Family Medicine

Family medicine is a medical specialty that focuses on the care of entire families, from newborns to seniors. It is one of the most diverse specializations in medicine, as family doctors are responsible for diagnosing and treating a wide range of illnesses and injuries. They also provide preventive care, such as immunizations and screenings, and they can refer patients to specialists if needed. One of the biggest benefits of choosing family medicine as your specialty is that you will have the opportunity to get to know your patients well. You will also have a lot of flexibility in terms of your work schedule, which can be important if you have other commitments outside of work. Plus, family doctors are in high demand, so you will likely find plenty of job opportunities once you complete your training.

Osteopathy

Osteopathy is a system of medicine that focuses on the whole body, rather than just treating symptoms. Osteopaths use a variety of manual therapies to restore balance to the body and improve overall health and well-being. They may also order tests or imaging studies to make an accurate diagnosis, and they can provide advice on lifestyle changes that can help to improve their patient’s condition. In Canada, osteopathy is considered a recognized medical specialty, so you will need to complete an accredited program to practice. You may also find both full-time and part-time programs at the Canadian College of Osteopathy in Toronto, so you can choose the one that best suits your lifestyle. This specialty requires a lot of dedication, but it can also be incredibly rewarding.

General Surgery

General surgery is a broad specialty that involves the diagnosis and treatment of a wide range of conditions, from cancer to hernias. Surgeons perform operations using advanced technology as well as traditional surgical techniques, such as suturing or cauterizing. They must have excellent problem-solving skills, be comfortable with making critical decisions in high-pressure situations, and be able to work long hours if needed. The job also requires strong interpersonal skills and emotional intelligence so that surgeons can effectively communicate with their colleagues and patients. General surgery is one of the most demanding specializations in medicine, but it can also be incredibly rewarding for those who are up to the challenge

Emergency Medicine

One of the most exciting and challenging specializations in medicine is emergency medicine. This specialty involves taking care of patients with life-threatening conditions, such as heart attacks or gunshot wounds. Emergency doctors must be able to quickly assess a patient’s condition and provide the appropriate treatment while under intense pressure. They also need to work well in a team setting and have excellent communication skills so they can effectively collaborate with other medical professionals. Becoming an emergency doctor requires extensive training and ongoing education, but it can be incredibly rewarding as you help save lives every day.

Radiology

While radiologists may not always interact directly with their patients, they play a crucial role in diagnosing and treating many medical conditions. Radiologists use various imaging technologies, such as CT and MRI scans, to diagnose illnesses or injuries. They also work closely with other physicians to interpret the results and develop comprehensive treatment plans for their patients. This specialty requires excellent problem-solving skills and attention to detail, as radiologists are responsible for identifying subtle abnormalities that could be indicative of serious health issues. Radiology is an incredibly complex yet rewarding field that offers plenty of job opportunities for those interested in it.

Psychiatry

For those interested in mental health, psychiatry is an incredibly rewarding specialty. Psychiatrists diagnose and treat mental health disorders using a variety of medical treatments, such as psychotherapy or medication. In addition to diagnosing and treating patients, psychiatrists also need to be able to provide compassionate care and support to those struggling with mental illness. This requires excellent communication skills, empathy, and the ability to build rapport quickly with their patients. Psychiatry is a demanding yet rewarding field that offers plenty of job opportunities for those who are up for the challenge.

Medicine is an incredibly broad and diverse field with many specializations that offer unique challenges and rewards. From cancer surgery to psychiatry, there are a variety of specialties to choose from depending on your interests and career goals. While all medical specialties require extensive training and dedication, they also provide incredibly rewarding opportunities that can help make a difference in people’s lives. No matter what specialty you choose, it will be a challenging but fulfilling journey as you embark on this noble profession.

Aga Khan University Hospital (AKU) and General Electric Healthcare (GE Healthcare) (www.GEHealthcare.com) hosted a PET CT and Cyclotron Symposium to drive dialogue on latest innovations and interventions in early cancer diagnosis and detection. The symposium was held to bridge the knowledge gap in the field. Aga Khan University Hospital (AKUH) in Nairobi has acquired an ultra-modern Positron Emission Tomography (PET) CT scanner and Cyclotron from GE Healthcare. No longer will people need to leave the region in order to benefit from its life-saving diagnostic capabilities. The acquisition of this highly specialised system by AKUH, reaffirms its premier status as the leading provider of quality clinical care, teaching and research in sub-Saharan Africa.

The symposium was attended by university faculty, radiologists and cancer specialists from the East Africa region. Key notes presentations were delivered by world renown Professor Gustav von Schulthess, Chairman and head of department of Medical Radiology at the University Hospital of Zurich and Professor Mansoor Saleh, Senior Scientist and Professor of Medicine in the Division of Hematology/Oncology in the University of Alabama at Birmingham USA. Professor Von Schulthess also hosted a webinar on The Impact of Molecular Imaging on Disease Evaluation Contents.

Aga Khan University (AKU) is committed to health professional education – from students in medicine, nursing and other health science professions and to the continuing education of health professionals in practice, supporting the building of health expertise in the region.

Professor Robert Armstrong Founding Dean, (AKU) Medical College in East Africa said “In addition to establishing the PET-CT service, we will establish in our hospital a new Department of Oncology that will provide a high quality integrated model of care that will be focused on continuous learning, developing and sharing best practice, and focused on the continuum of patient care. Closely linked to this will be a significant investment in creating a Centre for Oncology Research – ensuring that we are contributing to the development of research capacity in this field and that we can address the unique issues that present in the context of the communities of East Africa.”

The PET CT machine is a molecular imaging system that gives an accurate indication of the progress of the disease in its earliest stages. The clarity of this technology enables clinicians to confidently evaluate a patient’s response to cancer treatment, reducing on unnecessary procedures and cost of treatment.

President and CEO GE Africa and GE Healthcare, Africa Farid Fezoua said: “We are very happy to collaborate with the Aga Khan University Hospital to deliver the first PET CT and Cyclotron in Sub-Sahara Africa excluding South Africa, which will potentially impact over 800 million people. Today’s symposium is an important part in this huge milestone, to drive dialogue in the fight against cancer and equip healthcare professionals with knowledge in such advanced technologies.”

According to World Health Organisation, cancer is the second leading cause of death globally and 70% of deaths from cancer occur in low- and middle-income countries. About 70% of cancer patients don’t respond to their initial chemotherapy. Clear technology through PET CT and Cyclotron helps match the right therapy to the right patient, ensuring personalized care, and enabling clinicians to confidently evaluate a patient’s response to cancer treatment.

The PET CT and Cyclotron Symposium is part of GE Healthcare’s commitment to support education and training through leveraging its innovation and expertise in designing and running relevant courses in Healthcare. In 2016, GE inaugurated a healthcare training and skills institute in Kenya designed to train health professionals. Over 1,000 professionals have benefited from the institute since its launch. Recently, GE Healthcare also signed a partnership with the Society of Radiography in Kenya (SORK) to equip a minimum of 140 radiographers on the latest radiography technologies.

About the Aga Khan University:
Chartered in 1983, the Aga Khan University (www.AKU.edu) is a private, autonomous university that promotes human welfare through research, teaching and community service initiatives. Based on the principles of quality, access, impact and relevance, the university has campuses and programmes in Kenya, Tanzania, Uganda, the United Kingdom, Afghanistan and Pakistan. Its facilities include teaching hospitals, Faculties of Health Sciences with Schools of Nursing and Midwifery and Medical Colleges, Institutes for Educational Development, an Examination Board and an Institute for the Study of Muslim Civilisations. A Graduate School of Media and Communications, an East African Institute and an Institute for Human Development are under development while Faculties of Arts and Sciences are to be set up in Pakistan and East Africa. Through its needs-blind admissions policy, the University imbues the most promising leaders and thinkers of tomorrow with an ethic of service and the skills to help communities solve their most pressing challenges.

The Aga Khan University is one of nine agencies in the Aga Khan Development Network, a group of private development agencies with mandates ranging from health and education to architecture, culture, microfinance, rural development, disaster reduction, and the promotion of private-sector enterprise and the revitalisation of historic cities. www.AKU.edu

The report provides qualitative and quantitative insights into the market based on historic data and verifiable estimations. It examines key market indicators which include growth trends and technological improvements to determine the growth trajectory of the said market between 2016 and 2024.

The global physiotherapy services market is likely to rise at a significant pace over the coming years. Growing global geriatric population that suffers from ailments such as cardiovascular diseases, arthritis, and chronic pain account for maximum demand for physiotherapy services. This demographic also displays demand for palliative care which is extended via physiotherapy. According to the World Health Organization, the global geriatric population is expected to reach close to 2 billion by 2050, increasing from 547 million in 2010.

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Rising incidence of orthopedic disorders is likely to further accentuate the physiotherapy services market. Physical therapy is provided to patients who suffer from disabilities and impairments of mobility. Physical therapy helps improve quality of life coupled with increased functional ability of various body organs.

The global physiotherapy services market could be segmented on the basis of mode of treatment, area of specification, and geography. Depending upon mode of treatment, the global physiotherapy services market could be bifurcated into exercise, specialized treatments, manual therapy, and others. Manual therapy comprises massage, manipulation, and mobilization. Massage involves applying pressure on soft tissues of the body, thereby increasing blood circulation and muscle relaxation. Mobilization involves extending slow movement activities to patients to mobilize muscles.

Manipulation involves applying pressure on joints either manually or using machines to induce movement. Specialized treatments include wound care, vestibular rehabilitation, oncology therapy, decongestive lymphatic drainage, and pelvic health. Vestibular rehabilitation is effective among patients with vertigo. Pelvic health therapy is performed on patients with pelvic pain and urinary incontinence. Wound care therapy is provided to patients with slow wound healing due to poor blood circulation. Oncology therapy is provided to cancer patients for relief from painful therapeutics for cancer and to enhance quality of life.

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By area of specification, the global market for physiotherapy services could be segmented into orthopedic, cardiovascular and pulmonary, neurological, women’s health, geriatric, integumentary, pediatric, and palliative care. Among all, orthopedic and geriatric segments account for key revenue contribution to the overall market.

Leading players operating in the global physiotherapy services market are identified and profiled in this report. This includes AmeriCare Physical Therapy, Rehab Alternatives, Elam Sports Oahu, Meier & Marsh Physical Therapy, FullMotion Physical Therapy, and Minsu’s Healing Oasis among others.

Now, 100 years later, the world’s population has quadrupled, and global travel is much more common – two conditions that favor the spread of diseases. Using simple math and keeping all other factors equal, a similar pandemic could cause 80 to 200 million people to perish (one out of every 650 Americans). Some may naively counter that advances in medicine would prevent such a catastrophe, but our current influenza vaccines, therapeutics and diagnostics will likely not work well enough against a new strain of influenza virus to be very impactful.

Today’s vaccines target only circulating strains, and since the 2003-2004 flu season, the overall adjusted vaccine effectiveness has ranged from 10-60 percent, providing a modest to decent level of protection.   However, the yearly vaccine is not expected to protect us against a novel influenza virus. From a therapeutic perspective, the influenza drugs Tamiflu and Relenza only slightly lessen the severity of the disease and curtail the duration of symptoms by about one day when administered within 48 hours of symptoms onset.

Although these drugs have been shown to be effective on the currently circulating strains, there is no guarantee that they will work on the next pandemic strain. Further, our point-of-care diagnostics that are easy-to-use are all “closed-access” systems, which means that the manufacturers have pre-configured their tests to only detect currently circulating strains.

These technologies do not have the flexibility to be quickly modified to detect a novel strain. If these tests return a negative result, clinicians will be forced to send collected samples out for testing that can be customized using the expertise of a specialist. Such tests generally have a turn-around time of at least 24 hours – far too long for informing decisions in an emergency room setting.

In the event of a deadly outbreak, emergency rooms would be overwhelmed, and physicians would not be able to easily discriminate between the individuals who are in the early stages of being infected with the pandemic strain versus those who are infected with seasonal influenza, as the symptoms will likely be nearly identical. Once an ER becomes overcrowded, the pandemic virus will have an easier time infecting its next victims, and our emergency rooms will turn into depots for rapid viral spread.

Despite 100 years of preparation since the deadliest pandemic in humankind’s history, we still don’t have the tools to significantly reduce the impact of the next deadly influenza pandemic. Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Disease; Anne Schuchat, director of the CDC and Bill Gates have admirably been ringing this alarm bell for years. On the private side, The Coalition for Epidemic Preparedness Innovations (CEPI) – founded by the Bill & Melinda Gates Foundation, governments of India and Norway, medical research charity Wellcome and World Economic Forum – has $460 million in dedicated funding from private, public and philanthropic organizations.

These monies are being directed toward research to develop faster ways to make vaccines, because the current strategies are too slow. On the public side, this year’s influenza season has spurred some U.S. senators to propose legislation that would provide $1 billion over five years to the NIH for the development of a universal vaccine against influenza, which would be a significant increase over the $64 million that was awarded to researchers in 2017. Whether Congress approves such spending is yet to be determined, and these goals of developing vaccines that are more quickly manufactured or a universal vaccine / drug are extremely lofty. Even if millions to billions are injected for research, there is no guarantee of success. In fact, the chances of success are actually quite small, but this doesn’t mean that the pursuit is not worthy.

With all of the past support for better diagnostics, never has a government funding agency (e.g. NIH, NSF, BARDA, DARPA) or a private philanthropic group like CEPI released a significant funding announcement that requests the development of “open-access” diagnostics. It is time that this changed. Our best chance to successfully minimize the impact of the next pandemic is to start immediately funding the development of open-access diagnostics that are fully automated and could be placed at the point-of-care (POC).

Although the world is in desperate need of easy-to-use, open-access diagnostics, none have been commercialized yet. With that said, one is under development, and possibly other companies are in pursuit of the same goal. To be successful, the developed system needs to be designed largely foolproof so that the standard test for seasonal influenza (or other targeted pathogens) is not impacted if “pandemic mode” of the open-access system is activated.

Activating pandemic mode involves an end-user adding newly synthesized pandemics-specific reagents onto the instrument such that it can access these reagents to broaden its screening capability. The step of adding these reagents must be simple – ideally done in less than two minutes – by a single person who aseptically provides sufficient liquid reagents into an existing empty reservoir(s) for the automated instrument to access.

Ideally, this reservoir(s) is large enough to hold sufficient reagents so that the instrument can process hundreds – if not thousands – of samples before reagent replenishment becomes necessary. Once the reagent is added, other users of the instrument would not need to change how they interface with the instrument, aside from selecting “pandemic mode” on the instrument’s touch screen monitor to instruct it to use these newly added reagents for expanded screening.

To choose the base chemistry to be used in an open-access diagnostic instrument, it needs to be the TaqMan® PCR chemistry for numerous reasons. First, it is considered a gold standard chemistry and has been used in molecular diagnostics for over a decade. Second, there are numerous TaqMan reagent manufacturers, including Integrated DNA Technologies (IDT), LGC Biosearch Technologies, Thermo Fisher Scientific, Sigma-Aldrich, Bio-Rad Laboratories, Eurofin Genomics and Operon Technologies to name a few.

Any of these companies could provide pathogen-specific reagents for an open-access instrument that utilizes TaqMan chemistry. It is critical to understand this point, as open-access allows third parties to manufacture reagents for an instrument that’s made by a different company. This effectively reduces the bottleneck of relying on a single manufacturer to provide reagents to institutions in the event of a deadly virus emerging.

TaqMan chemistry is also low cost and can return results in about an hour, which is fast enough to inform quarantine decisions in an emergency room. TaqMan assays can be synthesized very quickly, and two of the top manufacturers could make sufficient reagents (e.g. 500 uL of a 10X assay) for every major hospital and medical clinic in the United States in three days. Lastly, these reagents can be easily shipped overnight at ambient temperature in a padded envelope to help achieve the goal of getting pandemic detection capabilities in a POC setting within two weeks of sequencing the newly emergent causative pathogen.

For open-access technology to be the most impactful, every hospital and sizable medical clinic needs to have an instrument in place, being used on a daily basis to detect common pathogens (not necessarily influenza). In the event of an outbreak, the CDC or an academic lab would determine the sequence of the new pathogen’s genetic code within one to two days. Bio-informaticists could use this information to design TaqMan assays that are specific for the pathogen’s genetic code in just a few hours.

The CDC would effectively bless these designs (and the FDA would provide emergency use authorization), and reagent manufacturers could begin synthesizing new TaqMan assays that are specific to the new pathogen. Hospitals that are running open-access instruments would order reagents from one of the many TaqMan reagent manufacturers, and they would likely receive these reagents within 48 hours and be successfully running pandemic-specific tests just minutes after delivery.

It is doubtful that any strategy can completely avert a pandemic since, by nature, these are generally worldwide events. However, now more than ever, the government needs to have the foresight to recognize the need for open-access technologies and provide a funding environment that encourages innovation in this area. We need to act now so that new technologies can be developed, penetrate the market and begin being used on a daily basis for the diagnosis of everyday pathogens. These instruments must be ready to go to work when the next new threats to humanity arise.

“Time is the enemy when it comes to sepsis, with the likelihood of death increasing by 8 percent for each hour that passes without treatment,” said Ginny Kwong, M.D., Vice President and Chief Medical Information Officer for Halifax Health. “Complicating early diagnosis is the need to aggregate data scattered across multiple clinical systems before it can be analyzed, and the results communicated to the point of care in a meaningful way.

“POC Advisor and Vocera integrate seamlessly into workflows to overcome these obstacles,” she continued, “quickly alerting our clinicians to a potential sepsis case so they can make the proper diagnosis and begin appropriate life-saving treatment to patients at the earliest, most treatable stages.”

Halifax Health is a two-hospital, 678-bed health system that is the largest medical provider in East Central Florida. A safety net hospital, Halifax is also one of the state’s busiest emergency departments, with more than 115,000 visits annually. Its goal in deploying a sepsis solution was to build upon the success of an internal campaign that resulted in a 33 percent improvement in mortality rates. They chose to implement POC Advisor because of its scientifically proven results, published patient outcomes and industry-leading precision and timeliness. Another key factor was interoperability with Halifax Health’s existing Electronic Health Record (EHR) and Vocera technology, making it easy for staff to use.

“At an average of nearly $19,000 per primary diagnosis, more than half of which is typically not reimbursed by Medicare, the financial cost of sepsis is staggering,” said Sean Benson, Vice President and General Manager of Specialized Surveillance at Wolters Kluwer Health. “At Halifax, POC Advisor analyzes more than 300 data points within a patient’s medical record to identify early signs of sepsis, warn caregivers of escalating risks and push evidence-based guidance to the point of care via the Vocera Badges and mobile apps that clinicians already use in their workflow. This results in faster diagnoses and treatment, which leads to reduced severity, decreased mortality and lower costs.”

POC Advisor is a clinical intelligence platform from Wolters Kluwer that aggregates, normalizes and analyzes patient data from disparate clinical systems to drive early detection with predictive accuracy. Real-time analytics leverage hundreds of rules built into the platform to account for possible comorbidities and medication abnormalities, enabling prescriptive alerts with unprecedented levels of sensitivity and specificity to warn clinicians of patient risks without alert fatigue. These findings, published in the Journal of American Medical Informatics Association, also revealed that POC Advisor cut sepsis mortality in half and reduced 30-day readmissions by 30 percent, while reducing length of stay.

The Vocera Badge is a hands-free, voice-controlled communication device that enables instant two-way and one-to-many conversations. It combines secure text messaging and alerting and enables voice calls with intelligent routing by name, role, group and availability.

“Many applications, technologies and devices have been implemented within hospitals and health systems, but they are used in silos. Too often, key connection points between these systems are missed. The integration between Vocera, POC Advisor and the EHR is helping Halifax Health extract key knowledge from each system, leverage platform functionality and share valuable information with the right clinicians at the right time with intelligent alerting,” said Rhonda Collins, MSN, RN, Chief Nursing Officer, Vocera. “It is a comprehensive and potentially life-saving assessment, detection and communication workflow that unfolds in less than one minute.”

About Vocera
The mission of Vocera Communications, Inc. is to simplify and improve the lives of healthcare professionals and patients, while enabling hospitals to enhance quality of care and operational efficiency. In 2000, when the company was founded, we began to forever change the way care teams communicate. Today, Vocera continues to offer the leading platform for clinical communication and workflow. More than 1,400 hospitals and health systems around the world have selected our solutions for care teams to text securely using smartphones or make calls with our hands-free, wearable Vocera Badge. Interoperability between Vocera and more than 120 clinical systems helps reduce alarm fatigue, speed up staff response times, and improve patient care, safety and experience. In addition to healthcare, Vocera is at home in luxury hotels, nuclear facilities, libraries, retail stores and more. Vocera makes a difference in any industry where workers are on the move and need to connect instantly with team members and access resources or information quickly.

About Wolters Kluwer
Wolters Kluwer N.V. is a global leader in information services and solutions for professionals in the health, tax and accounting, risk and compliance, finance and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.
Wolters Kluwer reported 2016 annual revenues of €4.3 billion. The company, headquartered in Alphen aan den Rijn, the Netherlands, serves customers in over 180 countries, maintains operations in over 40 countries and employs 19,000 people worldwide. Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry.

“Dubai Health Authority is on a mission to create a smart healthcare system and an important component of that vision is having an intelligent communication platform,” said Dr. Muna Tahlak, CEO Latifa Hospital. “The Vocera solution with its intuitive functionality to connect team members by role, name or group using voice or text aligns perfectly with our goal. The speed of connectivity will improve workflows and communication efficiency between nurses and doctors, which is critical for many of our patient cases like emergency c-sections.”

Latifa Hospital is well-known for its maternity services expertise and is a referral hospital for high-risk deliveries because of its sophisticated neonatal intensive care unit, fetomaternal services, and the pediatric surgery unit. A healthcare pioneer for almost 30 years, it is the oldest and largest maternity and pediatric government hospital in the emirate. Every year, approximately 6,000 deliveries take place at the hospital. In 2016, approximately 60,000 patients were seen in Latifa Hospital’s emergency department.

“With the insurance legislation coming through and more people being insured, we expect to see an increase in the number of patients we serve,” said Dr. Tahlak. “We need to have the right infrastructure in place, and a smart communication system is key to ensuring safe, high-quality patient care.”

Implementing an electronic health record (EHR) system is also part of the hospital’s expansion plan. Integration with the EHR and Vocera technology will help improve communication of critical lab results and other important information to the right clinicians at the right time on their device of choice.

“We are excited to support Latifa Hospital and be part of Dubai Health Authority’s mission to create a smart health system,” said Brent Lang, president and CEO of Vocera. “The combination of Latifa Hospital’s clinical expertise and an intelligent communication system is sure to transform the healthcare experience for patients, families and staff.”

About Latifa Women and Children Hospital
Latifa Hospital is a hospital for Women and Children. It is one of the largest maternity and children’s hospitals in the UAE and was built in 1987. The hospital was previously known as Al Wasl hospital and was renamed Latifa Hospital on the 4th of January, 2012 as per the orders of His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai to pay homage to the loving memory of his late mother Sheikha Latifa Bint Hamdan bin Zayed Al Nahyan. His Highness Sheikh Mohammed issued this directive on the sixth anniversary of his accession as the Ruler of Dubai. Latifa Hospital provides tertiary care for maternal and neonatal services including paediatric and neonatal surgery as well as treatment for genetic and metabolic issues. The hospital has a well-equipped Neonatal Intensive Care Unit and an expert team of health care professionals who provide international levels of neonatal, paediatric and maternal care. Visit www.dha.gov.ae/en/LatifaHospital for more information.

About Vocera
The mission of Vocera Communications, Inc. is to simplify and improve the lives of healthcare professionals and patients, while enabling hospitals to enhance quality of care and operational efficiency. In 2000, when the company was founded, we began to forever change the way care teams communicate. Today, Vocera continues to offer the leading platform for clinical communication and workflow. More than 1,400 hospitals and health systems around the world have selected our solutions for care teams to text securely using smartphones or make calls with our hands-free, wearable Vocera Badge. Interoperability between Vocera and more than 120 clinical systems helps reduce alarm fatigue, speed up staff response times, and improve patient care, safety and experience. In addition to healthcare, Vocera is at home in luxury hotels, nuclear facilities, libraries, retail stores and more. Vocera makes a difference in any industry where workers are on the move and need to connect instantly with team members and access resources or information quickly. Learn more at www.vocera.com, and follow @VoceraComm on Twitter.

The Vocera logo is a trademark of Vocera Communications, Inc. Vocera® is a trademark of Vocera Communications, Inc. registered in the United States and other jurisdictions. All other trademarks appearing in this release are the property of their respective owners.

Vocera Communications, Inc.
Shanna Hearon, 865-769-2028
shearon@vocera.com

“Our customers depend on Voalte Platform to ensure their care teams can communicate and collaborate efficiently,” said Trey Lauderdale, Voalte Founder and CEO. “This partnership with Lightning Bolt will add on-call schedules to desktop and mobile Voalte solutions, enabling staff to see who is available, and contact the appropriate person quickly via text message, phone call or pager.”

Independent research firm KLAS named Voalte No. 1 Secure Communications Platform, and Lightning Bolt No. 1 for Physician Scheduling in the 2017 Best in KLAS: Software & Services report.

“Efficient physician teams need efficient technology,” said Suvas Vajracharya, Founder and CEO of Lightning Bolt. “Voalte and Lightning Bolt are helping physicians securely communicate and coordinate, resulting in optimal care for patients and cost savings for health leaders. What could be more powerful than two No. 1 KLAS ranked technologies teaming up?”

About Voalte
Voalte develops smartphone solutions that simplify caregiver communication. Ranked number-one and named 2017 Category Leader in the Best in KLAS: Software & Services report for the Secure Communications Platform segment, Voalte is the only company to offer a comprehensive Mobile Communication Strategy that enables care teams inside and outside the hospital to access and exchange information securely. Founded in 2008, Voalte is a privately held company based in Sarasota, Florida. Voalte solutions are now available to more than 132,000 caregivers throughout the United States. For more information, visit voalte.com or follow @Voalte on Twitter.

About Lightning Bolt Solutions
Lightning Bolt Solutions is the leading provider of medical staff scheduling technology. Founded in 2002, the company has developed deep domain expertise in the areas of physician workflow, hospital operations, artificial intelligence, and professional balance. Lightning Bolt is the trusted solution for U.S. and international hospitals working to align the interests of their physicians and facilities to deliver excellent patient care. For more information, please visit http://www.lightning-bolt.com.

Named to “Health Care’s Most Wired ‘Advanced’” list by the American Hospital Association’s Health Forum and the College of Healthcare Information Management Executives (CHIME), Avera Health is an integrated health system based in Sioux Falls, serving South Dakota and surrounding areas of Minnesota, Iowa, Nebraska and North Dakota. Avera Health serves a population of nearly 1 million people through 33 hospitals, 208 primary and specialty care clinics, and 40 senior living facilities.

Candice Friestad, DNP, MSN, MBA, RN, Director of Clinical Informatics at Avera Health, will present the strategies and processes used to improve patient outcomes by integrating voice calls, text messaging, and alarm and alert notifications on one smartphone platform. Dr. Friestad will discuss how to smooth the discharge process to speed patient throughput, streamline the medication order process, and optimize alarm management to ensure patient safety. Register online for the free webinar.

About Voalte

Voalte develops smartphone solutions that simplify caregiver communication. Ranked number-one and named 2017 Category Leader in the Best in KLAS: Software & Services report for the Secure Communications Platform segment, Voalte is the only company to offer a comprehensive Mobile Communication Strategy that enables care teams inside and outside the hospital to access and exchange information securely. Founded in 2008, Voalte is a privately held company based in Sarasota, Florida. Voalte solutions are now available to more than 132,000 caregivers throughout the United States. For more information, visit voalte.com or follow @Voalte on Twitter.

About Zebra

With the unparalleled operational visibility Zebra (NASDAQ: ZBRA) provides, enterprises become as smart and connected as the world we live in. Real-time information – gleaned from visionary solutions including hardware, software and services – gives organizations the competitive edge they need to simplify operations, know more about their businesses and customers, and empower their mobile workers to succeed in today’s data-centric world. For more information, visit www.zebra.com or sign up for our news alerts. Follow us on LinkedIn, Twitter and Facebook.

About Avera Health

Avera is a regional health system comprised of 340 locations in 100 communities throughout central and eastern South Dakota and areas of four surrounding states. Avera serves a population of nearly 1 million throughout a geographical footprint of 72,000 square miles and 86 counties. Avera is the health ministry of the Benedictine Sisters of Yankton, South Dakota, and the Presentation Sisters of Aberdeen, South Dakota.

During childhood, an eye defect – such as one eye being out of focus – results in an abnormal signal to the brain. The neurons connected to the abnormal eye will themselves develop abnormally. The result: vision loss and poor depth perception. This is called amblyopia.

Therefore, amblyopia is a brain problem that presents as decreased visual acuity and poor depth perception. Affecting 3% to 5% of all children, amblyopia becomes permanent unless it is detected and treated early in life. Amblyopia is the primary cause of unilateral vision loss¹ and there is evidence that adults with amblyopia have reduced lifetime earnings, incur greater medical expenses, and are at increased risk of total blindness.² Indeed, amblyopia is a disease with consequences.

There are three causes of amblyopia. First, the eyes may be misaligned. This is called strabismus and is usually obvious. Second, there may be occlusion of one eye, with something blocking the image from entering the eye. More common examples are cataract and ptosis (droopy eyelid). Again, these are commonly evident or seen easily with exam instruments in the pediatrician’s office.

The third cause of amblyopia is the most common and, unfortunately, the most difficult to detect. When one eye is out of focus, this is called anisometropia. A blurred image from one eye causes amblyopia just as surely as strabismus or a cataract will. The hard part: It is impossible to know whether anisometropia is present unless it is tested for.

Ideally, vision screening begins shortly after birth. Newborns should be evaluated for cataracts and the front of the eye examined with a penlight. See the sidebar for a recommended schedule for ocular and vision screening from the American Association for Pediatric Ophthalmology and Strabismus. The gold-standard exam is having the child read an eye chart. If the child can tell us what they see, then we know whether there is a problem.

Many 4-year-olds can cooperate with reading a chart, but some cannot. And what about younger children or those with intellectual and cognitive problems who will never read a chart? How can we determine whether they are at risk of developing or currently have amblyopia? For these populations instrument-based vision screening is effective and very useful. The American Academy of Pediatrics (AAP) issued a Policy Statement in 2012 addressing this³

Screening for amblyogenic refractive error with instrument-based screening is not dependent on behavioral responses of children, as when visual acuity is measured. Instrument-based screening is quick, requires minimal cooperation of the child, and is especially useful in the preverbal, preliterate, or developmentally delayed child. Children younger than 4 years can benefit from instrument-based screening, and visual acuity testing can be used reliably in older children.

Earlier detection results in better outcome at lower cost. For this reason, all science-based professional organizations (such as AAPOS, AAP, NEI, etc.) recommend early and frequent vision screenings beginning as early in life as possible.

“Photoscreening and handheld autorefraction may be electively performed in children 6 months to 3 years of age, allowing earlier detection of conditions that may lead to amblyopia, as well as in older children who are unable or unwilling to cooperate with routine acuity screening,” the AAP stated³

MANAGEMENT

Amblyopia can be reversed and even cured by forcing the brain to use the amblyopic eye. This involves temporarily making the “good eye” see worse than the amblyopic eye. Once the brain accepts images from both eyes equally well there is no further need for treatment. The most common methods of treating amblyopia are to A) put a patch over the “good eye” or B) to use an eye drop (atropine) that blurs the “good eye.” There are specific indications for these therapies but both essentially force the brain to use the amblyopic eye.

Treatment should start as early in life as possible. The earlier in life that amblyopia treatment begins, the earlier it will end and the less expensive it will be⁴. The brain is much more “plastic” when it is younger and most children respond very well until around 7 to 9 years. That said, recent evidence demonstrates treatment can still be very effective until 12 years and somewhat effective until 16 years.⁵

Reference

1. Multi-ethnic Pediatric Eye Disease Study Group. Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months the multi-ethnic pediatric eye disease study. Ophthalmology. 2008;115(7):1229-1236.e1.
2. Hatt SR, Leske DA, Kirgis PA, et al. The effects of strabismus on quality of life in adults.
Am J Ophthalmol. 2007;144(5):643-647.
3. Miller JM, Lessin HR for the American Academy of Pediatrics Section on Ophthalmology. Instrument-based pediatric vision screening policy statement.
Pediatrics. 2012;130(5):983-986.
4. Membreno JH1, Brown MM, Brown GC, et al. A cost-utility analysis of therapy for amblyopia. Ophthalmology. 2002;109(12):2265-2271.
5. Holmes JM, Lazar EL, Melia BM. Effect of age on response to amblyopia treatment in children. Arch Ophthalmol. 2011;129(11):1451-1457.