scholarly journals Curriculum for vestibular medicine (vestmed) proposed by the barany society

2021 ◽  
pp. 1-10
Author(s):  
R. van de Berg ◽  
L. Murdin ◽  
S.L. Whitney ◽  
J. Holmberg ◽  
A. Bisdorff

This document presents the initiative of the Bárány Society to improve diagnosis and care of patients presenting with vestibular symptoms worldwide. The Vestibular Medicine (VestMed) concept embraces a wide approach to the potential causes of vestibular symptoms, acknowledging that vertigo, dizziness, and unsteadiness are non-specific symptoms that may arise from a broad spectrum of disorders, spanning from the inner ear to the brainstem, cerebellum and supratentorial cerebral networks, to many disorders beyond these structures. The Bárány Society Vestibular Medicine Curriculum (BS-VestMed-Cur) is based on the concept that VestMed is practiced by different physician specialties and non-physician allied health professionals. Each profession has its characteristic disciplinary role and profile, but all work in overlapping areas. Each discipline requires good awareness of the variety of disorders that can present with vestibular symptoms, their underlying mechanisms and etiologies, diagnostic criteria and treatment options. Similarly, all disciplines require an understanding of their own limitations, the contribution to patient care from other professionals and when to involve other members of the VestMed community. Therefore, the BS-VestMed-Cur is the same for all health professionals involved, the overlaps and differences of the various relevant professions being defined by different levels of detail and depth of knowledge and skills. The BS-VestMed-Cur defines a Basic and an Expert Level Curriculum. The Basic Level Curriculum covers the VestMed topics in less detail and depth, yet still conveys the concept of the wide net approach. It is designed for health professionals as an introduction to, and first step toward, VestMed expertise. The Expert Level Curriculum defines a Focused and Broad Expert. It covers the VestMed spectrum in high detail and requires a high level of understanding. In the Basic and Expert Level Curricula, the range of topics is the same and runs from anatomy, physiology and physics of the vestibular system, to vestibular symptoms, history taking, bedside examination, ancillary testing, the various vestibular disorders, their treatment and professional attitudes. Additionally, research topics relevant to clinical practice are included in the Expert Level Curriculum. For Focused Expert proficiency, the Basic Level Curriculum is required to ensure a broad overview and additionally requires an expansion of knowledge and skills in one or a few specific topics related to the focused expertise, e.g. inner ear surgery. Broad Expert proficiency targets professionals who deal with all sorts of patients presenting with vestibular symptoms (e.g. ORL, neurologists, audiovestibular physicians, physical therapists), requiring a high level of VestMed expertise across the whole spectrum. For the Broad Expert, the Expert Level Curriculum is required in which the minimum attainment targets for all the topics go beyond the Basic Level Curriculum. The minimum requirements regarding knowledge and skills vary between Broad Experts, since they are tuned to the activity profile and underlying specialty of the expert.   The BS-VestMed-Cur aims to provide a basis for current and future teaching and training programs for physicians and non-physicians. The Basic Level Curriculum could also serve as a resource for inspiration for teaching VestMed to students, postgraduate generalists such as primary care physicians and undergraduate health professionals or anybody wishing to enter VestMed.   VestMed is considered a set of competences related to an area of practice of established physician specialties and non-physician health professions rather than a separate clinical specialty. This curriculum does not aim to define a new single clinical specialty.   The BS-VestMed-Cur should also integrate with, facilitate and encourage translational research in the vestibular field.

2003 ◽  
Vol 99 (4) ◽  
pp. 779-782 ◽  
Author(s):  
Vini G. Khurana ◽  
Michael J. Link ◽  
Colin L. W. Driscoll ◽  
Charles W. Beatty

✓ The authors report on a patient with a rare schwannoma that arose from the cochlear division of the vestibulocochlear nerve. Distinctively, the lesion appeared to arise from the cochlea itself and was monitored with clinical and neuroimaging studies for 12 years before it was diagnosed and treated. The atypical occurrence of schwannomas of the vestibulocochlear nerve originating in the inner ear structures underscores the high level of clinical suspicion required for the diagnosis of these lesions in patients presenting with persistent auditory and vestibular symptoms.


2015 ◽  
Vol 39 (3) ◽  
pp. 249 ◽  
Author(s):  
Gretchen Young ◽  
Julie Hulcombe ◽  
Andrea Hurwood ◽  
Susan Nancarrow

Objective Queensland Health established a Ministerial Taskforce to consult on and make recommendations for the expansion of the scope of practice of allied health roles. This paper describes the findings from the stakeholder consultation. Methods The Ministerial Taskforce was chaired by the Assistant Minister for Health and included high-level representation from allied health, nursing, medicine, unions, consumers and universities. Widespread engagement was undertaken with stakeholders representing staff from a wide cross-section of health service provision, training and unions. Participants also tendered evidence of models incorporating full-scope and extended scope tasks undertaken by allied health professionals. Results The consultation incorporated 444 written submissions and verbal feedback from over 200 participants. The findings suggest that full scope of practice is often restricted within the Queensland public health system, resulting in underuse of allied health capacity and workforce inefficiencies. However, numerous opportunities exist to enhance patient care by extending current roles, including prescribing and administering medications, requesting investigations, conducting procedures and reporting results. The support needed to realise these opportunities includes: designing patient-centred models of service delivery (including better hours of operation and delegation to support staff); leadership and culture change; funding incentives; appropriate education and training; and clarifying responsibility, accountability and liability for outcomes. The taskforce developed a series of recommendations and an implementation strategy to operationalise the changes. Conclusions The Ministerial Taskforce was an effective and efficient process for capturing broad-based engagement for workforce change while ensuring high-level support and involving potential adversaries in the decision-making processes. What is known about the topic? Anecdotal evidence exists to suggest that allied health professionals do not work to their full scope of practice and there is potential to enhance health service efficiencies by ensuring practitioners are supported to work to their full scope of practice. What does this paper add? This paper presents the findings from a large-scale consultation, endorsed by the highest level of state government, that reinforces the perceptions that allied health professionals do not work to full scope of practice, identifies several barriers to working to full scope and extended scope of practice, and opportunities for workforce efficiencies arising from expanding scope of practice. The top-down engagement process should expedite the implementation of workforce change. What are the implications for practitioners? High-level engagement and support is an effective and efficient way to broker change and overcome intraprofessional barriers to workforce change policies. However, practitioners are often prevented from expanding their roles through an implied need to ‘ask for permission’, when, in fact, the only barriers to extending their role are culture and historical practice.


2020 ◽  
pp. 24-33
Author(s):  
K. V. Rozov

The article presents the structure, content and results of approbation of the C++ programming course developed for the 10th grade students of physics and mathematics profile and implemented as part of the academic subject “Informatics”. The aim of the course is to develop in the student not only knowledge and skills in programming, but also his algorithmic culture and programming culture as important qualities of a potential IT-specialist. This is facilitated by special control of educational process by the teacher, which consists in monitoring the activities of students in writing programs and timely correction of this activity. The assessment of the level of development of student algorithmic culture and programming culture relative to the basic level of their formation (when mastering the basics of algorithmization and programming in the 9th grade) was carried out on the basis of a number of criteria presented in the article. The results of approbation showed that the specially organized teacher activity makes it possible to increase the level of algorithmic culture and programming culture of high school students when studying the basics of programming in C++.


2020 ◽  
Vol 7 (1) ◽  
pp. 45-55
Author(s):  
Paul Hoehner ◽  
David H. Beyda ◽  
William P. Cheshire ◽  
Robert E. Cranston ◽  
John T. Dunlop ◽  
...  

The Christian Medical and Dental Associations (CMDA) was founded in 1931 and is made up of the Christian Medical Association (CMA) and the Christian Dental Association (CDA). CMDA has a current membership of over 19,000 physicians, dentists, and other allied health professionals. During and in direct response to the pressing urgencies of the COVID-19 universal pandemic of 2020 the President of CMDA commissioned a special task force to provide current and future Christian reflection and guidance on triage and resource allocation policies during pandemics and other forms of crisis surge medical conditions (e.g., mass casualty situations). This is a condensed version of the CMDA special task force position statement. 


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenney Ng ◽  
Uri Kartoun ◽  
Harry Stavropoulos ◽  
John A. Zambrano ◽  
Paul C. Tang

AbstractTo support point-of-care decision making by presenting outcomes of past treatment choices for cohorts of similar patients based on observational data from electronic health records (EHRs), a machine-learning precision cohort treatment option (PCTO) workflow consisting of (1) data extraction, (2) similarity model training, (3) precision cohort identification, and (4) treatment options analysis was developed. The similarity model is used to dynamically create a cohort of similar patients, to inform clinical decisions about an individual patient. The workflow was implemented using EHR data from a large health care provider for three different highly prevalent chronic diseases: hypertension (HTN), type 2 diabetes mellitus (T2DM), and hyperlipidemia (HL). A retrospective analysis demonstrated that treatment options with better outcomes were available for a majority of cases (75%, 74%, 85% for HTN, T2DM, HL, respectively). The models for HTN and T2DM were deployed in a pilot study with primary care physicians using it during clinic visits. A novel data-analytic workflow was developed to create patient-similarity models that dynamically generate personalized treatment insights at the point-of-care. By leveraging both knowledge-driven treatment guidelines and data-driven EHR data, physicians can incorporate real-world evidence in their medical decision-making process when considering treatment options for individual patients.


Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S8
Author(s):  
Lauren Ashley Rousseau ◽  
Nicole M. Bourque ◽  
Tiffany Andrade ◽  
Megan E.B. Antonellis ◽  
Patrice Hoskins ◽  
...  

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Angela Margaret Evans

Abstract Background Healthcare aims to promote good health and yet demonstrably contributes to climate change, which is purported to be ‘the biggest global health threat of the 21st century’. This is happening now, with healthcare as an industry representing 4.4% of global carbon dioxide emissions. Main body Climate change promotes health deficits from many angles; however, primarily it is the use of fossil fuels which increases atmospheric carbon dioxide (also nitrous oxide, and methane). These greenhouse gases prevent the earth from cooling, resulting in the higher temperatures and rising sea levels, which then cause ‘wild weather’ patterns, including floods, storms, and droughts. Particular vulnerability is afforded to those already health compromised (older people, pregnant women, children, wider health co-morbidities) as well as populations closer to equatorial zones, which encompasses many low-and-middle-income-countries. The paradox here, is that poorer nations by spending less on healthcare, have lower carbon emissions from health-related activity, and yet will suffer most from global warming effects, with scant resources to off-set the increasing health care needs. Global recognition has forged the Paris agreement, the United Nations sustainable developments goals, and the World Health Organisation climate change action plan. It is agreed that most healthcare impact comes from consumption of energy and resources, and the production of greenhouse gases into the environment. Many professional associations of medicine and allied health professionals are advocating for their members to lead on environmental sustainability; the Australian Podiatry Association is incorporating climate change into its strategic direction. Conclusion Podiatrists, as allied health professionals, have wide community engagement, and hence, can model positive environmental practices, which may be effective in changing wider community behaviours, as occurred last century when doctors stopped smoking. As foot health consumers, our patients are increasingly likely to expect more sustainable practices and products, including ‘green footwear’ options. Green Podiatry, as a part of sustainable healthcare, directs us to be responsible energy and product consumers, and reduce our workplace emissions.


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