Australian coder workforce survey 2002 - managers’ responses

In 1994–5, the Health Information Management Association of Australia (HIMAA) Ltd conducted a nation-wide survey of clinical coders working in Australian hospitals. The survey (National Coder Workforce Issues Project (NCWIP) funded by the then Commonwealth Department of Human Services and Health) provided baseline data about the coder workforce in terms of its size, the educational backgrounds of coders, circumstances relating to their employment and their needs in terms of continuing support and training. Importantly, the survey was conducted before casemix-based classification and funding had been implemented by all states and territories. It has now been nearly eight years since the original survey was conducted and casemix is in use in some form in all states and territories

Correlates of undefined cause of injury coded mortality data in Australia

The objective of this research was to identify the level of detail regarding the external causes of death in Australia and ascertain problematic areas where data quality improvement efforts may be focused. The 2003 national mortality dataset of 12591 deaths with an external cause of injury as the underlying cause of death (UCOD) or multiple cause of death (MCOD) based on ICD-10 code assignment from death certificate information was obtained. Logistic regression models were used to examine the precision of coded external cause of injury data.---- It was found that overall, accidents were the most poorly defined of all intent code blocks with over 30% of accidents being undefined, representing 2314 deaths in 2003. More undefined codes were identified in MCOD data than for UCOD data. Deaths certified by doctors were more likely to use undefined codes than deaths certified by a coroner or government medical office.---- To improve the quality of external cause of injuries leading to or associated with death, certifiers need to be made aware of the importance of documenting all information pertaining to the cause of the injury and the intent behind the incident, either through education or more explicit instructions on the death certificate and accompanying instructional materials. It is important that researchers are aware of the validity of the data when they make interpretations as to the underlying causes of fatal injuries and causes of injury associated with deaths

The Value of Academic Affairs and Student Affairs Collaboration: Living-Learning Communities at Historically Black Colleges and Universities

Too often Historically Black Colleges and Universities (HBCUs) function and operate in silos when addressing the academic and social needs of students. Many departments within universities tend to stay in their own lanes and want others to do the same. Both groups realize that collaboration is vital to the success of the institution, but faculty are overwhelmed with the demands of teaching assignments and student affairs professionals are challenged to meet the many demands and needs of students, so the two groups never unite. Acknowledging that a great deal of time and energy is required for true collaboration; the units fail to allocate time to discuss how both groups can best support students’ success. In a time of diminishing resources and a move toward performance based funding, it is important for HBCUs to reconsider educational reform efforts that will positively impact retention and graduate rates. Each group (academic affairs and student affairs) has a unique approach to reaching these goals and when they work together, the results will ultimately promote graduation and increase retention

A critical appraisal of “A Multicenter Randomized Double-Blind Study: Comparison of the Epley, Semont, and Sham Maneuvers for the Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo”

This paper is a critical appraisal of an article that compares the efficacy of 3 maneuvers in decreasing symptoms of Benign Paroxysmal Positional Vertigo (BPPV). I found this article using the Texas Tech Library Portal. The article contained both strengths and weaknesses in the sections of introduction, method, results, and discussion. Some strengths include the introduction providing a good explanation and delivering background information on what exactly BPPV is and ways to provoke symptoms. Another strength is the intervention of the experiment is easily replicable by some other individuals in the future, and the authors do a fantastic job of analyzing and explaining the results of the experiment. The article does not have many weaknesses, but those that are evident and apparent cannot be overlooked. The authors do not explain the process of how the assessors recorded the effects of the treatment, what tool was used, nor the procedure of data collection. In addition, the location of where the study took place was never mentioned. These things ultimately make the experiment irreplicable by other others in an additional experiment. In the end the weaknesses addressed in my paper generated too much skepticism and lead me to draw the conclusion that this is not a reliable source

Home hemodialysis: a comprehensive review of patient-centered and economic considerations

Internationally, the number of patients requiring treatment for end-stage kidney disease (ESKD) continues to increase, placing substantial burden on health systems and patients. Home hemodialysis (HD) has fluctuated in its popularity, and the rates of home HD vary considerably between and within countries although there is evidence suggesting a number of clinical, survival, economic, and quality of life (QoL) advantages associated with this treatment. International guidelines encourage shared decision making between patients and clinicians for the type of dialysis, with an emphasis on a treatment that aligned to the patients’ lifestyle. This is a comprehensive literature review of patient-centered and economic impacts of home HD with the studies published between January 2000 and July 2016. Data from the primary studies representing both efficiency and equity of home HD were presented as a narrative synthesis under the following topics: advantages to patients, barriers to patients, economic factors influencing patients, cost-effectiveness of home HD, and inequities in home HD delivery. There were a number of advantages for patients on home HD including improved survival and QoL and flexibility and potential for employment, compared to hospital HD. Similarly, there were several barriers to patients preferring or maintaining home HD, and the strategies to overcome these barriers were frequently reported. Good evidence reported that indigenous, low-income, and other socially disadvantaged individuals had reduced access to home HD compared to other forms of dialysis and that this situation compounds already-poor health outcomes on renal replacement therapy. Government policies that minimize barriers to home HD include reimbursement for dialysis-related out-of-pocket costs and employment-retention interventions for home HD patients and their family members. This review argues that home HD is a cost-effective treatment, and increasing the proportion of patients on this form of dialysis compared to hospital HD will result in a more equitable distribution of good health outcomes for individuals with ESKD

Resolved lower limb muscle tone abnormalities in children with HIV encephalopathy receiving standard antiretroviral therapy

BackgroundThis short report arose from a follow-up study of children previously diagnosed with human immunodeficiency virus (HIV) encephalopathy and spastic diplegia and is among the first to describe that increased lower limb muscle tone in children with a confirmed HIV encephalopathy diagnosis may resolve over time in some cases.ResultsOf 19 children previously diagnosed with HIV encephalopathy and increased lower limb muscle tone, some were found to have resolved muscle tone abnormalities during a follow-up physical examination [resolved group, n=13, median age 9years 7months (interquartile range 7years 3months–10years 9months)] whereas others continued to show increased lower limb muscle tone at follow-up [unresolved group, n=6 median age 8years 6months (interquartile range 7years 9months–9years 7months)]. A review of clinical records showed no significant differences in age or follow-up time between the resolved and unresolved groups. However, the unresolved group appeared to have severe disease at an earlier age than the resolved group, based on the age at antiretroviral treatment initiation [median age at start of treatment 2years 3months (interquartile range 7months–5years 3months) vs. 8months (interquartile range 6–12months), p=0.08] and had more severe neurological signs at the initial assessment.ConclusionsIt is anticipated that this information may be of immediate value to those involved in the treatment of children with HIV encephalopathy and increased lower limb muscle tone whilst awaiting the outcome of future controlled clinical trials

Recent advances in transition metal-catalysed hydroacylation of alkenes and alkynes

This highlight discusses developments in transition metal-catalysed alkene and alkyne hydroacylation reactions over the past three years. The discussion summarizes the development of new catalyst systems for alkene and alkyne hydroacylation and applications to the synthesis of important ketone building blocks. The highlight captures transition metal-catalysed alkene and alkyne hydroacylation at a time of impressive growth when cobalt, nickel, ruthenium, and iridium catalysts are emerging as complements or replacements for traditional rhodium catalysts

Inventing and Implementing LLCs at an HBCU in One Year: Lessons Learned

Living-Learning Communities (LLCs) have proven to be a successful high impact practice at institutions across the nation. Norfolk State University (NSU), a Historically Black University, recently established a formal LLC program as a part of the University’s Quality Enhancement Plan (QEP). Through a strong partnership with Academic and Student Affairs, NSU implemented and invented LLCs all within one academic year. Similar to the collaborative nature of LLCs, this paper examines the lessons learned from various perspectives (LLC director, teaching dean, faculty liaison, faculty) during the rapid inventing and implementing of LLCs

Patient and caregiver values, beliefs and experiences when considering home dialysis as a treatment option: a semi-structured interview study

Background Home dialysis can offer improved quality of life and economic benefits compared with facility dialysis. Yet the uptake of home dialysis remains low around the world, which may be partly due to patients' lack of knowledge and barriers to shared and informed decision-making. We aimed to describe patient and caregiver values, beliefs and experiences when considering home dialysis, to inform strategies to align policy and practice with patients' needs. Methods Semi-structured interviews with adult patients with chronic kidney disease Stage 4–5D (on dialysis <1 year) and their caregivers, recruited from three nephrology centres in New Zealand. Transcripts were analysed thematically. Results In total, 43 patients [pre-dialysis (n = 18), peritoneal dialysis (n = 13), home haemodialysis (n = 4) and facility haemodialysis (n = 9)] and 9 caregivers participated. We identified five themes related to home dialysis: lacking decisional power (complexity of information, limited exposure to home dialysis, feeling disempowered, deprived of choice, pressure to choose), sustaining relationships (maintaining cultural involvement, family influence, trusting clinicians, minimizing social isolation), reducing lifestyle disruption (sustaining employment, avoiding relocation, considering additional expenses, seeking flexible schedules, creating free time), gaining confidence in choice (guarantee of safety, depending on professional certainty, reassurance from peers, overcoming fears) and maximizing survival. Conclusions To engage and empower patients and caregivers to consider home dialysis, a stronger emphasis on the development of patient-focused educational programmes and resources is suggested. Pre-dialysis and home dialysis programmes that address health literacy and focus on cultural and social values may reduce fears and build confidence around decisions to undertake home dialysis. Financial burdens may be minimized through provision of reimbursement programmes, employment support and additional assistance for patients, particularly those residing in remote areas