0 What Is The Difference Between Pay for Performance and Accountable Care Organizations

Wheres that evidence?

The Disease Management Care Blog has occasionally wondered about the difference between pay for performance (P4P) and accountable care organizations (ACOs).  While the latter involves a more explicit transfer of risk, it thinks the underlying logic for both is ultimately the same: better quality performance should translate into less sickness, fewer specialist physician visits and reduced hospitalizations which, in turn, should save money that can be shared with the providers.  Assuming thats true, the possibility of getting that kind of money should prompt physicians to prevent, coordinate, counsel, immunize and screen instead of treat, er, ignore, not immunize and hustle out the door.

Unfortunately, a recently published Cochrane Review says otherwise. 

The DMCB likes CRs because they are state-of-the-art and highly disciplined reviews of the worlds scientific medical literature.  In this instance, after an exhaustive examination of every published paper on the topic of P4P, the authors conclude....

"....there is insufficient evidence to support or not support the use of financial incentives to improve the quality of primary health care."

The DMCB will be the first to argue that academic, rigorously conducted, randomized and controlled clinical trials are not the final answer when it comes to managing the subtle complexities of physician behavior change.  The DMCB has run into some very smart and passionate physician leaders who have few doubts about the real world links between P4P, increased quality and reduced cost.

That being said, given the commonalities between P4P and ACOs, no one should assume that ACOs are going to succeed based on any notions of "evidence" that the promise of savings will translate into a changed physician workforce.   Cochrane says it just aint there.

0 relationship between the Food and Teeth

Health for human | Some people claim that certain foods and certain substances harmful to health of teeth and mouth, then is there any food that we can not eat because it will cause problems on our teeth? Indeed, some foods have a certain effect in reaction to the teeth and mouth. But keep in mind that everything that happens must be through a process.

As well as making food (cooking), is not require the process as well? Sometimes some of us are always looking for scapegoats in certain issues, such as chocolate (Ive posted deh taste hehe), chocolate is considered detrimental to teeth, but the nutrient content and effect of chocolate for the body is very important. Are we ahrus away from chocolate because we want healthy teeth? if this ga bisa2 all food should be eaten well:)

Actually there is no food that needs to be shunned for getting your teeth and mouth healthy. All were returned to the process and time, is at issue in this case are the remains of meals yagn still attached to the teeth. Food residue on the teeth will react with the inhabitants of our mouths (enzymes, saliva, bacteria, germs, acids, bases, etc.). The reaction is the decomposition of food scraps that can later lead to caries / cavities, but it is a problem that caused bad breath.

The process of decomposition or spoilage of food that requires time, so wed better cut the process by brushing your teeth regularly. If we can cut the process by regularly brushing your teeth and mouth problems will be reduced and even disappear.

In addition to the way we eat also affects our oral health, such as eating or drinking hot and cold simultaneously or in a vulnerable short time, I berisedikit example: A person ordering hot food and ice are also well ordered portions of such foods that can cause damage to the tooth, you should eat hot food and water only once a while later when a new deh buy ice:)

There are still many who asked about the timing and the proper way to brush your teeth, the right time is after we sarapa morning (at the moment weve cut the process and the rest of the meal mengilangkan as described above) and at night before bed. Why not after dinner? Because after dinner there is still a vulnerable time until we sleep sometimes vulnerable time about eating more or snacking, and for smokers sometimes smoke before bed until well if you brush your teeth after dinner, and finally eat again, although slightly, the same as we do not rub the teeth. For it is better brush your teeth at night before bed. karen on beraktifitaslah occur when the mouth is not the decomposition process of food / food spoilage in the mouth which will cause tartar and caries.

0 Difference between Germs Virus and Bacteria

Difference between Germs, Virus and Bacteria - Microorganism cause of disease is everywhere, in the air, on food and beverages, in animals and other surfaces. If the immune system is weak and we are dealing with organisms whose immunity has not owned body, we get sick.
There are several types of disease-causing organisms, from bacteria, viruses, bacteria, fungi or worms. Actually, whats the difference?

1. Germ
Germ is the public term that identical to bacteria, namely single-celled organisms that can only be seen with the aid of a microscope. when the infection bacterial enter to body, the numbers will increase and potentially produce a number of powerful chemicals, called toxins, which can destroy certain cells in tissues that attacked so that makes us sick.

Not all harmful bacteria. Some bacteria that live in the body, such as the gut and mouth, even profitable. Diseases caused by bacteria such as pneumonia, acne, sore throat, cholera, etc., can be treated with antibiotics.

2. Virus

When attacking the human body, the virus enters to few cell in body and control it, ordered the cell "hosts" to produce the parts needed to reproduce themselves. In the process, the host cell eventually be eradicated. Polio, HIV/AIDS, influenza, measles, or meningitis is a disease caused by a virus. Treatment with antiviral.

3. Mushrooms

Single-celled organisms are slightly larger than bacteria. Actually, the fungus is not contagious, but there are certain types that can be transmitted, such as candida. Candida can cause thrush or canker sores. Meanwhile, the fungi become the biggest cause of diaper rash that causes the infection.

4. Worms

When this type of parasite or eggs entering the human body, usually he would stay in the intestinal tract, lung, liver, skin, or brain, and the life of existing nutrients in the human body.