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Health care delivery science focuses on ways to improve health and health care services provided to individuals and populations. Health care professionals must be trained in health care delivery science in order to diagnose and treat the sources of health care system dysfunction and achieve better outcomes while controlling costs. The ideal model for health care delivery science training has not been fully defined, but doing so is critical especially for frontline mid-career health care professionals whose original clinical training omitted these concepts. To better prepare leaders to address the complex challenges of health care, we created a novel hybrid residential/online 18-month master's degree in health care delivery science. Key strengths of the program are the curriculum, pedagogy, teaching team and close-knit cohort. Here, we discuss the program design rationale and six years of evaluation data of a novel master of health care delivery science program. Novel online education in health care delivery science can empower inter-professional leaders in multiple leadership positions throughout health care to improve the United States health care system.

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INTRODUCTION: Media reports on disasters may play a role in inspiring charitable giving to fund post-disaster recovery, but few analyses have attempted to explore the potential link between the intensity of media reporting and the amount of charitable donations made. The purposes of this study were to explore media coverage during the first four weeks of the 2010 earthquake in Haiti in order to assess changes in media-intensity, and to link this information to data on contributions for emergency assistance to determine the impact of media upon post-disaster charitable giving. METHODS: Data on newspaper and newswire coverage of the 2010 earthquake in Haiti were gathered from the NexisLexis database, and traffic on Twitter and select Facebook sites was gathered from social media analyzers. The aggregated measure of charitable giving was gathered from the Center for Philanthropy at Indiana University. The intensity of media reporting was compared with charitable giving over time for the first month following the event, using regression modeling. RESULTS: Post-disaster coverage in traditional media and Twitter was characterized by a rapid rise in the first few days following the event, followed by a gradual but consistent decline over the next four weeks. Select Facebook sites provided more sustained coverage. Both traditional and new media coverage were positively correlated with donations: every 10% increase in Twitter messages relative to the peak percentage was associated with an additional US $236,540 in contributions, while each additional ABC News story was associated with an additional US $963,800 in contributions. CONCLUSIONS: While traditional and new media coverage wanes quickly after disaster-causing events, new and social media platforms may allow stories, and potentially charitable giving, to thrive for longer periods of time.

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Liquid dietary supplements represent a fast growing market segment, including botanically-based beverages containing mangosteen, acai, and noni. These products often resemble fruit juice in packaging and appearance, but may contain pharmacologically active ingredients. While little is known about the human health effects or safety of consuming such products, manufacturers make extensive use of low-quality published research to promote their products. This report analyzes the science-based marketing claims of two of the most widely consumed mangosteen liquid dietary supplements, and compares them to the findings of the research being cited. The reviewer found that analyzed marketing claims overstate the significance of findings, and fail to disclose severe methodological weaknesses of the research they cite. If this trend extends to other related products that are similarly widely consumed, it may pose a public health threat by misleading consumers into assuming that product safety and effectiveness are backed by rigorous scientific data.

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Weight loss supplements often contain powerful pharmacoactive ingredients with the potential to cause harm. Trials used to determine product safety and effectiveness, meanwhile, tend to be small, of short duration, and frequently lack financial conflict of interest disclosures. These factors could conspire to place consumers at risk, especially when published research cited in advertising cloaks products with the suggestion that their safety and effectiveness have been proven by science. Examples of current and former weight loss products backed by potentially conflicted or low quality research include Metabolife-356, Hydroxycut, Xenadrine and LeptiCore. Published research, especially in the field of weight loss supplements, needs better conflict of interest disclosure, and regulators should consider how research findings are used in marketing claims.

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There is a growing number of case reports of hepatoxicity from the widely marketed weight-loss supplement Hydroxycut, which contains the botanical ingredient Garcinia cambogia. These case reports may substantially undercount the true magnitude of harm. Based on the past experience with harmful dietary supplements, US regulators should assume the more precautionary approach favored by Canada and Europe. Lacking effective adverse event surveillance for supplements, or the requirements to prove safety prior to coming to the market, case reports such as those summarized here assume added importance.

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OBJECTIVE: We sought to convey lessons learned by the Centers for Disease Control and Prevention's (CDC's) Prevention Research Centers (PRCs) about the value and challenges of private-sector alliances resulting in innovative health promotion strategies. Several PRCs based in a variety of workplace and community settings contributed. METHODS: We conducted interviews with principal investigators, a literature review, and a review of case studies of private-sector alliances in a microbusiness model, a macrobusiness model, and as multiparty partnerships supporting public health research, implementation, and human resource services. RESULTS: Private-sector alliances provide many advantages, particularly access to specialized skills generally beyond the expertise of public health entities. These skills include manufacturing, distribution, marketing, business planning, and development. Alliances also allow ready access to employee populations. Public health entities can offer private-sector partners funding opportunities through special grants, data gathering and analysis skills, and enhanced project credibility and trust. Challenges to successful partnerships include time and resource availability and negotiating the cultural divide between public health and the private sector. Critical to success are knowledge of organizational culture, values, mission, currency, and methods of operation; an understanding of and ability to articulate the benefits of the alliance for each partner; and the ability and time to respond to unexpected changes and opportunities. CONCLUSION: Private-public health alliances are challenging, and developing them takes time and resources, but aspects of these alliances can capitalize on partners' strengths, counteract weaknesses, and build collaborations that produce better outcomes than otherwise possible. Private partners may be necessary for program initiation or success. CDC guidelines and support materials may help nurture these alliances.

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Up to 52% of Americans spend $20 billion annually on dietary supplements, which rank among the top suspected causes of poisoning among adults. The recent recall by the US Food and Drug Administration (FDA) of a top-selling supplement linked to liver toxicity highlights the need for post-market surveillance. Unfortunately the agency is ill equipped to provide such surveillance, only recording about 1% of all adverse events. Poison control centers may be detecting 10 times more adverse events but are not forwarding them to the FDA. The FDA could increase its post-market surveillance capacity by coordinating with poison control centers and by utilizing external researchers.

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BACKGROUND: Aspirin desensitization is an effective therapy for moderate-to-severe aspirin-exacerbated respiratory disease (AERD). Desensitization also allows the use of aspirin for secondary cardiovascular prevention. OBJECTIVE: We sought to investigate the cost-effectiveness of aspirin desensitization with subsequent aspirin therapy in patients with AERD. METHODS: The Healthcare Cost and Utilization Project was used, together with average reimbursements from a large Midwestern health care plan, to model the costs of aspirin desensitization for therapeutic and prophylactic use in patients with AERD. Event probabilities were based on the published literature. RESULTS: Ambulatory desensitization for AERD cost $6768 per quality-adjusted life year (QALY) saved ($18.54 per additional symptom-free day). Aspirin desensitization for AERD remained cost-effective (<$50,000 per QALY saved) across a wide range of assumptions. When secondary cardiovascular prophylaxis was considered, ambulatory aspirin desensitization was less expensive than an alternative antiplatelet agent, clopidogrel. Clopidogrel cost $106,453 per incremental QALY saved when compared with desensitization. CONCLUSIONS: Aspirin desensitization is a cost-effective therapeutic intervention in patients with moderate-to-severe AERD. Although the incremental cost-effectiveness of clopidogrel in individuals with aspirin allergy is marginal, if available, ambulatory desensitization remains a less-expensive option for secondary cardiovascular prophylaxis.

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The effectiveness of humanitarian response efforts has long been hampered by a lack of coordination among responding organizations. The need for increased coordination and collaboration, as well as the need to better understand experiences with coordination, were recognized by participants of a multilateral Working Group convened to examine the challenges of coordination in humanitarian health responses. This preliminary study is an interim report of an ongoing survey designed by the Working Group to describe the experiences of coordination and collaboration in greater detail, including factors that promote or discourage coordination and lessons learned, and to determine whether there is support for a new consortium dedicated to coordination. To date, 30 key informants have participated in 25-minute structured interviews that were recorded and analyzed for major themes. Participants represented 21 different agencies and organizations: nine non-governmental organizations, eight academic institutions, two donor organizations, the US Centers for Disease Control and Prevention, and the World Health Organization. Common themes that emerged included the role of donors in promoting coordination, the need to build an evidence base, the frequent occurrence of field-level coordination, and the need to build new partnerships. Currently, there is no consensus that a new consortium would be helpful. Addressing the underlying structural and professional factors that currently discourage coordination may be a more effective method for enhancing coordination during humanitarian responses.

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During humanitarian response efforts, the mass media serves as the primary informational intermediary informing donors, policy makers, and the non-affected public. A lack of professional standards within the current culture of journalism, the politics of media ownership, and media manipulation by governments has distorted reporting on humanitarian crises, with possible detrimental effects on response efforts. Humanitarian response organizations must assume a proactive, leading role in the management and sharing of information with each other as well as with donors, policy makers, and the public. This will require working with the media as partners, as well as exploring innovative methods of mass communication. A multi-stakeholder, cooperative communication initiative could help improve media involvement, and harness the media as a credible and knowledgeable communication tool for response efforts. A professional publication dedicated to the discipline of humanitarian relief also could optimize efforts, communicate the perspectives of beneficiaries, and manage the underutilized resource of the general public.

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