Immunobiology

Vandana Gambhir, Julia Kim, Sarah Siddiqui, Michelle Taylor, Valarie Byford, Elaine O. Petrof, Glenville Jones, Sameh Basta

The vitamin D metabolite, 1,25-(OH)2D3, binds the vitamin D receptor(VDR) to exert its regulatory effects at the transcription level.  VDR is expressed in professional antigen-presenting cells (pAPCs), such as macrophages (Mø) and dendritic cells (DCs). We show for the first time that the 24-hydroxylase enzyme is activated in bone marrow-derived dendritic cell (BMDC), due to 1,25(OH)2D3 stimulation which resulted in the induction of its gene, CYP24A1.

Robert Freeman, Ph.D., Kristina M. Lybecker, Ph.D., D. Wayne Taylor, Ph.D., F.CIM

Executive Summary

In the midst of rising health care expenditures, increasingly limited health care budgets and economic uncertainty, the efficient use of government funds and other resources is of the utmost importance.  In March 2010, the Patient Protection and Affordable Care Act (ACA) expanded Medicaid, to help reduce the number of uninsured, thus potentially further increasing tremendously the fiscal burden on the states.  According to the Office of the Actuary of the Centers for Medicare and Medicaid Services the states’ Medicaid programs spending is forecast to increase by an annual rate of 8.4% from 2009 to 2019.
Some of the cost increase is due to the inefficiencies inherent in the highly fragmented nature of the delivery of Medicaid between state and private enterprise, between stand-alone and co-ordinated services models, between individual and population health management strategies, and among the 50 states themselves.

There is an old saying in political science, “if you change the language, you change the debate.” This has happened in Canada. Everyone is told, and most believe, that the number one driver of healthcare costs is drugs. This is just not true. The number one driver of healthcare costs is our health. Spending on drugs is a good thing. We are very lucky that medical therapies multiplied in number just as we were closing 36% of our hospital beds across Canada in the 1990’s.

Healthcare Management Forum
Michael Heenan, MBA, CPHQ; Brady Wood, MA; D. Wayne Taylor, PhD, FCIM

In the words of one hospital manager, “hospital data is currently indigestible and alien to the average user.” Drawing upon the experience of an academic hospital that, contrary to established practice, published real numbers alongside rates and ratios during a Clostridium difficile outbreak, the authors examined the pitfalls of publishing only abstract performance measures and the advantages of releasing real numbers to the public. This article identifies lessons for hospital board governance, media relations, employee communications, and citizen and patient engagement that are applicable across the healthcare industry in many countries. If healthcare is to be a caring industry, then care should be taken in the public reporting of data and information.