This document is a presentation by Douglas Elmendorf, the Director of the Congressional Budget Office, about CBO's analysis of health care policy. It discusses CBO's objective, nonpartisan approach and how it analyzes the effects of policies on the federal budget, state budgets, costs for beneficiaries, and health care outcomes. It also examines key types of federal health care policies that CBO studies, such as ways to improve population health, cut federal subsidies, change how Medicare providers are paid, and make structural changes to programs like Medicare.
Presentation by Peter Fontaine, CBO's Assistant Director for Budget Analysis, to a Global Network of Parliamentary Budget Offices Community Meeting Sponsored by the World Bank Institute
Presentation by Elizabeth Cove Delisle, an analyst in CBO's Budget Analysis Division, with Natalie Tawil, an analyst in CBO's Microeconomic Studies Division, to the Council of Large Public Housing Authorities.
In 2014, the federal government provided about $50 billion in housing assistance specifically designated for low-income households. This presentation describes the ways in which the federal government provides housing assistance to low-income households, provides information about the households that receive assistance, and lists some policy options for altering that assistance.
Presentation by Ben Page, CBO's Fiscal Policy Studies Unit Chief, at the National Tax Association 108th Annual Conference on Taxation.
CBO’s long-term budget projections generally reflect current law and estimates of future economic conditions and demographic trends. Those projections depend on estimates of the future paths of mortality rates, productivity, interest rates, and health care costs, among many other variables. To illustrate some of the uncertainty about long-term budgetary outcomes, CBO constructed alternative projections showing what would happen to the budget if those factors differed from the values used in the extended baseline.
Presentation by Damien Moore, CBO’s Assistant Director for Financial Analysis, at the Research Seminar in Quantitative Economics.
The Pension Benefit Guaranty Corporation (PBGC) is a government-owned corporation responsible for insuring the benefits of 41 million people who participate in defined benefit pension plans provided by private employers. About 10 million of those participants are covered by plans offered by groups of employers; such plans are insured by PBGC’s multiemployer program. That program has drawn increased scrutiny from policymakers in recent years because of the high likelihood that it will not be able to meet all of its insurance obligations, potentially causing participants to lose insured benefits or putting pressure on the government to provide PBGC with greater federal resources. CBO has projected the claims on PBGC’s multiemployer program—which are likely to be relatively small in the coming decade but are projected to be much larger in the following decade—and has analyzed options for improving the program’s finances.
Presentation by Peter Fontaine, CBO's Assistant Director for Budget Analysis, to a Global Network of Parliamentary Budget Offices Community Meeting Sponsored by the World Bank Institute
Presentation by Elizabeth Cove Delisle, an analyst in CBO's Budget Analysis Division, with Natalie Tawil, an analyst in CBO's Microeconomic Studies Division, to the Council of Large Public Housing Authorities.
In 2014, the federal government provided about $50 billion in housing assistance specifically designated for low-income households. This presentation describes the ways in which the federal government provides housing assistance to low-income households, provides information about the households that receive assistance, and lists some policy options for altering that assistance.
Presentation by Ben Page, CBO's Fiscal Policy Studies Unit Chief, at the National Tax Association 108th Annual Conference on Taxation.
CBO’s long-term budget projections generally reflect current law and estimates of future economic conditions and demographic trends. Those projections depend on estimates of the future paths of mortality rates, productivity, interest rates, and health care costs, among many other variables. To illustrate some of the uncertainty about long-term budgetary outcomes, CBO constructed alternative projections showing what would happen to the budget if those factors differed from the values used in the extended baseline.
Presentation by Damien Moore, CBO’s Assistant Director for Financial Analysis, at the Research Seminar in Quantitative Economics.
The Pension Benefit Guaranty Corporation (PBGC) is a government-owned corporation responsible for insuring the benefits of 41 million people who participate in defined benefit pension plans provided by private employers. About 10 million of those participants are covered by plans offered by groups of employers; such plans are insured by PBGC’s multiemployer program. That program has drawn increased scrutiny from policymakers in recent years because of the high likelihood that it will not be able to meet all of its insurance obligations, potentially causing participants to lose insured benefits or putting pressure on the government to provide PBGC with greater federal resources. CBO has projected the claims on PBGC’s multiemployer program—which are likely to be relatively small in the coming decade but are projected to be much larger in the following decade—and has analyzed options for improving the program’s finances.
Presentation by Julie Topoleski, Chief of the Long-Term Analysis Unit in CBO’s Health, Retirement, and Long-Term Analysis Division, to the Social Security Advisory Board.
Both CBO and the Social Security Trustees project a shortfall in Social Security’s finances, but they differ in their assessment of its magnitude. This presentation describes that difference and the major factors that contribute to it.
Presentation to the 2014 Fall Research Conference of the Association of Public Policy and Mangement, by Joyce Manchester, Vermont Legislative Joint Fiscal Office and formerly of CBO, Michael Simpson and Geena Kim, of CBO
Presentation by Xiaotong Niu, an analyst in CBO's Health, Retirement, and Long-Term Analysis Division, at the Biennial Conference of the American Society of Health Economists.
The consequences of any change to Medicare for different socioeconomic groups depend on the distribution of taxes paid to and benefits received from the current system by each group. However, only a few studies have estimated that distribution, and they offer conflicting views. This presentation describes an analysis of the distribution of Medicare taxes and spending using a unique dataset with information on beneficiaries’ lifetime earnings and Medicare spending. The dataset includes more recent cohorts of beneficiaries than earlier studies, and the distribution of Medicare taxes and spending is projected based on demographic and economic projections from CBO’s long-term microsimulation model.
The Medicare system is progressive. For people born in the 1950s, lifetime Medicare spending net of both premiums and dedicated Medicare taxes, as a share of lifetime earnings, tends to be lower for beneficiaries with higher lifetime household earnings. Almost all of the variation in lifetime Medicare spending net of premiums by lifetime household earnings can be explained by the variation in life expectancy. Medicare is projected to become more progressive for later cohorts because lifetime earnings are expected to grow faster for those with higher earnings.
Presentation by Wendy Edelberg, an Associate Director for Economic Analysis at CBO, at the Seminar on Forecasting at George Washington University.
Under current law, CBO projects that economic activity will expand at a modest pace this year and then grow more slowly in subsequent years.
Presentation by James Baumgardner, Ph.D., Deputy Assistant Director Health, Retirement, and Long-Term Analysis Division, CBO, to the 30th International Congress of Actuaries on April 4, 2014
This presentation provides information published in Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget (June 2012), www.cbo.gov/publication/43319
Presentation at the Fifth Biennial Conference of the American Society of Health Economists, by Allison Percy, Health, Retirement, and Long-Term Analysis Division
Presentation by Wendy Edelberg, CBO’s Assistant Director for Macroeconomic Analysis, and Teri Gullo, CBO's Assistant Director for Budget Analysis, to Congressional Staff.
CBO provides formal, written estimates of the cost of virtually every bill approved by Congressional committees to show how the bill would affect spending or revenues over the next 5 or 10 years, depending on the type of spending involved. In May, the Congress adopted a concurrent resolution on the budget for fiscal year 2016 that requires CBO, to the greatest extent practicable, to incorporate macroeconomic effects into its 10-year cost estimates for major legislation that Congressional committees approve. Such estimates must also include, when practicable, a qualitative assessment of the budgetary effects for the following 20 years. Incorporating such macroeconomic feedback into cost estimates is often called dynamic scoring. This presentation describes how CBO will prepare such estimates.
In 2010, more than 70 percent of families directly owned capital assets that had a combined worth of $50 trillion. In that year, taxpayers reported net long-term gains and net long-term losses that totaled $123 billion from the sale of those types of assets.
In this report, CBO and the staff of the Joint Committee on Taxation examine the distribution of capital assets and net capital gains and losses in 2010 by type of asset and by the income and age of the asset holder.
Presentation by Wendy Edelberg, an Associate Director for Economic Analysis at CBO, at the Australian Treasury Research Institute's conference, Modelling for Public Policy Analysis: Emerging Trends and Future Directions.
If current laws governing federal taxes and spending did not change, the United States would face steadily increasing federal budget deficits and debt over the next 30 years, according to projections by CBO. As a result, CBO estimates, public debt would reach 145 percent of GDP by 2047, higher than any percentage previously recorded in the United States.
Federal tax and spending policies can affect the economy through their impact on federal borrowing, private demand for goods and services, people’s incentives to work and save, and federal investment, as well as through other channels. CBO has devoted significant effort to developing analytical tools that enable it to assess the macroeconomic effects of fiscal policies and how such effects, or “macroeconomic feedback,” would affect the federal budget. CBO analyzes the economic effects of federal fiscal policies in current law as well as significant proposed changes in those policies.
The Innovation Center held a webinar on Wednesday, May 8, 2013 at 3:00pm ET to review the application process, provided important updates about the initiative and answered questions potential applicants may have had.
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CMS Innovations
http://innovation.cms.gov
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The CMS Innovation Center held the sixth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Thursday, July 11, 2013 from 1:00–2:00pm EDT, focused on developing payment models.
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CMS Innovations
http://innovations.cms.gov
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Presentation by Julie Topoleski, Chief of the Long-Term Analysis Unit in CBO’s Health, Retirement, and Long-Term Analysis Division, to the Social Security Advisory Board.
Both CBO and the Social Security Trustees project a shortfall in Social Security’s finances, but they differ in their assessment of its magnitude. This presentation describes that difference and the major factors that contribute to it.
Presentation to the 2014 Fall Research Conference of the Association of Public Policy and Mangement, by Joyce Manchester, Vermont Legislative Joint Fiscal Office and formerly of CBO, Michael Simpson and Geena Kim, of CBO
Presentation by Xiaotong Niu, an analyst in CBO's Health, Retirement, and Long-Term Analysis Division, at the Biennial Conference of the American Society of Health Economists.
The consequences of any change to Medicare for different socioeconomic groups depend on the distribution of taxes paid to and benefits received from the current system by each group. However, only a few studies have estimated that distribution, and they offer conflicting views. This presentation describes an analysis of the distribution of Medicare taxes and spending using a unique dataset with information on beneficiaries’ lifetime earnings and Medicare spending. The dataset includes more recent cohorts of beneficiaries than earlier studies, and the distribution of Medicare taxes and spending is projected based on demographic and economic projections from CBO’s long-term microsimulation model.
The Medicare system is progressive. For people born in the 1950s, lifetime Medicare spending net of both premiums and dedicated Medicare taxes, as a share of lifetime earnings, tends to be lower for beneficiaries with higher lifetime household earnings. Almost all of the variation in lifetime Medicare spending net of premiums by lifetime household earnings can be explained by the variation in life expectancy. Medicare is projected to become more progressive for later cohorts because lifetime earnings are expected to grow faster for those with higher earnings.
Presentation by Wendy Edelberg, an Associate Director for Economic Analysis at CBO, at the Seminar on Forecasting at George Washington University.
Under current law, CBO projects that economic activity will expand at a modest pace this year and then grow more slowly in subsequent years.
Presentation by James Baumgardner, Ph.D., Deputy Assistant Director Health, Retirement, and Long-Term Analysis Division, CBO, to the 30th International Congress of Actuaries on April 4, 2014
This presentation provides information published in Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget (June 2012), www.cbo.gov/publication/43319
Presentation at the Fifth Biennial Conference of the American Society of Health Economists, by Allison Percy, Health, Retirement, and Long-Term Analysis Division
Presentation by Wendy Edelberg, CBO’s Assistant Director for Macroeconomic Analysis, and Teri Gullo, CBO's Assistant Director for Budget Analysis, to Congressional Staff.
CBO provides formal, written estimates of the cost of virtually every bill approved by Congressional committees to show how the bill would affect spending or revenues over the next 5 or 10 years, depending on the type of spending involved. In May, the Congress adopted a concurrent resolution on the budget for fiscal year 2016 that requires CBO, to the greatest extent practicable, to incorporate macroeconomic effects into its 10-year cost estimates for major legislation that Congressional committees approve. Such estimates must also include, when practicable, a qualitative assessment of the budgetary effects for the following 20 years. Incorporating such macroeconomic feedback into cost estimates is often called dynamic scoring. This presentation describes how CBO will prepare such estimates.
In 2010, more than 70 percent of families directly owned capital assets that had a combined worth of $50 trillion. In that year, taxpayers reported net long-term gains and net long-term losses that totaled $123 billion from the sale of those types of assets.
In this report, CBO and the staff of the Joint Committee on Taxation examine the distribution of capital assets and net capital gains and losses in 2010 by type of asset and by the income and age of the asset holder.
Presentation by Wendy Edelberg, an Associate Director for Economic Analysis at CBO, at the Australian Treasury Research Institute's conference, Modelling for Public Policy Analysis: Emerging Trends and Future Directions.
If current laws governing federal taxes and spending did not change, the United States would face steadily increasing federal budget deficits and debt over the next 30 years, according to projections by CBO. As a result, CBO estimates, public debt would reach 145 percent of GDP by 2047, higher than any percentage previously recorded in the United States.
Federal tax and spending policies can affect the economy through their impact on federal borrowing, private demand for goods and services, people’s incentives to work and save, and federal investment, as well as through other channels. CBO has devoted significant effort to developing analytical tools that enable it to assess the macroeconomic effects of fiscal policies and how such effects, or “macroeconomic feedback,” would affect the federal budget. CBO analyzes the economic effects of federal fiscal policies in current law as well as significant proposed changes in those policies.
The Innovation Center held a webinar on Wednesday, May 8, 2013 at 3:00pm ET to review the application process, provided important updates about the initiative and answered questions potential applicants may have had.
- - -
CMS Innovations
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center held the sixth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Thursday, July 11, 2013 from 1:00–2:00pm EDT, focused on developing payment models.
- - -
CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center hosted an informational webinar March 11, 2014 on the parameters of Models 2-4 of the Bundled Payments for Care Improvement Initiative. This webinar was geared towards physicians, specialty practices and physician group practices.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Total Quality Management in HealthcareGunjan Patel
Now days, Healthcare systems are of fundamental interests to all level of Hospitals in our societies. Eventually, increasing importance and reliance are placed on total quality management in healthcare systems. Due to this rising importance that is also reflected in the increasing percentage of national and international resources for both private and public sector to allocated in hospital management systems. Hospitals and other healthcare organization across the globe have been progressively implementing TQM to reduce costs, improve efficiency and provide high quality patient care.
Presentation by Philip Ellis, CBO’s Deputy Assistant Director for Health, Retirement, and Long-Term Analysis, to staff of the U.S. Department of Commerce.
This presentation describes CBO’s general approach to policy analysis and its role in supporting the Congress; summarizes several elements of the agency’s projections of health care spending; and reviews examples of policy proposals and approaches affecting health care that CBO has analyzed recently.
Presentation by Lara Robillard, an analyst in CBO’s Budget Analysis Division, to the Leadership Fellowship Program at the National Hispanic Medical Association.
Presentation by Chapin White, CBO's Deputy Director of Health Analysis, to the Leadership Fellowship Program at the National Hispanic Medical Association.
Presentation by Lara Robillard, Principal Analyst, CBO’s Budget Analysis Division, to the Leadership Fellowship Program at the National Hispanic Medical Association.
Spending on federal health care programs is growing rapidly, driven by rising enrollment and rising health care spending per enrollee. This presentation describes CBO’s analyses related to health care, explains how the agency uses its health insurance simulation model, and provides examples of how CBO documents its work.
Presentation by Robert Sunshine, Senior Advisor in CBO’s Office of the Director, at the 10th Annual Meeting of the OECD Network of Parliamentary Budget Officials and Independent Fiscal Institutions.
Presentation by Molly Dahl, CBO’s Long-Term Analysis Unit Chief, at the American Enterprise Institute’s panel discussion “Methodologies in Fiscal, Economic, and Health Spending Projections.”
Presentation by Lara Robillard, an analyst in CBO’s Budget Analysis Division, at AcademyHealth’s 2023 Health Policy Orientation, "Information Sources for Policymaking."
Presentation by Julie Topoleski, Director of CBO’s Labor, Income Security, and Long-Term Analysis Division, at the 15th Annual Meeting of the OECD’s Working Party of Parliamentary Budget Officials and Independent Fiscal Institutions.
Preventive medical services encompass a wide range of interventions, including vaccinations that prevent diseases from occurring and screening tests designed to detect the presence of a disease before symptoms appear. Delivering preventive medical services results in costs for each person using the service. Vaccinations may cause some of those people to avoid the targeted disease, and screenings may allow some people to receive treatment earlier. Those people generally benefit from preventive medical services, but the net result can be decreases or increases in overall health care spending.
In this presentation, CBO’s Director provides an overview of the agency’s methods for estimating the budgetary effects of proposals to expand the use of preventive medical services.
CONGRESS OF THE UNITED STATESCONGRESSIONAL BUDGET OFFICEAlleneMcclendon878
CONGRESS OF THE UNITED STATES
CONGRESSIONAL BUDGET OFFICE
CBO
Social Security
Policy Options
JULY 2010
Pub. No. 4140
A
S T U D Y
CBO
Social Security Policy Options
July 2010
The Congress of the United States O Congressional Budget Office
CBO
Notes
Unless otherwise noted, all years are calendar years.
Numbers in the text and tables may not add up to totals because of rounding.
Preface
Social Security is the federal government’s largest single program, and as the
U.S. population grows older in the coming decades, its cost is projected to increase more
rapidly than its revenues. As a result, under current law, resources dedicated to the program
will become insufficient to pay full benefits in 2039, the Congressional Budget Office (CBO)
projects. Long-run sustainability for the program could be attained through various
combinations of raising taxes and cutting benefits; such changes would also affect the
Social Security taxes paid and the benefits received by various groups of people. This CBO
study examines a variety of approaches to changing Social Security, updating an earlier work,
Menu of Social Security Options, which CBO published in May 2005. In keeping with CBO’s
mandate to provide objective, impartial analysis, the current study makes no
recommendations.
The study was written by Noah Meyerson, Charles Pineles-Mark, and Michael Simpson of
CBO’s Health and Human Resources Division, under the direction of Joyce Manchester and
Bruce Vavrichek. Research assistance was provided by Philip Armour, Sarah Axeen, and
L. Daniel Muldoon. James Baumgardner, Sheila Dacey, Benjamin Page, David Rafferty,
Jonathan Schwabish, and Julie Topoleski provided helpful comments on earlier drafts.
Andrew Biggs of the American Enterprise Institute and Paul Van de Water of the Center for
Budget and Policy Priorities also provided useful comments. (The assistance of external
reviewers implies no responsibility for the final product, which rests solely with CBO.)
Kate Kelly edited the manuscript, and Leah Mazade and Sherry Snyder proofread it.
Maureen Costantino took the cover photograph and designed the cover, and Jeanine Rees
prepared the study for publication. Jonathan Schwabish provided help with graphics.
Monte Ruffin produced the initial printed copies, Linda Schimmel coordinated the print
distribution, and Simone Thomas prepared the electronic version for CBO’s Web site
(www.cbo.gov).
Douglas W. Elmendorf
Director
July 2010
CBO
www.cbo.gov
http://www.cbo.gov/doc.cfm?index=6377
MaureenC
Doug Elmendorf
Contents
Summary ix
Introduction 1
An Overview of Social Security 1
Social Security Projections 4
Assessing Options for Changing Social Security 7
Key Elements of Social Security 8
Scope of the Options 9
Effects of the Options on the System’s Finances 11
Effects of the Options on Payroll Taxes Paid and Benefits Received by
Various Groups 13
Effects of the Options on Work and Saving 15
Options That Wo ...
Similar to CBO’s Analysis of Health Care Policy (20)
Presentation by Jared Jageler, David Adler, Noelia Duchovny, and Evan Herrnstadt, analysts in CBO’s Microeconomic Studies and Health Analysis Divisions, at the Association of Environmental and Resource Economists Summer Conference.
Presentation by Mark Hadley, CBO's Chief Operating Officer and General Counsel, at the 2nd NABO-OECD Annual Conference of Asian Parliamentary Budget Officials.
Presentation by Daria Pelech, an analyst in CBO’s Health Analysis Division, at the Center for Health Insurance Reform McCourt School of Public Policy, Georgetown University.
This slide deck highlights CBO’s key findings about the outlook for the economy as described in its new report, The Budget and Economic Outlook: 2024 to 2034.
Presentation by CBO analysts Rebecca Heller, Shannon Mok, and James Pearce, and Census Bureau research economist Jonathan Rothbaum at the American Economic Association Annual Meeting, Committee on Economic Statistics.
Presentation by Eric J. Labs, an analyst in CBO’s National Security Division, at the Bank of America 2024 Defense Outlook and Commercial Aerospace Forum.
Presentation by Elizabeth Ash, William Carrington, Rebecca Heller, and Grace Hwang of CBO’s Labor, Income Security, and Long-Term Analysis and Health Analysis divisions to the Children’s Health Group, American Academy of Pediatrics.
Presentation by Molly Dahl, Chief of CBO’s Long-Term Analysis Unit, at a meeting of the National Conference of State Legislatures’ Budget Working Group.
In the President’s 2024 budget request, total military compensation is $551 billion, including veterans' benefits. That amount represents an increase of 134 percent since 1999 after removing the effects of inflation.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. Congressional Budget Office
CBO’s Analysis of Health Care Policy
Presentation to the Healthcare Leadership Council
Douglas W. Elmendorf
Director
January 29, 2014
Notes for each slide can be found at the end of the presentation on slide 17.
3. CBO Provides Objective, Nonpartisan Information
to the Congress
CBO makes baseline projections of federal budget
outcomes under current law.
CBO makes estimates of the effects of changes in
federal policies (sometimes in collaboration with JCT):
Legislation being developed by committees
Conceptual proposals being discussed on the Hill
or elsewhere
CBO makes no recommendations.
CBO
4. CBO’s Estimates…
Focus on the next 10 years, but sometimes look out 20
years or more
Are meant to reflect the middle of the distribution of
possible outcomes
Incorporate behavioral responses to the extent feasible
Use whatever evidence can be brought to bear given
available resources and time
Change in response to new analysis by CBO and others
Provide explanations of the analysis to the extent feasible
CBO
5. CBO Analyzes Different Types of Effects of
Health Care Policies
On the federal budget (always)
On state governments’ budgets (sometimes)
On beneficiaries’ costs (sometimes)
On health care (hopefully in the future)
CBO
7. Federal Spending for Health Care Programs Is
Growing Much Faster Than Other Federal Spending
and the Economy as a Whole
Percentage of GDP
CBO
8. Even After the Affordable Care Act Is Fully Implemented,
Most Federal Dollars for Health Care Will Support Care
for Older People
CBO’s projections for 2023:
Medicare (net of offsetting receipts)
$894 Billion
Medicaid and CHIP
$560 Billion
Exchange subsidies
and related items
$135 billion
Federal spending in 2023 for the major health care
programs will finance care for:
People over age 65
Three-fifths
CBO
Blind and
disabled
One-fifth
Others
One-fifth
9. Key Types of Federal
Health Care Policies that
CBO is Studying
CBO
10. Improving the Health of the Population Would Help
People and Might (or Might Not) Help the Federal Budget
Possible federal policies include taxes, subsidies, or other ways to:
Reduce smoking or obesity
Increase screening for diseases
Enhance compliance with regimens for chronic conditions
Presumed links between policy and the federal budget:
The federal budgetary effects depend on the combination of:
Any reduction in annual health care costs per person
Any increase in tax revenues from a larger or healthier workforce
Any increase in costs for Social Security and health care
benefits from people living longer
Any budgetary cost or savings of the policy itself
CBO
11. CBO Examined an Illustrative Increase in the Cigarette Tax, Including
Effects on Outlays (Shown Here) and Revenues (Not Shown)
Effects on Outlays of an Illustrative Increase in the Cigarette Tax, as Percentage of GDP
CBO
12. Cutting Federal Subsidies for Health Insurance Would
Help the Budget But Would Leave Affected People to Bear
Higher Costs
Possible federal policies include:
Repeal or narrow the expanded eligibility for subsidies
under the ACA
Reduce the size of exchange subsidies under the ACA
Raise the eligibility age for Medicare
Increase premiums in Medicare
Increase cost-sharing in Medicare
Reduce tax subsidy for employment-based health insurance
CBO
13. Paying Medicare Providers in Different Ways Could Help
the Budget But Would Have A Range of Effects on
Providers and Beneficiaries
Possible federal policies include:
Shifting physicians’ payments to new models
Bundling payments for related services
Federal savings would be achieved only if providers were paid
less in total than under current law, either because they would
be delivering fewer and less complex services or because they
would be receiving less money per service.
CBO
14. Making Larger Structural Changes to Federal Health Care
Programs Could Help the Budget But Would Have A
Range of Effects on Providers and Beneficiaries
Possible federal policies include:
Adopting a premium support system for Medicare
Capping payments to states for Medicaid
Under either of those policies, numerous design choices
would have very large effects on beneficiaries’ costs, state
governments’ budgets, and the nature and magnitude of
payments to providers.
CBO
17. Federal lawmakers often strive for policies that both
reduce the growth of federal health care spending
and improve the effectiveness of the national health
care system.
Designing federal policies to achieve those goals is
challenging:
Most policies have significant disadvantages as well as
advantages.
How health insurers, health care providers, and
individuals would respond to most policies is
uncertain.
CBO
18. Endnotes
Slide 2: JCT refers to the staff of the Joint Committee on Taxation.
Slide 6: These numbers reflect recent revisions by the Bureau of Economic Analysis (BEA) to estimates of gross domestic product (GDP) in past years and CBO’s
extrapolation of those revisions to projected future GDP. See Congressional Budget Office, The 2013 Long-Term Budget Outlook (September 2013),
www.cbo.gov/publication/44521.
Numbers for 2013 were derived from information reported in Department of the Treasury, Final Monthly Treasury Statement of Receipts and Outlays of the
United States Government for Fiscal Year 2013 Through September 30, 2013, and Other Periods (October 2013), www.fms.treas.gov/mts/mts0913.pdf.
Major health care programs consist of Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and subsidies offered through exchanges and
related spending. Medicare spending is net of offsetting receipts.
Slide 10: For more information, see CBO’s Options for Reducing the Deficit: 2014 to 2023 (November 2013), http://www.cbo.gov/budget-options/2013/44687,
and Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget (June 2012), http://www.cbo.gov/publication/43319. The illustrative tax
increase modeled in this analysis is a 50-cent per pack rise in the federal excise tax on cigarettes and small cigars, beginning in 2013 and indexed each year
thereafter to keep pace with inflation (and, after 2021, to keep pace with the growth of inflation-adjusted income). The outlay effects of the tax increase all
result from improvements in health. The effects shown here apply only to mandatory outlays.
Slide 11: For more information, see CBO’s Options for Reducing the Deficit: 2014 to 2023 (November 2013), http://www.cbo.gov/budget-options/2013/44687.
ACA refers to the Affordable Care Act.
Slide 12: For more information, see CBO’s Options for Reducing the Deficit: 2014 to 2023 (November 2013), http://www.cbo.gov/budget-options/2013/44687.
Slide 13: For more information, see CBO’s Options for Reducing the Deficit: 2014 to 2023 (November 2013), http://www.cbo.gov/budget-options/2013/44687
and A Premium Support System for Medicare: Analysis of Illustrative Options (September 2013), http://www.cbo.gov/publication/44581.
Slide 14: For more information, see A Premium Support System for Medicare: Analysis of Illustrative Options (September 2013),
http://www.cbo.gov/publication/44581.
CBO