Looking to the Future — Google / Navigating Tomorrow

About Ron Medford Ron Medford joined Google in January 2013 as its Safety Director for the Self-Driving Car Program. In this position Ron leads the program’s safety team that is working with other program development teams to ensure the safety of the self-driving car. Prior to taking on this role at Google, Mr. Medford served as the Deputy Administrator of the National Highway Traffic Safety Administration (NHTSA), U.S. Department of Transportation from January 2010 until December 2012. Ron began his career at NHTSA in May 2003 as the Senior Associate Administrator for Vehicle Safety. In this position, he was responsible for overseeing all aspects of the U.S. auto safety programs. This included vehicle safety research, regulations, enforcement as well as the National Center for Statistics and Analysis. Before joining NHTSA, Mr. Medford was the Assistant Executive Director for Hazard Identification & Reduction at the U.S. Consumer Product Safety Commission (CPSC). He was responsible for the regulatory and technical work of the Agency, such as overseeing the Directorates for Engineering Sciences, Health Sciences, Epidemiology, Economic Analysis as well as the Agency’s Chemistry and Engineering Laboratories. Mr. Medford spent more than 25 years in a variety of technical management positions at the CPSC. Just prior to joining NHTSA, Mr. Medford spent 10 months on a government-sponsored sabbatical to work with Dean Kamen, an inventor from Manchester, New Hampshire. Mr. Kamen is president of Deka Research and Development Corporation and is known for his inventions of the IBOTTM wheel chair and the SegwayTM Human Transporter (HT). Mr. Medford holds a B.S. and M.S. from the University of Maryland

Massachusetts Medicaid 50th Anniversary Timeline

July 30, 2015 marked the 50th anniversary of Medicaid, and to commemorate that milestone the Massachusetts Medicaid Policy Institute (MMPI) released a timeline of important events co-created by health policy experts at UMass Medical School. MMPI is a program of the Blue Cross Blue Shield of Massachusetts Foundation. Medicaid, a federal-state partnership program, has advanced a variety of health coverage reform goals over the last 50 years. There is perhaps no state in which Medicaid has played a more important role in the evolution of how health care is delivered and paid for than Massachusetts. And no state has played a larger role in influencing the evolution of Medicaid at the federal level

Outcome of pediatric heart transplantation in blood culture positive donors in the United States

Active donor infection at the time of organ procurement poses a potential infection risk and may increase post‐transplant morbidity and mortality in recipients. Our hypothesis was that pediatric heart transplant recipients from blood culture positive donors (BCPD) would have increased morbidity and mortality compared to non‐blood culture positive donors (NBCPD). A retrospective analysis of pediatric heart transplant recipients using the organ procurement and transplant network (OPTN) between 1987 and 2015 was conducted. Recipient as well as donor data were analyzed. Propensity score matching with 1:2 ratios was performed for recipient variables. Post‐transplant morbidity and mortality were compared for recipients of BCPD and NBCPD. Among 9618 heart transplant recipients, 450 (4.7%) were from culture positive donors. Recipients of BCPD had longer duration of listing as Status 1; diagnosis of congenital heart disease or restrictive cardiomyopathy and required support (IV inotropes, Inhaled NO and LVAD) prior to transplant. Post‐transplant survival between the 2 groups was not different. Propensity‐matched recipients had similar length of stay; stroke rate; need for dialysis; pacemaker implantation and treated rejection episodes in the first year post‐transplant. Careful acceptance of BCPD may have the potential to increase availability of donor hearts in the pediatric population.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144234/1/ctr13249.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144234/2/ctr13249_am.pd

Age-Friendly Communities Initiative:Public Health Approach to Promoting Successful Aging

Older adults consistently prefer aging in place, which requires a high level of community support and services that are currently lacking. With a rapidly aging population, the present infrastructure for healthcare will prove even more inadequate to meet seniors' physical and mental health needs. A paradigm shift away from the sole focus on delivery of interventions at an individual level to more prevention-focused, community-based approaches will become essential. Recent initiatives have been proposed to promote healthy lifestyles and preventive care to enable older adults to age in place. Prominent among these are the World Health Organization's Global Age-Friendly Communities (AFC) Network, with 287 communities in 33 countries, and AARP's Network of AFCs with 77 communities in the United States. In an AFC, older adults are actively involved, valued, and supported with necessary infrastructure and services. Specific criteria include affordable housing, safe outdoor spaces and built environments conducive to active living, inexpensive and convenient transportation options, opportunities for social participation and community leadership, and accessible health and wellness services. Active, culture-based approaches, supported and developed by local communities, and including an intergenerational component are important. This article provides a brief historical background, discusses the conceptualization of the AFC, offers a list of criteria, narrates case studies of AFCs in various stages of development, and suggests solutions to common challenges to becoming age-friendly. Academic geriatric psychiatry needs to play a major role in the evolving AFC movement to ensure that mental healthcare is considered and delivered on par with physical care