Anne C. Beale, MD, MPH, the president of the Aetna Foundation speaks about disparities in child health care, the causes behind those disparities, and policies that can reduce them.
Affordable Care Act Briefing, Joanne Grossi, LWVMCVAcalindstrom
Presentation made to LWV of Montgomery County, VA and friends on Aug. 7, 2012. Speaker, Joanne Grossi, Director Region U.S. Dept. of Health and Human Services. (Shared with her permission)
Anne C. Beale, MD, MPH, the president of the Aetna Foundation speaks about disparities in child health care, the causes behind those disparities, and policies that can reduce them.
Affordable Care Act Briefing, Joanne Grossi, LWVMCVAcalindstrom
Presentation made to LWV of Montgomery County, VA and friends on Aug. 7, 2012. Speaker, Joanne Grossi, Director Region U.S. Dept. of Health and Human Services. (Shared with her permission)
2014 accolades from the McCombs School of Business at The University of Texas at Austin. A list of McCombs business school rankings, school data, and career services information.
Where Leadership is Earned™
For more details visit: http://www.mccombs.utexas.edu/AnnualReport.aspx
12 Tools to help work better and more efficient with your Social Media. Use marketing automation and social media tools to boost your social media success.
Apache Drill [1] is a distributed system for interactive analysis of large-scale datasets, inspired by Google’s Dremel technology. It is a design goal to scale to 10,000 servers or more and to be able to process Petabytes of data and trillions of records in seconds. Since its inception in mid 2012, Apache Drill has gained widespread interest in the community. In this talk we focus on how Apache Drill enables interactive analysis and query at scale. First we walk through typical use cases and then delve into Drill's architecture, the data flow and query languages as well as data sources supported.
[1] http://incubator.apache.org/drill/
Une présentation du moteur d'exploration "Set-Based" utilisable en ingénierie (conception globale et conception détaillée), en production et en logiciel.
A IMPORTÂNCIA DOS ÍNDICES DE PREÇOS AO CONSUMIDOR PARA OS AGENTES ECONÔMICOS ...Adílio Francisco Rocha
Resumo: A interpretação econômica utiliza-
se de dados numéricos e estatísticos para
viabilizar o desenho de cenários. O presente
trabalho aborda a importância da existência
de Indicadores Econômicos (IE), sobretudo
do Índice de Preços ao Consumidor (IPC)
como instrumento no processo de tomada de
decisão do consumidor, empresários e
governos. Para análise e constatações
utilizam-se os índices de preços calculados
pela FAI - Centro de Ensino Superior em
Gestão, Tecnologia e Educação, o Índice de
Preços ao Consumidor de Santa Rita do
Sapucaí (IPCS) e o Índice de Preços ao
Consumidor de Pouso Alegre (IPCP) no
período entre Julho de 2011 e Junho de 2012.
Improving quality of care, using existing assets better and reducing medical ...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
2014 accolades from the McCombs School of Business at The University of Texas at Austin. A list of McCombs business school rankings, school data, and career services information.
Where Leadership is Earned™
For more details visit: http://www.mccombs.utexas.edu/AnnualReport.aspx
12 Tools to help work better and more efficient with your Social Media. Use marketing automation and social media tools to boost your social media success.
Apache Drill [1] is a distributed system for interactive analysis of large-scale datasets, inspired by Google’s Dremel technology. It is a design goal to scale to 10,000 servers or more and to be able to process Petabytes of data and trillions of records in seconds. Since its inception in mid 2012, Apache Drill has gained widespread interest in the community. In this talk we focus on how Apache Drill enables interactive analysis and query at scale. First we walk through typical use cases and then delve into Drill's architecture, the data flow and query languages as well as data sources supported.
[1] http://incubator.apache.org/drill/
Une présentation du moteur d'exploration "Set-Based" utilisable en ingénierie (conception globale et conception détaillée), en production et en logiciel.
A IMPORTÂNCIA DOS ÍNDICES DE PREÇOS AO CONSUMIDOR PARA OS AGENTES ECONÔMICOS ...Adílio Francisco Rocha
Resumo: A interpretação econômica utiliza-
se de dados numéricos e estatísticos para
viabilizar o desenho de cenários. O presente
trabalho aborda a importância da existência
de Indicadores Econômicos (IE), sobretudo
do Índice de Preços ao Consumidor (IPC)
como instrumento no processo de tomada de
decisão do consumidor, empresários e
governos. Para análise e constatações
utilizam-se os índices de preços calculados
pela FAI - Centro de Ensino Superior em
Gestão, Tecnologia e Educação, o Índice de
Preços ao Consumidor de Santa Rita do
Sapucaí (IPCS) e o Índice de Preços ao
Consumidor de Pouso Alegre (IPCP) no
período entre Julho de 2011 e Junho de 2012.
Improving quality of care, using existing assets better and reducing medical ...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Multiple health problems in elderly peoplepage 950Ex.docxgilpinleeanna
Multiple health
problems in
elderly people
page 950
Excessive
drinking in
young women
page 952
Adverse drug
reactions in
elderly people
page 956
Palliative care
beyond cancer
page 958
Drug resistant
infections in
poor countries
page 948
Management
of chronic pain
page 954
M
A
K
IN
G
A
D
IF
FE
R
E
N
C
E
945BMJ | 26 APRIL 2008 | VOLUME 336
BMJ | Making a difference | 26 april 2008 | VoluMe 336 947
Running the gauntlet to improve
patient care
This supplement is the result of a gauntlet
thrown down, and picked up, during a dinner
in London just over a year ago. The gauntlet
thrower was Don Berwick, president of the
Institute for Healthcare Improvement in Boston.
What, he asked, was the BMJ Publishing Group
really for? What were we trying to achieve? In
reply, I and our chief executive, Stella Dutton,
were quick to quote the BMJ’s mission, which
ends with the crucial words “to improve
outcomes for patients.” Fine, said Don, but how
about being more specific: which outcomes,
what patients, by how much?
We took his suggestion seriously. Why not
target a few important healthcare problems,
taking a quality improvement approach
and focusing on the evidence on how to
make a difference in these areas? But how
to choose which issues to tackle among
the many millions of pressing healthcare
challenges facing the world? We turned in the
first instance to BMJ readers. In May 2007
we asked you to tell us what information was
most needed to improve the quality of care of
patients in clinical practice. From your many
rapid responses we harvested more than 200
ideas. After categorising these and matching
them against the priorities of national and
international bodies, we created a shortlist
of 12. With the help of an expert panel (see
http://makingadifference.bmj.com) we cut
these down to six.
Inevitably the choice of topics is subjective
rather than scientific, but the six we have
ended up with are interesting. Several turn the
spotlight on areas that are less than glamorous
and are perhaps all too often passed over, even
as their impact on individual lives and society
increases. Two topics deal with problems of
old age: multiple illness and adverse drug
reactions. Two deal with palliation: of chronic
pain and in dying from non-malignant disease.
The remaining topics deal with two very
different but serious and growing public health
challenges: drug resistant infections in the
developing world and excessive drinking in
young women. You will no doubt find important
gaps in what we have chosen. But if this
initiative proves useful we can expand it further.
On each of the six topics we’ve invited
leading commentators to write the pairs
of articles that make up this supplement.
One article in each pair aims to describe
the importance of the problem in terms of
its health and societal impact. The other
looks at the available evidence on quality
improvement initiat ...
Global health care challenges and trends_ bestyBesty Varghese
GLOBAL HEALTH CARE CHALLENGES AND TRENDS: Analyses the global healthcare trends and challenges.
Healthcare providers have a unique window of opportunity to embrace efficient new technologies that directly support better healthcare and patient experiences at a lower cost.
New healthcare systems will be:
Evidence- and prevention-based
Interdisciplinary and coordinated
Transparent, accessible, accurate, and understandable
Focused on improving patient outcomes and experience
Based on partnerships among stakeholders
Visionary in their long-term thinking
And in total International health + Global public health + Collective health + Global health diplomacy = LIFE’S RIGHT.
Global health care challenges and trends_ bestyBesty Varghese
GLOBAL HEALTH CARE CHALLENGES AND TRENDS: Analyses the global healthcare trends and challenges.
Healthcare providers have a unique window of opportunity to embrace efficient new technologies that directly support better healthcare and patient experiences at a lower cost.
New healthcare systems will be:
Evidence- and prevention-based
Interdisciplinary and coordinated
Transparent, accessible, accurate, and understandable
Focused on improving patient outcomes and experience
Based on partnerships among stakeholders
Visionary in their long-term thinking
And in total International health + Global public health + Collective health + Global health diplomacy = LIFE’S RIGHT
National strategies on NonCommnicable Diseases (NCD's) the place of the Private Sector in Kenya. ACORD Round table. Dr. Kibachio Joseph Mwangi; MD, MPH (Lshtm), Msc (Epi),
Head; Non Communicable Diseases Control Unit
Ministry Of Health,
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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1. Innov8
for
Health
Catalyzing
a
Culture
of
Innova5on
to
Revolu5onize
Health
Presented
by:
Craig
Osterhues,
GE
Avia5on
Health
Execu5ve
Learn
more:
Innov8forHealth.com
Sunnie
Southern,
Founder
and
CEO
Viable
Synergy
Follow
us:
@Innov8forHealth
Learn
more:
Innov8forHealth.com
Follow
us:
@Innov8forHealth
Join
the
conversa7on:
Innov8forHealth.com
2. Innov8
for
Health
Discussion
Points
• What
is
Innov8
for
Health?
• Idea
Expo
2011
Challenge
– Challenge
Background
• Chronic
Condi5ons
• Transi5ons
in
Care
• Innov8
for
Health
Implementa5on
Plan
• What
you
can
Learn
more:
Innov8forHealth.com
Follow
us:
@Innov8forHealth
Join
the
conversa7on:
Innov8forHealth.com
3. Innov8
for
Health
What
is
Innov-‐8
for
Health?
• A
community
wide
effort
to
catalyze
innova5on
and
revolu5onize
health,
aWract
and
retain
top
talent,
and
create
jobs
in
greater
Cincinna5
• Private-‐public
partnership
between
–
Universi5es
– Start-‐ups/
Entrepreneurs
–
Employers
– Investors
Learn
more:
Innov8forHealth.com
Follow
us:
@Innov8forHealth
Join
the
conversa7on:
Innov8forHealth.com
4. Innov8
for
Health
2011
Challenge
• Improving
care
transi0ons
for
people
with
chronic
condi0ons:
– Home
to
Camp
– High
School
to
College
– Hospital
to
Nursing
Home
to
Home
Learn
more:
Innov8forHealth.com
Follow
us:
@Innov8forHealth
Join
the
conversa7on:
Innov8forHealth.com
5. Innov8
for
Health
Background
2011
Innov-‐8
Challenge
What
is
a
Chronic
Disease?
• Chronic
diseases
(also
called
chronic
condi5ons
or
chronic
illnesses)
are
noncommunicable
illnesses
that
are
prolonged
in
dura5on,
do
not
resolve
spontaneously,
and
are
rarely
cured
completely.
o Examples
of
chronic
diseases
include:
Heart
disease
Cancer
Stroke
Diabetes
Arthri5s
Asthma
Obesity
• 133
million
Americans
live
with
at
• ¼
of
persons
living
with
a
chronic
illness
least
one
chronic
illness
experience
significant
limita5ons
in
daily
– nearly
1
in
2
adults
ac5vi5es
• 7
in
10
deaths
caused
from
chronic
• %
of
U.S.
children
and
adolescents
w/
a
diseases
each
year
in
the
United
chronic
health
condi5on
increased
from
States
1.8%
in
1960s
t0
>
7%
in
2004
• >75%
of
health
care
costs
are
due
• 1
in
every
400
to
600
individuals
younger
to
chronic
condi5ons
than
20
years
affected
by
type
1
diabetes*
References:
hWp://www.cdc.gov/chronicdisease/resources/publica5ons/AAG/chronic.htm
hWp://tde.sagepub.com/content/34/6/996.full
Learn
more:
Innov8forHealth.com
Follow
us:
@Innov8forHealth
Join
the
conversa7on:
Innov8forHealth.com
6. Innov8
for
Health
Background
2011
Innov-‐8
Challenge
Economic
Impact
of
Managing
Chronic
Condi0ons
Is
Staggering-‐
Today
&
Tomorrow
Economic
Impact
of
Chronic
Condi7ons
in
Billions
of
US
$s
United
States
2003
2013
2023
Cost
of
Mgt
Chronic
Condi5ons
US
$1,324
$2,192
$3,030
Avoidable
Costs
NA
$297
(12%)
$1,123
(27%)
Totals
$2,489
$4,153
Ohio
2003
2013
2023
Cost
of
Mgt
Chronic
Condi5ons
Ohio
$57
$87
$111
Avoidable
Costs
Na
$12
(12%)
$40
(26%)
Totals
$99
$151
B=
Billions
of
$s
Reference:
The
Milken
Ins5tute
hWp://www.chronicdiseaseimpact.com/state_sheet/OH.pdf
,
hWp://
www.chronicdiseaseimpact.com/state_pdfs/StateFactSheets.pdf
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7. Issues
in
Care
Transi5ons
Impacts
People
of
All
Ages
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more:
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us:
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8. Innov8
for
Health
Issues
in
Care
Transi5ons:
Children
&
Adolescents
• A
study
of
135
pa5ents
with
type
1
diabetes
found:
– 33%
experienced
problems
during
transi5on
– 28%
experienced
a
loss
of
follow-‐up
between
their
last
pediatric-‐care
visit
and
their
first
visit
in
adult-‐care
services
of
>6
months
– 13%
experienced
a
loss
of
follow-‐up
of
>12
months
– Overall,
50%
of
respondents
either
felt
there
was
a
problem
or
had
a
loss
of
follow-‐up
for
more
than
6
months
References:
Problems
in
Transi5on
From
Pediatric
Care
to
Adult
Care
for
Individuals
With
Diabetes
Danièle
Pacaud
1,2
MD,
Jean-‐François
Yale3
MD,
David
Stephure1,2
MD,
Rebecca
Trussell
1,2
MD,
H.
Dele
Davies
1,2
1
Alberta
Children’s
Hospital,
Calgary,
Alberta,
Canada2
Department
of
Pediatrics,
Faculty
of
Medicine,
University
of
Calgary,
Calgary,
Alberta,
Canada
3
McGill
Nutri5on
and
Food
Science
Centre,
Department
of
Medicine,
McGill
University,
Montreal,
Quebec,
Canada
hWp://www.diabetes.ca/files/Pacaud.pdf
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9. Innov8
for
Health
Issues
in
Care
Transi5ons:
in
School
Children/
Adolescents
– 84.1%
of
children
surveyed
did
not
get
help
on
returning
to
school
from
hospital/illness
– ~
70%
of
children/
adolescents
felt
were
treated
differently
in
school
because
of
their
diabetes
at
least
some
of
the
5me
– 27.6%
of
children
and
adolescents
surveyed
felt
that
school
personnel
were
knowledgeable
to
adequately
care
for
their
diabetes
Parents
– 30.8%
of
parents
had
to
miss
work
due
to
inadequacy
of
school
to
care
for
needs
and
63.4%
because
child
had
to
go
to
the
doctor
– 40%
of
parents
felt
school
staff
was
not
adequately
trained
to
care
for
children
– No
wriWen
care
plan
or
nurse
at
school^
– Most
children
not
allowed
to
check
blood
glucose
levels
or
administer
insulin
in
class^
– Most
parents
worried
about
hyperglycemia
&
hypoglycemia
in
school^
School
Staff
– 38%
of
school
personnel
expressed
great
concern
about
the
inadequacy
of
training
– 65%
concerned
about
poten5al
liability
of
caring
for
children
and
adolescents
at
school
– 38%
of
school
personal
felt
concerned
about
preparedness
to
deal
with
an
emergency
References:
Experiences
of
Children
and
Adolescents
With
Type
1
Diabetes
in
School:
Survey
of
Children,
Parents,
and
SchoolsFrank
L.
Schwartz,
MD,
Sharon
Denham,
DSN,
Victor
Heh,
PhD,
Andrew
Wapner,
DO,
and
Jay
Shubrook,
DO.
Diabetes
Spectrum
Volume
23,
Number
1,
2010
Twenty-‐eight
surveys
were
returned
by
school
personnel
represen5ng
20
schools.
The
number
of
children
with
type
1
diabetes
in
each
school
ranged
from
none
(5.9%),
1–2
(27.5%),
3–4
(41.2%),
5–10
(13.7%),
and
>10
(11.8%).
^Parent
Perspec7ves
of
Diabetes
Management
in
Schools
Farrah
Jacquez,
PhD
Stacey
Stout,
MD
Rose
Alvarez-‐Salvat,
PhD
Michelle
Fernandez,
MA
Manuela
Villa,
MS
Janine
Sanchez,
MD
Margaret
Eidson,
MD
Robin
Nemery,
MD
Alan
Delamater,
PhD
From
the
University
of
Miami
School
of
Medicine,
Miami,
Florida
(Dr
Jacquez,
Dr
Stout,
Ms
Fernandez,
Ms
Villa,
Dr
Sanchez,
Dr
Eidson,
Dr
Delamater);
Miami
Children's
Hospital,
Miami,
Florida
(Dr
Alvaraz-‐Salvat);
and
Joe
Dimaggio
Children's
Hospital,
Hollywood,
Florida
(Dr
Nemery).
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10. Innov8
for
Health
Issues
in
Care
Transi5ons:
Medicare
Pa5ents
• Hospital
Readmissions
for
Medicare
Pa5ents
(Jenks,
NEJM
2009)*
– ~1/5
of
11,855,702
Medicare
beneficiaries
discharged
from
a
hospital
in
2004
were
rehospitalized
w/in
30
days
• 34.0%
were
rehospitalized
w/in
90
days
– $17.4
billion
was
cost
to
Medicare
of
unplanned
rehospitaliza5ons
in
2004
• Up
to
76%
of
re-‐hospitaliza5ons
may
be
preventable
(MedPAC,
2007)
Reference:
*Rehospitaliza5ons
among
Pa5ents
in
the
Medicare
Fee-‐for-‐Service
Program.
Stephen
F.
Jencks,
M.D.,
M.P.H.,
Mark
V.
Williams,
M.D.,
and
Eric
A.
Coleman,
M.D.,
M.P.H.N
Engl
J
Med
2009;
360:1418-‐1428.
April
2,
2009.
AhWp://www.nejm.org/doi/full/
10.1056/NEJMsa0803563
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11. Overview
of
Investments
to
Solve
Care
Transi5on
Issues
&
Improve
Healthcare
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more:
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us:
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12. Innov8
for
Health
Center
for
Medicare
and
Medicaid
Innova5on
(CMMI)
$10
Billion
2011
-‐
2019
• $10
billion
in
direct
funding
available
beginning
2011
to
2019
• “test
innova5ve
payment
and
service
delivery
models
to
reduce
program
expenditures,
while
preserving
or
enhancing
the
quality
of
care”
for
those
who
get
Medicare,
Medicaid
or
CHIP
benefits
CMMI
Current
Funding
Opportuni7es
Interven7on Funds
Allocated
Partnership for Patients $500 M
Transitions in Care Program $500 M
HH
2011.
hWp://www.hhs.gov/news/press/2011pres/06/20110622a.html
hWp://innova5ons.cms.gov/about-‐us/our-‐charge/
hWp://www.cms.gov/DemoProjectsEvalRpts/downloads/CCTP_Transcript.pdf
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13. Innov8
for
Health
Cincinna5’s:
$40
Million
in
Grants
and
Funding
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more:
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us:
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conversa7on:
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14. Innov-‐8
for
Health
Implementa5on
Plan
Learn
more:
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us:
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conversa7on:
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15. Innov8
for
Health
Idea
Funnel
Process
for
capturing,
cataloging,
and
incen5vizes
the
best
ideas
across
two
tracks
University
Entrepreneur/
Track*
Start-‐Up
Track*
All
Ideas
SubmiWed
to
Website
www.Innov8forHealth.com
Best
Ideas
Selected
for
Idea
Expo
Dec.
2,
2011
Idea
Expo
Winners
$s
+
More
Idea
Expo
Winners
Opportunity
for
mentoring,
Idea
Expo
Winners
course
credit,
&
Opportunity
for
mentoring,
presen5ng
during
the
acceptance
into
an
Business
Concept
Exhibi5on
accelerator,
For
more
$s
+
presen5ng
during
the
Business
Concept
Exhibi5on
For
more
$s
+
*Visit
Innov8forHealth.com
for
your
university
contact
or
to
learn
more
about
mentoring
and
the
accelerator
Learn
more:
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us:
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conversa7on:
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16. Innov8
for
Health
Innov8
for
Health
Capture
the
Best
Ideas
&
Cul5vate
into
Viable
Businesses
4
Events
w/
2
Tracks
Ini7ate
Cul7vate
Harvest
Prosper
University
University
Angel
Investor
Entrepreneur
Students
Support
Tracks
&
OR
Health
Venture
Entrepreneurs
Innova5on
Capital
Accelerator
Support
Business
Concept
Idea
Expo
Exhibi7on
Start-‐Up
Show
Case
BeWer
Health
&
Care
More
Talent
&
Jobs
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more:
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us:
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conversa7on:
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17. What
You
Can
Do
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more:
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us:
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conversa7on:
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18. Innov8
for
Health
What
You
Can
Do
• Start-‐ups
and
Entrepreneurs
– Bring
your
best
ideas
to
improve
transi5ons
in
care
• University
Students
– Bring
your
best
ideas
to
improve
transi5ons
in
care
• Investors
– Provide
mentorship
and
funding
to
help
make
the
ideas
into
viable
businesses
• University
Professors
– Engage
your
students
and
encourage
to
par5cipate
in
the
challenge
– Support
the
winners
from
your
University
via
the
entrepreneur
tracks
• Employers
– Support
live
events
with
sponsorship
funds
and
your
aWendance
– Encourage
entrepreneurs
in
your
organiza5ons
to
par5cipate
• Health
Systems
– Support
live
events
with
sponsorship
funds
and
your
aWendance
– Work
with
organizers
to
communicate
most
important
“challenges”
to
be
addressed
• Everyone
– Share
info.
about
Innov8
for
Health
with
friends
– Par5cipate
in
community
events
and
show
your
support
Learn
more:
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us:
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conversa7on:
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