Burnettchoi0197

Innovative medical products offer significant and potentially transformative impacts on health, but they create concerns about rising spending and whether this rise is translating into higher value. The result is increasing pressure to pay for therapies in a way that is tied to their value to stakeholders through improving outcomes, reducing disease complications, and addressing concerns about affordability. Policy responses include the growing application of health technology assessments based on available evidence to determine unit prices, as well as alternatives to volume-based payment that adjust product payments based on predictors or measures of value. Building on existing frameworks for value-based payment for health care providers, we developed an analogous framework for medical products, including drugs, devices, and diagnostic tools. We illustrate each of these types of alternative payment mechanisms and describe the conditions under which each may be useful. We discuss how the use of this framework can help track reforms, improve evidence, and advance policy analysis involving medical product payment.The Zuni Youth Enrichment Project provides a model for improving the health of American Indian youth by focusing on their culture and strengths.There is abundant literature on efforts to reduce opioid prescriptions and misuse, but comparatively little on the treatment provided to people with opioid use disorder (OUD). Using claims data representing 12-15 million nonelderly adults covered through commercial group insurance during the period 2008-17, we explored rates of OUD diagnoses, treatment patterns, and spending. We found three key patterns The rate of diagnosed OUD nearly doubled during 2008-17, and the distribution has shifted toward older age groups; the likelihood that diagnosed patients will receive any treatment has declined, particularly among those ages forty-five and older, because of a reduction in the use of medication-assisted treatment (MAT) and despite clinical evidence demonstrating its efficacy; and treatment spending is lower for patients who choose MAT. These patterns suggest that policies supporting the use of MAT are critical to addressing the undertreatment of OUD among the commercially insured and that further research to assess the cost-effectiveness of treatment with versus without medication is needed.Mesenchymal stem cells (MSCs) have provided a promising tool for cell therapy. Umbilical cord (UC) is one of the best sources of MSCs since its collection is noninvasive, and effortless, and the cells from this source are more capable and prolific. It has been proven that the differentiation, migration and protective properties of UC-MSCs are superior compared with other kinds of stem cells. Moreover, incurable neurodegenerative diseases, such as Alzheimer's disease, multiple sclerosis, Parkinson's disease and Huntington, encourage scientists to apply UC-MSCs transplantation in order to find a definite treatment. This review will focus on the preclinical and clinical use of mesenchymal stem cells derived from human umbilical cord in the treatment of neurodegenerative disorders.Problems with alcohol, marijuana and gambling are major public health challenges in Greenland but their prevalence in a hospital setting has not been explored. Healthcare facilities play a significant role in Greenland. One important aspect is their provision of both primary and secondary healthcare services to a small and scattered population while their potential as settings for screening for problems with alcohol, substances and gambling is an unexplored area with large public health potential. This study explored the prevalences of problems with alcohol, marijuana and gambling in a hospital and the potential for the use of a hospital as a setting for screening for alcohol, substance and gambling problems. Patients from the Northern Ilulissat Hospital filled in a self-administered questionnaire regarding their behaviour related to alcohol, marijuana and gambling. click here Data were weighted and compared to the nationally representative 2018 Health Survey. In the Ilulissat Survey, a large proportion were abstainers but there were still problems related to alcohol, marijuana and gambling indicating a potential for screening in a hospital setting. The results based on data from 2,554 respondents showed that prevalences of problems with alcohol, marijuana and gambling are lower in the Ilulissat Survey compared to the 2018 Health Survey.Introduction Parkinson's Disease (PD) is a chronic and slowly progressive neurodegenerative disease. Team-based care is required to address and manage the diverse array of motor and non-motor symptoms in PD and related conditions. As the evidence base for the efficacy of non-pharmacological treatment of PD is expanding, many different centers are implementing interdisciplinary models of care with allied health professionals trained in PD. Areas covered In this review, the authors outline these various models and review the evidence for multidisciplinary approaches to care in PD. They begin by defining the terms used to describe the spectrum of multidisciplinary and integrated care models, followed by synthesizing the evidence for these models in PD. The authors then highlight some representative models to illustrate the variety of multidisciplinary care interventions a community network-based model, a day-hospital model, an academic clinic-based model, and an intensive inpatient rehabilitation model. The authors synthesize these results and suggest directions for team-based PD care for the future. Expert opinion The future of medicine is team-based care that is decentralized and integrated vertically and horizontally across health systems. Building an evidence base for these complex interventions will require alternative models of evaluation other than randomized controlled trials.Objective To assess the contribution of maternal and placental factors to the development of superimposed preeclampsia in women with chronic hypertension. Methods Endothelial and renal function markers were serially assessed in 90 pregnant women with chronic hypertension and controls. Results Syndecan-1 concentrations were lower at 26-27+6 weeks in women with chronic hypertension who subsequently developed superimposed preeclampsia compared with those who did not. Decreased PlGF and raised urine albumincreatinine ratio were also associated with development of superimposed preeclampsia. Conclusion Decreased syndecan-1 and PlGF concentrations implicate endothelial glycocalyx disturbance and reduced placental angiogenic capacity, respectively, in the pathophysiology of superimposed preeclampsia.