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xyg9fje9j · 1 year

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y7vmhcg9x0ryl · 1 year

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casan0vafrankenbutt · 5 years

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Your own debunk of age vs gender shows you only vaguely get the issue. Age is a quantitative measure. When you say "many trans people say theyve always known theyre not the gender that matches up with their chromosomes", it tells me you believe there are genders that match chromosomes. What would you say is the gender that matches someone with only one x chromosome? Xyy? Xxy? Xxxxxy? What matches up with those?

Or is it all arbitrary, nonquantitative bullshit made up by dumb primates to make sense of outie vs innie. And then when we finally read gods fine print it all falls the fuck apart. There arent only two possible sex chromosome genotypes. There arent only two reproductive phenotypes. Binarism is mythology. Antigod mythology. Transphobia is a manifestation of a hatred of the natural.

Ultimately all shapiro is doing with his transphobia is being a stan for conscriptive (white) breeding, because he's afraid of being outnumbered by people who dont look like him.

And when we use language that implies some people's genders "match" their "sex", we arent doing much to dismantle the lies on which shapiro has built and sells his transphobia

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educationandtrainning · 3 years

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complete statements of Mechanical Engineering

Mechanical engineering Course is to design parts, components, products, or systems of mechanical nature. For example, designs of various machine elements such as shafts, bearings, clutches, gears, and fasteners fall into the scope of mechanical design. Numerous criteria have been proposed in mechanical design processes, some primary design criteria include functions, safety, reliability, manufacturability, weight, size, wear, maintenance, and liability. In general, a mechanical design problem should be formulated with clear and complete statements of functions, specifications, and evaluation criteria

▪Functions are specified for what a product can fulfill. Functions are usually described by nonquantitative statements. Exemplifying product functions are to charge power on electronics (charger), clean floors (vacuum), transport objects (mobile platform), or support loads (structure).

▪Specifications are detailed requirements described by quantitative statements. For example, product specifications can be defined in terms of size, weight, precision, working volume, speed, or load capacity. Specifications turn into design constraints in problem-solving processes.

▪Evaluation criteria are the statements of desirable qualitative characteristics. Evaluation criteria are treated as design objectives to optimize the solutions in problem-solving processes. Evaluation criteria are set to maximize benefits and minimize disadvantages of mechanical designs.

#Mechanical Engineering Course #Best Mechanical Engineering Course #Top Mechanical Engineering Course

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clarencelight-blog · 5 years

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PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

Follow Below Link to Download File

https://homeworklance.com/downloads/psy-843-module-5-assignment-program-evaluation-implementation-plan/

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Quantitative data analysis techniques provide guidelines for program evaluators to understand what to do with data from such sources as close-ended questions, checklist types of data, scales, number of years, and number of service contracts. Any data collection technique that is structured can be put into numerical form. Qualitative data analysis techniques enable program evaluators to analyze data from such sources as open-ended questions, process notes from training programs or group programs, descriptive-form records, case examples, and other types of nonquantitative data. In both quantitative and qualitative analysis, it is essential to have a plan for data analysis. In this assignment, you will propose and defend the methodology for implementing a program evaluation plan for the organization you referenced in Module 2.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Locate the mission statement and program description from the existing organization that you referenced in Module 2 to use as examples for this assignment.

· Instructors will be using a grading rubric to grade the assignments. It is recommended that learners review the rubric prior to beginning the assignment in order to become familiar with the assignment criteria and expectations for successful completion of the assignment.

· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Directions:

In a paper (1,250-1,500 words), propose a plan for implementing a program evaluation study for the program found in the organization you referenced in the Module 2 assignment. Your implementation plan should include the following:

1. The selection and description of both a quantitative and a qualitative method of data collection to carry out the study.

2. A research-based explanation of your rationale for selecting the data-collection procedures that clearly identifies the strengths and weaknesses of the procedures.

3. An explanation of how you would maintain validity and reliability of the quantitative data being collected.

4. A statement identifying methods for overcoming the kinds of problems you would expect as you collect the qualitative and quantitative data for this evaluation.

#PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

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williamgray1-blog · 5 years

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PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

Follow Below Link to Download File

https://homeworklance.com/downloads/psy-843-module-5-assignment-program-evaluation-implementation-plan/

We also Do 100% Original and Plagiarism Free Assignment / Homework and Essay

Email us for original and Plagiarism Free Work At ( [email protected] ) or order us at (https://homeworklance.com/custom-order/ )

Details:

Quantitative data analysis techniques provide guidelines for program evaluators to understand what to do with data from such sources as close-ended questions, checklist types of data, scales, number of years, and number of service contracts. Any data collection technique that is structured can be put into numerical form. Qualitative data analysis techniques enable program evaluators to analyze data from such sources as open-ended questions, process notes from training programs or group programs, descriptive-form records, case examples, and other types of nonquantitative data. In both quantitative and qualitative analysis, it is essential to have a plan for data analysis. In this assignment, you will propose and defend the methodology for implementing a program evaluation plan for the organization you referenced in Module 2.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Locate the mission statement and program description from the existing organization that you referenced in Module 2 to use as examples for this assignment.

· Instructors will be using a grading rubric to grade the assignments. It is recommended that learners review the rubric prior to beginning the assignment in order to become familiar with the assignment criteria and expectations for successful completion of the assignment.

· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Directions:

In a paper (1,250-1,500 words), propose a plan for implementing a program evaluation study for the program found in the organization you referenced in the Module 2 assignment. Your implementation plan should include the following:

1. The selection and description of both a quantitative and a qualitative method of data collection to carry out the study.

2. A research-based explanation of your rationale for selecting the data-collection procedures that clearly identifies the strengths and weaknesses of the procedures.

3. An explanation of how you would maintain validity and reliability of the quantitative data being collected.

4. A statement identifying methods for overcoming the kinds of problems you would expect as you collect the qualitative and quantitative data for this evaluation.

#PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

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lenoraferguson-blog · 5 years

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PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

Follow Below Link to Download File

https://homeworklance.com/downloads/psy-843-module-5-assignment-program-evaluation-implementation-plan/

We also Do 100% Original and Plagiarism Free Assignment / Homework and Essay

Email us for original and Plagiarism Free Work At ( [email protected] ) or order us at (https://homeworklance.com/custom-order/ )

Details:

Quantitative data analysis techniques provide guidelines for program evaluators to understand what to do with data from such sources as close-ended questions, checklist types of data, scales, number of years, and number of service contracts. Any data collection technique that is structured can be put into numerical form. Qualitative data analysis techniques enable program evaluators to analyze data from such sources as open-ended questions, process notes from training programs or group programs, descriptive-form records, case examples, and other types of nonquantitative data. In both quantitative and qualitative analysis, it is essential to have a plan for data analysis. In this assignment, you will propose and defend the methodology for implementing a program evaluation plan for the organization you referenced in Module 2.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Locate the mission statement and program description from the existing organization that you referenced in Module 2 to use as examples for this assignment.

· Instructors will be using a grading rubric to grade the assignments. It is recommended that learners review the rubric prior to beginning the assignment in order to become familiar with the assignment criteria and expectations for successful completion of the assignment.

· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Directions:

In a paper (1,250-1,500 words), propose a plan for implementing a program evaluation study for the program found in the organization you referenced in the Module 2 assignment. Your implementation plan should include the following:

1. The selection and description of both a quantitative and a qualitative method of data collection to carry out the study.

2. A research-based explanation of your rationale for selecting the data-collection procedures that clearly identifies the strengths and weaknesses of the procedures.

3. An explanation of how you would maintain validity and reliability of the quantitative data being collected.

4. A statement identifying methods for overcoming the kinds of problems you would expect as you collect the qualitative and quantitative data for this evaluation.

#PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

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carolboydblog-blog · 5 years

Text

PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

Follow Below Link to Download File

https://homeworklance.com/downloads/psy-843-module-5-assignment-program-evaluation-implementation-plan/

We also Do 100% Original and Plagiarism Free Assignment / Homework and Essay

Email us for original and Plagiarism Free Work At ( [email protected] ) or order us at (https://homeworklance.com/custom-order/ )

Details:

Quantitative data analysis techniques provide guidelines for program evaluators to understand what to do with data from such sources as close-ended questions, checklist types of data, scales, number of years, and number of service contracts. Any data collection technique that is structured can be put into numerical form. Qualitative data analysis techniques enable program evaluators to analyze data from such sources as open-ended questions, process notes from training programs or group programs, descriptive-form records, case examples, and other types of nonquantitative data. In both quantitative and qualitative analysis, it is essential to have a plan for data analysis. In this assignment, you will propose and defend the methodology for implementing a program evaluation plan for the organization you referenced in Module 2.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Locate the mission statement and program description from the existing organization that you referenced in Module 2 to use as examples for this assignment.

· Instructors will be using a grading rubric to grade the assignments. It is recommended that learners review the rubric prior to beginning the assignment in order to become familiar with the assignment criteria and expectations for successful completion of the assignment.

· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Directions:

In a paper (1,250-1,500 words), propose a plan for implementing a program evaluation study for the program found in the organization you referenced in the Module 2 assignment. Your implementation plan should include the following:

1. The selection and description of both a quantitative and a qualitative method of data collection to carry out the study.

2. A research-based explanation of your rationale for selecting the data-collection procedures that clearly identifies the strengths and weaknesses of the procedures.

3. An explanation of how you would maintain validity and reliability of the quantitative data being collected.

4. A statement identifying methods for overcoming the kinds of problems you would expect as you collect the qualitative and quantitative data for this evaluation.

#PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

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traceyperez7-blog · 5 years

Text

PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

Follow Below Link to Download File

https://homeworklance.com/downloads/psy-843-module-5-assignment-program-evaluation-implementation-plan/

We also Do 100% Original and Plagiarism Free Assignment / Homework and Essay

Email us for original and Plagiarism Free Work At ( [email protected] ) or order us at (https://homeworklance.com/custom-order/ )

Details:

Quantitative data analysis techniques provide guidelines for program evaluators to understand what to do with data from such sources as close-ended questions, checklist types of data, scales, number of years, and number of service contracts. Any data collection technique that is structured can be put into numerical form. Qualitative data analysis techniques enable program evaluators to analyze data from such sources as open-ended questions, process notes from training programs or group programs, descriptive-form records, case examples, and other types of nonquantitative data. In both quantitative and qualitative analysis, it is essential to have a plan for data analysis. In this assignment, you will propose and defend the methodology for implementing a program evaluation plan for the organization you referenced in Module 2.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Locate the mission statement and program description from the existing organization that you referenced in Module 2 to use as examples for this assignment.

· Instructors will be using a grading rubric to grade the assignments. It is recommended that learners review the rubric prior to beginning the assignment in order to become familiar with the assignment criteria and expectations for successful completion of the assignment.

· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Directions:

In a paper (1,250-1,500 words), propose a plan for implementing a program evaluation study for the program found in the organization you referenced in the Module 2 assignment. Your implementation plan should include the following:

1. The selection and description of both a quantitative and a qualitative method of data collection to carry out the study.

2. A research-based explanation of your rationale for selecting the data-collection procedures that clearly identifies the strengths and weaknesses of the procedures.

3. An explanation of how you would maintain validity and reliability of the quantitative data being collected.

4. A statement identifying methods for overcoming the kinds of problems you would expect as you collect the qualitative and quantitative data for this evaluation.

#PSY 843 Module 5 Assignment Program Evaluation Implementation Plan

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vishwanathblr-blog · 6 years

Text

Global Ventilator-associated pneumonia (VAP) Market 2027 Forecasts by Americas Industry Analysis in 2017 Report

Market Scenario:

Ventilator-associated pneumonia is a type of lung infection caused to patients who are on ventilators. Ventilator-associated pneumonia is caused mainly due to lung disease, neurologic disease, and trauma to critically ill persons. Diagnosing VAP requires aggressive surveillance combined with the radiographic examination, bedside examination, and microbiologic examinations of respiratory secretions. Growing Intensive Care Unit Admissions due to rising prevalence of respiratory diseases, rising number of ICU beds and high incidence of traumatic injuries provides favorable backgrounds for the market to grow. According to CDC in 2013, there were 2.8 million traumatic brain injury visits to emergency department and hospitals. The emergency department visits of brain injury patients increased by 47% from 2007. Thus, increasing incidence of TBI drives the growth of the market. Furthermore, increasing geriatric population is likely to fuel the market to grow. According to the U.S. Census Bureau in 2015, 47.8 million people were 65 years or older, and in 2060, 98.2 million are expected to be 65 years or older. Such increasing trend in the geriatric population provides favorable backgrounds for the market to grow.

Segmentation

The global Ventilator-associated pneumonia market is segmented on the basis of diagnosis, mode of treatment, and end-user. The Ventilator-associated pneumonia market, by diagnosis categorized into Clinical Examination, Radiological Examination, Microbiological Analysis and others. Microbiological Analysis is further sub-segmented into Blood and pleural fluid cultures, Nonquantitative or semi-quantitative airway sampling and Quantitative cultures of airway specimens. Mode of treatment segment is segmented into Homecare, Hospital care, and others. On the basis of end-user, the market is segmented into Hospitals & Clinics, Research centers, Ambulatory Care Centers and Emergency Medical Services (EMS).

Regional Analysis

Globally, Ventilator-associated pneumonia (VAP) market consists of four regions Americas, Europe, Asia Pacific and Middle East & Africa. America is the largest market for Ventilator-associated pneumonia (VAP) whose growth is contributed to increase in prevalence of smoking leading to lung diseases, large number of patients suffering from chronic heart diseases and demand of mechanical ventilators. The market is growing continuously in Europe due to extensive demand of medical devices in hospitals, and increasing healthcare expenditure. Asia Pacific is expected to be the fastest growing market owing to increase in environmental pollution, high incidence of asthma & chronic obstructive pulmonary disease and large patient pool. Moreover, Awareness regarding prevention of hospital acquired infection, pneumonia and quality control measures taken by hospitals for control of nosocomial infection favour the growth of this market. Increasing ageing population and incidence of infectious disease too contribute for the growth of this market in Asia Pacific. On the other hand, the Middle East & Africa region are likely to have a limited but steady growth in the market.

Key Players for global wireless health and fitness devices market

Some of the key players for the global Ventilator-associated pneumonia market Merck & Co., Inc. (U.S.), Adenium Biotech ApS (Denmark), AstraZeneca (UK), MedImmune (US), Nabriva Therapeutics AG (Austria) and other.

#Ventilator-associated pneumonia (VAP) Market

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khamgiodau · 6 years

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QUY TRÌNH KỸ THUẬT NỘI SOI KHÍ PHẾ QUẢN CẤP CỨU

I. ĐẠI CƯƠNG - Nội soi khí phế quản là biện pháp thăm khám trong lòng ph ế quản bằng ống nội soi - Nội soi phế quản có thể thực hiện bằng ống nội soi cứng hoặc ống nội soi mềm - So với ống nội soi phế quản cứng, ống nội soi phế quản mềm dễ thực hiện hơn và an toàn hơn cho Người bệnh, có thể quan sát thấy đư ợc toàn bộ cây phế quản và không cần gây mê toàn thân hoặc thực hiện trong phòng mổ II. CHỈ ĐỊNH 1. Chỉ định chẩn đoán 1.1. Ho ra máu - Xác đ ịnh vị trí chẩy máu và chẩn đoán nguyên nhân - Với chảy máu đang ti ếp diễn, vị trí và căn nguyên đư ợc phát hiện vào khoảng 90%. Tỷ lệ này giảm xuống 50% sau khi đã c ầm máu 1.2. Xẹp phổi Ngoài tắc nghẽn phế quản do khối u ác tính hoặc dị vật thì bít tắc do dịch nhầy là phổ biến nhất. Bít tắc do dịch nhầy thư ờng mở rộng ra ngoại vi vư ợt khỏi tầm quan sát của ống nội soi phế quản 1.3. Bệnh nhu mô lan tỏa - Sinh thiết phổi qua phế quản (transbronchial lung biopsy) và rửa phế quản phế nang (BAL - bronchoalveolar lavage) có thể cung cấp thông tin về các khối u nhu mô - BAL là biện pháp giúp chẩn đoán các nhi ễm trùng cơ h ội ở Người bệnh có suy giảm miễn dịch - Sinh thiết phổi bằng ống nội soi huỳnh quang (fluoroscopy) có thể cải thiện đư ợc việc xác đ ịnh vị trí và hạn chế tràn khí màng phổi 1.4. Tổn thương do hít c ấp tính - Xác đ ịnh vị trí giải phẫu và mức đ ộ nặng của tổn thương sau khi hít ph ải khói - Tắc nghẽn đư ờng hô hấp trên có thể xuất hiện trong vòng 24 giờ của tổn thương do hít - Suy hô hấp cấp tính khả năng là do thay đ ổi niêm mạc tại các phế quản thùy hoặc đư ờng hô hấp dư ới 1.5. Chấn thương ng ực do vật tù - Ngoài đ ứt đư ờng dẫn khí sau chấn thương v ật tù thì ho ra máu, xẹp thùy phổi, trán khí trung thất hoặc tràn khí màng phổi cũng có th ể gặp 29 1.6. Đánh giá t ổn thương sau đ ặt ống nội khí quản - Đánh giá t ổn thương thanh qu ản hoặc khí quản sau đ ặt ống nội khí quản 1.7. Nuôi cấy vi khuẩn - Để xác đ ịnh vi sinh vật đ ịnh cư t ại đư ờng hô hấp khi Người bệnh không thể khạc đ ờm - Nuôi cấy đ ịnh lư ợng bệnh phẩm đư ợc lấy bằng bàn chải có bảo vệ cải thiện đư ợc mức đ ộ chính xác của mẫu cấy lấy qua nôi soi phế quản thư ờng quy - Ở Người bệnh không đ ặt ống nội khí quản, mẫu bệnh phẩm đư ợc lấy qua nội soi phế quản không chính xác hơn m ẫu bệnh phẩm đư ợc Người bệnh khạc nhổ. Cả hai mẫu này đ ều có độ dương tính gi ả và âm tính giả cao 1.8. Chẩn đoán viêm ph ổi liên quan tới máy thở (VAP) - Cung cấp mẫu nuôi cấy vi khuẩn - Bài tiết mủ từ các phế quản ngoại vi trong thì thở ra có thể dự đoán có viêm phổi liên quan tới máy thở - Các số liệu gần đây cho thấy nuôi cấy đ ịnh lư ợng dịch rửa phế quản phế nang có thể không chính xác hơn nuôi c ấy không đ ịnh lư ợng mẫu bệnh phẩm lấy qua nội khí quản 2. Chỉ định đi ều trị 2.1. Tăng ti ết đờm quá mức/xẹp phổi - Xẹp thùy phổi không đáp ứng với vật lý trị liệu lồng ngực và ho - Nhỏ giọt thuốc N-acetylcysteine (NAC), surfactant và DNase tái tổng hợp đã đư ợc sử dụng đ ể giúp hóa lỏng chất nhầy cô đ ặc. Không có thử nghiệm lâm sàng nào ủng hộ cho mục đích s ử dụng này 2.2. Dị vật - Nội soi phế quản ống cứng là thủ thuật đư ợc lựa chọn đ ể lấy bỏ các dị vật hít phải - Các dụng cụ đi kèm có s ẵn giúp lấy bỏ dị vật bằng ống soi mềm 2.3. Đặt ống nội khí quản - Ống soi phế quản, đư ợc sử dụng như d ụng cụ trám bịt (obturator) đư ợc luồn qua bởi ống nội khí quản, có thể giúp đ ặt ống nội khí quản qua đư ờng mũi hoặc đư ờng miệng ở Người bệnh có đư ờng dẫn khí khó 2.4. Ho ra máu - Ép lòng phế quản có thể làm Người bệnh ổn đ ịnh đ ể tiếp tục tiến hành các biện pháp đi ều trị triệt đ ể hơn + Ép lòng phế quản có thể thực hiện đư ợc bởi ống thông có bóng ở đầu đ ể chèn vào các lỗ phế quản thùy - Ho ra máu ồ ạt có thể được kiểm soát bằng rửa nư ớc muối sinh lý đá 30 2.5. Tổn thương t ắc nghẽn đường hô hấp trung tâm - Xem xét cắt bằng la-de (laser photoresection) hoặc đ ặt giá đ ỡ (stent) qua tổn thương gây t ắc nghẽn thanh quản, khí quản và phế quản lớn 2.6. Đóng l ỗ rò khí quản màng phổi - Để quan sát đ ầu gần hoặc đ ịnh khu đ ầu xa hơn c ủa lỗ rò - Vật liệu đư ợc tiêm qua ống nội soi phế quản có thể đóng đư ợc lỗ rò 2.7. Mở khí quản qua da tại giường - Khi sử dụng thư ờng quy, việc quan sát qua ống nội soi phế quản trong khi làm thủ thuật làm giảm đáng k ể biến chứng của thủ thuật III. CHỐNG CHỈ ĐỊNH - Bác sĩ chưa đư ợc đào t ạo về kỹ thuật, không có kinh nghiệm - Người bệnh không hợp tác - Không thể duy trì đ ộ bão hòa oxy đ ầy đ ủ - Rối loạn đông máu ở Người bệnh cần nội soi phế quản đ ể sinh thiết (dùng bàn chải hoặc kẹp fooc-xép) - Người bệnh có tình trạng huyết đ ộng không ổn đ ịnh - Người bệnh hen phế quản có triệu chứng mà chưa đư ợc đi ều trị (nội soi phế quản ống mềm ít khi được sử dụng đ ể làm giảm tắc nghẽn do nút nhầy cho Người bệnh đã đ ặt ống nội khí quản có trạng thái hen phế quản) - Bệnh phổi tắc nghẽn mạn tính nặng có kết hợp tăng CO 2 máu (tiền mê, an thần, và hỗ trợ oxy phải đư ợc sử dụng một cách thận trọng) - Tăng áp lực nội sọ (sử dụng phối hợp các thuốc gây mê đ ể bảo vệ não, thuốc giãn cơ đ ể tránh ho, và theo dõi sát đ ể đảm bảo áp lực tư ới máu não đ ầy đ ủ) IV. CHUẨN BỊ 1. Ngư ời làm thủ thuật: Là bác sĩ, đư ợc đào t ạo về kỹ thuật nội soi phế quản, thành thạo kỹ thuật, luôn luôn dành thời gian đ ể kiểm tra Người bệnh trước khi tiến hành kỹ thuật nội soi phế quản 2. Người bệnh - Thăm khám phát hi ện các bệnh lý nền như hen, b ệnh tim mạch, suy thận, rối loạn đông máu - Khai thác tiền sử dị ứng, thuốc đang dùng có ảnh hư ởng tới chức năng đông máu - Kiểm tra xem Người bệnh đã ch ụp XQ phổi và làm đi ện tâm đ ồ chưa? Đ ộ bão hòa oxy của Người bệnh như th ế nào? - Người bệnh phải nhịn ăn trư ớc khi làm thủ thuật - Người bệnh và/hoặc ngư ời thân phải ghi bản cam kết làm thủ thuật - Đặt đư ờng truyền tĩnh m ạch 31 3. Dụng cụ - Máy nội soi phế quản, máy theo dõi Người bệnh, SpO2, thuốc tiền mê, ống xét nghiệm. - Dịch truyền, bơm tiêm, dây truy ền,.. 4. Hồ sơ b ệnh án Giải thích về kỹ thuật cho Người bệnh, gia đình Người bệnh và kí cam kết đồng ý kỹ thuật, phiếu ghi chép theo dõi thủ thuật. V. CÁC BƯ ỚC TIẾN HÀNH 1. Kiểm tra hồ sơ: Kiểm tra lại chỉ định, chống chỉ định và cam kết đ ồng ý thực hiện thủ thuật. 2. Kiểm tra Người bệnh: Kiểm tra lại các chức năng s ống của Người bệnh trước khi tiến hành thủ thuật. 3. Thực hiện kỹ thuật - Gây tê cục bộ bằng lidocaine khí dung và thạch lidocaine tại chỗ. + Sau khi sử dụng đ ể gây tê tại chỗ, lidocaine hấp thu qua niêm mạc và đ ạt được nồng đ ộ trong máu rất nhanh, thậm chí có thể gây đ ộc. + Nồng đ ộ trong phạm vi điều trị thấp đ ạt đư ợc nếu tổng liều sử dụng 24 giờ thì có khả là do năng viêm ph ổi sau nội soi phế quản VII. BIẾN CHỨNG VÀ TAI BIẾN - Khi đư ợc thực hiện bởi bác sĩ đư ợc đào t ạo thì nội soi phế quản bằng ống mềm thư ờng quy rất an toàn - Tỷ lệ tử vong không vư ợt quá 0,1% - Tử vong do tiền mê quá mức hoặc gây tê tại chỗ, ngừng thở do chẩy máu, co thắt thanh quản, co thắt phế quản và ngừng tim do nhồi máu cơ tim - Tỷ lệ biến chứng chung Bài viếtQUY TRÌNH KỸ THUẬT NỘI SOI KHÍ PHẾ QUẢN CẤP CỨU xuất hiện lần đầu tại website http://khamgiodau.com

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leeannclymer · 6 years

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Blog Post: Solving Pay Equity Questions With Regression Analysis

All types of companies, including law firms, often wonder how a pay analysis can be beneficial if there are so many factors that can't be captured in a statistical model. The good news is that regression analysis is quite adequate in modeling the quantitative factors that drive pay, but can also be used to understand and isolate nonquantitative factors, say Charles Diamond and Rick Holt of Resolution Economics LLC. Blog Post: Solving Pay Equity Questions With Regression Analysis published first on http://www.lexisnexis.com/legalnewsroom/workers-compensation/rss.aspx

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omcik-blog · 7 years

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New Post has been published on OmCik

New Post has been published on http://omcik.com/mental-health-payers-ask-trump-team-to-ax-obama-era-disclosure-rules/

Mental Health Payers Ask Trump Team to Ax Obama-Era Disclosure Rules

(Image: Thinkstock)

An executive at a company that manages behavioral health for millions of Americans says Obama administration officials went too far when they expanded behavioral health benefits design disclosure rules.

Meredith Delk, a senior vice president at Magellan Health Inc., says the Obama administration officials had no statutory authority to require plan managers to release so much data about how they develop mental health benefits and addiction treatment benefits.

The Employee Retirement Income Security Act of 1974 requires group health plans to give reasons for benefits denials, and the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) now requires a plan to explain denials of behavioral health claims, Delk writes in a comment letter.

The agencies that wrote the MHPAEA regulations, which were published in the Federal Register in November 2013, did implement the MHPAEA disclosure rules in an appropriate way, Delk writes.

“Unfortunately, the regulations then go on to invent alleged disclosure requirements under ERISA that do not exist,” Delk writes.

(Related: Feds: ERISA Plans Must Share Their Decision Support Tools)

Delk is asking the three bodies in charge of MHPAEA compliance — the Internal Revenue Service, the U.S. Department of Labor’s Employee Benefits Security Administration, and the U.S. Department of Health and Human Services — to kill a disclosure form created by to implement the MHPAEA benefit plan design disclosure regulations, or at least to revise the form.

The Association for Behavioral Health and Wellness (ABHW), a group for behavioral health and wellness companies, is also asking the “tri agencies” to cut down on the amount of information the MHPAEA regulations and disclosure form require a plan to provide.

“There are better ways to inform consumers about how their plan is implementing parity without overwhelming them with thousands of pages of documentation,” according to Pamela Greenberg, the ABHW president. “We support keeping the disclosure requirements at a level where consumers will understand the information they receive and will not be overwhelmed by a U-Haul truck of complex information.”

Delk and Greenberg were writing to comment on an MHPAEA disclosure form the tri agencies have been developing. The DOL has posted copies of the comment letters here.

MHPAEA

The MHPAEA is a successor to an older mental health parity law, the Mental Health Parity Act of 1996.

Neither law requires any employer to offer behavioral health benefits.

(Image: Thinkstock)

The 1996 law requires any affected employer that does offer mental health benefits to make the quantitative parameters for the medical benefits and the mental health benefits comparable.

Critics complained that plans were getting around the 1996 parity rules by making the quantitative parameters for medical care and mental health care similar, but watering down the “nonquantitative treatment limits” (NQTLs), such as the number and quality of in-network mental health care providers available.

The MHPAEA requires that, for an employer with more than 50 employees, both the quantitative care parameters and the nonquantitative care parameters to be comparable for medical care and behavioral health care.

In April 2016, tri-agency officials suggested, in what they framed as a response to a frequently asked question, that a behavioral health provider who is having trouble getting paid by a plan should ask the plan for extensive information, such as actuarial studies, to find out how it developed its medical health benefits and its behavioral health benefits.

Complexity

Many behavioral health providers have stopped taking insurance because of concerns about billing problems. The providers who still take insurance say they need all the help with understanding health plans and motivating plans to pay that they can get.

Janet Trautwein, the chief executive officer of the National Association of Health Underwriters, writes in a comment letter sent on behalf of NAHU that implementing the MHPAEA has been difficult for employers, in part because of the disclosure requirements. She notes that an employer plan must be prepared to provide information about the “processes, strategies, evidentiary standards and other factors” used to apply a nonquantitative treatment limit to either medical care or behavioral care benefit.

“One issue is that NQTLs are hard to understand and quantify,” Trautwein writes. “NAHU believes that companies and entities that businesses engage for health plan administration assistance would greatly benefit from more official guidance from the Departments about what constitutes an NQTL and what are acceptable processes, strategies, evidentiary standards and other factors to apply NQTLs. We strongly urge you to include as many detailed examples as possible when developing any such guidance.”

Trautwein offers many ideas for how to make the plan disclosure information easier for consumers to understand.

She writes, for example, that it appears that many people with group coverage are not aware of what kind of plan their employer provides.

The tri agencies should consider giving more information about different types of heath coverage, and advice about where to go for more information, in the introduction to the disclosure regulations, Trautwein writes.

— Read Tri-Agency Advice: What a Mental Health Counselor Should Ask a Plan on ThinkAdvisor.

— Connect with ThinkAdvisor Life/Health on Facebook and Twitter.

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atintintintin · 7 years

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Litigation Provides Clues to Ongoing Challenges in Implementing Insurance Parity.