This document outlines Colorado's process for establishing maternal and child health priorities and moving from identifying priorities to implementing action plans at both the state and local level. Key aspects included conducting a needs assessment to identify 7-10 priorities, forming implementation teams for each priority, developing logic models and action plans, providing training and support, and establishing accountability mechanisms. The process aimed to better align state and local efforts and promote a coordinated, evidence-based approach to improving MCH outcomes over five years. Feedback was incorporated to enhance communication, support, and timeline management for future priority setting cycles.
Webinar on the first actuarial analysis of Pakistan’s Sehat Sahulat Programme...Impact Insurance Facility
Since 2015, Sehat Sahulat Programme (SSP), an initiative of Pakistan’s Federal, Provincial and Regional Governments, has been working to provide financial protection to poor families against catastrophic health expenditure. Towards the end of 2018, the SSP was operating in 38 districts of Pakistan, covering over 3.2 million families. The first of its kind in the country, the Programme provides inpatient care to those living below the poverty line of US $2 per day. Since inception, the Programme has been supported by GIZ.
The webinar is aimed at those interested in learning more about what actuarial analyses is in the context of a public health programme such as SSP, why it is important and how others can apply the same thinking in their analytical work.
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
David Buck on improving the allocation of health resources in England The King's Fund
David Buck, Senior Fellow in Public Health and Inequalities at The King’s Fund, explains how health resources are allocated in the English NHS, and how improvements to the process could be made to support a more coherent health and care system.
Webinar on the first actuarial analysis of Pakistan’s Sehat Sahulat Programme...Impact Insurance Facility
Since 2015, Sehat Sahulat Programme (SSP), an initiative of Pakistan’s Federal, Provincial and Regional Governments, has been working to provide financial protection to poor families against catastrophic health expenditure. Towards the end of 2018, the SSP was operating in 38 districts of Pakistan, covering over 3.2 million families. The first of its kind in the country, the Programme provides inpatient care to those living below the poverty line of US $2 per day. Since inception, the Programme has been supported by GIZ.
The webinar is aimed at those interested in learning more about what actuarial analyses is in the context of a public health programme such as SSP, why it is important and how others can apply the same thinking in their analytical work.
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
David Buck on improving the allocation of health resources in England The King's Fund
David Buck, Senior Fellow in Public Health and Inequalities at The King’s Fund, explains how health resources are allocated in the English NHS, and how improvements to the process could be made to support a more coherent health and care system.
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Transforming Health Systems grants tackled four health systems concerns: stewardship and management, financing, information systems, and universal health care (UHC) policy and advocacy. In each target country, the grants provided transformative support to address key challenges.
Bangladesh faced serious constraints in its health sector workforce and weak health information systems. Thirty one grants helped provide training for health care professionals, assess and improve health information systems, and introduce UHC concepts to health sector stakeholders. The interventions increased awareness and commitment to UHC, contributed to improved and standardized medical education, and aided the development of integrated health information systems.
Ghana sought to build public sector capacity to steward and manage its mixed public-private health system. The program partnered with the International Finance Corporation, which assessed the private health sector. Thirteen grants subsequently sought to build capacity within the private sector unit in the Ministry of Health and to create a platform to facilitate engagement with the private sector. The interventions strengthened public sector capacity, increased policy dialogue around UHC, and strengthened the country’s National Health Insurance Scheme.
Rwanda’s health system reforms have sought to increase health service use, reduce out-of-pocket expenditures, and improve health indicators. Eleven grants focused particularly on building eHealth and technology platforms. The grants resulted in improved capacity to develop and implement sustainable eHealth solutions, as well as creation of a custom electronic medical records system and a Health Enterprise Architecture. Most grants included plans for sustainability beyond the life of the grant.
Vietnam wanted to find ways to expand coverage, improve financial protection, and reduce inequality, particularly through improving its provider payment system. Sixteen grants funded research to support reforms and design and test alternative capitation methods. The initiative built capacity in academic and research institutions, strengthened government capacity in health system management and planning, increased support for payment reform, and generated evidence to shape universal health insurance policies.
Revitalizing PHC: PHCUOR As a Policy in Financing Towards UHCHFG Project
Presented during Day Four of the 2016 Nigeria Health Care Financing Training Workshop. Presented by Mr. Charles Ijeomah. More: https://www.hfgproject.org/hcf-training-nigeria
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Lessons Learned in Institutional Capacity BuildingHFG Project
The objective of this document is to present lessons learned based on HFG’s ICB experience, and to provide practical guidance that will inform future work in health systems strengthening. Ultimately, improved health system governance and management lead to improvements in the quality of essential health services and in expanding universal health coverage (UHC).
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Transforming Health Systems grants tackled four health systems concerns: stewardship and management, financing, information systems, and universal health care (UHC) policy and advocacy. In each target country, the grants provided transformative support to address key challenges.
Bangladesh faced serious constraints in its health sector workforce and weak health information systems. Thirty one grants helped provide training for health care professionals, assess and improve health information systems, and introduce UHC concepts to health sector stakeholders. The interventions increased awareness and commitment to UHC, contributed to improved and standardized medical education, and aided the development of integrated health information systems.
Ghana sought to build public sector capacity to steward and manage its mixed public-private health system. The program partnered with the International Finance Corporation, which assessed the private health sector. Thirteen grants subsequently sought to build capacity within the private sector unit in the Ministry of Health and to create a platform to facilitate engagement with the private sector. The interventions strengthened public sector capacity, increased policy dialogue around UHC, and strengthened the country’s National Health Insurance Scheme.
Rwanda’s health system reforms have sought to increase health service use, reduce out-of-pocket expenditures, and improve health indicators. Eleven grants focused particularly on building eHealth and technology platforms. The grants resulted in improved capacity to develop and implement sustainable eHealth solutions, as well as creation of a custom electronic medical records system and a Health Enterprise Architecture. Most grants included plans for sustainability beyond the life of the grant.
Vietnam wanted to find ways to expand coverage, improve financial protection, and reduce inequality, particularly through improving its provider payment system. Sixteen grants funded research to support reforms and design and test alternative capitation methods. The initiative built capacity in academic and research institutions, strengthened government capacity in health system management and planning, increased support for payment reform, and generated evidence to shape universal health insurance policies.
Revitalizing PHC: PHCUOR As a Policy in Financing Towards UHCHFG Project
Presented during Day Four of the 2016 Nigeria Health Care Financing Training Workshop. Presented by Mr. Charles Ijeomah. More: https://www.hfgproject.org/hcf-training-nigeria
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Lessons Learned in Institutional Capacity BuildingHFG Project
The objective of this document is to present lessons learned based on HFG’s ICB experience, and to provide practical guidance that will inform future work in health systems strengthening. Ultimately, improved health system governance and management lead to improvements in the quality of essential health services and in expanding universal health coverage (UHC).
The FMBHP is a collaboration among frontier/rural healthcare communities; Mineral Community Hospital’s Interdisciplinary Medical Education Center; iVantage, an industry leader providing comprehensive hospital evaluation tools; Mayo Clinic’s Practice-Based Research Network (PBRN); and the Appalachian Osteopathic Postgraduate Training Institute Consortium (A-OPTIC). The FMBHP will partner with CMS, IHS, Veteran Administration and other private insurers to develop a seamless and sustainable model of patient-centered and community-based healthcare that produces better outcomes cost-effectively.
Primary Care Integration for a Rural Community Behavioral Health Clinic. 2015 Washington Behavioral Healthcare Conference: Fulfilling the Promise of Integrated Care
Vancouver, WA June 19, 2015
Cambodia Health Researchers Forum 11 Nov 2015 combined presentationsReBUILD for Resilience
Combined presentations given at Cambodia Health Researchers' Forum 11th November 2015, Phnom Penh. Hosted by the National Institute of Public Health. Presentations given by Peter Annear, Barbara McPake, Sreytouch Vong and Ir Por
Johan Vendrig
GM Information Services – healthAlliance
Andrew Terris
Programme Director, Patients First
Darrin Hackett
GM HIQ, Acting CIO Waikato DHB
Martin Wilson
GP, Sexual Health Physician, Clinical Leader
Pegasus, executive NICLG
Tony Cooke
Manager Health Systems Investment and
Planning, Information Group, NHB
(Thursday, 4.15, Panel)
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
Interested in sharing best practices within your organization?
Are you engaged in creating community health status reports? Are you interested in learning about how to improve health equity? The Equity-Integrated Population Health Status Reporting Action Framework can help health professionals at all levels identify and implement manageable steps for integrating equity into existing or new public health status reporting processes. The framework is suitable for use by health/public health staff, community organizations that provide local data, and academic researchers.
This framework was developed collaboratively by the six National Collaborating Centres for Public Health, building upon earlier work by the NCC for Determinants of Health.
To see the summary statement of this tool developed by NCCMT, click here: http://www.nccmt.ca/resources/search/240
The National Collaborating Centre for Methods and Tools is funded by the Public Health Agency of Canada and affiliated with McMaster University. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
NCCMT is one of six National Collaborating Centres (NCCs) for Public Health. The Centres promote and improve the use of scientific research and other knowledge to strengthen public health practices and policies in Canada.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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.
Follow us on: Pinterest
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
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!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
1. C OLORADO ’ S MCH
P RIORITIES : M OVING FROM
D ATA TO A CTION
G INA F EBBRA RO , MP H
M ATER N A L AND C HILD H EALTH U NIT M AN A G E R
C OLORADO D EPART M E NT OF P UBLIC H EALTH AND
E NVIRON M EN T
GINA . FE BB R A R O @ STAT E . C O . U S
2. D ISCUSSION O VERVIEW
MCH Program vision and direction
Identification of MCH priorities
State infrastructure and process
Local public health agency alignment and
support
Feedback and next steps
3. C OLORADO ’ S MCH
M ISSION
Optimize the health and well-
being of the MCH population
by employing primary
prevention and early
intervention public health
strategies.
4. MCH S TRATEGIC
D IRECTION
Integrating MCH/CYSHCN efforts
across the life course
Attention to primary prevention
and early intervention strategies
Focus on population-based
approaches to health
6. C OLORADO MCH
N EEDS A SSESSMENT
Occurred in 2010 for 2011-2015
Purpose to identify 7-10 specific priorities that
could be measurably impacted in five years using
public health strategies
Conceptual framework
MCH population – Integrated CSHCN
Life course model
Social determinants of health
7. N EEDS A SSESSMENT
P ROCESS
Phase I – Collection of quantitative/
qualitative data to identify potential MCH
priorities.
Expert Panel Process
Health Status Report
Phase II – Stakeholder surveys
Phase III – Final prioritization, including
identification of new priorities and State
Performance Measures.
8. C RITERIA FOR
E STABLISHING P RIORITIES
A clear MCH public health role exists.*
Evidence-based or promising practices exist
to address the issue.
Consistent with mission and scope of MCH
– alignment with MCH SOW.
Efforts could achieve measurable results in
5 years.
*Ability for MCH to impact.
9. C OLORADO ’ S MCH
P RIORITIES 2011-2015
Promote preconception health among
women and men of reproductive age
with a focus on intended pregnancy
and healthy weight.
Promote screening, referral and
support for pregnancy-related
depression.
Improve developmental and social
emotional screening and referral rates
for all children ages birth to 5.
10. C OLORADO ’ S MCH
P RIORITIES 2011-2015
Prevent obesity among all children ages
birth to 5.
Prevent development of dental caries in
all children ages birth to 5
Reduce barriers to a medical home
approach by facilitating collaboration
between systems and families.
11. C OLORADO ’ S MCH
P RIORITIES 2011-2015
Promote sexual health among all youth
ages 15-19.
Improve motor vehicle safety among all
youth ages 15-19.
Build a system of coordinated and
integrated services, opportunities and
supports for all youth ages 9-24.
13. MCH S TEERING T EAM
Redefined role from needs assessment to
implementation;
Members:
Karen Trierweiler, Title V Director
Rachel Hutson, Children and Youth Branch Director
Esperanza Ybarra, Women’s Health Branch Director
Gina Febbraro, Maternal and Child Health Unit
Manager
14. F ROM MCH P RIORITIES TO
S TATE AND L OCAL P LANS
Developed a new state-level
infrastructure that:
Promotes a coordinated approach between
state and local MCH efforts;
Provides support and capacity-building
among both state and local MCH staff;
Provides oversight and accountability to state
and local-level work;
15. MCH I MPLEMENTATION
T EAMS (MIT S )
MIT formed for each MCH priority;
State program staff person with expertise in
the priority area leading each team;
Teams (6-10 people) varied in composition:
state, local stakeholders;
Teams were required to complete a team
charter.
Required to engage local stakeholders for
input/ feedback;
16. B ROWNSON E VIDENCE - BASED
P UBLIC H EALTH M ODEL
Brownson, RC; Fielding JE; Maylahn CM. Ann. Rev. Public Health
2009.30:189
17. MIT W ORK
Develop state-level logic models and
action plans that guide the next 3 years of
work.
Develop coordinated local-level logic
models and action plans that guide the
next 3 years of work.
18. T RAINING AND S UPPORT
P ROVIDED
Ongoing communication and consultation
(Rebecca Heck and Kerry Thomson)
Collaboration and policy training
Logic model and action plan trainings
Will continue to identify and coordinate
ongoing professional development
opportunities for MITs and local MCH
staff working on priorities.
19. A CCOUNTABILITY AND
O VERSIGHT
MITs presented and discussed work with MCH
Steering Team 2x each last year.
MCH Director, Unit Manager, and Generalist
Consultants reviewed state and local level logic
models and action plans and provided feedback
to MITs.
Report on efforts and progress in annual Title V
Block Grant report
20. AT THE S AME T IME …
MCH L OCAL F UNDING P OLICY
Revised local funding formula for MCH and HCP
funding
2008 Public Health Act, MCH Priorities, Address
some funding inequities that evolved over time
Intensive communication and stakeholder
engagement, including LPHA workgroups
21. MCH L OCAL F UNDING
P OLICY R ESULTS
Using the same, consistent formula for all 55
LPHAs (MCH population x poverty of MCH pop.)
Combining both MCH and HCP funding in order
to provide more flexibility for LPHAs and due to
integrated nature of priorities
3-year transition/mitigation plan
Aligning contract expectations with priorities and
HCP program direction
22. A LIGNMENT OF L OCAL MCH
F UNDING <$50,000
Administered through Office of Planning and
Partnerships – LPHA per capita contracts
41 LPHAs / Total of $410,000
$1500-$15,000 and $15,000-$50,000 Levels
HCP Model of Care Coordination with data entry in
CYSHCN Data System (Required for higher level);
MCH priorities by implementing part or all of a state-
developed local action plan related to an MCH priority;
Community health assessment process and public
health improvement planning process;
23. A LIGNMENT OF L OCAL MCH
F UNDING >$50,000
FY13 LPHA MCH/HCP
Funding Expectations
HCP Care Coordination Other MCH Priorities and Action Plans
Includes costs
associated with
Medical Home Priority 10%
One example of what HCP
care coordination costs may
be.
40%
The parameters of the
"Other" work are similar to HCP Specialty
MCH funding parameters Clinic Funding
now. Efforts are determined
by LPHA.
50%
24. R ESOURCE R OLL -O UT
MCH Conference
150 LPHA and State staff (MCH, PSD, OPP)
2 days that included a variety of Plenary
Sessions
State MCH strategic direction
State and regional MCH data overview
Brownson’s Evidence-based Public Health
Framework
Importance of population-based approach to
health
25. R ESOURCE R OLL -O UT
MCH Conference
MCH Priority Break-out Sessions (most
priority session offered 3 times each)
Background and data on priority issue
Brief intro. to state logic models and action
plans
Focus on local logic models and action plans
Interactive sessions highlighted local partner
input
27. A ND T HE S URVEY S AYS …
What is one thing you learned at the conference that you are
excited to apply at the job?
“Almost plug and play action plans, logic models, and the
stats”
“Utilization of Brownson's model and the MCH Pyramid”
“Action plans”
“Partnership building”
“Best practices for MCH work”
28. A ND O UR PARTNERS S AY …
“I just wanted you to know how useful it has been over the
last weeks to have the priority areas, each with
workplans, logic models, etc. I have met with our WIC
director about ECOP (and preconception), and have
promoted Teen Motor Vehicle with some injury
folks. Although we are not likely to undertake ABCD per
say, the information has helped us so much with Medical
Home Systems Building planning, and of course we are full on
with Youth Sexual Health in many arenas and are using that
material broadly. All though I could not articulate what is
was I exactly needed when I took on this role, this body of
tools fills multiple needs for Denver and I would like the staff
who spent so many hours developing the information to
know how useful it has been, even beyond its official
purpose.”
--Denver Public Health MCH Program Manager
29. R EFLECTIONS F ROM MIT S :
W HAT W ORKED ?
Communication: Expectations for MITs were clear
and flexible; MIT quarterly meetings; learning and
sharing from other MITs was very helpful
Aspects of process helpful for accountability and
moving the work forward: Assigning 1 lead per
MIT; Sponsor and Steering Team check-in meetings
Support, resources and tool: Logic model and
action plan templates; devoted EPE point-person;
EPE infrastructure specifically for LM and AP
consultation; MCH Generalist Consultant support
30. R EFLECTIONS F ROM S TEERING :
W HAT W ORKED ?
Steering Team check-in meetings –
accountability and quality control
Creation of support infrastructure for
MITs, including resourcing individual to
support MITs
Continuity and intentionality from needs
assessment through to implementing plans
31. R EFLECTIONS FROM MIT S :
W HAT C OULD W E I MPROVE ?
Communication: more time for Steering Team
check-in’s at the beginning of the process;
increased sharing, mentorship, and lessons
learned among the MITs during the development
of LMs and APs; more frequent MIT lead
meetings during ‘busy decision making time’ and
prior to MCH conference; common
communication platform for the MITs to access
More time: From to digest feedback and adjust
LM and AP prior to MCH Conference; Between
LM and AP trainings and the due date for the
LMs and APs.
32. R EFLECTIONS FROM S TEERING :
W HAT C OULD W E I MPROVE ?
Developing process and infrastructure in real time;
created tight timelines – be more planful in the
future;
Modify structure to meet needs; Check-in routinely
Value of sponsor role? Sponsor = supervisor
Communication strategy overall and specifically
related to stakeholders
33. N EXT S TEPS – A CTION TO
O UTCOMES
Dissemination of Work and Resources
CoPrevent / MCH web site
Presentations (conferences/webinars/podcasts)
and Publications
Ongoing and Enhanced Communication
(internal and external)
Ongoing MIT/LPHA support and capacity-
building
Oversight and evaluation of state and local
work plans
34. T HANK YOU AND Q UESTIONS !
GINA . FEBBRARO @ STATE . CO . US
303 692 2427
Editor's Notes
Phase IDIP – Doable, important, public health roleA clear MCH public health role exists.Evidence-based or promising practices exist to address.Consistent with mission and scope of MCH.Efforts could achieve measurable results in 5 years.Identification of 20-30 potential MCH public health-related priority areas across the three population groups. Results aggregated across groups by health issues and infrastructure/ capacity-building priorities.Phase IIPurpose: To further refine and prioritize MCH potential priorities.To assess state and local organizational capacity.Result:Focused set of issues for prioritization in Phase III.Phase IIIIssues assessed according to:Impact/FeasibilityCapacity/Resources – State and LocalAbility of MCH to impact and measureAlignment with MCH statement of workTools used:Issue papersState/local capacity scoresSpecific indicators for measurementImpact and feasibility grid
PP/EI - In looking at the PH role – we were also looking at EB efforts that would impact more people than 1:1 interventions to serve entire pop.In terms then of best use of resources & having $$ to address new priorities, we defined our MCH SOW – Mandatory/statutory reqs - had to do/resource but did not include them in the priorities unless they met the criteria.Discretionary activities – re-allocated to address new priorities.Small area for new/emerging issues. Way to maintain focus & evaluate new funding opportunities or proposed mandates that might not align with our priorities.Identify specific issues with EB strategies employed across the MCH life course to produce measurable outcomes.
Implementing these priorities will be the responsibility of both state and local MCH stakeholders. Guidance on how to address these priorities is still being developed.
Oversight of the MCH Implementation Teams’ plans and progress; Guiding and coordinating the MCH Priority Implementation process; Coordinating the integration of various priorities within the PSD Branches and Units; Providing support and resources for MCH Implementation Teams.
Applied each step of this framework to their priority area from December 2010 – present.
Identifying and implementing state & local strategies to address the MCH Priorities while utilizing the public health process; Employing evidence-based/promising practices grounded in sound public health theory or research; Enhancing collaboration among internal and external partners; Ultimately impacting MCH state performance measures.
Quarterly meetings with all MIT leads, individual consultation, email communication; You can see the LM and AP templates that were developed and used in your handouts.
As this is a new process, the MCH steering team, MCH generalists and OPP nurse consultants, and MCH Implementation teams are committed to a continuous quality improvement effort of learning how the implementation of the action plans are going at the state and local levels and making adjustments collaboratively as needed along the way.
1.5 year-long processExamined many scenarios and determined the scenario that would negatively impact the least number of LPHAs
Same formula feds use
14 agencies and almost $4.8 millionThis slide is only an example to show how a LPHA might use the funding. Required to implement the HCP Care Coordination Model including data entry in the CYSHCN Data System; Required to implement the local action plan related to the medical home priority LPHAs determine percent of funding allocated to HCP care coordination and medical home priority meet these requirements.Percent of total MCH/HCP funds must focus on implementing MCH-priority action plans, including the medical home priority. FY13 - At least 10% of total MCH/HCP fundsFY14 – At least 20% of total MCH/HCP fundsFY15 and FY16 - At least 30% of total MCH/HCPThese percentages will be reassessed each fiscal year.
Also facilitated a half-day contractor training following the 2-day conference where we highlighted the local funding expectations and guidance that support work on these priority efforts.
Conference feedback from LPHA’s:What is one thing you learned at the conference that you are excited to apply at the job? - “Almost plug and play action plans, logic models, and the stats”“Utilization of Brownson's model and the MCH Pyramid” “Believe it or not, the MCH Pyramid!”“Action plans”“Partnership building”“Best practices for MCH work” “How to apply the Brownson's Model to my MCH work plan”
Reflections from the MIT leads about what worked well- Communication: Expectations for MITs were clear and flexible; MIT quarterly meetings; learning and sharing from other MITs was very helpful Aspects of process helpful for accountability and moving the work forward: assigning 1 lead per MIT; Sponsor and Steering Team check-in meetingsSupport, resources and tool: logic model and action plan templates; devoted EPE point-person; EPE infrastructure specifically for LM and AP consultation; MCH Generalist Consultant support MCH Conference: Beginning presentations of MCH Conference were valuable in providing context; peer to peer conversations in breakout sessions; conference evaluations Reflections from Steering Team on what worked well:Creation of MIT and Steering Team infrastructureSteering Team check-in meetings – accountability and quality control Creation of support infrastructure for MITs, including individual to support MITs Continuity and intentionality Systematic data to action
Reflections from the MIT leads about what worked well- Communication: Expectations for MITs were clear and flexible; MIT quarterly meetings; learning and sharing from other MITs was very helpful Aspects of process helpful for accountability and moving the work forward: assigning 1 lead per MIT; Sponsor and Steering Team check-in meetingsSupport, resources and tool: logic model and action plan templates; devoted EPE point-person; EPE infrastructure specifically for LM and AP consultation; MCH Generalist Consultant support MCH Conference: Beginning presentations of MCH Conference were valuable in providing context; peer to peer conversations in breakout sessions; conference evaluations Reflections from Steering Team on what worked well:Creation of MIT and Steering Team infrastructureSteering Team check-in meetings – accountability and quality control Creation of support infrastructure for MITs, including individual to support MITs Continuity and intentionality Systematic data to action
Reflections from the MIT leads about improvement - More time and communication! Communication: more time for Steering Team check-in’s at the beginning of the process; increased sharing, mentorship, and lessons learned among the MITs during the development of LMs and APs; more frequent MIT lead meetings during ‘busy decision making time’ and prior to MCH conference; common communication platform for the MITs to access Time: more time from to digest feedback and adjust LM and AP prior to MCH Conference; more time between LM and AP trainings and the due date for the LMs and APs. Accountability: non-value add - sponsors and supervisors are one in the same personMCH Conference: MITs meet before conference to review common topics and themes; more time for LPHA networking Reflections from Steering Team related to improvement: Tight timelinesConference drive towards outcomes Modify structure to meet needs; check-in routinelyValue of sponsor role? Sponsor = supervisor Communication strategy related to stakeholdersTranslate Who’s Who document into a visual?Build in draft AP submissions to assure alignment
Reflections from the MIT leads about improvement - More time and communication! Communication: more time for Steering Team check-in’s at the beginning of the process; increased sharing, mentorship, and lessons learned among the MITs during the development of LMs and APs; more frequent MIT lead meetings during ‘busy decision making time’ and prior to MCH conference; common communication platform for the MITs to access Time: more time from to digest feedback and adjust LM and AP prior to MCH Conference; more time between LM and AP trainings and the due date for the LMs and APs. Accountability: non-value add - sponsors and supervisors are one in the same personMCH Conference: MITs meet before conference to review common topics and themes; more time for LPHA networking Reflections from Steering Team related to improvement: Tight timelinesConference drive towards outcomes Modify structure to meet needs; check-in routinelyValue of sponsor role? Sponsor = supervisor Communication strategy related to stakeholdersTranslate Who’s Who document into a visual?Build in draft AP submissions to assure alignment
MCH Steering Team and MCH Generalists will monitor implementation of state and local action plans in the future.