Craniocervical Instability Measurements

CHRIS CENTENO | July 23, 2019

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Did you know that some people have problems with the ligaments that hold their head on? These patients often become like a pinball in the great arcade game of medical specialists, going from one to the other without a diagnosis. They can sometimes find a diagnosis if they meet a doctor who knows which tests to order or which measurements to take. So today we’ll explore all of this a bit.

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Covenant Health Canada

On October 7, 2008, 16 Catholic health care facilities across Alberta came together under a single board and administration. Today, Covenant Health has a team of more than 14,000 staff, physicians and volunteers across our sites in Banff, Bonnyville, Camrose, Castor, Edmonton, Killam, Lethbridge, Mundare, St. Albert, Trochu and Vegreville.

OTHER ARTICLES

IMMERSIVE ENVIRONMENTS COULD BE THE NUDGE WE"RE ALL LOOKING FOR WHEN IT COMES TO FRAMING BEHAVIORAL FRAMEWORKS...

Article | December 21, 2020

Yes, empathy has become a fad. Connecting to another human is actually something cool kids do now. If a brand doesn’t have an impact model that includes a practical social issue, consumers tend to not take that brand seriously. In this case, empathy needs to be revisited beyond the trend itself for these strategies to have real, lasting impact. Practical strategies around compassion meanwhile have similarly become an intrinsic part of social impact organisations. They have become so commonplace that prosocial behaviour has strayed into a kind of tokenism. It is common for instance for consumers to donate their hard-earned money to companies who focus their energies on trying to alleviate real-world issues. The question then is whether this proxy for compassion isn’t in fact watering down human connections, as well as our positive impact on the issues business and organisations seek to solve with our help. Postmodern behavioral science If it is, then we must understand why and how to change that. This is where postmodern behavioral science provides a possible better alternative to social impact strategies. Postmodern behavioral science suggests that the current approach to understanding human behaviour lacks even a rudimentary understanding of empathy, defined in the area of social impact as a discursive strategy that allows us to feel what the group we are trying to help is feeling. Of course, compassion has very close ties with empathy. Empathy is an innate ability we all have, one that we can learn to develop and fine-tune over time. It is our emotional connection to another human, though one that lies beyond our own ego. It takes the perspective of the person who is struggling and seeks to understand their life, their struggle, and their worldview. It also resolves to value and validate their perspective and experience — something that donating money to a social impact cause does not. In its broader definition, empathy is a shared interpersonal experience which is implicated in many aspects of social cognition, notably prosocial behavior, morality, and the regulation of aggression. Empathy has a host of positive after-effects when applied as an interpersonal experience. If a social impact organisation is preoccupied with raising capital, then it is likely to disregard the practical worth of empathy for those who truly want to achieve its mission. Immersive empathy One way that behavioral science can contribute is to utilise tools that can help augment the experience of those in need for those needing to understand those needs. Both AR and VR can help people visualise and follow the stories of those who require compassion. These create virtual environments for partners, governments, and consumers to experience with the people they seek to help. But of course, much of human behaviour is geared toward seeking pleasant experiences and avoiding unnecessary pain. Our in-built hedonic valuation systems guide decisions towards and away from experiences according to our survival instincts. This is precisely why business owners who want to encourage empathy in their customers go the easy route, but should seek a more participatory frameworks to inspire and provide experiences for those on board with a social mission. Then there are issues like financial literacy in underserved populations, access to clean water, education for women and girls, and environmental conservation, to name a few of the problems that social impact companies are attempting to tackle. If a company is trying to tackle an issue such as access to clean water, then rather than start there, it should first ask exactly how this issue arose and developed. It should question the beliefs that underpin this chronic social inequality, those that inform policies, practices, cultural taboos, and beliefs about water and people’s access to it. To simply respond to an issue in its developed form is to leave it unfixed. We must be willing to reverse engineer the origins of that issue that got us to where we are. In other words, human behaviour is not the only component to consider in this. The main behavioral framework public servants should take with them is to develop a nudge unit solely based on the relationship between behavioural science and technology. This is mainly because technology is an inevitable part of how we now relate to one another. Immersive Compassion meanwhile should embrace tools like AR/VR that seek to create empathetic environments and valuable impact longevity. To fully embrace empathy as an organisation is to create relevant and rigorous responses that go as far as to alter the infrastructure of its target goals. Optimising social impact comes down to optimising human experience.

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Addressing social determinants of health with data interoperability

Article | April 20, 2020

Across the spectrum of healthcare delivery – payor, provider, vendor, consumer, there is a land rush underway to embrace consumer-centric care. With tools like value-based care, chronic disease management, retail services, analytics, and remote patient monitoring, healthcare organizations are pivoting towards capabilities that provide a deeper understanding of patient behaviors and address the whole patient and not just the condition.

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GUIDE TO THE BEST MANAGED SERVICES FOR HEALTHCARE

Article | March 5, 2020

Healthcare, more than most sectors, is heavily data-driven. This has prompted the industry to innovate using technology. The healthcare cloud computing market, for example, is expected to be valued at $55 billion by 2025. Technologies such as cloud computing, give healthcare new ways of collecting, sharing, and analyzing data, that will ultimately result in better healthcare and patient outcomes. But keeping up to date with new technologies can be a costly business. Both in terms of time, but also in the need for specialist IT staff. This is where outsourcing IT to a managed service provider (MSP) comes in. Here we look at why using an MSP is a healthy choice.

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COVID-19: How do we get out of this quagmire?

Article | July 17, 2020

The COVID-19 virus (C19) pandemic is turning out to be the event of the century. Even World War seems timid in comparison. We are in the 4th month of the virus (in non-China countries) and have gone past the lockdown in many places. Isn’t it time we re-think the approach? What if there is another wave of C19 coming soon? What if C19 is the first of many such events in the future? Before we get into analysis and solution design, summarizing the C19 quirks: While a large section of the affected population is asymptomatic, for some it can be lethal There isn’t clarity on all the ways C19 spreads It’s known to affect the lungs, heart, and kidneys in patients with weak immunity It has been hard to identify a definitive pattern of the virus. Some observations in managing the C19 situation are: With no vaccine in sight, the end of this epidemic looks months or years away Health care personnel in hospitals need additional protection to treat patients Lockdowns lead to severe economic hardship and its repeated application can be damaging Quarantining people has an economic cost, especially in the weaker sections of society If one takes a step back to re-think about this, we are primarily solving 2 problems: Minimise deaths: Minimise the death of C19 and non-C19 patients in this period Maximise economic growth: The GDP output/growth should equal or higher than pre-C19 levels One needs to achieve the 2 goals in an environment of rising number of C19 cases. Minimise deaths An approach that can be applied to achieve this is: Data driven health care capacity planning Build a health repository of all the citizens with details like pre-existing diseases, comorbidity, health status, etc. The repository needs to be updated quarterly to account for patient data changes This health repository data is combined with the C19 profile (disease susceptibility) and/or other seasonal diseases to determine the healthcare capacity (medicines, doctors, etc.) needed The healthcare capacity deficit/excess needs to be analysed in categories (beds, equipment, medicine, personnel, etc.) and regions (city, state, etc.) and actions taken accordingly Regular capacity management will ensure patients aren’t deprived of timely treatment. In addition, such planning helps in the equitable distribution of healthcare across regions and optimising health care costs. Healthcare sector is better prepared to scale-up/down their operations Based on the analysis citizens can be informed about their probability of needing hospitalisation on contracting C19. Citizens with a higher health risk on C19 infection should be personally trained on prevention and tips to manage the disease on occurrence The diagram below explains the process Mechanism to increase hospital capacity without cost escalation Due to the nature of C19, health personnel are prone to infection and their safety is a big issue. There is also a shortage of hospitable beds available. Even non-C19 patients aren’t getting the required treatment because health personnel seek it as a risk. This resulted in, healthcare costs going up and availability reducing. To mitigate such issues, hospital layouts may need to be altered (as shown in the diagram below). The altered layout improves hospital capacity and availability of health care personnel. It also reduces the need for the arduous C19 protection procedures. Such procedures reduce the patient treatment capacity and puts a toll on hospital management. Over a period, the number of recovered C19 persons are going to increase significantly. We need to start tapping into their services to reduce the burden on the system. The hospitals need to be divided into 3 zones. The hospital zoning illustration shown below explains how this could be done. In the diagram, patients are shown in green and health care personnel are in light red. **Assumption: Infected and recovered C19 patients are immune to the disease. This is not clearly established Better enforcement of social factors The other reason for high number of infections in countries like India is a glaring disregard in following C19 rules in public places and the laxity in enforcement. Enforcement covers 2 parts, tracking incidents of violation and penalising the behaviour. Government should use modern mechanisms like crowd sourcing to track incidents and ride on the growing public fear to ensure penalty enforcement succeeds. The C19 pandemic has exposed governance limitations in not just following C19 rules, but also in other areas of public safety like road travel, sanitation, dietary habits, etc. Maximise economic growth The earlier lockdown has strained the economy. Adequate measures need to be taken to get the economy back on track. Some of the areas that need to be addressed are: One needs to evaluate the development needs of the country in different categories like growth impetus factors (e.g. building roads, electricity capacity increase), social factors (e.g. waste water treatment plants, health care capacity), and environmental factors (e.g. solar energy generation, EV charging stations). Governments need to accelerate funding in such projects so that that large numbers of unemployed people are hired and trained. Besides giving an immediate boost to the ailing economy such projects have a future payback. The governments should not get bogged down by the huge fiscal deficit such measures can create. Such a mechanism to get money out in the economy is far than better measures like QE (Quantitative Easing) or free money transfer into people’s bank accounts Certain items like smartphone, internet, masks, etc. have become critical (for work, education, critical government announcements). It’s essential to subsidise or reduce taxes so that these items are affordable and accessible to everyone without a financial impact The government shouldn’t put too many C19 related controls on service offerings (e.g. shops, schools, restaurants, cabs). Putting many controls increases the cost of the service which neither the seller not buyer is willing or able to pay. Where controls are put, the Govt should bear the costs or reduce taxes or figure out a mechanism so that the cost can be absorbed. An event like the C19 pandemic is a great opportunity to rationalise development imbalances in the country. Government funding should be channelized more to under-developed regions. This drives growth in regions that need it most. It also prevents excess migration that has resulted in uncontrolled and bad urbanisation that has made C19 management hard (guidelines like social distance are impossible to follow) Post-C19 lockdown, the business environment (need for sanitizers, masks, home furniture) has changed. To make people employable in new flourishing businesses there could be a need to re-skill people. Such an initiative can be taken up by the public/private sector The number of C19 infected asymptomatic patients is going to keep increasing. Building an economy around them (existing, recovered C19 patients) may not be a far-fetched idea. E.g. jobs for C19 infected daily wage earners, C19 infected taxi drivers to transport C19 patients, etc. In the last 100 years, mankind has conquered the destructive aspects of many a disease and natural mishap (hurricanes, floods, etc.). Human lives lost in such events has dramatically dropped over the years and our preparedness has never been this good. Nature seems to have caught up with mankind’s big strides in science and technology. C19 has been hard to reign in with no breakthrough yet. The C19 pandemic is here to stay for the near future. The more we accept this reality and change ourselves to live with it amidst us, the faster we can return to a new normal. A quote from Edward Jenner (inventor of Small Pox) seems apt in the situation – “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases”.

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Spotlight

Covenant Health Canada

On October 7, 2008, 16 Catholic health care facilities across Alberta came together under a single board and administration. Today, Covenant Health has a team of more than 14,000 staff, physicians and volunteers across our sites in Banff, Bonnyville, Camrose, Castor, Edmonton, Killam, Lethbridge, Mundare, St. Albert, Trochu and Vegreville.

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