Evaluating the Impact of Proactive Care Management with IDStrat

This purpose of this study is to quantify potential cost savings and member care improvements as a result of engagement through BlueCross BlueShield of Tennessee’s (BCBST) Identification and Stratification (IDStrat) process. Commercial members engaged in clinical management that were identified through IDStrat were compared to commercial members identified through other means across several metrics including per-member, per-month (PMPM) cost and physician visits. Members identified by IDStrat experienced a statistically significant 7% greater reduction in costs after being engaged when compared with those identified by other methods. Members identified by IDStrat also experienced a significant reduction in emergency room visits after engagement. Future work aims to study the impact of wait time on cost savings

A re-examination of the life and work of A.F.G. Kerr and of his colleagues and friends

Arthur Francis George Kerr’s life is reviewed and related to a previously published account. Kerr’s collecting activity is analysed using an expanded version of the Thai Biogeography Group’s database of collections. 8,666 of the total 48,970 collections are Kerr’s and 3,178 are those of his colleagues and friends. Therefore, the total number of collections made by Kerr and his acquaintances is likely to be larger and more diverse than previously believed. Mapping of these data using GIS show that Kerr’s collecting activities focussed on particular regions of Thailand at particular times. Also large areas of the country remained unexplored by Kerr and his acquaintances: a pattern that, to some extent, persists to this day. The large, but dispersed, archive of Kerr’s photographs, maps, living collections and correspondence indicate that he was a skilled photographer (taking at least 3,000 images), cartographer (producing many hand-drawn maps) and exceptionally acute, accurate and detailed observer (filling numerous notebooks and leaving other records). It is clear that digitising these collections to form an on-line dedicated website is highly desirable to further progress on the flora of Thailand and surrounding countries and would form an unique record of the social history of early 20thC Thailand

Self-help groups challenge health care systems in the US and UK

Purpose: This research considers how self-help groups (SHGs) and self- help organizations (SHOs) contribute to consumerist trends in two different societies: United States and United Kingdom. How do the health care systems and the voluntary sectors affect the kinds of social changes that SHGs/SHOs make? Methodology/approach: A review of research on the role of SHGs/SHOs in contributing to national health social movements in the UK and US was made. Case studies of the UK and the US compare the characteristics of their health care systems and their voluntary sector. Research reviews of two community level self-help groups in each country describe the kinds of social changes they made. Findings: The research review verified that SHGs/SHOs contribute to national level health social movements for patient consumerism. The case studies showed that community level SHGs/SHOs successfully made the same social changes but on a smaller scale as the national movements, and the health care system affects the kinds of community changes made. Research limitations: A limited number of SHGs/SHOs within only two societies were studied. Additional SHGs/SHOs within a variety of societies need to be studied. Originality/value of chapter Community SHGs/SHOs are often trivialized by social scientists as just inward-oriented support groups, but this chapter shows that local groups contribute to patient consumerism and social changes but in ways that depend on the kind of health care system and societal context

Nutritional divergence in genotypes of forage peanut

The objective of this study was to evaluate the nutritional divergence between ten genotypes of forage peanut, based on chemical composition as well as fermentation and in vitro degradation kinetic characteristics. Treatments consisted of ten genotypes of Arachis pintoi, namely eight accessions (31135, 30333, 15121, 31828, 15598, 31534, 13251 and 31496) and two cultivars (cv. Belmonte and cv. Amarillo). The genotypes were harvested in each plot at a height of 3 cm from the ground, in 42-day intervals, during the time of heaviest rainfall. For the multivariate analysis the following variables, the following were used: crude protein, neutral detergent fiber, potential degradation in 48 hours, degradation rate of insoluble potentially degradable fraction and degradation rate of non-fibrous carbohydrate. The application of the hierarchical clustering analysis, using the Euclidian distances matrix of standardized averages allowed for the identification of five homogeneous groups. Among them, the accessions 31828, 31534, 15121 and cv. Belmonte stood out nutritionally among the remaining genotypes evaluated, depicting as promising for the utilization in ruminant feeding

Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies