Patients – Less Meat More Veg

Considerations For Assessing Patients Via Telehealth

CX3 — Thu, 02 Sep 2021 06:43:46 +0000

During the COVID-19 pandemic, many mental health services moved their patients to telehealth practices to maintain physical distancing guidelines. While the services based on verbal interactions run smoothly, assessment services requiring in-person contact have proven challenging. Here are some important considerations when determining how to move forward with assessments in telepractice.

Assessment Technology

The assessor will need access to proper technology, including high-speed internet, a webcam, and online assessment access. Connections need to be secure on both ends. You must understand the functions of the platform you’re using and carefully consider how it can best mimic traditional services. Another important aspect of telepractice is to ensure test security even in a virtual environment. Remote audio-visual monitoring is critical to maintain security and ensure the validity of test results.

Function Of The Assessment

Before conducting a telehealth assessment, consider its purpose and criticality. The decision to wait or proceed with analysis is dependent on the possibility of skewed data from telepractice.

Extra care for a diagnosis, legal issue, or prescription of services, is necessary to preserve data integrity and avoid ramifications from an assessment. Evaluations least likely to be harmed by skewed data through a remote platform include screeners and progress monitors.

Data Quality

Once you’ve determined that an assessment needs to be green-lighted, you should think through each task of the instrument to determine how much of the data quality will be affected by the alternate format. Quality images, distortion of sound, and state of mind of the patient are all considerations that could affect the potential outcome.

Rating Scales

Teacher rating scales should be used with caution following COVID-19, keeping in mind that many schools were fully virtual or hybrid. Teachers should have at least a month’s worth of in-person instruction with a student in order to complete an accurate rating scale. Parent rating scales can be weighted more heavily in the overall observation if the teachers’ ratings don’t meet qualifications. Another possibility is to widen the confidence interval when making decisions based on rating scales and any telepractice assessments where the margin of error is likely broadened.

Different Time Points

It is unethical to move forward with an evaluation without using all the pieces of information gathered throughout the process. However, if part of the data was collected prior to the pandemic and part was collected in the middle of quarantine, there can be discrepancies in the results. Including data such as interviews focused on behavior and social-emotional conditions. Used correctly, this data can provide a valuable look at changes over time.

Client Characteristics

Some clients are less able to participate in telepractice assessments. Patients in the following categories may need alternative assessment plans:

Younger children
lack of technology expertise
unable to read
short attention span
Patients with significant disabilities
fine or gross motor delays
physical disabilities
significant attention difficulties
Patients from lower socioeconomic households
may not have computer, internet, webcam
may not have a distraction-free space
Individuals with language barriers
Those with high anxiety levels

Ultimately, it is the professional’s decision whether assessments should be given through telehealth and how much weight the results should receive. Think through the assessment and the individual to determine whether it’s best to evaluate remotely or wait until conditions allow in-person testing. Visit WPS for more information about psychological and educational assessments.

*collaborative post

This article was originally published by artofhealthyliving.com. Read the original article here.

The First Place This Functional MD Checks When Patients Have Mystery Symptoms

CX3 — Sun, 25 Apr 2021 13:54:52 +0000

One thing I check is my patients’ fillings. For years, holistic dentists and integrative doctors have recommended avoiding mercury amalgams—based on the belief that neurotoxin can leech, potentially causing systemic issues for some people. (Note: If you do have these kind of fillings, be careful not to remove them the wrong way, look for someone on IAOMT who is SMART certified.)

If my patients are experiencing mystery symptoms, I also take note if they’ve had a root canal. I’ve found that my patients with infected root canals often suffer from difficulty with clarity of thought, brain fog, head and shoulder pain, tinnitus, visual disturbances, or fleeting tooth pain or numbness.

Root canals are typically done if there’s trauma to the tooth or the infection has breached the inner pulp of the tooth. The pulp chamber, smack dab in the center of the tooth, houses the living blood supply and nerves—along with an astonishing network of microscopic tubules that supply nutrients to the dentin (the layer just below the enamel). During the procedure, all the soft, living tissue of the pulp is removed so the the chamber and root can be filled. But we cannot clean, or fill, those miles of microtubules. In my experience, because these tubules are active, exchanging fluid, bacteria can infect them and continue to replicate—which can be problematic systematically. In these cases, I personally recommend ozone therapy, if it is an option for you.

What are other options besides a root canal? Pulling the tooth is one, however, it’s important to take great care in making these decisions. Keep in mind that a cone beam scan X-ray often misses the infection until the tooth is pulled, so I often recommend a CT scan. Ultimately, not everyone is the same, and each treatment plan should be individualized.

I also believe patients with neurodegenerative conditions should have a five minute oral exam, at a minimum. I have witnessed connections in my own patients to oral health and multiple sclerosis, for example. One of my MS patients had a cavitation problem, or a low grade simmering infection, after wisdom teeth removal.

This article was originally published by mindbodygreen.com. Read the original article here.

COVID Patients Face Higher Risk for Stroke

CX3 — Mon, 22 Mar 2021 13:22:01 +0000

FRIDAY, March 19, 2021 (HealthDay News) — A new study adds to mounting evidence that COVID patients have an added risk of stroke.

Researchers analyzed data on more than 20,000 U.S. adults hospitalized with COVID-19 between January and November 2020. The analysis found that their risk of stroke was higher than for patients with other types of infections, including flu.

“These findings suggest that COVID-19 may increase the risk for stroke, though the exact mechanism for this is still unknown,” said lead author Dr. Saate Shakil, a cardiology fellow at the University of Washington.

The new study found that 1.4% of COVID patients had a stroke confirmed by diagnostic imaging.

Of those, 52.7% had an ischemic stroke (caused by blocked blood flow to the brain); 45.2% had a bleeding or unspecified type of stroke; and 2.5% had a transient ischemic attack (also called a mini-stroke or TIA).

COVID patients who suffered a stroke were more likely to be male (64%) and older (average age: 65) than those who didn’t have a stroke (average age: 61).

The study revealed that 44% of ischemic stroke patients had type 2 diabetes, compared with about one-third of patients who didn’t have a stroke. Eight in 10 ischemic stroke patients had high blood pressure, compared to 58% of non-stroke patients.

The heart rhythm disorder atrial fibrillation was found in 18% in ischemic stroke patients and 9% in those without stroke, the study found.

Stroke patients averaged 22 days in the hospital — 12 days more than patients who didn’t have a stroke.

In-hospital deaths were more than twice as high among stroke patients (37%) than in those without stroke (16%).

Black patients accounted for 27% of COVID patients in the study, and 31% of ischemic stroke cases, according to findings presented Friday at a virtual meeting of the American Stroke Association.

Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

“As the pandemic continues, we are finding that coronavirus is not just a respiratory illness, but a vascular disease that can affect many organ systems,” Shakil said in a meeting news release.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

SOURCE: American Stroke Association, news release, March 19, 2021

Original Source