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The State University of New York (SUNY), Downstate Medical Center initiated a Master of Public Health (MPH) degree program in July 2001 following planning efforts that began in 1995. Twelve students entered the program in June 2002, and currently some 110 MPH students and 12 Doctor of Public Health (DrPH) students are enrolled. This article describes the long and complex process of transforming the original MPH degree program, with its single focus on urban and immigrant health, with a student enrollment of 12 and 8 full-time faculty, into a school of public health with a large student enrollment of 122 students, 25 full-time faculty, five MPH degree tracks, and four DrPH degree tracks. The process of establishing the SUNY Downstate School of Public Health in 2009 from its inception as an MPH program in 2001 spanned a period of 8 years. This process was guided by a commitment to two basic principles. The first was to maintain the original 2005 program accreditation by the Council on Education for Public Health (CEPH). The second was to sequentially secure accreditation for all subsequent four MPH and four DrPH degree tracks through CEPH's procedure of substantive change approval. This policy assured continuous national CEPH accreditation of the original Urban and Immigrant Health MPH degree track and all added degree programs. The 5-year period following the initial CEPH accreditation of the MPH program in 2005 was one of intense development during which all of the essential elements for CEPH accreditation of a school of public health were put into place. This rapid development was made possible by the vision and full support of Downstate's president, John C. LaRosa, MD, FACP, and the dedicated efforts of many. This included the students, faculty, staff, and administrators of the School of Public Health, the school's Community Advisory Group, several external advisors, and many in the medical center's Central Administration, College of Medicine, School of Graduate Studies, College of Nursing, College of Health Related Professions, and the University Hospital of Brooklyn. From the very beginning of the planning phase for an MPH program and through the ultimate accreditation of the School of Public Health in 2010, broad participation was solicited from all major units in the medical center. Thus, the MPH program became a center-wide initiative and not merely that of the College of Medicine's Department of Preventive Medicine and Community Health. This broad participation has been continuously maintained through the involvement of leaders of other medical center academic units and the University Hospital of Brooklyn in the program's and then the school's standing and ad hoc committees, and in other activities as well. Similarly, community representation has been maintained, some through formal linkages relevant to the practical field experiences required of all students. In October 2010, the Board of Councilors of CEPH accredited the SUNY Downstate School of Public Health for a 5-year period through 31 December 2015...

Current PCA techniques using i.v. or epidural administration have limitations. Development of new technology offering alternative routes for PCA administration is at the forefronts of PCA research.

OBJECTIVES: Chronic immune thrombocytopenia (ITP) is characterized by low platelet counts and an increased risk of bleeding-related episodes (BRE). The study purpose was to estimate the cost of BREs in the US. METHODS: A BRE includes rescue medication use, a bleeding event, or both. The BRE endpoint was tested in two 6-month placebo-controlled trials for romiplostim in adult patients with ITP (median baseline platelet counts of 16 x 10 9 /L; 64% received ≥3 treatments prior to baseline). Results from pooled analyses across studies and treatment arms showed that 63% of BREs were mild (outpatient management without immunoglobulins), 31% were moderate (outpatient management with immunoglobulins), and 6% were severe (inpatient management with immunoglobulins). The annual BRE rate per patient was 1.80 for patients with platelets ≥50 x 10 9 /L at the time of BRE and 7.33 for patients with platelets <50 x 10 9 /L. BRE costs were estimated using 2012 Medicare rates for office visits, oral steroids, immunoglobulins (IVIg dose of 2 g/kg per episode, and Anti-D dose of 50 mcg/kg in 25% of non-splenectomized patients), and hospitalization for intracranial hemorrhage, gastrointestinal hemorrhage, and coagulation disorders.