Jaw disorders in cats

Arzi B, Cissell DD, Verstraete FJ, Kass PH, DuRaine GD and Athanasiou KA. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006-2011). J Am Vet Med Assoc. 2013; 242: 69-75.

There are very few studies published on temporomandibular joint (TMJ) disorders in cats and dogs. These disorders are often painful and debilitating, with a detrimental impact on quality of life. In humans, the most common cause of TMJ disorders is osteoarthritis, but less in known for cats and dogs. The standard diagnostic tool in humans is magnetic resonance imaging (MRI), but computed tomography (CT) remains an important tool for TMJ disorders in small animals.
 
In this study, the investigators evaluated CT findings in 41 dogs and 17 cats with TMJ disorders. Medical records and CT images of the skull were examined from a dentistry and oral surgery practice for a 5-year period. In the 17 cats with evidence of a TMJ disorder, a fracture of the condylar process of the mandible was the most common finding (9 cats). Osteoarthritis (8 cats), luxation (4 cats), ankylosis (2 cats), and a tumor (1 cat) were the other findings on CT. Animals with TMJ disorders generally have multiple joint abnormalities and the most common signs are pain or decreased range of motion of the joint. All the cats with a TMJ fracture had signs of pain while resting along with fractures of bones in the maxillofacial region and soft tissue trauma. The study found no association between the presence and severity of TMJ osteoarthritis and age or body weight. CT is valuable for evaluating osseous (boney) lesions and the spatial positioning of the TMJ, and should be considered essential as part of a diagnostic workup of suspected TMJ disorders. [VT]

See also: Schwarz T, Weller R, Dickie AM, Konar M and Sullivan M. Imaging of the canine and feline temporomandibular joint: a review. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association. 2002; 43: 85-97. 

More on cat health:
Winn Feline Foundation Library
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Arzi B, Cissell DD, Verstraete FJ, Kass PH, DuRaine GD and Athanasiou KA. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006-2011). J Am Vet Med Assoc. 2013; 242: 69-75.

There are very few studies published on temporomandibular joint (TMJ) disorders in cats and dogs. These disorders are often painful and debilitating, with a detrimental impact on quality of life. In humans, the most common cause of TMJ disorders is osteoarthritis, but less in known for cats and dogs. The standard diagnostic tool in humans is magnetic resonance imaging (MRI), but computed tomography (CT) remains an important tool for TMJ disorders in small animals.
 
In this study, the investigators evaluated CT findings in 41 dogs and 17 cats with TMJ disorders. Medical records and CT images of the skull were examined from a dentistry and oral surgery practice for a 5-year period. In the 17 cats with evidence of a TMJ disorder, a fracture of the condylar process of the mandible was the most common finding (9 cats). Osteoarthritis (8 cats), luxation (4 cats), ankylosis (2 cats), and a tumor (1 cat) were the other findings on CT. Animals with TMJ disorders generally have multiple joint abnormalities and the most common signs are pain or decreased range of motion of the joint. All the cats with a TMJ fracture had signs of pain while resting along with fractures of bones in the maxillofacial region and soft tissue trauma. The study found no association between the presence and severity of TMJ osteoarthritis and age or body weight. CT is valuable for evaluating osseous (boney) lesions and the spatial positioning of the TMJ, and should be considered essential as part of a diagnostic workup of suspected TMJ disorders. [VT]

See also: Schwarz T, Weller R, Dickie AM, Konar M and Sullivan M. Imaging of the canine and feline temporomandibular joint: a review. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association. 2002; 43: 85-97. 

More on cat health:
Winn Feline Foundation Library
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If Republican governors are agreeing to expand Medicaid after lobbying by hospitals, can Beshear be far behind?

By Al Cross
Kentucky Health News

Florida Gov. Rick Scott's surprising announcement that he would use federal health-care reform money to expand the Medicaid program to households earning up to 138 percent of the poverty level "means the dominoes are falling," says Ron Pollack, executive director of Families USA, a consumer group that lobbied for the law. And another domino seems likely to be Democratic Kentucky Gov. Steve Beshear, without involvement by the state legislature.

Beshear has said he will expand Medicaid if Kentucky can afford it, and has mentioned that the state can reserve the right to pull out of the deal in 2017, when it must start paying a small but increasing share of the cost, reaching 10 percent in 2020. Scott used the same qualification.

Pollack told The New York Times that the message sent by seven Republican governors' acceptance of the deal is  “Even though I may not have supported and even strongly opposed the Affordable Care Act, it would be harmful to the citizens of my state if I didn’t opt into taking these very substantial federal dollars to help people who truly need it.” The GOP governors (of states outlined in Times map below) have said they will expand the program partly to protect rural hospitals and the poor.

"The change of heart for some Republican governors has come after vigorous lobbying by health industry players, particularly hospitals," the Times notes. "Hospital associations around the country signed off on Medicaid cuts under the health care law on the assumption that their losses would be more than offset by new paying customers, including many insured by Medicaid. . . . Every few days, state hospital associations and advocates for poor people issue reports asserting that the economic benefits of expanding Medicaid would outweigh the costs." (Read more)

Kentucky Hospital Association President Michael Rust said the trade group is for "universal coverage" by whatever means but is not lobbying Beshear for Medicaid expansion. "We assume he is" going to expand it, Rust said in an interview today. He said the association has not taken a position on bills that would require legislative approval of expansion and the health-insurance exchange being set up under the reform law. The legislation, Senate Bill 39 and SB40, passed the Republican-controlled Senate on party-line votes today, and are expected to die in the Democratic-majority House.

Senate Majority Floor Leader Damon Thayer said the bills were aimed at reining in "big daddy government." Here's a video from cn|2:

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

By Al Cross
Kentucky Health News

Florida Gov. Rick Scott's surprising announcement that he would use federal health-care reform money to expand the Medicaid program to households earning up to 138 percent of the poverty level "means the dominoes are falling," says Ron Pollack, executive director of Families USA, a consumer group that lobbied for the law. And another domino seems likely to be Democratic Kentucky Gov. Steve Beshear, without involvement by the state legislature.

Beshear has said he will expand Medicaid if Kentucky can afford it, and has mentioned that the state can reserve the right to pull out of the deal in 2017, when it must start paying a small but increasing share of the cost, reaching 10 percent in 2020. Scott used the same qualification.

Pollack told The New York Times that the message sent by seven Republican governors' acceptance of the deal is  “Even though I may not have supported and even strongly opposed the Affordable Care Act, it would be harmful to the citizens of my state if I didn’t opt into taking these very substantial federal dollars to help people who truly need it.” The GOP governors (of states outlined in Times map below) have said they will expand the program partly to protect rural hospitals and the poor.

"The change of heart for some Republican governors has come after vigorous lobbying by health industry players, particularly hospitals," the Times notes. "Hospital associations around the country signed off on Medicaid cuts under the health care law on the assumption that their losses would be more than offset by new paying customers, including many insured by Medicaid. . . . Every few days, state hospital associations and advocates for poor people issue reports asserting that the economic benefits of expanding Medicaid would outweigh the costs." (Read more)

Kentucky Hospital Association President Michael Rust said the trade group is for "universal coverage" by whatever means but is not lobbying Beshear for Medicaid expansion. "We assume he is" going to expand it, Rust said in an interview today. He said the association has not taken a position on bills that would require legislative approval of expansion and the health-insurance exchange being set up under the reform law. The legislation, Senate Bill 39 and SB40, passed the Republican-controlled Senate on party-line votes today, and are expected to die in the Democratic-majority House.

Senate Majority Floor Leader Damon Thayer said the bills were aimed at reining in "big daddy government." Here's a video from cn|2:

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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Deaths by overdose, mainly of prescription drugs, hit a new record in U.S. in 2011; a huge problem in Kentucky

Drug overdose deaths in the U.S. rose for the 11th straight year and accidental deaths involving addictive prescription drugs overshadow deaths from illicit narcotics, new federal data show.

In 2010, there were 38,329 drug overdose deaths nationwide, and prescription drugs were the cause of nearly 60 percent of them.  As in recent years, opioid drugs such as OxyContin and Vicodin were the biggest problem, contributing to three-fourths of medication-overdose deaths, report Lindsey Tanner and Mike Stoppe of The Associated Press.

Anti-anxiety drugs including Valium were involved in almost 30 percent of medication-related deaths.  Most were unintentional overdoses; 17 percent were rules suicides. The data were reported Tuesday in the Journal of the American Medical Association.

In Kentucky, drug abuse is epidemic and more than 1,000 Kentuckians a year die from prescription-drug overdoses, more than the number who die in car accidents, according to a 2012 Kentucky Justice & Public Safety Cabinet report. About 85 percent of Kentucky's drug-related deaths were accidental and approximately 2 percent were suicides, according to federal Centers for Disease Control and Prevention data.

The number of drug-overdose deaths in Kentucky rose a staggering 296 percent from 2000 to 2010. In 2010, the record number of deaths reflected the national trend and also involved opioid painkillers, according to a study by the Kentucky Injury Prevention and Research Center. The highest rates of overdose deaths during the study period were concentrated in Eastern Kentucky and among men, reports Bill Estep of the Lexington Herald-Leader.

Many doctors and patients don't realize how addictive these prescription drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs, said Dr. Thomas Frieden, head of the CDC. He said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" -- doctor offices and pharmacies that over-prescribe addictive medicines, AP reports.

That was the aim of House Bill 1, passed in last year's legislative session. The Kentucky All-Schedule Prescription Electronic Reporting  (KASPER) system has undergone several changes since the bill's passage to help crack down on so-called pill mills.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be placed in a more restrictive drug category, which would make them harder to prescribe. Refills wouldn't be allowed without a new prescription, and faxed or called-in prescriptions wouldn't be accepted; only a handwritten prescription from a doctor would be allowed.

Drug overdose deaths in the U.S. rose for the 11th straight year and accidental deaths involving addictive prescription drugs overshadow deaths from illicit narcotics, new federal data show.

In 2010, there were 38,329 drug overdose deaths nationwide, and prescription drugs were the cause of nearly 60 percent of them.  As in recent years, opioid drugs such as OxyContin and Vicodin were the biggest problem, contributing to three-fourths of medication-overdose deaths, report Lindsey Tanner and Mike Stoppe of The Associated Press.

Anti-anxiety drugs including Valium were involved in almost 30 percent of medication-related deaths.  Most were unintentional overdoses; 17 percent were rules suicides. The data were reported Tuesday in the Journal of the American Medical Association.

In Kentucky, drug abuse is epidemic and more than 1,000 Kentuckians a year die from prescription-drug overdoses, more than the number who die in car accidents, according to a 2012 Kentucky Justice & Public Safety Cabinet report. About 85 percent of Kentucky's drug-related deaths were accidental and approximately 2 percent were suicides, according to federal Centers for Disease Control and Prevention data.

The number of drug-overdose deaths in Kentucky rose a staggering 296 percent from 2000 to 2010. In 2010, the record number of deaths reflected the national trend and also involved opioid painkillers, according to a study by the Kentucky Injury Prevention and Research Center. The highest rates of overdose deaths during the study period were concentrated in Eastern Kentucky and among men, reports Bill Estep of the Lexington Herald-Leader.

Many doctors and patients don't realize how addictive these prescription drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs, said Dr. Thomas Frieden, head of the CDC. He said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" -- doctor offices and pharmacies that over-prescribe addictive medicines, AP reports.

That was the aim of House Bill 1, passed in last year's legislative session. The Kentucky All-Schedule Prescription Electronic Reporting  (KASPER) system has undergone several changes since the bill's passage to help crack down on so-called pill mills.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be placed in a more restrictive drug category, which would make them harder to prescribe. Refills wouldn't be allowed without a new prescription, and faxed or called-in prescriptions wouldn't be accepted; only a handwritten prescription from a doctor would be allowed.

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Alimentary lymphoma in cats

Russell KJ, Beatty JA, Dhand N, et al. Feline low-grade alimentary lymphoma: how common is it? J Feline Med Surg. 2012; 14: 910-2. 

The most common anatomical form of lymphoma in cats is alimentary lymphoma (AL). It is characterized by an infiltration of the gastrointestinal tract and/or associated lymph nodes with neoplastic (cancerous) lymphocytes. There are three subtypes based on mitotic rate and cell type (determined by examination of biopsy samples): low grade (LG-AL), intermediate-grade (IG-AL), and high-grade (HG-AL). Low-grade alimentary lymphoma requires a histological evaluation of biopsies for diagnosis while intermediate- and high-grade alimentary lymphoma can be diagnosed by cytology of intestinal or mesenteric lymph node aspirates. It is usually not possible to differentiate LG-AL from inflammatory bowel disease or benign lymphoid hyperplasia by using cytology alone. 

The authors investigated the relative prevalence of AL subtypes diagnosed by both histopathology and cytology among cases in Australia over a 5-year period. The studied identified 53 cases of AL, comprising 30 diagnosed by histology (15 LG-AL, 13, HG-AL, 2 IG-AL) and 23 (IG-AL/HG-AL) diagnosed by cytology. LG-AL accounted for 28% of all diagnosed alimentary lymphoma cases, and 50% of cases diagnosed by histopathology. A palpable abdominal mass, anemia, and a gastrointestinal mural (wall) mass found on abdominal ultrasound (0% of LG-AL cases) were more common in IG-AL/HGAL than in in LG-AL. Gastric/intestinal wall thickening was the most commonly reported abnormality (82%) when a detailed abdominal ultrasound report was available. When intestinal thickening was noted, a loss of normal layering was more common in cats with IG-AL/HG-AL than those with LG-AL. Hypoalbuminemia (low serum albumin levels) was found in 25% of the cats with IG-AL/HG-AL and none of the cats with LG-AL. Of 15 cats tested for FIV and FeLV, 3 were positive for FIV antibody and none were positive for FeLV antigen. [VT]

See also: Willard MD. Alimentary neoplasia in geriatric dogs and cats. Vet Clin North Am Small Anim Pract. 2012; 42: 693-706, vi. 

Related blog posts:
Feline lymphoma and body weight status (Apr. 2012)
Feline lymphoma therapy (Sept. 2011)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Russell KJ, Beatty JA, Dhand N, et al. Feline low-grade alimentary lymphoma: how common is it? J Feline Med Surg. 2012; 14: 910-2. 

The most common anatomical form of lymphoma in cats is alimentary lymphoma (AL). It is characterized by an infiltration of the gastrointestinal tract and/or associated lymph nodes with neoplastic (cancerous) lymphocytes. There are three subtypes based on mitotic rate and cell type (determined by examination of biopsy samples): low grade (LG-AL), intermediate-grade (IG-AL), and high-grade (HG-AL). Low-grade alimentary lymphoma requires a histological evaluation of biopsies for diagnosis while intermediate- and high-grade alimentary lymphoma can be diagnosed by cytology of intestinal or mesenteric lymph node aspirates. It is usually not possible to differentiate LG-AL from inflammatory bowel disease or benign lymphoid hyperplasia by using cytology alone. 

The authors investigated the relative prevalence of AL subtypes diagnosed by both histopathology and cytology among cases in Australia over a 5-year period. The studied identified 53 cases of AL, comprising 30 diagnosed by histology (15 LG-AL, 13, HG-AL, 2 IG-AL) and 23 (IG-AL/HG-AL) diagnosed by cytology. LG-AL accounted for 28% of all diagnosed alimentary lymphoma cases, and 50% of cases diagnosed by histopathology. A palpable abdominal mass, anemia, and a gastrointestinal mural (wall) mass found on abdominal ultrasound (0% of LG-AL cases) were more common in IG-AL/HGAL than in in LG-AL. Gastric/intestinal wall thickening was the most commonly reported abnormality (82%) when a detailed abdominal ultrasound report was available. When intestinal thickening was noted, a loss of normal layering was more common in cats with IG-AL/HG-AL than those with LG-AL. Hypoalbuminemia (low serum albumin levels) was found in 25% of the cats with IG-AL/HG-AL and none of the cats with LG-AL. Of 15 cats tested for FIV and FeLV, 3 were positive for FIV antibody and none were positive for FeLV antigen. [VT]

See also: Willard MD. Alimentary neoplasia in geriatric dogs and cats. Vet Clin North Am Small Anim Pract. 2012; 42: 693-706, vi. 

Related blog posts:
Feline lymphoma and body weight status (Apr. 2012)
Feline lymphoma therapy (Sept. 2011)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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Plunge into a Carnival Cruise! Passengers newest victims of corporate atrocities, Natural News has more on this

Expecting a great time onboard? Surely you wouldn’t feel the same after reading about the latest corporate atrocity that victimized a few hundred Americans looking for nothing more than a few days of luxurious holidays. What did they get? Hellish conditions – take it figuratively, literally, materialistically, whichever way you want to – all is true. And to add insult to injury, a spokesperson for Carnival seems to put all the blame on the passengers.

 

The passengers were left stranded on a floating potty with no electricity, unequally rationed food and water, toilets that didn’t flush, floors covered in urine and toilet paper. Anything could have happened – people could have been killed or raped or robbed. Natural News Editor Mike Adams gets to the readers  exclusive coverage of this incident, the side the mainstream media buries.

http://www.naturalnews.com/039100_Carnival_cruise_cleansing_Law_of_Attraction.html

"You create your own reality"

Carnival Cruise spokesperson;

"They brought that on board with them like baggage." - (refering to their feces and urine!)

- So what does this mean? Passengers were supposed to empty their bowels and stay without food for 48 hours prior to boarding the cruise?

Is there any limit to how much deeper in excrement these corporate biggies can take themselves to just for the sake of bathing in profits earned from the misery of innocent citizens?

 

Did you know that traveling in airplanes is equivalent to flying in 'tube of human feces?' Read this:

http://www.naturalnews.com/038108_airplanes_filth_human_feces.html

In fact, officials have admitted themselves – they have no regulations for cleaning the seats or handles or trays. In such a situation, how can you increase your immunity? Go through the blogs in Natural Newsand get to know more about Superfoods if you want to survive these difficult times.
 

http://store.naturalnews.com/Superfoods_c_4.html

Immunity response: Mike Adams has the Natural News Store on line and user friendly:

http://store.naturalnews.com/Immunity-Response_c_11.html

 

 

 

 

Expecting a great time onboard? Surely you wouldn’t feel the same after reading about the latest corporate atrocity that victimized a few hundred Americans looking for nothing more than a few days of luxurious holidays. What did they get? Hellish conditions – take it figuratively, literally, materialistically, whichever way you want to – all is true. And to add insult to injury, a spokesperson for Carnival seems to put all the blame on the passengers.

 

The passengers were left stranded on a floating potty with no electricity, unequally rationed food and water, toilets that didn’t flush, floors covered in urine and toilet paper. Anything could have happened – people could have been killed or raped or robbed. Natural News Editor Mike Adams gets to the readers  exclusive coverage of this incident, the side the mainstream media buries.

http://www.naturalnews.com/039100_Carnival_cruise_cleansing_Law_of_Attraction.html

"You create your own reality"

Carnival Cruise spokesperson;

"They brought that on board with them like baggage." - (refering to their feces and urine!)

- So what does this mean? Passengers were supposed to empty their bowels and stay without food for 48 hours prior to boarding the cruise?

Is there any limit to how much deeper in excrement these corporate biggies can take themselves to just for the sake of bathing in profits earned from the misery of innocent citizens?

 

Did you know that traveling in airplanes is equivalent to flying in 'tube of human feces?' Read this:

http://www.naturalnews.com/038108_airplanes_filth_human_feces.html

In fact, officials have admitted themselves – they have no regulations for cleaning the seats or handles or trays. In such a situation, how can you increase your immunity? Go through the blogs in Natural Newsand get to know more about Superfoods if you want to survive these difficult times.
 

http://store.naturalnews.com/Superfoods_c_4.html

Immunity response: Mike Adams has the Natural News Store on line and user friendly:

http://store.naturalnews.com/Immunity-Response_c_11.html

 

 

 

 

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Vaccine Bombshell: Leaked Confidential Document Exposes 36 Infants Dead After This Vaccine

A confidential GlaxoSmithKline document recently leaked to the press exposed that within a two-year period, a total of 36 infants died after receiving the 6-in-1 vaccine, Infanrix Hexa.
According to the website Initiative Citoyenne who reported the news, the 1271 page document revealed that GlaxoSmithKline received a total of 1,742 reports of adverse reactions between October 23, 2009, and October 22, 2011, including 503 serious adverse reactions and 36 deaths.
Initiative Citoyenne stated:
“It’s not that 14 deaths were recorded by GSK between October 2009 and end in October 2011 as we had originally calculated but 36 (14 from 2010 to 2011 and 22 from 2009 to 2010).  

In addition to these 36 deaths at least 37 other deaths (sudden death mainly), bringing the total to at least 73 deaths since the launch of the vaccine in 2000, and again, this concerns only the death by sudden death, no further recovery of under-reporting.”
Click the link to read more:
Vaccine Bombshell: Leaked Confidential Document Exposes 36 Infants Dead After This Vaccine

A confidential GlaxoSmithKline document recently leaked to the press exposed that within a two-year period, a total of 36 infants died after receiving the 6-in-1 vaccine, Infanrix Hexa.
According to the website Initiative Citoyenne who reported the news, the 1271 page document revealed that GlaxoSmithKline received a total of 1,742 reports of adverse reactions between October 23, 2009, and October 22, 2011, including 503 serious adverse reactions and 36 deaths.
Initiative Citoyenne stated:
“It’s not that 14 deaths were recorded by GSK between October 2009 and end in October 2011 as we had originally calculated but 36 (14 from 2010 to 2011 and 22 from 2009 to 2010).  

In addition to these 36 deaths at least 37 other deaths (sudden death mainly), bringing the total to at least 73 deaths since the launch of the vaccine in 2000, and again, this concerns only the death by sudden death, no further recovery of under-reporting.”
Click the link to read more:
Vaccine Bombshell: Leaked Confidential Document Exposes 36 Infants Dead After This Vaccine

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Three Kentucky health departments in first group up for national accreditation; requires local health assessment, improvement plan

By Molly Burchett
Kentucky Health News

Three Kentucky health departments are among the first in the nation to be considered for national accreditation, a process that could help improve patient care and put the agencies in closer touch with their communities' needs.

The national Public Health Accreditation Board will make its first accreditation decisions next week. Among the first group being considered are the Franklin County Health Department, the Three Rivers District Health Department in Carroll, Gallatin, Owen and Pendleton counties, and the Northern Kentucky Independent District Health Department, in Boone, Grant, Kenton and Campbell counties.

The decision will be a historic one, and this is an exciting time for the board and Kentucky, said board Chair Dr. Douglas Scutchfield, professor of health services research and policy at the University of Kentucky College of Public Health.

The accreditation program was launched in September 2011 after a seven-year development process aimed at advancing quality and performance and value in the departments, and their accountability to stakeholders, Scutchfield said.

Departments are assessed by rigorous standards tested in 30 diverse health departments across the country to ensure essential public health services are provided in the community, according to the board's website. Two of the 12 "domains" of the standards deal with administration and governance. In Kentucky, state law makes county health boards responsible for the health of the county. Counties served by district health departments still have county boards.

Accreditation can help a board and department identify opportunities to improve performance and management, and to improve relationships with the community, since the process requires a community health assessment, a community improvement plan and a strategic plan to address the need of the community, said Scutchfield.

The process, often called "Mobilizing for Action through Planning and Partnerships," can help boards and departments be better prepared to proactively respond to emerging and re-emerging health challenges. For a PDF of Franklin County's MAPP document, click here.

The accrediting board has received 108 applications from health departments around the nation: 13 state health departments, 94 local health departments and one tribal agency. In addition to the three Kentucky agencies being considered in the first group, the other Kentucky departments that have applied for accreditation and are awaiting site visits are Lexington-Fayette County, Barren River District, Madison County and Christian County, Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said in an email.

The accreditation process encourages departments to move away from the "silo" model to collaborate with community programs. In Christian County, it has changed the way department employees view their jobs, because they have to continuously reflect on their methods and brainstorm for ways to improve, Health Department Director Mark Pyle told Nick Tabor of the Kentucky New Era.

"Accreditation will likely open new revenue streams," Tabor writes. "But in a way, the process matters more than the status designation."

Midkiff said, "In addition to benefiting from the process itself, our federal and state resources in public health are increasingly shrinking, we are being asked to do more with less. And there is a need for transparency within agencies."

Midkiff said accreditation "may make the agency more competitive for grants in the future. We are actually seeing quality improvement and performance management requirements being written in many federal grants now, so it is being expected at the national level."

Although accreditation is completely voluntary, it is being encouraged for local health departments by the state Department for Public Health, which is in the process of applying for its own accreditation in 2014. Midkiff said the department just completed its state health assessment, which is now being reviewed, and is beginning to assemble partners to write a state health improvement plan, which should take about a year.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

By Molly Burchett
Kentucky Health News

Three Kentucky health departments are among the first in the nation to be considered for national accreditation, a process that could help improve patient care and put the agencies in closer touch with their communities' needs.

The national Public Health Accreditation Board will make its first accreditation decisions next week. Among the first group being considered are the Franklin County Health Department, the Three Rivers District Health Department in Carroll, Gallatin, Owen and Pendleton counties, and the Northern Kentucky Independent District Health Department, in Boone, Grant, Kenton and Campbell counties.

The decision will be a historic one, and this is an exciting time for the board and Kentucky, said board Chair Dr. Douglas Scutchfield, professor of health services research and policy at the University of Kentucky College of Public Health.

The accreditation program was launched in September 2011 after a seven-year development process aimed at advancing quality and performance and value in the departments, and their accountability to stakeholders, Scutchfield said.

Departments are assessed by rigorous standards tested in 30 diverse health departments across the country to ensure essential public health services are provided in the community, according to the board's website. Two of the 12 "domains" of the standards deal with administration and governance. In Kentucky, state law makes county health boards responsible for the health of the county. Counties served by district health departments still have county boards.

Accreditation can help a board and department identify opportunities to improve performance and management, and to improve relationships with the community, since the process requires a community health assessment, a community improvement plan and a strategic plan to address the need of the community, said Scutchfield.

The process, often called "Mobilizing for Action through Planning and Partnerships," can help boards and departments be better prepared to proactively respond to emerging and re-emerging health challenges. For a PDF of Franklin County's MAPP document, click here.

The accrediting board has received 108 applications from health departments around the nation: 13 state health departments, 94 local health departments and one tribal agency. In addition to the three Kentucky agencies being considered in the first group, the other Kentucky departments that have applied for accreditation and are awaiting site visits are Lexington-Fayette County, Barren River District, Madison County and Christian County, Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said in an email.

The accreditation process encourages departments to move away from the "silo" model to collaborate with community programs. In Christian County, it has changed the way department employees view their jobs, because they have to continuously reflect on their methods and brainstorm for ways to improve, Health Department Director Mark Pyle told Nick Tabor of the Kentucky New Era.

"Accreditation will likely open new revenue streams," Tabor writes. "But in a way, the process matters more than the status designation."

Midkiff said, "In addition to benefiting from the process itself, our federal and state resources in public health are increasingly shrinking, we are being asked to do more with less. And there is a need for transparency within agencies."

Midkiff said accreditation "may make the agency more competitive for grants in the future. We are actually seeing quality improvement and performance management requirements being written in many federal grants now, so it is being expected at the national level."

Although accreditation is completely voluntary, it is being encouraged for local health departments by the state Department for Public Health, which is in the process of applying for its own accreditation in 2014. Midkiff said the department just completed its state health assessment, which is now being reviewed, and is beginning to assemble partners to write a state health improvement plan, which should take about a year.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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