Getting Started in Your Neighborhood: Piloting Community Health Teams through a Multi-Payer Approach

The Care Transformation Collaborative of Rhode Island (CTC), a patient-centered medical home initiative managed by UMass Medical School, explains how primary care practices can build a medical neighborhood by creating a community health team to provide behavioral health and social support services to patients with high-cost, complex care needs. CTC used a multi-payer approach to pilot and evaluate two community health teams in two diverse areas of Rhode Island

Integrating Community Health Workers across the Healthcare Continuum

This presentation explores the positive effect the Care Transformation Collaborative of Rhode Island (CTC) has had on in-home care of the elderly across the state. CTC helps existing community health teams develop new systems of care coordination, improve the communication between caretakers and patients and assist coordinators to measure success in effective ways. CTC is a patient-centered medical home initiative managed by UMass Medical School

Care Transformation Collaborative Rhode Island: Transforming Primary Care in Rhode Island

This annual report outlines the 2015 accomplishments of Care Transformation Collaborative (CTC) Rhode Island, a primary care initiative managed by UMass Medical School. CTC includes more than 80 primary care practices across the state. In 2015 CTC had many achievements, including: Improving the cost of care and efficiency – through new programs like our Advanced Collaborative, practices developed and implemented projects focused on improving quality and reducing costs of care. Evaluating, refining and scaling our Community Health Teams – we evaluated the progress of these pilot programs and look forward to building off their successes and lessons learned. Expanding to include additional practices – we have proudly expanded our Collaborative to include pediatric practices, with an increased focus on the needs of children and families. Integrating behavioral health care – we took big steps forward to improve access to behavioral health services within primary care. Expanding our learning curriculum – through ongoing best practice sharing, learning sessions and workshops, we continue to advance our Collaborative through shared learning, leadership development, collaboration, and growth. Improving data analytic capability – we began working toward transitioning to an all-payer claims database to evaluate our practices and programs, increasing actionable reports to practices to support continued progress. The Office of Program Development within UMass Medical School’s Commonwealth Medicine division has been providing project management support for the initiative since 2011 under a contract with The Rhode Island Foundation. UMass Medical School’s Office for Program Development staff assists the Rhode Island primary care initiative by providing leadership, project management, program development and subcontract management support

Global initiatives for improving hospital care for children: State of the art and future prospects

Deficiencies in the quality of health care are major limiting factors to the achievement of the Millennium Development Goals for child and maternal health. Quality of patient care in hospitals is firmly on the agendas of Western countries, but has been slower to gain traction in developing countries, despite evidence that there is substantial scope for improvement, that hospitals have a major role in child survival and that inequities in quality may be as important as inequities in access. There is now substantial global experience of strategies and interventions that improve the quality of care for children in hospitals with limited resources. WHO has developed a toolkit containing adaptable instruments, including a framework for quality improvement, evidence-based clinical guidelines in the form of the Pocketbook of Hospital Care for Children, teaching material, assessment and mortality audit tools. These tools have been field-tested by doctors, nurses and other child health workers in many developing countries. This collective experience was brought together in a global WHO meeting in Bali in 2007. This article describes how many countries are achieving improvements in quality of paediatric care, despite limited resources and other major obstacles, and how the evidence has progressed in recent years from documenting the nature and scope of the problems to describing the effectiveness of innovative interventions. The challenges remain to bring these and other strategies to scale, and to support research into their use, impact and sustainability in different environments

Mutualisms drive plant trait evolution beyond interaction‐related traits

Mutualisms have driven the evolution of extraordinary structures and behavioural traits, but their impact on traits beyond those directly involved in the interaction remains unclear. We addressed this gap using a highly evolutionarily replicated system – epiphytes in the Rubiaceae forming symbioses with ants. We employed models that allow us to test the influence of discrete mutualistic traits on continuous non‐mutualistic traits. Our findings are consistent with mutualism shaping the pace of morphological evolution, strength of selection and long‐term mean of non‐mutualistic traits in function of mutualistic dependency. While specialised and obligate mutualisms are associated with slower trait change, less intimate, facultative and generalist mutualistic interactions – which are the most common – have a greater impact on non‐mutualistic trait evolution. These results challenge the prevailing notion that mutualisms solely affect the evolution of interaction‐related traits via stabilizing selection and instead demonstrate a broader role for mutualisms in shaping trait evolution

Development and delivery of an exercise programme for falls prevention: the Prevention of Falls Injury Trial (PreFIT)

This paper describes the development and implementation of an exercise intervention to prevent falls within The Prevention of Fall Injury Trial (PreFIT), which is a large multi-centred randomised controlled trial based in the UK National Health Service (NHS).Using the template for intervention description and replication (TIDieR) checklist, to describe the rationale and processes for treatment selection and delivery of the PreFIT exercise intervention.Based on the results of a validated falls and balance survey, participants were eligible for the exercise intervention if they were at moderate or high risk of falling.Intervention development was informed using the current evidence base, published guidelines, and pre-existing surveys of clinical practice, a pilot study and consensus work with therapists and practitioners. The exercise programme targets lower limb strength and balance, which are known, modifiable risk factors for falling. Treatment was individually tailored and progressive, with seven recommended contacts over a six-month period. Clinical Trials Registry (ISCTRN 71002650)

Rydberg atom mediated polar molecule interactions: a tool for molecular-state conditional quantum gates and individual addressability

We study the possibility to use interaction between a polar molecule in the ground electronic and vibrational state and a Rydberg atom to construct two-qubit gates between molecular qubits and to coherently control molecular states. A polar molecule within the electron orbit in a Rydberg atom can either shift the Rydberg state, or form Rydberg molecule. Both the atomic shift and the Rydberg molecule states depend on the initial internal state of the polar molecule, resulting in molecular state dependent van der Waals or dipole-dipole interaction between Rydberg atoms. Rydberg atoms mediated interaction between polar molecules can be enhanced up to $10^{3}$ times. We describe how the coupling between a polar molecule and a Rydberg atom can be applied to coherent control of molecular states, specifically, to individual addressing of molecules in an optical lattice and non-destructive readout of molecular qubits