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Renown Health President and CEO Tony Slonim, MD, DrPH, discusses efforts nationwide to develop a more effective and efficient way to deliver care. explains the benefits of Renown Health’s population health study with the Desert Research Institute and 23andMe.

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Not all memory loss is inevitable — there are several things you can do to keep your brain nimble at any age. Find out how brain exercises, a healthy diet and daily movement can improve your brain’s focus. A modest decline in memory is to be expected as we get older. We forget someone’s name but recall it later. We find the need to make lists to remember things more pressing. Manageable? Yes. But frustrating nonetheless. The good news is we don’t have to sit back and succumb to age-related memory loss. There are concrete things we can do at any age to keep our brains sharp, nimble and engaged. Five Simple Brain Exercises 1. Volunteer or participate in meaningful activities outside of work. This engages your brain and emotions in a healthy, positive way. 2. Engage in moderate, regular exercise to tone body and mind. Overall good health is critical to brain health. Even casual daily walking can boost your mental abilities. 3. Eat the rainbow. Choose to include plenty of colorful fruits and veggies and ease up on processed foods in your daily diet. The proper nutrients can improve circulation to your brain, which will amp up your cognitive abilities. Consult your doctor for the best diet and supplement choices for your specific health needs 4. Get a blood test to determine your body’s hormonal and nutrient levels. Specific hormones and nutrients can affect cognition. Be mindful of your cholesterol levels, and if you take cholesterol medications, such as statin drugs, be aware they can also affect your mental faculties. 5. Engage in brain activities like reading, crossword puzzles, Sudoku and Trivial Pursuit. These types of activities can improve your brain’s focus and concentration and — most important — test your memory and general knowledge. You derive more benefit by engaging in these activities consistently for short amounts of time, so make a weekly appointment with yourself to build brainpower.

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Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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Award given to Truckee Meadows Health Communities, Renown Health & Washoe County Health District. Truckee Meadows Healthy Communities (TMHC), Renown Health and the Washoe County Health District received the BUILD Health Challenge® award, a $250,000 grant to support Caring For Reno’s Elders (C.A.R.E.) program. The award comes as a collaborative result of more than 30 local organizations submitting a proposal for the funding. Renown Health announced that the organization is matching the grant alongside other pledged funding from the community, bringing the current C.A.R.E. support to $580,000. Together the entities will focus on senior loneliness and the health issues it creates. The partners are honored that Truckee Meadows was selected as one of 18 communities to receive funding from BUILD in the 2019-2021 term. “C.A.R.E will be a community approach to enhance life quality for elders by reducing social isolation and loneliness, issues that seriously impact senior health,” said co-team leader Kindle Craig, Sr. Director Renown Institutes. “Loneliness is the root cause of many issues including suicide1 , chronic disease2 and a reduction in lifespan3 . Washoe County senior suicide rates are two and four times the national rate for those aged 65 and 85 years, respectively4 . That is unacceptable.” Sharon Zadra, TMHC executive director and co-team leader, said this project will tackle barriers to socialization such as access to affordable housing, transportation and healthcare.  “We’ll bring the entire community on-board, long-term, to increase social connectedness and reduce health and mortality issues associated with loneliness by starting a cross generational ‘Kindness Epidemic,’” Zadra said. The BUILD Health Challenge is a national program focused on bold, upstream, integrated, local and data driven projects that can improve community health. The award provides funding, capacity building support and access to a national peer-learning network to enhance collaborative partnerships locally to address our community’s most pressing health challenges. The C.A.R.E team expresses special thanks to the BUILD Health Challenge for its support of this initiative. “Loneliness and isolation in our senior population leads to declines in both mental and physical health, and increased mortality,” said Kevin Dick, Washoe County District Health Officer. “We are incredibly honored to join the BUILD cohort, teaming with TMHC and Renown Health to bring long-term solutions by building a cohesive social network to improve the health of our elders.”  The BUILD Health Challenge® is made possible with the support of: BlueCross BlueShield of South Carolina Foundation, the Blue Cross and Blue Shield of North Carolina Foundation, Blue Shield of California Foundation, Communities Foundation of Texas, de Beaumont Foundation, Episcopal Health Foundation, The Kresge Foundation, Methodist Healthcare Ministries of South Texas, Inc., New Jersey Health Initiatives, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation. TMHC, Renown Health and WCHD have worked united for the last five years, rallying diverse partners and community leaders to influence and advocate for the region’s capacity to ensure a healthy community.

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In recent years, healthcare has undergone many important transitions. One of the greatest changes has been the transition from a fee-for-service model to a value-based care model. Historically, healthcare organizations were paid for the amount of services they performed. This payment model resulted in more tests and procedures ordered, which, in turn, increased our country’s health care costs. However, now our government incentivizes health systems to provide the highest quality of care at the lowest cost possible. This new payment model is called value-based purchasing or value-based care. In this model, providers focus on delivering more coordinated and effective care. Additionally, healthcare organizations track important metrics like patient engagement, population health, and hospital readmissions. At Renown Health, we know that progress on these metrics represents real improvements in our patients’ lives. Shifting Focus from Illness to Wellness Healthcare organizations have traditionally viewed a hospital stay as the center of a patient’s wellness journey. At Renown Health, we believe a key part of our job is to help people live well every day. This means we focus not only on treating illness and injury but also on prevention efforts to keep people out of the hospital. For example, our employees help patients hazard-proof their homes to prevent falls, as falls are the leading cause of injuries in older adults. We also provide affordable health screenings to catch disease in its early stages, when it is more treatable. Renown Health also recognizes that many of the diseases our patients face – from diabetes to cancer – have social and environmental origins. We know that creating a healthier community will have a positive impact on their physical and mental health. Renown Health partners with local organizations to address community-based issues like addiction, pedestrian safety, air and water quality, climate change, and nutrition. Working together, we can lower the number of people who need care and improve the health and wellbeing of our community. Creating healthier environments and communities will help us prevent disease, which in turn will help us decrease spending and improve health. Most importantly, it will help people live up to their full potential. Dr. Slonim on Twitter | @RenownCEOTonyMD Interested in hearing more of Dr. Slomin’s thoughts on health and healthcare? Engage with him on Twitter. Follow Tony

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As a clinician and a cancer survivor, I know that hope is an essential force that drives people to work through difficult situations. I also believe there’s a strong correlation between hope and wellness. Hope inspires us to make healthy choices today with the understanding that these behaviors will benefit us in the future.   In addition, an optimistic outlook helps patients face illness and injury with strength and confidence. While it’s easy for some people to maintain a positive outlook, it’s common to feel hopeless on a bad day. An important part of our job as healthcare providers is to help patients cultivate hope and build a strong foundation that carries them through their medical journey. The Importance of Family A common source of hope, for me and many others, is family. My family has recently welcomed our newest member, my first granddaughter, Emory. Becoming a grandparent has inspired me to reflect on the many blessings in my life. It’s not only been a opportunity to reflect, but also look ahead to the future. I often dream about the things Emory will accomplish one day, the kind of person she will become, and the world I want her to live in. These aspirations have renewed my determination to work hard and lead by example. At Renown Health, we know that hope and resilience are just as important in the recovery process as excellent medical care. That’s why we work with our patients to find sources of strength and inspiration in their own lives. We’re committed to helping our patients keep fighting the good fight for a healthier tomorrow.

Read More About My Inspiration to Keep Fighting Becoming a Grandparent