erm framework
University of Cumberlands
11
Lessons learned
Key success factors
Senior management buy-in
Culture of innovation
Consistency of model across goals
Resource requirements for department SMEs
Department accountability for key risks
Process of selecting and implementing framework
Takes linger than expected
No system is perfect
Do not roll out all at once
Clearly define all milestones and deliverables
University of Cumberlands
12
CHAPTER NINE
Medicating Children
This chapter is divided into seven sections. Section One is an overview that discusses current trends in medicating children, problems the trends cause, and directions for the future. It also discusses developmental issues. Section Two focuses on stimulant medication and the diagnosis of attention deficit hyperactivity disorder (ADHD). Section Three focuses on research on combined interventions and particularly the Multimodal Treatment Study (MTA study) of Children with ADHD. Section Four focuses on children taking mood stabilizers. Section Five focuses on antipsychotics and children. Sections Six and Seven focus on anxiolytics and antidepressants in children, respectively.
SECTION ONE: PERSPECTIVES, DILEMMAS, AND FUTURE PARADIGMS
Learning Objectives
• Understand the problematic increase in psychotropic medications for children despite a dearth of evidence of the effectiveness of these drugs.
• Have a general understanding of the impact of the FDA Modernization Act and the Best Pharmaceuticals Act for Children.
• Be able to state the “developmental unknowns” associated with giving kids psychotropic medications.
Thus far, we have explored the medical model and psychological, cultural, and social perspectives as they relate to psychopharmacology. In this chapter, we demonstrate that using psychotropic medications with children and adolescents raises particular problems and concerns fro ...
Copyright 2020 Foundation of the American College of Healthcare AlleneMcclendon878
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Marketing Health Services
Fourth Edition
Richard K. Thomas, PhD
Health Administration Press
Part I
Healthcare Marketing: History and Concepts
The Origin and Evolution of Marketing in Healthcare
Basic Marketing Concepts
Marketing and the Healthcare Organization
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Chapter 2
Basic Marketing Concepts
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Chapter 2 objectives
Define key marketing terms
Review the functions of marketing
Introduce traditional marketing techniques
Review targeting approaches
Describe healthcare products and their users
Introduce the four Ps of marketing
Describe marketing support services
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Key marketing terms
Marketing
Healthcare marketing
Market
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
The functions of marketing
Enterprise-wide functions
Operational functions
Educational functions
Promotional functions
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Overview of traditional marketing techniques
Public relations
Communication
Community outreach
Government relations
Networking
Sales promotion
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Overview of traditional marketing techniques (continued)
Advertising
Personal sales
Database marketing
Direct marketing
Customer relationship marketing
Social marketing
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Target levels
Mass marketing
Target marketing
Micromarketing
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Healthcare products and their users
Products
Ideas
Goods
Services
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Healthcare products and their users
Users
Consumers
Customers
Clients
Patients
Enrollees
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
Patients versus other categories
Patients differ in terms of:
Official status (“vetted” by physician)
Degree of subservience
Relationship with clinician
Ability to control circumstances
Expectations with regard to care
Copyright 2020 Foundation of the American College of Healthcare Executives. Not for sale.
Health Administration Press
The four Ps of marketing
Product
Price
Place
Promotion
Copyright 20 ...
PAGE
20
Dissertation Prospectus
Factors Influencing Individuals' Decision to Utilize Mental Health in South Texas
Submitted by:
The Prospectus Overview and Instructions
Prospectus Instructions:
1. Read the entire Prospectus Template to understand the requirements for writing your prospectus. Each section contains a narrative overview of what should be included in the section and a table with required criteria for each section. WRITE TO THE CRITERIA, as they will be used to assess the prospectus for overall quality and feasibility of your proposed research study.
2. As you draft each section, delete the narrative instructions and insert your work related to that section. Use the criterion table for each section to ensure that you address the requirements for that particular section. Do not delete/remove the criterion table as this is used by you and your committee to evaluate your prospectus.
3. Prior to submitting your prospectus for review by your chair or methodologist, use the criteria table for each section to complete a realistic self-evaluation, inserting what you believe is your score for each listed criterion into the Learner Self-Evaluation column. This is an exercise in self-evaluation and critical reflection, and to ensure that you completed all sections, addressing all required criteria for that section.
4. The scoring for the criteria ranges from a 0-3 as defined below. Complete a realistic and thoughtful evaluation of your work. Your chair and methodologist will also use the criterion tables to evaluate your work.
5. Your Prospectus should be no longer than 6-10 pages when the tables are deleted.
Score
Assessment
0
Item Not Present
1
Item is Present. Does Not Meet Expectations. Revisions are Required: Not all components are present. Large gaps are present in the components that leave the reader with significant questions. All items scored at 1 must be addressed by learner per reviewer comments.
2
Item is Acceptable. Meets Expectations.Some Revisions May Be Required Now or in the Future. Component is present and adequate. Small gaps are present that leave the reader with questions. Any item scored at 2 must be addressed by the learner per the reviewer comments.
3
Item Exceeds Expectations. No Revisions Required. Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions. No changes required.
Dissertation Prospectus
Introduction
Southern Texas encompasses different groups of people whose behavior, gender identity, and gender expression varies depending on cultural identity and norms. About a quarter of individuals in United States have a history or are experiencing a mental disorder with approximately 6% of the population having critical mental illness. These mental problems typically affect the general well-being of an individual. For instance, patients living with severe mental disorders are more likely to die in average of twenty-six years earlier than the average ...
There are many challenges to achieving an accurate census count in 2010. Educating yourselves about the barriers to participation and motivators to respond will help your organization use effective communication strategies and messages in the upcoming months.
Providing oral care to people with autism requires adaptation of the skills you use every day. In fact, most people with mild or moderate forms of autism can be treated successfully in the general practice setting
As in the past, MPCA will again present an immunization update on influenza vaccines. Both Seasonal Flu vaccine and H1N1 flu vaccine will be included in this presentation.
This “Customer Service Excellence Training” slideshow is geared to help participants understand:
- The principles of strong customer service
- The concept of internal and external customer service
- Ideas for customer service improvement within their workplace
Presented at the annual Health Center Board Member Training, this presentation focuses on the core principles of legislative advocacy as it relates to MPCA and CHCs in Michigan.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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9. Defining a Positive Screen Cut-off point defining a positive screen: Total Score ≥ 30 - 14% of 13-18 year olds in a SBHC located in a small city scored positive - 20% of 9-14 year olds in an inner-city public school OR Recent Suicidal Ideation Reported - 3% of 11-18 year olds endorsed SI on the DPS in a PC sample OR Past Suicide Attempt Reported - 2% of 11-18 year olds endorsed SA on the DPS in a PC sample
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11. Interpreting the Results These are the problem areas addressed by the PSC-Y and the most critical items associated with them. Symptoms endorsed as “often” are of greatest significance.
17. Reimbursement Codes The Modifier 25 should be added to the visit to indicate that a significant, separately identifiable E/M service was performed in addition to the preventive medicine visit. Evaluation/ Management CPT Codes Initial assessment can involve a lot of time determining the differential diagnosis, a diagnostic plan and potential treatment options. Therefore, most pediatricians will report either an evaluation and management code using time as the key factor or a consultation code for the initial assessment. New Patients 99201 99202 (20 minutes) 99203 (30 minutes) 99204 (45 minutes) 99205 (60 minutes) Established Patients 99212 (10 minutes) 99213 (15 minutes) 99214 (25 minutes) 99215 (40 minutes) 99216
20. Reimbursement Codes 96110: Developmental Screening 96111: Developmental Testing In 2003, two CPT codes were approved by the Centers for Medicare and Medicaid Services (CMS) specifically related to developmental and behavioral screening in pediatrics:
26. Teen Brochure with PSC-Y A free brochure designed for adolescent patients that contains the PSC-Y screening questionnaire and information about mental health screening. This brochure can be placed in the waiting room so that patients can access the screening questionnaire on their own or it can be handed out to patients as they come in for their appointment. Available in English and Spanish.
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28. Free, Supplemental Materials Available Upon Request Mental Health Checkup Resource Guide Provides additional materials you may find helpful to your implementation of mental health checkups. Post-Screening Interview Resources Includes post-screening interview checklist, information for conducting a suicide risk assessment and sample questions by symptom area. Tips for Integrating Mental Health Checkups into Your Practice A slide presentation is available for providers who are interesting in learning more about the logistics of mental health screening and receiving tips for integrating mental health checkups into their practices. TeenScreen Web Site Learn more about TeenScreen Primary Care at: http://www.teenscreen.org/teenscreen-primary-care
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Editor's Notes
Introduction of TeenScreen Primary Care Teen mental illness and suicide are significant and prevalent problems for adolescents. One in ten American children suffer from mental illness, but only 2/3 of them get the help that they need. Further, suicide is the third leading cause of death for youth ages 11-18 in our country. Mental health checkups are a routine screening test for adolescent patients that can quickly identify underlying mental health problems that may be undiagnosed, contributing to physical symptoms or creating risk for harmful behaviors (drug, alcohol abuse or suicide). The way these checkups work is by having patients complete a brief validated screening questionnaire that can alert the child’s primary care provider if that patient may be suffering from mental health problems – screening can easily be incorporated into regular healthcare visits for adolescent patients. TeenScreen Primary Care is a mental health checkup initiative being offered through the TeenScreen National Center for Mental Health Checkups. This presentation will review how to incorporate mental health check-ups into routine adolescent office visits, as part of a comprehensive approach to healthcare.
Columbia University’s model for providing mental health checkups to adolescent patients gives doctors and medical professionals evidence-based practices and tools to screen adolescent patients for mental illness and suicide risk. Columbia University makes tools, materials and resources available to providers who are interested in implementing mental health check-ups for 11-18 year old patients at no cost. Mental health checkups through screening are becoming a standard of care in medicine and are being recognized at the national level. The AAP calls for and supports confidential screening and referral for behavioral and mental health problems in patients, one of the many groups who support screening. SAM supports the early identification of mental illness as a critical standard of care Mental health check-ups are a quick and easy way for medical providers to evaluate teen patients for potential mental health problems and concerns. Screening can be incorporated into a number of regular visits with adolescent patients, like well child visits, sports or regular health physicals, sick visits, etc. The primary focus of mental health checkups is three-fold: The early identification of mental illness Suicide prevention And, the piece that takes that identification one step further – not only identifying those who may be at-risk for mental illness and suicide, but to also linking them and their families with appropriate services or help. In other words, it is not just the process of completing a questionnaire, but also providing options for how to assist patients and their families once they are identified as being at possible risk.
In order to begin thinking about how this process may work best for you, there are a few things that it will be helpful to consider as you prepare to implement mental health checkups in your practice. The points on this slide highlight some of the logistical pieces that will be helpful to consider as you think about mental health checkups and how they might work in your setting. Determining when and to whom screening will be offered and administered Establish a referral network and develop a list of providers to share with families of patients who receive a referral Discuss how the questionnaire will be administered and scored and how the results will get into the hands of the PCP Where will the post-screening interview/ exam be conducted Who will notify parents of the screening results, assist families in need of a referral and activate the referral process. Columbia University also has other tools and supportive materials to provide additional supports in the implementation of screening, available at your request.
This section provides an overview of the screening questionnaire, the Pediatric Symptom Checklist (PSC-Y).
PSC-Y The Pediatric Symptom Checklist, Youth Completion version, was developed by clinicians at Harvard University. It is a 35-item self-report that identifies patients at-risk for psychosocial dysfunction and has questions that cover attention, externalizing and internalizing problems. In addition to the 35 items, there are two items from the Columbia Suicide Screen that ask specifically about suicidality. Takes less than 5 minutes to complete and score. PSC is a very widely used questionnaire and has been validated for use in pediatric primary care settings. Administering the PSC-Y It is recommended that the questionnaire is administered and scored before the patient’s exam with the PCP to ensure that once the patient takes the questionnaire, their results are reviewed by the doctor. The questionnaire can be administered during the office visit and can be scored by a nurse, med technician or other office staff. Recommended that patients are left alone in a private location to complete the questionnaire (to ensure that they feel comfortable answering the questions honestly) and that they are informed of their rights to confidentiality. It’s also a good idea to inform parents that a mental health checkup will be administered as part of their child’s regular exam.
Here is a sample of the PSC. There are 35 items, each item has 1 of 3 answer choices, (never, sometimes and often). You will also notice that toward the bottom of the screen, the 2 questions that focus on suicidality. Previous research has shown that there is a 14-20% screen positive rate (just to give you a general idea of what to expect). There also a little space on the bottom to write in the total score, comments and also to record the recommended next steps for that particular patient.
Each of the rankings (never, sometimes and often) are assigned a number value to help calculate the score (0, 1, 2). To calculate the score of the questionnaire, you add all of the item scores together (which will give you a range 0-70). For the purposes of scoring, you should note if either suicide question has been endorsed. You should also note if any items are left blank. If any of the 35 items are left blank, they are scored as 0, however if 4 or more items are left blank, the questionnaire is considered invalid. If either of the suicide questions are left blank, the PCP should address this in their post-screening interview with the patient.
An overall score that is greater than or equal to 30, or endorsement of either suicide question, defines a positive score. Previous research has shown that there is a 14-20% screen positive rate on the PSC (without the suicide questions; just to give you a general idea of what to expect).
A positive score on the PSC-Y suggests the need to further evaluate the patient to further assess the symptoms reported on the questionnaire to determine if they are significant, causing impairment and warrant a referral for further evaluation or treatment. The results of the PSC-Y are not meant to be a diagnosis – both false positives and false negatives can occur, which underscores the importance of the post-screening interview with the PCP, with all patients. Studies on PSC-Y show that 2 out of 3 teens who score positive are correctly identified as having moderate to serious impairment 96% accuracy on negative screens (1 out of 20 teens who score negative may be impaired)
This slide highlights the main problem areas addressed by the PSC-Y and the most critical items associated with them. If a patient scores positive and their answers are weighted toward one problem area, it suggests the need to further evaluate the patient for disorders commonly associated with that problem area. Symptoms reported on the PSC-Y as “often” are of greatest significance. PSC-Y also contains questions about functioning and impairment, which should also be reviewed with the patient. It is recommended that the PCP also briefly reviews the symptoms endorsed as “sometimes” and “often” with patients that score negative.
Once the provider has reviewed the results of the PSC-Y, it is recommended that they conduct a post-screening interview as part of the patients exam to discuss the results of screening.
It is suggested that the results of the screening are discussed with all patients as part of their exam, regardless if their score is positive or negative. Patients that score positive on the questionnaire are briefly evaluated by the PCP to explore symptoms endorsed on the questionnaire, including those related to functioning and impairment (to determine level of impairment caused by symptoms at school, at home or with peers). This discussion with the patient should focus on the main areas of concern identified by the screen. It may be helpful to see if the answers cluster by internal, external or attention problems. It is recommended that you inquire about suicidal thoughts and behaviors with all patients that score positive. Parent Notification & Referral It is recommended that the PCP provides feedback to the parents regardless of the screening results. For those who are identified as positive, we recommend informing parents of the positive results, clinical recommendations, suicidal thinking or any suicidal behavior reported. You may want to educate parents about their children’s mental health needs to underscore the importance of obtaining appropriate services. When a referral is recommended, staff should assist the family with connected to a local mental health provider, who can provide a complete mental health evaluation. In addition, it is recommended that you pull together a list of referral resources to share with parents who receive a referral for their child. TeenScreen has additional materials and tools to assist with conducting the post-screening interview, including a suicide risk assessment, checklist and sample questions by symptom area and with notifying parents and making a referral.
AACAP has developed a number of recommendations for primary care providers on when to seek a referral or consultation with a child psychiatrist; these recommendations may be useful as you determine when to refer patients for mental health concerns. Referrals for ongoing evaluation and treatment Referral for evaluation and initial treatment with referral back for continued care Consultation and evaluation with continued supervision of treatment provided by other practitioners Consultation without face-to-face evaluation of the patient
Additional Guidelines developed by AACAP to provide guidance around when PCPs should refer patients: If there is a threat to safety of the patient or of others (e.g., actively suicidal) If there is a significant change in emotional or behavioral functioning for which there is no obvious or recognized precipitant The child’s primary caretaker has serious emotional impairment or substance use problem If there is evidence of significant disruption in day to day functioning If the adolescent has had a course of treatment for 6 to 8 weeks without meaningful improvement If the adolescent presents with complex diagnostic issues If there is a history of abuse, neglect or removal from home If symptoms and family psychiatric history suggests that treatment with medication may result in adverse response If child has had only a partial response to a course of medication When a behavior seriously interferes with the treatment of a chronic medical condition
TeenScreen has put together references and information on obtaining reimbursement for screening. Mental health assessments and discussions with patients and families can be time and resource intensive. The information provided on the following slides is designed to assist providers with helpful tips for obtaining reimbursement through a number of insurance carriers. It is recommended that providers consult with their office’s coding and billing staff to determine the combination of codes that will work best for mental health checkups. It may be helpful to first determine what type of visit mental health checkups will be incorporated into (e.g., well-child, sick visits, sports physicals, etc) and to examine what codes are currently being used for that type of visit to determine if the codes provided below can be used in conjunction with what is already being used.
There are a number of Evaluation and Management CPT Codes that can potentially be used to bill for screening. When counseling and/ or coordination of care dominates (more than 50%) the physician patient and/ or family encounter, then time may be considered the controlling factor to qualify for a particular level of E/M service. These codes use time as the key factor in the patients appointment. When using these codes, a modifier 25 can be added to the visit. Modifier 25 tells insurers that the particular visit is different; it should be added to the office/ outpatient visit to indicate that a significant, separately identifiable E/M service was performed in addition to the preventive medicine visit. Please note, however, many insurers do not recognize nor reimburse for modifier 25.
ICD-9 Diagnosis Codes/ V Codes for preventative health visits that may be used: V20.0 – typically used to code for general well child visits V79.8 – can be used to code for negative screening results V40.9 – can be used to code for positive screening results
This slide highlights a fact sheet that was developed by the AAP that provides guidelines on coding for pediatric preventative care, and includes information about some the CPT and ICD-9 codes we just discussed. This fact sheet is available in the Mental Health Checkup Resource Guide, available at your request.
In 2003, the two CPT codes below were approved by the Centers for Medicare and Medicaid Services (CMS) specifically relating to developmental and behavioral screening in pediatrics. Reimbursement rates for these codes are determined at the state level and generally cover the cost of administering and scoring one screening questionnaire. 96110: Developmental Screening 96111: Developmental Testing
This fact sheet developed by the AAP provides additional information for the two CMS codes and how they may be used. It lists the PSC as one of the sample screening tools that can be used in primary care under the 96110 CPT code. This fact sheet is also available in the Mental Health Checkup Resource Guide, available at your request.
The Mid-America Coalition on Health Care developed a work group of key stakeholders to collaboratively address the complexities surrounding diagnosis, coding and reimbursement for the management of depression in primary care. As a result, two fact sheets for primary care depression reimbursement were developed – some of the codes we just discussed are explored. Two fact sheets, available in Mental Health Checkup Resource Guide.
AAP Bright Futures Toolkit also has a section that provides information on CPT codes that may be used for screening. Bright Futures: The information and resources in this guide provide primary care health professionals with the tools they need to promote mental health in children, adolescents and their families. This excerpt from the toolkit provides information on selected CPT codes, and also includes a template letter that providers can use for documentation of the reimbursement.