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Bed-er Bed Rules
"Bed-er" Bed Rules

What is insomnia? Insomnia means “difficulty sleeping”. It is important to know that this can include more than just trouble falling asleep.

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'All Bahamians' List Grows By 19

A number of young Bahamians are about to be recognized for their work in athletics as well as in the classroom. For the fourth consecutive year, the Parents Association, under the umbrella of the Bahamas Association of Athletic Associations (BAAA), will honor young deserving Bahamian student-athletes. On Friday evening, 19 junior athletes, inclusive of all three Bahamian World Youth Champions, will be recognized for their hard work, at Government House. The 19 young adults represent the biggest class of All-Bahamians to be honored. President of the Parents Association, Harrison Petty, said it is a direct indication that the program is growing and athletes are beginning to take academics more seriously.

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'Crazy' Customs duties harming medical costs


Tribune Business Editor

Doctors Hospital Health Systems' chief executive told Tribune Business that he hoped the increasing interest in the Bahamas as a medical tourism destination could reduce the cost of healthcare supplies, describing as "crazy" the amount of Customs duties levied on imported equipment.

Charles Sealy said the cost of medical supplies and equipment elevated the cost of installing and setting-up the hospital's MRI unit from an initial budget of $1.1 million to $2.7 million when everything was completed.

"There's ways to reduce costs, and reduce the cost to the Bahamian public," Mr Sealy said, adding that given the ever-intensif ...

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'Extremely risky' to implement NHI without data system

A Canadian company bidding to provide an integrated health information system in The Bahamas said it could be "extremely risky" for the government to forge ahead with National Health Insurance (NHI) without having such an "informatics" system in place, arguing that it would enable much-needed accuracy in forecasting the likely costs involved.
Populus Global Solutions (PGS), a Fredericton, Canada-based company, provides a software product called ACSIS, which aims to allow governments to harness the power of the vast quantities of data arising from interactions between patients and their physicians as well as correspondences between physicians and other entities such as pharmacies, labs and hospitals.
In doing so, it intends to allow this data to be collected on a more timely basis and utilized more easily for evidence-based decision making by those in the health sector.
Populus Global Solutions is currently participating in a request for proposal (RFP) issued by the Public Hospitals Authority last year. The company's CEO, Tristan Rutter, said that implementing these types of "health informatics" in The Bahamas could have a major impact on the success of the roll-out of an NHI plan, such as the one which the Bahamas government has indicated to move ahead with in 2016. Rutter also believes the implementation could encourage better cost control.
This, he suggested, is due to the more informed forecasting it could enable and the ability of the system to contribute to reducing the incidence of serious disease that would require most costly healthcare interventions.
"The ideal, particularly as The Bahamas gets closer to the ideal of a National Health Insurance scheme, is that the more comprehensive and accurate the total data set is, the more reliable the forecasting on National Health Insurance will be. A lot of people would say health informatics is the penicillin of our generation: the notion is there is no miracle cure in the pipeline, sadly, to fix everything that ails us...(so) the next step for us is about using better data to deliver more quality services."
PGS states that it aims to achieve three core objectives: improving public access to the healthcare system, improving health outcomes, and enhancing fiscal efficiency - essentially value for money spent by the government and the public on healthcare in both the public and private system.
"In The Bahamas, I can see a topline of, I think, somewhere in the region of $300 million spent a year in the public sector and I think there's a number not far off that in the private sector. When the government looks at that, the question is, 'How are we doing?' We know costs are going up and know more and more people are getting more things like hypertension and diabetes.
"So when you start to look at National Health Insurance plans, the risk with it is if you are going to get into this type of program - and there's all types of reasons why you should - it becomes extremely risky if we don't know what is most likely to happen, if you don't know what is the biggest threat to the
health sector. As you move into a NHI system, that's the kind of data you need to know. With NHI you say you are going to create a basket of services, based on certain conditions, to be offered to certain qualified residents. Depending on which services you put in or take out, depending on how citizens qualify or don't, the price of the system goes up and down.
"The key point is at some point you're going to say we're going to have a consumption tax or a payroll tax or whatever it is (and) the government or tax payer needs to know are we putting the right amount in the piggybank to match the basket of services. Trying to manage it without the appropriate information is an extremely difficult task."
Clinical encounter
The ACSIS system enables the gathering and sharing of information among segments of the healthcare infrastructure, starting with the first visit to the doctor/clinician.
"It all comes down to that transaction which is that clinical need the ability to aggregate that data in support of evidence-based decision making," said Rutter.
Each patient will be assigned an electronic record and, once a patient sees a doctor, information can be automatically transmitted to the pharmacist, to the drug dispensary and the lab, with appropriate privacy safeguards, PGS asserts.
Consequently, comprehensive data is gathered, which can share the types of illnesses that are being diagnosed and at what levels, as well as how they are being treated and to what effect; this information can be analyzed to facilitate more strategic and effective policy-making, Rutter suggested.
The company has rolled its system out in St. Lucia, St. Vincent and the Grenadines and Belize, and will do so in Barbados in the next 12 months.
Rutter said: "Belize went live in 2007 and they've proven they've improved access. People have got healthier and they've saved money. The biggest thing is that the World Health Organization has essentially said that what Belize has done is trade very expensive hospital care for inexpensive community-based care. So when we get ahead of these chronic non-communicable diseases, like diabetes, we can detect these conditions and keep people on their treatment protocol.
"Belize had hypertension as the third-highest cause of death in 2007; by 2011 it was the 12th; they saw fast results."
Evidence in the International Journal of Medical Informatics supports the company's contention the implementation of the "Belize integrated patient-centered country-wide health information system" (BHIS) appears to have had an impact on mortality and been related to the stabilization of healthcare expenditures in that country.
"Hypertension-related deaths dropped from first cause of death in 2003 to ninth by 2010. Public expenditures on healthcare steadily rose until 2009 but then declined slightly for the next three years. Conclusion: For modest investment, BHIS was well accepted nationwide and, following deployment, mortality in the eight BHIS disease management algorithm domains declined significantly and expenditures on public healthcare stabilized.
"The BHIS is more than an electronic medical record or health information system but rather is an electronically facilitated health improvement system with feed forward loops (embedded patient management algorithms) to assist health care providers in making better care decisions and feedback program review loops to assist health system managers to make better health care system decisions," states the report in the journal.
It adds that the program was implemented in 2007 at a cost of $4 per citizen. In Barbados, the company will roll out the project for (U.S.) $2 million.
'Costs went flat'
Rutter said: "We put it in [Belize] in 2007, by 2009 costs went flat and stayed there for three to four years. If you were to look at that and say what happened if they stayed in the previous trend, costs would've gone up by about 25 percent. Realistically it's about whether we can make people healthier and slow down these major cost escalations."
He added: "The Bahamas is at a really interesting point as you start to contemplate this scheme. You are not alone in that, but you are going to make some big decisions that you'll live with for an awfully long time. If done right, I think it can be remarkably successful. But everyone needs to be responsible."

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'Great need' for autism awareness in The Bahamas


Tribune Features Reporter

A LOCAL doctor is encouraging people to unite and work together in an effort to raise awareness about autism in The Bahamas.

Dr Michelle Major, who began her career in the field of autism as an inclusion teacher and a verbal behaviour therapist for children with autism, said awareness of the neurological disorder in The Bahamas, and indeed the Caribbean, is limited.

The Bahamas, she said, is in need of early intervention, early identification and adult training programmes, just to name a few initiatives.

With her experience of speaking on autism at international forums, Dr Major said in her view government support is essential in helping children ...

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'Help my son to walk again'
'Help my son to walk again'

A Mother is making an emotional plea for help with her paralysed son’s physical rehabilitation.

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'Help our little girl to defeat cancer'

SINCE last November, five-year-old Zion Knowles has needed 16 different types of medication at a cost of $4,679.75 each month to prevent a leukaemia relapse...

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'I should not be loved'

At 22 years of age, a time when Jane Doe (as she prefers to be called) should be living the carefree life of a young adult, she is consumed by the fact that she doesn't think she should be loved; and she says she does not want to have children.  It's all because she's HIV positive.

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'If this had happened to me inNew York, I would have died'

EDITOR, The Tribune.

This letter is about a gift of life given to my family by the doctors (private and government), nurses at the Rand ICU and the remarkable EMS in Freeport.

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'Major Pain' lands 20th win

A quick left, followed by a right and three upper cuts were just one combination of blows used by Meacher 'Major Pain' Major in his six-round boxing bout on Saturday, in the King of the Ring Series.
The series of punches would push his opponent Jeff Skyler to the ropes, giving him room to go to work. Major would deliver two quick jabs to the forehead, a right to the jaw before Skyler stumbled off the ropes. Just as he was gathering his footing, Major struck again with a couple of body shots forcing Skylar to 'drop his guard'. The left-hook to the nose would be the last Major would get off the 46-year old. Although it was not the technical knockout (TKO) blow Major would have liked to delivered, it was enough to wound his opponent.
The medical doctor was called to Skyler's corner, in between the third and fourth rounds, to exam the two cuts received. After a close look, it was ruled safe for Skyler to continue on. With the sound of the bell. Skyler got to his feet, danced around and motioned for Major to 'bring it on'. He avoided Major on a few occasions by 'bobbing and weaving' but forgot to protect his face. When Major did catch up with him, a blow to the right eye, sent him flying to the ropes. The referee, who stepped in for a quick exam sent Skyler back to his corner, motioning for the medical doctor to come. The referees had no choice but to end the match. Skyler was bleeding profusely at this time from his mouth and two cuts.
"It feels great," said Major who thanked the Almighty God, fight fans, family and all who were involved in making the event a success. "Now that I am 20-4 things are looking pretty bright from here on. It was great [the fight]. I never took him lightly. Like I said, people would say you are fighting this old guy but you are never too old in the sport of boxing because former world champions like George Foreman, Bernard Hopkins they are still beating the young fellows. So I am grateful that he came down and took the fight on short notice, due to the few cancelations that I had. I am most grateful for this victory, like I said things look bright for the future.
"Now that I have this victory my management team back in Buffalo will try to get me back into the ratings again, and hopefully I will try and fight for the NABA title - comeback eliminator come March 31, in Buffalo."
Saturday's fight is the first for Major this year. The young boxer is eyeing the British Commonwealth title but needed one more match under his belt to be a viable contender. With a win-loss record of 20 (KO 17) and 4 (KO 2) losses, Major will return to Buffalo to train. He is hoping to improve on his speed and power before stepping into the ring.
In the bout on Saturday, Major set the pace early. Even though he gave up a few hits, he had great foot work and controlled the fight from the opening bell. He thanked the fight fans for giving him the energy.
He said: "I had a chance where I could have stopped him earlier in the round, but my trainer told me it made no sense putting in all that hard work, that I should put on a great show for the fight fans. I really put on a great show. I was really surprised by the way he came out tonight really fighting and really in great shape.
This is not the first time Skyler and Major have met in the ring. Major scored a knockout victory, in the second round.
Skyler said: "I got two days notice for this fight. I am 46-years old and I said let's go. Prepare for what? I didn't have time. I am not making up any excuses. He is young. He won and that is life. But for two days notice......
"I am going to fight for the crowd win or lose, I am here to fight. He won, he knocked me down. He didn't really stop me. Cuts are a part of life. But I didn't quit. I would have kept going if I could and he saw that. At 46-years old I have already won. How many guys at 46 can do this? This kid can fight."

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