Buscar

Northern Nevada's stunning lakes, including Lake Tahoe, with its average summer water temperature of 50 degrees, present a potential risk of hypothermia. Unlike mild 50-degree air, water at the same temperature poses severe, life-threatening risks, including rapid-onset hypothermia and drowning. Awareness of the symptoms and taking proper precautions are crucial to prevent cold-water drowning. The 4 Phases of Cold-Water Drowning 1. Cold Shock Response: This response affects breathing and happens within the first minute. An automatic gasp reflex occurs in response to rapid skin cooling. If the head goes below water, water may be breathed into the lungs, resulting in drowning. A life jacket will help keep your head above water during this critical phase. Additionally, hyperventilation, like the gasp reflex, is a response to the cold and will subside. Panic will make this worse, so the key is to control breathing. 2. Cold Incapacitation: This response occurs within the first five to 15 minutes in cold water. In order to preserve core heat, vasoconstriction takes place decreasing blood flow to the extremities to protect the vital organs. The result is a loss of movement to hands, feet, arms and legs. Unless a life jacket is being worn, the ability to stay afloat is next to impossible. 3. Hypothermia: Important to note, it can take 30 minutes or more for most adults to become hypothermic. So there’s time to take action and survive. Keeping panic at bay is critical, as you have more survival time than you think. Symptoms include: Shivering Slow and shallow breathing Confusion Drowsiness or exhaustion Slurred speech Loss of coordination Weak pulse 4. Circum-rescue Collapse: This experience can happen just before rescue and is not well understood. Symptoms range anywhere from fainting to death. Some experts believe an abrupt drop in blood pressure may cause this final stage of cold water drowning, post-rescue. Additional Safety Tips and Helpful Resources Always wear a personal flotation device as well as a wetsuit or drysuit. Your personal flotation device is the most important piece of water safety gear. Try not to panic as the first phases will subside. Controlled breathing is to staying calm. Research suggests the body can withstand the cold longer than we think. The Heat Escape Lessening Posture (HELP) is a position which helps conserve energy if you’re wearing a personal flotation device. By hugging your knees to your chest, this posture helps maintain body heat for some time.

Read More About What You Need To Know About Cold Water Drowning

Whether you're a parent, grandparent, caregiver, or sibling, it's vital to recognize that drowning is the second leading cause of death among children," states Dr. Leland Sullivan, of Northern Nevada Emergency Physicians. "While we diligently work to protect children from water-related accidents, there's a lesser-known threat that often goes unnoticed—dry drowning, also known as delayed drowning. Surprisingly, many people remain unaware of its existence and potential dangers. Dry drowning defined Dry drowning is a side-effect of a near-drowning experience and includes spasms of the vocal cords and larynx — known as a laryngospasm. This occurs when the body attempts to shut down the passage of any liquid into the lungs. Unfortunately, it can also shut down the passage of air into the lungs and force fluid into the stomach and lungs. Often the condition is not discovered until it's too late — severe cases can cause death within one to 24 hours after a water incident occurs. Who is susceptible? Novice or first-time swimmers are at increased risk, as are children with asthma and known breathing issues. In addition, children who have had pneumonia or experienced acute respiratory distress syndrome are also at greater risk. To reduce these factors, caregivers should be exceptionally watchful of inexperienced swimmers. According to Dr. Sullivan, children under the age of 5 are most susceptible to drowning and often drown in residential swimming pools. Infants less than 1-year-old most often drown in bathtubs. What are the signs of a dry drowning episode? If your child has a near-drowning incident, a few moments of coughing until they calm down is normal. However, you should know the more severe signs and symptoms to watch for during the 24 hours following the incident, including: Persistent coughing Difficulty breathing and/or shortness of breath Chest pains Extreme fatigue and/or lethargy Change in typical behavior Face becomes pale   What is the treatment and prognosis for dry drowning? Dr. Sullivan recommends that all victims of near-drowning incidents seek medical attention, even if they have no symptoms. If caught early, dry drowning can be treated. If you think your child is experiencing a dry drowning episode, go to the nearest emergency room as quickly as possible — do not attempt treatment at home. Healthcare professionals will work to supply oxygen to your child's lungs to restore and regulate breathing.

Read More About What is Dry Drowning?

If you have the chance to meet Tami and Richard Dethmers, you will quickly discover a remarkable couple who embody a heartwarming spirit. Married for 44 years, they cherish family above all else. With five children and 10 grandchildren, their family is not just their priority—it's their whole world. It is this love and their steadfast faith that led Tami and Richard to make a transformative donation to Renown Children’s Hospital. The Heart of Giving In 2023, Tami toured the construction of the new Wilbur D. May Neonatal Intensive Care Unit and Pediatric Intensive Care Unit at Renown Children's Hospital. She was touched by the idea of creating a special place for sick children and their families. That night, she talked with Richard about how they could help. Together, they both agreed to make a generous donation that could help ease the pain for families with children in the hospital. A Comforting Consultation Room Their donation established a consultation room in the Wilbur D. May NICU and PICU at Renown Children's Hospital. Tami and Richard's motivation stems from personal experience, having seen their grandson endure four open-heart surgeries. "I remember challenging conversations with doctors, surrounded by other families in the open PICU. It was difficult,” said Tami.  In this new consultation room, families have a private space to learn about the next steps in their journey, gaining insights into the illnesses affecting their children. It is a dedicated space where doctors can discuss treatment plans and medical information with families. Designed to be a supportive and calming environment, the room features art on the walls, and a window bathes the space in beautiful, natural light, offering comfort to families in need. Tami and Richard’s donation ensures that families in the NICU and PICU can navigate difficult conversations with doctors in a thoughtfully designed space. Because We Love You and We Care In the new consultation room, a powerful message is printed and framed: 'Because we love you and we care.' This phrase is an important part of Tami and Richard’s donation, reflecting words they spoke to their children while they were growing up. For them, it symbolizes love, care, and a commitment to offering support. A Legacy of Comfort Tami and Richard, along with their family, are dedicated to an ongoing legacy of giving. Together, they also donated blankets to patients and families who use the consultation room. “I hope they provide an added layer of comfort,” said Tami. Each blanket includes a custom tag repeating those same words 'Because we love you and we care.' Richard echoes Tami's sentiments. “We do what we can because we love children, and there is no greater pain than a child in distress,” Richard said, emphasizing their shared dedication to helping children in need. Together, with their children and grandchildren, they continue to make a difference, embodying the power of compassion and generosity in their family's legacy.

Read More About Why I Give: Tami and Richard's Story

Above: Brian Cushard (left), Renown Health Foundation Board Chair, with his family At Renown Health Foundation, our mission is simple yet powerful – to raise funds that support Renown Health, the largest not-for-profit health system in northern Nevada. We are the driving force behind initiatives that bring state-of-the-art equipment, conduct groundbreaking research, enhance healthcare services, improve patient outcomes and contribute to the overall well-being of our community.  Our Dedicated Board of Directors  Our impactful work would not be possible without our Board of Directors – a fantastic team of 27 local volunteers. They bring diverse skills to the table, working together to create positive changes in healthcare for northern Nevada. Our board is at the core of our Foundation's success by guiding important decisions, sharing valuable insights and actively engaging in community relationships.  Meet Brian Cushard – Renown Health Foundation’s Chair  Brian Cushard took on the role of Foundation Board Chair at the beginning of 2024. Brian, who is the President of LP Insurance Services in Reno, will lead us for the next two years, bringing a wealth of experience and a deep commitment to community well-being. Since joining Renown Health Foundation’s Board in 2018, Brian has been instrumental in shaping our strategic direction.  Brian’s Vision: Advocating for Renown Health’s Mission and Making a Difference  We had the opportunity to sit down with Brian and explore his passion for healthcare philanthropy and the positive changes he envisions. Brian's 'why' is firmly rooted in the belief that a robust health system serves as the backbone of the community. His vision extends beyond fundraising; it's about inspiring the community by sharing remarkable stories of care and championing Renown's impactful contributions.  Q: Why does Renown's mission matter to you, and how do you see your role making a difference?  A: Renown's mission matters deeply to me because, without a highly functioning healthcare system, the economic structure of the community can be impacted. At LP Insurance, where I work, we see ourselves as guardians of our clients' hopes and dreams. This translates to my role on the Board as stewards for the health of others. Advocating for a highly functioning health system is crucial in supporting community members and clients alike. Surrounding ourselves with a solid network is essential. As advocates, our voices are integral in ensuring that everyone's voices are heard.  Q: Can you share a moment that made you want to support healthcare causes?  A: There are those stop-in-your-tracks healthcare moments that make you reassess life's priorities. I've had moments where life comes to a standstill, and what you once thought was important takes a backseat to the basics of life—getting better, one step at a time. In those vulnerable moments, you realize the importance of every person at the hospital. In desperate need, we rely on them. It's eye-opening and gives perspective on what's truly valuable in life.  Q: Tell us about a time when you saw the positive impact of healthcare or philanthropy. How did that influence your decision to get involved?  A: One impactful moment in philanthropy stands out — the Music and Miracles concert featuring the Beach Boys. LP Insurance was a major donor, contributing $100,000 to benefit Sophie’s Place, a music therapy room coming to Renown Children's Hospital. On the day of the event, my wife and I volunteered and saw the remarkable community support for Renown Children’s Hospital. The collective efforts that day raised over $1 million, specifically designated to establish Sophie’s Place. This experience inspired me to want to do more, as I recognized the profound positive impact that philanthropy can have on healthcare and the community.  Note: Sophie’s Place, opening later this year, will offer vital care and healing experiences for young patients at Renown Children’s Hospital.

Read More About The Impactful Role of Renown Health Foundation's Board of Directors

Flu shots don’t just protect those who get vaccinated; they protect everyone, including your family and the community. As we continue navigating the COVID-19 (coronavirus) pandemic, Renown Health infection prevention expert Whitney Robinson explains how getting your flu shot is vital for staying healthy. 5 Ways to Schedule Your Flu Shot Call Us! 775-982-5000 Urgent Care Appointments Renown Pharmacy Vaccinations Make an Appointment via MyChart Need a Doctor? Find One Now Reasons to get the flu shot Chills, body aches, fever, congestion; getting the flu isn’t fun. But in addition to protecting yourself with a flu shot, you’re helping reduce flu cases and hospitalizations, Whitney said. Flu shots are currently available at pharmacies throughout the Reno area. Whitney says the ideal time to get your flu shot is September through October, but remain relevant throughout the winter months as it only takes two weeks for the antibodies to develop in your body. This timing allows the vaccine to provide the strongest protection during the length of flu season. Who needs a flu shot? Almost everyone. The Centers for Disease Control and Prevention recommends the yearly flu shot for everyone six months of age and older. Equally, they consider it the first and most crucial step in protecting against the flu virus.

Read More About Protect Yourself and Others with the Flu Shot

Heat and ice are two of the most common treatments used to relieve pain and reduce swelling in injuries. However, each one is better suited for certain types of injuries Dr. Luis Palacio, MD explores the differences between the two.  When it comes to treating aches and pains, the debate between heat and ice has been ongoing for quite some time. Both have their benefits making it crucial to understand which option is better suited for your specific needs.   Determining which method is better depends on various factors such as the type of injury or pain you are experiencing. For instance, if you have recently sprained your ankle or pulled a muscle during exercise, applying ice within the first 48 hours can help minimize swelling and alleviate discomfort.   It's worth noting that some individuals find alternating between heat and ice therapy beneficial as well. This approach combines the benefits of both methods by using heat to increase blood flow followed by ice to reduce inflammation.  Cold Therapy  Cold therapy can help to reduce inflammation after an injury, heat can have the opposite effect. Therefore, heat therapy should be reserved for those who have chronic pain issues and are not dealing with an acute injury. Cold therapy is often recommended immediately after an injury or during the initial stages of inflammation.  Cold therapy such as ice packs are especially effective in treating: Sprains  Strains Any injury that involves swelling Heat Therapy  Heat therapy is known for its ability to relax muscles, increase blood flow and soothe pain. It is often used for chronic conditions or injuries that are not inflamed. Applying heat can help alleviate stiffness, promote healing and provide a comforting sensation. This increased circulation can bring more nutrients and oxygen to the area, helping it to heal faster.  Heat therapy such as heating packs are especially effective in treating:  Stiffness with associated pain   Injuries that are not inflamed  Muscle pain

Read More About Guide to Injury Healing: Heat or Ice?

Seeking specialized care for your teen from a sports medicine doctor is essential. Like a coach fine-tunes a player's skills, our experts fine-tune your teen's health, ensuring they stay at the top of their game. Luis Palacio, MD, a sports medicine physician with Renown Health, shares information to help young athletes safely push their boundaries and achieve their personal best. The Role of Sports Medicine Sports medicine is a specialized branch of healthcare that focuses on preventing, diagnosing and treating injuries related to physical activity and sports. Renown's Sports Medicine team consists of skilled professionals passionate about keeping young athletes performing at their peak while minimizing the risk of injury. With a comprehensive approach to care, our sports medicine doctors provide tailored guidance and solutions to help your teen reach their full potential. Injury Prevention and Education Prevention is the key to maintaining a long and successful athletic journey. Our sports medicine doctors collaborate with young athletes to educate them about proper warm-up techniques, body mechanics, and techniques to prevent overuse injuries. From understanding the importance of rest days to practicing correct form, our experts empower teen athletes with the knowledge they need to stay in the game.

Read More About Why Your Teen Athlete Should See a Sports Medicine Doctor

Injuries happen to everyone. They are caused by participating in sports, recreational activities like hiking, and even by accidentally stepping off a curb wrong. If you experience a sprain or strain, the first few days are often the most painful. Renown Sports Medicine physicians Luis Palacio, MD and Brandon Hockenberry, MD walked us through what to do after an injury.  Listen to Your Body See a medical professional right away if: You know or suspect that a bone is broken You are having difficulties putting full weight on a joint of the leg Pain or swelling is severe There is a sign of an infection, such as redness and warmth in the joint  The First 24-72 Hours Joint sprains tend to swell more than muscle strains. You can use ice as needed for comfort and to relieve any pain, but do not use ice for more than 15-20 minutes at a time. Ice and NSAIDs (such as ibuprofen) can help prevent excessive swelling and mask the pain, but they do not speed recovery. Some research shows that overuse of ice actually delays recovery.    During the first 24-72 hours, your injury will go through an inflammation phase. Inflammation is your body’s natural way to dispose of dead tissue cells, build new healthy structures, and hopefully heal even stronger than before.

Read More About How to Treat a Sprain or Strain

Tendonitis occurs when a tendon in your body is inflamed or irritated. This painful condition can impact your day-to-day activities, but can be managed and prevented. Luis Palacio, MD, shared some insights into how to manage tendonitis. Overuse and Repetitive Motion Tendons are complex tissues in our body that connect muscles to bones, allowing us to move. Unfortunately, sometimes these tendons become inflamed, worn down or injured, a condition called tendonitis. Symptoms of tendonitis include pain or dull ache, tenderness and mild swelling at the site. While tendonitis can be caused by a sudden injury, it is more commonly seen in frequent motions, including: Repetitive motions in exercise, work or other physical activities. Awkward positions in a movement, including poor posture. Forced movements that strain your body. Sudden increase in frequency of movement or level of difficulty, including little to no recover time between new activity. Shoes without proper support or hard surfaces, such as concrete floors. Evaluation is Key If you suspect that you have tendonitis and it does not resolve on its own after a few days, you should get it evaluated by a primary care or sports medicine doctor. They can make recommendations to aid your recovery and refer you to the right sub-specialist if needed. With some intentional actions, you can help reduce the risk of tendonitis with the following suggestions: Add variety: Mixing up the type of exercise you do will help prevent repetitive motions that can result in overuse. Stretch and condition: Make sure the keep up with proper stretching and muscle strengthening to support your physical activities. Do it right: Make sure that the way you are completing exercise or work-related physical activities is correct. Seek out a professional for lessons or guidance if you are unsure.

Read More About How to Manage and Prevent Tendonitis

Concussions are an unfortunate occurrence in youth sports and other physical activities. Learning the signs now will help you respond if you suspect that someone near you has suffered a concussion. A concussion is a mild type of traumatic brain injury (TBI) that can occur after any injury to the head/neck area. It’s important to seek the appropriate level of care if they occur. Brandon Hockenberry, MD with Renown Sports Medicine shares tips on concussion signs to look for and what to do next. Look for these Dangerous Signs First Call 911 or visit an ER right away if you notice one of the following in the person who suffered a blow to the head or body: One pupil is larger than the other Severe or worsening headaches Drowsiness or inability to wake up, including any period of unconsciousness Slurred speech, weakness, numbness or decreased coordination Multiple episodes of vomiting Convulsions, shaking or twitching Monitor for Concussion Signs and Symptoms If someone suffers a bump, blow or other jolt, it’s important to look out for changing symptoms. Symptoms can continue to evolve for up to 24 hours after the injury. Seek care from your primary care provider, an urgent care or a sports medicine provider if you notice any of the following: Cannot recall events prior to or after the incident Appears confused or disoriented Clumsy movements Slow reaction, including movements and speech Changes to normal behavior or mood You should also question the person about how they are feeling. If they report any of the following symptoms, seek care: Headache or feelings of pressure in their head Nausea or vomiting Dizziness or balance issues Problems with eyesight, such as blurriness or double vision Increase sensitivity to light or sound Sluggishness, or feelings described as “hazy” or “foggy” Struggles with remembering or concentration Just “not feeling right”

Read More About How to Spot the Signs of a Concussion

Renown Health is closely following the national outbreak of the monkeypox virus and urging healthcare providers to be alert for patients with illnesses associated with a rash. In working with the Washoe County Health District (WCHD), Renown is closely monitoring the spread of monkeypox in the community and looking to prevent and reduce the spread of monkeypox. To help to ease worries, we consulted with Paul De Leon, Infection Preventionist at Renown Health. What Exactly is Monkeypox? Monkeypox is a rare viral illness caused by the monkeypox virus — the same family of viruses that causes Smallpox. Although symptoms are similar to Smallpox, monkeypox symptoms are milder and rarely fatal. However, it's important to mention that this virus can be more severe for these susceptible groups: Immunocompromised Pregnant women A fetus or newborn baby Women who are breastfeeding Young children Those with severe skin diseases such as eczema How is Monkeypox Transmitted? The monkeypox virus is not easily transmitted but occurs through sustained person to person close contact with an infected individual. Monkeypox can also be transmitted through direct contact with infectious rash, scabs, or body fluids. Monkeypox can also be spread through prolonged intimate physical contact, such as kissing, cuddling or sex. Lastly, monkeypox can be spread through contaminated linens or bedding. Transmission through respiratory secretions is uncommon but has been reported after prolonged face-to-face contact with symptomatic individuals. In addition, pregnant women can spread the virus to their fetuses through the placenta. Monkeypox Testing If you think you have monkeypox, contact your primary care physician or other medical providers to obtain testing. Notify the provider ahead of time before entering the physical office. Signs & Symptoms This current outbreak of West African monkeypox does not have the typical presentation of classic monkeypox. Symptoms usually appear one to three weeks after infection and include: Pimple-like rash or blisters on the face, inside the mouth, and on other areas of the body, like the hands, feet, chest, genitals, or anus. The rash will go through serval stages, including scabs, before healing and may be painful or itchy. Other symptoms of monkeypox can include: Fever Headache Muscle aches and backache Swollen lymph nodes Chills Exhaustion Respiratory symptoms such as sore throat, nasal congestion, or cough Symptoms of monkeypox may occur before or after a rash with some individuals only report experience a rash. Individuals with monkeypox are infectious once symptoms begin and remain infectious until lesions form scabs, scabs fall off, and a fresh layer of skin forms. The illness typically lasts 2-4 weeks.

Read More About Monkeypox: A Renown Expert Weighs In

On March 19, 2020, Renown Regional admitted the first patient in need of care while sick with COVID-19. Our providers navigated two years of a pandemic and overcame many challenges while providing the best care for our patients and the community. Anicia Beckwith’s series “The Art of Healing” captured Renown Health during this time. Let's take a look back on the last two years. February 2020: Standing Up the Hospital Incident Command System (HICS) On February 25, 2020, leaders at Renown Health stood up Renown’s Hospital Incident Command System (HICS), a standardized system used to organize response personnel and resources and manage response operations during emergencies and crises. March 2020: Temporary Deployable Medical Structure Placed Outside Renown Regional Emergency Department On March 12, 2020, Renown set up a deployable medical facility to serve as a respiratory illness screening center for emergency room patients at Renown Regional. A similar tent was also set up outside the emergency room at South Meadows Medical Center. This proactive measure helped our teams care for community members with respiratory illness symptoms while protecting patients and staff in the emergency department and other areas of the hospital. Check out photos of the tent here. Read the Reno Gazette Journal Article about the tent here. April 2020: Alternate Care Site at Mill Street Parking Structure at Renown Regional Renown’s HICS team decided to create an Alternate Care Site (ACS) in the Renown Regional Medical Center Mill Street parking structure. The ACS served additional hospitalized patients and allowed caregivers to remain on campus and still have access to existing hospital infrastructure such as lab, pharmacy, imaging, food services and other critical services. After just 10 days of construction, the ACS was completed on April 3, 2020 with space to hold up to 1,400 patients. Check out photos of the ACS under construction here. On Nov. 12, 2020, Renown opened the ACS to serve additional hospitalized patients diagnosed with COVID-19 who were clinically stable or improving. Healthcare workers at Renown cared for hundreds of patients at this site. In early Jan. 2021, the remaining patients returned home. Check out the video of Connie, a patient who received care in the ACS. April and July 2020: The LOVE Sculpture Placed at Renown Regional On April 16, 2020, during a time of darkness and uncertainty, Artown loaned Renown the LOVE sculpture, a one-ton aluminum piece of art created by artist Laura Kimpton and fabricated by Jeff Schomberg. The structure, which originally debuted at Burning Man, was lit up Renown Regional's main entrance on Mill St. Watch a video about the LOVE sculpture’s debut at Renown Regional. On July 13, 2020, thanks to the support of former board chair and community supporter Blake Smith and the Keyser Foundation, the LOVE sculpture is now a permanent fixture at Renown Health. Throughout the pandemic, it has served as a source of inspiration, hope and positivity for our community and care providers. Check out a video of the LOVE is Here to Stay celebration. June 2020: Renown Offers In-House COVID Testing In June 2020, the Renown laboratory team sprang into action to help meet the growing demand for COVID-19 testing amongst Washoe County residents and businesses. Renown invested in expanded staffing and in-house testing capabilities that ensured our teams could swab and process up to 1,000 COVID-19 tests for patients each day. All with results returning within hours. November 2020: Renown Introduces “Hospital At Home” Remote Monitoring In November 2020, six patients at Renown Regional Medical Center and Renown South Meadows Medical Center diagnosed with COVID-19 were outfitted with a remote Hospital at Home monitoring system. Renown clinicians plan to continue using this system to monitor upwards of 1,000 hospitalized patients and lower acuity patients from their homes. December 2020: Renown Administers COVID-19 Vaccines to Health Care Employees On Dec. 17, 2020, Renown began to vaccinate its healthcare workers. Among those receiving the first vaccines was Luis Martinez, a technician on Renown’s Clinical Decision Unit who cared for patients recovering from COVID-19 in the Alternate Care Site field hospital. Read the Reno Gazette Journal article about the COVID-19 vaccine rollout at Renown. January 2021: Renown Administers COVID-19 Vaccines to Community After several weeks of successful employee and volunteer drive-thru vaccination events, Renown supported the Washoe County Health District and the state in vaccinating Washoe County community members. Click here for a playlist of videos featuring Renown Health employees and patients talking about the importance of the COVID-19 vaccine. February 2021: Local Widow Inspires Renown to Change Visitor Supporter Policy Darlene Randolph’s husband Dave spent 17 days hospitalized at Renown Regional Medical Center before losing his battle with COVID-19 on December 13, 2020. Darlene wrote a passionate letter to Renown Health asking for the visitor policy that allowed patients with COVID-19 to receive visitors. In February 2021, Renown hospitals were among the first in the country to lift visitor restrictions for patients with COVID-19 to encourage families to be at the patient's bedside. Read Darlene’s full story here. May 2021: Renown Celebrates Volunteers, Partners and Community Who Aided in Vaccine Efforts In May 2021, Renown administered the last dose of COVID-19 vaccines to community members in Renown’s drive-thru clinic. Between January and May 2021, over 80,000 doses were administered at the drive-thru. View drone footage of this effort here. Click here to see pictures of vaccine volunteers and employees. November 2021: Renown Offers Vaccine for Children Ages 5+ In November 2021, Renown vaccinated children in the Reno-Sparks community with the 2-dose series in a limited round of weekend clinics. The vaccine clinics featured therapy dogs, local mascots and donuts donated by Doughboy’s Donuts. Click here to see pictures of the children’s vaccine clinics and watch a video about the clinics here.

Read More About Two Years We Won't Forget: COVID-19 at Renown Health