Health for life

In 2004, the CDC published a study that found:

" ... the prevalence of overweight or obesity was 85.2% [among people with diabetes]."
- Prevalence of Overweight and Obesity Among Adults with Diagnosed Diabetes

Given the strong correlation between weight and type 2 diabetes, the following documentary might be worth a watch.

PBS is currently broadcasting "Fat: What No One Is Telling You", a film investigating the issues surrounding the obesity epidemic.

From their website:

"With 66 percent of U.S. adults either overweight or obese, our girth is a serious public health issue. Yet many of us still view being overweight as a character flaw, a lack of self-control, or even a moral crime.

But does fat really equal failure? FAT: What No One Is Telling You explores the myriad psychological, physiological and environmental factors that can make it so tough to shed pounds and keep them off. In this documentary, Executive producer Naomi Boak and producer/director Tom Spain, both Emmy Award honorees, share new scientific knowledge about hunger, eating, and human metabolic operation. This film also explains our psychological responses to food, and shows how external pressures (such as oversized restaurant portions and the unending barrage of food advertisement) make fighting fat so difficult, both on the personal and national levels."

You can watch a preview here:



Check their site for local listing dates and times.
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Measuring ROI

In yesterdays posting on Al Lewis book Why No One Believes the Numbers, the Disease Management Care Blog pointed out that the measurement of population health management (PHM) outcomes remains an inexact and still evolving science. While that can be a source of endless fascination for the DMCB, the inability of the industry to rustle up credible "return on investment" numbers has prompted some observers to condemn PHM as a waste of money.

The search for simple answers explains much of the appeal of this book.

According to author, one important solution is the "dummy year analysis" (DYA). This relies on repeated year-over-year measurements of utilization that use multiple comparison pairings of all patients with the condition of interest. When thats combined with a "plausibility" check list, Mr. Lewis says purchasers of the Patient Centered Medical Home (PCMH), disease management or wellness programs should be able to get a better fix on whether they saved any money. You can a sense of that perspective here.

The DMCB isnt too sure about that because a) other factors that have nothing to do with population health management can also impact utilization during and after the dummy years, making it difficult to assign an attributable ROI and b) entire health plan populations can likewise regress toward a regional or national mean.

The DMCB also sees three additional reasons why there may be less to this books methodology than meets the eye:

1. When employers, health plans, accountable care organizations or other buyers have a list of names that have been through a care program, they typically want to understand the outcomes for the individuals on that list. If thats the case, the challenge is to find an adequate comparator that portrays what would have happened in the absence of the care program. Multiple options for identifying a parallel comparator have been used in published science for decades. Thats difficult, imperfect, but not broken.  It remains an option.

2. While the book is replete with examples of "actuaries behaving badly," it is impossible to underestimate the influence of actuarial science and trending on premium rate setting, statutory accounting, and the regulation of insurance. As a result, if the actuaries say money is - or is not - being saved, health system leaders ignore their insights at their peril.

3. Isolating the impact of PCMH, disease management or wellness program out of all the other "noise" of a changing economy, evolving consumerism, benefit changes, electronic health record databases, medical advances, inflation and the news media is a function of an increasingly sophisticated and changing statistical sciences and computational technology. Its ironic, but one outcome has been a better description and measurement of the uncertainty surrounding a result.
 
To the authors credit, Why No One Believes the Numbers is not being promoted as the single best methodology that will lead PCMH, disease management and wellness programs to outcomes certainty. Rather, it is one option among many in asking whether a program had any financial impact.

Ultimately, theore, thats why the DMCB advises that measuring outcomes in PHM - absent an ironclad methodology - comes down to using multiple approaches to triangulate on the truth. After reading Why No One Believes the Numbers, some readers may choose it as one of those approaches.

Writing a guest post to a co blogger, any blogger can dream about it, thank god its happens quite often to me and am loving it. Recently Nalini of Nalinis Kitchen asked me to write a guest post for her, as she is celebrating her second blog anniversary. How can i miss a chance, i immediately said yes and i did this wonderful dessert for her.



Actually i know Nalini through blogging marathon before few years back,ill never forget to visit her space and she shares mouthwatering recipes with breath taking pictures. Beware dont go to her space while you are hungry,yes each and every pictures of her food will tempt you definitely and you will go crazy. If you are searching authentic dishes, just check her space and you will definitely fallen in love with her post.

When she asked me for the guest post, she wants me to make a French bakes,but sorry Nalini i couldnt keep my words, i prepared a no bake French dessert specially for you.


Crème caramel or caramel custard is a custard dessert with a layer of soft caramel on top, as opposed to crème brûlée, which is custard with a hard caramel top. The dish is eaten throughout the world eventhough is dessert is from French Cuisine.

Crème caramel goes for a plain custard where sugar syrup cooked to caramel stage is poured into the mold before adding the custard base. It is usually cooked in a bain-marie on a stove top or in the oven in a water bath. It is turned and served with the caramel sauce on top, hence the alternate French name crème caramel renversée.

But my version of No Bake Eggless Créme caramel doesnt need a oven and its completely egg free, this dessert goes for custard flour, Full fat milk, sugar and agar agar. Just with 4 ingredients you can make an incredible french dessert even if dont have oven at home. Have you noticed that this dessert is also gelatin free, i used china grass aka agar agar in this créme caramel, if you want to make with gelatin feel free to use it.

Check Nalinis space for my guest post..