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This document outlines the consent form for participation in a research study to evaluate the effectiveness of a neck strengthening program in preventing or mitigating sports concussions among student athletes.
Note:
Year
Document Type:
Written Consent for Research Study
Institution / Organization:
HCMC
Author:
Dr. Uzma Samadani, Dr. Thomas Bergman
Target Audience:
Student Athletes
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Institution:
Baylor College of Medicine
Department:
Otolaryngology – Head & Neck Surgery
Document type:
Course overview document
Revision date:
April 16, 2021
Academic level:
Medical students
Rotation type:
Selective rotation
Rotation duration:
Two weeks
Clinical sites:
Ben Taub General Hospital; Michael E. DeBakey Veterans Affairs Medical Center; Texas Children’s Hospital
Geographic location:
Texas Medical Center, Houston, Texas
Course prerequisites:
None
Course directors:
Sunthosh Sivam, MD
Course coordinator:
Evelyn Trevino
Educational framework:
BCM Core Competencies and Graduation Goals
Assessment methods:
Case log; evaluations; E*value student performance assessment
Related policies:
Baylor College of Medicine Teacher-Learner Compact
Year:
Not specified
Region / City:
Not specified
Theme:
Radiology, CT scans
Document Type:
Medical report
Organization / Institution:
Not specified
Author:
Dr. Vilayat Ali, Dr. Sandeep Agarwal, Dr. Annie Agarwal, Dr. Shivani Agarwal
Target Audience:
Healthcare professionals, Radiologists
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2024
Region / City:
USA
Topic:
Ice Hockey Safety Regulations
Document Type:
Guidelines
Organization:
USA Hockey
Author:
USA Hockey
Target Audience:
Officials and Coaches
Effective Period:
2024-25 Season
Approval Date:
08/01/2024
Note:
Year
Theme:
Medical Referral
Document Type:
Referral Form
Institution:
Bristol Dental Hospital
Target Audience:
Healthcare professionals
Year:
2024
Region / City:
Morriston Hospital, Swansea Bay University Health Board
Topic:
Hip Fracture, Frailty, Orthogeriatrics
Document Type:
Report
Organization / Institution:
Swansea Bay University Health Board
Author:
Rhodri Davies, Charlotte Le Brocq
Target Audience:
Healthcare Professionals, Hospital Management, Medical Team
Action Required:
Approval
Approval Date:
23 April 2024
Period of Action:
2024
Date of Last Update:
February 2024
Year:
2026
Type:
Educational publication
Topic:
Dermatology / Aesthetic Medicine
Author:
All rights reserved
Target audience:
Medical professionals and aesthetic practitioners
Content focus:
Facial anatomy, subcutaneous tissue, muscles, and advanced dermal filler techniques
Regions covered:
Periorificial craniofacial region, cervicofacial region, periorbital, nasal, and perioral areas
Structure focus:
Musculoaponeurotic system, SMAS, subcutaneous fat layers, facial muscles
Format:
Written and produced manual
Year:
2013
Region / city:
N/A
Theme:
Oral cancer surgery
Document type:
Study
Institution:
N/A
Author:
N/A
Target audience:
Medical professionals, researchers
Period of action:
2011-2013
Date of approval:
N/A
Date of amendments:
N/A
Year:
2026
Region / City:
Germany
Subject:
Oncology, Head and Neck Cancer
Document Type:
Certification Catalogue / Standards
Issuing Organization:
Certification Committee for Head and Neck Cancers
Chairmen:
Univ.-Prof. Dr. med. Dr. med. dent. M. Heiland, Prof. Dr. H. Iro
Working Groups Involved:
ACO, ADT, ADO, AHMO, AIO, AOP, OPH, AGORS, APM, PRIO, PSO, ARO, ASO, BDP, BVK, BVDST, CAO, BVHNO, DBL, DGPRÄC, DGHNO, DGHO, DeGIR, DGMKG, DGNR, DGN, DGP, DGPP, DEGRO, DGZMK, DÖSAK, DRG, DVSG, IAG-KHT, KOK
Guidelines Referenced:
S3 Laryngeal Cancer, S3 Oral Cavity Cancer, S3 Oropharynx/Hypopharynx
Applicable Classifications:
TNM 8th edition 2017, ICD-10-GM 2025, ICD-O-3 2019, OPS 2025
Audit Version:
H2
Date of Document:
11.12.2025
Changes Implemented:
2024, effective from 01.01.2025
Scope:
Technical and medical requirements for diagnostics, treatment, and certification of head and neck cancer centres
Network / Main Cooperation Partners:
Listed in OnkoZert Master Data Sheet
Clinical Sites:
Multiple, with specified distance limitations
Patient Involvement:
Annual events for patients and referrers
Target Audience:
Oncology centres undergoing certification and audits
Data Sheets / Annexes:
Excel templates for centre information and cooperation agreements
Procedure Code:
CPT 51715
Procedure Name:
Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck
Clinical Indication:
Stress urinary incontinence in women
Population:
Women with stress urinary incontinence
Evidence Sources:
Cochrane Review (Kirchin 2012); NICE 2005; NICE 2019; American Urology Association 2017; Syan 2016; MODA 2019; Aetna 2019
Study Types Referenced:
Randomized controlled trials; case series; systematic review; guideline statements
Comparators:
Conservative treatment; placebo injection; surgical management; pelvic floor muscle training
Reported Outcomes:
Continence rates; quality of life; patient satisfaction; adverse events; objective cure
Adverse Events Reported:
Urinary tract infection; urinary retention; dysuria; abscess; urgency of micturition; prolonged pain; haemorrhage; migration of bulking agent; allergic reaction
Regulatory Reference:
FDA-cleared bulking agents listed (Coaptite, Contigen, Durasphere, Macroplastique, Uryx)
Coverage Criteria:
Prior conservative management; defined duration of symptoms; documented improvement after initial treatments; limitation on number of injections
Guideline Recommendations:
Consider in patients unsuitable for or declining surgery; counseling on limited long-term efficacy and potential need for repeat injections
Review Date Mentioned:
August 2019
Last updated:
12 October 2023
Effective date:
1 November 2023 (subject to the passage of legislation)
Country:
Australia
Sector:
Health
Subject:
Otolaryngology, Head and Neck Surgery and Diagnostic Audiology Services
Type of document:
Government policy update
Issuing body:
Department of Health and Aged Care
Related framework:
Medicare Benefits Schedule (MBS)
Related legislation:
Health Insurance Act 1973
Consultative bodies:
MBS Review Taskforce; Otolaryngology, Head and Neck Surgery Clinical Committee; Otolaryngology, Head and Neck Surgery Implementation Liaison Group
Target audience:
Health providers; Medical specialists; Audiology professionals
Implementation and compliance:
Subject to MBS compliance processes, audits, and post-implementation review
Scope:
Amendments to specified MBS item descriptors and billing conditions
Year:
2022
Region / City:
N/A
Topic:
Oncology, Pathology
Document Type:
Protocol
Organization:
CAP (College of American Pathologists)
Authors:
Raja R. Seethala, MD; Wonwoo Shon, DO; Bonnie L. Balzer, MD, PhD; Umamaheswar Duvvuri, MD, PhD; Nima M. Gharavi, MD, PhD; William Lydiatt, MD
Intended Audience:
Pathologists, Clinical Laboratories, Medical Institutions
Effective Period:
From March 2023
Approval Date:
September 2022
Amendment Date:
N/A
Organization:
Society for Immunotherapy of Cancer
Document Type:
Bibliography
Subject:
Cancer Immunotherapy
Focus:
Head and Neck Squamous Cell Carcinoma
Publication Date:
December 17, 2018
Date Range of Literature Search:
December 1, 2013 – December 17, 2018
Search Limits:
Humans, Clinical Trial, Meta-Analysis, Practice Guideline, Randomized Controlled Trial, Review
Therapeutic Agents Covered:
Pembrolizumab, Nivolumab, Cemiplimab, Durvalumab
Biomarkers and Targets:
PD-1, PD-L1, HPV
Total References Identified:
199
Total Duplicates Removed:
42
Total Records in Bibliography:
157
Topics Included:
Immune checkpoint inhibitors, biomarkers, combination immunotherapy, adverse events, toxicity, vaccine, adjuvant and neoadjuvant immunotherapy, rare head and neck cancers
Year:
2014
Region / City:
Bristol, United Kingdom
Subject:
Head and neck suspected cancer
Document Type:
Medical referral form
Institution:
Bristol Dental Hospital
Author:
Bristol Dental Hospital Administration
Target Audience:
Healthcare professionals referring patients
Submission Methods:
Choose & Book system or fax
Patient Information Included:
Yes
Medical History Included:
Yes
Consent Required:
Yes
Special Requirements Section:
Yes
Year:
2025
Region / City:
Nigeria
Topic:
Cardiometabolic risk and anthropometric measures
Document Type:
Original research article
Institution:
Tertiary health facility, Nigeria
Author:
Not specified
Study Population:
Adults with Type 2 diabetes mellitus and healthy controls
Sample Size:
180 (120 T2DM patients, 60 controls)
Methodology:
Comparative cross-sectional study
Measurements:
Neck circumference, waist circumference, waist-hip ratio, body mass index, HOMA-IR
Exclusion Criteria:
Pregnant women, thyroid disease, goiter, prior neck surgery
Study Duration:
6 months
Year:
2014
Region / City:
Bristol, UK
Subject:
Head and Neck Cancer Referrals
Document Type:
Medical Referral Form
Issuing Institution:
Bristol Dental Hospital
Target Audience:
Healthcare Professionals
Submission Method:
Choose & Book or Fax
Patient Consent Required:
Yes
Special Care Information Included:
Yes
Contact Details Provided:
Yes
Year:
2026
Region / City:
Florida, USA
Subject:
Concussion awareness and head injury prevention
Document Type:
Informed consent form
Organization:
Davie Youth Lacrosse Foundation
Target Audience:
Parents/guardians and youth players
Purpose:
Acknowledgement of receipt of concussion information
Legal Requirement:
State of Florida mandatory concussion awareness
Year:
2011
Region / City:
Louisiana
Topic:
Concussion Management in Youth Sports
Document Type:
Guidelines
Organization / Institution:
Louisiana High School Athletics Association (LHSAA)
Author:
Eddie Bonine, LHSAA Executive Director
Target Audience:
Coaches, Officials, Student-Athletes, Parents
Period of Validity:
Ongoing
Approval Date:
2011
Amendment Date:
Not specified
Note:
Year
Theme:
Health, Rehabilitation
Document Type:
Patient Information Sheet
Organization:
Occupational Therapy Department
Target Audience:
General Public, People with Concussions, Families
Context:
A patient information sheet providing guidance on symptoms, recovery strategies, and special considerations for people recovering from concussions or head injuries, aimed at those affected and their families.
Year:
2026
Region / City:
Columbia
Theme:
Concussion Awareness, Athlete Safety
Document Type:
Information Sheet
Organization:
Columbia Volleyball Academy
Target Audience:
Coaches, Parents, Student-Athletes
Period of Validity:
Ongoing
Approval Date:
Not specified
Modification Date:
Not specified
Note:
Year
Subject:
Sports injuries, Concussions
Document Type:
Acknowledgement Form
Target Audience:
Athletes, parents, sports organizations