A typical memory aid that helps in remembering the order in which sound travels from the peripheral to the central components of the auditory pathway would be E.C.O.L.I.M.A.
Sound (high or low-frequency sounds) at first gets to the hair cells of the Ear receptors (E) in Cochlea and cranial nerve number 8 (CN VII), then it gets to the Cochlear nuclei (C) which are cells dedicated to these high or low-frequency sounds.
At the Superior Olivary nucleus (O) sound is localized before it gets to the midbrain - Lateral lemniscus (L) and Inferior colliculus (I). The inferior colliculus receives auditory nerve fibers from ipsilateral superior olivary nuclei through the lateral lemniscus.
Sounds then get to the thalamus at the Medial geniculate body (M) which receives nerve fibers from the inferior colliculus; eventually sounds then get to the auditory cortex.
In summary, ECOLIMA is an easily understandable mnemonic device to help remember how sound waves move from the external ears to the auditory nerves and cortex.
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Answer:
Very low density lipoprotein (VLDL) is a particle containing triglycerides and cholesterol and protein that is made by the liver. VLDL goes up with diets that contain a lot of fat, sugar, or alcohol. It can also be high in conditions such as diabetes and kidney disease.
Explanation:
A Drug Trend report published in 2009 had predicted continued price increase among traditional branded and biotech drugs that lack generic competition. Now, further, CMS has reduced its Average Sales price (ASP) margin from 6 percent to 4 percent for non-pass-thorough. This has affected pharmacy reimbursement. However, there are certain other aspects of Pharmacy Billing that can affect reimbursement and thereby the Revenue Cycle Management (RCM) process if not well implemented.
1. Data Workflow:
Recognizing how the revenue cycle works in pharmacy is very essential. Procurement to Inventory, billing and reimbursement involves purchase of medications, their storage, and method of dispensing, how they are administered, way they are coded & billed, and finally reimbursed. If the drug is covered as a pharmacy benefit, or the payer needs that to be obtained via a specialty pharmacy as identified through patient-specific benefit verification, then here both the provider and the pharmacy are part of the reimbursement process. The physician writes a prescription and orders the drug. This is followed by the pharmacy that fills the order and issues the drug to the physician, CMHC, or hospital outpatient department. Here the pharmacy bills the insurance company for the drug. If any information is entered incorrectly into the pharmacy system in the initial phase of the cycle, errors can prove to be costly, impacting aspects of clinical and revenue cycle.
2. Procurement:
During this phase information is converted from purchased quantities and pricing to storage units of measure (UOM) and inventory costs. Manually entering the data is followed in most cases. UOM conversions, when data is uploaded from the wholesale distributor to the pharmacy system, are also checked and verified manually. Here too mistakes can lead to breakdown in the revenue cycle management (RCM) process.
3. The Charge master:
Critical & substantial revenue leakage can occur when separately reimbursable medications are either missing from or miscoded in the charge master. Conversion of pharmaceutical quantities is a must from purchased amounts to patient-administered amounts, and only then made billable. There is often a difference between dosage amounts required for patient use as from that purchased. Besides inventory, the clinician and pharmacist should convert dosage, strength, and delivery mechanism for each drug. Drug data must be correctly converted from the quantities residing in clinical systems into the payer-billable quantities appropriate for the financial system or charge master. The UOMs must be reconciled to avoid any under- or over-payments. More than often, missing or incorrect data in the charge master can result in negative financial consequences – denied claims, partial reimbursement, and compliance risks.
4. Linkages between Purchases & Billing:
Most hospitals have separate processes to order drugs, administer them, and process reimbursement. Without linkage between pharmacy expenditures for medications (i.e., spend data) and the charge master, ensuring proper charge capture and optimal reimbursement is a challenge. Besides hospitals should have automated tools to identify charge capture errors precisely, so as to pinpoint when and where their occurrence to decreasing revenue loss.
Osteoporosis affects the a) skeletal body system
Answer:
The Diathesis-Stress Model explains that psychological disorders derive from the combination of a predisposition to vulnerability or diathesis, as an innate factor, together with experiences of stress as an acquired factor. Therefore, innate factors and acquired factors are needed to develop certain disorder.
Explanation:
From the perspective of the diathesis-stress model, a disorder is the result of the interaction between a genetic predisposition or vulnerability (diathesis), with external factors or personal experiences (stress). This model is used to explain the development of mental disorders with a clear genetic basis, such as schizophrenia, bipolar disorder, etc. The appearance of the disorder will depend on the combination of both factors. The more genetic predisposition you are, the more likely you are to develop these low-stress diseases. And on the contrary, a low predisposition protects us from suffering a mental disorder, even if different stressors occur in our life.
