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Understanding the reimbursement process.

Nurse practitioners must be fiscally responsible to obtain reimbursement for services provided. A thorough knowledge of the reimbursement process is required to accomplish this goal. This article explores the reimbursement process, generation of revenue, and personal productivity determination for nurse practitioners. Parameters for billing using the resource-based relative value scale, the Evaluation and Management Documentation Guidelines, the International Classification of Disease, and the Physicians' Current Procedural Terminology code book are explained.

Disease↗

ICPC-2-E: the electronic version of ICPC-2. Differences from the printed version and the consequences.

BACKGROUND: In 1998, ICPC-2 was published as a book. In the process of translating the book, and preparing an electronic version of chapter 10 (the actual classification), ICPC-2 proved to contain many errors and inconsistencies. Particularly, major problems were identified in the conversion between ICPC-2 and ICD-10, which could lead to major errors when used in electronic patient records. OBJECTIVES: We prepared an electronic version of chapter 10 of ICPC-2, ICPC-2-E, with all necessary corrections, to be published on the Oxford University Press web site as a part of this article. METHODS: Errors and inconsistencies were redressed, including particularly those in the con-version structure with all consequences on the level of inclusion and exclusion criteria, through a process of careful checking. RESULTS AND CONCLUSION: ICPC-2-E, the electronic version of chapter 10 of ICPC-2, is specifically to be used in an electronic patient record and for research purposes. It is to be used together with the first nine chapters of ICPC-2, since the book is indispensable to make a correct use of ICPC.

Bias↗

Positive psychology progress: empirical validation of interventions.

Positive psychology has flourished in the last 5 years. The authors review recent developments in the field, including books, meetings, courses, and conferences. They also discuss the newly created classification of character strengths and virtues, a positive complement to the various editions of the Diagnostic and Statistical Manual of Mental Disorders (e. g., American Psychiatric Association, 1994), and present some cross-cultural findings that suggest a surprising ubiquity of strengths and virtues. Finally, the authors focus on psychological interventions that increase individual happiness. In a 6-group, random-assignment, placebo-controlled Internet study, the authors tested 5 purported happiness interventions and 1 plausible control exercise. They found that 3 of the interventions lastingly increased happiness and decreased depressive symptoms. Positive interventions can supplement traditional interventions that relieve suffering and may someday be the practical legacy of positive psychology.

Depressive Disorder↗

[Transition from malum coxae senile to the arthrosis deformans concept. A summary of the best known theories and classifications].

The disease of degenerative arthritis has been known for thousands of years. Paleopathology has provided findings of ancient degenerative alterations. Furthermore, physicians in classical antiquity described several forms of joint diseases. A challenging problem was the therapy, which was limited at that time. For centuries all joint diseases were subsumed under the term"rheumatism." In 1683 Thomas Sydenham, who suffered himself from gout, first differentiated this joint disease from the larger group of rheumatic joint diseases. Another early classification was undertaken by John Haygarth in 1779. He differentiated gout from malum coxae senilis and the chronic rheumatic diseases. The different theories and the resulting classifications were influenced by different disciplines such as surgery, internal medicine, pathology, anatomy, neurology, microbiology, and radiology. This investigation includes the time period from the early nineteenth century until 1925 when the word "arthrosis" was first used in a medical publication. This investigation is based on research at the library of the German Museum for Orthopedic History and Science as well on the systematic search for articles in different German journals such as Zeitschrift für Orthopddie and Fortschritte auf dem Gebiet der Röntgenstrahlen. It includes almost all important books and publications about degenerative arthritis for this time period. In the past there were many different descriptions for degenerative arthritis. The establishment of X-rays and new methods in histology and microbiology and the aspect of biomechanical theories led to a better understanding of the different diseases. The authors tried to construct new classifications without the knowledge of the causal and formal pathogenesis. This is the reason for the large number of different classifications, which had to be revised after a short period of time. This publication gives an overview about the most important articles and books which led to the classification currently in use.

Aged↗

Thomas Bateman MD FLS 1778-1821.

Thomas Bateman was a physician to the Carey Street Public Dispensary with Robert Willan in the first decade of the nineteenth century when the latter was developing the classification that would act as a foundation for modern dermatology. Following Willan's death with his work still incomplete, Bateman published a book, as an abstract of Willan's full concept, which was probably the most influential dermatology text of the nineteenth century. This was the first classification of dermatology that precisely defined the terms used and fitted individual diseases into a single class, rather than considering different stages of the same disease as maladies that belonged in different classes. This was the first attempt to link treatment to the disease process rather than to the clinical appearances and thus represents the origin of modern scientific clinical dermatology.

Dermatology↗

The book of names: DSM-IV in context.

The authors review the constraints of current mental disorder classification systems that rely upon descriptive symptom-based approaches, and weigh the benefits and hazards of these classification and diagnostic strategies. By focusing principally on superficial descriptions of symptoms, current systems fail to address the complex nature of persons' transactions within and adaptations to difficult environments. While attempting to be atheoretical, current systems exclude types of information that may elucidate individuals' functioning across various contexts, often because it is difficult to obtain such data reliably. With current approaches, misdiagnosis is likely, particularly when diagnostic criteria are applied to persons in nonclinical settings. Alternative approaches that take fuller advantage of clinicians' expertise and other forms of clinical data are reviewed, and recommendations are made for the next generation of classification systems. Application of evolutionary theory to psychiatry and psychology, as well as development of a theory and nosology of context in terms of persons' adaptations, are needed to expand our knowledge of normal and abnormal human development and psychopathology.

Adaptation, Psychological↗

"The sound must seem an echo to the sense": Pope's use of sound to convey meaning in his translation of Homer's Iliad.

In his Essay on Criticism, Pope suggested that sound both could and should be used to convey meaning in poetry. To test his practice of this principle, the 52,000 sounds or phonemes in the first two Books of Pope's translation of the Iliad were scored with the help of Whissell's 2000 classification of sounds in terms of emotional meaning. A chi-squared contingency analysis indicated that there was a preferential and face valid use of Passive sounds in some passages and of Active sounds in others. There was also a significant difference between Books (Book I was more Active) and a distinct pattern of rise and then fall within each of them in the preferential use of Active phonemes.

Auditory Perception↗

Dental chapters of Serefeddin Sabuncuoglu's (1385-1468?) illustrated surgical book Cerrahiyyetu'l Haniyye.

From the 7th to the 11th centuries Arabic authors translated ancient Greek and Roman medical textbooks into their own languages. In the 11th and 12th centuries, noted authors used these early translations when writing other classical texts. One of these was that of the Andalusian surgeon, Albulcasis (936-1013), whose famous work is entitled, at-Tasrif (4,6). It has been used as a reference book for centuries and was translated into Latin in the 15th century and into Turkish by me when I discovered a manuscript of it in the Manisa Library in Turkey (14). The best interpreter of it, however, was Serefeddin Sabuncuoglu (1365-1468). He used the classification of at-Tasrif, but improved on it by adding original observations and three original chapters. His book is entitled, Cerrahiyyetu'l Haniyye which means The Imperial Surgery (15).

Arab World↗

Tumors of the meninges: proposed modifications of the World Health Organization classification.

The present WHO classification of meningiomas has served us well. In keeping with the adage, "if it ain't broke, don't fix it," alterations should be made with due caution. These proposed modifications of the WHO classification are prompted by advances in our understanding of the pathobiology of meningeal neoplasms, as well as a need for an orderly scheme based upon factors of clinical importance. The author is well aware, that given the vastly differing technologies available to those utilizing the "blue book," its application must have a basis in routine histology rather than in "high-tech" procedures. No classification is ideal, but the modifications suggested represent a compromise between the pathologist's need for a complete morphologic exposition and the clinician's desire for a concise classification of therapeutic and prognostic significance.

Humans↗

[Educational objectives in the new interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Techniques" under the 9th Revision of the Licensing Regulations for Doctors--consensus recommendations of the German Society for Rehabilitative Sciences and the German Society for Physical Medicine and Rehabilitation].

In October 2003 the 9 (th) revision of the Federal Medical Training Regulations (Approbationsordnung) came into effect. The new compulsory interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Treatment" offers the opportunity to teach all students in comprehensive concepts of Rehabilitation such as the International Classification of Functioning, Disability and Health (ICF) of the WHO and the new book 9 of the German Social Code (SGB 9), as well as Physical Medicine and Naturopathic Treatment. Since the content of this new subject has not been defined up to date a joint task force of the German Society of Rehabilitation Science and the German Society of Physical Medicine and Rehabilitation was founded in order to recommend teaching standards. As part of these teaching standards educational objectives are introduced in this article. They should guide the persons in charge of teaching the subject in the medical faculties. In some areas the students should acquire profound abilities and skills in addition to knowledge. The medical faculties may focus on different educational targets according to their individual teaching profile.

Complementary Therapies↗

[A scientific dialogue between Freud and Fliess. The research project on neurasthenia (1893)].

This study, following upon the publication of the letters written by Freud to Fliess, deals with the objective content of the relationship between Freud and Fliess as it appears in a joint research project drawn up in 1893 and that was never carried out. This project had been elaborated with an extensive use of practician's notes in mind, this practice being in accordance with Fliess's habits but contrary to Freud's: this is to be linked with the rivalry existing between practitioners with scientific ambitions and university doctors. One of the principal goals of the project was to establish a nosography of the diffuse clinical picture of "neurasthenia". It was with this aim in mind that Fliess had already published a book on "nasal reflex neurosis" which fully reveals his tendency to establish descriptive classifications; on the contrary, Freud endeavoured--following the principle that form is to be found in typical cases (the "initial cases")--to arrive at an etiological and theoretical understanding of phenomena, an ambition that he also opposed to Fliess. Even if an interest for sexuality could be detected in Fliess's work, it was only under Freud's influence that it became an explicit theme. His role consisted--and this remained valid throughout their relationship--in supplying an organic basis to Freud's theses, the corner-stone of which was a theory of sexuality. He thus aided Freud in ridding himself of his scientific scruples and facilitated the construction of the psychoanalytic theory under its psychological form.

Germany↗

[The germination and preliminary formation of science of TCM formula in the pre Qin dynasty].

Shennong tasted hundreds of grasses and found herbs during the legend period. The appearance of prescription should be so early if single drug was regarded as single -- item recipe. However, the explicit records in literature appeared at the end of the Spring and Autumn period and the beginning of the Warring States at the latest, evidenced by the custom of "presenting a recipe" of the Qi states. The medical books of Mawangdui, mainly Wu shi er bing fang (Prescriptions for 52 Kinds of Diseases), recorded the classification of prescriptions based on the sort of diseases, composing, preparation, method of decocting medicinal herbs, contraindication of prescriptions, and the therapeutic methods, compatibility of complex prescriptions and determination of treatment based on the differentiation of syndromes (Zheng), etc. reflected in the recipes, which could represent the primary level of science of TCM formula of the Warring States in China. The classic medical book Nei jing (Internal Canon of Medicine), including denominations, composition, principles of compatibility and rules of clinical application of concrete prescriptions, especially therapies and theories of composed prescription, have great actions on the development of science of TCM formula.

China↗

The International Classification of Diseases: the structure and content of the Tenth Revision.

The Tenth Revision of the International Classification of Diseases is due to be published this year, and introduced from 1993. The aim of the classification is to facilitate comparisons between countries at the same point in time and within, and between, countries over time. The provision of comparable statistics is essential for facilitating policy decisions relating to health promotion and disease prevention, and for the collection of epidemiological data for research purposes. This article describes the major changes and important features in this revision, and compares them to the Ninth Revision of the International Classification of Diseases.

Disease↗

Psychiatric needs in local jails: emergency issues.

There is an urgent need for psychiatric services for mentally ill inmates in local jails. The authors recommend that a psychiatric team be established inside the jail to provide short-term crisis evaluation, disposition, and treatment; that special training be provided for jail booking personnel in the recognition of psychiatric problems during the initial jail screening and classification process; that special modules be developed for mentally ill inmates; and that inmates in need of hospitalization have easy access to hospital beds. They describe a psychiatric ward actually located within a county jail to treat mentally ill inmates who are considered security risks.

Adult↗