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Tom Richards is the only Australian-born rugby player to have played for both Australia and the British Lions. When the Australian team won the Gold Medal for rugby at the 1908 Olympic Games, the London Times pronounced: \"If ever the Earth had to select a Rugby Football team to play against Mars, Tom Richards would be the first player chosen.\" This book will tell something of Richards' extraordinary sporting life, but it mainly reproduces highlights from the very entertaining diary he kept during WWI. He had worked part-time with the Sydney Morning Herald before he enlisted and he would write between 100-800 words about his experiences each day, giving a revealing, intimate account of what occurred throughout the Gallipoli campaign and then the Western Front, where he received a Military Cross for his courage under German fire. He was acerbic in his opinions, often critical of his superiors and fellow soldiers; he was a great observer of human tragedy and frailties, repeatedly finding fault with the British in charge, and meeting numerous important War figures, including Simpson at Gallipoli. He included vivid descriptions of football matches played in Egypt, Gallipoli, and on the Front, and there are also numerous lighter moments, as Richards sought out and was intrigued by strange characters.

Using electronic health records (EHRs), in addition to claims, to systematically identify patients with factors associated with adverse outcomes (geriatric risk) among older adults can prove beneficial for population health management and clinical service delivery. To define and compare geriatric risk factors derivable from claims, structured EHRs, and unstructured EHRs, and estimate the relationship between geriatric risk factors and health care utilization. We performed a retrospective cohort study of patients enrolled in a Medicare Advantage plan from 2011 to 2013 using both administrative claims and EHRs. We defined 10 individual geriatric risk factors and a summary geriatric risk index based on diagnosed conditions and pattern matching techniques applied to EHR free text. The prevalence of geriatric risk factors was estimated using claims, structured EHRs, and structured and unstructured EHRs combined. The association of geriatric risk index with any occurrence of hospitalizations, emergency department visits, and nursing home visits were estimated using logistic regression adjusted for demographic and comorbidity covariates. The prevalence of geriatric risk factors increased after adding unstructured EHR data to structured EHRs, compared with those derived from structured EHRs alone and claims alone. On the basis of claims, structured EHRs, and structured and unstructured EHRs combined, 12.9%, 15.0%, and 24.6% of the patients had 1 geriatric risk factor, respectively; 3.9%, 4.2%, and 15.8% had ≥2 geriatric risk factors, respectively. Statistically significant association between geriatric risk index and health care utilization was found independent of demographic and comorbidity covariates. For example, based on claims, estimated odds ratios for having 1 and ≥2 geriatric risk factors in year 1 were 1.49 (P<0.001) and 2.62 (P<0.001) in predicting any occurrence of hospitalizations in year 1, and 1.32 (P<0.001) and 1.34 (P=0.003) in predicting any occurrence of hospitalizations in year 2. The results demonstrate the feasibility and potential of using EHRs and claims for collecting new types of geriatric risk information that could augment the more commonly collected disease information to identify and move upstream the management of high-risk cases among older patients.

OBJECTIVE:The aim of this study was to identify areas of consensus in response to proposed Equal Employment Opportunity Commission Americans with Disabilities Act of 1990 and Genetic Information Nondiscrimination Act of 2008 regulations on employer-sponsored health, safety, and well-being initiatives. METHODS:The consensus process included review of existing and proposed regulations, identification of key areas where consensus is needed, and a methodical consensus-building process. RESULTS:Stakeholders representing employees, employers, consulting organizations, and wellness providers reached consensus around five areas, including adequate privacy notice on how medical data are collected, used, and protected; effective, equitable use of inducements that influence participation in programs; observance of reasonable alternative standards; what constitutes reasonably designed programs; and the need for greater congruence between federal agency regulations. CONCLUSION:Employee health and well-being initiatives that are in accord with federal regulations are comprehensive, evidence-based, and are construed as voluntary by employees and regulators alike.