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The Right Horse Initiative has received The Lavin Cup from the American Association of Equine (AAEP) in recognition of the nonprofit organizations innovative approach to solving the growing problem of horses in transition in the United States.

Known as the AAEPs equine welfare award, The Lavin Cup recognizes a nonveterinary organization or individual that has distinguished itself through service to improve the welfare of horses. Representatives of The Right Horse Initiative accepted the award during the Dec. 10 Presidents Luncheon at the AAEPs 65th Annual Convention, currently underway in Denver, Colorado.

Founded in January 2016 by the Arnall Family Foundations WaterShed Animal Fund, The Right Horse Initiative is a collective of equine industry and welfare professionals and advocates working together to improve the lives of horses in transition. Their mission is to massively increase horse adoption in the United States by working together to reframe the adoption conversation and shatter the stigma surrounding horses in transition.

The Right Horse Initiative is most deserving of the recognition that comes with receiving The Lavin Cup, said Harry Werner, VMD, founding owner of Werner Equine in North Granby, Connecticut, who recommended the organization for this award. Its impossible to state a precise number of horses helped by The Right Horse Initiative since its inception; however, its adoption partners successfully transitioned a total of 1,742 horses in 2018 alone.

The Right Horse Initiative operates three pilot programs designed to assist partner organizations, with the goal of increasing horse adoptions in the United States: regional training centers for transition horses; community resources; and collaborations between equine welfare advocates and equine industry stakeholders to promote good outcomes for horses. To learn more about the Right Horse Initiative, visit https://therighthorse.org.

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The Right Horse Initiative Recognized by AAEP for Horse Adoption Efforts - TheHorse.com

Physiotherapy is beneficial in patients with ankylosing spondylitis and while more research is needed, expanding traditional exercise programs to include aerobic and cardiorespiratory components along with patient education may improve outcomes for patients with non-radiographic axial spondyloarthritis as well.

These findings by Fabio Perrotta at the Universita Degli Studi del Molise in Campobasso, Italy can be found in the August 13th edition of Rheumatology and Therapy.

Dr. Perrotta states, Helping rheumatologists and other physicians who treat patients with axial spondyloarthritis to know the benefits and limitations of exercise and to prescribe it, with educational sessions, could be useful to better manage patients.

Axial spondyloarthritis is a group of inflammatory conditions typically affecting the spine and characterized by the presence of back pain caused by enthesitis of the sacroiliac joints and sometimes extra-articular sites as well. The two major forms of spondyloarthritis are ankylosing spondylitis and non-radiographic axial spondyloarthritis with both leading to significant pain and mobility issues that are progressive.

Biologic drugs such as anti-tumor necrosis factor and anti-interleukin medications have dramatically improved the quality of life and prognosis for patients with axial spondyloarthritis however, the needs of non-responders remain unmet. Even with new treatments physical therapy and rehabilitation remain crucial in the management of axial spondyloarthritis.

The authors conducted a review of the current literature in an effort to produce this concise review examining the role of physical therapy and rehabilitation in both ankylosing spondylitis and non-radiographic axial spondyloarthritis.

When a patient with axial spondyloarthritis presents to a clinician they should be assessed for disease activity, workability, pain, function, psychological impact, and overall quality of life. Patient functioning, disability and disease activity can be quantified by the multitude of scales and measures recommended by the international rheumatologic community allowing clinicians to risk stratify and treat patients with spondyloarthritis appropriately.

When physiotherapy is undertaken for axial spondyloarthritis, supervised outpatient exercise programs have been shown to reduce the burden of pain and stiffness. Inactivity has been linked to more pain and psychological depression. Rheumatologists consider regular exercise to be a key component in the management of axial spondyloarthritis.

Recent evidence suggests that physiotherapy initiated early is beneficial for both ankylosing spondylitis and non-radiographic axial spondyloarthritis. While exercise improved global disease activity in both conditions overall quality of life did not change for these patients. Evidence is sparse however, and more research is needed to determine if exercise improves function, reduces pain, and or enhances quality of life over the long term in patients with non-radiographic axial spondyloarthritis.

With regards to ankylosing spondylitis good evidence exists showing the positive effects of physical exercise in the control of disease activity, pain, mobility, function and quality of life.

When a combination of pharmacological and rehabilitation therapy was examined anti-tumor necrosis factor treatment plus physiotherapy was associated with improvements in function, disability and quality of life in ankylosing spondylitis when compared to either drug treatment or exercise alone. In addition to improvement in quantitative measures, exercise and medication together led to improvements in patient perceived stiffness, function, fitness, and overall wellbeing.

While cardiorespiratory exercise improved fitness in patients with axial spondyloarthritis, it had no real effect on disease activity, quality of life or spinal mobility; however, improvements in overall fitness may have beneficial effects on other comorbidities.

Educating patients about exercise and axial spondyloarthritis is crucial for successful treatment. Education and monitored group exercise programs leads to improvements in disease activity, quality of live and spinal mobility.

Many patients may be afraid that activity will worsen their pain or even damage their bodies. Clinicians should reassure patients with ankylosing spondylitis who may be afraid to engage in exercise that it is safe.

Patients should be selected on a case-by-case basis since baseline mobility and comorbidities may limit the type and intensity of exercise they can participate in. Clinicians should strive to educate patients with axial spondyloarthritis that adherence to prescribed medication along with monitored exercise is likely to reduce their pain and improve their function more than simply taking the medication alone.

REFERENCE

Perrotta, F.M., Musto, A. & Lubrano, E. "New Insights in Physical Therapy and Rehabilitation in Axial Spondyloarthritis: A Review."Rheumatol Ther (2019). https://doi.org/10.1007/s40744-019-00170-x

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Physiotherapy Improves Outcomes in Ankylosing Spondylitis - Rheumatology Network

Kansas City Chiefs quarterback Patrick Mahomes may be an NFL star, but his girlfriend and high-school sweetheart Brittany Matthews has created an athletic empire of her own.

Matthews, who earlier this week said she was harassed by New England Patriots fans at Gillette Stadium in Foxborough, Massachusetts, while supporting the Chiefs, played professional soccer in Europe and launched her own fitness company in the years since graduating college.

Together Mahomes and Matthews, who have been together since they were teens, are an athletic powerhouse adored by Chiefs fans.

The 24-year-olds met in the while attending Whitehouse High School in Whitehouse, Texas. According to Yahoo Sports, the pair started dating when Mahomes was in 10th grade.

After Matthews graduated in 2013, she went on to play college soccer at the nearby University of Texas at Tyler, while Mahomes, who graduated in 2014, went to Texas Tech University 440 miles away in Lubbock to play college football and baseball.

The pair stayed together through the long distance. Mahomes was selected by the Kansas City Chiefs in the first round of the NFL Draft in April 2017. Matthews, meanwhile, graduated with a kinesiology degree, and signed to play soccer professionally with UMF Afturelding/Fram in Iceland in May 2017.

"Every coach I have had at UT Tyler made a huge impact on my love for this game and my decision to play professional soccer,"Matthews told the Morning Telegraph. "An opportunity opened up for me in Iceland and I could never pass up such an amazing experience to go do what I love."

It's unclear how long Matthews lived in Iceland, but it appears to be less than a year. Her team won its league in September 2017, according to Matthews' Instagram, and by October 2017 she was in Kansas City.

The pair document their relationship on Instagram, and are pursuing their own athletic dreams.

In his first season as a starter for the Chiefs in 2018, Mahomes completed 5,097 yards and 50 touchdowns, and was named the NFL's MVP for the season.

Matthews became a certified fitness trainer, and in 2019, launched Brittany Lynne Fitness, a website that offers training programs and fitness merchandise designed by Matthews.

"I have experience with all levels of fitness and have carried that experience with me to create exercise programs for people at all stages on their fitness journey," she wrote on the website. Her program, she continued, consists of "working hard, staying dedicated, not making excuses, and most of all, no BS!"

The couple bought a house in Kansas City in 2019, spending $1.925 million in the city's Mission Hills neighborhood. The pair showed the house off on Bleacher Report earlier this year, and highlighted Mahomes' custom shoe gallery, where he stores around 180 pairs of shoes.

In the video, Mahomes and Matthews explained their love for Kansas City.

"Setting down roots in Kansas City was huge for us. I think the people are what we love the most about Kansas City," Mahomes said. "We're trying to be here for a long, long time."

The couple spend the offseason in Kansas City, and recently launched a foundation to help underprivileged youth.

Mahomestold USA Today: "The fans come out every single week and show passion and love for us and our team and what we're doing here, so for me, I want to be back in the community, giving back. And just be a part of it, to show the same love and passion to them."

Though Mahomes experienced a hand injury this season, he's optimistic about his future with the team, which has a record of 9-4 in the current season.

"It doesn't feel great right now, but it's something that you play with," Mahomes said in a post-game press conference about his hand injury. "In this sport, you're going to bang something. So for me, it's about going out there and competing and relying on my teammates to help me out whenever I'm not feeling 100 percent."

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Patrick Mahomes and his girlfriend Brittany Matthews are childhood sweethearts who have both built their own sports empires - Business Insider

The Senior Program at the Greater Maple Valley Community Center, located at 22010 SE 248th St. in Maple Valley, invites all adults ages 50+ to come and see what we are all about! Call us at 425-432-1272 with any questions or visit our website http://www.maplevalleycc.org for more information and our monthly calendar.

We would like to offer our sincere thanks to Covington Place Sr. Apts. for their continued support of our programs.

Trips, Groups, Special Events

Payment for all trips is due at time of registration. Cancellations are refunded if seats can be filled; a $5 non-refundable service fee will be applied. Trip costs include all Community Center and travel expenses.

Friday, December 20 Holiday Lunch Celebrate the season with friends at our annual Holiday Lunch. On this day, Bingo will run from 10-11a.m., followed by a vocal performance by the Honor Choir at Lake Wilderness Elementary, and a very special visit from Santa (with photos)! Lunch will be served at noon. Cost for lunch is a $4 suggested donation for those age 60 and over, and a $7 fee for anyone 59 and under. Please sign up in advance for this event so we know how many to expect.

Wednesday, January 1 CLOSED

Tuesday, January 7 Reptile Zoo The Reptile Zoo in Monroe provides a unique opportunity to get up close and personal with exotic reptiles from across the globe: including turtles, alligators, lizards and many types of snakes. You dont want to miss the turtle with two heads, the albino alligator, and the worlds deadliest snake the black mamba. Be prepared to have fun and enjoy quality time with these magnificent creatures! We will leave GMVCC at 9:15 a.m., and will have lunch together at the Maltby Caf after visiting the museum. Cost is $18, plus $8.95 admission at the door. You will also need to bring money for your lunch.

Tuesday, January 21 Seattle Antiques Market and Dukes Seattle Antiques Market is one of the largest collectibles and antiques dealers in Washington! This 6,000 sq. ft. store is filled with thousands of treasures from the past. Youll discover a wide selection of antique furniture for the home, nautical antiques, collectible vinyl, vintage typewriters, vintage cameras, mid-century modern home decor, antique office furniture, vintage toys, and much, much more! We will leave GMVCC at 9:30 a.m., shop for a while, then head to Dukes Chowder House for lunch. Cost is $15, plus money for shopping and lunch.

Senior Fitness

Mon/Wed/Fri at 9:00 a.m. Walking Group Meeting in the GMVCC lobby MWF at 9:00 a.m., we walk on the Lake Wilderness Trail as a group, rain or shine. Everyone walks at his or her own pace; covering approx. 3 miles round trip. This is a drop-in activity; no need to call ahead. There is a $1 suggested donation to support on-going GMVCC Health and Wellness programs.

Mons and Weds., at 9:00 a.m. Aging-Well Yoga Instructor will help you gently increase strength, flexibility, posture and balance. Everyone will be working at their own pace. 4-class punch card is $30; 8-class punch card is $50; 12-class punch card is $70; drop-in rate is $10. No reservations are necessary; pay in class. This class is held in The Den. Call us with any questions.

Mons., Weds. and Fris. at 10:30 a.m. Fall-Prevention Exercise The Fall StopMove Strong exercise program was designed specifically to improve balance and strength. It is a series of 3 different 12-minute sessions. This is free and no sign-up is necessary. Please note: no exercise on party days.

Socials and Games

Time and availability might vary because of holidays and parties. Suggested donation of $1 in the activity donation box.

Mons. Bingo at 11:00 a.m.; Pinochle at 12:30 p.m.; Ping Pong 12:30

Weds. (2nd & 4th Weds.) Quilting & Sewing at 10:45 a.m. in the Den; Bingo at 11:00 a.m., Pinochle at 12:30 p.m.

Fris. Bingo at 11:00 a.m., Painting at 1:00, Ping Pong 12:30 p.m., Pinochle and Mah Jong at 12:30 p.m.

Fris. at 1:00 p.m. Painting

Calling all painters (all mediums) to come in to use our main hall to paint, socialize, and share ideas. Tables and space to spread out is available, however, there are no easels for use, and no instruction given.

Lunch Menus

Lunch served each Mon., Wed., Fri. at 12:00 p.m.. For those age 60+ there is a suggested donation of $4. For all others, there is a $7 fee.

All menus are subject to availability of food items. Milk, coffee, and tea are available for all lunches.

Wed., Dec 11: Lasagna, green salad, garlic bread, peaches, milk

Fri., Dec 13: BBQ Baked Chicken, rice pilaf, zucchini and squash, garden salad, roll, milk

Mon., Dec 16: Loaded Baked Potato, chili, broccoli, pineapple, milk

Wed., Dec 18: Beef Stroganoff, Normandy vegetables, oranges, milk, birthday cake

Fri., Dec 20: Baked Ham, scalloped potatoes, green beans, bread pudding, warm pears, milk

Health and Wellness

Routine Pedicure/Footcare Karens Foot Care is offered to seniors on the 2nd & 4th Friday of each month and the 4th Thurs. Cost is $32. Please call GMVCC to make an appointment as this popular service fills quickly.

Blood Pressure Checks are offered on the 1st and 3rd Fridays between 10:30 a.m. and 11:00 a.m.. This service depends on availability of MV Firefighters.

Services

Community Center Shuttle Need a ride in? Our shuttle runs M/W/F between 9 a.m. and 3 p.m. and provides rides to GMVCC for programs and lunch. Shuttle rides are $1 each way within our transportation boundaries. Call 425-432-1272 for availability at least 24 hours in advance. $20 bus passes (good for 20 rides) are available.

Volunteer Transportation Need a ride to a medical appointment? Call Janet at 425-432-1272 at least one week in advance to arrange a free volunteer-provided ride. This Volunteer Program is now in great need of drivers. If you think you would like to help seniors get to medical appointments, please call the above number to become a volunteer.

Meals on Wheels (by application only). Applications must be obtained from and submitted to Sound Generations (call 206-448-5767 or mealsonwheels@soundgenerations.org and http://www.soundgenerations.org). A new, expanded menu is now available.

Free Pet Food In partnership with the Seattle Humane Society, the Greater Maple Valley Community Center offers free pet food for qualifying low-income seniors.

Medical Lending Closet Free walking aids & bathroom equipment are available from our lending closet free of charge (call for current items). We also welcome donations of these items!

Cell Phone Drop Off Drop off your old cell phones here to be distributed to US military as well as people in general disaster areas. This is part of the Phones for Soldiers Program. More information can be found at: http://www.cellphonesforsoldiers.com

Eye Glass Drop Off Drop off old prescription glasses here for the Lions Club to refurbish and redistribute to those who need them. Computer Assistance Volunteer Curtis Patterson specializes in working with senior citizens and provides free, caring, patient, one-on-one computer assistance including repairs, upgrades, diagnostics, tutoring, virus/spyware cleaning, and more. PC and Android are his specialty, but Curtis is willing attempt to help with Apple products as well. Call us at 425-432-1272 to arrange and appointment. Age requirement is 50+.

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Maple Valley Senior News Updated 12-10-19 - Voice of the Valley

While sciatica is one of the most common forms of back pain, people often assume they have it when they dont, says U of A physical therapy researcherGreg Kawchuk.

Thats because the conditionnamed for the sciatic nerve running down the spine and through the legis a general term for many different situations. It can come on suddenly in an acute, disabling way, resolving after a couple of months, or it can fluctuate over time, he said.

Since the pain tends to radiate, it can be felt in a number of places, from the lower back to the buttocks, groin and down the back or front of the leg. It usually results from compression of the nerve roots as they exit the spine, which is caused when jelly-like cushions between vertebrae herniate, said Kawchuk.

Sometimes the jelly comes out and it will either push on the nerve root or create inflammation that bothers the nerve. What's nice is that we know that in the majority of patients, it usually resolves and goes away over timejust not that quickly.

Its also possible to have sciatica without back pain, he said, just as it is possible to have symptoms of sciatica without involvement of the back.

There are all sorts of other reasons you can have pain down the leg, he said. But in sciatica, there is typically pain, numbness or tingling down one leg, and these symptoms are typically worse than any back pain. Most often these leg symptoms go down the back of the leg, past the knee and into the foot, although there are different flavours of this situation.

Chiropractor James Lemieux demonstrates some simple exercises to ease sciatic pain. (Video: Geoff McMaster)

About 85 per cent of the population will suffer from back pain at some point in their life, but only between two and 10 per cent will have true sciatica, said Edmonton chiropractor James Lemieux, who is pursuing a masters degree in rehabilitationmedicine under Kawchuk.

If the pain doesnt go away after about three months, and symptoms seem to mimic those of sciatica, you might have pain from other causes, said Lemieux, such as hip-joint arthritis or muscle-referral pain.

Despite potentially aggravating pain, true sciatica doesnt have to result from severe trauma, he said.

Sometimes just sneezing or a good cough will bring it on. But typically it's a result of herniation from age-related changes in the spine.

Kawchuk had a bad case of sciatica last winterso debilitating he was literally forced to his hands and knees.

I couldnt even sit, and it was three months before I could put my shoes on, he said.

When severe sciatica does strike, he recommends starting with conservative care. Pain medications should be resisted or only used for very short periods at very low doses. Many medications, such as opioids, show little evidence of effect.

Even the rush towards imaging such as X-rays and MRIs is not recommended, he said, because they often dont reveal the source of the problem.

We know you don't need to image the hell out of these things. In fact, it probably sets up a lot of poor behaviours on the part of patients. You expect to find the thing and get rid of it, and most often that's not the way it is.

If there is pain or numbness in the groin or saddle area, and particularly if there is dysfunction of urination or bowel control, you should go see a doctor right away, he said.

But for the most part, we know that the condition is one that usually clears up with non-surgical conservative care. If the problem persists after 12 weeks, imaging may be appropriate, he added.

When sciatica is more persistent, the best plan of attack is a targeted exercise and education program.

When its acute, some short-term pain relief can help, but once things kind of stabilize we know that specific exercise programs designed for these conditions are really helpful. We've got strong evidence for that.

There are two programs that may be helpful for sciatica when the condition calms down and is less acutea boot camp for sciatica developed at the University of Toronto by Carlo Ammendolia, and a therapy originating in Denmark for osteoarthritis in the hip and knee called GLA:D Canada. Both are now highly respected and spreading widely, said Kawchuk.

The boot camp is a tough program, but the results are phenomenal, he said. It basically involves getting fit in the right areas at the right time. Its not a magic silver bullet that affects 100 per cent of patients, but a good majority say they dont have to use drugs anymore.

The secret sauce in the programs isnt in either the exercises or education in isolation, he said. Its the fact that someone has bundled it up and said, Here you go, do it this way.

Lemieux, whose masters research focuses on the GLA:D program, recommends starting an exercise program once the worst of the pain recedes and staying on it even if the condition appears to clear up.

A lot of people want to rest, and they develop whats called avoidance behaviour, fearing that movement will make the pain worse, he said. You want to get them on an exercise program so they don't create long-term problems like time lost at work on disability.

For some, the pain of sciatica may never go away completely, which is sometimes hard for people to accept, said Kawchuk. In that case, a more realistic goal is to improve quality of life by retaining mobility and remaining active.

There may be 15 possible causes of your back painwhich one is yours? Until we can figure that out, how do we make people's lives better? We can't wait for science to figure out the cure.

We hope to find the cure, but in the meantime these are pretty good solutions.

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Think you have sciatica? It's not as common as people assume, says physical therapy expert - Folio - University of Alberta

This story is part of The Plain Dealers Cleveland City Champions series, which honors people and organizations that have done bold, innovative work to lift up a neighborhood or a community. The series was produced in partnership with The Guardian and with public broadcaster Ideastream.

CLEVELAND, Ohio When Fatima Family Center in Hough was due for a brand-new building about 20 years ago, director LaJean Ray gleaned ideas for programs and architecture from the community, right down to the bricks.

When we began to think about getting a new building, we [administrators] didnt go into a room and make all of the decisions ourselves, remembers Ray, 69, who has been with the center since 1986, and director since 1997.

We knocked on doors in the neighborhood and said, Dream with us. So everything that the neighborhood asked for is here. We even sold the bricks that are out front just so people would feel like they own a piece of the building. We sold them for $25 and raised $17,000. Its really a blessing to be here.

Ask center-goers spanning elementary schoolers to seniors how they feel about Rays diplomacy, and the word blessing comes up conversations. In fact, during a recent tour of the center led by Ray, one senior blurted, We love her!

Fatima Family Center is under the umbrella of Catholic Charities Diocese of Cleveland. Programs in this bright, bustling building include exercise, yoga and wellness for seniors; quilting and other crafts; summer day camp; computer lab, teen leadership and other after-school activities for older kids; a food bank and emergency assistance; family nights; a boutique in which women can twice a month drop in for clothing to wear to church or job interviews; and more. Thats what happens in-house.

Over the years, Ray has shepherded Cleveland School District high-schoolers to Africa, an opportunity that they otherwise wouldnt have dreamed possible. Ben Hughes, 48, hung out at Fatima as a youngster and now works here as a program coordinator and computer technician.

Without Miss Ray, I wouldnt have had a lot of the opportunities that Ive had, Hughes says. We went to Tanzania and Zanzibar with students 10 years ago, and it was life-changing for all of us. I went to Morgan State [University] because every year Miss Ray takes high school kids to visit campuses during spring break. I never would have even heard of Morgan State if it werent for her.

In these times of tension between the black community and law enforcement, Ray found ways to forge a positive relationship between neighborhood youngsters and police officers in that district. Police officers drop in and talk after school to children and teens, including providing career information. During the summer, the police escort children during weekly bicycle rides. And so on.

Our officers are frequent visitors in our building, says Ray.

Programs for seniors are crucial, Ray says, because Hough is an old neighborhood, and many seniors live all alone. Programs get them out of the house and amongst one another to quilt, craft, exercise, do yoga or just hang out and talk. Ray not only gets seniors out of the house, but out of the city. She leads group excursions to as far away as Washington, D.C., to as near as Ohio Amish country.

Oneida Collins, 70, said of one trip, We stayed at a hotel where they carried our luggage up to our rooms, and there was a jacuzzi in the bathroom. Were not used to that.

Ray and her husband, Ulysses, who live in Hough, have two sons and attend Antioch Baptist Church. She is a member of Sigma Gamma Rho sorority. Ironically, Ray grew up in a Cleveland neighborhood called The Village. She was the oldest of four, so Ive always been taking care of folks, she says.

Before Fatima, for 10 years Ray worked at Harvard Community Center, founded by Rubie McCullough. When Ray returned to school later in life and earned a masters degree in 1997 from Kent State University, her thesis was on McCullough.

In 2000, Ray and the Fatima team received major kudos when the center was recognized by the Annie E. Casey Foundation as one of the top five family centers in the United States.

Ray was nominated to be recognized as a Cleveland City Champion by Marianne Crosley, president and CEO of Cleveland Leadership Center.

I have been there [Fatima] 10 times, and every time I go, I meet groups and individuals whose lives have been impacted by what LaJean is doing, Crosley says. She has the unique ability to care about individuals as well as the entire community, and she relates to everyone. She works constantly, and she does it graciously and always with a smile. She makes people feel like their lives have purpose.

Cheryl Hutson-Law, 68, has been best friends with Ray since the two were students at John F. Kennedy High School.

We were in the library sitting near each other, and somehow we got into a conversation about pity, piety and love, Hutson-Law remembers. It was enlightening. She was a good student and I was a good student, and we were of similar mindset.

Adds Hutson-Law, who now lives in Tampa, Florida, She [Ray] has always been an advocate and a lover of people. I do so admire the work that she does and the lives that she has changed. There are a bunch of kids who, if it werent for her and the center, they might be off doing other things. But they come here and learn respect.

Name: LaJean Ray

Organization: Fatima Family Center, under the umbrella of Catholic Charities Diocese of Cleveland

Cleveland credentials: Ray, 69, has been with Fatima Family Center in Hough since 1986; director since 1997. She grew up in The Village neighborhood on Clevelands East Side.

Champion credentials: Ray cares deeply for the residents of Hough, from elementary schoolers to seniors. Under Rays leadership, children enjoy summer day camp. Teens come for leadership training, social activities and, during spring break, visits to college campuses. Ray also fosters a positive relationship between teens and police officers in that district. Seniors enjoy crafts, yoga and group trips led by Ray. In 2000, Ray and the Fatima team were recognized by the Annie E. Casey Foundation as one of the top five family centers in the United States.

Read more about Cleveland City Champions:

Cleveland Champions: 25 people and organizations who are lifting up their communities

Heroism, selflessness and race became the main characters in our Cleveland Champions series: George Rodrigue

Birthing Beautiful Communities wants to fix terrifying reality of black infant mortality in Ohio

Rhonda Crowder and Hough Reads battle widespread illiteracy

Edwins, a restaurant serving up second chances for ex-offenders

Kim Foreman doesnt overpromise, delivers solutions for toxic neighborhoods

Rid-All shows us how to create a green oasis in a segregated city

Leftovers are black gold to Rust Belt Riders

Renee Jones uplifts human trafficking survivors through empowerment, respect

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Twelve Literary Arts taps power of poetry to heal, celebrate communities of color

Urban Community School beat the odds to become a beacon for low-income students

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LaJean Ray asks the community to Dream with us at Fatima Family Center: Cleveland City Champions - cleveland.com

Female cyclists are at a lower risk of suffering Sudden Cardiac Death than male athletes, but women should still learn about ways to screen for heart problems before engaging in endurance sports.

Dr. Mehreen Quhreshi is a cardiologist with advanced training in stress testing and cardiac imaging from Columbia University Medical Center in New York. She practices in Harrisburg, Pennsylvania and serves as the director of the Preventative Cardiology Program and the Nuclear Stress Lab at UPMC Pinnacle Heart and Vascular Institute. Dr. Bill Apollo, an amateur bike racer, runner, and duathlete is a Harrisburg, Pennsylvania-based cardiologist, who directs the UPMC Pinnacle Sports and Exercise Cardiology Clinic.

At the Paris Olympics in 1900, endurance sports were exclusively dominated by men; a mere 22 women participated, competing in the five gentrified events of croquet, equestrian, golf, tennis, and sailing. It took until the latter half of the twentieth century for the world to witness women competing in major Olympic endurance sports such as cycling (Los Angeles, 1984) and triathlon (Sydney, 2000).

Wider womens participation in the Olympics roughly coincided with the establishment of Title IX of the United States Educational Amendments of 1972, which mandated equal access for women in any program that received Federal funding including sports in public schools and universities. These two major developments fueled an explosion of female participation in a variety of events at all skill levels. The percentage of women finishers in marathons in the U.S. rose from only 10% in 1980 to a robust 45% by 2015. Women set a new record for Olympic participation at the 2016 Rio Olympics, with nearly equal numbers (5,176 athletes, or 45% of total), and with representation in all events included in the games.

Paradoxically, women have generally been under-represented in medical research studies looking at cardiac health, adaptation to endurance training and its potential consequences. Despite this surge of female athletic participation, we still havent achieved gender equality when it comes to understanding and caring for the female athletes heart. And recent small-scale studies suggest that there are in fact important cardiac differences between the sexes.

Some of the key questions are: to what extent do underlying genetic and hormonal factors impact normal changes in a womans heart related to exercise? How do these influences alter her risk for developing chronic heart problems or sudden cardiac death during competition? Are women better equipped to handle endurance training by design? Some recent research suggests that pregnancy subjects the female body to cardiac stresses similar to those that male athletes experience in even the most competitive events, including events like the Tour de France.

Below we examine the current understanding of cardiac development and risks in women endurance athletes, how and why women may differ from men in this regard, and recommended precautions that should be taken in training and competition by elite female endurance athletes.

Sudden cardiac death (SCD) during athletic competition is fortunately a rare occurrence, and it tends to affect men more commonly than women. In fact, a womans risk of SCD during endurance sports is estimated to be some 10 times lower than for her male colleagues. Professional cycling, during the past 3 seasons, has seen a total of 6 elite men tragically die directly from heart problems during races (5 in road racing, 1 on the track), with the most recent being Robbert de Greef in March 2019. During the same time period, there were zero incidents involving women, and indeed there are no known reports of SCD during elite womens cycling events for the past 20 years. Professional female cyclists are far more likely to die from training accidents (usually involving automobile collisions) than from heart problems.

Interestingly, these observations regarding SCD in cycling seem not to be true for other endurance sports. Marathon running has a huge participant base much larger than the womens pro peloton with nearly a half million participants in 2019 alone. This huge statistical sampling clarifies the measure of SCD risk: 1 incident per 150,000 participants overall, but more commonly occurring in men (1/ 100,000), and much less likely to occur in women (1/243,000).

Despite this fairly low risk of SCD in women, the sheer volume of running participants makes it easier to find reports of SCD. For example, Taylor Ceepo, age 22, died in May 2019 less than 1 mile from the finish line at the Rite-Aid Cleveland Marathon. The medical examiners report indicated that Ceepo experienced sudden cardiac death in association with physical exertion, pseudoephedrine use (a fairly benign over-the-counter decongestant) and cardiomyopathy. Her tragedy should remind us that even in very young and apparently healthy women, undiagnosed heart disease is still a common killer (3rd behind unintentional injuries and cancer in her age group), and her autopsy findings highlight the importance of screening women for underlying heart problems.

The most common causes of SCD are generally driven by age rather than sex. Athletes under age 35 both men and women alike are susceptible to genetically inherited structural heart problems including hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC), as well as potentially lethal heart rhythm problems called channelopathies. Above age 35, coronary artery disease predominates, with women being preferentially protected by their higher estrogen levels, until they reach menopause. Initially, the ten-fold higher incidence of SCD in men was thought to be simply due to the much larger numbers of men participating in endurance sports. But now that participation rates are becoming nearly equal, womens risk of SCD is still not as high as that experienced in the male population.

Several theories exist that might explain why women appear to be more protected from SCD during intense competition. One explanation may lie in the sympathetic nervous system, which is responsible for the bodys fight or flight response. Male physiology is observed to be wound more tightly, meaning that their arteries and blood vessels tend to constrict more during intense activity than women. The increased blood pressure adds resistance to blood the heart is pumping out. When this increased pressure load is coupled with an outpouring of adrenaline during competition, the strains placed on the heart may trigger lethal rhythm problems in susceptible individuals generally those with underlying inherited cardiac problems or acquired fibrosis (scarring) from long-term training. For unclear reasons, even in the context of equal training volumes, men more commonly develop potentially lethal fibrosis substrate, placing them at higher risk of SCD than women.

Another possible explanation relates to obvious hormonal differences between men and women. In some animal models, testosterone has been shown to affect the way the heart conducts impulses making men, at least in theory more susceptible than women to developing electrical instability resulting in malignant heart arrhythmias. Clinically, testosterone promotes thickening of the heart muscle, which may explain why men are more susceptible than women in developing complications from diseases like HCM and ARVC. Estrogens, on the other hand, are protective in this regard, and delay that same process of heart muscle thickening. Despite equal patterns of genetic transmission of HCM and ARVC between both sexes, hormonal differences may explain why these maladies tend to remain latent for a longer period of time in women, presumably translating to a survival advantage and lower risk of SCD.

Sports medicine screening programs are designed to identify potential cardiac risks in individuals who exhibit no outward symptoms of heart problems. Such programs aim to increase participation but to do so with a reasonable level of caution, to ensure the safety of the athlete. Despite the lower risk of SCD in women, screening is still important.

Pre-participation screening typically involves a comprehensive medical history review, focused physical examination, and in some cases an electrocardiogram (EKG). EKG tests are proven to be more sensitive than history and physical examination alone in detecting pathology, especially regarding heart rhythm issues. EKG interpretation should always be completed by a skilled reader able to distinguish the fine line between normal adaptation to exercise and pathology. Guidelines like the International Recommendations for EKG Interpretation in Athletes will increase reading accuracy and reduce the number of false findings, which often lead to expensive and unnecessary longitudinal testing. Men exhibit changes in their EKG patterns more often than women, and these variations in many instances are considered normal purely as the result of physiologic adaptation to training. On the other hand, women are less likely to stray from normal parameters, so most EKG changes are concerning and more likely represent a real problem.

Consistent endurance training induces physiologic remodeling, or normal adaptations to the heart resulting in improved efficiency of an athletes engine. Cyclists are unique because they typically perform the most prolonged exercise pattern more hours per day and more days per year than nearly any other athletes. Cyclists often sustain markedly elevated heart rates for extended periods of time during two distinct types of high cardiac output workouts. First, high intensity aerobic workouts at near peak efficiency, coupled with sustained elevations in heart rate, create a dynamic stress, or a volume load on the heart. And second, long tempo efforts punctuated by intense anaerobic dashes create static stress, exposing the heart to a pressure load because of sustained increases in blood pressure.

Cyclists therefore typically exhibit prominent changes in heart structure due to a combination of dynamic stress (volume overload) and static stress (pressure overload) resulting in generally increased cardiac mass, with mildly enlarged hearts and mildly increased heart wall thickness at least in men. Statistically, women are generally smaller than men with lower lean body mass. Due to their higher estrogen levels, women tend to adapt to exercise in a qualitatively similar manner, but quantitatively different than men showing only minimal heart enlargement and virtually no heart wall thickening. In fact, only about 7% of healthy women show any significant increase in their heart size due to habitual exercise, whereas 47% of men show cardiac enlargement.

Symptoms of heart problems in women are often different to those reported by men. For example, women are less likely to experience classic chest pain due to a heart problem, but may report more subtle symptoms like indigestion, heartburn, fatigue, or poor exercise performance. Misinterpretation of these sometimes confusing symptoms often leads to a delay in diagnosis and poorer long-term outcomes for women. An unexplained decline in athletic performance is obviously concerning to any elite athlete whether male or female because this may be the only clue to a serious underlying heart problem.

However, in young women, such nonspecific symptoms are often incorrectly blamed on things like menstrual problems, eating disorders, iron deficiency anemia, pregnancy, or thyroid disease. In many cases it is the womans primary care provider who must be savvy enough to exclude these other diagnoses, realizing there is a potential heart problem and then making an appropriate referral to a cardiologist.

Estrogen generally protects women from developing CAD at young ages, but the risk rises as they reach menopause. And paradoxically, some young women may actually be at increased risk for CAD because of a syndrome called Relative Energy Deficiency in Sports (RED-S). Sports which favor lean body mass are often associated with heavy training loads and dieting to achieve optimal body weight. In some women this results in the Female Athlete Triad of menstrual dysfunction, unexplained decline in performance (with or without an eating disorder), and decreased bone density, leading to increased probability of fractures.

Prolonged endurance training in young women can lead to menstrual irregularities resulting in the same kind of reduced estrogen levels typically seen in older postmenopausal women. These athletes should be evaluated for the more traditional cardiac risk factors such as high blood pressure, cholesterol problems, and diabetes, with appropriate intervention to modify their risk. Treatment of the Female Athlete Triad is challenging and may require a multidisciplinary approach to improve an athletes overall energy balance. Strategies include decreasing training volume, modifying dietary habits, medically replacing estrogen levels, promoting bone health with dietary supplements, and seeking appropriate professional help to correct eating disorders if present. Due to the focused and highly competitive nature of many endurance athletes, this is often a tall order to fill since they may resist decreasing their training volume.

Regular exercise is the cornerstone of prevention and treatment of many cardiac and non-cardiac diseases. But some researchers suggest that the benefits of exercise are like a drug the benefits of moderate training reach a plateau and exceeding that plateau, or overdosing, may be detrimental to the athletes health. Several studies have reported unexpected abnormalities in endurance athletes primarily in men suggesting either transient or permanent heart damage which puts them at risk for chronic heart issues. Findings have included a five-fold increased risk of atrial fibrillation (AFIB), increased coronary artery calcium deposits (which indicate clinically silent CAD), and scarring of the heart muscle. However, there are several general guidelines that all athletes should be aware of:

The biological adaptation to handle the stress of pregnancy may be a key reason for the apparently better female adaptation to endurance training. Recent research has highlighted that during pregnancy, the body functions at a basal metabolic rate of 2.2 times the normal burning up to 4000 calories a day. Extended over a period of 40 weeks, pregnancy can essentially be considered the ultimate endurance event a true test on the limits of human performance. Under typical circumstances, a body functioning above 2.5 times the normal metabolic rate over a prolonged period will begin to break down. But most women emerge from pregnancy and go on to live healthy lives, having tolerated a level of metabolic strain considered by some to be similar to that experienced by athletes participating in some of the most competitive endurance events.

There are also massive changes in the amount of fluid in a womans body during pregnancy, creating cardiac stresses similar to endurance training. In order to support the developing fetus, she must increase her blood volume by a massive 50%, and her cardiac output by 40-50% constituting the ultimate dynamic stress on the heart. The female body appears to require less adaptation by the heart muscle and chambers to accommodate these changes.

More overlap in research examining the similarities between the effects of endurance training in women and the cardiac demands placed on them during pregnancy may help to explain these gender-based differences in adaptation to exercise and related cardiac risk. Additional research specifically devoted to women is critical to a better understanding of how gender influences normal cardiac adaptation to exercise, as well as to more accurately identify pathologic conditions which sometimes seem to overlap with normal physiology.

Despite the substantially lower risk of SCD in women, cardiac risk screening of female endurance athletes and at-risk pregnant women is still important, and should be carried out by clinicians familiar with the differences in adaptive physiology between men and women. Women often experience challenging and atypical cardiac symptoms, requiring a high index of suspicion on the part of their doctors often at the primary care level to identify these underlying problems. As the current generation of elite female athletes matures into tomorrows Masters champions, we will undoubtedly learn a great deal more about the long-term cardiac implications of endurance training in women.

Link:
The Outer Line: The impact of endurance training on the cardiac health of women - VeloNews

* Rep. Keith Wheeler (R-Oswego) asked the Legislative Research Unit, which is now part of the Commission on Government Forecasting and Accountability, to look into how much was swept or transferred out of any state funds which pay for the FOID card program, background checks for gun-related purposes and concealed carry licensing.

LRU produced this chart on spending from the State Police Firearm Services Fund. Click the pic for a better view

Man, thats a lot of money being left on or swiped from the table that could be used to better administer those programs.

* From Illinois State Rifle Association lobbyist Ed Sullivans analysis

1.) The State Police have consistently not used all the money available in the Firearm Services Fund over the five years covered in this report. On average the State Police have not used $2,698,753 per year for the identified purposed in this report: administration of the FOID Program, background checks for firearm-related services, and conceal-carry licensing.

2.) The average ending balance of the Firearm Services Fund over the five years covered in this report is $6,847302. This number includes five years of fund sweeps totaling $13,210,268. If the fund sweeps are added back into the total ending balance for the five years covered in the report, the Firearm Services Fund would have an average ending balance of $9,489,355.

3.) The State Police Services Fund receives $1 of every FOID Card fee. This fund is used to administer the Firearm Transfer Inquiry Program (FTIP). The five years that this report covers there has been $15,296,510 swept from this fund.

4.) Total fund sweeps/transfers into the General Fund of $13,210,268 from the State Police Firearm Services Fund and $15,296,510 from the State Police Services Fund over the five years covered in this report total $28,506, 778.

5.) When the conceal Carry act was being written, the sponsors of the bill purposefully made the fee $150 so the State Police had enough money to run the FOID System and the CCW System. Former Gov. Quinn was starving the FOID system and FOID card turnaround was pushing six months or more. The intent of the high CCW fee was to make the systems self-reliant.

6.) According to this report, the FY2018 BIMP, which authorized interfund borrowing and fund sweeps, required that money be transferred back to a fund from which it had been swept or borrowed if that fund has insufficient cash to support appropriated spending.

7.) If the FOID card fee was increased by $10, and all the revenue generated went to the Firearm Services Fund, the fees generated would equal approximately $2,300,000 a year for ten years. Put another way, the State Police are not spending fees presently collected that would equal a $10 increase in the FOID fees per year. These statistics do not include average ending balances that have not been spent or average ending balances with Fund Sweeps not spent.

* ISRA press release

Five years of fund sweeps is unacceptable and needs to be addressed immediately. Beyond the delays and problems in the FOID and ICCL program, these fund sweeps are hampering citizens from exercising their Constitutional Right. Our office gets daily calls from people who are having difficulties navigating the FOID card process so its no wonder we see these problems, given a significant portion of the money intended to fund the program has been raided for other state programs, [Richard Pearson, Executive Director of the Illinois State Rifle Association] said.

Efforts by anti-gun groups to push legislation that would more than double the FOID card fee was a call to action for ISRA to get unbiased data on how the FOID and Concealed Carry programs have been managed and how they are funded. The anti-gunners insisted the program was underfunded and therefore the FOID fee must be raised. The experienced ISRA lobby team worked with Rep. Wheeler (R-Oswego) to have the Legislative Research Unit produce an unbiased accounting of the revenues generated by the FOID card and ICCL fees.

We pursued this investigation because we wanted honest gun owners to know the truth about what was happening to the fees that they pay for the right to own a firearm in Illinois, Pearson said. We worked with Rep. Wheeler to secure a report from the Legislative Research Unit on what was happening to the user fees and now we know. There is no shortage just money being taken from these accounts to be used for other things.

Read more here:
Your Illinois News Radar LRU finds millions diverted from or not spent by gun-related fund - The Capitol Fax Blog

Photo by Wyron A on Unsplash.

Healthcare in the United States is changing rapidly, and within the next few years, it will look very different than it does today.

If your first thought while reading that statement was, Ive heard that before and nothing actually ever changes, your skepticism is well founded, as industry experts have been purporting significant transformation for at least a decade. However, I truly believe weve reached a tipping point, and that consumers will see real healthcare change in the near future. Its a bold statement to make, but there are a few forces at work that I believe will make it true namely, the intersection of value-based care and technological innovation.

Well cover technology below, but first, lets spend some time talking about value-based care.

What is Value-Based Care? And Why Should I Care?

Value-based care is a new healthcare payment model that shifts medical providers reimbursement from fee-for-service to fee-for-value, with value defined as care quality, cost, efficiency and effectiveness (you can read more about it here). Put simply, this means physicians salaries will be tied directly to care quality, patient outcomes and overall cost efficiency, rather than to the act of performing a test or procedures i.e. physicians will only receive full reimbursement from insurers for effective care. As a patient, this means you should experience improved quality of care with lower costs.

This is a seismic shift in our healthcare model, and yet, many consumers arent even aware it's taking place. Value-based care models have, in fact, been a topic of discussion as far back as 2008 and were a part of the Obama Administrations Health Information Technology for Economic and Clinical Health Act, or HITECH Act, of 2009. However, significant implementation of the model did not occur until late last year when, with the Centers for Medicare and Medicaid Services (CMS) leading the way, key payer and provider organizations announced that 48% of their business was finally tied to value-based reimbursement models. As we head into 2020, this number is forecast to grow as high as 75% and will likely reach 100% in the not-too-distant future. Keeping this in mind, its fair to say were going to finally see true healthcare change in 2020.

Technology plays a big role in this shift for the simple reason that benchmarking and reporting on patient outcomes and care quality necessitates unprecedented health data and analytics, increased patient engagement and heightened visibility into the patient journey. Patients are beginning to demand more from their medical providers, such as the ability to book appointments online and access medical records via smartphone. These services are commonplace in other industries, yet pointedly absent from many aspects of care. Known as the consumerization of healthcare, physician practices that offer quality and convenience are poised to succeed in this new value-based marketplace. Additionally, there is more responsibility on physicians especially primary care providers (PCPs) to act as care coordination liaisons and to balance quality care with cost control. As we head into 2020, here are some of the changes speeding down the pipeline that consumers can expect to see in the months to come.

1. Digital Therapeutics: Engaging With Patients During Recovery

Therapeutic video games can help seniors and people in need of care to maintain their physical and ... [+] mental abilities.

As a nation, were increasingly recognizing that healthcare doesnt take place solely in a hospital or physician office setting. If the ultimate goal of value-based care is to improve a patients well-being, this means consumers must take their health into their own hands, acting on prescribed dietary or lifestyle changes and following through on physician referrals. New app-based digital patient engagement tools are poised to play a key role, helping patients to stay focused on health goals and giving them a place to turn for questions that come up between visits.

One area proving particularly promising is the adoption of physical therapy exercise apps for home rehab post-operatively. According to Elana M. Oberstein, MD, MPH, Patients can now have an Avatar to do their exercises with who helps encourage and remind them what theyre supposed to be doing and when. Such an app could also come with a brace device to give the surgeon real-time feedback regarding joint range of motion, number of steps, activity level, etc., and help the physician assign additional exercises to be taught by the Avatar.

A recent survey of patients who had participated in physical or language therapy found that 90% reported challenges with their current course of traditional treatment, ranging from cost to transport to insurance.

As we move toward value-based care models, providers may soon be graded on the types of post-operative recovery options they offer. While in-person visits certainly arent going away anytime soon, providing at-home monitoring and exercise options, especially for elderly patients or those in remote areas, is exactly the type of quality care that value-based initiatives promote.

According to WebPT, adherence to home exercise programs is a major factor in overall patient outcomes, and telehealth has massive potential for widespread application in rehab therapy. However, many therapists feel their hands are tied with payer and government regulations, so there are still changes that need to take place before virtual therapy becomes a care standard.

2. Promoting Patient Wellness With Wearables

wearable technologies can help support patients with chronic conditions and those with personal ... [+] health goals.

Sticking with the app theme, wearable technologies and associated apps will likely have a larger role to play in the general healthcare landscape as well, guiding and supporting patients with chronic conditions and those with personal health goals. While wearables are already ubiquitous for tracking fitness, in the future, theyll help measure health objectively, identifying changes in habits that may be indicative of a developing condition and relaying this information to providers.

In fact, wearable devices and associated apps already exist to help manage type 2 diabetes, asthma, arrhythmias, clinical depression and other disorders. For example, several existing wearables have been shown to help obese, at-risk populations avoid full-blown diabetes by tracking blood glucose measurements and reporting changes to providers. Wearable EKG sensors like those in the popular Apple Watch have helped catch irregular heart rhythms in wearers, alerting them (and their doctors) of a possible health condition and even saving lives. They can even act as a modern day life alert system with fall detection capabilities.

These technologies are getting smaller and more economically accessible (just check out this electronic tattoo that can measure vital signs) and are bringing continuous health monitoring to a level previously seen only in an intensive care unit. This additional data is coming to be known as the personal health record (PHR), and when combined with the electronic medical record (EMR), can help physicians and patients make even more informed care decisions.

3. Price Transparency: Whats The Cost Of My Care?

I doubt there are many readers here who havent heard of the fierce cost of care debates playing out at the national level, as healthcare is probably one of the only industries where consumers opt for a service before knowing the price. What may not be immediately apparent is that not only do patients not know the cost of their care, but providers also dont know how they will be compensated before carrying out a service. Prices are heavily dictated by government regulations and increased transparency for both patients and providers has been a major topic of discussion. For example, check out the current administrations new price disclosure rules. Keeping all of this in mind, its fair to say the cost of care will remain top of mind for some time to come.

We are, however, making progress when it comes to price transparency, and technology is playing a big role in bringing relief to consumers. Tools exist that can show patients the out-of-pocket medication costs while in the exam room, where theyre able to determine alternative drug options that fit their wallet with their provider. Price comparison technologies are becoming more common, and theres a good chance youll encounter it in the coming months.

In 2020 and beyond, these technologies will go further, alerting patients and providers about in-network options for care referrals and preventing out-of-network visits to keep costs down. According to a recent study, physicians send about 25% of their patients to out-of-network specialists for procedures and surgeries, even though they recognize that this incurs a higher cost of care. But why? Nearly half of providers say they have difficulty determining whether a provider is in network. However, the technology to give providers insight about in-network options for specialist referrals already exists, and the roll-out of these platforms will continue to increase in the coming months.

4. Healthcare, Personalized: Precision Medicine and Genetics

Saliva collection kit for DNA testing.

More and more consumers have had their genetic profile tested by companies like 23&Me and AncestryDNA, the result of which are better-informed consumers who know more about the diseases they have and are susceptible to (plus uncovering some family secrets like a cousin they didnt know existed). This allows patients to act as a partner in their own care, coming to the table with a sense of their overall health, screening plans and treatment. Because precision medicine hasbeen shown to lead to better patient outcomes, organizations like the American Medical Associationhave spoken out strongly about the need for genetic testing to be a part of the value-based care model.

Combining a patients genetic data with that available from wearable devices will open even more avenues toward understanding disease. Databases tracking medication performance of patients with similar genetic profiles will allow physicians to prescribe patient-specific treatments. This sophistication will allow us to move beyond episodic and reactive care the kind that happens after a disease is discovered toward even more proactive and preventative care.

5. Dr. A.I. Will See You Now

It seems these days that you cant discuss the future of technology without mentioning artificial intelligence (A.I.), but truth be told, true A.I. in healthcare is still in its infancy so, no youre not going to be booking an appointment with Dr. A.I. in 2020. However, we are on the cusp of using A.I. and deep learning technology to help physicians make more even more informed care decisions for their patients by helping to scan test results and identify anomalies.

Ophthalmology is one area where AI-guided decision support is proving to be highly beneficial, as it can provide a cost-effective and easy way to scan for retinal diseases. Many Americans today skip their yearly eye check, thinking that unless they notice any irregularities, its not necessary. However, that couldnt be further from the truth. This is true especially for diabetic patients who are at risk of developing diabetic retinopathy, a debilitating disease that causes blindness, and which cant be reversed once its begun.

Studies have shown that A.I. is effective at scanning high-resolution images of a patients retina to detect for signs of retinopathy, signaling when its time to see the eye doctor. A recent study found that 73% of adults age 40 and over with diabetic retinopathy were unaware of their condition, so performing tests such as this in the primary care setting could help prevent the disease from progressing before its too late. A.I-guided image analysis has the potential to scan for a whole host of eye diseases, and will also be important for glaucoma screening in the near future.

Value-Based Care is Bringing Real Change

Theres no doubt that were at an exciting juncture in the healthcare field. Changes that have been happening over the past decade are finally reaching critical mass and our technological innovations are poised to enable true connected care.

Still not convinced? Keep an eye on industry news and the political debates surrounding value-based care, interoperability and price transparency to keep pulse on where we stand in the months to come. And better yet, see what changes you experience the next time you visit your physicians office.

View original post here:
5 Ways Technology Will Enable Value-Based Care in 2020 and Beyond - Forbes

1 / 5 Show Caption + Hide Caption Assistant Secretary of the Army for Installations, energy and environment, hands an Army Community Partnership award to military and civilian representatives from Fort Belvoir, Va. (Photo Credit: Joe Lacdan) VIEW ORIGINAL 2 / 5 Show Caption + Hide Caption Members of the Prickly Pear Land Trust trains volunteers about land and natural resource conservation on the outskirts of Helena, Montana, and Fort Harrison. The land trust created a "Peeks to Creeks" initiative that helps prevent construction projects from encroaching on lands near the Fort Harrison borders. Many Soldiers use the surrounding land for physical training, exercise and recreation. The Prickly Pear Land trust and the Montana Army National Guard were honored in a Pentagon ceremony by the Army Community Partnership Program Dec. 5. (Photo Credit: Courtesy photo) VIEW ORIGINAL 3 / 5 Show Caption + Hide Caption Volunteers learn the dynamics of stream restoration in the Montana wilderness while learning about natural resource conservation from members of the Prickly Pear Land Trust. The Land Trust partners with the Montana Army National Guard to build hiking trails, connect public lands to private grounds, and protect stream corridors, flood plains and environmental projects of varying scale. The Prickly Pear Land trust and the Montana Army National Guard were honored in a Pentagon ceremony by the Army Community Partnership Program Dec. 5. Nine other Army and community partnerships were recognized. (Photo Credit: Courtesy photo) VIEW ORIGINAL 4 / 5 Show Caption + Hide Caption Gila River Indian Community partnered with Fort Huachuca, Arizona to teach 30 military children how to create ceramic tile masterpieces. Youth were taught how to create new colors by mixing paint and how the colors change when heated in the kiln. (Photo Credit: courtesy photo) VIEW ORIGINAL 5 / 5 Show Caption + Hide Caption Maj. Gen. Matthew Quinn, Adjutant General for Montana, Mary Hollow, executive director of the Prickly Pear Land Trust, and Col. James Hesterberg, construction facility management officer, Montana National Guard accept the Army Community Partnership Program award from Assistant Secretary of the Army for installations, energy and environment Alex Beehler (far left), and Lt. Gen. Jason Evans, deputy chief of staff of the Army, G-9 (far right) (Photo Credit: Courtesy photo) VIEW ORIGINAL

WASHINGTON -- Beneath the shadow of Mount Ascension, lying in the vast expanse of Montana's wilderness, a community of Soldiers joined a staff of 10 civilians to help preserve the outdoor land many veterans use to exercise, hike and enjoy.

For nearly a decade, the Montana Army National Guard and the Prickly Pear Land Trust have combined their efforts to protect the natural tranquility of Tenmile Creek, a 26.5-mile tributary that winds southwest near Fort Harrison. The land trust's Peaks to Creeks Initiative also helps prevent construction developments from encroaching on grounds bordering the installation and potentially disrupting Soldiers training.

The Army Community Partnership Program, or ACPP, recognized members of the Montana National Guard and the land trust for their efforts in a Pentagon ceremony Wednesday, along with nine other installations and communities. The partnerships strengthen and solidify the service's ties to its surrounding neighborhoods, said Lt. Gen. Jason Evans, deputy chief of staff of the Army, G-9.

According to a recent USA Today report, Montana has the third-highest percentage of service members in its population and the large veteran community depends on fostering local partnerships.

"Our Soldiers live in the community and retire in the community," said Col. James Hesterberg, construction facility management officer, Montana National Guard. "It's a great partnership and it's an important partnership. We sustain each other."

Hesterberg added that Fort Harrison benefits from the land trust's efforts in supporting the installation's infrastructure. The land trust's staff of 10 people, with the help of the Guard, builds hiking trails, connects public lands to private grounds, and protects stream corridors, flood plains and environmental projects of varying scale.

"We can accomplish the goals of the military installations; we can also address really important community needs," said Mary Hollow, executive director of the land trust.

OVERSEAS PARTNERSHIP

For the first time the ACPP recognized a foreign partner, the South Korean city of Pyeongtaek, and Hoseo, Pyeongtaek and Namseoul Universities for their role in joining Camp Humphreys to establish community relationships to organize community events, as well as engage in programs fostering greater cultural understanding.

Pyeongtaek Vice Mayor Jong-Ho Lee along with a South Korean delegation attended the ceremony including Yoongi-Gi Baik, the director-General of the Anjung district office of Pyeongtaek city, Byeong-Bae Lee, the vice chairman of the Pyeongtaek city council.

HOMELAND BONDS

Partnerships like those forged between the Montana Army National Guard and the land trust underscore the Army's larger effort to strengthen its bond to communities on the home front.

That relationship has become paramount in Austin, Texas, where the Army formed a new major command, Army Futures Command. The ACPP honored AFC's partnership with the University of Texas System, from which AFC rents its headquarters building, as well as the state of Texas and the host city.

AFC planted its roots deep into the community by forming relationships with university faculty to further develop research into robotics, and assured positioning, navigation and timing programs, which is alternative navigation programs to GPS.

"Our national defense strategy has stated what we all know," said Alex Beehler, assistant secretary of the Army for installations, energy and environment. "That the homeland is no longer a safe haven. The fence line has become the front line. And that clearly means the surrounding communities are very much integral to any Army installation, any military base, particularly the large ones."

In the southwest, less than 30 miles from the U.S.-Mexico border, Fort Huachuca in Arizona earned recognition for forming four partnerships with the city of Sierra Vista, the local United Service Organization, Upper San Pedro Partnership, and the Arizona Department of Forestry and Fire Management.

By aligning with the ADFFM, Fort Huachuca removed fuel from wildlands and helped conserve the habitat of the Mexican spotted owl near Army training areas.

As the population of Sierra Vista and the surrounding region near Huachuca swelled, the installation joined the Upper San Pedro Partnership to help balance delicate water distribution in the region. And the base established a USO center to provide programs for military families.

"Fort Huachuca and Sierra Vista have a long history of partnering with each other in extraordinary ways," said Sen. Martha McSally, R-Ariz. "Fort Huachuca is Sierra Vista. Sierra Vista is Fort Huachuca. And like many small towns, support across the board is extraordinary, and I know that's the same for a lot of communities around the country."

Along the East Coast, the ACPP praised community partnership efforts in New Jersey, New York, Maryland and Virginia.

The New Jersey Guard along with Rowan and Stockton Universities created an internship program based on operational and mission readiness improvement in sustainability, facilities management and environmental programs.

New York's Fort Hamilton, located on the shores of south Brooklyn, joined nearby Poly Prep Country Day School to share use of indoor and outdoor fitness facilities for both Poly Prep students and Soldiers.

Fort Drum and New York state police combined forces to respond to critical incidents that target base personnel and property. Fort Drum and Jefferson County partnered to improve Soldier and family member support services that include emergency relief, financial readiness and relocation.

At Fort Belvoir, the installation and northern Virginia's Community Military and Federal Facility Partnership developed a cyber training and education program to establish a new cybersecurity work force.

The Fort Meade Alliance in Maryland transformed an aging 9,000 square-foot Kuhn Hall into a renovated, state-of-the art program and information hub, providing mental health, educational and family services.

On the West Coast, the Presidio of Monterey, home of the Defense Language Institute Foreign Language Center, signed an intergovernmental support agreement with the city of Monterey to provide support services for POM facilities and at Camp Robert's Army Signal Activity.

"We are such a small installation that we depend on our community partners to help us accomplish our mission," said Command Sgt. Maj. Roberto Marshall, POM garrison command sergeant major. "So it's important for us to reach out to get this community engagement to help us support our mission on the Pacific."

Originally posted here:
Partnership program highlights bonds between Army, cities nationwide - United States Army

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