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This can be achieved through a combination of:

Improving the work organization and the working environment
Promoting active participation of employees in health activities
Encouraging personal development
Workplace health promotion is seen in the EU network Luxembourg Declaration as a modern corporate strategy which aims at preventing ill-health at work and enhancing health promoting potential and well-being in the workforce. Documented benefits for workplace programs include decreased absenteeism, reduced cardiovascular risk, reduced health care claims, decreased staff turnover, decreased musculoskeletal injuries, increased productivity, increased organizational effectiveness and the potential of a return on investment.

However, many of these improvements require the sustained involvement of employees, employers and society in the activities required to make a difference. This is achieved through the empowerment of employees enabling them to make decisions about their own health. Occupational Health Advisors (OHA) are well placed to carry out needs assessment for health promotion initiatives with the working populations they serve, to prioritize these initiatives alongside other occupational health and safety initiatives which may be underway, and to coordinate the activities at the enterprise level to ensure that initiatives which are planned are delivered. In the past occupational health services have been involved in the assessment of fitness to work and in assessing levels of disability for insurance purposes for many years.

The concept of maintaining working ability, in the otherwise healthy working population, has been developed by some innovative occupational health experiencenissanleaf services. In some cases these efforts have been developed in response to the growing challenge caused by the aging workforce and the ever-increasing cost of social security. OHA’s have often been at the forefront of these developments.

There is a need to develop further the focus of all occupational health services to include efforts to maintain work ability and to prevent non-occupational workplace preventable conditions by interventions at the workplace. This will require some occupational health services to become more pro-actively involved in workplace health promotion, without reducing the attention paid to preventing occupational accidents and diseases. OHA’s, with their close contact with employees, sometimes over many years, are in a good position to plan, deliver and evaluate health promotion and maintenance of work ability interventions at the workplace.

Health promotion at work has grown in importance over the last decade as employers and employees recognize the respective benefits. Working people spend about half of their non-sleeping day at work and this provides an ideal opportunity for employees to share and receive various health messages and for employers to create healthy working environments. The scope of health promotion depends upon the needs of each group.

Some of the most common health promotion activities are smoking reducing activities, healthy nutrition or physical exercise programs, prevention and abatement of drug and alcohol abuse.

However, health promotion may also be directed towards other social, cultural and environmental health determinants, if the people within the company consider that these factors are important for the improvement of their health, well-being and quality of life. In this case factors such as improving work organization, motivation, reducing stress and burnout, introducing flexible working hours, personal development plans and career enhancement may also help to contribute to overall health and well-being of the working community.

The Healthy Community setting In addition to occupational health and workplace health promotion there is also another important aspect to Workplace Health Management. It is related to the impact that each company may have on the surrounding ambient environment, and through pollutants or products or services provided to others, its impact on distant environments. Remember how far the effects of the Chernobyl Nuclear accident in 1986 affected whole neighbouring countries.

Although the environmental health impact of companies is controlled by different legislation to that which applies to Health and Safety at work, there is a strong relationship between safeguarding the working environment, improving work organization and working culture within the company, and its approach to environmental health management.

Many leading companies already combine occupational health and safety with environmental health management to optimally use the available human resources within the company and to avoid duplication of effort. Occupational health nurses can make a contribution towards environmental health management, particularly in those companies that do not employ environmental health specialists.

Defining a Health Information Exchange

The United States is facing the largest shortage of healthcare practitioners in our country’s history which is compounded by an ever increasing geriatric population. In 2005 there existed one geriatrician for every 5,000 US residents over 65 and only nine of the 145 medical schools trained geriatricians. By 2020 the industry is estimated to be short 200,000 physicians and over a million nurses. Never, in the history of US healthcare, has so much been demanded with so few personnel. Because of this shortage combined with the geriatric population increase, the medical community has to find a way to provide timely, accurate information to those who need it in a uniform fashion. Imagine if flight controllers spoke the native language of their country instead of the current international flight language, English. This example captures the urgency and critical nature of our need for standardized communication in healthcare. A healthy information exchange can help improve safety, reduce length of hospital stays, cut down on medication errors, reduce redundancies in lab testing or procedures and make the health system faster, leaner and more productive. The aging US population along with those impacted by chronic disease like diabetes, cardiovascular disease and asthma will need to see more specialists who will have to find a way to communicate with primary care providers effectively and efficiently.

This efficiency can only be attained by standardizing the manner in which the communication takes place. Healthbridge, a Cincinnati based HIE and one of the experiencenissanleaf largest community based networks, was able to reduce their potential disease outbreaks from 5 to 8 days down to 48 hours with a regional health information exchange. Regarding standardization, one author noted, “Interoperability without standards is like language without grammar. In both cases communication can be achieved but the process is cumbersome and often ineffective.”

United States retailers transitioned over twenty years ago in order to automate inventory, sales, accounting controls which all improve efficiency and effectiveness. While uncomfortable to think of patients as inventory, perhaps this has been part of the reason for the lack of transition in the primary care setting to automation of patient records and data. Imagine a Mom & Pop hardware store on any square in mid America packed with inventory on shelves, ordering duplicate widgets based on lack of information regarding current inventory. Visualize any Home Depot or Lowes and you get a glimpse of how automation has changed the retail sector in terms of scalability and efficiency. Perhaps the “art of medicine” is a barrier to more productive, efficient and smarter medicine. Standards in information exchange have existed since 1989, but recent interfaces have evolved more rapidly thanks to increases in standardization of regional and state health information exchanges.

History of Health Information Exchanges

Major urban centers in Canada and Australia were the first to successfully implement HIE’s. The success of these early networks was linked to an integration with primary care EHR systems already in place. Health Level 7 (HL7) represents the first health language standardization system in the United States, beginning with a meeting at the University of Pennsylvania in 1987. HL7 has been successful in replacing antiquated interactions like faxing, mail and direct provider communication, which often represent duplication and inefficiency. Process interoperability increases human understanding across networks health systems to integrate and communicate. Standardization will ultimately impact how effective that communication functions in the same way that grammar standards foster better communication. The United States National Health Information Network (NHIN) sets the standards that foster this delivery of communication between health networks. HL7 is now on it’s third version which was published in 2004. The goals of HL7 are to increase interoperability, develop coherent standards, educate the industry on standardization and collaborate with other sanctioning bodies like ANSI and ISO who are also concerned with process improvement.

In the United States one of the earliest HIE’s started in Portland Maine. HealthInfoNet is a public-private partnership and is believed to be the largest statewide HIE. The goals of the network are to improve patient safety, enhance the quality of clinical care, increase efficiency, reduce service duplication, identify public threats more quickly and expand patient record access. The four founding groups the Maine Health Access Foundation, Maine CDC, The Maine Quality Forum and Maine Health Information Center (Onpoint Health Data) began their efforts in 2004.

In Tennessee Regional Health Information Organizations (RHIO’s) initiated in Memphis and the Tri Cities region. Carespark, a 501(3)c, in the Tri Cities region was considered a direct project where clinicians interact directly with each other using Carespark’s HL7 compliant system as an intermediary to translate the data bi-directionally. Veterans Affairs (VA) clinics also played a crucial role in the early stages of building this network. In the delta the midsouth eHealth Alliance is a RHIO connecting Memphis hospitals like Baptist Memorial (5 sites), Methodist Systems, Lebonheur Healthcare, Memphis Children’s Clinic, St. Francis Health System, St Jude, The Regional Medical Center and UT Medical. These regional networks allow practitioners to share medical records, lab values medicines and other reports in a more efficient manner.

Seventeen US communities have been designated as Beacon Communities across the United States based on their development of HIE’s. These communities’ health focus varies based on the patient population and prevalence of chronic disease states i.e. cvd, diabetes, asthma. The communities focus on specific and measurable improvements in quality, safety and efficiency due to health information exchange improvements. The closest geographical Beacon community to Tennessee, in Byhalia, Mississippi, just south of Memphis, was granted a $100,000 grant by the department of Health and Human Services in September 2011.

A healthcare model for Nashville to emulate is located in Indianapolis, IN based on geographic proximity, city size and population demographics. Four Beacon awards have been granted to communities in and around Indianapolis, Health and Hospital Corporation of Marion County, Indiana Health Centers Inc, Raphael Health Center and Shalom Health Care Center Inc. In addition, Indiana Health Information Technology Inc has received over 23 million dollars in grants through the State HIE Cooperative Agreement and 2011 HIE Challenge Grant Supplement programs through the federal government. These awards were based on the following criteria:1) Achieving health goals through health information exchange 2) Improving long term and post acute care transitions 3) Consumer mediated information exchange 4) Enabling enhanced query for patient care 5) Fostering distributed population-level analytics.

Regulatory Aspects of Health Information Exchanges and Healthcare Reform

The department of Health and Human Services (HHS) is the regulatory agency that oversees health concerns for all Americans. The HHS is divided into ten regions and Tennessee is part of Region IV headquartered out of Atlanta. The Regional Director, Anton J. Gunn is the first African American elected to serve as regional director and brings a wealth of experience to his role based on his public service specifically regarding underserved healthcare patients and health information exchanges. This experience will serve him well as he encounters societal and demographic challenges for underserved and chronically ill patients throughout the southeast area.

The National Health Information Network (NHIN) is a division of HHS that guides the standards of exchange and governs regulatory aspects of health reform. The NHIN collaboration includes departments like the Center for Disease Control (CDC), social security administration, Beacon communities and state HIE’s (ONC).11 The Office of National Coordinator for Health Information Exchange (ONC) has awarded $16 million in additional grants to encourage innovation at the state level. Innovation at the state level will ultimately lead to better patient care through reductions in replicated tests, bridges to care programs for chronic patients leading to continuity and finally timely public health alerts through agencies like the CDC based on this information.12 The Health Information Technology for Economic and Clinical Health (HITECH) Act is funded by dollars from the American Reinvestment and Recovery Act of 2009. HITECH’s goals are to invest dollars in community, regional and state health information exchanges to build effective networks which are connected nationally. Beacon communities and the Statewide Health Information Exchange Cooperative Agreement were initiated through HITECH and ARRA. To date 56 states have received grant awards through these programs totaling 548 million dollars.

Why are Americans so worked up about health care reform? Statements such as “don’t touch my Medicare” or “everyone should have access to state of the art health care irrespective of cost” are in my opinion uninformed and visceral responses that indicate a poor understanding of our health care system’s history, its current and future resources and the funding challenges that America faces going forward. While we all wonder how the health care system has reached what some refer to as a crisis stage. Let’s try to take some of the emotion out of the debate by briefly examining how health care in this country emerged and how that has formed our thinking and culture about health care. With that as a foundation let’s look at the pros and cons of the Obama administration health care reform proposals and let’s look at the concepts put forth by the Republicans?

Access to state of the art health care services is something we can all agree would be a good thing for this country. Experiencing a serious illness is one of life’s major challenges and to face it without the means to pay for it is positively frightening. But as we shall see, once we know the facts, we will find that achieving this goal will not be easy without our individual contribution.

These are the themes I will touch on to try to make experiencenissanleaf some sense out of what is happening to American health care and the steps we can personally take to make things better.

A recent history of American health care – what has driven the costs so high?
Key elements of the Obama health care plan
The Republican view of health care – free market competition
Universal access to state of the art health care – a worthy goal but not easy to achieve
what can we do?
First, let’s get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher?

To begin, let’s turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time!

Let’s skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a “wait and see” approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions.

This very basic review of American medical history helps us to understand that until quite recently (around the 1950’s) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; “nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual.

What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today.

I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor’s offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the “perfect storm” for higher and higher health care costs. And by and large the storm is only intensifying.

Introduction: We’re Not #1

I believe Americans need a new way of thinking about health. Look where our current perspectives on the subject have gotten us – we are last among the world’s 17 most industrialized nations in all the key indicators of health. It’s hard to believe but true: we’re last in life expectancy; we have the highest rates of obesity, infant mortality, low birth weights, heart disease, diabetes, chronic lung disease, homicide rates, teen pregnancy and sexually transmitted diseases.

The lead author of the Institute of Medicine, NIH sponsored study that revealed this situation remarked that “Americans get sicker, die sooner and sustain experiencenissanleaf more injuries than people in all other high-income countries.” (That’s a quote from the report.) Then he added this coup de grace: “We were stunned by the propensity of findings all on the negative side – the scope of the disadvantage covers all ages, from babies to seniors, both sexes, all classes of society. If we fail to act, life spans will continue to shorten and children will face greater rates of illness than those in other nations.”

Two Ways to Think of Health

I believe Americans are overly passive about their health. Good health can only be attained and maintained by conscious deeds. These deeds require planning and disciple. Examples include exercising regularly and vigorously, dining in ways that nourish the body without causing problems and otherwise behaving in positive, active ways.

The level of health you will enjoy is clearly affected by your lifestyle choices. Your health status depends to a great extent on whether you invest in your well being or not. If you make little or no such investments, your health will depend on chance, genetics, the aging process and the timeliness of the quality of medical care you receive.

If, on the other hand, you do invest, if you seek, protect and defend an advanced state of well being, the nature of the health status you will have will be dramatically different – and better.

Therefore, we need to distinguish these two kinds of health situations – one passive, one active.

The Institute of Health report that places America last reflects that segment of America that is passive. If the quite small segment of the American population that practices active health were separated, if their health data were compiled and compared, I’m sure we would be #1.

For these and related reasons, I propose we view health in two different ways – by making a distinction between static health – which is how most view and approach their health, and earned health. The latter is what you get when you invest wisely in your own well being.

It’s a way of life I call REAL wellness.

Health As Currently Perceived

The WHO definition of health is unrealistic (nobody, not even the most devout wellite, enjoys “complete physical, mental and social well-being,” at least not every day). Most think of health in far less exalted ways. Most think they are well if they are not sick. This is pathetic. It equates with not needing immediate medical attention. For the vast majority, this is a “good enough” view of health. Thinking that way is a self-fulfilling prophesy. It means that not healthy is the best you can hope for. This is the static definition of health and it must be reformed and at least accompanied by another, comparison perspective for those Americans willing to do their part. That would be earned health.

I think we need ideas about health that remind people of a key fact, namely, that a passive situation is not as effective, desirable, protective or rewarding as a dynamic earned state of health. We should all be aware that static health, the default setting you get for just existing and doing nothing special to enhance health, can and must be reinforced and boosted.

Employing a term like earned health might remind people that health can be much more than non-illness. The term earned health can signal the availability of a richer level of well being. It can remind everyone that health at its best is more than a static condition. Health is a dynamic state; it gets better with effort, worse if ignored.

Earned health represents a higher health standard. Earned health is more ambitious and more consistent with a REAL wellness mindset and lifestyle than the current norm of health as non-sickness.

Check Out This Solid Advice To Improve Your Acne

Acne is an embarrassing problem. You can have control of your breakouts, even though at times it seems impossible. There are many natural remedies that work just as well as medications, sometimes better. Sometimes your body just needs proper skin care and the right nutritional balance to help acne go away for good. Take a look at these great hints.

A paste of nutmeg and milk makes an effective treatment for acne. Combine ground nutmeg with some room temperature milk until it forms a paste. Apply this to the areas affected by acne and leave it on overnight. Often the acne will disappear quickly and without leaving unsightly marks on your face.

If you want to get clear skin and feel your best during the day, try to get eight hours of sleep at the minimum. Sleep is essential for healthy skin, as it helps to replenish your body with the nutrients that it lost during the day, while reducing stress and anxiety.

Reduce stress in your life so that you are able to maximize the benefits that you’ll see from your anti-acne efforts. Emotional and physiological stress are common reasons behind breakouts. Physiological stress, such as an illness, can leave the body dehydrated, leaving less water for your skin to use to purge toxins. Emotional stress can wreak havoc on your internal systems, making you more susceptible to breakouts.

Do not pick at or squeeze blackheads, instead use a special blackhead cleaner and wash your face often. This will keep you from getting scars and help clear the acne scarf blackheads in the long run. There are many different brands of blackhead cleaning products available that will make your skin look its very best.

Cut back on coffee. Some studies show that coffee, with or without caffeine, stimulates cortisone production. This can cause acne to flare up or get worse. Instead of coffee, try drinking either green or white tea. If you feel stressed out you should completely stop drinking coffee until your acne clears up.

To help your skin resist and recover from acne, avoid using hair care products with excessive liquid residue. These residues tend to drip or spatter on the face, where they can clog pores and contribute significantly to acne infections. Minimize the amount of product you use. Switch to lighter products, or consider forgoing such products entirely.

If you have problems with pimples, try using a honey mask one to two times per week. The natural antibacterial properties of honey can kill bacteria, which helps prevent infection as well as giving your immune system less work to do, so it can clear up your acne faster. Honey is also thought to contain nutrients that are essential for healing, and it may even reduce pain.

If your breakouts are not severe, or do not cover your entire face, then the best option for treatment would be spot treatment. Using an over the counter cream or gel with benzoyl peroxide, sulfur, or salicylic acid have typically shown the best results. These ingredients will dry out the affected area and leave the rest of your skin hydrated.

If you are trying to get rid of acne, you do not want to stay in the sun too long. This will cause cells to die and create more blockage in your pores. One way to prevent this is to wear some kind of protective head gear like a hat.

To help make sure you don’t suffer from acne breakouts, you should exfoliate your skin. When you exfoliate you are removing the build-up of dead skin cells, which are one of the causes of acne breakouts. A daily exfoliation will keep your skin soft and smooth, brighten your complexion and make your skin less prone to breakouts.

If you have acne, you need to make sure that you treat your infected skin very gently. If you try to squeeze and hurt your face roughly, then you may cause permanent damage to your face. The skin where acne forms is very sensitive, so it is important that you treat it so.

New acne-fighting gadgets that are on the market, claim to quickly and effectively eliminate acne within hours. While these devices have been proven to treat acne, at over $100 each, they are overpriced and unnecessary. Especially is this the case when you find out that these machines work simply by directing intense heat at the offending blemish.

An important tip to consider when concerning acne is to make every attempt to not touch your face throughout the day. This is important because your hands typically will carry dirt, oil and bacteria on them, at any given time. Try to use a tissue, if you do need to scratch or rub an area of your face, if you are not able to wash your hands first.

Acne not only affects teenagers but also affects adults as well. While some teens with acne may notice acne disappear as they enter adulthood, for other teens, it may continue unabated into adulthood while for others who may never have had acne in their teens, they may suddenly develop adult acne. Acne is the most common skin condition and before we look into how to stop acne, we need to get an understanding of this common skin condition.

What is Acne?

Acne vulgaris as mentioned previously is one of the most common skin conditions that affects people all over the world (over 80 percent of people). Acne represents the appearance of small raised bumps or pustules (pimples or large cysts). Although the complete understanding of what causes acne is still a work in progress, several theories tie it to genes as well as hormone activity.

Hormones are believed to be a big part of what causes acne specifically the male sex hormone testosterone. Both men and women have this male hormone with men obviously having more of testosterone than women. When male hormone levels increase in men and women, it stimulates the sebaceous (oil) glands in the skin to produce excessive amounts of sebum (oil).

These excessive amounts of sebum end up clogging the pores as they are released by the sebaceous glands into the hair follicles that the sebaceous glands surround. The acne scarf clogged pores then allow certain bacteria (propionibacterium acne) to fester and multiply which then leads to this bacteria releasing certain enzymes that lead to the inflammation of the hair follicles (sebaceous glands are attached to hair follicles). This inflammation may result in swelling followed by rapture which then allows the bacteria to spread onto the skin leading to various acne blemishes.

The raised swellings resulting from acne are frequently found on the face, back, neck, chest as well as the shoulders. These bumps can be painful or sore and may even itch. In severe cases, acne may feature pus filled sacs that break open leading to the discharge of the fluid. While hormonal imbalance at puberty is believed to be one of the causes of acne, hormonal imbalance can also occur around the time of the menstrual cycle, during stressful times, etc.

Acne can also be caused by the use of certain cosmetics that are comedogenic (pore clogging) and this is known as acne cosmetic. Certain drugs may also lead to acne (acne medicametosa) such as some epilepsy medications. There is another type of acne known as acne rosacea which is a different type of severe acne altogether that usually affects those over the age of 40. Acne rosacea is a complication of the skin condition rosacea and is different from other types of acne because it features inflammation (swelling), redness as well as dilated blood vessels. It is also usually centered around the nose and cheeks and rarely includes blackheads but instead includes a lot of pustules (pimples containing pus).

How to Stop Acne

Seeing as this skin condition affects more than 80 percent of the general population, it can be difficult but not impossible to treat so that you can have clear skin free of blemishes or at least keeping breakouts to a minimum. Most of us like looking good and dealing with acne can prevent this from happening which is why severe acne can rob a sufferer of their self-esteem. Acne eruptions can cause one to hide away and not interact with people because you may feel like other people are judging you negatively because of the acne. If acne is a big problem, here are some tips on how to stop acne and have clear skin;

1. Proper Cleansing

Keeping the face clean with an oil free cleanser is sometimes all you need or a step in the right direction especially in cases of mild acne. Washing the face more than twice a day may be too taxing on the skin though causing it to dry out which then causes the sebaceous glands to go into overdrive producing excessive amounts of sebum or oil. Do use a gentle hand too. Being overly aggressive to get your skin clear and free of oil by using rough wash cloths, scrubs, etc, can make an already bad situation worse. So be gentle with your skin. It is not your enemy even if it may feel like it at times.

2. Benzoyl Peroxide, Salicylic Acid, Sulfur, etc

These are generally over the counter medications that can be used quite effectively for acne treatment and are usually included in cleansers, toners, moisturizers, masks, etc, to help kill the acne causing bacteria as well as normalize excessive oil production. Some of these ingredients though such as salicylic acid and sulfur may be too irritating and drying for certain people’s skin and may actually make acne worse.

If this is the case for you, start at the lowest concentration and only use products containing these active ingredients once a day and gradually build up to twice a day as your skin gets more tolerant. Another alternative is to switch to benzoyl peroxide. Many dermatologists actually believe that benzoyl peroxide is the most effective acne ingredient that is available over the counter but you also want to start at the lowest concentration especially if you have sensitive skin.

Acne plagues thousands of people around the world. From teenagers to adults on the wrong side of middle age, it is a skin disorder that is extremely common as well as very unpleasant. It is painful, distressing, and often leaves scars even after it is treated.

There are hundreds of skin-care products that claim to treat acne. Finding the right treatment for you is almost like finding a needle in a haystack. To make things a little easier for you, here is a comprehensive review of five of the best acne treatment solutions as per popular ratings.

The reviews are accurate, based on substantiate research, and are aimed at helping you make a healthy and informed choice. The five products being reviewed here are Murad Acne Complex, Proactive Acne Solutions, Clinique Acne Solutions, Clear Skin Max and Exposed Skin Care.

Murad Acne Complex

The Murad Acne Complex consists of a three-step process, which consists of a acne scarf Clarifying Cleanser, an Exfoliating Acne Treatment Gel, and lastly a Skin Perfecting Moisturizer. It was developed by Howard Murad and has been a popular product for treating acne breakouts.

The product has yielded mixed reviews from viewer ratings and is different from most other acne treatment products in the sense that it does not contain benzoyl peroxide, which is a leading ingredient used in most acne treatments.

The product claims to remove all signs of acne in just 4 weeks. While this is not exactly accurate, results are often visible within the second month, depending on the severity of the condition.

Pros

While the purging period does see some aggravation of the condition, the product pulls through and actually gives visible results. The moisturizer smells pleasant and does not stick. The Pore Cleansing mask that the treatment comes with is quite helpful and has a lot of positive reviews.

It uses a lot of natural extracts such as bitter orange oil, tea tree extracts, camellia leaf extract, menthol along with known acne fighters such as salicylic acid that help in curing acne without causing much damage to the skin. Spot sulfur treatment that it includes has also given positive results among a large number of users.

Cons

The purging period is extremely painful and itchy. The acne increases considerably before it is healed, if at all. Moreover, the product does not work for all skin types, and the moisturizer is not enough to help soothe the roughness and pain. Reviews have revealed that the system leaves the skin oily and shinier and that acne takes a lot of time to heal, especially if it is in its moderate or severe phase.

Verdict

The Murad Acne Complex might or might not work for you. It has mixed user ratings and though it can be helpful for minor to moderate acne, it has reportedly shown less impressive results for severe cases of acne. However it might work if you have oily skin.

Today, health care fraud is all over the news. There undoubtedly is fraud in health care. The same is true for every business or endeavor touched by human hands, e.g. banking, credit, insurance, politics, etc. There is no question that health care providers who abuse their position and our trust to steal are a problem. So are those from other professions who do the same.

Why does health care fraud appear to get the ‘lions-share’ of attention? Could it be that it is the perfect vehicle to drive agendas for divergent groups where taxpayers, health care consumers and health care providers are dupes in a health care fraud shell-game operated with ‘sleight-of-hand’ precision?

Take a closer look and one finds this is no game-of-chance. Taxpayers, consumers and providers always lose because the problem with health care fraud is not just the fraud, but it is that our government and insurers use the fraud problem to further agendas while at the same time fail to be accountable and take responsibility for a fraud problem they facilitate and allow to flourish.

1. Astronomical Cost Estimates

What better way to report on fraud then to tout fraud cost estimates, e.g..

For more information visist: https://experiencenissanleaf.com

• “Fraud perpetrated against both public and private health plans costs between $72 and $220 billion annually, increasing the cost of medical care and health insurance and undermining public trust in our health care system… It is no longer a secret that fraud represents one of the fastest growing and most costly forms of crime in America today… We pay these costs as taxpayers and through higher health insurance premiums… We must be proactive in combating health care fraud and abuse… We must also ensure that law enforcement has the tools that it needs to deter, detect, and punish health care fraud.” [Senator Ted Kaufman (D-DE), 10/28/09 press release]
• The General Accounting Office (GAO) estimates that fraud in healthcare ranges from $60 billion to $600 billion per year – or anywhere between 3% and 10% of the $2 trillion health care budget. [Health Care Finance News reports, 10/2/09] The GAO is the investigative arm of Congress.
• The National Health Care Anti-Fraud Association (NHCAA) reports over $54 billion is stolen every year in scams designed to stick us and our insurance companies with fraudulent and illegal medical charges. [NHCAA, web-site] NHCAA was created and is funded by health insurance companies.

Unfortunately, the reliability of the purported estimates is dubious at best. Insurers, state and federal agencies, and others may gather fraud data related to their own missions, where the kind, quality and volume of data compiled varies widely. David Hyman, professor of Law, University of Maryland, tells us that the widely-disseminated estimates of the incidence of health care fraud and abuse (assumed to be 10% of total spending) lacks any empirical foundation at all, the little we do know about health care fraud and abuse is dwarfed by what we don’t know and what we know that is not so. [The Cato Journal, 3/22/02]

2. Health Care Standards

The laws & rules governing health care – vary from state to state and from payor to payor – are extensive and very confusing for providers and others to understand as they are written in legalese and not plain speak.

Providers use specific codes to report conditions treated (ICD-9) and services rendered (CPT-4 and HCPCS). These codes are used when seeking compensation from payors for services rendered to patients. Although created to universally apply to facilitate accurate reporting to reflect providers’ services, many insurers instruct providers to report codes based on what the insurer’s computer editing programs recognize – not on what the provider rendered. Further, practice building consultants instruct providers on what codes to report to get paid – in some cases codes that do not accurately reflect the provider’s service.

Consumers know what services they receive from their doctor or other provider but may not have a clue as to what those billing codes or service descriptors mean on explanation of benefits received from insurers. This lack of understanding may result in consumers moving on without gaining clarification of what the codes mean, or may result in some believing they were improperly billed. The multitude of insurance plans available today, with varying levels of coverage, ad a wild card to the equation when services are denied for non-coverage – especially if it is Medicare that denotes non-covered services as not medically necessary.

3. Proactively addressing the health care fraud problem

The government and insurers do very little to proactively address the problem with tangible activities that will result in detecting inappropriate claims before they are paid. Indeed, payors of health care claims proclaim to operate a payment system based on trust that providers bill accurately for services rendered, as they can not review every claim before payment is made because the reimbursement system would shut down.

They claim to use sophisticated computer programs to look for errors and patterns in claims, have increased pre- and post-payment audits of selected providers to detect fraud, and have created consortiums and task forces consisting of law enforcers and insurance investigators to study the problem and share fraud information. However, this activity, for the most part, is dealing with activity after the claim is paid and has little bearing on the proactive detection of fraud.

4. Exorcise health care fraud with the creation of new laws

The government’s reports on the fraud problem are published in earnest in conjunction with efforts to reform our health care system, and our experience shows us that it ultimately results in the government introducing and enacting new laws – presuming new laws will result in more fraud detected, investigated and prosecuted – without establishing how new laws will accomplish this more effectively than existing laws that were not used to their full potential.

With such efforts in 1996, we got the Health Insurance Portability and Accountability Act (HIPAA). It was enacted by Congress to address insurance portability and accountability for patient privacy and health care fraud and abuse. HIPAA purportedly was to equip federal law enforcers and prosecutors with the tools to attack fraud, and resulted in the creation of a number of new health care fraud statutes, including: Health Care Fraud, Theft or Embezzlement in Health Care, Obstructing Criminal Investigation of Health Care, and False Statements Relating to Health Care Fraud Matters.

In 2009, the Health Care Fraud Enforcement Act appeared on the scene. This act has recently been introduced by Congress with promises that it will build on fraud prevention efforts and strengthen the governments’ capacity to investigate and prosecute waste, fraud and abuse in both government and private health insurance by sentencing increases; redefining health care fraud offense; improving whistleblower claims; creating common-sense mental state requirement for health care fraud offenses; and increasing funding in federal antifraud spending.

Undoubtedly, law enforcers and prosecutors MUST have the tools to effectively do their jobs. However, these actions alone, without inclusion of some tangible and significant before-the-claim-is-paid actions, will have little impact on reducing the occurrence of the problem.

What’s one person’s fraud (insurer alleging medically unnecessary services) is another person’s savior (provider administering tests to defend against potential lawsuits from legal sharks). Is tort reform a possibility from those pushing for health care reform? Unfortunately, it is not! Support for legislation placing new and onerous requirements on providers in the name of fighting fraud, however, does not appear to be a problem.

Health insurance has proven itself of great help and financial aid in certain cases when events turn out unexpectedly. In times when you are ill and when your health is in grave jeopardy and when finances seem to be incapable to sustain for your care, health insurance is here to the rescue. A good health insurance plan will definitely make things better for you.

Basically, there are two types of health insurance plans. Your first option is the indemnity plans, which includes the fee-for-services and the second is the managed care plans. The differences between these two include the choice offered by the providers, the amount of bills the policy holder has to pay and the services covered by the policy. As you can always hear there is no ultimate or best plan for anyone.

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As you can see, there are some plans which may be way better than the others. Some may be good for you and your family’s health and medical care needs. However, amidst the sweet health insurance plan terms presented, there are always certain drawbacks that you may come to consider. The key is, you will have to wisely weigh the benefits. Especially that not among these plans will pay for all the financial damages associated with your care.

The following are a brief description about the health insurance plans that might be fitting for you and your family’s case.

Indemnity Plans

Flexible Spending Plans – These are the types of health insurance plans that are sponsored when you are working for a company, or any employer. These are the care plans inclusive in your employee benefit package. Some of the specific types of benefits included in this plan are the multiple options pre-tax conversion plan, medical plans plus flexible spending accounts, tax conversion plan, and employer credit cafeteria plans. You can always ask your employer of the benefits included in your health care/insurance plans.

Indemnity Health Plans – This type of health insurance plan allows you to choose your own health care providers. You are given the freedom to go to any doctor, medical institution, or other health care providers for a set monthly premium. The insurance plan will reimburse you and your health care provider according to the services rendered. Depending on the health insurance plan policy, there are those that offers limit on individual expenses, and when that expense is reached, the health insurance will cover for the remaining expenses in full. Sometimes, indemnity health insurance plans impose restrictions on services covered and may require prior authorization for hospital care and other expensive services.

Basic and Essential Health Plans – It provides a limited health insurance benefit at a considerably low insurance cost. In opting for this kind of health insurance plan, it is necessary that one should read the policy description giving special focus on covered services. There are plans which may not cover on some basic treatments, certain medical services such as chemotherapy, maternity care or certain prescriptions. Also, rates vary considerably since unlike other plans, premiums consider age, gender, health status, occupation, geographic location, and community rated.

Health Savings Accounts – You own and control the money in your HSA. This is the recent alternative to the old fashioned health insurance plans. These are savings product designed to offer policy holders different way to pay for their health care. This type of insurance plan allows the individual to pay for the current health expenses and also save for untoward future qualified medical and retiree health costs on a tax-free basis. With this health care plan, you decide on how your money is spent. You make all the decisions without relying on any third party or a health insurer. You decide on which investment will help your money grow. However, if you sign up for an HSA, High Deductible Health Plans are required in adjunct to this type of insurance plan.

High Deductible Health Plans – Also called Catastrophic Health Insurance Coverage. It is an inexpensive health insurance plan which is enabled only after a high deductible is met of at least $1,000 for an individual expense and $2,000 for family-related medical expense.

Managed Care Options

Preferred Provider Organizations – This is charged in a fee-for-service basis. The involved health care providers are paid by the insurer on a negotiated fee and schedule. The cost of services are likely lower if the policy holder chooses an out-of-network provider ad generally required to pay the difference between what the provider charges and what the health insurance plan has to pay.

Point of Service – POS health insurance plans are one of the indemnity type options in which the primary health care providers usually make referrals to other providers within the plan. In the event the doctors make referrals which are out of the plan, that plan pays all or most of the bill. However, if you refer yourself to an outside provider, the service charges may also be covered by the plan but the individual may be required to pay the coinsurance.

Health Maintenance Organizations – It offers access to a network of physicians, health care institutions, health care providers, and a variety of health care facilities. You have the freedom to choose for your personal primary care doctor from a list which may be provided by the HMO and this chosen doctor may coordinate with all the other aspects of your health care. You may speak with your chosen primary doctor for further referrals to a specialist. Generally, you are paying fewer out-of-pocket fees with this type of health insurance plan. However, there are certain instances that you may be often charged of the fees or co-payment for services such as doctor visits or prescriptions.

Government-Sponsored Health Insurance

Indian Health Services – This is part of the Department of Health and Human Services Program offering all American Indians the medical assistance at HIS facilities. Also, HIS helps in paying the cost of the health care services utilized at non-HIS facilities.

Medicaid – This is a federal or s state public assistance program created in the year 1965. These are available for the people who may have insufficient resources to pay for the health care services or for private insurance policies. Medicaid is available in all states. Eligibility levels and coverage benefits may vary though.

Medicare – This is a health care program for people aging 65 and older, with certain disabilities that pays part of the cost associated with hospitalization, surgery, home health care, doctor’s bills, and skilled nursing care.

The rapid development of workplace health protective and preventive services has been driven by government strategies and recommendations, as well as by the European Union legislation in the areas of health and safety at work and by the European Commission programme in public health. This was also largely due to the new demands and expectations from employers, employees and their representative bodies as they recognize the economic, social and health benefits achieved by providing these services at the workplace, thus providing the available knowledge and evidence necessary for the continuous improvement of workplace health management. Comprehensive workplace health management is a process involving all stakeholders inside and outside any business.

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It aims at empowering them to take control over their own health and their family’s health considering environmental, lifestyle, occupational and social health determinants and quality of health care. It is based on health promotion principles and it creates a great challenge to health, environment and safety professionals providing services, advice, information and education to social partners at work. It involves also taking care of considerable socioeconomic interest of all involved stakeholders. It has been shown in several instances that the business utilizing a well managed research based occupational health service can gain a competitive advantage by:

Protecting human health against health and safety hazards occurring in the work environment.
Promoting human health workplaces for all ages and healthy aging by appropriate work culture, work organization and support to social cohesion.
Promoting mental health, healthy lifestyle and preventing major non-communicable diseases using specific workplace health policies and management tools.
Maintaining work ability thus also employability throughout working life.
Reducing health care costs caused by employees’ and employers’ injuries, diseases, illnesses and premature retirement resulting from or influenced by occupational, environmental, life style and social health determinants
Using resources effectively, protecting the natural environment and creating a health supportive environment.
Improving social communication and literacy on health, environment and ethics.
This article series describes the author’s observations of various roles undertaken by the occupational health nurse. Whilst recognizing the wide variation that exists in occupational health nursing practice between different industrial and blue collar environments this series reflects the standards that have already been achieved where occupational health nursing is at its most advanced. However it has to be recognized that the level of education, professional skills and the exiting national legislation determines what role can be actually undertaken by occupational health nurses. Even more important is to remember that no one professional out of the exiting workplace health professions is now capable to meeting all health needs of the working population. A multi-disciplinary approach is needed to effectively manage the growing workplace health and safety demands in business today.

The workplace health services use the skills of many professionals such as specialist occupational physicians, safety engineers, occupational hygienists, occupational health nurses, ergonomists, physiotherapists, occupational therapists, laboratory technicians, psychologists and other specialists. The role and tasks actually performed for the companies by representatives of different health and safety professions vary greatly depending upon legislative needs, scope of the workplace health concept perceived by directors, enforcement practice, the level of their education, position in the occupational health infrastructure, actions undertaken by insurance institutions and many other factors. Occupational health nurses are the largest single group of health professionals involved in delivering health services at the workplace and have the most important role to play in the workplace health management. They are at the frontline in helping to protect and promote the health of the nations working population.

The role of the occupational health nurse in workplace health management is a new and exciting concept that is designed to improve the management of health and health related problems in the workplace. Specialist occupational health nurses can play a major role in protecting and improving the health of the working population as part of this strategy. Occupational health nurses can also make a major contribution to the sustainable development, improved competitiveness, job security and increased profitability of businesses and communities by addressing those factors which are related to the health of the working population. By helping to reduce ill health occupational health nurses can contribute to the increased profitability and performance of organizations and reduce health care costs. Occupational health nurses can also help to reduce the externalization of costs onto the taxpayer, by preventing disability and social exclusion, and by improving rehabilitation services at work. By protecting and promoting the health of the working population, and by promoting social inclusion, occupational health nurses can also make a significant contribution towards building a caring social ethos within the UK. This article provides guidance to employers and employees on establishing workplace health management systems within their own organizations. On how to determine and develop the role and functions of the occupational health nursing specialist within each enterprise and where to go for additional help and advice in relation to occupational health nursing.

Changing nature of working life and the new challenges

The world of work has undergone enormous change in the last hundred years. To a large extent the very heavy, dirty and dangerous industries have gone, and the burden of disease, which came with them, in most European countries, has declined. However, the new working environments and conditions of work that have replaced them have given rise to new and different concerns about the health of the working population. Exposure to physical, chemical, biological and psychosocial risk factors at work are now much more clearly linked to health outcomes in the mind of the general public. Expectations of society in regard to health at work have also changed, with increasing demands for better standards of protection at work and for the improvement of the quality of working life. Employers are also recognizing that health-related issues, such as sickness absence, litigation and compensation costs, increasing insurance premiums, are expensive; ignoring them can lead to serious economic consequences. The best employers’ emphasize the important message that good health is good business, and that much can be achieved in this field simply by introducing good management practices.

The Need for Workplace Management

There are approximately 400 million people who work in the EU Member States. The majority of whom spend more than one half of their waking life at work. However, fatal accidents at work are still common. The standardized incident rates per 100,000 workers in the European Union show that the fatal accident rate varies between 1.6 in the UK to 13.9 in Spain, with Austria, Greece, France, Italy and Portugal all above 5.0%. In the entire European region there are approximately 200 to 7500 non-fatal accidents per 100,000 employees per year, of which around 10% are severe leading to over 60 days absence from work, and up to 5%, per year, lead to permanent disability. It has been estimated that the total cost to society of work related injuries and ill health in the European Union is between 185 billion and 270 billion ECU per year, which represents between 2.6% to 3.8% of Gross National Product (GNP) in member states. The cost of workplace accidents and ill health, in both financial and human terms, remains an enormous, largely unrecognized burden in UK. The majority of those accidents and diseases could have been prevented if appropriate action had been taken at the workplace. Many responsible employers have consistently demonstrated that by paying attention to these issues this type of harm and the subsequent costs can be avoided, to the benefit of everyone concerned. Increasing concern is the growing awareness of occupational stress. Up to 42% of workers in a recent survey complained about the high pace of work. Job insecurity, fear of unemployment, lack of a regular salary and the potential loss of work ability are all additional sources of stress, even for those in employment.

The wide ranging social and health effects of occupational stress on the health of the working population are well documented, for example 23% of workers surveyed claimed that they had been absent from work for work related health reasons in the previous twelve months. The resulting cost of sickness absence in United Kingdom is considered to be substantial. In the UK 177 million working days were lost in 1994 as a result of sickness absence; this has been assessed at over 11 billion in lost productivity. HSE statistics are encouraging given in 2009; only 29.3 million days were lost overall, 24.6 million due to work-related ill health and 4.7 million due to workplace injury. Much of this burden of ill health and the resulting sickness absence is caused, or is made worse by working conditions. Even where ill health is not directly caused by work, but by other non-occupational factors such as smoking, lifestyle, diet etc. Interventions designed to improve the health of the working population, delivered at the workplace, may help to reduce still further the burden of ill health. At present the socioeconomic impact of environmental pollution caused by industrial processes on the working population is uncertain, but it is likely to contribute further to the burden of ill health in some communities.