Healthcare Progression in the United States Background and Strategy for a Universal Healthcare System

The purpose of this research is to focus on the feasibility and implementation of a universal healthcare system in the United States. The research is focused on the areas of historical data, healthcare in foreign countries, political forces, financial assessments, insurance, current healthcare systems, and strategies for developing and implementing a universal healthcare system in the United States. There are many forces at work in the healthcare industry. Political and financial interests are two of the main roadblocks to a successful universal healthcare system and health reform. The research discussed in this piece will provide information and strategies on how a universal healthcare system could be implemented and examine the positive and negative effects such a system would have. There is historical data and modern examples of universal healthcare systems in other countries, as well as, certain instances in our own past in the United States. Several European countries, as well as, Canada, have been using some form of universal healthcare system for years. The goal of this research is to determine, based on population size, healthcare systems, and governmental structure, which systems and reforms from other countries could be used to help adapt our own form of a universal healthcare system

Challenges in Building a Knowledge-Based Technology Infrastructure for Population Health

In his current role, Dr. Niloff is responsible for the strategic development of population health analytics and solutions. This forum presentation focuses on ACO’s and ways of achieving organizational alignment and management through healthcare transformation. He describes tools and data needed for successful population health management and how to achieve credibility with physicians and meaningful engagement. Presentation: 49 minutes PowerPoint slides at bottom of this page. 42 slides

Effects of Blood Collection Conditions on Ovarian Cancer Serum Markers

Evaluating diagnostic and early detection biomarkers requires comparing serum protein concentrations among biosamples ascertained from subjects with and without cancer. Efforts are generally made to standardize blood processing and storage conditions for cases and controls, but blood sample collection conditions cannot be completely controlled. For example, blood samples from cases are often obtained from persons aware of their diagnoses, and collected after fasting or in surgery, whereas blood samples from some controls may be obtained in different conditions, such as a clinic visit. By measuring the effects of differences in collection conditions on three different markers, we investigated the potential of these effects to bias validation studies.We analyzed serum concentrations of three previously studied putative ovarian cancer serum biomarkers-CA 125, Prolactin and MIF-in healthy women, women with ovarian cancer undergoing gynecologic surgery, women undergoing surgery for benign ovary pathology, and women undergoing surgery with pathologically normal ovaries. For women undergoing surgery, a blood sample was collected either in the clinic 1 to 39 days prior to surgery, or on the day of surgery after anesthesia was administered but prior to the surgical procedure, or both. We found that one marker, prolactin, was dramatically affected by collection conditions, while CA 125 and MIF were unaffected. Prolactin levels were not different between case and control groups after accounting for the conditions of sample collection, suggesting that sample ascertainment could explain some or all of the previously reported results about its potential as a biomarker for ovarian cancer.Biomarker validation studies should use standardized collection conditions, use multiple control groups, and/or collect samples from cases prior to influence of diagnosis whenever feasible to detect and correct for potential biases associated with sample collection

The regulation of gefiltin mRNA expression by the tectum during optic nerve regeneration in the goldfish /

Reorganization of the intermediate filament (IF) network during axonal regeneration is accompanied by changes in the expression of various IF proteins. An increase in expression of the neuronal IF subunit gefiltin in goldfish retinal ganglion cells (RGCs) has been linked to the unique ability of the goldfish optic nerve to regenerate following injury. Evidence suggests that the optic tectum may regulate the expression of gefiltin during regeneration. The goal of this thesis was to determine the function of the tectum in the regulation of gefiltin mRNA expression during optic fiber regeneration in the goldfish. It was found that gefiltin mRNA levels in the RGCs of animals that received an optic nerve crush (ONC group) increased by 10 days, peaked from 20 to 38 days at around 5.5-fold over normal, and declined to near normal by 115 days. In animals that had the entire tectum removed and an optic nerve crush (ETR group), gefiltin mRNA levels increased by 10 days, peaked at 20 days at around 5.5- to 6.5-fold over normal, and although they dropped slightly thereafter, they remained elevated at around 5-fold over normal for at least 115 days. When axons regenerated to the ipsilateral tectal lobe as a result of a left tectal lobe removal and left eye removal surgery the expression pattern of gefiltin mRNA paralleled that of the ONC group. It was also found that the abundance of gefiltin subunits in the retina was elevated at 30 days of regeneration in ONC and ETR animals, and that levels in the nerve were reconstituted to 80% of normal by 30 days. These results demonstrate that increases in gefiltin mRNA and protein levels during optic nerve regeneration are independent of the tectum, whereas the downregulation of gefiltin mRNA levels is entirely dependent upon the tectum. (Abstract shortened by UMI.

An experimental study of collateral coronary circulation produced by transplanting the left mammary artery to the left ventricular myocardium.

Considerable investigation has been carried out in an effort to develop a satisfactory procedure to augment the blood supply to the heart. The stimulus in this work has been great due to the high mortality and morbidity resulting from diseases of the coronary arteries. [...] Since medical therapy does not alter or diminish the progress of the underlying changes in the vessels, there is a need for surgical therapeutic measures. In eighty percent of cases coronary artery disease is not immediately fatal when first diagnosed; thus, surgical therapy may be employed to modify or prevent further progression of the disease which almost invariably follows. The present investigations were carried out to study the development of anastomoses between a transplanted left internal mammary artery and the vessels of the left ventricular myocardium. Previous work by Vineberg et al. [...] showed that in a dog a left internal mammary artery transplanted into the left ventricular myocardium could form anastomoses with the coronary circulation. In one series anastomoses occurred in forty-four percent of cases. The object of the present work was (1) to determine and clarify the factors responsible for the development of functioning anastomoses and (2) to determine whether such anastomoses would protect the myocardium against coronary occlusion