Developing Targeted Interventions to Advance Maternal Health in a Geographic Medicaid Accountable Care Organization: Lessons From the Implementation of Camden Delivers

Through the design and launch of Camden Delivers the Coalition developed targeted interventions within an ACO infrastructure to advance maternal health in a Medicaid-covered population. Key insights from this process include the need to:* Utilize data to understand community need and design interventions around that need* Establish a population health surveillance system to produce actionable data to intervene with a complex population* Institute a tiered intervention system targeted to identified need, and* Leverage and coordinate across existing resources in the community to reduce duplication.Going forward, with the infrastructure developed by the Coalition to collect and review health data, along with the intricate web of community partners and resources, the next step in this program is to enhance feedback loops between partners and to help navigate patients seamlessly between partners during the highly fragmented experience of managing a pregnancy and healthcare during the interconception period. A formal network of communication between patients, case workers, care managers, providers and community resources through more sophisticated use of data and convening will allow us to support vulnerable patients in an even more effective manner. The Coalition looks forward to playing this convener role and working across groups to the end of better care management services and improved health for women of maternal age in Camden

A method for the analysis of cyclist shorts with different pads for perineal area protection: comparison between drum and road tests

AbstractAim of the present study was to develop an integrated protocol consisting on drum indoor tests and road outdoor tests to quantify the compression of the cyclist perineal zone. During indoor tests 5 cyclists performed 3 trials with different shorts on a cycling drum simulator: the pressure distribution between the saddle and the bottom of the cyclist, and the 3D pelvic motion were synchronously recorded. In the outdoor tests three of the five cyclists performed 5 trials for each shorts at the same speed and cadence of the indoor tests on a flat tarmac road including three potholes in each trial. Finally the pads were mechanically tested with a cyclic fatigue test. Results allowed to have more precise information about the pressure distribution acting on the perineal area in different conditions and to define significant loading cycles for the fatigue testing of the shorts padding material

Ophthalmoplegia and Slurred Speech in an Intravenous Drug User

A 35-year-old heroin user presented with acute, progressive diplopia and slurred speech. Krishna and colleagues discuss the diagnosis and management of this patient

Co-producing research with academics and industry to create a more resilient UK water sector

This is the final version. Available on open access from UCL Press via the DOI in this recordSocietal, economic and environmental impact generated by academic research is a key focus of publicly funded research in the UK. Drawing on experiences from the Safe & SuRe project, a five-year research project that was co-produced with industry, this paper explores the challenges, learnings and benefits of co-producing research with academics and practitioners to create a more resilient UK water sector. Three aspects of the project are explored in detail: the use of a steering group, co-developing research intensively with a water company, and co-dissemination industry-facing events. Emerging themes include: (1) benefits of the industry steering group to develop working relationships and trust among the group; (2) increased dialogue and sharing of information between industry and academics going beyond the one-way communication more commonly reported by STEM academics; and (3) the value of co-disseminating research to maintain and engage new connections and spark new research questions.Engineering and Physical Sciences Research Council (EPSRC

The relationships between golf and health:A scoping review

OBJECTIVE: To assess the relationships between golf and health. DESIGN: Scoping review. DATA SOURCES: Published and unpublished reports of any age or language, identified by searching electronic databases, platforms, reference lists, websites and from consulting experts. REVIEW METHODS: A 3-step search strategy identified relevant published primary and secondary studies as well as grey literature. Identified studies were screened for final inclusion. Data were extracted using a standardised tool, to form (1) a descriptive analysis and (2) a thematic summary. RESULTS AND DISCUSSION: 4944 records were identified with an initial search. 301 studies met criteria for the scoping review. Golf can provide moderate intensity physical activity and is associated with physical health benefits that include improved cardiovascular, respiratory and metabolic profiles, and improved wellness. There is limited evidence related to golf and mental health. The incidence of golfing injury is moderate, with back injuries the most frequent. Accidental head injuries are rare, but can have serious consequences. CONCLUSIONS: Practitioners and policymakers can be encouraged to support more people to play golf, due to associated improved physical health and mental well-being, and a potential contribution to increased life expectancy. Injuries and illnesses associated with golf have been identified, and risk reduction strategies are warranted. Further research priorities include systematic reviews to further explore the cause and effect nature of the relationships described. Research characterising golf's contribution to muscular strengthening, balance and falls prevention as well as further assessing the associations and effects between golf and mental health are also indicated

Clinical Recovery and Circulating Botulinum Toxin Type F in Adult Patient

A 56-year-old woman in Helena, Montana, USA, who showed clinical signs of paralysis, received antitoxins to botulinum toxins A, B, and E within 24 hours; nevertheless, symptoms progressed to complete quadriplegia. On day 8, she began moving spontaneously, even though blood tests later showed botulinum toxin type F remained