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Public health and mental health By Dr Sabah M Abdelkader Assist Prof of Public Health
Objectives By the end of session, students will be able to: Explain connection of public health with mental health. Define good mental health correctly. Express understanding of characteristics of a mentally healthy person. Discuss factors affecting mental health. Recognize warning signals of poor mental health. Describe causes of mental ill health. Identify crucial points in human life cycle. Discuss prevention of mental health illness. Define mental health promotion. Recognize factors affecting mental health promotion. Describe mental health services.
Introduction Concept of mental health within a public health context is obvious. Everybody experiences psychological distress at some point but not everybody will experience such trauma to debilitating degree. An individual with a mental health problem is seen as unwell, psycho-pathogenic or as requiring treatment, care and adaptation. The individual will be required to change, to be less unwell and more functional. Mental health is a diverse and complex concept. Mental ill health affects around one in six individuals in UK.
Definitions Good mental health is defined as " emotional and spiritual resilience which enables enjoyment of life and the ability to survive pain, disappointment and sadness" Also a positive sense of wellbeing and underlying belief in our own and others' dignity and worth. Mental health is not exclusively a matter of relation between persons, it is also a matter of relation of individual towards community, society, and social institution that guide his life, determine his way of living, working, leisure, and the way he earns and spends money.
Cont. Mental health is not a static condition but subject to variations and fluctuations. Mental health implies the capacity of an individual to form harmonious relations with others and participate constructively in changes in social and physical environment. Mental health implies his ability to achieve a harmonious and balanced satisfaction of his own potentially conflicting instinctive drives.
Characteristics of a mentally healthy person Mental health is not mere absence of mental illness. 1. Feels comfortable about himself, neither underestimate or overestimate his own ability. 2. Able to be interested in others and love them. He has lasting and satisfying friendships. 3. Able to meet demands of life, able to think and take decisions, sets reasonable goals for himself.
Factors affecting mental health Age: transitional related events affect many individuals e.g. adolescence, stressful events, biological degenerative conditions. Gender: women are more likely to suffer from depression. Migration: impacts negatively. Socio-economic background: inverse correlation with more and less privileged background. Occupation: doctors, nurses, teachers, farmers experience stress-related disorders.
Warning signals of poor mental health Are you always worried? Are you unable to concentrate due to unrecognized reasons? Are you always unhappy without justified causes? Do you lose your temper easily and often? Are you troubled by regular insomnia? Do you have wide fluctuations in your moods? Do you continually dislike to be with people? Are you upset if the routine of your life is disturbed? Do your children consistently get on your nerves? Are you afraid without real cause? Are you always right and others always wrong? Do you have many aches for which no doctors can find physical cause?
Causes of mental ill health 1. Organic conditions: cerebral arteriosclerosis, metabolic diseases, epilepsy….etc. 2. Heredity: two schizophrenic parents are 40 times more likely to have a schizophrenic child. 3. Social pathological causes: worries, anxieties, emotional distress, tension, frustration, unhappy marriage, broken homes, poverty, changing family structure, rejection, economic insecurity, population mobility (together with genetic factors)
4. Environmental factors: Toxic substances: mercury, lead. Psychotropic drugs: barbiturates, alcohol. Nutritional factors: thiamine, pyridoxine deficiency. Minerals: iodine deficiency. Infective agents: measles, rubella. Traumatic factors: accidents. Radiation: nervous system is most sensitive to radiation during neural development.
Crucial points in life cycle 1. Prenatal period: pregnancy is stressful for some women, they have physical and emotional needs. 2. First 5 years of life: roots of mental health. Studies confirmed behavioral disorders in broken homes. 3. School child: school practices may satisfy or frustrate emotional needs, affect his effectiveness in learning.
4. Adolescence: Stormy transition from adolescence to manhood constitute dangers to mental health. 5. Old age: causes of mental illness are usually due to organic changes in the brain, economic insecurity, lack of homes.
Prevention Primary: on community basis, improving social environment and promotion of social emotional and physical well being of all people on individual basis: satisfying needs of man throughout his life for affection, belonging, independence, achievement, recognition and approval, sense of personal worth, self actualization. Mental Health promotion: Defined as the process by which an individual or community is assisted in achieving a positive sense of well being.
Secondary: Early diagnosis of social and emotional disturbance through screening programs in schools, universities, industry, recreation centers Provision of treatment through family based health services (family counseling). Tertiary: seeking to reduce duration of mental illness, thus reducing stress for family and community, to prevent further break-down and disruption.
Emotional processing. Self-management skills. Self-esteem. Environmental quality. Social alienation. Stress. Emotional negligence. Emotional abuse. Social participation. NB a deficit in one area may be offset by strength in another. Explain ??? Factors affecting mental Health promotion
Mental health services Early diagnosis and treatment. Rehabilitation. Group and individual psychotherapy. Mental health education. Modern psychoactive drugs. After-care services.
Comprehensive mental health program Since 95% of psychiatric cases can be treated with or without hospitalization close to their homes, current trend is full integration of psychiatric services. Community mental health program includes all community facilities: 1. Inpatient services. 2. Outpatient services. 3. Partial hospitalization. 4. Emergency services. 5. Diagnostic services. 6. Pre-care and after-care services. 7. Education. 8. training. 9. Research.
Thank you
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The world changed…
A recent article in the Wall Street Journal had me lean back in my chair and consider the possibilities… of a world that is about to change. Approximately 285 million smartphones were shipped in the first quarter of 2014 (Strategy Analytics) and more than a billion smartphones will ship this year where Samsung and Apple will be about 50%. Currently the cost of an iPhone 5s is $649 without a contract/discounts with the Samsung S5 nearly the same. The feature/function sets of smartphones are asymptotically approaching no change beyond the basic workings of the fundamental elements: camera, apps, microphone, speaker, display screen, connectivity, geo-location, and a relatively beefy CPU with memory.
The smartphone market is changing and the article states (The Cheap-Smartphone Revolution, By Andy Kessler May 12, 2014) we are entering into an new era, the post-iPhone era where the price of a smartphone is dropping to $25 to $35. There are currently several models either in the prototype stage or about to be released.
What used to take a year's salary in developing countries will be available for 3 weeks of salary, creating the availability of a highly capable connected computer literally in your pocket for billions of inhabitants of our globe. There are of course challenges to connectivity, but with Google's project Loon and other programs with the goal of bringing connectivity to rural and poor areas of the globe, this should start mitigating the challenge
The availability of smartphones for the general world population will have unbelievable impact on local economies and increase the potential of general well-being for large portions of our population. It has been shown that smartphones in industrialized countries have accelerated economic growth and provided new entrepreneurial opportunities that were unheard of a few years back. The smartphone obviously touches all aspects of our lives. Where is the business case for these inexpensive smartphones, connectivity, $.99 apps, and hardware? These rural and poor regions do not have disposable income.
But…get it right, and the opportunity is off the charts for apps and non-streaming entertainment.
Entertainment is a big driver for smartphones and will continue to be in rural and poorer regions of the world. I believe here the opportunity is for what I call non-streaming entertainment. Non-streaming entertainment is where a local shop could download videos from the web to a SD card and then make them available to his customers for viewing during travel or at home. This is basic retail. Find a way to get shoppers into your store and keep them coming back. This approach almost harkens to the early days of Blockbuster and solves problems for customers with spotty connections or avoiding bandwidth consumption.
Other opportunities for both streaming and non-streaming are possible simple apps dealing with health and self-diagnosis with videos or graphics showing "how-to" and possible local remedies. This could even be a library of SD cards discussing various local ailments.
What if you can get rural farmers to be more productive by understanding when and where to plant seeds based on geo-locating? This "planting app" could use local weather patterns to forecast and determine crop rotations, dramatically increasing efficiency and yields. Have the app add the farmer to the supply chain base where it can provide to the distributor or food producer what to expect in crop productivity and quality. A video of crop progress can be added to the supply chain and even adding a click to call/IM to talk to the farmer of what he's seeing in the field and what is needed. The same process can be used for forestry, fishing, and host of other food producing activities.
What if your machinery in the field like pumps, tractors, and mechanical components could be diagnosed simply with a video connection or a link to the actual machinery? One could then create a mesh of M2M smartphones that help with diagnostics and reporting. What if you could add cognitive work like optical character recognition or tagging images or videos? The population could get rewarded with payments to micro banks or even in app or entertainment credits similar to what is happening today with Airtel Money in India, an electronic wallet. Trading is done through virtual money.
Today's app model should be reconsidered, where in poorer regions, the driver for apps is the value of the app. Charge for unlimited use of the app regardless of bandwidth consumption.
The ability to predict and understand the supply chain by the local population whether that is factory output, crops, water usage, or equipment efficiency, can provide a significant competitive advantage to producers who are able the harness this labor force. These are the early days, but a wave is coming I call "the commoditization of the smartphone", and like the PC/laptop the value will be in the software and the ability to communicate. I'm an optimist and of course there are barriers for connectivity, distribution, local politics etc. but I believe those will be an issue for a smaller and smaller portion of our population as the smartphone rolls forward.
There will be many entrepreneurial inventions that we can't even imagine from people who are not yet technologists but now have new tools to use to be more productive and competitive. Co-opt the local developers if they exist. They know the local culture and what will work. In India alone it's expected to have 50 million smartphone subscribers at current smartphone costs and nearly 300,000 developers. Embrace the coming revolution.

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Hi folks it's been a while …sorry about that. Anyway for now here's a few stories I recorded while on the air some years ago. It begins with my character "Timmy Tom" the Half-Angel, and his friend "June June" . This is followed by "Beulah's Window", and another short piece from the "Beulah" series of stories from long ago. I hope you like them.
"Live Show" coming up after the July 4th Holiday.
( Click on file to listen )
"Timmy Tom the Half Angel"
Stay Tuned.


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- 08000 32 8040
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We want to make identifying your body shape and getting it right as clear as possible, so that every piece you invest in feels like it was made with your body in mind.
There's a science to buying clothes. It's all very good if something 'catches your eye', but you have to be a bit practical about it too by considering the following in relation to your body shape:
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Understanding your body shape gives you clues to the overall shape of the clothes best suited to you, as well as the placement of lines, both horizontal and vertical. With a little help from us, you'll be an expert shopper in no time. Goodbye bad impulse buys, hello savvy, stylist-like you.


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Crisis Management Guide
Convention Services Manager
As more PCMA planners add new business destinations to their site visit itineraries, the map of the meetings industry is beginning to look very different. However, planners aren't the only ones who are getting serious about emerging international opportunities. The landscape of convention visitors bureaus is beginning to shift as destinations themselves recognize the importance of attracting conferences.
There's no better place to see how CVBs are adapting to the changing times than BestCities, an alliance between 10 global destinations committed to consistently raising the bar for CVBs. BestCities recently joined PCMA in Chicago to host a dialogue with a group of global meeting executives. Now in its 15th year as an alliance, Karen Bolinger, Board Chair of BestCities, and CEO of the Melbourne Convention Bureau, says BestCities recognizes the time is right to reevaluate the organization's strategic plan.
"There are times when we all wish we had a crystal ball to foretell the future," Bolinger says. "However, in reality, we have to chart our own destiny, which is why conducting a strategic review at this stage in our development is so important."
LEARN: How To Boost Revenue From Your International Meeting
In addition to welcoming new insights from meeting planners about their needs, Bolinger says BestCities is focused on establishing a global footprint in new regions. That footprint is already taking shape with the recent announcement of the Tokyo CVB as a new member of the alliance.
Becoming a member of BestCities isn't as simple as signing on the dotted line, either.
"The process of recruiting and accepting new partners is an important one for the Alliance and the unanimous agreement from the Board is required to invite a prospective convention bureau to formally apply and to approve a new partner," Bolinger says.
Asia-Pacific isn't the only place where the BestCities network will take hold.
"We are currently in discussions with selected CVBs in Latin America who have an emphasis on client service excellence, business focus on international associations and a proven international meetings record."
LEARN: How To Build A Social Media Plan For Your International Meeting
As the BestCities network shares information and influences the level of CVB professionalism in new parts of the world, it will certainly pay off for the planning community.
"A strong CVB partner can make all the difference when a planner is exploring how to help an organization expand its reach," Michelle Crowley, Director, Global Development, PCMA, says. "The local and regional expertise is an essential ingredient of knowing how to navigate the business environment and how to effectively communicate with prospective attendees."
Interested in learning more about BestCities? Click here to see what the network offers meeting planners.
Are you considering hosting your first meeting outside the US? Most likely, there are plenty of questions swirling in your mind. Go to Catalyst to get helpful tips from your colleagues on going global.
Please log in to post comments.
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09 Jan 2017, 04:51pm by Andrew Potter
Monday afternoon updates on the injury news for every team left in the NFL Playoffs after wild-card weekend.
6 comments, Last at 19 Jan 2017, 4:38am by Amily
09 Jan 2017, 02:25pm by Mike Tanier
Going back into recent history, there are plenty of examples of teams with huge wins in the first round that go down to defeat in the second round. Allow us to drop a bucket of ice water on all four of this weekend's big winners.
4 comments, Last at 12 Jan 2017, 9:38am by CM
06 Jan 2017, 02:00pm by Scott Kacsmar
The 2016 AP All-Pro teams are announced.
70 comments, Last at 11 Jan 2017, 4:12am by Bobman
03 Jan 2017, 09:43pm by Scott Kacsmar
The 15 finalists for the 2017 Pro Football Hall of Fame are revealed.
114 comments, Last at 20 Jan 2017, 5:43am by bachslunch
03 Jan 2017, 04:40pm by Aaron Schatz
Hey everybody! Time for the annual Football Outsiders Playoff Challenge game. Here's how it works: You need to pick a roster consisting of 2 QB, 4 RB, 4 WR, and 2 TE. However, you must pick one player from each of the 12 playoff teams, no duplicates. Whoever has the highest fantasy score during the playoffs wins a copy of Football Outsiders Almanac 2017 and the 2017 KUBIAK fantasy football projections. (Click to read more.)
41 comments, Last at 21 Jan 2017, 10:23pm by surebrec
02 Jan 2017, 03:27pm by Andrew Potter
With the regular season now ended, we turn our attention exclusively to the playoff teams. For the AFC, that means a whole pile of backup quarterbacks.
2 comments, Last at 24 Jan 2017, 3:24am by adamganda33
01 Jan 2017, 09:55pm by Tom Gower
Here's our traditional Black Monday discussion thread, chronicling the senior NFL coaches and front office executives who will not be in their present jobs next season. (Click to read more.)
123 comments, Last at 06 Jan 2017, 9:43pm by BroncosGuyAgain
29 Dec 2016, 02:22pm by Aaron Schatz
I thought this was an interesting tidbit, and worth discussing. A lot of football folks know that Bill Belichick will actually open up and talk in detail about football if you ask him questions that aren't specific to his team. This morning he went into detail about players who have switched positions, suggesting that most players in the back seven are playing defense because they weren't good enough playmakers on offense. On the line, he thinks it works the other way: defensive linemen who don't have enough speed to rush the passer often get moved to the offensive line.
49 comments, Last at 04 Jan 2017, 10:54am by Bright Blue Shorts
27 Dec 2016, 05:11pm by Vincent Verhei
Geoff Schwartz, a former offensive lineman for the Panthers, Vikings, Chiefs, and Giants with 74 NFL games and 39 starts under his belt, wrote this piece for SB Nation breaking down various blocking schemes used in pass protection around the league. Very informative, and goes well beyond "leave in extra players to block."
10 comments, Last at 19 Jan 2017, 4:22am by Amily
27 Dec 2016, 12:57pm by Aaron Schatz
The Bills decided not to wait until Black Monday to can Rex Ryan and brother Rob. Offensive coordinator Anthony Lynn will serve as interim coach for the Bills' finale Sunday against the New York Jets. This is the 17th straight season the Bills have missed the playoffs. They brought in Ryan to be a defensive expert, and instead the offense improved and the defense collapsed. Clear in-game mistakes didn't help, like the play this weekend where the Bills had only 10 men on the field and Jay Ajayi ran for 57 yards.
35 comments, Last at 07 Jan 2017, 5:54am by t.d.
It's a year of huge cornerback contracts, with A.J. Bouye and Stephon Gilmore breaking the bank. But will these big-money contracts, and the big-time gambles associated with them, pay off?


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Photo By klaus mayer
PS Marion Dining RoomPS Marion Dining Room - PHOTOGRAPHER COMMENT
Panorama of the dining room of Paddle Steamer Marion.
PS Marion Dining Room - FURTHER INFORMATION
PS Marion Dining Room - Mannum visitor guide showing a virtual tour of 'PS Marion Dining Room' linked to an interactive map with local and travel information. 360° panoramas from South Australia.


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Child Advocacy Center Over the Edge registration
January 12 - May 26
| variesEvent Navigation
On June 3, the Child Advocacy Center will once again take their fundraising to new heights. Partnering with Canadian-based "Over the Edge" and The Vecino Group in Springfield, they are offering 92 people the opportunity to rappel the Sky Eleven building in downtown Springfield. In exchange, each participant must raise a minimum of $1,000 to support the CAC's mission of putting the needs of the child first in the investigation of abuse.
A $50 non-refundable Early Bird Registration fee is offered through March 3, with scheduled monthly increases thereafter. To reserve a rappel spot, participants must be 16 years of age and raise a minimum of $1,000 before May 26. The $1,000 amount is the estimated cost of serving one child at the CAC.
The CAC provides child-friendly and age-appropriate services in a warm, welcoming, child-friendly environment. Behind the scenes a full team of investigators collaborates to determine the most appropriate action to take on behalf of each child victim. The agency served 1,349 children from 16 counties in 2016.


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This is a roomy motoryacht powered with Twin Caterpillar Diesels. She has three staterooms and a large saloon and aft deck. There have been many recent updates. She represents a lot of boat for the money.
Jeff Boger Cell 843.222.6167
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Harbourgate Marina
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This homemade costume for boys entered our 2015 Halloween Costume Contest.
A word from Cindy, the 'Little Ice Cream Man' costume creator:
this is my son Jandel Jioni age 3.
this costume idea came from the show "Face Off" I used foam sheet for the cone hat and cone on the sholder. The waffle effect was made with... Read more »


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Specialty Hospitals:
Geographic Location, Services Provided, and Financial Performance
GAO-04-167: Published: Oct 22, 2003. Publicly Released: Oct 22, 2003.
Additional Materials:
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The recent growth in specialty hospitals that are largely for-profit and owned, in part, by physicians, has been controversial. Advocates of these hospitals contend that the focused mission and dedicated resources of specialty hospitals both improve quality and reduce costs. Critics contend that specialty hospitals siphon off the most profitable procedures and patient cases, thus eroding the financial health of neighboring general hospitals and impairing their ability to provide emergency care and other essential community services. Critics also contend that physician ownership of specialty hospitals creates financial incentives that may inappropriately affect physicians' clinical and referral behavior. In April 2003, GAO reported on certain aspects of specialty hospitals, including the extent of physician ownership and the relative severity of patients treated (GAO-03-683R). For this report, GAO was asked to examine (1) state policies and local conditions associated with the location of specialty hospitals, (2) how specialty hospitals differ from general hospitals in providing emergency care and serving a community's other medical needs, and (3) how specialty and general hospitals in the same communities compare in terms of market share and financial health.
The 100 existing specialty hospitals identified by GAO--hospitals that focus on cardiac, orthopedic, or women's medicine or on surgical procedures--are geographically concentrated in areas where state policy facilitates hospital growth. Although 28 states have at least 1 specialty hospital, approximately two-thirds of the 100 specialty hospitals are located in 7 states. At least an additional 26 specialty hospitals were under development in 2003 and will tend to reinforce the existing pattern of geographic concentration. Specialty hospitals are much more likely to be found in states where hospitals are permitted to add beds or build new facilities without first obtaining state approval for such health care capacity increases. Relative to general hospitals, specialty hospitals, as a group, were much less likely to have emergency departments, treated smaller percentages of Medicaid patients, and derived a smaller share of their revenues from inpatient services. For example, 45 percent of specialty hospitals, but 92 percent of general hospitals, had emergency departments. There were, however, important differences among the four specialty hospital types in these and other service indicators. Although general hospitals typically have more beds than specialty hospitals, the focused mission of specialty hospitals often resulted in their treating more patients in their given fields of specialization. Financially, specialty hospitals tended to perform about as well as general hospitals did on their Medicare inpatient business. However, specialty hospitals tended to outperform general hospitals when the costs from all lines of business and the revenues from all payers were considered. Officials from three specialty hospital organizations commented on a draft of this report. They generally agreed with the report's information and commented on key differences between specialty and general hospitals.
Mar 2, 2017
FDA Has Encouraged Development, but Needs to Clarify the Role of Draft Guidance and Develop Qualified Infectious Disease Product GuidanceGAO-17-189: Published: Jan 31, 2017. Publicly Released: Mar 2, 2017.
Feb 27, 2017
Electronic Health Records:
HHS Needs to Improve Planning and Evaluation of Its Efforts to Increase Information Exchange in Post-Acute Care SettingsGAO-17-184: Published: Jan 27, 2017. Publicly Released: Feb 27, 2017.
Feb 15, 2017
Private Health Insurance:
In Most States and New Exchanges, Enrollees Continued to be Concentrated among Few Issuers in 2014 [Reissued on February 14, 2017]GAO-16-724: Published: Sep 6, 2016. Publicly Released: Sep 6, 2016.
Feb 13, 2017
CMS Needs Better Data to Monitor the Provision of and Spending on Personal Care ServicesGAO-17-169: Published: Jan 12, 2017. Publicly Released: Feb 13, 2017.
Feb 8, 2017
Medical Devices:
Cancer Risk Led FDA to Warn Against Certain Uses of Power Morcellators and Recommend New LabelingGAO-17-231: Published: Feb 7, 2017. Publicly Released: Feb 8, 2017. -
Medicaid Managed Care:
Improved Oversight Needed of Payment Rates for Long-Term Services and SupportsGAO-17-145: Published: Jan 9, 2017. Publicly Released: Feb 8, 2017.
Feb 6, 2017
Program Oversight Hampered by Data Challenges, Underscoring Need for Continued ImprovementsGAO-17-173: Published: Jan 6, 2017. Publicly Released: Feb 6, 2017.
Jan 31, 2017
CMS Has Taken Steps, but Further Efforts Are Needed to Control Improper PaymentsGAO-17-386T: Published: Jan 31, 2017. Publicly Released: Jan 31, 2017. -
Patient Protection and Affordable Care Act:
Concentration, Plan Availability and Premiums, and Enrollee Experiences in Health Insurance Markets Since 2014GAO-17-383T: Published: Jan 31, 2017. Publicly Released: Jan 31, 2017.
Jan 23, 2017
Federal Health Care Center:
VA and DOD Need to Develop Better Information to Monitor Operations and Improve EfficiencyGAO-17-197: Published: Jan 23, 2017. Publicly Released: Jan 23, 2017.
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National Public Radio recently reported the suspected abuses of nonprofit hospitals that sue and garnish the wages of low income, uninsured or underinsured patients. As a result of these reports, Senator Charles Grassley, R-Iowa and Chairman of the Senate Judiciary Committee says hospitals could be breaking the law.
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Category Archives: Health Reform
Noble Health Alliance Launches Website
In the age of healthcare reform, providers are looking for ways to offer patients a more comprehensive and integrated experience. Enter in Noble Health Alliance, a partnership of four Pennsylvania health systems (to date), formed to encourage population health and eliminate redundancies in healthcare.
Noble Health Alliance is based in Philadelphia and was founded 2013. The organization is one of our newest clients, and the first health alliance website we've launched.
Continue reading
CVS Health Rebranding – What Can Providers Do to Counter?
CVS rolled out a new brand along with the announcement that they are removing tobacco products from their shelves in all 7,600 stores and replacing those products with smoking cessation products. As a side note, Walgreens has also removed tobacco from their shelves but CVS Health rebranding takes this move to a new level.
Promises of More Patients: Uncertainties of the Affordable Care Act
It is almost a certainty that patient care volumes will increase after the complete rollout of the Affordable Care Act. Already, health systems are seeing a new level of demand that is burdening systems because of increased volumes. The patients you are currently treating that don't have health insurance are mandated to enroll in a health insurance product offered either through a Federal or State exchange program.
The most recent figures from the Department of Health show that 7.1 million people are now enrolled in ObamaCare. Of those, more than 26% or 1.8 million people are between the ages of 26 and 34. The thought behind Affordable Care was that more young people would enroll and force the premium cost down through risk sharing. Although the number of young people enrolling has not achieved the levels anticipated it is a very good start and creates an opportunity for health systems and providers.
The Affordable Care Act ensures that health plans in the individual and small group markets offer a comprehensive package of services, known as essential health benefits. Essential health benefits must include services such as: hospitalization; maternity and newborn care; substance abuse disorder treatment; wellness services, emergency care, along with pediatric services that includes oral and vision care.
The 2013 SHSMD Annual Conference in One Word
Having spent my week at SHSMD schmoozing with the biggest gathering of healthcare strategy, planning, communications, marketing and PR professionals that the Society has ever had, the current state of our industry can be summed up in a single word:
We've been on the cusp of major industry shifts for a few years now, but for all of the discussions and debate, no one is really sure what our industry is going to look like three years from now.
This week saw the biggest step to date in terms of actual implementation of the ACA (AKA Obamacare) and we're still playing a guessing game to determine what its real meaning to our service mix and financial picture will really be. Obamacare applies leverage to the edges of the healthcare system, but doesn't dictate what the care delivery system will look like or how it will work.
Healthcare Marketing Reform
I've spent a lot of time recently pondering the role of marketers in a post-reform healthcare system. Healthcare is undergoing an incredible period of change. While we're still unclear on the specifics of how things will play out, the failures of the current system that we hope to correct are well established:
- Costs are growing out of control.
- No accountability for the costs of delivering care.
- No accountability for quality or outcomes.
- The results that we get from the current investment is mediocre.
- A lack of consistent, evidence-based, data-driven decision making.
- Lots of waste resulting from a lack of coordination.
As marketers look to understand how we'll adapt to reform, there's no shortage of ideas. Some suggest that marketing will go away. Others predict that the goals of marketing will simply change. Instead of driving usage of expensive services such as cardiology and oncology, marketers would focus on driving volume to preventive and early detection services that would reduce or eliminate the overall costs of treatment. Still others suggest that, despite the changes, marketers will do pretty much of what they do today, only targeting that slice of the patient population with high-paying private insurance.
What I don't hear is any discussion about changing how marketing gets done.
What Health Reform Means for the Healthcare Web
We've written quite a lot about health reform in its various forms including Meaningful Use, ACOs, ACA, and medical home. But a question that I received this week made me realize that I've never written specifically about health reform's impact on your hospital's online strategy.
Greater Organization Complexity
Merging, acquiring, and employing docs and the many flavors of business relationship between hospitals, clinics and insurers that are emerging under reform means that your brand is getting pretty complicated. This isn't just a question about names and logos – your website has suddenly become the front door to a very complex and likely changing mix of doctors and services. Your job is to make it simple for every site visitor to get the information they want. I strongly recommend our webinar on using the Web to support complex organizations to dive into the topic in greater detail.
AHA Leadership Forum – Our World is About to Change
"Our world is about to change. Now, let's figure out what that might look like."
That is, in essence, what my week at the AHA Leadership Forum in San Francisco was all about. We all know that there's a tremendous wave coming in healthcare. The recurring theme was actually "the second wave" representing the shift from pay-for-service to the new models of healthcare reimbursement that are on the horizon. And the conference focused on determining what the industry will look like in the future.
As much as we've discussed the changes, much of that talk has either been very conceptual or very tactical – in essence missing the forest for the trees. The various legislative efforts that have gotten this ball rolling (ARRA, ACA) are really applying leverage at the edges of the healthcare system. But they don't do a good job describing what the core of the system will really look like when it's all said and done, let alone what will happen as we work through the processes of transformation.
While it may add to our collective discomfort, this is fundamentally a good thing. For all the complaints of politicians trying to change a healthcare system that they do not fully understand, we should be happy that they haven't attempted to dictate the details. They've set out meaningful goals specifically around the reimbursement model and then stepped out of the way to allow the healthcare system work out the details.
It's clear that we don't really know the details just yet – at least not all of the details. We do seem to understand where enough major challenges lie to keep us occupied for a while, however.
The ACA is Upheld! (Mostly)
It's been a crazy morning as everyone waited anxiously for the ruling. In fact, CNN cycled through several versions of pre-written responses to the decision flip-flopping from "The Supreme Court has struck down the individual mandate for health care" to simply "Upheld."
Within a few moments of the decision, the big items have become clear:
- The individual mandate, a critical lynchpin of the legislation, was upheld as constitutional. The key argument against the mandate held that the government cannot compel citizens to buy a product. In a 6-3 decision, with Chief Justice Roberts joining the majority, the mandate was determined to be a tax (or, rather, the fine that individuals would be required to pay for not purchasing insurance is a tax), nothing more, which the Federal Government has the right to levy.
- Broader questions of the constitutionality of the overall Accountable Care Act (ACA) were contingent on the fate of the individual mandate and were therefore not an issue.
- The other key issue relating to the Federal Government's ability to force an expansion of Medicaid. This too was ruled constitutional, but with the caveat that states would lose only a portion of Medicaid funding. Essentially, new funding that was added along with the new eligibility requirements, rather than all of their Medicaid funding.
Surprisingly simple, really.
Preparing for a SCOTUS ACA Ruling
Rather than adding to the conjecture and scenario-weaving running rampant through the blogosphere in anticipation of tomorrow's Supreme Court decision on the future of the Accountable Care Act, I thought I'd share a few worthwhile reads from other bloggers who have already covered every aspect of the health reform case.
Meaningful Use Stage 2 Ushers In the Age of the Patient
We've had a few weeks to wrap our heads around the Meaningful Use Stage 2 Notice of Proposed Rulemaking (NPRM) and it's clear that the Feds are looking to shake up the industry a bit. Why? It's time to pursue the true objectives underlying healthcare I.T. adoption in HITECH.
Meaningful Use Stage 1 has been successful in moving the industry toward medical record adoption. The hurdles for demonstrating Meaningful Use in Stage 1 are low, but have caused organizations to begin implementing basic infrastructures – and this will turn out to be a good foundation for what's to come. Unfortunately, Meaningful Use Stage 1 requirements have not broken the boundaries that exist between providers, hospitals and patients.
As we predicted, Meaningful Use Stage 2 seeks to give everyone involved the data they need by placing renewed focus on sharing information between providers, submitting public health data, and engaging patients and families.
The requirements around engaging patients and families have been amongst the most often deferred by provider organizations in Meaningful Use Stage 1. The NPRM clearly establishes that this goal of the HITECH Act isn't going away and raises the bar significantly for connecting with patients and their families online.
Meaningful Use Stage 2 Criteria
The following is a summary of the Meaningful Use Stage 2 criteria for patient and family engagement (with comparison to Meaningful Use Stage 1 in parenthesis):
- Of all patients who are discharged from the inpatient or emergency department:
- More than 50% have their information available online within 36 hours of discharge (Stage 1 was 10% and optional)
- More than 10% are provided patient-specific education resources identified by Certified EHR Technology (Stage 1 was optional)
- More than 10% view, download or transmit to a third-party their information during the reporting period (New)
- Of all unique patients seen by the eligible providers during the EHR reporting period:
- More than 50% are provided timely online access to their health information (timely is defined as within 4 business days after the information is available) – ( Stage 1 was 10% and optional)
- More than 10% view, download, or transmit to a third-party their health information (New)
- A secure message was sent by more than 10% of unique patients (New)
- For office visits:
- Clinical summaries provided to patients for more than 50% of office visits within 24 hours (Stage 1 was within 3 days)
- Patient-specific education resources are available for more than 10% of all office visits (Stage 1 was optional)
Obamacare, The Problem Child
In a series of high-stakes court battles, the Patient Protection and Affordable Care Act (PPACA) has viciously torn its way through the legal labyrinth. From a high-level procedural posture standpoint, many lower courts have heard cases involving PPACA.
U.S. District Judge Roger Vinson ruled that the individual health insurance mandate falls outside the federal authority in the Constitution, and that the provision could not be disconnected from PPACA; therefore concluding the entire Act must be struck down. In the converse, members of a three-judge panel at the District of Columbia U.S. Circuit Court of Appeals ruled 2-1 that the individual health coverage mandate is constitutional. The dissenting judge on the panel argued that the federal Anti-Injunction Act prohibits the federal courts from considering suits seeking to block implementation of new federal taxes, at least until they incur some sort of penalty. The 4th Circuit Court of Appeals agreed with that judge, dismissing two PPACA cases concerning the individual mandate, finding that the suits were barred under the Anti-Injunction Act.
The Eleventh Circuit Court of Appeals dividedly affirmed Judge Vinson's decision in part; the panel agreed that the mandate was unconstitutional, but held that it actually could be severed from the rest of the Act, allowing the rest of PPACA to remain. The federal government declined to seek review by the Eleventh Circuit and instead petitioned for the U.S. Supreme Court to review the panel's ruling. On November 14, 2011, the Supreme Court agreed to hear the case, and here we are today; the commencement of that hearing.
Does the problem child have a future?
Every child has a future. In this case, even if PPACA is struck down, all parties seem to agree that future healthcare reform will draw at least in part on Obamacare. However, in this case, of the four issues the Supreme Court has agreed to hear, the key issue is the constitutionality of the individual mandate.
According to a CMIO post, if the Court upholds the individual mandate it will go into effect in 2014. If they strike it down, the Court will then consider whether the mandate is severable from the remainder of the law, which will determine whether PPACA's other provisions survive. If the Court decides that the individual mandate is "inextricably linked" to PPACA as a whole, they will likely strike down the entire Act.
One of the most frequently asked questions in regard to the individual mandate is, "What does the provision mean for those who don't purchase healthcare?" Individuals who can but choose not to obtain qualifying health care coverage under this law will be required to pay a penalty as part of their income tax returns. In 2014, the penalty is $95 or 1% of the individual's income, whichever is greater.
However, according to NPR, PPACA provides a vast system of subsidies to help people afford health insurance. Subsidies are available to people on a sliding scale, up to 400% of the poverty level. This year that would be a family of three with an income up to $76,360 and a family of four up to $92,050. Even then, if there's no affordable policy available, people can be declared exempt. And most of those with insurance provided by their employer will meet the requirement automatically, so they won't have to do anything.
Happy 2nd Birthday, Baby Obamacare!
Just over two years ago, President Barack Obama officially gave birth to the Patient Protection and Affordable Care Act (PPACA) – inarguably one of the most momentous healthcare laws in our country's history. In fact, you'd be hard pressed to find a single person in America who won't at some point in the next two years be affected by PPACA, should it be upheld. And for those of you thinking you have no idea what I'm talking about, you might be more familiar with PPACA's alias "Obamacare."
Advocates of PPACA define PPACA as a federal statute that will ensure all Americans have access to affordable healthcare, and ultimately improve quality of care by rewarding doctors and hospitals who meet Meaningful Use criteria. Challengers of PPACA claim it's an act of socialism that will degrade quality of care, as the once uninsured masses flood ERs across the country causing demand to rise far more rapidly than supply.
One thing is certain: PPACA has led to an all-out war. Soldiers on both sides of this battle continue to launch politically contentious bombs at one another in the court of public opinion, seemingly oblivious to the fact that PPACA actually headed to the Supreme Court yesterday. And while these proceedings should catch the attention of all Americans (and even those abroad), members of the healthcare community should be particularly keen on how these pivotal six hours of arguments over the next few days play out.
Before anyone goes into this week's almost certain media frenzy over the Supreme Court hearing, there's some very basic information that can help get you up to speed on how President Obama's baby, so-called Obamacare, has grown – from conception to birth to its second birthday.
Conception by the Senate in the privacy of the House.
Many on the right fail to realize that the first iteration of what would become the PPACA was initially passed by the House – where the Constitution requires all revenue-related bills to originate – as a modification to the Internal Revenue Code. Many on the left fail to realize that the Senate used this iteration to catapult their own healthcare reform plan by completely revising it, incorporating terms they knew were favored by the Senate Health and Finance committees. After some debate and negotiations, the Senate passed the bill on December 24, 2009.
Planning for Kiddie Care.
Once the Senate's version of the bill got back to the House, White House Chief of Staff Rahm Emanuel argued for a scaled back bill in the face of the recently-elected Senator Scott Brown's imminent stalling tactics. Although President Obama leaned in support of Emanuel's proposal, he was soon convinced not to back down by House Speaker Nancy Pelosi, who dubbed Emanuel's pared down bill idea, "Kiddie Care."
President Obama then introduced a healthcare reform plan of his own, and over time was successful in gaining buy-in. The most viable option at that point for advocates of comprehensive reform was for the House to pass the Senate's bill, with every intention of subsequently passing amendments to it – much like the Senate did to the House's original version. After a considerable amount of negotiations that involved controversial concessions by President Obama, including one related to certain restrictions on federal funding of abortions, the House passed the bill on March 21, 2010.
Improved Health Literacy Won't Fix Healthcare
In many of the discussions about creating empowered, engaged patients, I hear a common theme: that improving the general health literacy of Americans will largely solve the problem. It's a view that, in hindsight, I've generally agreed with. If only health consumers understood the problems, challenges and tradeoffs of healthcare more fully we would stop bad behavior and when injury or illness occurred, we would make better decisions.
I have come to the conclusion that I've been wrong.
This idea has been percolating for a few weeks in the back of my mind after listening to a podcast debating a similar question for financial products. The always thought provoking Freakonomics podcast, an extension of the successful books of the same name, looked at the question of financial literacy as a way to prevent the next financial crisis.
We know the recent financial crisis had many causes, but at the bottom of the food chain were a lot of individual consumers who took out loans they couldn't afford. Some of those loans couldn't be afforded because the monthly payments were simply outside what's reasonable for that individual's income while others were very complex instruments in which payments ramped up dramatically over the course of the loan and, in some instances, included expensive penalties which made refinancing all but impossible.
More Insights on Meaningful Use Stage 2
As the conference room, and then the overflow room both surged beyond their capacities with HIMSS attendees looking for insights on Stage 2 of Meaningful Use, I began wondering if there would be anything for the presenters to say. Rumors of a new Notice of Proposed Rulemaking (NPRM) have been swirling for weeks with the date gradually slipping back. Checking Twitter again confirmed that nothing had yet been released this morning.
But we soon learned the NPRM was submitted this morning and will be released to the world later this week. Most importantly, our presenters were allowed to start sharing the important details.
Today's Meaningful Use Stage 2 discussion was a joint presentation with Farzad Mostashari and Steven Posnack from ONC joined by Elizabeth Holland and Travis Broome from CMS.
The presenters all reiterated that the committees involved have all stayed the course with the intent of the legislation, Stage 1 rules and discussions to date. And, as advertised, most of the information shared was to be expected. Still, with so many different stakeholders involved, it was good to get some confirmation about the direction they're proposing.
The major themes (and in the time available, we weren't able to get much more than themes) are as follows:
Streamlined Process
The regulations should be clearer and more flexible. Much of the feedback that the committees took to heart seems to have been in areas where the process didn't fit the situation. Organizations can now implement only what they need to achieve compliance rather than installing software simply to check a box. Likewise, vendors working on modular certification won't be required to test against criteria that do not apply to their tools.


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Leo's Fortune is an award-winning platform adventure game where you hunt down the cunning and mysterious thief that stole your gold!
Leo's Fortune play.google.com.leosfortune
Beautifully hand-crafted levels bring the story of Leo to life in this epic adventure.
through lush environments from mossy forests and arid deserts, to pirate cities and snowy mountains.
vicious traps and solve physics-based puzzles through 24 levels of treacherous platform adventure.
the trail of gold and uncover the truth behind Leo's stolen fortune in this award-winning platformer.
Finish Leo's Fortune to unlock Hardcore Mode: try to beat the whole game without dying, a rare feat among players of this epic platform adventure! Compete with your friends to beat as many levels as you can in the fastest time possible.
Leo's Fortune supports Game Controllers and Gamepads made for Android devices, Cloud Save, Leaderboards and Achievements.
What's in this version : (Updated : 17 October 2016)
- -Fixes for Android N and Chrome OS
Required Android O/S : 4.0.3+


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Seven sightings of mountain lions in Marin reported since July
There are 98 comments on the Marin Independent Journal story from Sep 24, 2010, titled Seven sightings of mountain lions in Marin reported since July. In it, Marin Independent Journal reports that:
The sighting of a mountain lion a few blocks from San Anselmo Town Hall last Saturday night wasn't the first time this year Marin residents have reported seeing a cougar.Join the discussion below, or Read more at Marin Independent Journal.
Since: Jul 09 297 Novato |
Sep 24, 2010
I guess we'll have to wait until someone is killed before we do anything about these predators. And it will happen, count on it.
""In dog years, I'm dead."" Since: Feb 08 2,568 Novato |
Sep 24, 2010
good . natural selection in action. Start with the city and county officials. |
Sep 24, 2010
Nicely watered gardens = deer = mtn lions. Duh. So best way to have fewer of 'em is... deer-proof your yards and encourage your neighbors to do the same. And don't feed your pets outside. And empty pet water bowls and bring your pets in before dark.
Oh, and yes, if you move into foothills, expect foothill fauna. Also duh. You can't shoot all the deer, therefore you won't get rid of all of the mountain lions. Seriously, people. |
Sep 24, 2010
Go change your shorts and deal with living in a wonderful County surrounded by Open Space.
Sep 24, 2010
California has no formal management plan for mountain lions.
Mountain Lions have no natural predators in California to keep their populations in check, so it's just a matter of time until there will be avoidable tragedy(s) before this is corrected. There have been many unsuccessful attempts by variuos lawmakers to introduce legislation that would overturn Proposition 117's lion-hunting restrictions, but the California urban population centers around San Francisco, Los Angeles and San Diego rule the roost and they've been told the story about "nice little kitty". This will hit home like a ton of bricks and it will be sad for those victims and their families when this comes to a head. |
United States |
Sep 24, 2010
who was in the area first ? thats right the cat so do not invite them if you do not want them . here kittie kittie
Sep 24, 2010
Cougar got the munchies while snacking on illegal aliens pot farm up in the watershed, came down for a meal of some dumb liberal suburbanites pet deer. Obama's fault!
Sep 24, 2010
Oh, I thought the story was about the other kind of cougars.
Sep 24, 2010
If you have ever taken an environmental science or a biology class you would know that populations of predators are generally low because they heavily depend on their prey. The more prey that are present, the more predators. When the predator populations becomes to high, they overeat their food source, therefore lowering it and leading to their own death. This keeps the mountain lion population pretty steady. Another example of this in Marin is the bobcat. They are rarely seen around here, but are present. If hunting was aloud, they would probably become extinct which would be detrimental for the ecosystem in Marin. |
Sep 24, 2010
I understand your viewpoint but also see pollution and encroachment hindering their day to day activities more so than your run of the mill predator. |
Sep 24, 2010
If its in my yard I am threatened and I got the gun.
Sep 24, 2010
Whoa...I actually learned something from this reading the IJ. I was unaware that a favorite suburban food of catamounts was feral/outdoor housecats. That is great. I like these guys more and more. Ironic that it is a cat that takes care of horrible eco damaging feral house cats. That is awesome. I was wondering why the coyotes moved away from the area in recent times...more lions coming in.
Sep 24, 2010
that's a little cold. |
Sep 24, 2010
There actually loads of bobcats in and around Marin country. I am well traveled in the more "wild" parts of the watershed land. And have seen many a bobcat on early morning/late afternoon jaunts. As for the cougars. Only 1 in all my travels. To be expected, since Bobcats are more successful, smaller and have more prey options around here. We even have a male that has claimed the area around my property as his current territory. Have seen him probably 10 times in the last year. As to your original statement...there is a slight problem with that. When the lions overproduce and have a population that is unsustainable, that is when problems occur. Noted attacks many times occur with stressed mothers trying to feed cubs(usually 2). Desperation makes them roam closer to people and take chances with what they decide to attack. Also young inexperienced animals being pushed out of territories are problems. Both cases could apply to the lions in Marin. I could endorse "removal" of problem cats. But at this time, nothing has happened to justify it. |
Sep 24, 2010
It is, yes. But I have personally seen what house cats that are breeding out of control do to the surrounding area. They are pretty bad to the surrounding natural areas. I have had some close bonds to lovely housecats. I knew a Maine Coon(not mine but a gf's) that was great...he was almost a dog in temperament...smart, loyal and loving. That still doesn't change the fact that feral cats are a scurge. |
Sep 24, 2010
Coyotes, skunks and cougars. It's a jungle out there. Still safer than Boro City.
Sep 24, 2010
I certainly wouldn't call them "horrible". I'd call then victims. And, they're not living their ideal life, trust me. There at the mercy of cars, creeps, critters, and more and must eke out their survival somehow.
And, that means eating whatever they can find...just like any other animal in the wild. That's certainly not their fault. Look to irresponsible people for that. They're your scourge. |
Sep 24, 2010
Cougars in the 80's were known to be sighted at Baxter's, The Cantina, and the 2am Club. Since then, it's just not the same.
Sep 25, 2010
And in the 60's and 70's were sighted at the Trident, Wimbledon, Sid & Jim's, Ancient Mariner, Old Mill Tavern, Uncle Charlies, Seetwater, Black Oak Saloon, Positively Fourth Street and more. |
Sep 25, 2010
Like the illegals, if nothing is done, we will have "anchor," kittens, and you know the rest of the story.
| |
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Comment | Dear Maria, Thank you for your great explanation about the use of the adjective basso. I so much appreciate your help, and I want you to know that your answer has helped me very much. Thank you for the many examples you gave me to study. I especially wanted to thank you for including the use of the imperfetto in some of your examples. This has helped me, and reminded me, to review the use of this important past tense. I very much appreciate the time you take to help me. Very Sincerely, Rich |
Italian is my mother tongue and I'll be glad to answer any questions concerning Italian Language.
Over 25 years teaching experience.
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Power BI Ideas
AWS Athena
Ability to connect to AWS Athena would be ideal. It is an excellent platform to manage large data while you are in the exploratory stages.
6 votes -
Microsoft Power BI does not support kerberos authentication while connecting Hadoop
Hi ,
BI Power not supporting Kerberos authentication to connect to Hadoop ,
PLease enable this asap , we are checking for another BI tool as BI power don't have this connectivity setup.
our Hadoop platoform is authincated by Kerberos.13 votes -
Conditional Dimensions
Qlik supports conditional dimensions. For example, the user can click a dropdown on top of the first column in a table and select another field. This binds the first column of the table to the selected field. So, instead of having a bunch of tables to show sales by product category, product, customer type, etc., there is just one table that can be dynamically rebound. In Power BI, this can be supported by allowing expression-based fields in the areas when configuring the visualization.
6 votes -
PLEASE!!! Make it available to signup using personal account
PLEASE!!! Make it available to signup using personal account to POWERBI.
7 votes -
Disable Export data function in Power BI Embeded
Currently Export data can be disabled from the service but not from Power BI Embeded. We want to keep our data from being able to exported by others and see Power BI Embeded as our prefered roll out solution but the lack of ability to turn off the export feature means that we are not currently able to use Embeded for this purpose. Ideally we need a way to control export data at a visual level but at minimum control at a dashboard / report level. This is a high priority feature for us to be able to complet our…
73 votes -
Customize report on real-time streaming in Power BI
Customer want to customize report (Custom visuals/ get visualization types from Power BI Visuals Gallery) on real-time streaming in Power BI.
Currently, It has only 5 report templates on real-time streaming.
1. Cards
2. Line Charts
3. Clustered Bar Charts
4. Clustered Column Charts
5. Gaugeshttps://www.pubnub.com/blog/2016-08-31-realtime-charts-and-graphs-with-microsoft-power-bi/
3 votes -
Add word wrap to bar chart Y-Axis Labels
If you have long names on a bar chart Y-Axis they get truncated. This is a problem if you have ones that start with something similar. Could we have a word wrap option on the format menu that takes advantage of the vertical space so the whole label can be shown.
6 votes -
It will be great if we can flow the slicer select from one page to another page. For example if I select category slicer in page 1 then it also needs to be reflect on page 2. Is it possible?
5 votes -
Advanced conditional formatting (based on another metric/cell/dimension)
I know there is a condtional formatting option available. However, it's to simple for my business case. I want to make a dashboard in which I can easily see if my results meet their target. The target is a changing metric, so I can't fill in a standard value (which is currently the case), but I would need to make the conditional formatting based on another metric/cell.
I would like to color my MetricA green if they are higher than MetricB. That's currently not possible. Also conditional formatting based on text or dimension is yet not possible. For example,…5 votes -
Automatic date hierarchy for direct query data
Automatic creation of a date hierarchy for date fields only seems to work for imported data. Please enable the same feature for direct query data!
54 votes -
Button or command to delete all selections (filters) made.
The idea is that there is a button or command that filters the selections (filters) made.
4 votes -
Custom Visuals Enabled every time Power BI Desktop launches
The idea would be that Custom Visuals can be downloaded to a local desktop "library". Then, each time you launch Power BI, all Custom Visuals would be available along with the Default Visuals. Having to import the Custom Visual each time you create a new .PBIX file is a pain!
221 votes -
Allow Free Users to see Reports that have Row Level Security Roles (made by a PRO)
It should be urgent to allow Free Users to see Reports that have Row Level Security Roles.
I got the PRO Trial for my work account and created a Report intended to be shared with different groups of (Free) users, each group with an specific Role.
It turns out they cannot look into the Report now since PRO License it's required.
Does this means I need to create a single different Report with a different filter each? This seriously diminishes the usefulness of the tool. What's the point of the PRO license if anything the PRO does cannot be shared…5 votes -
Export Dashboard in Interactive PDF
User should have the option in Power BI to export current dashboard in Interactive PDF (iPDF).
Interactive PDF can have the following features:
1- Easy to navigate
2- Easy to understand
3- Top navigation toolbar having different buttons allow you to navigate into the report
4- Easy drill down from one chart to another chartYou can see the demo video on the following link
https://docs.google.com/forms/d/e/1FAIpQLSdo1GWVtvF7W0InM6a4nrjNdrLPM_HPXoYWVw0I2zEKWWuAfw/viewform26 votes -
Automatically add spaces to column names upon data import
Please automatically add spaces to column names when they are named in Pascal/CamelCase/Underscores/etc.
Automate Friendly Column Naming (Pascal to Space Based)
3 votes -
Number formatting
The number formatting should be in accordance with excel. The options available in excel for number formatting is quite brilliant.
I hope Power BI can somehow integrate custom number formatting in the desktop version.Thank you.
8 votes -
Disable focus mode buttons in Power BI Embedded
Every visual on every report page now has the focus mode button, and there is no way of switching this off per visual.
It should be possible to switch this button off per visual.
Most visuals actually don't need focus mode at all (e.g. slicers, text boxes, etc.)
To deliver a high quality experience to the paying users of our app this is absolutely necessary, right now all pages of the report are littered with unnecessary boxes and buttons appearing all over it as the user interacts with a page, and no way for us to switch this off.
38 votes -
PowerBI In-session interactivity in PowerPoint
<<Stop cropping Power BI screenshots in a PowerPoint presentation!>>
I love this message, but I'm thinking that...people used to interact with reports, and If I'm seeing a report I want to use it.
To have PowerBI reports in powerpoint, in interactive mode, will be really great. (allowing an offline access using something like cache memory) I will not need anymore to create an account for people, and training them to show reports and dashboards, demo, ideas, whatever I can create in PowerBI.
People are always super busy and don't like to do something that take more times... this will be…5 votes -
Allow copy and paste between different PBIX's
Often we need to expand on an idea from one report further and copy and paste visuals/pages from one PBIX to another. This would be a huge productivity and quality benefit.
977 votesWanted to set expectations this isn't in our short term roadmap. 1/25/2017….This is pretty complicated due to the underlying data dependencies
Office 365 Audit Log Connector
Provide a Connector to the Office 365 Audit Log. While you can download the data into a CSV and then upload into Power BI, it would seem make sense that we should be able to take advantage of the Power BI functionality directly to analyze the Office 365 Audit Logs.
5 votes
- Don't see your idea?


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Palmistry, which is the fancy word for the 'art' of reading palms, is not exactly a science. It's not actually a science at all. We're not exactly sure how much we believe in this sort of thing, but the fact is, we've met some spooky people in our lives who really do seem to have at least some kind of insight beyond what the rest of us can hear, taste, touch, see and smell. Whether they're just particularly intuitive or really do have strange powers is something best left to the experts. We're here to have a little fun.
So, what do all those lines mean, anyway? Well, as you can imagine, the answer is a little complicated. But one major feature to look for is a connected "M" shape in the center of your palm when you hold it out in front of yourself.
According to Jon Saint-Germain, a palmistry practitioner confident enough in his craft to have authored several books on the subject, this shape is a clear indicator of several personality traits, including being a good judge of character.
Or maybe he says that about all his clients, eh?
For more information on this fascinating fringe subject, check out the video.


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NEW DELHI (AP) — At least six people, including two policemen, have died in explosions in eastern Bangladesh as troops battle suspected militants holed up with an ammunitions cache, police said Sunday.
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LONDON (AP) — Former Girls Aloud star Cheryl and her partner Liam Payne of One Direction fame have announced the birth of their first child.
ISLAMABAD (AP) — Pakistan says it has started building a fence along the Afghan border in areas where it says militants have launched cross-border attacks, a move that could worsen tensions with Afghanistan, which has never accepted the colonial-era frontier.
CINCINNATI (AP) — Police say 15 people were shot and one person was killed when gunfire erupted at a Cincinnati nightclub.
PARIS (AP) — French voters just won't tolerate corruption in politics anymore — that appears to be the message from the swift downfall of the country's powerful security minister.
LONDON (AP) — British police investigating an assault on Parliament that claimed four victims and wounded dozens say they still believe the assailant acted alone.
GAZA CITY, Gaza Strip (AP) — Gaza's Hamas rulers shut down the territory's main border crossing with Israel Sunday in a rare measure following the mysterious killing of a senior militant.
HONG KONG (AP) — A committee dominated by pro-Beijing elites chose Hong Kong's next leader Sunday in the first vote since huge pro-democracy protests erupted over the election system in 2014.
ATLANTA (AP) — Americans who have benefited from the Affordable Care Act are feeling some relief at the failure of Republican efforts to repeal it, but they face new anxieties with President Donald Trump tweeting that "ObamaCare will explode."
BLOUNT COUNTY, Ala. (AP) — Authorities in Alabama say two teenagers and two adults have been killed in a small plane crash.
The most entertaining college basketball game of the regular season came in December.
BEAVERTON, Ore. (AP) — On a misty Wednesday night, James Fowler spent hours driving around the Portland suburbs, directed by the phone affixed to his maroon Nissan's dashboard.
Charlie Hunnam has confessed his latest movie 'Lost Cities of Z' was a "love letter" to his girlfriend Morgana McNeils.
Justin Bieber is keen to collaborate with Zayn Malik as he was impressed with the singer's new sound.
NASHVILLE, Tenn. (AP) — A red hot Nashville Predators team made sure San Jose stayed ice cold.
LOS ANGELES (AP) — Take the New York Rangers off Broadway and they suddenly know how to shine again.
WASHINGTON (AP) — Alex Ovechkin is heating up down the stretch for the NHL-leading Washington Capitals.
Benedict Cumberbatch has reportedly become a father for the second time after his wife Sophie Hunter gave birth to a baby boy called Hal on March 3.
SOFIA, Bulgaria (AP) — Bulgarians are heading to the polls for the third time in four years in a snap vote that could tilt the European Union's poorest member country closer to Russia.
BERLIN (AP) — A state election Sunday in western Germany offers Chancellor Angela Merkel's conservatives a tough test against their resurgent center-left rivals six months before Merkel seeks a fourth term in a national vote.
BERLIN (AP) — A state election Sunday in western Germany offers Chancellor Angela Merkel's conservatives a tough test against their resurgent center-left rivals six months before Merkel seeks a fourth term in a national vote.
PORTLAND, Ore. (AP) — CJ McCollum seems to have a knack for playing well against the Minnesota Timberwolves.
GENEVA (AP) — A medical relief advocacy groups says over 100 hospitals in Syria were hit by Syrian or Russian airstrikes last year, urging the "fortification" of medical facilities such as by adding reinforced concrete or blast-resistant windows.
Fleur East admits she will be "stingy" on Mother's Day as she and her sister Keshia are buying a joint present for her mother Irene.
EDMONTON, Alberta (AP) — The Oilers know a postseason berth is imminent. Now it's just a matter of finding out where they'll fit in that playoff picture.
SCIO — Philomath senior Austin Gerding doesn't believe he's ever hit a ball 370 feet. In a nonconference baseball game Saturday against South Umpqua on the artificial turf field at Scio High School, Gerding sent a ball to straightaway center…
WASHINGTON (AP) — Alex Ovechkin recorded his 30th goal of the season and Daniel Winnik scored two goals, including the game-winner late in the third period, as the Washington Capitals overcame listless stretches to beat the lowly Arizona Coyotes 4-1…
SUNRISE, Fla. (AP) — The Florida Panthers needed a reason to feel good about themselves, and they got it.
HONG KONG (AP) — In no surprise, Hong Kong election panel picks Carrie Lam, Beijing's favored candidate, to be city's next leader.
Samira Wiley and Lauren Morelli tied the knot on Saturday March 25 in Palm Springs, six months after getting engaged.


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Donaji & the Magical Poncho
This is the story of a fearless girl and her encounter with the wicked cold wind god
4.31 / 5.00 5,683 ViewsHello,
This video was made for an art class exploring the ability to share art on the internet.
Music remix by DJ2% found at http://soundcloud.com/wpar3890/electro-k-pop-mix. Images in background taken from christmasstockimages.com. Animation video inspired by the dances of Korean pop stars.
The video can be downloaded at http://www.archive.org/details/K-popLove
All content (music, background images and video) is publicly available, so feel free to use any of these.
(PS: Excuse the lack of frames, I had to make the best I could in a day.)
i like it...bigfan of kpop
OHH B.E.G(Brown Eyed Girls) song=) good choice
Audio is clean, animation plays out fine too, not bad at all
easy on the eyes
Alright, that was not bad for making it in one day. Better than a lot of stuff on NewGrounds. Keep up the good work, i'd like to see what you come up with next.


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St. George Slays the Dragon (Serbian: Sveti Georgije ubiva aždahu) is a Serbian World War I drama. The movie starts with Kingdom of Serbia battling the remaining Turkish occupiers during the First Balkan War in 1912 and ends with the outbreak of World War I in 1914. The movie's central theme is a love triangle between the village gendarme Đorđe, his wife Katarina and the young disabled war veteran Gavrilo who was previously engaged to Katarina before he went to war and lost his arm in battle. Even though Katarina in the meantime married Đorđe, she still has affection for Gavrilo. At the onset of World War I, all able-bodied men in the village are recruited for combat. Left in the village are only women, children and disabled veterans from previous Balkan wars. Rumours start circulating that the invalids in the village are trying to take advantage of the situation by making their moves on the women in the village – the wives and sisters of the recruited men.
Overview from themoviedb.org


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The Gardens of Covington joyously celebrates women and friendships, families and love, laughing through the tears, thinking with the head and the heart. The ladies, so real and inspiring, will make you wish they were your neighbors.
If this is your first visit to the small town of Covington, you'll feel comfortably at home in the white farmhouse with the yellow shutters on Cove road that once again teems with warmth and fresh hope for today and tomorrow. If it's your second visit, you'll be thrilled to sit on the front porch once again and catch up with old friends and neighbors.
Hannah, cool-headed and calm, battles to save their beloved hills from the rapacious development that has already ruined Loring Valley, only five minutes form Cove Road. Amelia, giddy with a newfound love, abandons the ladies and her photography to please her dashing new beau. And Grace is driven to prove she has an eye for business when she and her steady companion, Bob Richardson, open the Cottage Tearoom.
New friends and neighbors are introduced. Eccentric Lurina Masterson, an eighty-one-year-old bride, brings tears of joy to all when, wearing her childhood dream of white satin, she married "Old Man," who is ninety-one. And George Maxwell, the ladies' closest neighbor, provides an inspired solution to preserving Covington's lush hills and valleys.
Joan Medlicott writes lovingly about the complexity and tenderness of women. she writes with honesty about relationships, about love and passion, about commitment and friendship, as well as about the intricate bonds between parents and their children.
As you join the ladies of Covington through their highs and their lows, their joys and their sorrows, you will not want the book to end, nor will you wish to leave their world behind you.
To view this DRM protected ebook on your desktop or laptop you will need to have Adobe Digital Editions installed. It is a free software. We also strongly recommend that you sign up for an AdobeID at the Adobe website. For more details please see FAQ 1&2. To view this ebook on an iPhone, iPad or Android mobile device you will need the Adobe Digital Editions app, or BlueFire Reader or Txtr app. These are free, too. For more details see this article.
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This has happened before, but it's still weird to see us entering an era of "PS4 Pro exclusive patches."
The next one on the docket is Dark Souls III, which will be rolling out patch 1.11 soon across all platforms, but the PS4 Pro specifically will be getting an extra benefit -- an enhanced framerate. It wasn't announced exactly how much of a boost it would be, but it's happening. It's the "pre-DLC" patch for the Ringed City add-on that hits on March 28, and will bring a bunch of extra bug fixes in as well.
Can we get that frame fix for Bloodborne next? That's one Souls (esque) game that would benefit from it the most, and it's a PS4 exclusive -- what a perfect match!
Dark Souls III [Steam]
... read more


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Motto sampler kits, Sampler Charts, Hand Carved frames, over dyed floss, Counted cross stitch charts and kits, hand dyed ric rac, chenille trim, buttons,and lace trims at affordable prices delivered worldwide.
Sunday, February 24, 2013
Spring floss give-away enter now!
Lets give 5 stitchers 5 skeins of floss to start. After this give away I will show some more spring colors and give away some more. Maybe some trims in new spring colors too.....
Rules: Be a follower and post a comment here. Post on your blog and get 10 more entries. Send a friend and get 10 more entries.
Drawing to be March 15th.
Let the comments begin!!!!
Thanks for stopping by.
214 comments:
- AnonymousFebruary 24, 2013 at 9:53 AM
Please add me to your giveaway! What a generous way to begin the countdown to spring!
Thank you!
Robin in Virginia
rlbrowninva @ gmail.com Would love to be entered. Found out from/sent by Angela Cruz-Garcia of http://stitchinginthezoo.blogspot.co.uk/2013/02/victorian-motto-sampler-shoppe-spring.html ... will also let you know once I post the details on my blog.
ReplyDelete- AnonymousFebruary 25, 2013 at 5:02 AM
Oh, Nancy, you tease! I would love to have some of your new spring colors. I have many of your colors and just love your floss. In fact I just finished an ornament using your floss...some reds and greens. It turned out gorgeous.
Thank you for your continued generosity.
Judy in Kansas - Kay EylesFebruary 25, 2013 at 5:19 AM
I am a happy follower. Thank you for sharing. Sprig is my favourite time of the year, full of hope and pretty flowers. I am sure the threads look lovely too.
ks(dot)eyles(at)yahoo(dot)co(dot)uk I'm here just in time for a giveaway! I love giveaways but there's just something about yours...could it be all that beautiful floss? or maybe the trims? the charts? Must be anything you give away is something we want! please throw my name in the pot. Going over to put you on my blog right now
ReplyDeleteNancy, I am SO READY for Spring in the Midwest. We had 4" of snow today and more to come tonight they tell us. I like the 4 seasons but winter can be a little too long. I hope you are staying warm and having a good winter. Thanks for the wonderful work you do for stitchers!!! I know you are appreciated and your love of floss just gets everyone excited with these lucious colors! Hope to win!
pjstitcher...pam in iowaFun! The colors sound so nice! Antique springy...just my style! After fighting to keep the flu bug off me all winter it finally caught me! So some nice spring stitching with beautiful colors sounds like the perfect medicine! I am a follower! And I have pinned it on my Pinterest. http://pinterest.com/pin/53761789274134621/
My pins for your giveaways have been re-pinned several times, so I'm glad your awesome site is making the rounds :)Hello Nancy,
Here I am again.Your follower,your floss lover.:)
Your giveaway is on my sidebar,on the right.


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From sensors to servers, TI has the right DSPs for every application.
Learn more about TI's Digital Signal Processors.
Ideal solutions for a variety of applications with reference designs.
Get news about your favorite digital signal processors, tools & software!
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Highest performance floating point DSPs in the industry
TI DSPs excel in performance-to-power ratio
DSP processors enable applications from sensors to servers
Quickly create differentiated products with TI's comprehensive suite of programming and debug tools


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Planning a party in Yuba and need a DJ? Searching for the perfect party Disc Jockey in Yuba, WI?
Get a FREE PRICE QUOTE from qualified DJs serving the Yuba area!
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Find the perfect Yuba DJ or Disc Jockey! Party Blast lists professional DJs and Disc Jockeys for parties in Yuba, WI.
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So I love the Head Raptors LTD. I can cant them I can adjust the flex etc. Just as importnat I like the rom in the toe box. What I don't like is that the heel feels too loose for my taste, at least on my right leg. So what do I do? Looking at the Raptor 130 and 150 the last is about 4mm less. Is that going to make that much of a difference, 4mm? Will any type of customizing help and if so what kind?
Thank you all.


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Navigating the New Testament with Emily Hatfield
About This Show
Show Info: Encourage. Enlighten. Empower.
Show Info: Encourage. Enlighten. Empower.
Episode #027 "Christian Symbols" HOST: Emily Hatfield Video of this episode: Show Notes: Explore two well-known Christian symbols and find out why they were used and what they mean. See photos of the symbols still in existance today in certain New Testament cities! Your Feedback Email: email@example.com Voicemail: 903-26-LIGHT (903-265-4448) If you enjoyed the show, please rate it on iTunes and write a brief review. That would help tremendously in getting the word out! Thanks. Previous Episodes Click here to see all of the episodes of Navigating the New Testament with Emily Hatfield. Subscription Links


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