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American Journal of Perinatology May 2024Point-of-care ultrasound (POCUS) has increasingly been used by neonatal providers in neonatal intensive care units in the United States. However, there is a lack of...
Point-of-care ultrasound (POCUS) has increasingly been used by neonatal providers in neonatal intensive care units in the United States. However, there is a lack of literature addressing the complexities of POCUS coding and billing practices in the United States. This article describes the coding terminology and billing process especially those relevant to neonatal POCUS. We elucidate considerations for neonatal POCUS billing framework and workflow integration. Directions on image storage and supporting documentation to facilitate efficient reimbursement, compliance with billing regulations, and appeal to insurance claim denial are discussed. KEY POINTS: · Code neonatal POCUS procedure precisely allows accurate reimbursement and reduced errors in billing.. · Document details to support medical necessity and reimbursement claims effectively.. · Adhere to regulations to avoid audits, denials, and ensure proper reimbursement..
PubMed: 38698594
DOI: 10.1055/s-0044-1786721 -
Ethnicity & Health May 2024Perceived discrimination (PD; e.g. racism, agism, sexism, etc.) negatively impacts quality of life (QOL) among cancer patients. Prior research has established that for... (Review)
Review
Perceived discrimination and quality of life for African American and Caucasian American cancer patients: a coping mediation analysis of subtle and overt microaggressions.
OBJECTIVE
Perceived discrimination (PD; e.g. racism, agism, sexism, etc.) negatively impacts quality of life (QOL) among cancer patients. Prior research has established that for African American Cancer Patients (AACPs) only disengagement/denial coping mediated the PD-QOL relationship. In contrast, for Caucasian American Cancer Patients (CACPs), both agentic and disengagement/denial coping were mediators of the PD-QOL relationship. However, according to social constraint theory there may be a difference between subtle and overt PD in terms of the utility of certain coping mechanisms in relation to QOL, especially for AACPs.
METHOD
217 AACPs and 121 CACPs completed measures of PD, coping (agentic, disengagement/denial, adaptive disengagement) and QOL. PD items were classified as subtle or overt microaggressions. PD was mainly attributed to race/ethnicity by AACPs and to income, age, and physical appearance for CACPs.
RESULTS
: In both subtle and overt microaggression models with CACPs, agentic coping and disengagement/denial coping were significant mediators of PD-QOL. Like CACPs, for AACPs, agentic and disengagement/denial coping were significant in the context of subtle microaggressions. In contrast, for overt microaggression only disengagement/denial coping was a significant mediator of the PD-QOL relationship for AACPs. Adaptive disengagement was related to QOL only for AACPs.
CONCLUSIONS
: Whereas more research is needed, it appears that overt microaggressions for AACPs, that consist mainly of racial and ethnic maltreatment, constitute a class of social contexts that may raise above the threshold for serious threat and harm, and, as a result, disengagement/constraint may reduce negative consequences. This additional burden for AACPs contributes to disparities in QOL. Future research is needed on the utility of adaptive disengagement for AACPs in relation to PD.
PubMed: 38698588
DOI: 10.1080/13557858.2024.2347569 -
ISA Transactions Jun 2024The finite-horizon optimal secure tracking control (FHOSTC) problem for cyber-physical systems under actuator denial-of-service (DoS) attacks is addressed in this paper....
The finite-horizon optimal secure tracking control (FHOSTC) problem for cyber-physical systems under actuator denial-of-service (DoS) attacks is addressed in this paper. A model-free method based on the Q-function is designed to achieve FHOSTC without the system model information. First, an augmented time-varying Riccati equation (TVRE) is derived by integrating the system with the reference system into a unified augmented system. Then, a lower bound on malicious DoS attacks probability that guarantees the solutions of the TVRE is provided. Third, a Q-function that changes over time (time-varying Q-function, TVQF) is devised. A TVQF-based method is then proposed to solve the TVRE without the need for the knowledge of the augmented system dynamics. The developed method works backward-in-time and uses the least-squares method. To validate the performance and features of the developed method, simulation studies are conducted in the end.
PubMed: 38692974
DOI: 10.1016/j.isatra.2024.04.025 -
Nicotine & Tobacco Research : Official... May 2024Menthol cigarettes and flavored cigars (MC/FC) bring profits to U.S. tobacco companies at the cost of Black/African American (B/AA) lives. This exploratory...
INTRODUCTION
Menthol cigarettes and flavored cigars (MC/FC) bring profits to U.S. tobacco companies at the cost of Black/African American (B/AA) lives. This exploratory cross-sectional study describes perceptions of tobacco company engagement and activities in B/AA communities related to MC/FC.
AIMS AND METHODS
Among 2307 U.S. adults aged 18-45 surveyed in 2022, six items addressed beliefs about tobacco company funding of B/AA community organizations, payment of B/AA lobbyists to oppose public health policies, support of health equity efforts in B/AA communities, and targeted marketing of MC/FC in B/AA communities. Adjusted proportions were calculated for each belief overall and by race and cigarette smoking status.
RESULTS
Among all adults, 37% believed that tobacco companies deny the harms of MC/FCs, 20% believed they pay Black lobbyists to oppose health policies, and 12% believed they fund Black community organizations. Compared with non-B/AA adults, a higher proportion of B/AA adults believed that tobacco companies target Black communities with MC/FC marketing (62% vs. 46%). More adult smokers (ie, menthol or non-MC) than nonsmokers thought that tobacco companies support health equity efforts and did not target Black communities with MC/FC marketing nor deny the harms of MC/FCs to B/AA communities.
CONCLUSIONS
Few B/AAs and adult smokers believed that tobacco companies used B/AA organizations and lobbyists to oppose MC/FC policies in the B/AA community as well as reject MC/FC's harmfulness. Culturally tailored and community-engaged communication efforts are needed to correct disinformation about MC/FC tobacco companies' engagement and activities in B/AA communities among B/AA and menthol cigarette smokers.
IMPLICATIONS
Tobacco companies have a history of predatory marketing that promotes flavored tobacco products to Black/African American (B/AA) individuals and more recently has spread disinformation to dissuade policy support for menthol cigarette/flavored cigar (MC/FC) bans. It is unclear what are the perceptions of tobacco company engagement and activities in B/AA communities related to MC/FC. Our study shows that B/AA adults and current cigarette smokers hold misperceptions about tobacco companies' role in spreading disinformation about MC/FC. This study identified beliefs about the industry's role in funding B/AA organizations and lobbyists who oppose policy, as well as the industry's denial of menthol cigarette and flavored cigar harms as potential messaging targets for communication efforts designed to correct disinformation about MC/FC policies among B/AA and those who currently smoke MC.
PubMed: 38692654
DOI: 10.1093/ntr/ntae066 -
PNAS Nexus Apr 2024Past theories have linked science denial to religiosity but have not explained its geographic variability. We hypothesize that it springs not only from religious...
Past theories have linked science denial to religiosity but have not explained its geographic variability. We hypothesize that it springs not only from religious intensity but also from religious intolerance, which depends greatly on the experience of religious diversity and hence on geography. The belief that one's religion trumps other faiths precipitates the stance that it trumps science too. This psychological process is most likely to operate in regions or countries with low religious heterogeneity. We measure the rejection of science not only in people's refusal to follow specific health recommendations, such as taking COVID-19 vaccines, but also in general measures of scientific engagement and attainment. We rule out alternative explanations, including reverse causality and spurious correlations, by conducting controlled experiments and running robustness checks on our statistical models.
PubMed: 38689708
DOI: 10.1093/pnasnexus/pgae144 -
Epileptic Disorders : International... Jun 2024Psychosis of epileptic origin can present a wide range of cognitive and affective symptoms and is often underrecognized. Usually occurring in the inter- and postictal...
Psychosis of epileptic origin can present a wide range of cognitive and affective symptoms and is often underrecognized. Usually occurring in the inter- and postictal phase, epileptic psychosis is mostly related to temporal lobe epilepsy. Here, we describe the clinical presentation and diagnostic workup including routine EEG recording and brain MRI of a 63-year-old woman expressing isolated nihilistic delusions comprising belief of being dead and denial of self-existence. EEG showed an ictal pattern fulfilling the Salzburg criteria of nonconvulsive status epilepticus and brain MRI revealed extensive peri-ictal hyperperfusion. Delusional symptoms and EEG abnormalities subsided after acute antiseizure treatment. Our case illustrates how nihilistic delusions can occur as a direct clinical correlate of seizure activity, thereby expanding the spectrum of ictal neuropsychiatric phenomena in temporal lobe epilepsy and highlighting the need to consider an epileptic origin in patients presenting with psychotic symptoms.
Topics: Humans; Status Epilepticus; Female; Delusions; Middle Aged; Electroencephalography; Magnetic Resonance Imaging; Psychotic Disorders; Anticonvulsants
PubMed: 38686977
DOI: 10.1002/epd2.20221 -
Frontiers in Psychiatry 2024The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout...
BACKGROUND
The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region.
METHODS
An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools.
RESULTS
The study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels.
CONCLUSIONS
The results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient care.
PubMed: 38686129
DOI: 10.3389/fpsyt.2024.1373743 -
Heliyon Apr 2024Recent years have witnessed security as a great concern in vehicular networks (VANET). Particularly, Denial of Service (DoS) and Distributed Denial of Service (DDoS)...
Recent years have witnessed security as a great concern in vehicular networks (VANET). Particularly, Denial of Service (DoS) and Distributed Denial of Service (DDoS) attacks can jeopardize the network by broadcasting a storm of packets. Correspondingly, the network resources are jammed with malicious traffic. In this connection, the existing research presented various techniques to cope with DoS and DDoS attacks. Different from those traditional approaches, this study proposes an Intelligent Intrusion Detection System (IDS) by leveraging Machine Learning (ML). The proposed IDS utilizes a publicly available dataset on the application layer for mitigating DDoS attacks. The designed ML-based IDS relies on combining both the Random Projection (RP) and Randomized Matrix Factorization (RMF) methods to achieve the best results for enhancing the detection capabilities of the IDS. This amalgamation enhances the system's detection capabilities by extracting and analyzing meaningful features from network traffic data. Experimental validation of our approach involves a comprehensive evaluation of various ML models, including Extra Tree Classifier (ETC), Logistic Regression (LR), and Random Forest (RF). Remarkably, the combined accuracy of these models yields an average system accuracy of 0.98, surpassing existing methods. Unlike conventional approaches, our proposed IDS excels in efficiency and exhibits notable performance in detecting DoS and DDoS attacks in VANET. This proficiency ensures the integrity and safety of vehicle communications. Thus, our research substantially contributes to the vehicular network security field. The presented findings establish a foundation for future advancements in securing connected vehicles.
PubMed: 38681562
DOI: 10.1016/j.heliyon.2024.e28844 -
Journal of Clinical Medicine Apr 2024: The implications of delaying surgical intervention for patients with adolescent idiopathic scoliosis (AIS) wishing to undergo vertebral body tethering (VBT) have not...
: The implications of delaying surgical intervention for patients with adolescent idiopathic scoliosis (AIS) wishing to undergo vertebral body tethering (VBT) have not yet been explored. It is important to understand how these delays can impact surgical planning and patient outcomes. : This was a retrospective review that analyzed all AIS patients treated between 2015 and 2021 at a single tertiary center. Time to surgery from initial surgical consultation and ultimate surgical plan were assessed. Patient characteristics, potential risk factors associated with increased curve progression, and reasons for delay were also analyzed. : 174 patients were evaluated and 95 were scheduled for VBT. Four patients later required a change to posterior spinal fusion (PSF) due to excessive curve progression. Patients requiring PSF were shown to have significantly longer delays than those who received VBT. Additionally, longer delays, younger age, greater curve progression, and lower skeletal maturity were correlated with significant curve progression (≥5 degrees). : Surgical delays for AIS patients awaiting VBT may lead to significant curve progression and necessitate more invasive procedures. Patients with longer delays experienced an increased risk of needing PSF instead of VBT. Of those requiring PSF, the majority were due to insurance denials. Optimizing surgical timing and shared decision-making among patients, families, and healthcare providers are essential for achieving the best outcomes.
PubMed: 38673483
DOI: 10.3390/jcm13082209 -
International Journal of Environmental... Apr 2024Within the field of research on the promotion of teachers' social and emotional competence, the present paper illustrates preliminary evidence of the efficacy of a new...
Promoting Teachers' Social and Emotional Competence in Light of the Close Connection between Professional Role and Personal Characteristics: Preliminary Evidence of the Efficacy of the "ME4YOU" Training Program.
Within the field of research on the promotion of teachers' social and emotional competence, the present paper illustrates preliminary evidence of the efficacy of a new training program named "ME4YOU" aimed at supporting teachers' self-reflexive competences to deal with the emotional and relational dimensions of teaching, with constant and continuous attention towards underlining the close connection between the way teachers perform as professionals at work and the way they function as individuals in their personal life. A total of 109 teachers from kindergarten to primary school took part in the experimental group, while 67 teachers constituted the control group; the two groups were compared using a pre-test/post-test approach with regard to some self-reported variables related to professional and personal aspects. Teachers in the experimental group exhibited increased levels of professional self-efficacy and self-efficacy as emotional socializers toward students' emotions; moreover-although with a more limited impact-they reported benefits with regard to their personal life (i.e., reduced denial of own emotions and improved authenticity). The findings are discussed highlighting that health promotion among teachers is both of value in itself and an investment that can generate health in the whole school system.
Topics: Humans; School Teachers; Female; Male; Emotions; Adult; Professional Role; Self Efficacy; Middle Aged; Social Skills; Professional Competence; Health Promotion
PubMed: 38673422
DOI: 10.3390/ijerph21040511