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RUSK Insights on Rehabilitation Medicine

RUSK Insights on Rehabilitation Medicine is a top podcast featuring interviews with faculty and staff of RUSK Rehabilitation as well as leaders from other rehabilitation programs around the country. These podcasts are being offered by RUSK, one of the top rehabilitation centers in the world. Your host for these interviews is Dr. Tom Elwood. He will take you behind the scenes to look at what is transpiring in the exciting world of rehabilitation research and clinical services through the eyes of those involved in making dynamic breakthroughs in health care.
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Aug 31, 2016

Dr. Bruce Gans serves as Executive Vice President and Chief Medical Officer of the Kessler Institute for Rehabilitation and National Medical Director for Rehabilitation for Select Medical, the parent company for Kessler. He also currently is the Chairman of the Board of the American Medical Rehabilitation Providers Association. His distinguished career in the field of Physical Medicine and Rehabilitation spans five decades as a leading clinician, educator, researcher, administrator, and advocate. A prolific writer and researcher, he has served on the editorial boards and as a reviewer for numerous medical journals and just concluded many years of service as an Associate Editor of the American Journal of Physical Medicine and Rehabilitation. Dr. Gans also has presented hundreds of lectures throughout the world on various topics in PM&R. He is past president of both the American Academy of Physical Medicine and Rehabilitation and the Association of Academic Physiatrists. His medical degree is from the University of Pennsylvania and he also holds Master of Science degrees from both the University of Pennsylvania and the University of Washington. Among his many honors, he is the 2016 recipient of the Rusk Award for Leadership and Innovation in PM&R. In this special three-part edition, Dr. Gans provides incredible insight on a multitude of topics including managed care and Continuing Care Hospitals, pediatric transition to adult care services, and the importance of patient-reported outcomes. 

Aug 24, 2016

Dr. Bruce Gans serves as Executive Vice President and Chief Medical Officer of the Kessler Institute for Rehabilitation and National Medical Director for Rehabilitation for Select Medical, the parent company for Kessler. He also currently is the Chairman of the Board of the American Medical Rehabilitation Providers Association. His distinguished career in the field of Physical Medicine and Rehabilitation spans five decades as a leading clinician, educator, researcher, administrator, and advocate. A prolific writer and researcher, he has served on the editorial boards and as a reviewer for numerous medical journals and just concluded many years of service as an Associate Editor of the American Journal of Physical Medicine and Rehabilitation. Dr. Gans also has presented hundreds of lectures throughout the world on various topics in PM&R. He is past president of both the American Academy of Physical Medicine and Rehabilitation and the Association of Academic Physiatrists. His medical degree is from the University of Pennsylvania and he also holds Master of Science degrees from both the University of Pennsylvania and the University of Washington. Among his many honors, he is the 2016 recipient of the Rusk Award for Leadership and Innovation in PM&R. In this special three-part edition, Dr. Gans provides incredible insight on a multitude of topics including managed care and Continuing Care Hospitals, pediatric transition to adult care services, and the importance of patient-reported outcomes. 

Aug 17, 2016

Dr. Bruce Gans serves as Executive Vice President and Chief Medical Officer of the Kessler Institute for Rehabilitation and National Medical Director for Rehabilitation for Select Medical, the parent company for Kessler. He also currently is the Chairman of the Board of the American Medical Rehabilitation Providers Association. His distinguished career in the field of Physical Medicine and Rehabilitation spans five decades as a leading clinician, educator, researcher, administrator, and advocate. A prolific writer and researcher, he has served on the editorial boards and as a reviewer for numerous medical journals and just concluded many years of service as an Associate Editor of the American Journal of Physical Medicine and Rehabilitation. Dr. Gans also has presented hundreds of lectures throughout the world on various topics in PM&R. He is past president of both the American Academy of Physical Medicine and Rehabilitation and the Association of Academic Physiatrists. His medical degree is from the University of Pennsylvania and he also holds Master of Science degrees from both the University of Pennsylvania and the University of Washington. Among his many honors, he is the 2016 recipient of the Rusk Award for Leadership and Innovation in PM&R. In this special three-part edition, Dr. Gans provides incredible insight on a multitude of topics including managed care and Continuing Care Hospitals, pediatric transition to adult care services, and the importance of patient-reported outcomes. 

Aug 10, 2016

Elena Savvides is a music therapist on the in-patient pediatric unit at Rusk Rehabilitation where she provides both individual and group music therapy services to children and families, with occasional services provided on the surgery recovery unit. She has received specialized training in neurologic music therapy, which is the therapeutic application of music to cognitive, sensory, and motor dysfunctions that come from varied neurologic disorders. She is currently in the process of developing a Rhythmic Auditory Stimulation (RAS) pilot program in the pediatric outpatient rehabilitation unit at Rusk. Her Master’s of Music Therapy degree with specialization in Psychotherapy is from Wilfrid Laurier University in Waterloo, Ontario. In this interview, Elena discusses her experiences with initiating the RAS program. 

Aug 3, 2016

Dr. Kenneth Harwood is Director of the Health Care Quality Program and Director of Research for the Program in Physical Therapy at The George Washington University. Prior to his being at The George Washington University, he was the Vice President of Practice and Education for the American Physical Therapy Association where he oversaw Association efforts and activities designed to improve and enhance the state of physical therapy education and practice. Dr. Harwood has held academic positions at Columbia University, New York University and SUNY, Health Sciences Center at Brooklyn. He earned his bachelor’s in Physical Therapy from the State University of New York at Downstate Medical Center and his master’s and PhD degrees from New York University’s Biomechanics and Ergonomics Program. He has published and presented nationally and internationally in the area of physical therapy, occupational health, low back pain care and prevention, safe patient handling and movement, health care policy and quality, and leadership. In this interview, Dr. Harwood discusses his study of the benefits of direct access to physical therapy and the effects that direct access has on health care costs, emergency department visits, and opioid use.

Jul 27, 2016

Dr. David Cifu is Chairman and the Herman J. Flax Endowed Professor of the Department of Physical Medicine and Rehabilitation at the Virginia Commonwealth University School of Medicine in Richmond, Virginia. He also is Chief of PM&R Services of the VCU Health System and Founding Director of the VCU-Center for Rehabilitation Sciences and Engineering. He is the Senior Traumatic Brain Injury Specialist for the U.S. Department of Veterans Affairs. He also serves as the Executive Director of the Athletic Development and Integrated Injury Management System for the National Hockey League Florida Panthers. He has been funded on 39 research grants for over $130 million, including currently serving as Principal Investigator of the VA/DoD $62.2 million Chronic Effects of Neurotrauma Consortium. As an academic physiatrist, he has delivered more than 525 regional, national and international lectures, published more than 200 scientific articles and 65 abstracts, and co-authored or edited 30 books and book chapters. He is a Past President of the American Academy of PM&R (2007-8) and Editor-in-Chief of the 5th Edition of Braddom’s Physical Medicine and Rehabilitation textbook (2015). His medical degree is from Boston University and he did post-graduate training at the Baylor College of Medicine. In this two-part interview, Dr. Cifu discusses traumatic brain injury with most of the emphasis on what is being done with veterans who were hurt in combat, as well as other aspects of treating brain injury, such as patient-reported outcomes and reducing health disparities among different racial/ethnic groups in the U.S. population. 

Jul 20, 2016

Dr. David Cifu is Chairman and the Herman J. Flax Endowed Professor of the Department of Physical Medicine and Rehabilitation at the Virginia Commonwealth University School of Medicine in Richmond, Virginia. He also is Chief of PM&R Services of the VCU Health System and Founding Director of the VCU-Center for Rehabilitation Sciences and Engineering. He is the Senior Traumatic Brain Injury Specialist for the U.S. Department of Veterans Affairs. He also serves as the Executive Director of the Athletic Development and Integrated Injury Management System for the National Hockey League Florida Panthers. He has been funded on 39 research grants for over $130 million, including currently serving as Principal Investigator of the VA/DoD $62.2 million Chronic Effects of Neurotrauma Consortium. As an academic physiatrist, he has delivered more than 525 regional, national and international lectures, published more than 200 scientific articles and 65 abstracts, and co-authored or edited 30 books and book chapters. He is a Past President of the American Academy of PM&R (2007-8) and Editor-in-Chief of the 5th Edition of Braddom’s Physical Medicine and Rehabilitation textbook (2015). His medical degree is from Boston University and he did post-graduate training at the Baylor College of Medicine. In this two-part interview, Dr. Cifu discusses traumatic brain injury with most of the emphasis on what is being done with veterans who were hurt in combat, as well as other aspects of treating brain injury, such as patient-reported outcomes and reducing health disparities among different racial/ethnic groups in the U.S. population. 

Jul 13, 2016

This special panel discussion includes three leading professionals including Dr. Jonathan Whiteson, Dr. Tamara Bushnik, and Michelle Smith. Dr. Whiteson is Medical Director of Cardiac and Pulmonary Rehabilitation at Rusk. His research interests include: cardiac rehabilitation for patients with advanced congestive heart failure and after left ventricular assist device placement. His medical degree is from the University of London and he did his residency at NYU Medical Center in Physical Medicine and Rehabilitation where he also completed a fellowship in cardiac and pulmonary rehabilitation. Dr. Tamara Bushnik is the Director of Research at Rusk. She oversees the activities, research, and administration of the Research Department, including responsibility for teaching roles for the Physical Medicine & Rehabilitation residents and allied health care professionals.  Her PhD in Neuroscience is from the University of Ottawa and she has completed post-doctoral work at Stanford University. Michelle Smith is an Assistant Research Scientist. at Rusk. She received her Masters of Public Health from Columbia University with a focus on health promotion. Her background and interests are in health communication with the goal to provide vital information to patients as a means of improving their health status.  In this two-part interview, the three panel members discuss the future of mobile technology and tele-monitoring in cardiac rehabilitation as well as specific aspects of an out-patient study being conducted by the interviewees.

Jul 6, 2016

This special panel discussion includes three leading professionals including Dr. Jonathan Whiteson, Dr. Tamara Bushnik, and Michelle Smith. Dr. Whiteson is Medical Director of Cardiac and Pulmonary Rehabilitation at Rusk. His research interests include: cardiac rehabilitation for patients with advanced congestive heart failure and after left ventricular assist device placement. His medical degree is from the University of London and he did his residency at NYU Medical Center in Physical Medicine and Rehabilitation where he also completed a fellowship in cardiac and pulmonary rehabilitation. Dr. Tamara Bushnik is the Director of Research at Rusk. She oversees the activities, research, and administration of the Research Department, including responsibility for teaching roles for the Physical Medicine & Rehabilitation residents and allied health care professionals.  Her PhD in Neuroscience is from the University of Ottawa and she has completed post-doctoral work at Stanford University. Michelle Smith is an Assistant Research Scientist. at Rusk. She received her Masters of Public Health from Columbia University with a focus on health promotion. Her background and interests are in health communication with the goal to provide vital information to patients as a means of improving their health status.  In this two-part interview, the three panel members discuss the future of mobile technology and tele-monitoring in cardiac rehabilitation as well as specific aspects of an out-patient study being conducted by the interviewees.

Jun 29, 2016

Dr. Marilyn Moffat is a Full Professor of Physical Therapy at NYU, where she directs both the professional doctoral program (DPT) and the post-professional graduate master's degree program in pathokinesiology. She is immediate Past-President of the World Confederation for Physical Therapy and she coordinated efforts to develop international guidelines for physical therapist educational programs and standards of physical therapy practice around the world. She completed a six-year term as the President of the American Physical Therapy Association (APTA) in 1997 during which time she was instrumental in the development of both the “Guide to Physical Therapist Practice” and the “Normative Model for Physical Therapist Education.” She has taught and provided consultation services in countries all over the globe. Her many publications include two books for the lay audience and a four-book series for physical therapy clinicians and students. She has received numerous national and international awards, including the Rusk Rehabilitation Ambassador Award in 2015 and also has had various honors named after her. Her physical therapy certificate, master’s degree, and PhD are from New York University. In this interview, Dr. Moffat discusses the human movement system and the degree to which physical therapy has adopted and integrated it in the three areas of practice, education, and research.

Jun 22, 2016

Dr. Komal Shah is a full time senior physical therapist in the acute care hospital setting. She has been practicing for more than seven years. Her focus is on the intensive care units, starting in the neurological ICU, and currently working in the medical ICU. Her experience includes treating patients on the neurology floor, neurological intensive care unit, stroke step down unit, general medicine floor, and medical intensive care unit. Her special interests are on the neurological and cardiothoracic populations and engaging in various quality improvement projects. She has collaborated with an interdisciplinary team to create a lecture for registered nurses to understand the role of PT/OT/SLP across the continuum of care. Her doctorate in physical therapy is from the University of Medicine and Dentistry of NJ and she is board certified in Neurology. Most recently, Dr. Shah made a presentation at the national physical therapist conference in 2016. In this interview, she discusses her involvement in the early mobilization of patients at high risk of vasospasm in the neurological intensive care unit.

Jun 15, 2016

Katie Ann Sheeran received her doctorate degree from New York Medical college and has worked for over 5 years at Rusk specializing in adult neurological rehabilitation. Mike Post received his doctorate degree in physical therapy from Ithaca College and has worked for 2 years at Rusk in the departments of outpatient neurological, orthopedic, and vestibular rehabilitation. Estelle Gallo received her doctorate degree from NYU, and has worked for over 14 years at Rusk. She is a board certified clinical specialist in neurology from the American Board of Physical Therapy Specialties. Jaime Cepeda received his doctorate degree from Rutgers University and has worked for over 7 years at Rusk specializing in neurological and limb loss rehabilitation. In this interview, panel members discussed their combined efforts to enable patients with an acquired brain injury to continue on with their lives more successfully through high level mobility training. 

Jun 8, 2016

​Holly Cohen is the Program Manager of the Assistive Technology Service at NYU Langone Medical Center. Along with her clinical experience, she holds certification in assistive technology from the Rehabilitation and Engineering and Assistive Technology Society of North America and has a specialty certification in environmental modifications from the AOTA.  She has been an adjunct professor in the Department of the Occupational Therapy in the Steinhardt School at New York University since 2005 and has lectured at national conferences focusing on technology use for individuals with disabilities. A previous interview with her was posted in the Rusk podcast series on October 29, 2015. It had a focus on a Driving Rehabilitation program, which she started and continues to manage. In this interview, Holly focuses on how assistive technology is used in occupational therapy to treat patients.

Jun 1, 2016

Dr. Sonya Kim is a research scientist at the NYU School of Medicine, where she has a joint appointment as a clinical instructor in the Neurology and Rehabilitation Medicine departments. She is a licensed clinical psychologist and a certified rehabilitation counselor. Her major research interests include chronic traumatic brain injury, cognitive deficits in individuals with multiple sclerosis, and exploring the mechanisms and interventions that help rehabilitate functioning post-brain injury. She pioneered the use of heart rate variability biofeedback to improve emotional regulation for individuals with severe and chronic brain injury. Currently, she is the principal investigator on a study funded by the Consortium of Multiple Sclerosis Centers. Using a qualitative approach, this study aims to develop an instrument to measure post-traumatic growth in the partner of an individual with this disease. Dr. Kim
earned her doctoral degree in clinical psychology with an emphasis on health from Yeshiva University’s Ferkauf School of Psychology in 2011. Her postdoctoral fellowship was at the Holy Name Medical Center’s Multiple Sclerosis Center. In this interview, Dr. Kim discusses the use of heart rate variability feedback to improve regulation for patients with severe and chronic traumatic brain injury. Sonya Kim: Pioneed of Heart Rate Variability in TBI Provides In-Depth Look at Novel Approach

May 25, 2016

Dr. Mary Fischer is a Physical Therapy Clinical Specialist inAcute Care at NYU Langone Medical Center and a board-certifiedGeriatric Clinical Specialist. Her Masters degree in PhysicalTherapy is from Columbia University and she has a Doctorate inPhysical Therapy from Stony Brook University.
Dr. Kristine Josef is a Physical Therapy Clinical Specialist in theMedically Complex and Cardiac Adult Inpatient Rehabilitation unitat Rusk Rehabilitation and a board-certified Neurologic ClinicalSpecialist. Her doctorate in Physical Therapy is from RutgersUniversity.
In this special edition two-person interview, Dr. Fischer and Dr.Josef discuss over two parts the factors contributing to the riskof falling by patients recently discharged from the hospital andthe role that gait speed plays in falls.

May 18, 2016

Dr. Mary Fischer is a Physical Therapy Clinical SpecialistinAcute Care at NYU Langone Medical Center and aboard-certifiedGeriatric Clinical Specialist. Her Masters degree inPhysicalTherapy is from Columbia University and she has a DoctorateinPhysical Therapy from Stony Brook University.
Dr. Kristine Josef is a Physical Therapy Clinical Specialist intheMedically Complex and Cardiac Adult Inpatient Rehabilitationunitat Rusk Rehabilitation and a board-certified NeurologicClinicalSpecialist. Her doctorate in Physical Therapy is fromRutgersUniversity.
In this special edition two-person interview, Dr. Fischer andDr.Josef discuss over two parts the factors contributing to therisk of falling by patients recently discharged from the hospitalandthe role that gait speed plays in falls.

May 11, 2016

Dr. Allen Brown from the Mayo Clinic Physical Medicine and Rehabilitation studies the process of providing medical rehabilitation care to individuals after their brain function has been altered by injury or disease. The long term goal of his research is to improve participation in roles meaningful to these individuals through testing of rehabilitation models of care in the real world. His research team works within the communities of the upper Midwest to study population-based epidemiology of brain injury (such as incidence, cost, survival), new interventions for improving walking after stroke and negotiating public transportation using smart phone technology, and community-based randomized clinical trials of complex clinical interventions to improve advocacy skill and quality of life after brain injury. His team has investigated the benefit of using personal activity monitors to provide detailed feedback about physical activity and progress during inpatient rehabilitation after stroke. A graduate of the University of Minnesota Medical School, his work has been published widely in prestigious journals. In this interview, Dr. Brown discusses enhancing advocacy skill attainment by patients, their family members, and caregivers to obtain community-based services; headache classification and development of standardized approaches; characteristics of inpatient traumatic brain injury patients that influence discharge location; key rehabilitation research topics; transforming patterns of workforce training; and fostering patient-centered care.

May 4, 2016

Dr. Allen Brown from the Mayo Clinic Physical Medicine and Rehabilitation studies the process of providing medical rehabilitation care to individuals after their brain function has been altered by injury or disease. The long term goal of his research is to improve participation in roles meaningful to these individuals through testing of rehabilitation models of care in the real world. His research team works within the communities of the upper Midwest to study population-based epidemiology of brain injury (such as incidence, cost, survival), new interventions for improving walking after stroke and negotiating public transportation using smart phone technology, and community-based randomized clinical trials of complex clinical interventions to improve advocacy skill and quality of life after brain injury. His team has investigated the benefit of using personal activity monitors to provide detailed feedback about physical activity and progress during inpatient rehabilitation after stroke. A graduate of the University of Minnesota Medical School, his work has been published widely in prestigious journals. In this interview, Dr. Brown discusses enhancing advocacy skill attainment by patients, their family members, and caregivers to obtain community-based services; headache classification and development of standardized approaches; characteristics of inpatient traumatic brain injury patients that influence discharge location; key rehabilitation research topics; transforming patterns of workforce training; and fostering patient-centered care.

Apr 27, 2016

Dr. Katie Ann Sheeran is a senior Physical Therapist in the neurologic outpatient physical therapy department at Rusk. She has worked at NYU since June 2010 and rotated through acute care and acute rehabilitation before becoming a permanent senior physical therapist in the outpatient department. Along with treating patients with neurologic, medically complex, and orthopedic conditions, she runs the Facial Reanimation Program, which focuses on restoring symmetry and spontaneous functional facial movement in patients with facial nerve palsy and synkinesis, a condition that can develop in patients after an episode of Bell’s palsy and other diagnoses, including acoustic neuroma resection, Guillain-Barre, and Ramsey Hunt syndrome. Her bachelor’s degree is from the University of Vermont and she has a Doctorate in Physical Therapy from New York Medical College. In this interview, she discusses several neurologic conditions that require physical therapy and provides additional details on the importance of this area.  

Apr 20, 2016

Claribell Bayona is a senior occupational therapist who has been working at New York University Langone Medical Center for 11 years. At Rusk, her responsibilities are in the outpatient service providing occupational therapy to individuals with neurological conditions where she specializes in limb loss rehabilitation of upper and lower limb amputees. She has provided multiple in-services to staff and interdisciplinary team members on the role of occupational therapy and limb loss rehabilitation and works closely with the rehab team to help limb loss clients achieve independence with their everyday activities. She has written chapters in rehabilitation textbooks and made presentations at national conferences. One of her bachelor’s degrees is in Anthropology from the University at Buffalo and a second one is in Occupational Therapy from Stony Brook University. She currently is pursuing a doctorate in occupational therapy at Quinnipiac University. In this interview, she discusses the kinds of conditions and situations  that result in amputation as well as a number of other elements of amputation and functional ability. 

Apr 13, 2016

Jeffrey M. Cohen, MD is a Clinical Professor of Rehabilitation Medicine at New York University School of Medicine and an Attending Physician in the Department of Rehabilitation Medicine at, NYU-Langone Medical Center. He is the Chief of the Medically Complex Specialty Program, Director of the Limb Loss Program, and Rehabilitation Director of the Neuromuscular Disease Center and the Diabetic Foot and Ankle Clinic at NYU. In this two-part interview, Dr. Cohen discusses kidney and liver transplant and the process for rehabilitation. 

Apr 6, 2016

Jeffrey M. Cohen, MD is a Clinical Professor of Rehabilitation Medicine at New York University School of Medicine and an Attending Physician in the Department of Rehabilitation Medicine at, NYU-Langone Medical Center. He is the Chief of the Medically Complex Specialty Program, Director of the Limb Loss Program, and Rehabilitation Director of the Neuromuscular Disease Center and the Diabetic Foot and Ankle Clinic at NYU. In this two-part interview, Dr. Cohen discusses kidney and liver transplant and the process for rehabilitation. 

Mar 30, 2016

Dr. Miguel Escalón is an Assistant Professor and Attending Physician in the Department of Rehabilitation Medicine at Mount Sinai since 2014. He is the Director of Critical Care Rehabilitation at Mount Sinai and the Associate Residency Program Director of the PM&R residency program. He was voted teacher of the year by the residents during his first year as an attending physician. He specialized in cellular and molecular biology at The University of Chicago before obtaining his medical degree and a Master’s in public health from the University of Illinois. After medical school, he  completed a Physical Medicine and Rehabilitation residency at The Alliance Program of the Baylor College of Medicine and University of Texas at Houston. Following residency, he completed a Spinal Cord Injury fellowship at Mount Sinai in NYC in 2014. He is a board member of Wheeling Forward, a non-profit organization dedicated to bettering the lives of persons with disabilities. In this interview, Dr. Escalon provides background on Wheeling Forward, post-stroke spasticity management, the use of robotic exoskeletons, stem cell implantation, and the role of technology in helping to improve care among other exciting topics. 

Mar 24, 2016

Dr. Mia Palazzo is the Program Manager of Physical Therapy, Occupational Therapy, and the Sports Performance Center at NYU Langone’s Center for Musculoskeletal Care. Her areas of specialty and interest include concussion related neck pain, mechanical spine disorders, and running related injuries. As Program Manager of the Sports Performance Center, Mia has been an integral part of the development and implementation of the internationally known Running Lab at NYU Langone. Mia is a Board Certified Clinical Specialist in Orthopedics through the American Board of Physical Therapy Specialties. She also is certified by the McKenzie Institute in the Mechanical Diagnosis and Treatment of the Spine.  She earned her Master’s degree in Physical Therapy from Long Island University and went on to receive her Doctorate in Physical Therapy from Temple University. In this interview, Dr. Palazzo discusses the Running Lab, the role of the neck in concussion patients, whiplash injuries, and broader market trends in the field of physical therapy. 

Mar 16, 2016

Dr. Michael D'Agati is a Clinical Specialist at The Center for Musculoskeletal Care at NYU Langone Medical Center and a Clinical Instructor, at NYU’s School of Medicine. The Rusk Institute has given him advanced skills and research awards and two substantial grants to support his research. He is the current Chairperson of the NYU Rusk Physical Therapy Research Committee. He is a Board Certified Clinical Specialist in Orthopedics through the American Board of Physical Therapy Specialties and a Certified Orthopedic Manual Therapist through Maitland Australian Physiotherapy Seminars. Dr. D’Agati graduated Summa Cum Laude with his clinical doctorate in physical therapy from NYU. In 2013, he won the Clinical Educator of the Year Award from The New England Consortium of Academic Coordinators of Clinical Education. He currently is a Ph.D. candidate at Rutgers University, pursuing a second doctorate leading to a teaching and research career. In this interview, Dr. D'Agati reviews the literature supporting orthopedic manual therapy, factors determining what interventions may be most appropriate for patients, prevention, and low technology approaches. 

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