Tuesday, May 29, 2012

Minority-Based Community Clinical Oncology Program Groups

The National Institutes of Health, more commonly referred to as NIH, is a federal government agency operating under the purview of the United States Department of Health and Human Services that is primarily responsible for supporting the nation's biomedical and health-related research studies.
The grants and programs of the NIH are all magnanimously engineered to assist in the realization of its primary agency mission which is to "seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce the burdens of illness and disability."
In line with this mission, the National Institutes of Health has recently collaborated with the National Cancer Institute (NCI) in an attempt to establish the Minority-Based Community Clinical Oncology Program Groups (MBCCOP).
The primary purpose of the program is to support research initiatives involving physicians who are participating in the care of minorities and who are eligible to participate in NCI-sponsored cancer prevention, control, and treatment clinical trials.
In addition, the program also serves as an opportunity for practicing oncologists who serve large racial/ethnic minority populations to participate in clinical trials sponsored by the National Cancer Institute.
Essentially, this program is designed to cater to minority populations and to bring forth state-of-the-art cancer clinical trials to minority individuals in their own communities.
The MBCCOP Groups will work by providing patients with access to clinical trials in cancer centers, major university centers, and community programs. And in this manner, this access will be realized through another, separately funded, arm of the program called "Research Bases," which are comprised of participating NCI Cooperative Groups and Cancer Centers.
As a result, the linkages that will soon be developed as a result of this access is expected to facilitate the transfer of advances in cancer prevention/control/treatment practices to minority communities and their physicians.
The National Institutes of Health is ready to administer funds in the amount of $5,500,000 to support the Minority-Based Community Clinical Oncology Program Groups.
The institutions and organizations who will be deemed eligible to submit an application under this program are the following:
a) Public and State Controlled Institutions of Higher Education
b) Native American Tribal Governments
c) Federally recognized Native American Tribal Organizations
d) Nonprofit Organizations
e) Private Institutions of Higher Education
f) For-profit organizations
g) Small businesses
The United States Department of Health and Human Services, the mother agency funding the program, is the nation's premiere agency for protecting the health of all Americans and providing essential human services to everyone, especially to those who are medically challenged and financially vulnerable.

Tuesday, May 22, 2012

Easier Medical Billing

With little to no extra time on their hands doctors have to work smarter not harder and that is when they turn to the assets of a medical billing service company. As they work around the office day in and day out, the time to really create the bills and send them out is just too time consuming. Getting medical providers paid is often nothing more than having the time to send out the proper documents but so few providers grasp what documents or how to document them. Medical billing companies are more efficient at establishing all the documents necessary to get providers paid not only by the insurance companies but by the patients as well.
Different companies make different guarantees to doctors about their services, but then always go back on it. The best companies will honor their word, will look as if to charge more but in reality collect far more than the lower cost competitor and will offer a money back pledge. Not only can the best company deliver everything with precision, but they also can find the best ways for the doctors to earn the maximum amount of money available without ripping off the customers. The values of each office are going to be different, so every billing services should look to please the needs of the practice not the needs of the billing company. Honoring one's word is important. A competent company will ensure that all payments go to the provider and not to the billing company.
There are many different options out there for medical offices, but very few can actually make the doctors money and save them time. The doctor's time is valuable and cannot be replaced so it is imperative that the right company be selected. Summarizing the previous line simply means that time is money. You can replace money but you cannot replace time. Only those companies with a track record of ten to 15 years will be able to do what they claim. Otherwise they would have collapsed long ago. Doctors should make keen decisions when looking for which one can do the best with what specifications they set for the provider medical services to complete.
Basically, the only companies that can help, are the ones that give it there all and get consequences. Not only should they be trained to make the money, but they have to be able to make both customer and office happy and at ease with the work done. Such companies will develop a relationship with you that will create a bond showing a duty to your needs. Only one company in the end can come out on top in every qualification, and that company deserves the be the one that is trusted above the rest. Any company that has a long track record and a list of pleased customers should rise to the top of your list.

Tuesday, May 15, 2012

Motion Sickness Prevention Tips for Children

It can be distressing for parents to see their children not feel well and have frequent motion sickness. Children from 5 years to 12 years are more susceptible to motion sickness.
What is Motion Sickness
Motion sickness is caused by a disturbance of the inner ear where there is a conflict between the vestibular inputs and visual inputs. These conflicting messages are sent to the brain which results in imbalance and thus leads to motion sickness.
Motion sickness can occur in air, sea, bus, car, roller coaster or from playing video games.
Symptoms and Signs
  • Dizziness
  • Nausea
  • Vomiting
  • Headache
  • Pale skin
  • Cold sweat
  • Fatigue
Remedies for Motion Sickness
  • Always ask the child to look at a distant point, at the horizon or focus his attention somewhere out of the window.
  • Have a plastic bag ready. Wiping your child's face with wet towels will also make him feel better. While traveling in air keep the air sickness bag ready for the child.
  • If traveling by car, let your child sit in the front seat. This helps him to focus and keep his eye in tune with the motion of the vehicle. If in a bus, choose the middle seat.
  • Give your child a pillow or use the head rest to avoid unnecessary head movements. Your child should keep his head as still as far as possible.
  • Calm your child. Anxiety can make the problem worse. Tell your child that he is not the only one and he will get over it as he grows a little older.
  • Always carry lots of liquids while traveling. Frequent vomiting can cause dehydration in children.
  • Give your child small sips of water or electrolytes if he's vomiting.
  • Motion sickness can get worse if your child is on empty or full stomach. Avoid giving big or greasy meals to your child before travel. It is a good idea to have a light snack before the motion.
  • Avoid drinking and eating during short trips.
  • Make frequent stops. Take short breaks when the child starts complaining about feeling sick.
  • If you are flying, request for a seat near the airplane wing. This helps to reduce the turbulence.
  • Try covering the windows as bright sun can make nausea worse.
  • Fresh air can also help prevent nausea. Try and open the windows whenever possible.
Useful herbs and medicines
Before starting any therapy make sure you consult a health care professional or doctor about the exact dosage and method of treatment.
-Black Horehound
-Nux Vornica
Other Medicines
According to psychologists parenting begins even before the child in unborn. A mother talking, reading and singing to the unborn child creates a mother-infant bond early on. Even after the child is born, parent's interaction plays a very very important role in child's brain development. This goes a long in shaping the child's brain and affecting his psychological state. Some studies have also shown that children who have received responsive and sensitive care from their parents in their early years grow up to be more confident and successful individuals in their lives. Recent advances in brain research has shown that the brain development in children is not only dependent on genetics but is also determined by the child's experience.

Tuesday, May 8, 2012

Value of the Pre Nursing Home Admission Visit

The Pre-Admissions Visit Does Have Critical Value Before Nursing Home Admissions
If you talk to Diana Waugh, a registered nurse from Ohio, long-term care quality advocate and former director of nursing she would tell you she believes in the value of the pre-admission visit. What is that? It is when nursing home personnel visit a hospital and gain an in-depth understanding of a referred patient's needs before accepting this person for admission.
Of course this typically does not happen in our age of electronic referrals and stiff competition among skilled nursing facilities. Plus hospitals are gun-shy, afraid that facility reps will come in and try to market to other patients.
Unfortunately post admission many skilled facilities are finding there may be a financial and clinical incompatibility with this new admission and it becomes almost impossible to undo the process without infringing upon the patient's and their family's comfort level and dignity. Typically the discharge, whenever it is time for it to occur is a complicated one.
Of course there is also the convenience factor. Many nursing home personnel rarely leave the building for anything, except for business development staff. Many are simply in a rut and that can be hard to break away from.
However, Diana's concerns are very legitimate. Accepting certain admissions without really feeling confident this patient is an appropriate behavioral, clinical and psychological fit can open a can of worms that can be hard to manage and hard to close.
Further, when the dominant pre-admission questions center around insurance coverage and skilled days already consumed that calendar year, it is easy to slip into that "cattle herding" mode where we start to move away from the human side of care delivery and care management and focus solely on reimbursement.
Of course location plays a role since the hospital referring the patient may be 30 miles away and even if the pre-admission visit became an industry wide rule we still cannot escape the reality that no admission is perfect. Additionally this can never become a system wide practice unless everyone gets on board or the more aggressive marketers will keep accepting anyone who can pay regardless of the lack of person-centeredness involved.
Maybe there is another solution. If you have it we hope you will share. Let's talk about it. In the meantime may families and patients take a more active role in ensuring that every admission is as close a match as possible in order to ensure quality care delivery remains the priority.
Thanks for allowing us to share.

Tuesday, May 1, 2012

Candidate Physical Aptitude Test

As an increasing number of Municipalities across Canada and the United States make the CPAT their official physical test as part of the firefighter hiring process, recruitment candidates should familiarize themselves with this test, as well as understand how a metabolic and strength conditioning program can properly prepare them for it.
The CPAT began in 1997 as a result of what the IAFF (International Association of Fire Fighters) and IAFC (International Association of Fire Chiefs) viewed as a need to standardize the physical testing of candidates being hired into fire services all across North America. The rationale was that candidates who were incapable of achieving the physical requirements of fire fighting were slipping through the cracks. A task force consisting of the IAFF / IAFC and ten leading fire services and their unions created the Fire Service Joint Labor-Management Wellness-Fitness Initiative. In turn, the CPAT was developed.
Using 1000 randomly selected fire fighters from the ten fire services, various standards were developed based on averages. Averages such as; what kinds of tasks fire fighters are required to complete, how much the average gear and tools weigh, the average height and weight of the fire fighters, and even the average weight of patients entering the ER departments of the cities where the ten fire services were located. Using these averages, an 'obstacle course' was created that the task force felt best replicated what the average firefighter would experience at an average fire ground scenario. After running their fire fighters through it, they also came up with an average time that candidates should pass.
Municipalities that decide to run the CPAT as their official test must be licensed accordingly by the IAFF in order to do so. This results in an across-the-board baseline whereby every CPAT is essentially the exact same thing. All distances, weights, instructions, and sequence is the exact same. The individuals manning the test have received recognized training as well. Because the CPAT is a recognized standard that has been developed with such an excellent attention to detail, candidates are essentially unable to legally challenge the results as being 'unfair' - since thousands upon thousands of applicants and hires have set precedence before them as to the universal acceptance of this test.
The general rules of the CPAT are pretty straight-forward. Every step of the CPAT has a particular aspect to it that can constitute an instant fail. Sometimes you get to have a 'warning' before you fail, again, this depends on the step you're on. There is a set time you must complete all eight steps in to pass.
The CPAT starts with a candidate being 'loaded' with a 50lb weighted vest. They are asked to make their way to a stair-climbing machine and given an extra 25lbs (12.5 add-ons on each shoulder). A 20 second warm-up at 50 steps per minute is quickly followed by a 3 minute, 60 steps per minute set. You cannot touch the rail twice, or you will fail. This is the only part of the whole CPAT where you cannot go more quickly than the time allocated for it.
Step 2, the hose drag, involves grabbing a nozzle on 200 feet of 1 ¾ hose and running with it 75 feet to a drum then turning 90 degrees and running another 25 feet. You then get on one knee and drag the hose until the first coupling, at 50 feet, crosses the finish line. This is the only part of the CPAT that you can run as fast as you can. If you fail to go around the drum, it's an instant fail. If one of your knees is outside the finish-line 'box' you get a warning. The second time it's a fail.
Step 3, the equipment carry, involves carrying two saws around a cone and back to the starting point. This starts by picking up each saw from a shelf and placing it on the ground, one at a time. Once both saws are on the ground, they are picked up at the same time, one in each hand, and carried around the cone and back. They are then returned to the shelf in the reverse sequence as they were removed, one at a time. If the saws fall or touch the ground during the carry in any way, it's a fail. If you run at all, it's a fail.
Step 4, the ladder raise and extension, involves raising a 24 foot aluminum ladder from a lying position to a vertical one against a wall. You then move to the side and extend the fly-section of an identical ladder to its limit, then lower it back down to the ground in a controlled, hand-over-hand manner. Any loss of control during any part of this step, including having the rope slip in any fashion, will result in an instant fail.
Step 5, forcible entry, involves striking a 10lb sledge-hammer against a mechanical measuring device which is meant to simulate the resistance of a typical front door. Once the buzzer sounds, signalling that a successful amount of force has been applied, the step is concluded. Dropping the sledge hammer will result in an instant fail. Stepping outside of a marked box that you are standing in to swing the sledge hammer will result in a warning. A second warning is an instant fail.
Step 6, search, involves crawling through a darkened 64 foot u-shape maze (two 90 degree angles) with obstacles in your path requiring you to feel and make your way through it. Any event that results in the candidate requiring assistance out of the maze, either by panicking or running out of time, will lead to an instant fail.
Step 7, rescue, involves dragging a 165lb dummy around a drum and back to the starting line, totalling 70ft. If the candidate fails to drag the dummy around the drum, or the candidate touches or rests on the drum, they instantly fail.
Step 8, ceiling breach and pull, involves using a pike pole to perform four complete sets of three repetitions of pushing up a hinged door, followed by 5 repetitions of pulling down on a hook attached to a ceiling device. Both the hinged door and the ceiling device provide a weighted resistance. Stepping outside the designated area will result in a warning. A second time will result in an instant fail. Candidates are allowed to drop the pike-pole once, a second time will result in an instant fail.
Even without failing any of the eight steps, you must still complete them in a set time. If you go over the set time unfortunately this results in an instant fail as well.
Like most fire fighters, I spent a few years working hard to get hired. This resulted in my having done more CPATs than I care to remember. Because most of these CPATs were out of town, I spent numerous hours sitting around waiting for my turn, and this enabled me to see hundreds of other candidates perform the CPAT. While the majority passed, a surprisingly large number also failed - I would never have guessed that the failure rate was as high as it was unless I saw it for myself. I saw people pretty much fail at every single step. While many people failed for technical reasons such as dropping the ladder, panicking in the maze, not running around a drum, running when not supposed to, dropping a sledge-hammer (pretty much every failure mentioned in the steps above I've seen happen!) - The majority of people failed because they simply were not in proper shape to undertake the CPAT, plain and simple. I've seen people give up after less than a minute on the stair-climber! What on earth were they thinking the job entailed? A lot of people managed to make it through the CPAT, but not under the amount of time allocated.
Passing the CPAT requires that you get yourself in fire fighter shape. Fitness programs such as the metabolic and strength conditioning combined with powerlifting workouts are perfect for the particularities of becoming a fire fighter. I've seen my share of body-builder types (the stereotypical types that you would have to assume are in excellent shape if you didn't know better) who made it off the stair-climber with rubber legs looking like they just got off a boat that completed a 6 year journey at sea. They had no gas left in their tanks and couldn't complete the rest of it in time.
The fact of the matter is that unless you train for all aspects of fitness, you will lack the strength, endurance, cross-training, recovery, and general conditioning required for not only passing the CPAT, but performing your job as a fire fighter. Barely passing the CPAT is also not enough. Most fire services one you get hired and are in their drill school have their own physical tests which are much more demanding than the CPAT and have no problems cutting you if you can't handle it. The days of getting instantly hired for the rest of your life are behind us and recruits are at an ever increasing chance of being let go due to poor physical conditioning. Even more challenging than the drill school physical tests are dealing with an actual fire. Ask any fire fighter with actual experience what the difference is - it's pretty much day and night.
The CPAT should be seen as an absolute bear minimum of fitness level. If you can't smoke the CPAT in under 7:30, you may get a nasty wake-up call in drill school or worse, on the fire ground. You shouldn't be walking around with your head high if you barely passed. Use the time between the CPAT and getting hired to increase your physical conditioning! Being in excellent physical condition is your responsibility once you get hired - and if you are not willing to put in the sacrifice to achieve a high level of fitness, this job simply isn't for you. There are numerous programs out there that can take you to the next level, so look around and do your homework. We like to think our program, which takes you safely and effectively from beginner to advanced is great, but we're obviously partial since we've seen great results from it and have been perfecting it for over 4 years now. Whatever fitness program you come across, give it your best. As a fire fighter, doing nothing is never an option.
General tips for passing the CPAT are as follows:
  • Get in shape!
  • Follow all directions
  • Familiarize yourself with all the steps
  • Hydrate yourself properly prior to starting
  • Eat a healthy breakfast on testing day (as you should every day)
  • Get a goodnight sleep
  • Don't stress out - Getting in shape, knowing what to expect, and being fueled will result in your success!